In the video, called, “Making a difference. One app at a time,” Apple highlighted Skyscape, the company that makes the mobile medical reference software that Health eVillages, and sent a camera crew to a Health eVillages pilot site in rural Lwala, Uganda. A nurse from the clinic showed how he visits patients by motorcycle, using an iPad to help treat and educate the area’s residents. (Skyscape parent company Physicians Interactive provides operational support to Health eVillages, and CEO Donato Trumato, also featured in the video, co-founded the program with Kerry Kennedy.)

Two of the other three apps that Apple chose to include also are related to healthcare: Galileo, an app from Orthocare Innovations that helps amputees adjust prosthetic limbs; and Proloquo2Go, a product from AssistiveWare that in the video helped an apparently autistic child learn to speak.

Speaking at WTN Media’s annual Digital Health Conference on Wednesday, ONC’s deputy national coordinator for programs and policy, Judy Murphy, R.N., recalled that national coordinator Farzad Mostashari, M.D., and CMS Administrator Marilyn Tavenner said at HIMSS13 in March that there would be no more activity on Stage 3 regulations this year. “The focus this year is on helping people understand the Stage 2 criteria,” Murphy said.

Then she discussed how long it takes to go through the regulatory process, including issuing a proposed rule, taking public comments, reviewing the comments, then issuing a final rule. “If you do an extrapolation of that, 2016 would be a problem,” Murphy said.

That was not exactly an announcement that Stage 3 will be pushed back to 2017 — or three years after a provider gets to Stage 2 — but it might be the strongest hint to date. It’s not a huge surprise since so many entities have called for slowing down the program, but there you have a bit more evidence that the federal government is leaning that way.

Look for more coverage of this conference from me at Wisconsin Technology Network’s WTN News.

The Franklin, Tenn.-based company, formerly known as MedQuist, announced Tuesday that CEO Vern Davenport has “chosen to leave the company,” as has COO Amy Amick. In their place, MModal named Duncan W. James, formerly of QuadraMed, as the new CEO and promoted CFO Ron Scarboro to COO. Finance VP David Woodworth takes over as acting CFO. In addition, MModal brought in Graham O. King, ex-head of both Shared Medical Systems — now part of Siemens — and  HBO & Co. — cleaning up a scandal at the latter company prior to its 1999 takeover by McKesson — to fill the newly established position of chairman of the board.

In a statement, Greg Belinfanti of MModal owner One Equity Partners said, “This is a very exciting, positive period for MModal as it continues to grow and increase its presence in the healthcare industry’s important clinical documentation segment.” Say what? You just lost two of your top three executives for reasons you aren’t disclosing and it’s an “exciting, positive period” for the company?

The only thing I can guess is that Davenport and Amick might be working on a new venture together. The two were both executives at Misys Healthcare Systems — Davenport as CEO — in 2008 when that vendor merged with Allscripts. For what it’s worth, at least two other top Misys people, namely Paul Edge and Michael Raymer, remain at MModal, as far as I can tell from their LinkedIn profiles and from MModal’s current list of executives. Stay tuned.

• Avia, Chicago, which is partnering with HIMSS
• Blueprint Health, New York
• DreamIt Health, Philadelphia
• Health Wildcatters, Dallas
• Healthbox, with programs in Chicago, Boston, London and soon in Florida
• HealthXL, Dublin and London
• The Iron Yard, Greenville, S.C.
• New York Digital Health Accelerator, New York
• Nike+ Accelerator for exercise, fitness and sports, Beaverton, Ore.
• PhiloMetron, San Diego
• Rock Health, San Francisco and Boston
• Sanotron, Vancouver, British Columbia
• South By Southwest Interactive, Austin, Texas
• StartUp Health, a New York-based “network and academy for health and wellness entrepreneurship”
• Tigerlabs Health, Princeton, N.J.
• WellTech Funding, New York

In addition, the USC Center for Body Computing has announced plans for its own incubator/accelerator in Los Angeles, but we continue to await details.

That’s a lot. Is it too many? We have seen plenty of failures in digital health entrepreneurship over the years, in no small part because too many companies don’t understand the unique economics of healthcare, particularly in the U.S. With the possible exception of fitness products, direct-to-consumer simply does not work in healthcare because most of the expenses are paid for by third parties. (I’d argue that wellness and fitness are distinct from traditional healthcare anyway because healthcare really does focus on sick care.)

