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The top 20 news stories of 2019
Healthcare information technology underwent some significant challenges in 2019, reflected by the wide array of stories that HDM readers read most frequently. Industry luminaries announced they were moving to new positions; large technology companies continued their forays into the healthcare industry; and payers revealed new strategies to take healthcare information IT to better serve their members and reinvent their roles within the healthcare industry.

Here are the most-read stories from Health Data Management in the past year.
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Karen DeSalvo, MD
Karen DeSalvo to join Google as chief health officer
Former National Coordinator for Health IT Karen DeSalvo, MD, will be joining Google’s healthcare division as the tech giant continues to ramp up its presence in the market. DeSalvo will be starting at the tech giant later this year, according to a Google spokeswoman. She will be serving as chief health officer—a new role—at Google Health, a division that earlier this year was placed under the leadership of David Feinberg, MD, the former Geisinger president and CEO.

Read the story here.
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HDM names 2019 class of Most Powerful Women in HIT
Health Data Management has named 50 women to this year’s list of the Most Powerful Women in Healthcare IT. This is the fourth year that HDM has sponsored its program to recognize the top women in healthcare IT leadership positions across the country. Nominations for the program were sought earlier in the year. HDM editorial staff weighed those nominations, and also brought their own nominations to the process.

Read the story here.
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UnitedHealth Group Inc. headquarters stands in Minnetonka, Minnesota, U.S., on Wednesday, March 9, 2016. Photographer: Mike Bradley
UnitedHealthcare launches new app to manage care, use telehealth
UnitedHealthcare, the nation’s largest health plan, is introducing a new app that will help its members streamline their care and conduct telehealth visits with their doctor. The app is available for free on Android and Apple devices to the more than 27 million people enrolled in UnitedHealthcare employer-sponsored health benefit plans. With the app, members can virtually visit with their physicians on their mobile phones, tablets or computers, 24 hours a day, according to a spokesperson for United. Some members may have to pay out-of-pocket costs for the telemedicine services, depending on the plan and any applicable state requirements.

Read the story here.
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A jogger passes Google Inc. sign at the headquarters in Mountain View, California, U.S., on Wednesday, Oct. 13, 2010. Google, owner of the world's most popular search engine, said third-quarter profit increased as businesses spent more on advertising for online consumers. Photographer: Tony Avelar/Bloomberg
Google begins to stake out its place in healthcare
It’s no secret that Alphabet is knee deep in healthcare projects. Through acquisitions, new hires, partnerships and research efforts, Alphabet, parent company of Google, is using its expertise to organize and analyze enormous volumes of healthcare data. In mid-November, DeepMind—a London-based Alphabet company focused on AI research— handed off its health team to a newly formed Google division, called Google Health. Former Geisinger President and CEO David Feinberg, MD, is overseeing the new division of Google which he officially joined this month.

Read the story here.
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Auto contouring generated by EchoGo, calculating key cardiac parameters
FDA clears 2 AI applications for use in imaging studies
The Food and Drug Administration is ramping up the pace in clearing the use of artificial intelligence in healthcare imaging. The agency provided 510(k) clearance, through which the FDA approves the further use of a technology that has demonstrated substantial equivalence to a currently marketed device. In one instance, the FDA granted 510(k) clearance to Ultromics, based in the United Kingdom, for an image analysis system that automates cardiac analysis to aid in the early detection of cardiovascular disease. In addition, the FDA has approved technology from Hologic, a Marlborough, Mass.-based company that uses an AI-powered algorithm that the company contends can reduce mammography read times without compromising image quality, sensitivity or accuracy.

Read the story here.
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How IT will impact healthcare in the next decade
The landscape of healthcare entering the new decade is immeasurably different than it was in 2010. From an information technology perspective, electronic health records systems have become standard tools of the trade at almost all healthcare organizations. That’s a far cry from 2010, when a minority of hospitals and only a tiny fraction of physician practices had such systems in place. And only 10 years ago, information technologies such as artificial intelligence, augmented and virtual reality devices and precision medicine have moved from experimental to capacities that hold significant hope for impacting medical delivery in the new decade.

