Class Action Lawsuit Filed Against Allscripts For Misleading Investors With Merging Data Systems–Too Much Code and Not Enough Time – Attack of the Killer Algorithms Chapter 30

Let’s start out with this, if one is a developer/coder this is probably not a great atmosphere to be in right now, I would not want to be

working there writing code to integrate.  I don’t know the entire insides and outs to intelligently talk specifically on some of this but do know we had 2 very differently constructed system that needed to come together with the merger of the two companies for an even more powerful system for medical records.

  I wonder if somebody got sold a bill of goods here?  When you have management involved they are basically “magpies” as far as knowing what the whole job entails as they rely on the “hands on” folks for accurate information. 

On the other hand too, you cannot push the coders and get good algorithms and software and the average person is not really cognizant of how massive these system have become with all the working parts that need to integrate and support each other.  When I did my little integration on the desktop with client server with billing software, that even took me a while but I had the same data product for the back end and I’m sure on the two products merged here.  With existing clients, some would need to be migrated if they are different, the way data works and when as a consumer you sit down and see the magic, you have no clue on all the coding work that goes into the system, you just want it to work. 

According to this article the join in date expires on 2012 for investors to stake their claim.  Sometimes you can’t put developing on a schedule as there’s always something that comes up that is not expected and will take extra time, especially with writing to HIPAA standards and security which is of course a major concern and component with any medical records system.  This was the news a few days ago.  Investors, better ask more questions and in cases with complex software like medical records, don’t think we have web fairies out there flying around.  Just with some of the small stuff I do I have people thinking oh you just sit down for a couple hours and like magic you have their project done..not so. 

Allscripts CFO Resigns Along With A Few Other Key Individuals, Board Fires Chairman–1st Quarter Had Lower Sales And Net Earnings Down–Long Haul to Get Software Technologies Merged So They Work

Let’s go back in time a little further as I have been around this business for a while to Misys Memory Lane when Misys and Allscripts merged in 2008, this was done once with integrated code, so a few years later here we go again and new compilers, etc. to bring in.  I don’t know how much or if any of the old Misys code is left but they grew by integrating and buying up other software so before Allscripts even came along you had integrated code to work with, so one wonders how much more can it go before you scratch and write a new system or considerably revamp big portions of the entire program.  This stuff takes time.  Remember these 2 guys telling us how great it would be and it did work but again we don’t know the back side and now it’s lot more expensive as there’s a lot more code. 

Misys-Allscripts merger is all about SaaS

Misys Sells Allscripts Shares to Enable Eclipsys Merger – Medical Records

Misys is still around but they don’t do medical records any more.  Last year they were even working with Humana to give doctors discounts to buy and again this was the original Allscripts system as the merged system had not arrived.

Revenue projections were based on the successful integration here-so much for business intelligence projections if the code is not all done.  I hope we get to hear more on this topic as folks dig in.  Investors beware of what some software folks claim when you have projects of a big magnitude as this.  I don’t think that maybe they lied outright, they may not have said anything as heck investors and consumers buying this kind of stock don’t understand it anyway and how it all has to come together, they just want money. 

The creative projecting with clients and revenue though I would think that some curious tech minded analysts might have asked about, and they are pretty sharp but when you get down to asking about “real” work in progress and don’t nail down the right specific questions, nobody’s going to tell you. 

So due to this fact and usually it’s the consumers getting bit by the algorithms and this time investors based on this lawsuit so we have the Attack of the Killer Algorithms (or lack of in this case) that came to bite.  Analysts with some IT background might want to think about making some on premise visits in the future you think?  That could or could not help though if they are not shown the entire picture and saw a lot of “virtual” work.  You just don’t know.  If you would like to read more about the other Killer Algorithm Chapter, use the link below or scroll down to the bottom left hand side of my blog for more every day examples on how the Killer Algorithms function today along with a ton of flawed data accumulating out there.   BD

 

Attack of the Killer Algorithms–Digest & Links for All Chapters–How Math and Crafty Formulas Today Running on Servers 24/7 Make Life Impacting Decisions About You–Updated 3-11-2012

 

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Levi & Korsinsky announces that a class action lawsuit has been commenced in the United States District Court for the Northern District of Illinois on behalf of investors who purchased Allscripts Healthcare Solutions, Inc. (“Allscripts” or the “Company”) (Nasdaq: MDRX - News) securities between November 9, 2010 and April 26, 2012.

