Bright.md, Orbita, Oncology Analytics, MDMetrix, and Higi announce new funding rounds.
Healthcare associations take a huge revenue hit as their conferences move to virtual.
China’s expansion of its COVID-19 contact tracing app with new functions raises privacy concerns.
ONC funds The Sequoia Project to continue as the Recognized Coordinating Entity for TEFCA for a second year.
The National Institutes of Health issues an RFI on digital health solutions that can help it build a central data hub for COVID-19 researchers.
Central Logic is reportedly nearing a $100 million-plus acquisition.
Kaiser Permanente EVP/CIO Dick Daniels announces his retirement.
Best Reader Comments
KLAS: Is it me or does it seem odd to rank vendors based on such small sample sizes? n = 6 is not exactly a big sample when considering there are ‘000s of hospitals in the USA to award top spot. I suppose at least they front up to the fact by publishing sample sizes as opposed to most obtuse and ropey awards out there. (Plucky Brit)
As one of the couple dozen companies sending a petition to HIMSS, I’ll just say that some large companies (some very large) who were originally signatories to the petition have dropped out, possibly when they saw their logos on the letter. Regardless, HIMSS should continue to be made aware just how unhappy the industry is about their actions. (Ed Chung)
Watercooler Talk Tidbits
Readers funded the Donors Choose teacher grant request of Ms. M in Texas, who asked for programmable robots and board games for her kindergarten and first grade technology classes. She reports, “Having Kinderbot and Botley have allowed them to have first hand experience with block coding. They immediately wanted to get to know them by name and play with them. Their colorful appearance was visually engaging and the child friendly buttons made it easy to use. This allowed them to be more actively engage in learning and feel successful as they completed an assignment. Again, we greatly appreciate your donation! It has opened my students’ desires to learn more about coding, and it has allowed them to feel successful and more willing to challenge themselves. Thank you!”
Novant Health is running 10 test flights of drones each day, using the 11-foot aircraft to deliver PPE to one of its hospitals in exploring the option for future health crises.
A Texas doctor recommends that residents change their face masks for summer, choosing lighter masks “much like men in North Texas change their cowboy hats in style during the summer.”
A Texas woman is arrested for threatening an Ecuador-born medical resident (who has been treating COVID patients) and her husband with a hammer in Houston, where she ran after them on the street screaming, “You Mexicans, get out of my f—ing country.” Her family, many members of which are Latino, say she was drawn to extremist political beliefs and possibly experienced mental decline after losing her job as a nuclear medicine technologist and medical sales specialist. Her resume says she is “HIPPA certified.”
London doctors are using Microsoft’s HoloLens 2 mixed reality headsets with Remote Assist 365 software to conduct virtual rounds on COVID-19 patients, reducing PPE usage by sending in just one doctor whose encounter can be broadcast to other team members who are away from the bedside. The system also displays diagnostic images and lab results.
A Las Vegas couple is charged with $13 million in Medicaid fraud after posting social media photos of their private jet, piles of newly delivered Tiffany boxes, an Aston Martin, and a Bora Bora vacation. The wife started a fake home health company, cross-checked obituaries against North Carolina’s Medicaid eligibility tool, and then back-billed those accounts for fictitious charges. The husband’s Instagram is full of biblical quotes about honesty and hard work.
Three boys in Bolivia are discharged from a week-long hospital stay after they provoked a black widow spider to bite them in hopes of gaining Spiderman-like powers.
Retail health kiosk company Higi raises $30 million in an investment round that includes financing from Babylon Health, the high-profile, UK-based telemedicine vendor that has strong ties to the NHS.
Babylon Health CEO Ali Parsa plans to integrate his company’s software and services with Higi’s Smart Health Stations.
Reader Comments
From B4 You Leap: “Re: work from home. Your editorial on reader comments related to office space was great. I am surprised that in everyone’s haste to make working from home a permanent lifestyle change, none have considered the many downsides. Most notably, outsourcing. Sure if you bring an A game every day, all the time, you are probably safe. You are probably also the top 15 percent of everyone working. For the rest, when you are perpetually remote and providing detailed performance metrics of your productivity, you have given every outsourcer a blueprint of what exactly you do and how much it costs for you to do so. I’d like to believe that our employers also place value on the intangible benefits and loyalty of long-term employees. But I doubt it.” I agree. Employee-manager relationships are likely to be devalued in the ongoing absence of an interpersonal connection. I’ve managed a few higher-level IT folks who worked permanently and by choice from my health system’s far-flung hospitals, and while they loved keeping distant from the day-to-day corporate politics and developed closer relationships with their appreciative users that the rest of us envied, they weren’t fully participative in our decisions that involved them and they were never promoted because that would have required them to relocate to the corporate office. I also agree that remote workers may be more susceptible to having their work seen as a commodity. Remember that the so-called “gig economy” sounded entrepreneurial and worker-focused until it became clear that driving for Uber or delivering DoorDash was a regular job with all the good parts skimmed off.
From Kermit: “Re: HIPAA. A PA GOP spokesperson cites HIPAA to justify not telling representatives about a fellow lawmaker’s positive COVID diagnosis.” It’s the now-common, ugly admixture of science and politics as Democratic members accuse the Republicans of intentionally hiding the positive COVID-19 test of State Rep. Andrew Lewis. Lewis says he immediately self-isolated even before his test result arrived and he then provided the information that officials needed to conduct mandatory contact tracing. All of that sounds rational until you get to the House Republican spokesperson, who declared, “I know you guys know that in the media, but HIPAA limits exactly what anyone can say about a co-worker’s medical history.” It would be great if HIPAA really was what people misbelieve it to be.
Dear people of the US, especially those who work in marketing: you are unfortunately and perhaps unknowingly displaying your ignorance or indifference (or your Arizona or Hawaii residency) when you list your pre-November event with a time zone qualifier that contains the letter “S” (like EST). We are on “daylight” time (EDT) for the next several months, so anything with an “S” is wrong except for events in those two non-DST states. I truly don’t understand why this is so hard to comprehend or remember, and yet the jarring prevalence of this error suggests that it is. Just use ET, CT, MT, or PT year round and you’ll look smarter.
HIStalk Announcements and Requests
Welcome to new HIStalk Gold Sponsor Health Data Movers. The company, which was founded in 2012, offers services related to EHR implementation, optimization, and interoperability, specializing in Epic implementations, data conversions, and product development. Some of its notable Epic successes include helping clients with EpicCare Ambulatory, Phoenix, Healthy Planet, Beacon, Kaleidoscope, Resolute HB, and Resolute PB. It partners with the top health systems, medical device companies, and digital health vendors to move healthcare data in putting patients first. Thanks to Health Data Movers for supporting HIStalk.
Webinars
June 10 (Wednesday) 1 ET. “COVID-19: preparing your OR for elective surgeries.” Sponsor: Intelligent Medical Objects. Presenters: Janice Kelly, MS, RN, president, AORN Syntegrity Inc.; David Bocanegra, RN, nurse informaticist, IMO. The presenters will cover the steps and guidelines that are needed for hospitals to resume performing elective surgeries and how healthcare information technology can optimize efficiencies and financial outcomes for the return of the OR.
Acquisitions, Funding, Business, and Stock
Care automation vendor Bright.md raises $16.7 million in a Series C funding round, bringing its total raised to $29 million.
Oncology Analytics raises $28 million in a Series C funding round.
Clinical operations improvement startup MDMetrix raises $1.1 million as it accommodates increasing demand for its COVID-19 Mission Control technology. The company spun out of Seattle Children’s hospital in 2016. CEO Warren Ratliff is the co-founder and former COO of Caradigm, which GE Healthcare sold off in pieces between 2017 and 2018.
Sales
Forty-nine municipalities in Sweden’s Västra Götaland region will implement Cerner Millenium.
Sanford Health (SD) signs a contract with Sectra for cardiology-focused enterprise imaging software.
Pittsburgh-based ClinicalConnect HIE selects real-time, patient event alerts from Secure Exchange Solutions.