At least one report from the California HealthCare Foundation backs up my belief that the DTC focus is a recipe for failure, one reason why health accelerators probably have it harder than their counterparts in other industries.

On first read, I gave it a big “Duh!” for the explanation that the Patient Protection and Affordable Care Act (that’s how the law is officially known, Mr. Friedman) creates a “new industry” of innovation by encouraging the federal government to release of terabytes of health data — information already legally in the public domain — and then allowing the private sector to figure out how to structure, interpret and use the data. As you probably are, I’m well aware of digital health, Health Datapalooza, federal CTO Todd Park and some of the companies Friedman mentions. (Health Datapalooza IV is less than a week away.)

But on second read, I realized Friedman needed to write that column because America needs a lot of education about the Affordable Care Act, education that the Obama administration and its supporters don’t seem all that willing to provide. The public still thinks of Obamacare largely in terms of health insurance coverage. It’s much more than that, including, as Friedman points out, an attempt “to flip this fee-for-services system (which some insurance companies are emulating) to one where the government pays doctors and hospitals to keep Medicare patients healthy and the services they do render are reimbursed more for their value than volume.”

Coupled with the 2009 American Recovery and Reinvestment Act, which created the $27 billion EHR incentive program for “meaningful use” of electronic health records, the ACA takes some steps toward actual reform of actual care, not just insurance coverage. Friedman does not discuss Accountable Care Organizations, an experiment in realigning incentives around care coordination, nor does he mention the Medicare policy, dictated by the ACA, of not reimbursing for preventable hospital readmissions within 30 days of initial discharge for certain specific conditions, currently heart attack, congestive heart failure and pneumonia. Likewise, he fails to bring up outcomes research, another component of Obamacare. But at least he gets something out there that’s not about insurance coverage.

Unfortunately, many of the online comments posted in response to Friedman’s commentary predictably focus on insurance coverage or government control, but some actually discuss EHRs, population health, healthy behaviors and payment incentives. That’s good. Still, those are just people who read Friedman and the Times. Hyperpartisan conservatives — probably even some hyperpartisan liberals, even though the ACA is more centrist than a lot of folks wish to admit — and the less-educated won’t read the column and won’t comment on the Times site. Those are the people who misunderstand this imperfect but occasionally reform-minded law the most.

Roberts and Granfortuna don’t seem like they’re anti-EHR, just anti-EHR that makes their work more difficult. From the song: “Now we ain’t saying the EHR is bad/When all the bugs are fixed I know we’ll all be glad/It’s just by then us pioneers will all be dead.”

It all sounds great, but how much of this is grounded in the real world today and how much is wishful thinking? I mean, connected medical records? It sounds so idealistic.

Here is the description from Sivad:

A pleasure to welcome Suzanne Leveille to the program today. Suzanne is a professor of nursing at The University of Massachusetts-Boston, and the research director for OpenNotes.

OpenNotes is an initiative that invites patients to review their visit notes written by their doctors, nurses, or other clinicians.

As a patient, you have the right to read the notes your doctor or clinician writes about you during or after your appointment. Having the chance to read and discuss them with your doctor or family member can help you take better control of your health and health care.

As a healthcare professional, you may build better relationships with your patients and take better care of them when you share your visit notes. Our evidence suggests that opening up visit notes to patients may make care more efficient, improve communication, and most importantly may help patients become more actively involved with their health and health care.

Some highlights from the conversation include: the dramatic improvement between patient and doctor communications; how they overcome potential push back and resistance from physicians; patients became more engaged in their personal health care; OpenNotes has been pleasantly surprised at the patient engagement; how advanced technologies and mobile technology are going to impact the future of this idea; and how they are planning to spread the word and get more patients and doctors improving communications and care with OpenNotes!

On the quality front, which is my primary interest these days, there is some interesting discussion about  whether the new Medicare hospital readmissions policy truly will produce better care or will prod some into providing the minimum level of service to readmitted patients.

(Frankly, hospitals have been overtreating for years. If a minimal level of service gets the job done for the patient, that’s a good thing. And the policy is supposed to cause hospitals to do the right thing in the first place, knowing that they will lose out later if they don’t. I’m all for that.)

My post on consumer ignorance of telemedicine is in there, as is a good one from Vince Kuraitis and Leslie Kelly Hall about the duty providers have to share information with patients. EHRs and wearable sensors also make this edition of HWR. Not bad from an IT perspective.