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Tuesday News Day. Here are the Stories:

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 Welcome to this weekend Health IT News, where we look at as many stories as we can in 20 minutes or less that will impact health. It. It is Tuesday Newsday, and here's what we have on tap. Cerner, CEO, unveils, next generation cognitive platform in health Conference keynote, Allscripts, Northwell, uh, a bunch of EHR uh, stories.

Actually this week, Allscripts, Northwell, uh, co-developed next generation EHR. Second, next generation EHR being developed. Uh, Meditech works with Google to host EHRs to the public cloud intro's, iPhone support. So exciting, uh, news within the EHR front. Uh, we're gonna take a look at the, uh, HHS announcements around the Stark law of changes and, uh, not comprehensively, but, uh, as, as much as we can.

And, uh, then given enough time, I'm gonna talk about the VA shifting, uh, to opt out model for sharing health data and InterSystems unveils. Uh, clean data as a service solution, helping normalize data sets for analytics and ROII have six other stories here, but we'll see what we get to. My name is Bill Russell, recovering healthcare, CIO, and creator of this week in health.

It a set of podcasts and videos dedicated to developing the next generation of health IT leaders. This podcast is sponsor sponsored by health lyrics. Professional athletes have coaches for every aspect of their life to improve performance, yet many CIOs and health executives choose to go it alone.

Technology is taking center stage in healthcare. Get a coach in your corner. Visit health lyrics.com to schedule your free consultation. If you're going to the health conference in Vegas at the end of October, you'll wanna stop by a discussion. We're gonna be having that. I'm actually gonna be moderating for, uh, VMware on Tuesday, October 29th at 1240, and, uh, it's VMware until Deloitte and others.

Uh, it's going to be discussion on the opportunities, challenges. And promise of leveraging multi-cloud environments. Uh, if you're there, please stop by. I would love to see you. Alright, let's get to the news. So Cerner, CEO, unveils, next generation cognitive platform and Health Conference keynote. This is actually, I pulled this from the Cerner blog.

Why not? Um. Because , I'm gonna go back to why I chose the blog to, uh, to do this, but, uh, healthcare, here's some, uh, quotes from it. Healthcare will change more in the next five years than it has in the past 30, uh, Schaeffer. The CEO, uh, told the audience of 5,000 clients, innovators, and other healthcare industry professionals during the keynote address.

As we have for the past four decades, Cerner's technology and collaborative programs along with the most, uh, respective providers, will lead a wave of disruptive innovation focused on making healthcare better. Great. We're all for it. Let's hear what you're gonna do. Aligning with the conference's theme of now next Schaeffer shared enhancements to Benefit Turner clients today.

Now then announced next generation health platforms. Next generation seems to be the new buzzword. Uh, maybe the buzzword for 2019. We'll see. Uh, code name Project Apollo. This initiative brings a more cognitive approach to practicing medicine. Uh, let's see. Leveraging the powerful combination of its healthcare technology with AWS infrastructure, Cerner's new cloud-based platform will accelerate the speed, uh, that innovations are integrated by removing manual steps that the cl uh, for clients that slow the pro the pace of adoption.

Additionally, Cerner is creating an intelligence ecosystem to innovate next generation user experience and care delivery algorithms. The Future Innovations will support caregivers in giving them full focus to delivering high quality patient care support by the power of Cerner's intelligent, uh, platform.

Um, once again, I'm going to go back 'cause I, I shared this, uh, the, you know, the signing day announcement, Cerner going with, uh, AWS and going with Amazon. And, uh, I, I believe that the announcement has a lot of promise and directionally, I like this. This is directionally . Uh, pretty interesting to marry, uh, Amazon's, uh, AWS intelligence platform with, uh, Cerner's.

Uh, EHRI think has a lot of promise. Um, I, I don't think much has been, much more has been shared here. Um, but I think what you're gonna see in this story the next and the next is, um, cloud is becoming central to the, to an effective EHR strategy. Uh, EHRs are not gonna be able to live on their own and be effective anymore.

They need to plug into cloud. They need to plug into . Um, this is, but this is me going off here, but they need to plug into cloud. They need to plug into the, uh, tools that are available in the cloud. The, uh, cognitive tools, intelligence tools, uh, analytics tools, uh, the ability to share the, uh, APIs that are available, the ability to plug into, um, the market and the innovators in the market as, uh.