LabCorp’s drug development business, Covance, will use Medable’s digital clinical trials platform to enroll and manage patients.
Tom Barnett (University of Rochester Medical Center) replaces retiring Beverly Jordan as VP/CIO at Baptist Memorial Health Care (TN).
3M Health Information Systems promotes Mark Endres to VP of international business development.
Announcements and Implementations
Propeller Health receives FDA 510(k) clearance to connect patients using AstraZeneca’s Symbicort inhaler to its digital health technology, which delivers analytics on medication usage via sensors and an accompanying app. The company was acquired by ResMed for $225 million in late 2018.
Waiting room content company Outcome Health emerges from media hibernation to announce GA of its Virtual Waiting Room, which gives providers the ability to show patients custom media while they wait for video appointments to begin.
Consumer health advocate CARIN Alliance launches My Health Application, a website that helps visitors choose an aggregation tool for their clinical, coverage, and payment information.
Revenue cycle and workflow management platform vendor ESolutions offers providers free use of a new Medicare Beneficiary Identifier lookup tool for claims reimbursement.
Government and Politics
The National Institutes of Health issues an RFI on digital health solutions that can help it build a central data hub for COVID-19 researchers. The NIH is especially interested in wearables, smartphone apps, and new ways to analyze and aggregate de-identified data for population health management efforts.
COVID-19
Herd immunity is unlikely to deter the spread of COVID-19 any time soon, according to several studies in which even areas with heavy infection rates (and thus heavy death counts) have mostly single-digit percentages of people testing positive for antibodies versus the 60% that would be needed to inhibit the virus’s spread. Only 20% of people have tested positive for antibodies in New York City even after 200,000 cases, 51,000 hospitalizations, and at least 16,000 deaths.
In more negative herd immunity news, only half of polled Americans say they will volunteer to receive a COVID-19 vaccine if one is developed, with around one-third of poll respondents saying they aren’t sure. Groups with the highest “I’m definitely not getting it” percentage are blacks and Republicans. Just 20% of those polled expect to see a vaccine made publicly available in 2020.
Former CDC director Tom Frieden, MD believes that the key to saving lives during and after the pandemic is found in reporting deaths of all causes weekly, protecting healthcare workers and the most vulnerable, ensuring that non-COVID-19 care is available and accessible, and managing safe re-openings to make sure communities don’t fall into poverty and poor health.
Cerner develops COVID-19 re-opening and social distancing projections for 60 countries using data from sources that include CDC, Johns Hopkins, Definitive Healthcare, and the COVID Tracking Project.
Other
Modern Healthcare notes the steep revenue declines that healthcare associations are experiencing as their conferences move to a virtual format. RSNA will lose 45% of its total revenue from its just-announced cancellation of its November meeting, MGMA says it generates 80% less revenue from virtual versus in-person conferences, HFMA’s cancelled live annual conference contributes one-third of its total revenue, and HIMSS declined to comment. It’s interesting that HIMSS and RSNA were by far the most dependent on meeting revenue, but HIMSS made 70% more money on its conference than RSNA’s.
Sponsor Updates
Ellkay offers a testimonial from LetsGetChecked CEO Peter Foley about the companies’ efforts to expand access to COVID-19 testing at home.
Greenway Health CMO Geeta Nayyar, MD appears on the HIT Like a Girl podcast.
The National Committee for Quality Assurance names Imat Solutions a beta testing partner for its ECQM Certification Program.
Optimum Healthcare IT publishes a case study titled “Multi-Facility Integrated EHR and Technology Implementation & Training at Tower Health.”
Meditech will host its 2020 Nurse Forum online June 17-19.
T-System earns the top client experience ranking for emergency department information systems for the sixth year in a row, according to a new Black Book survey of 1,100 end users.
Omni-HealthData wins Best Overall Healthcare Data Analytics Platform in the MedTech Breakthrough Awards for the second year in a row.
The Chartis Group publishes a new paper, “Telehealth: Current Trends and Long-Term Implications.”
Memorial Day in the US looked a lot different this year to most of us. I hope people were able to have some thoughtful time about the challenges our nation has faced in the past. Although the National Cemetery Administration didn’t allow “public” groups to place flags in the National Cemeteries as we usually do, I was glad to see that the 3rd US Infantry Regiment was able to take care of Arlington National Cemetery. I found this picture with a great piece featuring quotes and remembrances to honor those who died for our freedom.
It’s nearly impossible to keep up with my inbox lately, so I was glad that the announcement for the ONC Virtual Working Session on Patient Identity and Matching on June 1 caught my eye. Feedback gained from the meeting will inform ONC’s report to Congress. Nearly all of the organizations I work with struggle with patient matching, and the problem frequently leads to patient safety issues (missing data, erroneous data) or excess costs (repeating tests because they’re not in the right chart). Participants are encouraged to discuss their insights into existing challenges and innovations that can help. I’m registered and hope to see you there.
Another inbox item that caught my eye covered Google’s efforts to help COVID-19 responders find hotel rooms. The recently-launched feature allows searches to be filtered for hotels that offer “COVID-19 responder rooms.” I tried a couple of searches to see what the special rooms might include – discounted price, quiet floor, consolidated part of the hotel, etc. – but all of them just said “contact the hotel for details.”
I was dabbling in telemedicine prior to the pandemic, and then things got real very quickly. Patients were scrambling to understand whether they had been exposed and trying to obtain refills from medications they would usually obtain from doctors whose offices were suddenly closed.
As offices reopen in my area, volumes are trending back to the baseline. I chuckled when I saw the headline of this op-ed piece, “Telemedicine Tales: Let’s Reschedule When You’re Not Shopping.” Especially when wait times were long, it wasn’t unheard of for calls to connect when patients were somewhere other than at home, but fortunately I didn’t encounter some of the situations described by the author, including the “telephone encounter plus scalp exam” that resulted when a patient couldn’t resolve a camera angle issue. I completely agree with his assertion that he is “looking forward to the time when patients and doctors can determine whether in-person, video, or telephone visits best meet their mutual needs rather than having this dictated by public health emergencies or inflexible payment rules.”
Physicians in my area are sharply divided on whether telemedicine is going to be the wave of the future or the proverbial flash in the pan. There are some significant data points coming out of institutions like NYU Langone Health, which recently published in the Journal of the American Medical Informatics Association. They saw 683% growth in virtual urgent care visits and 4,345% growth in non-urgent virtual visits between March 2 and April 14. Most of my physician friends have enjoyed being able to see their patients virtually and be paid, especially when performing services that were previously uncompensated under traditional fee-for-service reimbursement models.
Those owning their own practices were happy with the flexibility, but employed physicians were a little less thrilled, depending on the arrangements. One large health system made the physicians physically come to the office to perform telehealth services, stating that it is required by HIPAA.
Speaking of large health system response to COVID-19, we’re not out of the woods yet for PPE. At my workplace, each employee has been issued four masks that they are expected to rotate on a daily basis and can only replace masks when the straps break or when they are visibly soiled. Apparently Missouri-based Mercy isn’t doing quite so well, with workers reporting that they’re wearing the same masks three shifts in a row. Competing health systems in the region are sterilizing masks daily. Most of the physicians I know still report a critical shortage of PPE and many are wearing non-medical respirators, such as those used for woodworking. Now that businesses are reopening and even more people need masks, the problem is worsening for some types of PPE, including surgical masks and gloves.
A recent Perspective piece in JAMA Internal Medicine describes some of the tensions found in expanding hospital volumes. It looks at the difference between making the hospital safe and making it feel safe, which aren’t always the same thing. I’ve experienced this in my own practice. Patients who acted shocked when I was masked during flu season and asked if I was afraid of catching their cold have become patients who file a complaint if they see a staffer removing their mask to grab a quick drink of water.
The author describes a new world where services that were previously in demand are no longer in demand and the importance of creating an appearance of safety. He notes the fine line between how new routines and procedures are presented, and whether they create an appearance of safety or danger that might cause hospitals to “inadvertently scare away the patients who need them.”