The Complaint alleges that the Company made materially false and misleading statements in regards to its progress in assimilating both Allscripts’ and Eclypsis’ disparate systems and its ability to translate its fragmented product lines into revenue. In particular, the Complaint alleges that defendants concealed from the investing public that: (a) the process of developing a unified product offering after the Merger had suffered debilitating setbacks which ultimately resulted in the loss of key personnel and harmful upheaval in Company leadership; (b) a material portion of Allscripts' revenue and net income was based on the successful integration of these systems and substantial business relationships had been destroyed by the inability to make material progress in this area; and (c) as a result of the foregoing, Allscripts lacked a reasonable basis for its claims of progress in post-Merger integration and continued growth.

http://finance.yahoo.com/news/law-firm-levi-korsinsky-notifies-221000244.html

Komen Public Relations Vice President In Charge of Public Relations, Branding and Marketing Resigns–Business Intelligence Decisions/Marketing Not Popular With Consumers–Algorithm Attack #10 Revisited

I think we have reached a stage to where consumers are a bit tired of hearing “it was business decision” when those decisions cut care and funds that helped people.  Sure it exists in other businesses but right now with the war on women’s health, not popular and myself I took their link off and replaced it with Planned Parenthood.  This was the second strike though as a year ago they suing other non profits who also helped people for using the name “cure”. 

Susan G. Komen Foundation Attacking Other Charities Over Use Of The Word 'Cure'

Ok so the lady resigning today, was that her call too?  Inquiring minds asking questions here.  I talk a lot today about the imbalance of using business tools today for intelligence and we don’t have enough people sometimes with enough common sense on how to use them.  Komen found out the hard way about “unintended outcomes” and again you have very unsympathetic public with the economy in it’s current state. 

Komen Foundation Cuts of Funds to Planned Parenthood - Wall Street Was Lit up in “Pink” Last Week For Fund Raising from Hedge Funds and Other Financial Companies

I have said it many times that when you have folks in positions without a little bit of tech background that make decisions you are in  trouble.  No doubt we will see more of this as we are reaching a crossing point of where decision hurt and nobody seems to care and that is sad.   I watched the women struggle with this on the videos they put out and it was not enough.  I keep using this picture of the New York Stock Exchange as a reminder for all as to where some philanthropy efforts are going. 


The Komen Foundation made the number 10 spot on my Attack of the Killer Algorithm series.  I suppose when you can’t justify in words any longer to meet with approval form the public, it’s time to move on.  BD 

Komen Reverses Decision With Planned Parenthood–Hard Lesson on How Business Analytics Are Misunderstood And/Or Abused–Attack of the Killer Algorithms Chapter 10

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Another key executive at Susan G. Komen for the Cure’s national headquarters is leaving the organization after a public relations debacle regarding funding to Planned Parenthood of America.

Leslie Aun, who as vice president of marketing and communications served as the lead spokesperson for the organization, will leave Komen May 15 to become vice president of communications at Venture Philanthropy Partners (VPP).

She will become at least the sixth executive to leave the organization, either at headquarters or at the affiliate level, since the Planned Parenthood controversy exploded four months ago.

As vice president of marketing and communications, Aun was responsible for directing Komen’s public relations, branding, advertising, interactive marketing and event planning teams. Prior to joining Komen in March 2011, Aun was vice president of communications for the World Wildlife Fund (WWF) and chief communications officer for Special Olympics.

http://www.huffingtonpost.com/2012/05/03/leslie-aun-susan-g-komen-resigns_n_1475587.html?ncid=edlinkusaolp00000003

Johnson and Johnson Acquires First Medical Device Company In China - Guangzhou Bioseal .

