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The vendor members of the HIMSS Electronic Health Record Association raise “significant concerns” about proposed federal rules covering interoperability. Their draft comments note that:

  • The rule limits EHR vendor profits and thus discourages innovation because it requires them to share their intellectual property. The proposed rule would require vendors to offer interoperability elements with “reasonable and non-discriminatory terms.”
  • The compulsory licensing rule would require developing documentation, APIs, and patents, creating a regulatory burden that might “outweigh the opportunity that remains.”
  • ONC’s definition of “interoperability elements” and “electronic health information” are overly broad and unreasonable, while some of the defined exceptions would be nearly impossible to enforce.
  • EHR vendors can’t deliver the programming necessary in the proposed 24-month timeline, especially when they are dealing with other CMS and ONC regulatory requirements.
  • The proposed rule includes ambiguous definitions such as “reasonable,” “as soon as possible,” and “near real-time,” which is risky when penalties can be issued of up to $1 million per infraction.
  • EHRA recommends publishing an Interim Final Rule this year to allow continuing clarification and feedback and to create a way that vendors can get quick answers to their questions.

The Health Innovation Alliance this week said the rule is too vague and contains too many loopholes, recommending that ONC and CMS “go back to the drawing board.”

HIStalk Announcements and Requests


More than half of poll respondents say vendor and hospital burnout in health IT is caused by excessive workload and time pressure rather than organizational, management, and compensation issues. Furydelabongo says that work overload could be a symptom of having incompetent or overly ambitious managers, while Drex cites the nearly universal absence of good IT governance in hospitals that encourages employees work at whatever tasks they believe are important or that executives complain the loudest about.

New poll to your right or here: What method did you use the last time you communicated directly with a doctor who was providing care to you? I’m looking for your most recent exchange, the final one in your most recent encounter.


Happy 16th birthday this week to HIStalk, which I started writing in June 2003. I think it was June 6, but I’m not certain since I sometimes think it was June 3. Back then:

  • Some big healthcare names were George W. Bush, Tommy Thompson, Tom Scully, Dennis O’Leary, Erich Reinhardt, Linda Kloss, Anthony Principi, and Neal Patterson.
  • Hospitals were struggling with early CPOE implementations.
  • Kaiser Permanente had just chosen Epic.
  • Cerner had just made its first UK sales and opened its new headquarters.
  • HIMSS offered HIMSS03 in San Diego (with keynotes from Jeff Immelt, Rudy Giuliani, and Patch Adams) following Summer HIMSS in Chicago and also launched Solutions Toolkit, the predecessor to HIMSS Analytics.
  • Computers ran Windows XP while users licked their wounds caused by Windows ME and awaited / dreaded the promised magic of Windows Vista as the effects of the “every other Windows release sucks” rule were about to be felt.
  • People sent messages on BlackBerry devices and talked on the Nokia cell phones that dominated the market.
  • Companies such as MercuryMD, Misys, First Consulting Group, Per-Se, IDX, Healthlink, Quovadx, Alaris, and Sentillion were making a few sales.
  • Health IT news came slowly and with little critical review other than from expensive, influential newsletters such as “Inside Healthcare Computing” and “HIS Insider.”

Listening: new from NF (Nate Feuerstein), a 28-year-old, Michigan-based, Eminem-influenced rapper whose lyrics are emotional but commendably free of profanity (a change he made in 2010, saying that he’s Christian even though his music is not) and misogyny. His vocal rhythms immediately embed themselves in your head even if the lyrics don’t. The link is for “Let You Down,” which is not only a dramatic video, but also a powerful song about the strained relationship between a disappointed father and his son who has bitterly decided that their superficial relationship is over.

Thanks to the following companies that recently supported HIStalk. Click a logo for more information.



None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre for information.


  • Bayhealth (DE) switched from Avaya To Cisco Systems for call center technology in April 2019.
  • Highpoint Health (IN) will replace Meditech with Allscripts in July 2019.
  • ProMedica Coldwater Regional Hospital (MI) replaced Meditech with Epic on May 1, 2019.
  • Chestnut Hill Hospital (PA) will go live on Epic in August 2019.
  • Baptist Health Floyd (IN) will replace Allscripts with Epic In June 2019.

These provider-reported updates are supplied by Definitive Healthcare, which offers a free trial of its powerful intelligence on hospitals, physicians, and healthcare providers.

Announcements and Implementations

SailPoint earns a US patent for its application of AI/ML to identify peers among system users to detect those whose access profile is unusual enough to warrant review for potential security concerns.



Eric Topol notes the nearly identical, relentless price increases for competing best-selling injectable arthritis drugs Humira and Enbrel, which generated a combined $28 billion in 2018 sales. Today’s price is more than double that of 2012, with cash-paying patients paying more than $5,000 per month even with the best coupon offered by GoodRx. The cost is much less in the UK, which doesn’t allow endless drug company patent filings and lawsuits that block competition for biologic drugs.

CDC reports that the number of US measles cases has broken the 25-year-old record even though we’re only halfway through the year. Measles is classified as “eliminated” in the US, but that achievement is at risk for the first time in a generation.


I’m fascinated that Cincinnati-based Bon Secours Mercy Health will sell its majority stake of an RCM company it bought for $60 million in 2016 for $1.2 billion. The Catholic health system, former in September 2018 with the merger of Mercy Health and Bon Secours Health System, had just announced its merger with Ireland’s largest healthcare provider, a five-hospital system in Dublin, with intentions I don’t quite understand (unless they’re using Ireland’s favorable tax status to benefit their for-profit ventures).

Sponsor Updates

  • Sansoro Health announces an integration partnership with OpiSafe, which provides clinical decision support for opioid prescribers.
  • TriNetX will exhibit at Academy Health June 2-4 in Washington, DC.
  • A study finds that hospitals using Meditech Expanse outperformed Cerner and Epic clients in CMS quality and value measures.
  • Wolters Kluwer Health promotes Greg Samio to president and CEO of health learning, research, and practice.
  • The SSI Group will exhibit at the Alabama HFMA Annual Institute June 2-4 in Destin, FL

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