He closes by noting the difference between his weekend errand-running and life in the hospital with its critical care tasks. These are the skewed realities that many of us are living with every day, when we go from 12 hours of hazmat duty to hearing people complain about masks at the supermarket. Some days it’s surreal.
I see a lot of masks and gloves on the ground at retail locations, and at the same time, my office is limiting workers to one surgical mask per shift if they elect to not wear one of the four provided N95s. It’s a jarring visual and I certainly understand why many healthcare workers are seeking care for anxiety and acute stress reactions. This may be our new normal, but it doesn’t quite feel routine just yet.
The bottom line is that healthcare is still in crisis mode, but it feels like the rest of the world has moved on, especially when you see the videos of debauchery at some of the country’s lakes and beaches.
Is there anyone who is not operating under crisis standards of care? Leave a comment or email me.
Propeller Health receives FDA clearance to connect patients using Symbicort inhalers to its digital health technology, which delivers analytics on medication usage via sensors and an accompanying app.
China’s continued use of its COVID-19 contact tracing phone app raises concerns that the government will make it an ongoing standard since features unrelated to COVID-19 are being added even as the pandemic’s impact wanes.
China’s continued use of its COVID-19 contact tracing phone app – which assigns users color codes that permit or deny them access to stores and public transportation — raises concerns that the government will make it an ongoing standard since features unrelated to COVID-19 are being added even as the pandemic’s impact wanes.
A Communist Party secretary says his city’s app should be an “intimate health guardian” that is “loved so much that you cannot bear to part with it.”
Officials in Hangzhou are considering using the app to assign a “personal health index” that is based on the user’s sleep, exercise, and smoking and drinking. Other cities are trying to keep users running the apps by giving them access to store coupons and the ability to schedule hospital visits.
Another region is using the app to assigned an “honesty health code” in which party officials will downgrade the user’s normal green code to yellow or red based on “whether your party spirit is healthy.”
Reader Comments
From Stayin’ Alive: “Re: returning to campus. At our place, there’s a generational gap. Younger leaders are pressing for more remote work with adequate monitoring. The older guard want butts back in seats, but can’t explain the why, other than that healthcare is unique. We’ve supported applications and other technology remotely for three months, but nobody can explain why that can’t be sustainable.” Management is always challenged to quantify the deliverables of most employees, whether they’re sitting in a cubicle or at their dining room table (and of course to justify their own existence as overseers). That’s why a lot of performance reviews end up being based on subservience, peer likeability, and creating the image of efficiency and expertise even when it doesn’t exist. Old-school managers were taught to use oppressive practices to make their least-productive employees behave themselves in the absence of willingness to terminate them, coupled with the feel-good idea that every employee should be treated the same. Everybody can point out the employees who contribute disproportionately and anchor the boat for everybody around them, so it’s crazy not to reward them with looser oversight, more self-direction, a few nice perks, and a more collegial interpersonal approach. It’s a lot easier to keep them than replace them.
From Home Office Space: “Re: working from home. What do you expect to see as the downside of that as a permanent arrangement?” The lack of ability to raise the knowledge level of less-experienced employees via face-to-face conversations, serendipitous break room encounters, and interpersonal dynamics. Another is the difficulty creating a culture as happens in all-travel consulting firms. It’s exactly the same as in online education – both are good for self-directed, experienced people or for relatively short terms, but not a good substitute for those who are trying to work their way up. It will be interesting to see how job promotions are doled out now that face time has been replaced by FaceTime.
From John: “Re: scam award emails. Here is another, the third I’ve received in a week, all from different organizations. Desperation?” This one came from International Forum on Advancements in Healthcare, which offers “the most-awaited healthcare conference” in Las Vegas in December. This is yet another offering from Prism Events, a think tank of diligent India-born workers who occupy a rented PO box in a rundown house in Wilmington, DE. The “manager of speaker outreach” who sent John an unsolicited email asking for his phone number (while not providing her own) says in her LinkedIn that her job is to sift through other LinkedIn profiles to create nominees for “Top 100 Leaders” and “Top 50 Companies.” A ton of folks have slapped this made-up award on their LinkedIn, which would be reason enough for me to not hire them even if I was otherwise inclined. I am always shocked at how many people – many of them light on education and upward job mobility – who will plaster all kinds of eye-rolling certifications, awards, and obviously inflated job descriptions on their LinkedIn.
HIStalk Announcements and Requests
Welcome to new HIStalk Platinum Sponsor Halo Health. The Cincinnati-based company’s cloud-based Halo Clinical Communication Platform (the company was formerly known as Doc Halo) reduces care delays and clinician burnout via unified clinical communication (secure messaging, VoIP calling, mobilization of critical alerts, and advanced clinical workflow that incorporates on-call scheduling). Real-time integration includes EHR, PBX, PACS, LIS, and middleware. Halo Health is offering urgent deployment of its secure messaging for COVID-19 efforts at no charge for up to six months and offers a best practices guide and webinar, with customer examples including anesthesia intubation, virtual care teams, clinical team mobilization, SNF messaging, and instant notification of test results. CEO and co-founder Jose Barreau, MD is board certified in internal medicine, hematology, and medical oncology and is passionate about addressing the need for clinicians to improve care through better communication, while co-founder and CFO Alessio Nasini is an industry long-timer with Merge Healthcare. Some of its customers are Atrium Health, Henry Ford Health System, and Trinity Health. Thanks to Halo Health for supporting HIStalk.
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.
Acquisitions, Funding, Business, and Stock
Insiders report that an unnamed private equity firm will acquire patient transfer management platform vendor Central Logic for more than $100 million. I interviewed President and CEO Angie Franks in late January.
ONC provides $1.1 million in funding to engage The Sequoia Project to continue as the Recognized Coordinating Entity for TEFCA for a second year.
Announcements and Implementations
A new KLAS report on clinical optimization services – which it defines as workflow refinement, application enhancement, and clinician training – places “2020 Best in KLAS” winner Chartis Group as #1, with both Chartis Group and Nordic also earning client nods for deep Epic expertise.
A UPMC cardiologist’s app that generates a post-visit summary using AI-extracted speech finds new use in telehealth visits, where patients are more likely to forget their session details due to technology and proximity distractions. Doctors use the Abridge service by calling the patient using an assigned phone number, after which the call is recorded and the medically relevant portions are transcribed and made available to the patient. Patients can use the app directly for in-person and telehealth visits. UPMC-owned Abridge plans to to send the information to the EHR in its next phase.
Philips earns FDA’s 510(k) clearance for its wireless, wearable biosensor for measuring vital signs for patients who are in lower-acuity hospital rooms. The five-day disposable patch collects respiratory and heart rate every one minute and integrates with the company’s analytics software for early warning of deterioration, including in COVID-19 patients, where it reduces the use of PPE.
COVID-19
Premier Inc. and 15 of its member health systems acquire a minority stake in Prestige Ameritech, the US’s largest surgical face mask manufacturer. The company manufactures its products in Fort Worth, TX and sells only to US customers. The US sources 80% of its masks from China and Southeast Asia, complicating the supply chain.
A pre-print study finds that coronavirus levels in a given city’s sewer sludge is highly correlated with the days-later COVID-19 epidemiological curve hospital admissions.
A CNN report concludes that “the world sacrificed its elderly in the race to protect hospitals” as nursing mortality home death rates are finally starting to surface. Countries in Europe are reporting that from one-third to more than half of their total COVID-19 deaths occurred among elderly residents of care homes as testing capacity was insufficient, national guidelines were lacking, and those facilities were given low priority for PPE and support for absent employees. Employees at a New York City state-run veteran nursing home defiantly publish a Memorial Day list of the nearly 50 of its 250 residents that died of COVID-19 in a four-week period through late April.
An interesting observation by former CMS Acting Administrator Andy Slavitt. The pandemic and its death toll are, for most of us, an abstract concept of someone else’s problem.
A JAMIA-published article finds that the biggest problem with local, state, and federal public health agencies using hospital data to manage the pandemic is that most of those agencies aren’t capable of receiving electronic data. I might point out, however, that the underlying data came from surveyed hospitals who rarely self-identify as interoperability obstructers.
