Well if you think the market glitches were enough to enough to deal with we have some glitches over in the healthcare medical records end of things now.   As the world of software gets more complex, we end up with more issues as such.  This was a company that UnitedHealthcare purchased back in 2010, so it was not developed “in house” you could say.  The subsidiary of United formerly called Ingenix, made the purchase and now the name has been dropped a while back and Optum and/or Optum Insights replaced the name. 

Ingenix (Subsidiary of UnitedHealthGroup) Buys Picis Hospital Software Analytics Company – Algorithms of Healthcare Continue To Grow

As you can see from a prior link from a while back the software is used even at the VA and when it comes to looking at subsidiaries of health insurers, take a look as I keep telling all that this is where the actions take place in the money areas at least and now we other types of actions taking place. 

VA Awards Contract to Picis, Subsidiary of Ingenix for Anesthesia Record Keeping Software

Also noted in here was the fact that the FDA had records of of six recalls relating to electronic medical records on file.  When companies are certified by the ONC, this goes to show you can’t catch everything and sometimes other problems develop later.  There’s been an issue of who should be in control of monitoring mHealth software and electronic medical records and perhaps this issue might be what I was headed for when I commented to stop fighting and move the ONC over to the FDA as a division as this recall clearly shows the need for collaboration amongst both of them.  I wrote that up back in July after reading numerous article about “who should be in control”, answer is both, working together.  Some of the folks over there liked the idea too as noted on Twitter. 

mHealth Why Battle Over Where the Responsibility Lies, Make the ONC A Division of the FDA, Better Collaboration and Software Engineering Exposure Both Ways Around

This is not the first battle UnitedHealthcare has had with software as we can go back to the AMA  lawsuit whereby doctors and hospitals were short paid for 15 years on out of network reimbursements.  So we have a little bit of both going on in the world today, some issues by accident and some by design when it comes to models and making money for sure. 

The recall looks pretty big here and includes California, New Jersey and Florida, and the particular software was “Pulsecheck” portion of the software suite.  Just recently too in discussing the FDA I brought up the fact too that we have  insurer subsidiaries actually competing with the FDA Sentinel program too with “selling” claim and other data versus a “free contribution” as Sentinel was set up to do and all insurers a few years ago made their statements that they would donate this information.

It is interesting to follow the crosshairs when profits and money are discussed in healthcare I must say.  In this case it’s all about those SQL action queries not posting the data as it was designed to do.  Way back in my early days I spent many long nights getting bugs out for such items and sometimes you never find them all, like in this case and with complexities with interfacing with other software, that could be the culprit as well as it may have functioned perfectly as a stand alone but now some code from other software disrupts this process. 

It happens all the time and time to call in the the Query Master to figure out what when wrong with the code.  This is why HHS drive me nuts when they publicly come out and say “hurry up Health IT”..lack of digital literacy gets exploited like this and they do it to themselves:)  We also get this with the exchanges from Deparle, “all the IT work is done” while campaigning for the program…we all know that’s not true either:)

Anyway, this should be an eye opener to all to really look and see what health insurers do with their subsidiaries and you will find their businesses in  areas you never thought of before and this is kind of dangerous as we are ending up with “insurers being too big to fail”..lots of the same things that happens in markets finds its way to healthcare too and it usually profit related.  How many of you realized United was in the medical records business before this?  They have a couple other subsidiaries that sell medical records too, not just limited to this one.  Back in 2010 they bought this company too that does EHRs and HIE so they are right in the heart of things when it comes to meaningful use and physician incentives. 

Axolotl (A Subsidiary of Ingenix) Creates Reporting and Analytics Solution for Health Information Exchanges–Algorithms for HIE–Business Intelligence -Subsidiary Watch

If you read the Picis site they are talking they just went live in the middle east so their markets are international and all of this goes right down to the UnitedHealthcare bottom line profits.  Take a look at Aetna and Humana and others, doing a lot of the same but not as long and big as United is with subsidiaries.   Have you ever heard of CanReg?  This is a Untied company that consults and introduces drugs and devices to the FDA and takes their client through the processes.  Interesting at times to look and see if and how subsidiaries interface with each other, you think?  There’s also the Chinese company, ChinaGate kind of doing the same thing with drugs and devices made in China, another subsidiary. 

Sometimes with software you think you have a problem fixed and you do, but the fix creates other issues or other areas of the software code that also need to be checked or revised…the way it works…voice of experience here as year ago I wrote a very simple EMR before the big complexities rolled in and that’s when I quit:)  This is why too what you see here at the Quack is a lot different than what you might read else where as whether it’s me or someone else, nothing beats hands on experience.  We have problems with that today too with too may so called experts never having any hands on whether it be a simple consumer app or business software.  They read about something, become a magpie but never do any investigating hands on when if the situation allows. 

So does this situation demand a big panic and leave hospitals without software, no as I am guessing they will revert back to a prior version of it where the problem did not exist and that’s the first route any software company would take.  United is busy though on the payment software as they have a subsidiary that they created to work with Epic on being a clearinghouse to go after that business.  Ok so nobody wants to talk about subsidiaries a lot in the news maybe…I call such posts “subsidiary watch” and have been writing them for about 3 years.  Just use those search words and you will find a ton of them here as relates to all insurers and Health IT companies. 

OptumInsight (A Wholly Owned Subsidiary of United HealthCare Optum Division) Creates Medical Clearinghouse Integrated With Epic Practice Management Software-Subsidiary Watch

This situation does say something though for Epic though with keeping all their development in house and why they fly above others with those who feel confident with their software, they have control and CEO Judy know that as well (smart lady) as do some of their clients so when it comes to buying up code someone else wrote, you run into this and there’s the Allscripts story too as they did a lot of buying up someone else’s code and got into trouble when their integration process was not done on time to please the shareholders…can’t help some of this but don’t stretch the truth either as you can make the coder work any faster, public and HHS is just now learning this fact too.   It was better that United reported their issue first before it was found by the users of course.  This issue this time is somewhat critical though as I read where the doctors notes are not being included…some rogue algorithm at work here. 

There are and will be errors and we end up with flawed data too out there so be a skeptic when you need to be and the Algo Duping video page I have has some great videos that will open up your eyes as to how some of what you see out there works, relative to clinical trials, all these reports on “how much money can be saved” and so forth as it gets difficult to see what’s coded for profit and when you are being duped to some degree.  It’s not all bad out there but it’s not all good either as data selling has reached epidemic stages in the US and you do see some strange stuff out there with numbers that make one say hmmmm at times if they are presented out of context. 

I’m sure with a subsidiary of United  building the federal data hub for exchanges, this might open up some opportunities for questions there as well.  That was also another company United bought, two weeks after HHS awarded the contract.  More code…so as the markets goes with glitches, so does healthcare.  BD 



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