As the press release reads, this is a product used in China only and not in the US.  The company will fall under the Ethicon division of J and J and produces a sealant used for adjunct hemostasis undergoing surgery, controls the bleeding when other methodologies are not sufficient.

Ethicon biosurgery brands already on the market in China include SURGICEL® and SURGIFLO®.  J and J is not new to China as they have had other interests there for years and have a Chinese website.  BD 

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Health care giant Johnson & Johnson (NYSE:JNJ) made its 1st acquisition in China this week, picking up Guangzhou Bioseal Biotech for an undisclosed amount.

J&J has been doing business in China for more than 25 years, including last year's launch of a medical device and diagnostics innovation center there.

"This transaction reinforces our commitment to China and delivering innovative medical device solutions to the Chinese market," J&J's Chinese medical president Xie Wen Jian said in prepared remarks. "We are very pleased to add the Bioseal brand to our growing portfolio of hemostasis products in China and we look forward to working with our new Bioseal colleagues to bring their innovative products to more physicians and patients."

https://www.massdevice.com/news/jj-nabs-its-1st-chinese-device-maker-wall-street-beat

Depression, Antidepressants, and the Endocrine System

It's all connected.  I know it, you know it.  Hormones and mood and the brain and inflammation… precisely how and precisely what to do about it?  Well, that is surely the sticking point.

Santigold: LES Artistes (right click to open in new tab)

I'm working from a paper today (as always) but it is not the world's greatest paper (1).  A small study hardly worth mentioning, but the discussion and conclusions have some interest.  So put your mind in an open frame but don't believe too much what you are reading.

Depression.  Not just a state of mind, really.  Can I tell you how common it is for someone to come in to see me, having just experienced a major loss (job or death in the family) and tell me: "My antidepressant isn't working.  I'm really sad."

I don't know why it is we are blessed and cursed with emotions.  There's some good explanation about how hominids survived via groupings and attachment and all that.  We are left with the baggage, as it were.  We love.  We hate.  We murder, and we grieve.  Sometimes if you sit outside and let the humid air in through your nose and watch the leaves flicker in the wind you can forget all that for a moment, and just exist, where dying is tomorrow, or yesterday, and not important.  Outside of the moment we are left with hopes, ambitions, failures, and loss.

My 9th grade biology teacher, Mr. Turner (who abandonned the profession to become a forest ranger) said to us once:  "Evolution is a fact.  Deal with it."

We have a hormonal system to deal with trauma of all kinds.  Emotional, physicical, present, past.  The lack of differentiation is the problem, frankly.  But it is what it is.  And folks suffering from  major depressive episode frequently have activation of the hypothalamic-pituitary-adrenal axis along with an increase in insulin resistance and increased accumulation of visceral fat.  Things go to hell in a handbasket pretty quickly.  There are elevations in inflammatory cytokines, not just in the brain, but all over the body.

In the traditional medical model, we add antidepressants to the mix.  I know there is no such thing as a serotonin or norepinephrine deficiency but bear with me.   Long ago, the tricyclics, which can indeed improve depression symptoms but result in an increase in body weight and possible worsening of diabetes.  The newer agents of SSRIs (prozac and the like) are actually associated with an improvement in glycemic control.

(Classical music, some of the best ever: Beethoven: Symphony No 7, II)  Classical not your drug of choice?  Sleigh Bells, Comeback Kid, ads up front.  Sorry about that.)

Weirdly, the old fashioned antidepressants who cause weight gain and dry mouth are known to decrease cortisol, whereas the new ones with fewer weight gain side effect have no immediate effects on the HPA axis.  (The wizened psychiatrists who sit in the front row of grand rounds always bemoan the lack of use of the old fashioned antidepressants in favor of the SSRIs.  But no one wants to be fat and dry-mouthed, not to mention the death in overdose so possible with the tricyclics).