Data from China, which has largely defeated coronavirus if their reported numbers are to believed, suggests that patterns of lower subway ridership and higher levels of online collaboration have persisted, suggesting that work is changing there.
The latest projection from the most accurate US COVID-19 prediction model says the current death toll will rise from today’s 100,000 to more than 200,000 by September 1, which I note is pretty close the 220,000 low-end number that was projected early in the pandemic by the Imperial College group to much skepticism. Photos from this past weekend of beaches and bars packed with non-mitigating celebrants should encourage bettors to choose the “over.” It’s also important to note that our antiquated and politically manipulated methods of counting at the state level mean the real death count is a lot higher than the official numbers. Meanwhile, Brazil’s daily COVID-19 death count exceeded that of the US for the first time this week, as the country reported 807 deaths in 24 hours versus 620 in the US.
Texas Governor Greg Abbott defends issuing a $295 million, 27-month contract – paid for by federal taxpayers – to a little-known company that will perform COVID-19 contact tracing. Salesforce tech firm MTX Group, which has 200 mostly India-based employees, refuses to provide details on the similar work it claims to be performing for several other states and was allowed to redact its own state contract before it was released to the press.
Other
The New York Times reports that 20 large health systems received $5 billion in federal bailout grants even as they were sitting on $100 billion of stockpiled cash. The article highlights Providence Health System, which received $509 million from the fund that was intended to keep health systems solvent even though Providence invests in hedge funds, runs two venture capital funds, and works with private equity firms as it banks $1 billion in annual profit. The quickly designed bailout program assigned payouts that were based on Medicare payments for 2019, meaning most of the money went to big, profitable systems instead of struggling community hospitals that are quickly depleting their modest cash reserves. According to Health Care Institute President Niall Brennan, “If you ever hear a hospital complaining they don’t have enough money, see if they have a venture fund. If you’ve got play money, you’re fine.”
Sponsor Updates
Datica provides EHR integration for clinical surveillance company VigiLanz’s COVID Quick Start solution, available to hospitals for free for six months.
The Chartis Group develops the interactive Telehealth Adoption Tracker.
Mindstrong. a Silicon Valley-based startup that has developed a teletherapy app for patients with severe mental illnesses, raises $100 million in a Series C funding round.
Employee health management software company Castlight Health will introduce a COVID-19 screening, assessment, symptom management, and contact tracing app for employers next month.
Healthcare workers in Oregon claim hospitals are neglecting to accurately document their PPE needs via the state’s HOSCAP reporting system, leaving some facilities without adequate supplies.
Digital health companies experience record utilization, revenue, investment, and stock market surges as healthcare organizations have quickly pivoted to telemedicine and remote monitoring.
FDA’s Sentinel Operations Center at Harvard Pilgrim Health Care Institute is working with TriNetX’s global health research network to monitor priority drugs that are being used for treating hospitalized COVID-19 patients.
Kaiser Permanente EVP/CIO Dick Daniels announces his retirement.
Daniels joined the organization in 2008. He reports to Kaiser Permanente Chairman and CEO Gregory Adams. His retirement will be effective in mid-June.
Reader Comments
From Gary:“Re: your Top Healthcare Leader nomination. The photo you included really conveys how prestigious that award is. Still, if there was an award for someone who provides value to me as a healthcare professional, you would be on the top of my list – no joke. I have been a daily reader of your blog for as long as I can remember because you not only provide timely, valuable information but also because of the humorous notes like the above. Thank you for all you do to inform, educate and amuse.” You made my day – thanks. I’m especially contemplative and appreciative as HIStalk approaches its 17th birthday in a few days.
From HCITMasterClass: “Re: your Top Healthcare Leader nomination. Here’s another one you might find fun.” The Healthcare Technology Report lists its “Top 50 Healthcare Technology CEOs of 2020.” This outfit isn’t as scammy as others I’ve noted and its writers appear to be closer to native English speakers than its lower-rent competitors, although it carefully protects its anonymity by offering no address or employee lists. I Google-stalked its phone number and found that the owner is ZenLeads (dba Apollo) which sells lead generation software and databases from co-working spaces in San Francisco and Phoenix. It runs a maze of publications across unrelated industries, all of which seem to issue similar “top executives” awards. My interest in crappy news and awards sites isn’t that they attempt to extract cash in playing to executive egos since that’s apparently a viable market – it’s to see which of their featured authors and award winners proudly tout their “gosh, I sure love me” accomplishment.
From Swing Bar: “Re: HIMSS. Will they make a run at your HISsies ‘worst vendor’ and “stupidest vendor strategic move’ awards over their HIMSS20 refund policy?” Quite possibly, depending on the mood of readers in early 2021 when I conduct the nominating and voting. Egotistical behavior usually has an influence, and by many reports, HIMSS is still being terse in steadfastly defending its claimed lack of flexibility in offering HIMSS20 refunds. My experience is that it is not unfortunate or self-inflicted events that harms an organization as much as a lack of humility or commitment to change in its response to the event. We will see the full impact only when the HIMSS21 site is launched, which will include the available exhibit hall space. HIMSS may even hide that Freeman-produced floor map out of fear of creating a bandwagon effect that will reduce exhibitor and attendee registrations even further. Meanwhile, Las Vegas still has hotel deals available for HIMSS21 dates while bypassing HIMSS and OnPeak, with Harrah’s going for $69, Bellagio for $199, Caesar’s Palace for $149, Flamingo for $63, Excalibur for $40, and Luxor for $53 (upcharges over the previous non-nonconference week are modest). All hotels are offering the free, flexible cancellations that HIMSS does not. The Venetian is $483 and that makes me wonder if it’s the only hotel that HIMSS has locked down so far.
HIStalk Announcements and Requests
Only about 10% of poll respondents expect their family’s financial security to be a lot worse 18 months from now.
New poll to your right or here: What will your job look like a year from now?
Thanks to the provider IT folks who shared their plans for returning employees to campus.
Memorial Day 2020
People are fretting how they’ll spend their Memorial Day summer kickoff given coronavirus restrictions and concerns, but here’s an idea – use a subset of the time as it was intended to honor those who died while serving in the armed forces. You don’t have to be a fan of the military to support those who signed up voluntarily, were paid little, disrupted their families, and died carrying out the task that was assigned to them.
In Flanders Fields
By John McCrae
In Flanders Fields the poppies blow
Between the crosses row on row
That mark our place; and in the sky
The larks, still bravely singing, fly
Scarce heard amid the guns below.
We are the Dead. Short days ago
We lived, felt dawn, saw sunset glow,
Loved and were loved, and now we lie
In Flanders fields.
Take up our quarrel with the foe:
To you from failing hands we throw
The torch; be yours to hold it high.
If ye break faith with us who die
We shall not sleep, though poppies grow
In Flanders fields.
Webinars
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.
Announcements and Implementations
FDA’s Sentinel Operations Center at Harvard Pilgrim Health Care Institute is working with TriNetX’s global health research network to monitor priority drugs that are being used for treating hospitalized COVID-19 patients, studying its real-time, de-identified COVID-19 data set to review utilization and safety of drugs being used in the field.
COVID-19
Only 60% of states report COVID-related hospitalizations, but of those that do, Florida, Alabama, Georgia, Wisconsin, Virginia, Minnesota, and Ohio are all reporting upticks. Hospitals in some large Alabama cities have no ICU beds available, while Minnesota’s COVID units are full.
President Trump vows that “we’re not going to close the country” if predictions of a second wave of COVID-19 in winter turn out to be true.
In a “good news, bad news” item, scientists say that lower levels of virus circulation in summer will push clinical trials of vaccines back into the fall.
A NEJM-published preliminary report on using remdesivir in hospitalized COVID-19 patients with lower respiratory tract involvement finds that recovery time was 11 days versus 15 for placebo. Expected death rates were 30% lower, but the study was stopped early and thus doesn’t prove that survival odds were improved. The drug’s benefit seems most significant in early-stage patients with less-severe symptoms, but study design influenced that finding as well.