As I have said, and I'm sure I stole it from someone I don't know who, uh, you can out innovate the market and the market is catching up to these EHR vendors and, uh, Cerner. I, I applaud them. They're taking the lead here and getting out in front of it. Um, and, uh, not only that focus of of taking cognitive.

Uh, into the EHR. Again, it's, it's kind of nebulous because I think their solution is kind of nebulous at this point. It's more of an announcement kind of thing, and the conference sort of snuck up on 'em. They don't really have real live use cases. Uh, I think if at this time next year or maybe at himss, if we're not talking about solutions coming outta this partnership.

You'll know that the, uh, bureaucracy within the organizations has gotten in the way and it is not advanced as quickly as it can, and the normal healthcare thing is slowing it down. Um, that would be the bad news. The good news is if we start to see things, you will see the ability for these next generation.

And I'm not talking about the EHR, I'm talking about the next generation cloud platforms, being able to be overlaid on top of these legacy platforms and really move the needle forward. That's the hope, that's the promise of this. And, uh, I think it's an exciting announcement, and I wish they had more to share at this point.

Again, let's look to, uh, let's look about four or five months out at himss. See what they're showing off at their booth. See what they're talking about. Uh, and then let's give 'em about a year to see if they're really moving the needle, uh, with this. But, uh, again, directionally great. Uh, love the, uh. Uh, love what they're doing.

Allscripts, Northwell. Next story. Allscripts, Northwell Health to co-develop next generation, EHRA, next generation EHR. Wow. Uh, well anyway, next generation. David RAs Healthcare Innovation Group. Lemme give you a few quotes from this new, uh, the new platform will be cloud-based, voice enabled and artificial intelligence.

Uh, based. So it's cloud based, artificial intelligence based and voice enabled. And that sounds like a, uh, good combination. And you're seeing, you saw that also at the, uh, UGM, uh, this year. Uh, voice enabled, uh, artificial intelligence. You saw, uh, the thing, I think, uh. Uh, I think you're seeing that, uh, epic might be a little slow here on, is this whole, uh, cloud adoption.

They believe in building it all themselves, and I think that it's gonna be one of their downfalls. I I, I, I hope that someone in there is whispering in Judy's ear to say, Judy, uh, you know, which cloud platform are we going to embrace? Uh, because most clients I talk to that are looking at the, uh, at the, uh, epic

Cloud environment are finding that it is too expensive. That's what I'm hearing right now. Uh, maybe it is just a simple, uh, reconfiguration and a re-architecting of the platform, or maybe it's adopting a partner that helps them to, uh, scale it, uh, national and even globally for that matter. But anyway, this story is about all Allscripts in Northwell, uh, EHR vendor.

Allscripts announced it is working with, uh, New York based Northwell Health to create what it describes as the next generation EHR. Which will be cloud-based voice enabled artificial intelligence base. The EHR will be designed and tested using input from Northwell clinicians, information technology experts and administrators, with the goal of ultimately deploying IT system-wide Allscript said increasingly health systems and health IT vendors are looking for ways to work more closely together on technology innovations.

Northwell Health is a New York State, uh, is New York State's largest healthcare provider and a private employer with more than 13,600 affiliated physicians. It has been using Allscripts since 2009. Okay. Uh, Chicago based Allscripts, uh, will provide the development and systems integration expertise.

Allscripts in Northwell will jointly develop in pilot its new HEHR, while continuing to support and enhance Allscripts Sunrise, uh, the EHR platform currently in use at the 19 Northwell Hospitals and Allscripts touchworks currently in use. Have more than 750 outpatient practices that Northwell owns and operates throughout, uh, New York area.

Uh, we're excited about the possibilities You get the idea it goes on to and has the, uh, the normal stuff. Uh, again, I think this is, uh, directionally, uh, fantastic. Uh, and, uh, it's adopting the right things. Cloud-based voice enable artificial intelligence based. Again, this is early on. This is, uh, the followers of Epic.