Wht could be going on?  Cortisol from stress centrally increasing craving for high-caloric, palatable food… and increasing the secretion of resistin, an adipokine that causes decreased insulin sensitivity and an increase in fat storage and diabetes? In rats that is probably true.  In humans?  Not so clear.

Resistin is typiclly released in rats due to inflammatory and obesigenic influences.  But what about adiponectin, the supposedly antiinflammatory and anti-obesity hormone release in humans in response to stress or excess sugar… In humans, adiponectin is higher in women than in men, and are reduced in obesity and insulin resistance.

In the small study in the paper I've linked, free cortisol levels (STRESS) were strongly associated with levles of resisin in depressed patients.  In follow up, those who were on medicine and had decreased symptoms also had decreased levels of resistin.  There were no changes in hormone levels for those who did not improve on antidepressant treatment.  BMI was correlated with resistin also.

What do we learn?  Depression = increased cortisol secretion = increased resisitin = increased obesity.  Direct or indirect mechanisms may be unknown.  In mice, increased resistin increases fasting glucose in insulin resistance.  This may be true in depressed humans and may explain the link between depression and diabetes.  We don't know for sure.

Adiponectin concentrations didn't change during the six weeks of measurements of these depressed patients on or off antidepressants.  Only resistin measurements were statistically significant.

The endocrine system is always a bit of an investment in reading, and it doesn't always deliver.  That's why we read the Hunger Games Trilogy instead of books about the thyroid.  I get it.  Peeta v. Gale is more interesting than resistin and adiponectin.  That's not hard to understand.  We're human, after all.  We love, we hate.  We let go, we give in.

Colbert Talks Accretive Care–Collections in the Hospital ER (Video) Attack of the Killer Algorithms Chapter 30!

The blue ball system Accretive uses..funny but you know what it’s about the Killer Algorithms once again.  I’m glad he did this one as it needs attention as there’s more of this under the rafters that consumers don’t see.  It’s all about the math and flawed data, and/or formulas created for profit, and accuracy and ethics take the back seat.  Read the link below for a couple other examples of how “consultants” function today, all in the math and algorithms. Kind of sad that pay for performance has to enter the ER before one can get care with employees being graded on what they collect. 

If you have followed this from the start, it all began with a stolen notebook that exposed all, with a consultant running around with patient medical records on it and they had been sharing this information with Wall Street investors. 

Accretive Health Debt Collector Employee Has Laptop Stolen With Non Encrypted Patient Data from 2 Hospitals And Had Access to All the Data Via Revenue Cycling - Patient Information Was Shared With Wall Street Investors – Algorithms For Profit Again?

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Now the next back link for some additional history here below and this makes Chapter 29 of the Attack of the Killer Algorithms at the Medical Quack.  What is that…read further…it’s on the front page of the Medical Quack every day so see how numbers and formulas with spun marketing to save or make money are affecting lives all over the US, actually this is the reasoning behind the Occupy movement.  You can’t see, feel or touch those algos and we are also gathering a lot of flawed information. 

Accretive Medical Collections and Analytics Cited by Minnesota by Attorney General For Collecting from Patients At Bedside and Worse–Employees on Pay for Performance Too? Killer Algorithms Chapter 28

 

Here’s a digest along with a great video that will get you up to speed and hopefully explain some of this.  I work with code and numbers and to the average consumer you would never see this and of course the connection between financial and healthcare is critical.  You can be easily snowed.

Attack of the Killer Algorithms–Digest & Links for All Chapters–How Math and Crafty Formulas Today Running on Servers 24/7 Make Life Impacting Decisions About You–Updated 3-11-2012

Take it from a higher source than me and this is the same video that is on the front page of the Medical Quack.  Actually Professor Siefe borrowed a word from Colbert “Proofiness” so these two are in tune.  The name of his book is called “Proofiness, The Dark Arts of Mathematical Deception” and it’s out there but few want to talk about it.  I have the National Institute of Statistical Science talking to me too about the Killer Algorithms as they know as well they are out there and emailed me a while back and said “keep it up, this needs attention and awareness”.  