A large-scale, observational study finds that widely hyped drugs hydroxychloroquine and chloroquine did not improve COVID-19 outcomes and were associated with heart rhythm problems and higher death rates, the same conclusions that previous observational studies reached.
Updated CDC guidance says COVID-19 doesn’t spread easily from touching surfaces or objects – it’s getting near your fellow humans you have to worry about.
Another round of studies finds that COVID-19 PCR tests for active infection continue to register as positive long after a recovering patient is free of infection and thus not contagious, because the tests detect dead virus. That makes clearing patients for a return to work more difficult.
Former FDA Commissioner Scott Gottlieb, MD says China is developing its COVID-19 vaccine efforts around the old-school method of using inactivated virus, while the US is focusing in newer, less-proven technology that should provide a better result. His conclusion is that China is focusing on being “first to get shots in arms” even though the resulting protection will not be broad.
President Trump suspends travel to the US from Brazil three weeks after it became the world’s new pandemic epicenter even as its president has called COVID-19 a “little flu,”refused to implement lockdowns, and has promoted chloroquine treatments. Cities there are digging fields of mass graves and two health ministers have departed in just four weeks after conflicts with President Jair Bolsonaro. Brazil officially reports 360,000 cases and nearly 23,000 deaths, second only to the US, and a study says the real numbers likely higher than those being reported, perhaps as much as 12-fold.
The US COVID-19 death toll will likely hit 100,000 this holiday weekend and the virus remains all around us, including at Lake of the Ozarks, Missouri, where they’re partying like its 2019. Perhaps there’s an obvious reason that we have one-third of the world’s cases and deaths. It’s not really Darwin Awards territory when these folks may walk away unharmed but kill unfortunate others due to their lax behavior.
Sponsor Updates
VoyageLA profiles artist and NextGate VP of Software Engineering Gevik Nalbandian.
Clinical Computer Systems releases the latest edition of The Critical Care Obstetrics podcast, “The Hemodynamics of Hemmorrhage.”
Redox releases new podcast episodes, “Exploring Healthcare Platforms.”
ROI Healthcare Solutions receives a Bronze Stevie Award in the 2020 American Business Awards.
Vocera will transition its annual stockholders meeting to a virtual event on June 5.
Working from home and remote meetings are both still considered the norm. Only have 50% of normal occupancy of the office, and have a sign-up SharePoint so that we stay until that limit. We keep track of everyone present and which rooms they’ve used in case there’s an infection later and we need to keep track. Avoid using anyone else’s wings /floors /meeting rooms. Hand sanitizers at almost every single intersection. Everyone is required to wipe down the meeting room and/or desk before use with sanitizer, which is provided. Point person who is in charge of maintaining rules in each area. No use of refrigerators, and dishwashers have to be run at highest temperature. No external visitors unless already approved.
For the near term, we are not. We have virtualized all our contact center agents, finance, HR, marketing, IT, legal etc. As we get into a groove, we are finding that maybe not everyone returns. Also, being in the epicenter of NY/NJ, we still are very cautious. When we return (after Labor Day), it will be on a rotating basis, 2-3 days a week, to be able to do social distancing, deep cleaning, masks, Plexiglas in cubicles, not sharing of equipment, etc. Right now our focus is on returning the hospitals and physician practices to operations. And we are starting antibody testing of every single teammate, which will be completed by mid to late June – that’s 36,000 people.
We have four different office spaces. We are reviewing the spaces and will schedule staff onsite alternating 2-3 days per week ensuring social distancing. Will rotate staff weekly two days in office and three three home and than the reverse.
Bringing back while requiring masks to be worn. No travel.
My IT organization announced today that all employees will continue remote work practice until 1/1/21 at the earliest. This includes all install and go-live support and all corporate travel has been suspended until that date. The remote employees were approximately 40% of the workforce prior to the lockdown. The “bring back in” is not an issue for use today. Ask again in seven months.
Temp check when entering designated employee entrances. Must wear mask into the building. Mask must be worn when outside of office. Can remove mask if in office alone.
The IT department employees returning on-site follow the exact same protocols that all hospital and clinic employee departments follow. There is no differentiation. All employees must enter through the same designated employee entrances where temperature is checked via an infrared thermometer. Any employees (and visitors) with a temp of 100 degrees Fahrenheit or higher OR exhibit visible signs of illness symptoms are not allowed to enter the building. Employees who are turned away must contact the their supervisor and the employee health department to make arrangements for continued remote work and for X number of days away from the hospital before being allowed to attempt to enter on-site again. X changes are set according CDC guidelines. Cloth face mask worn at all times in the hospital. The only exception is at your desk or in other areas where there are not other people or the possibility that other people would enter the area. CDC social distancing guidelines are to be observed as well.
There is nothing formal. Departments are taking it on a person-by-person basis. A big challenge is reconfiguring work areas so that workers are more than six feet away from each other. Since many have been successfully working remotely, there will be a clash of opinions about having employees return at all (We need you back in the office. Why? We’ve been successful not being in the office.)
Bringing back 50% of staff on alternating days. Created A/B groups based on the office cubicle configuration so that no more than two employees per pod would be in on a given day. Keeping an alternating three-day / two-day bi-weekly work from home schedule. Marked off six-foot separations on the floors to indicate proper social distancing from cubicles and in conference rooms. Removed extra chairs from conference rooms and kitchen to allow only the number of individuals to conform with social distancing. Providing masks, hand sanitizer, and disinfectant wipes to staff for work space use.
Not allowed in the break room without mask and gloves on. Limit the number of people allowed in the break room at a time. Moved people around so that desks and offices create safe distances. Not everyone is allowed in the office at one time, so staggered schedule between WFH days and in office days. If you go to a hospital for more than a few hours, you WFH for 14 days.
We will continue remote work for the foreseeable future. We’ve been doing just fine being 100% remote for the past two months, so there is no rush to bring folks back into the office.
Presently evaluating how many workers we will ask to return to offices, considering office reconfiguration requirements to ensure proper social distancing. Many workers are rightly concerned with potential COVID spread. We are working to demonstrate the productivity impact of working from home, which we believe to be positive. With a large number of elderly workers, we must be concerned wit their vulnerability. As communities reopen, we have to watch for increased COVID incidence.
Schedule time for people to come to the office and remove all of their personal items and non-work items from their work surfaces to allow consistent cleaning. Extra furniture being removed. Face coverings required in common areas and screening required upon entering building. Still requiring manager approval to return to the office. We will have to have staggered start times to avoid congregation at the screening stations and staggered work days to ensure proper social distancing. That dense cube farm that seemed great is now a major liability. No personal reusable water bottles, coffee cups, etc. are allowed unless filled at home but cannot be refilled at work. Bottom line, still encouraging IT staff to stay at home unless absolutely necessary to be on campus.
Our team was almost entirely remote (almost entirely out-of-state, in fact) so we’ll see no change. Our sibling teams were more local-focused, but I expect they will drop to two or three onsite days per week, in shifts (likely in perpetuity, in my opinion).
For the most part, continuing to encourage them to work from home and limit days in the office. When in the office, they will be under the same masking policies as all staff. No in-person meetings unless social distancing can be enforced. No allowing vendors on campus unless they are required as part of installation, implementation, or service. No sales calls.
We are not actually trying to bring everyone back into the office. And we will wait until some time after the recommendations take place to do so. We are planning a very gradual increase to onsite work, starting with only coming in if needed to perform a function not able to be done appropriately remotely (where interacting with other individuals and/or equipment requires it). We’ve found that our team has been quite productive in the current mode and I see no reason to rush them back in.
We are considering 100% work from home and giving up our office space. Our employee productivity remains high, our employees are happier, and we believe it will be an advantage in recruiting new employees. We already have departments 100% remote, and more departments are considering going 100% remote.