Trying to, uh, figure out a way to leapfrog them. And, uh, this has the most potential to be honest with you. If they could figure out a way to get much more efficient using cloud, uh, much more, uh, in integrated, uh, using, uh, APIs, uh, not only FHIR, but other APIs that might be available to them, uh, being able to, uh, leverage a new

Uh, way of interfacing with the EHR. We've heard that most people don't like the EHR because it's, uh, way too burdensome. They're spending extra hours in the office. Uh, voice has that potential. Uh, hopefully something beyond what Nuance is doing. Uh, but nuance is doing great things, uh, and artificial intelligence based, right?

If we can overlay artificial intelligence, which right now is kind of a buzzword in these marketing things. . Um, but I, you know, I am seeing more and more use cases for how it's being used, uh, to, uh, uh, predict, uh, issues and, uh, get ahead of, uh, get ahead of the curve on some of these things. Uh, not only sepsis, but code blues and other things.

So, very exciting possibility. But again, these are early announcements. Let's see what's happening on this one. I'd say give 'em a year. Uh, give me a year and let's see, uh, you know, what Northwell and Allscripts are doing together to really advance this. And then finally, um, you know, and one of the interesting things here, finally we're gonna talk about Meditech.

And one of the interesting things here is people forget how big Meditech is. Meditech's actually a pretty large provider of, uh, EHR software, not only in our country, but uh, in other countries. In fact, one of the largest providers, uh, in, uh, Canada across the entire, um, . It's not a province country, uh, but the major provinces, uh, are predominantly using Meditech.

So it's, it is, uh, pretty extensively installed. It is still one of the least expensive EHRs to run, which is what makes it so attractive when you get into that case of finally looking at the numbers and saying, you know what? We can't afford a $500 million rollout, and Meditech is, you know, half of that, or a quarter of that.

Uh, to roll out. And actually some of this announcement here is gonna talk about how they've really driven the cost out even further. Uh, okay. So Meditech works with Google to host EHRs to the public cloud intro's, iPhone, spark, uh, support, uh, Mike Millard Healthcare IT News. Uh, the co, uh, Meditech this week revealed that it's Expanse platform, which is their sort of EHR as a service kind of platform, will be made available via Google Cloud.

In another announcement, it said that it now supports health records for the iPhone. Two completely separate, uh, conversations. Uh, you know, I, uh, Apple's Health record is available on, uh, several EHRs. Um, I think Allscripts, uh, Cerner, and uh, epic. It's now available on Meditech, which is great. Now, um, gosh, I mean, you're gonna cover probably 85% of the market.

Uh, in terms of the EHRs, uh, so Apple's health record is, uh, is expanding and that's, uh, that's a good sign. Um, to get the information into the hands of the patient. So, uh, let's see. Meditech is collaborating with Google Cloud to offer its electronic health record through its public cloud platform, which it says will boost security, interoperability, and scalability for its EHR customers.

That is . Absolutely true. Um, you know, I, I really don't trust the EHR providers to build out a cloud. They shouldn't be building out a cloud. There's too many clouds out there that are already secure. They're, uh, interoperable and, uh, they're much more reliable than anything that they would build from scratch.

So, uh, by working with Google Cloud, uh, Google Cloud platform, Meditech. Uh, we'll be able to offer options aligned with Meditech as a service subscription model the company said on Tuesday with faster and more cost effective implementation of. . Uh, evolving. EHR technology. Public Cloud also helps healthcare organizations with finite resources for cybersecurity bolster their InfoSec, uh, preparedness and protect against ransomware attacks and Google Cloud Collaboration also extends to application development.

Claims are underway to develop a Native Cloud product as well as APIs to be used on these products, says Meditech, president and COO Michelle O'Connor. . So the innovation will be extended to our on-premise customers as well, uh, on Thursday. Meanwhile, the company announced that it will support health records, so forth.

So we already talked about that. Um, this is an interesting announcement. Uh, I think it's an interesting announcement because this has the ability to, you, you take a low cost. Fully functioning, very high functioning, uh, EHR that can run a, um, anything from a federally qualified health clinic to a 16 hospital system.

Well, not expanse, but uh, Meditech has that capability, uh, to run those kinds of hospitals. And you now overlay, quite frankly, the, the power of the Google Cloud platform. And you get those two organizations working together and you now might have a much . More cost effective, high functioning EHRI. I don't know if that's the case.