Read the story here.
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Epic to gather records of 20 million patients for medical research
Epic is unveiling a massive data compilation effort intended to gather de-identified patient information from participating systems that eventually could be used by clinicians to improve care decisions. Called Cosmos, the initiative aims to aggregate patients’ medical information from its customers to offer a wider base of information from which to enable real-world evidence based practice of medicine, even for conditions that are now currently rare and on which it’s difficult to have a large enough sample size on which to make medical decisions. The Verona, Wis.-based hospital systems vendor publicized the project on Tuesday at its users group meeting, which attracted about 17,000 healthcare IT professionals to its campus.

Read the story here.
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Signage is displayed outside the Humana Inc. office building in Louisville, Kentucky, U.S., on Saturday, Nov. 26, 2016. The Justice Department sued in July to block the union of Aetna Inc. and Humana Inc., saying they would reduce the number of large, national health care insurance providers, leading to increased costs for their clients. Photographer: Luke Sharrett/Bloomberg
Business associate causes a breach for Humana, affecting 5,569
Humana has notified 5,569 members that a limited amount of their protected health information may have been compromised. Unauthorized third parties posing as physician provider groups registered on one of Humana’s authorized vendors—Availity—the web portal of which providers use to check eligibility and benefits for multiple health plans. The hackers requested eligibility and benefit verification of health plan members by using certain personal information they already had in their possession. Humana executives say they have no reason to believe the information was obtained from Humana or Availity, and the breach was complex in nature and affected other health insurers—suggesting that other payers may soon be issuing similar notices.

Read the story here.
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CMS final rule aims to reduce physician billing, coding burdens
The Centers for Medicare and Medicaid Services on Friday issued a final rule reducing clinician burden regarding billing and coding requirements for evaluation and management services. Evaluation and management (E/M) coding is the process by which physician-patient encounters are translated into five-digit Current Procedural Terminology (CPT) codes, which are submitted for payment to Medicare for common office visits. As part of a new Medicare Physician Fee Schedule final rule, CMS has made changes—effective Jan. 1, 2021—to the “burdensome and overly complicated” E/M documentation and coding framework that dates back to the mid-1990s.

Read the story here.
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Cleveland Clinic first to perform robotic single-port kidney transplant
Surgeons at the Cleveland Clinic have successfully conducted a kidney transplant using a new generation of robot that inserts all surgical instruments and the donor organ through a small abdominal incision. According to the Cleveland Clinic, it is the first hospital in the world to perform a robotic single-port kidney transplant using the Single Port SP Robot from Intuitive Surgical, which is designed to provide more precise and effective surgeries with improved surgical outcomes.

Read the story here.
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UPMC cuts hospital readmission rates with ML algorithm
The University of Pittsburgh Medical Center’s clinical analytics team has leveraged machine learning to develop an algorithm that rates hospital patients for their risks of being readmitted. Specifically, the ML algorithm identifies patients at highest risk of re-hospitalization within seven and 30 days of discharge. To date, re-hospitalizations have been reduced by about 50 percent at UPMC Presbyterian hospital.

Read the story here.
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Sheila Shapiro
Humana, UnitedHealthcare among those pushing ICD-10 coding for SDOH
Health plans and other stakeholders are convinced that the use of ICD-10 coding can greatly launch the uniform capture of data related to social determinants of health and improve health outcomes. In an October webinar hosted by the eHealth Initiative, Jennifer Bordenick, eHi’s CEO, called SDOH a “critical issue today.” That’s why eHi, the American Hospital Association, Humana, UnitedHealthcare and other organizations have been working in the past year to push the use of ICD-10 related to SDOH. “It’s encouraging that despite the competitive nature of healthcare, the private sector is working together to address factors pertinent to patient care and well-being in a sustainable, scalable manner,” eHi says.

Read the story here.
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Lawmakers voice concerns about VA’s plans for Cerner EHR
Members of Congress are growing increasingly concerned about Department of Veterans Affairs plans to implement the same Cerner electronic health record system as the Department of Defense. Senior VA officials incurred the wrath of a House appropriations subcommittee on Wednesday, taking heat from both Democrats and Republicans regarding the projected $16.1 billion cost of implementing the EHR over 10 years, as well as their concerns that the new system will not be able to seamlessly exchange data with community care providers.