At our organization in Colorado, we’ve been using the CareCognitics workforce assessment tool for all of our employees. This includes evaluating each employee every day for risk for COVID-19 and escalating those at risk to testing when needed. The tool also assesses the mental health state of each employee. It has escalation to HR or other supervisors as needed. The analytics back end also tells us who hasn’t done their daily assessment so we can address that with the employee. Along with daily assessments, we also have created back to work assessments for those that have been off so we can assess them before they return.
We aren’t. Honestly, we’re evaluating whether we will for a large majority or just move to mostly permanent work from home.
Optum acquires post-acute care management company NaviHealth.
Amwell raises a $194 million Series C funding round.
Microsoft announces Cloud for Healthcare.
Omada acquires Physera for a rumored $30 million.
Cerner joins the Fortune 500.
Cerner begins bringing its employees back to campus.
Best Reader Comments
Optum are the healthcare Borg. Now they add Navihealth’s service and technological distinctiveness to their own. Resistance is futile. (Lazlo Hollyfeld)
If you look at all the ‘successful’ vendors, ALL of them (Epic, Cerner, Meditech, CPSI) started in HIT and built a business solely around HIT. Seems to me there is significant message there. (FLPoggio)
What I am curious about is how all those Epic-ites will react when the stay stay at home order goes away how much pressure will there be to not return to the office. And if Epic goes the route that many Silicon Valley companies seem to be (remote working can work), what happens to the billion dollar edifices in Verona? (HISJunkie)
Epic doesn’t need differentiation in their video visits to be successful and valuable for their customers. They’ve already done the leg work to get through hospital bureaucracy and get clinicians using their products. Their products are the safe choice for administration and reliable enough to have staying power with users. Unless your product is stunningly better, people are just going to wait for Epic to release your functionality. Having a technical product in an app store is living on borrowed time. Have you ever noticed how Apple takes the good iPhone apps and puts the functionality in iOS? If your product is just an app in an app store, you’re the first fish eaten whenever the sharks start getting hungry. The good thing is that Epic is slow and not hungry, but you still have to swim fast or be swallowed. (Sidelines)
Watercooler Talk Tidbits
Readers funded the Donors Choose teacher grant request of Mr. M in California, who asked for codable Legos. He reported in February, “We have been having so much fun with our basic Lego set, and this expansion set will make our Coding club even better! I think students really love to build and code because it builds their confidence. They are able to experience the pride of creating something from scratch and tell their family and friends about it. We have only been able to scratch the surface with this expansion set, but the projects that are included in it will allow my students to continue in our club next year!”
New York’s requirement that recovered, hospitalized COVID-19 patients can’t be transferred back into nursing homes until they test negative is causing hospital backups, as PCR tests can show positive results – most likely from measuring dead virus – for up to several weeks after the patient recovers and is likely not infectious.
A UK bus operator takes just two weeks to roll out an app-powered service in which hospital staff can request free transportation to and from work. The app allows workers to book a seat in advance, with the bus company then using their pick-up and drop-off information to choose the most efficient routing.
Florida spent $283 million in a no-bid deal to create temporary COVID-19 hospitals that were never used, with a politically connected bidder signing a deal to operate a 200-bed hospital for $42 million per month. That construction contractor has no hospital experience, but has developed emergency shelters and previously won a $789 million contract to build a wall on the US-Mexico border.
Lloyd Falk, a 100-year-old World War II veteran, is cheered by employees of Henrico Doctors’ Hospital as he is discharged following a 58-day stay for COVID-19. His wife of 74 years died from COVID-19 a few weeks before.
The UK funds a brilliantly creative trial to see if “bio-protection” dogs – which can detect some forms of cancer and malaria from smell alone – can sniff out COVID-19 as an early warning measure or for screening travelers. NHS will collect odor samples from infected patients and train six dogs being provided by the Medical Detection Dogs charity for 6-8 weeks, and then launch a three-month trial.
Flagler Health (FL) and consumer digital health company Healthfully develop a COVID-19 screening and monitoring app for employers that includes virtual visit capabilities.
The FDA launches a research project into the origin, treatment, and diagnostic patterns of COVID-19 using Aetion’s Evidence Platform, which aggregates data from EHRs, claims, registries, and clinical trials.
Optum acquires post-acute care management company NaviHealth.
The company’s private equity owner gets $1.1 billion in cash after buying a majority stake in the company for $400 million just 21 months ago.
The deal values NaviHealth at $2.5 billion.
Reader Comments
From Dumas: “Re: Epic’s COVID-19 immunity passport. They didn’t name the organization they are working with, but I think it’s probably Bluetree, which is owned by one of Epic’s biggest shops in Providence. They are working with Lumedic, which is also owned by Providence, to create an app that stores COVID-19 test status and immunity status that Bluetree specifically calls an immunity passport that is being considered by other organizations.” Unverified, but Lumedic has published screen shots of such a credential (above). I assume that Epic’s role is to provide results of COVID-19 diagnostic and antibody tests.
From Serrano Seed: “Re: HIMSS20. A group of exhibitors is petitioning for a refund of exhibit space fees.” The group of a couple of dozen companies, most of which I admit I’ve never heard of, hopes to shame HIMSS into refunding their exhibitor money for the cancelled conference. I suspect their efforts will be futile since (a) big-name exhibitors aren’t included; (b) their leverage is minimal given that HIMSS already has their money and, short of legal proceedings, seems unwilling or unable to return it; and (c) the cost of every company that is listed bailing on HIMSS21 (not likely) is minimal compared to the cost of refunding all exhibitors. I suspect that their polite petition will be far less effective than an impolite lawsuit.
From Nasty Parts: “Re: IBM Watson Health. I hear they are cleaning house, with some saying up to 80% of employees have been let go and a number of products (minus the employees who support them) being sold to Vizient.” Unverified. IBM Watson Health’s PR contact did not respond to my inquiry.
HIStalk Announcements and Requests
It’s my lucky day, y’all! I have learned from Mr. Prashant Kumar via LinkedIn that I have been “shortlisted for the Top 100 Healthcare Leaders award,” where I (fingers crossed!) will stride humbly across a Las Vegas stage later this year for my bestowment at a conference that is conveniently operated by Mr. Kumar’s employer, with my award consisting of a registration fee discount. I am especially grateful that the judges recognize my global healthcare leadership, given that I don’t actually lead anyone and despite the fact that my only job that is listed on LinkedIn is “Cynical Blowhard Healthcare IT Blogger.” Above is the upscale Wilmington, DE headquarters of the conferring organization Prism Events, in which the fate of my esteemed award rests in the capable hands of several dozen all-Indian employees who conduct their deliberations in a rented PO box.
Provider IT folks, help your peers by describing your department’s plan for bringing employees back to the office (or not, as the case may be), even if you’re just following organization-wide policies and would like to summarize those. I’ll post a recap this weekend. Thanks to those who have already provided some good (and sometimes surprising) ideas.
Webinars
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.
Acquisitions, Funding, Business, and Stock
Amwell will use a $194 million Series C funding round to further scale its telemedicine technology and services. Reports of delays and crashing calls due to record utilization during the COVID-19 pandemic had already forced it to upgrade its hardware and software, in addition to onboarding new providers. The Boston-based company has raised over $700 million since launching in 2006.
Sales
The Idaho Health Data Exchange selects 4medica’s enterprise master patient index software and data-cleansing service.
Pathos Clinical Solutions will implement OpenText’s EMR-Link for secure EHR integration and CPOE between its lab and clinicians.
Sunnybrook Health Sciences Centre in Toronto signs a seven-year contract with Allscripts for managed services of the company’s Patient Flow software.
Texas-based GI Alliance selects Modernizing Medicine’s EHR for gastroenterology.
University of Alabama Birmingham Medicine will deploy sepsis-monitoring software from Ambient Clinical Analytics.
Valley Children’s Healthcare (CA) goes live on Epic with virtual support from Optimum Healthcare IT.
Engage offers a free version of its WaitTimes app customized for COVID-19 testing sites for 90 days.
Carequality announces that 1 billion clinical documents have been exchanged via its interoperability framework since it launched in 2016. The organization will soon add image-sharing to its HIE capabilities.
