Weekender 3/2/18

Weekly News Recap

• Intermountain Healthcare launches a virtual hospital that brings its 35 telemedicine programs under one roof
• EClinicalWorks announces a cloud-based hospital system whose cost starts at $599 per bed per month with no upfront capital cost
• R1 announces that it will acquire Intermedix’s healthcare division for $460 million
• Apple’s plans to create an employee wellness clinic are disclosed by CNBC
• The Wall Street Journal describes OurNotes, the follow-up project to OpenNotes that will allow patients to share their own notes with their doctor
• Researchers find no relationship between hospitals implementing a new EHR and their credit ratings afterward

Best Reader Comments

These wellness ventures strike me as little more than internalization of the wellness programs bundled in with insurance products that work very poorly today. Per the article, Apple seems to be working with Stanford. If my goal was pop health/wellness, I wouldn’t take my advice from an academic medical center, particularly not one that’s currently trying to buy its way into the primary care market. The branding is interesting because it almost sounds more like part of Stanford’s strategy to put clinics on tech campuses (I believe they have a few in the works already). (Midwest User)

One positive of a travel-heavy job is that you have a chance to meet healthcare execs and leaders from all over the country and really get to know them versus only having a network of people in a city or metro area. Over years, it does incredible things to your professional network, not to mention giving you the ability to experience many different settings and organizations rather than just a few. (HIStalk Groupie)

Inherently there are still silos within managing the different applications, competing agendas on the vendor side and organization side, lack of integration between initiatives, and more importantly, involving IT with sign-off for any device and EHR enhancements or changes. (Sandy Walker)

Watercooler Talk Tidbits

Readers funded the DonorsChoose teacher grant request of Mrs. M, who asked for six Boogie Board memo pads for her high-poverty elementary school third grade class in North Carolina. She reports, “My students love using the Boogie Boards. They are fun, engaging, and offer a nice alternative to paper and pencil work. My students are in third grade and are in my bottom reading group. Their eyes lit up when they saw the Boogie Boards. It is often hard to keep them engaged. We use the boards during guided reading groups, math groups, and during word work. We plan to also use the boards to take notes from research and during quick writes. I can’t thank you enough for your donation.”

Also checking in was Ms. M from New Mexico, who requested STEAM center materials for her elementary school class. She was nice to provide this update: “Unbelievable! You have simply made the start of the new year fantastic! We have new translucent, magnetic blocks to use on our new light table! The sensory options are endless. We have new math games to collaborate with that cover all four operations. They are more than drill and skill – they involve problem solving. It’s been a great review station. We also received two Whack-a-Mole type of games that involve NOISE and LIGHTS and SOUNDS! Most teachers hers would cringe. Not this teacher! We are soooo excited. The bottom line is, you are changing our classroom. We have supplies such as dice for multiple review stations. We have rubber bands (seems so simple) to create geometric shapes on our geo-boards. We have a light table with manipulative to create patterns, work fractions, and all of it is bright, sensory, exciting, and engaging. We have amazing new wobble stools that allow my students to wiggle and move. All of this is because of you and your amazing generosity! Nothing we write can explain how sincerely we thank you or appreciate this gift. You have a lot of choices when donating and we are grateful you found us.”

An anonymous CIO reader working in United Arab Emirates made a very generous donation to my DonorsChoose project, to which I applied matching funds from my anonymous vendor executive and other sources to fully fund these classroom projects:

• A tablet, case, charging station, and 3D building blocks for Ms. B’s elementary school class in Forest Park, GA
• A wireless drawing pad, math games, and basic classroom supplies for Ms. W’s high school class in Houston, TX, which lost all of its classroom items during Hurricane Harvey
• Math and art supplies for Ms. Y’s elementary school class in Naples, FL, which was impacted by Hurricane Irma
• Two tablets and learning aids for Ms. W’s first grade class in Moscow, KS
• Math centers and games for Mr. M’s elementary school class in Northglenn, CO
• Math tools and games for Ms. S’s elementary school class in Denver, CO
• A trip to the state aquarium on Saturday Deaf Day for the deaf students of all 15 county schools by Ms. M in New Bern, NC

Federal authorities arrest two Southern California weight loss doctors who they claim cheated insurers and patients out of $250 million (!!) by falsifying test results to get insurers to pay for lap band surgeries. An unrelated newspaper investigation found that five patients died after having weight loss surgery performed there.

Every year we get the dregs of the HIMSS exhibit hall booths since we don’t spend enough money with them to earn HIMSS points, so I was too depressed until yesterday to look at the exhibit hall map knowing that we’ll be in Siberia. We certainly are – we’re in the low-ceilinged, cheerless basement (Hall G) among companies I’ve never heard of, with our tiny 10×10 space sitting next to what passes for an anchor tenant down there, the Philippine Trade and Investment Center. Hall G was so dead at HIMSS12 that HIMSS hastily posted signs practically begging people to head down the easily missed staircase and they even gave out a free lunch coupon that was good only in the Hall G food court thinking that might drive traffic (it didn’t, except to the food court). This might be the year in which I’m convinced that exhibiting isn’t worth the significant cost since booths aren’t any cheaper downstairs. I implore you to bring your miner’s lamp, descend with trepidation into the labyrinth of poorly-numbered booths, and soothe our shattered self-esteem that will be on full display at Booth #11228. We exhibit only to say hi to readers and we don’t really have anything to sell, so I’m trying to convince Lorre that she should offer a new-sponsor bonus of some kind to reward companies that are brave enough to seek us out in the catacombs.