It’s all about context!

We need balance and ethics with using our intelligence and need to make sure we are not marketed with numbers but rather given intelligence to help us.  BD 
http://www.colbertnation.com/the-colbert-report-videos/413584/may-02-2012/the-word---debt-panels

Practice Fusion Medical Records Launches First of It’s Kind Lab API Where Any Lab in the US Can Connect

This is pretty good and I remember back when I wrote an interface to work with Quest Labs that I about fell off my chair when it worked.  That was back when HL7 was still in it’s infancy and creating the crosswalk at the time was a lot of work, for me anyway as I never done one before.  Things are long past those days for sure with the sophistication that we have today by comparison.  Back in 2009 the company was also one of the first medical records systems to embrace cloud technology. 

Practice Fusion EMR to Sit on Salesforce.com’s Cloud

If you want to find out more about Practice Fusion, follow the link on the Medical Quack for more information on the left hand side of the page.  BD 

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SAN FRANCISCO, May 2, 2012 /PRNewswire via COMTEX/ -- Practice Fusion, the free Electronic Medical Record (EMR) company, today announced the launch of its new lab API, which allows any laboratory in the country to connect directly to the EMR. The lab API - first of its kind in the health sector - enables rapid deployment of new laboratory connections that would ordinarily take weeks or months to establish, giving over 150,000 medical professionals easy access to their local commercial, hospital and private laboratories. Practice Fusion already has 70 labs signed up for connectivity with the help of the new API

Practice Fusion's Lab API allows laboratories to connect to the EMR platform instantly with almost no turnaround time

Labs can use the API connection to instantly send lab results to Practice Fusion users with standard HL7 data files

Labs interested in connecting to Practice Fusion's EMR should contact Erica Martinez at emartinez@practicefusion.com or request more information online. Physicians interested in signing up for the free EMR should visit http://www.practicefusion.com

http://www.marketwatch.com/story/practice-fusion-launches-api-to-democratize-lab-integrations-2012-05-02

San Diego Hospitals Having Issues With Anthem Blue Cross Refusing Claims for Psychiatric Emergency Services–Attack of the Killer Algorithms Chapter 29

The California Hospital Association is involved here with stating there had been several complaints from providers.  The story states that they have more denied claims from Blue Cross than all the other carriers combined.  Mental health again is getting the short end of the stick.  Sharp Hospital says that patients are not getting access to proper care. 

Two years ago is when the hospital began to change how it reviewed claims, and hmmmm let me see that’s when the new business intelligence algorithms could have come into play, right?  That’s what usually happens with insurers and it’s algorithms that give the yes or the no based on analyzing data.  About one third of the days submitted have been refused and now an increasing number of doctors are refusing to see patients.  BD

San Diego Hospitals Blue Cross

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SAN DIEGO — San Diego’s largest private providers of mental health services are having problems with California’s second biggest HMO.

These hospitals complain Anthem Blue Cross refuses to cover a high percentage of hospital stays for psychiatric emergencies. 

Health care providers complain the situation is affecting access to care.

We now have more denied days from Anthem Blue Cross than any other payer," Dr. Plopper said. "We have more hospital stays here that include denied days by the insurance company, than all of our other insurance companies combined."

Medical director Tom Flanagan used to sit on one of Anthem Blue Cross’s medical advisory committees. But he resigned two years ago, when he noticed the insurer began to deny care for a high number of his patients.

Sharp has recently appealed 366 hospitalization days that Anthem wouldn’t pay for. The company reversed its decisions on only six of those days, a reversal rate of 1.6 percent.

Sharp said the average reversal rate for all of its insurers is 53.8 percent.

http://www.kpbs.org/news/2012/may/01/san-diego-providers-having-problems-anthem-blue-cr/