Valley Community Healthcare (CA) rolls out virtual visit software from Otto Health.
Patient engagement software vendor Conversa Health launches Employee HealthCheck, an automated COVID-19 screening app for employers that was developed with help from UCSF Health.
Flagler Health (FL) and consumer digital health company Healthfully develop a similar app that also includes virtual visit capabilities.
A KLAS report on go-live support finds that engagement size is decreasing as the large health system market for new systems has matured. CSI Healthcare IT, Engage, and Medasource excel at executive involvement, while HCI Group and Nuance draw the most customer complaints about employee quality.
Government and Politics
HHS will award $5 million to support research into the ways healthcare organizations are responding to COVID-19, including the impact of expanded telemedicine services and digital care tools.
HHS issues an RFI on re-developing the IT strategy behind its Strategic National Stockpile of items associated with coronavirus-like pandemics. The new strategy would include greater use of analytics to forecast requirements. Comments are due May 29.
COVID-19
Alabama, North Dakota, and South Carolina become the first states to publicly commit to using contact-tracing technology developed by Google and Apple in their respective COVID-19 exposure notification apps.
The FDA launches a research project into the origin, treatment, and diagnostic patterns of COVID-19 using Aetion’s Evidence Platform, which aggregates data from EHRs, claims, registries, and clinical trials.
UC San Diego Health develops a remote patient monitoring program for COVID-19 patients recovering at home that includes a wearable to track vital signs, and activity and sleep levels; and an app through which they can report symptoms and communicate with their providers. The next phase of the program will use machine learning to predict a change in symptoms.
The Atlantic reports on the CDC’s practice – and that of four states as well — of combining the results of viral and antibody tests, which produces misleading metrics that governors are using to develop their re-opening plans.
The federal government will pay AstraZeneca up to $1.2 billion for the development and delivery of 300 million doses of a COVID-19 vaccine by October.
Officials in Iceland are underwhelmed by the impact the national contact-tracing app has had on COVID-19 containment efforts, stressing that, despite its high adoption rate, manual techniques like phone calls have been more effective: “The technology is more or less … I wouldn’t say useless. But it’s the integration of the two that gives you results. I would say it has proven useful in a few cases, but it wasn’t a game changer for us.”
Current and former government and health system leaders collaborate on a national #OpenSafely plan that calls for, among other things:
Following already documented plans to open communities up after two weeks of declining case counts.
Ensuring adequate diagnostic testing is available.
Implementing contact tracing and voluntary isolation.
Improving and implementing safety standards and protocols.
Protecting populations most at risk.
Ensuring adequate PPE.
Widespread use of telemedicine.
Screenings and symptom monitoring.
Other
Researchers develop a wearable they hope can successfully predict the onset of COVID-19 symptoms. The patch tracks coughing and respiratory activity, heart rate, and temperature, and then transmits the data to cloud-based data management software, where algorithms transform it into graphical summaries.
Sponsor Updates
Elsevier’s Clinical Path wins Best Computerized Decision Support Solution award from MedTech Breakthrough for the second year in a row.
Ellkay offers a customer testimonial featuring its COVID-19-related interoperability work with Acutis Diagnostics.
Infusion service company Option Care Health expands its use of Wolters Kluwer’s compounding compliance solutions for patient care.
Omni-HealthData adds new data visualizations and interactive dashboards to its COVID-19 Resource Center.
InterSystems publishes a new case study, “Helping Care Teams on the Front Lines: Providence St. Joseph Health.”
Kyruus ProviderMatch for Consumers wins the Best Patient Registration & Scheduling Solution award from MedTech Breakthrough.
ROI Healthcare Solutions launches an EDI Benchmarking and Health Check Eligibility Survey for Infor (Lawson) users.
The Healthcare Technology Report includes Waystar CEO Matt Hawkins, AdvancedMD CEO Raul Villar, and CompuGroup Medical Chairman Frank Gotthardt on its list of “The Top 50 Healthcare Technology CEOs Of 2020.”
Wolters Kluwer Health will publish the American Society of Clinical Oncology’s portfolio of five medical specialty journals.
InterSystems adds support for AWS Graviton2-based Amazon EC2 M6g instances for IRS and IRIS.
Relatient expands availability of its solutions in Athenahealth’s Marketplace to include patient self-scheduling, patient intake, and secure two-way messaging.
There has been a significant amount of chatter among my friends in the public health community, mostly around how COVID-19 tests are being documented, counted, and tracked. When we deal with other public health scourges such as measles, typically there would only be one positive test per person. With this pandemic, patients may be receiving numerous tests, generating both positive and negative results.
I followed one case where a patient tested negative three times and then positive four times before finally getting the two negative results that were needed for release from quarantine. There are plenty of public health organizations out there that are using lower-tech solutions — including paper, fax, and Excel — as opposed to the sophisticated databases that we all picture.
The issue of multiple tests per person is only one of the issues. Another is understanding which humans have been tested, since patients use a patchwork of identifying information that depends on the circumstance.
Let’s say a patient gets tested at an office that sends the specimen out to a national reference lab and wants the test billed to insurance. It’s likely that patient is going to be registered at the office under the name that is on their insurance card so that the claims get paid. If the patient goes to a drive-through public health clinic that is funded by grants, they might use the name that’s on their driver license, which may not match the one on their insurance card. If they order a kit online, such as those offered by a couple of labs, they might use the name on their credit card if they are paying out of pocket.
Now you have three names, which hopefully are similar, but might not be associated with one date of birth. Less-sophisticated matching algorithms might not identify them as the same person.
The Pew Charitable Trusts sent a letter to the US Congress last week, urging legislators to work with federal agencies such as ONC and the US Postal Service to enhance patient matching. Matching can be improved even with small steps, such as adding more data elements and standardizing those in use. The final ONC interoperability role focused on interoperability for EHRs, but didn’t address the role of other systems, such as those that handle laboratory information. Mandates for all systems to handle this information would be of benefit for data sharing.
This level of mismatch isn’t new. These are the same kinds of issues that EHR users have been having for years. We have been mandated to do various things that other parts of the industry are not. This has created all kinds of confusion in prescribing workflows and delays in patient safety efforts, as rule makers mandated actions for providers that receiving systems were unable or unready to process.
Standardizing existing data elements, such as phone numbers and addresses, would also be a benefit. According to a 2019 study in the Journal of the American Medical Informatics Association, patient matching could be increased by 3% with the addition of address formatting that is consistent with that used by the US Postal Service. The use of the USPS formatting is complicated by the fact that USPS doesn’t share its address standardization web tools with healthcare providers – they are reserved for exclusive use in shipping and mailing efforts. Congress would need to address this and expand the use of the tools to healthcare.
I’m always interested in solutions that promote desired health behaviors or encourage patients to receive recommended services. I wasn’t initially sure what to think of a recent article in JAMA Network Open that looked at participation in an end-of-life conversation game and its association with advance care planning. The study participants included nearly 400 underserved African American patients who participated in a game that was designed to help overcome reluctance to discuss death and dying. Researchers found that a positive association with care planning behavior among patients who participated in games at community events.
My initial skepticism at the idea of a game around death and dying was overcome by their results. The intervention was low cost and delivered by community organizations rather than health professionals. There are significant disparities among end-of-life care and I’m a huge proponent of access to a “good death,” so I hope these results can be replicated on a larger scale.
I picked up an urgent care shift this week and it was an absolute circus. The site was offering coronavirus antibody testing and the community came out in force to have their blood drawn. It was almost more exhausting than flu season, since every visit involved a fairly extensive discussion about what the results might mean, whether they were positive or negative.
The majority of patients were under the impression that a positive antibody test is akin to an immunity passport that allows them to run out and see their grandkids or have a bunch of people over. A couple of people wanted to have the test to know if they could donate convalescent plasma, and were saddened to learn that in our area, they can only donate if they had a positive COVID-19 test while they were sick rather than just having the antibody. One patient wanted to know whether the intravenous vitamin C he received from a mobile infusion center would be protective, and wasn’t too receptive of my explanation that we have no data on that treatment for this disease.