The biggest booths at HIMSS18 in terms of square footage are:

• IBM (15,400)
• Cerner (14,200)
• Epic (10,610)
• Change Healthcare (9,000)
• Skipping a zillion more, HIStalk (100)

Things I’ll miss at HIMSS18:

• MedData’s amazing scones, since Sands Expo Center doesn’t allow baking on the show floor
• Bistro HIMSS, the moderately-priced, decent-quality buffet where we’ve held our CMIO lunches, since they don’t run it in Las Vegas
• The chance to breathe air not infused with cigarette smoke
• HIStalkapalooza

Also note that Daylight Saving Time (I just realized that the first two words should be hyphenated since they form a compound adjective) starts the Sunday morning after the conference.

Definitive Healthcare lists the top 50 hospitals by annual revenue, in which $2 billion doesn’t even get you into the top 20.

A Medgadget editorial says the site is struggling financially despite doing the right things journalistically – paying skilled writers, not running obnoxious ads, and not publishing clickbait or time wasting listicles. It blames Google (“an evil monopoly”) and Facebook, which control 70 percent of digital advertising even though they produce no content and use privacy-invading techniques to place ads everywhere you travel on the Web. 

Microsoft co-founder Paul Allen will invest $125 million to fund Project Alexandria, which will work on AI that exhibits common sense. Possible applications include medical diagnosis.

A Georgia pediatric cardiologist who admits he allowed a drug company sales rep to use his EHR password to find pediatric patients for the company’s $295,000-per-year specialty drug will get off with probation for the misdemeanor charge of wrongfully disclosing PHI.

CNBC covers the “positive stress” movement embraced by young Silicon Valley tech workers who hope that cryotherapy chambers, hot yoga, fasting, and extreme workouts will allow them to work more hours and/or to live longer.

A startup’s dating app matches people by assigning a compatibility score based on results of a cheek swab DNA test, the fourth company over several years to try to make a business of shaky science paired with sifting through the social media accounts of users trying to quantify love. I worry about “The Onion” since headlines like these are as goofy as any they could make up.

Apple is working with police near its Elk Grove, CA repair center to figure out why they’ve received 1,600 calls to 911 from phones waiting to be fixed.

My increasing frustration with my PCP’s incompetent office staff and the lack of alternate decent doctors who accept both my insurance and new patients led me to try concierge medicine. I’m delighted with it so far. I get unlimited access to my well-credentialed, mid-career doctor (his practice is solo), appointment scheduling is online, I have his personal cell phone number, he makes house calls when needed, and his panel is just 500 patients. Just about everything is covered in the annual fee: all visits, minor procedures such as wound repair and mole removal, EKG, flu shot, labs drawn right in the office with common labs either free or cheap ($5 for HbA1c or lipid profile), inexpensive imaging ($35 for an X-ray, $225 for a non-contrast CT scan), and he even provides maintenance medications at his wholesale cost — my 90-day supply of blood pressure med cost me $6 with no extra trip to Walgreens. All of that costs just over $500 per year, which is probably even cheaper than co-pays and deductibles. My new patient session lasted nearly 90 minutes as he took a thorough medical and social history and had me sign forms so he could retrieve my medical records from the other practice (assuming the incompetent people over there can find them). I was the only person in the tiny waiting room when I arrived, and when I went back to the exam room, he was waiting for me rather than vice versa. The only aspect of concierge medicine that I don’t understand is the pricing – other similarly credentialed doctors offer pretty much the same services for up to $7,000 per year, so I like to think I’m getting a deal. 

Vince digs through his March 1988 health IT archive with fond memories of the 1988 HMSS conference (that’s not a typo), Meditech winning the color monitor wars, and household names in laboratory information systems such as Antrim, Medizinische, Rubicon, and Hex FF. The big song then was Rick Astley’s “Never Gonna Give You Up,” which is entirely forgettable except for one thing – it later spawned the Internet meme “rickrolling,” a prank in which someone publishes a link to a video claiming to be one thing that instead launches the “Never Gonna Give You Up” video. I think I would prefer the link to launch a ransomware attack.

In Case You Missed It

• News 3/2/18
• EPtalk by Dr. Jayne 3/1/18
• HIStalk Interviews Colin Konschak, CEO, Divurgent
• News 2/28/18
• Curbside Consult with Dr. Jayne 2/26/18
• HIStalk Interviews Tom Borzilleri, CEO, InteliSys Health
• HIStalk’s Guide to HIMSS18
• Monday Morning Update 2/26/18
• What I Wish I’d Known Before … Taking a Travel-Heavy Job

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