Read the story here.
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Signage is displayed outside the Humana Inc. office building in Louisville, Kentucky, U.S., on Saturday, Nov. 26, 2016. The Justice Department sued in July to block the union of Aetna Inc. and Humana Inc., saying they would reduce the number of large, national health care insurance providers, leading to increased costs for their clients. Photographer: Luke Sharrett/Bloomberg
FHIR at core of Humana’s strategy for data sharing with providers
HL7’s Fast Healthcare Interoperability Resources standard is the linchpin of health insurer Humana’s efforts to support data sharing with provider organizations to improve care for its members. Humana CEO and President Bruce Broussard told an earnings call earlier this month that interoperability is at the core of the payer’s corporate strategy, “which facilitates our relationship with our provider partners, while simplifying the experience of our members.”

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DoD learning, resolving issues as it deploys new Cerner EHR
As the Department of Defense begins to deploy its new Cerner electronic health record system over the next five years, the military is leveraging important lessons learned from the EHR’s initial deployment. The EHR system—called MHS GENESIS—is on track for full deployment worldwide by the end of 2023. However, the initial rollout of the Cerner Millennium platform to pilot sites has not been without some major challenges. The system was deemed “neither operationally effective nor operationally suitable,” according to a 2018 report from DoD’s director of operational test and evaluation that was based on an assessment of three of four pilot sites in Washington State.

Read the story here.
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Webinar, WIM month,
UnitedHealthcare, AMA ask ICD-10 for 23 new codes for SDOH
UnitedHealthcare and the American Medical Association have joined forces to enable healthcare organizations and payers to use ICD-10 codes for social determinants of health. The two organizations say they are working together to standardize how data is collected, processed and integrated when it comes to the factors that contribute to a patient’s overall health. As part of that effort, last month they recommended 23 new codes to the ICD-10 Coordination and Maintenance Committee. The codes cover problems related to education and literacy; psychological development disorders; employment and unemployment; occupational exposure to risk factors; housing and economic circumstances; the inability to pay for prescriptions, utilities, medical care and other needs; the inability to deal with stress; inadequate social interaction; and feeling unsafe.

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New Indian Health Service EHR to cost billions of dollars
The Indian Health Service intends to replace its legacy electronic health record system with a modern EHR that will take seven to 10 years to implement and will cost American taxpayers billions of dollars. That’s the estimate that Rear Adm. Michael Weahkee, IHS principal deputy director, provided on Wednesday to a Senate appropriations subcommittee. “Our current aging system exists as more than 400 separate instances that are maintained at individual locations throughout the country,” testified Weahkee. “Replacing this antiquated system with a single, modern national system would enable IHS to enhance medical quality, maximize the time that our doctors, our nurses and other healthcare professionals have to provide direct patient care, and increase the security of our patients’ medical records.”

Read the story here.
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The push for interoperability gains new urgency in 2019
Now that most providers have implemented an electronic health or medical record system to comply with federal Meaningful Use requirements, the government has turned its attention in healthcare technology to interoperability. In fact, last April, the Centers for Medicare and Medicaid Services renamed the program—it’s now Promoting Interoperability. It makes sense to shift the attention to data exchange, experts say. “There’s no need to measure things people are already doing universally,” says David Harlow, a lawyer and consultant who specializes in healthcare business and regulatory issues.

Read the story here.
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Replacing an EHR comes with many challenges and costs
The vast majority of healthcare provider organizations use electronic health records and physician practice management systems to manage the care they give to patients. Over time, functionality in the EHR and PPM systems can’t keep up with emerging demands, often compelling an organization to initiate a search for new systems. Often idyllically viewed as an easy answer to emerging challenges, switching systems often offers a gauntlet of challenges. As healthcare organizations rethink their original—or even second or third—system choices, they often take on new—and sometimes, unexpected—problems and costs.

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CVS Health takes telemed nationwide with MinuteClinic Video Visits
A telemedicine service from MinuteClinic—CVS Health’s retail medical clinic—is providing access to care 24 hours a day, seven days a week to consumers in 32 states and the District of Columbia. Launched last year, the telehealth service—called MinuteClinic Video Visits—costs $59 and is for patients ages two years and up who are seeking treatment for a minor illness, injury or skin conditions.

Read the story here.