Again, this is announcement wear kind of stuff. Um, but directionally it's correct. This is how you, uh, this is how you start winning bids in the future against, uh, uh, against Epic and Cerner. And, um, you know, we're lower cost and higher functioning. Seems like a no brainer to me. But, uh, we'll see. They have to work on their user interface.

Clearly, I haven't looked at the Expanse platform. Maybe they have. Uh, but their user interface, well actually all the, all the EHR user interfaces, uh, look like, uh, dBase four, uh, kind of, uh, applications going back to that. So anyway, uh, let's go to the Stark Law. So HHS proposes stark law changes that would broaden providers maneuverability under APMs, mark Haglin.

Healthcare Innovation Group. So CCMS administrator, SEMA Verma, an announcement stated, we serve patients poorly when government regulations gather dust in the attic as the stark laws have the announcement continued. The stark laws, new value-based, uh, exceptions under the proposed rule issued. And I'm only gonna focus on a portion of this by the way.

Proposed rule issued by the center, and if you wanna see the whole thing, it's out on the CMS website, cms.gov. Proposed rule issued by the CMS acknowledged that incentives are different in a healthcare system that pays for value rather than for volume. Of services provided. This included preference safeguards that ensure that Circ Law will continue to provide meaningful protection against over utilization and other harms, while giving physicians and other providers, uh, added flexibility to improve the quality of care for their patients.

Uh, it talks about the penalties and other things. Um, the important thing here is that the stark laws were, uh, put in place to, uh, protect patients, protect from overbilling and, and, uh, unneeded. Uh. Uh, services and those kind of things. And also to protect against kickbacks that would, uh, uh, allow health systems to, uh, create an unfair advantage within the marketplace.

And so some of the, as you know, the stark laws allow you to, uh, go out to your clinically integrated network and help to pay for certain aspects of their technology, but it's, uh, it's more of a gift than it is a, um, . Uh, it's, there's no quid pro quo, as they say. Uh, and there's no kickback. So, uh, they, they, they thought they would update this because one of the things that was happening was health systems were looking at this and saying, Hey, you know, stark laws don't allow us to help them with cybersecurity and stark laws don't allow us to continue to do enhancements and don't allow us to do, uh, certain things like that.

And, uh, and Sema Verma and the team, again, being very proactive, and I really like this. They, they looked at it and they said, you know what? That was not the intention here. The intention here was to, um, to, to modernize obviously through, uh, the electronic health record, but to keep that secure. And if all we do is give, if all health systems do is give the, um, uh, the medical practice, the technology in order to run their EHR, but they don't give 'em the right cybersecurity.

Overlay on top of it on an ongoing basis, uh, then you have a problem. And what they're essentially saying here is, uh, there's a whole host of things like, um, some IoT, uh, IoT, things around pill boxes, uh, cybersecurity around their EHR, uh, that can be given. Again, it's pseudo gifts to the, uh, medical groups, uh, so that we can continue to maintain a high level of, of security and interoperability and integration.

Uh, for those clinically integrated networks. So I, I didn't do a great job on that. Again, hit cmms.gov. Uh, uh, chime is also, uh, doing a great job following this and, uh, and, uh, promoting it, uh, and, uh, lobbying for the right things to be, uh, included in it. So, uh, keep an eye on your chime emails. Uh, you could also hit the Chime website, I'm sure they have something out there for it.

And, uh, you could also, uh, hit the cms.gov. Uh, but good move directionally great. Uh, I'm saying that a lot directionally great. Uh, this is good stuff. We'll, uh, and, and this is actually pretty tangible, so we'll see where it goes. Uh, I want hit two things. 1840 we're at on this episode. Let's see if I can hit two things real quick.

VA shifting to Optout model for sharing health data. David RAs Healthcare Innovation Group. This is actually a pretty big announcement and I'm not gonna do it justice, but, um, going from Optout to Optin, optin meant that the veterans would have to actually go out there if they wanted to be a part of being able to share their, uh, VA health record to the, uh, surrounding.

Uh, community health systems, they would actually, actually have to go in there and opt in, which we know is very cumbersome and it's very hard to do. Uh, and they are now shifting that to an opt out model, which means that all veterans will be automatically enrolled and if you don't want to be in it for whatever reason, um, and I'm sure there's some good reasons, uh, maybe privacy or some other things that, uh, some veterans will, uh, want to not be in included.