The best patient of the day was a retired general surgeon, who responded to my introduction by taking my hand firmly, staring deeply into my eyes, and asking, “How ARE you? How are you holding up in all this?” He was genuine and his compassion was palpable. I spent a few extra minutes with him and learned that he had previously been a residency program director, but retired “when selecting residents became all about the test scores and not about whether they were a good person or whether they could walk and chew gum at the same time.” I’m sure he could tell that I was just about laughing behind my mask. He was reading the latest issue of JAMA, and not surprisingly, had his surgical mask tied in precise knots behind his head.
It’s always great to see a patient like that, even in the midst of a wild and crazy day. It certainly recharges your clinical batteries. I’m not sure when I’ll work again, but it’s a nice memory and I can hope our paths cross again.
What has your bright spot been amid all the coronavirus chaos? Leave a comment or email me.
Amwell will use a $194 million Series C funding round to further scale its telemedicine technology and services, which have seen record utilization during the COVID-19 pandemic.
Alabama, North Dakota, and South Carolina become the first states to publicly commit to using contract-tracing technology developed by Google and Apple in their respective COVID-19 exposure notification apps.
Philip Meer, MBA is CEO of PatientKeeper of Waltham, MA.
Tell me about yourself and the company.
I grew up in New Jersey. I’ve spent my entire career leveraging software to advance a greater good. I’m an operator by trade. I enjoy solving problems and tinkering, using operations and using software to ultimately improve the quality of human life, but more tactically, to help companies scale their operations and make things better, faster, and cheaper, ultimately benefiting the end customer.
PatientKeeper is a 20-year-old software company whose mission is advancing healthcare by creating instinctive, empowering technology that respects the importance of the physician. I joined PatientKeeper because we can solve the big healthcare problem of providing a better clinical experience for the physician, who is at the core of what we do.
As an operator and tinkerer, it must be either terrifying or exhilarating to see healthcare and technology throwing out the rules and trying new ideas in response to the pandemic.
I think you said it very well — terrifying and exhilarating. What’s terrifying to me about the pandemic is that the healthcare IT and software community has not fully grasped the size, scale, and scope of the pandemic. It’s just now, a couple of months in, that we are advancing real solutions to support the healthcare ecosystem. It is terrifying because it took us by surprise. I’m not sure what we could have done differently, but it is terrifying to see the scale of a pandemic and what it can do to our healthcare system.
What’s exhilarating is that healthcare was already undertaking new strategies. Telehealth and home care allow mobility and enable the provider to provide care wherever they are, under whatever circumstances come their way. I’m proud as an operator that we are deploying software in these areas that the healthcare community had begun to embrace pre-COVID and now have accelerated with the pandemic.
What have we learned from moving physicians out of their specialties, and in some cases out of retirement, and placing them on the COVID front lines in new hospitals that have unfamiliar technologies and workflows?
The primary learning is that the new norm is mobility — the ability for a provider to render care, collaborate with the care team, and to reach patients and family members in an ergonomic way. Collaboration, both inside and outside the four walls of the hospital, must be a strategy when it comes to healthcare technology.
EHRs are great systems of record, as they were designed to be. But we have learned that the imperative is a system of experience, in which a clinician can provide care and also ergonomically tackle their administrative and data entry responsibilities in a way that minimizes their burden. Mobility and ergonomic systems that support physician productivity are no longer nice to have — they must be at the forefront of healthcare as we look beyond the pandemic.
How will increased use of telehealth and remote monitoring and the resulting changes in clinical collaboration change the demand for technology?
There’s a growing need to have, at your fingertips, a workflow tool or a system of experience where you can do your job in a way that doesn’t sacrifice the interpersonal care that is needed. That is the jigsaw puzzle that we are all being asked to solve right now as software engineers and technologists. That is the puzzle that PatientKeeper is being faced with.
How do you do clinical documentation without sitting at a dumb terminal by a patient’s bedside? How do you capture the work you’re doing from a billing perspective by quickly speaking or typing into your mobile device from the golf course or working from home? How do you view lab results, x-rays, and lab results virtually and be able to take actions to support your patient? No question about it, the ability to deliver care in a virtual setting and tools that provide an ergonomic experience for the physician have become the imperative in the COVID world and beyond.
What should the working relationship be between EHR vendors and companies like yours whose products improve and in some cases replace theirs?
Surveys have found that more than 50% of healthcare executives wish they could have made a different decision in their EHR selection process. I don’t fault the EHR for that. It was designed to be a system of record, and over the last 20 years, EHRs have done their best to serve the healthcare community in that way. PatientKeeper’s 20-year experience has been focused exclusively on the actual experience that the physician undergoes to do their job and to render care to the patient.
It is a complementary relationship between EHR vendors and PatientKeeper and other third-party tools that focus on end user experience, workflow, mobility, and integration that fits the way the provider chooses to practice medicine. The key for PatientKeeper and others going forward is interoperability. How do we work with multiple EHRs in a standardized way so that clinicians can serve patients seamlessly regardless of the underlying tech stack and EHR that they or their employer have chosen?
How is that vendor relationship managed, in terms of both technology and philosophy?
I don’t think there’s a simple answer to that question. From a technology perspective, I don’t know of any major EHR vendor who is against interoperability. Judy Faulkner herself recently said that Epic invented interoperability or created the concept of interoperability. From a technology perspective or philosophical perspective, the closed, monolithic EHR system will not survive into the next decade. It is inevitable that with standardization, open architecture, and APIs that EHRs will have the ability to provide a common patient experience across multiple EHRs.
From a philosophical and competitive perspective, the companies that succeed will be those that put the physician experience first and spend time speaking them and understanding their experience. The product in healthcare is the ability to render care in the best possible manner and to incorporate the best possible physician experience while serving interoperably among multiple EHRs or any healthcare tech stack. That has been our mission at PatientKeeper and will continue to be our mission in the coming years.
How is it different working under the ownership of hospital operator HCA instead of as a standalone vendor?
It’s all positive as I see it. One of the reasons I joined PatientKeeper was the support and the partnership between PatientKeeper and our owner. HCA offers us a treasure trove of physicians to observe, to listen to, and to help design PatientKeeper solutions. That’s the single biggest advantage of being owned by HCA.
Secondly, HCA does not just focus on one thing. They are across 185 hospitals and 40,000 clinicians across all service lines, practicing in many of the geographies around the country. We can truly understand the breadth of a solution that we need to provide, but we can also capture the depth of the solution required for a particular service line or geography. HCA is the greatest learning lab any CEO could ask for.
Financially speaking, HCA is an investor in PatientKeeper, but we also serve a large bulk of commercial customers beyond HCA . We listen them to and incorporate best practices across HCA and non-HCA systems. That gives PatientKeeper a huge competitive advantage in understanding what the end user, the clinician, is looking for so that we can deliver world-class solutions to meet those needs.
What will be the most significant impact of COVID-19 on the company?
Mobility and mobile solutions have always been part of our strategy and a differentiator for us. The greatest impact is that we will emphasize mobility even more in our strategy. The ability to provide clinicians with mobile tools on their smartphones and IPads so they can do their job virtually with a better clinical experience will have the biggest impact on PatientKeeper. We will accelerate our investments in mobility and mobile capabilities. It will also accelerate our partner strategy, where we will be looking to do more on the telehealth and home healthcare side with third parties that are working diligently and quickly to provide solutions based on the new way that healthcare is being practiced as a result of the pandemic.
Do you have any final thoughts?
We have done a good job of innovating in healthcare since 2010. The healthcare ecosystem has better solutions that allow providers to deliver better care for consumers and patients, with a better experience for the providers themselves. We haven’t done enough. The next 10 years will be defined by the patient experience and the physician experience, and I’m so excited by that. That creates a great opportunity for an operator and a tinkerer like me to get involved and actually solve a greater problem to meet the healthcare community’s needs in 2020 and beyond. I am excited by the opportunity to take on this challenge and to lead PatientKeeper.
Reader Comments