Uh, they can do that and they can opt out. So this will get much higher participation. And probably serve the, our veterans a lot better. The, uh, final one is, uh, final Story. InterSystems, unveils Clean data as a service solution, helping normalize data sets for, uh, analytics, RI, Mike Millard, healthcare IT News, uh, new offering from InterSystems.

And I am a, a, uh, huge proponent of InterSystems. They're not a sponsor of the show. Um, but I've purchased their software before as ACIO. , uh, it's really good software. Um, and I'm not promoting for that reason, but this clean data as a service solution is like the holy grail, and that's why I wanted to, to bring it up.

I think they're not gonna be the last to do it, uh, but uh, they're one of the first to do it that I, uh, really have seen. Uh, so here's essentially what it does. Uh. Uh, uh, in an effort to help healthcare organizations achieve more from their analytics, a better, uh, position and better position them to take, uh, take advantage of the new artificial intelligence and machine learning initiatives.

InterSystems has launched a new service called Clean Data as a solution. The service, which the company says can help not just hospitals and health systems, but also payers, life sciences, you got the picture, uh, can help position health organizations as they move towards more AI and automation to help manage data sets.

Uh, from multiple sources. Clean data as a solution offers product and data normalization functionality to support specific use cases such as integration, patient matching, aggregation, normalization, terminology and enrichment, uh, deduplication into a unified care record, uh, clinical viewing capabilities and more.

According to InterSystems, it's delivered as a service. Um, as everyone knows, data governance is one of the hardest challenges facing health systems. Payers, providers, everybody. Uh, we do not have a common, um, model, data model across all the EHRs and across all the payer systems. And so we are constantly having to normalize the data in order to make it effective and the ability to offer that as a service is interesting to me.

Again, this is announcement wear and, and I apologize. I did a lot of these announcement wear kind of, uh, conversations, but this is one to look at. And keep an eye on if they're able to really make inroads and really make this work. Um, this is a huge, huge, huge expense in the industry. Um, I, I can't tell you how much money gets wasted on, not Wasted, gets spent on really good, productive work around normalizing this data and making it available and making it

Um, effective for good analytics within the health system and to be shared across clinic, clinically integrated network so that we can coordinate care better and do all those things. So this is an interesting service. I am going to keep a close eye on this. I will, uh, talk to these guys when I see them again.

Who knows, maybe one of these conferences coming up. Maybe there'll be a chime. Maybe it'll be at, uh, HIMSS in, um, early next year. We'll have to see. Well, that is, uh, that's all as much news as we can do in 20 minutes or less with me just rambling as fast as I can. Um, if you wanna take a look at those stories again, uh, a lot of 'em came from healthcare IT news and, um,

Healthcare Innovation Group, my two, uh, go-to sources really for news. Um, and, uh, I recommend you hitting those stories, uh, well worth reading. So that's all for this week. Every Friday checkout our interviews with industry influencers, . And, uh, you know, keep the comments coming. Uh, you know, one of the things I'm trying to do is, is keep refining this show some, some of you're telling me, Hey, go deeper on the topics.

Some of you're telling me cover more news stories. Um, I'm gonna see which one I get more feedback on. If I get more on one or the other, I'll, I'll do, uh, more shows. But I will bounce back and forth when there's something to go deep on. I will do that. And, uh, when there are just so many stories that I think are worth covering, that's what we're gonna do.

Um, so thanks. Keep the feedback coming, bill at this week in health it.com. Um, I'm gonna be at the health conference coming up. Also gonna be at the, uh, CHIME conference coming up. So if you're there, please reach out. I would love to talk to you. This show is a production of this week in Health It. For more great content, you check out our website at, uh, this week.

health.com, uh, YouTube channel off of that. Plus, did a complete redesign of the website. Uh, have gotten some help from, uh, some younger people who have told me, uh, my website looked too much like a, uh, like a 50 year old engineer had designed it, uh, which a 50 year old engineer had designed it. So, uh, that was pretty accurate and they have helped me to, uh.

Um, rethink how we organize the website so that you can find the information you're looking for. So again, give me feedback. Let me know how that looks to you. Thanks for listening. That's all for now.

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