Weekender 4/27/18

Weekly News Recap

• A proposed HHS rule would retarget the Medicare and Medicaid EHR Incentive Programs to “a new phase of EHR measurement with an increased focus on interoperability and improving patient access to health information.”
• Kansas-based transcription firm Medantex takes down its customer web portal after security researcher Brian Krebs notifies the company that its audio recordings and site administrative functions were wide open to any Internet user.
• Doctor on Demand raises $74 million in a Series C funding round led by Princeville Global and Goldman Sachs Investment Partners.
• Rear Admiral Ronny Jackson, MD withdraws his nomination for VA Secretary after Senate Democrats publish allegations against him that include giving out prescription drugs to staffers, drinking to excess while on the job, and managerial misconduct.
• The FDA launches a digital health incubator and announces it will tweak its pre-certification software program to better accommodate AI-powered technology.

Best Reader Comments

All the hullabaloo around UIC’s Epic and Cerner mess is pretty pointless. And so are the Black Book and KLAS results. Nobody, absolutely nobody (and that includes providers, patients, IT support people) is delighted with either Cerner or Epic (13 clicks to get the right information out in ICU from Epic!!!). At the end of the day, these are two highly mediocre products with not much daylight between them in an industry that has traditionally not asked much from its IT vendors probably because as an industry, it itself doesn’t believe in excellence in customer service. To paraphrase an old computer science term: “mediocrity in, mediocrity out.” (John Yossarrian)

I’m not struck by the infighting or backstabbing; that’s par for the course at a complicated organization as you describe. I am struck — shocked even — that you’ve got physicians who want to be involved in decision making during the implementation. Maybe we all have finally learned that if you’re at the table, you get to make decisions. All too often, docs who were begged to come to meetings but are “too busy” are upset at the final result they see at go-live! (Craig Joseph, MD)

I have seen a mixed bag of tricks for these situations. There is no specific singular “path” for for every organization or hospital/medical center to follow. “Buy in” starts with ownership and who has control of the purse strings- for instance, one hospital contracted their anesthesiologist and the anesthesia group contracted their nurse anesthetist who did not want to use the electronic surgical record. “ Buy In” came when we worked with the anesthesia group to give them the “WIIFM” (What’s In It Form Me) benefits of using the EHR. Once we had anesthesia on board. We worked with the nurse anesthetist groups “key influencers” to gain their willingness. ultimately, the organization made the EHR trading mandatory and they agreed to pay for RNA’s time spent learning to use the EHR which turned out to be the biggest “buy in.” We worked out the residency problems by coming to the conclusion the organization would hire scribes in emergency areas. These methods may not have worked in another organization or another part of the country. It also depends on whether they have unions and the budget. (Lisa Hahn, RN)

On the whole conference thing and engaging the audience. If the purpose of a conference (or one of the main purposes) is to educate an audience, and if the lecture is one of the least effective methods for educating an audience, then it would follow that trying some different techniques to engage the audience would make sense. There’s a pretty great story of how Professor Eric Mazur changed his teaching at Harvard (physics), when he discovered his students really didn’t learn anything (just memorized). You can take a deep dive on that here. My point is not that a cheesy unmotivational speaker is good, but rather that most presentations done in a lecture format deliver far less educational value than methods that engage the learner. I get that you are a no-nonsense guy, and I really don’t want to hug people I don’t know either, but we can do better than a talking head and a PPT. (jp)

Watercooler Talk Tidbits

Readers funded the DonorsChoose grant request from first-year teacher Ms. P in Louisiana, who asked for math manipulatives and whiteboard supplies for her Grade 7-8 special education math class. She checks in, "Thank you for your support of my students in our classroom! Our class operates 2-5 years below grade level, but still needs to access seventh-grade material. With your help, our new math ‘toys’ have made a tremendous difference in their understanding and ability to conceptualize many abstract math practices. Thank you again for being a champion and cheerleaders for our class."

In Australia, Royal Adelaide Hospital comes under fire for spending money on memos instructing staff on how to open doors that don’t even appear to be new. The hospital made news in February after a software failure led to a power outage during two surgeries.

After being fired from the Texas Health and Human Services Commission for unspecified HIPAA violations, the agency mistakenly mails Tracy Ryans a box full of state assistance applications that include Social Security numbers, billing statements, check stubs, green card certificates and driver’s license copies. The matter has since been referred to the OIG, which is looking into any HIPAA-related transgressions.

California investigators attribute the capture of suspected Golden State Killer Joseph James DeAngelo to DNA samples and genealogical websites, though 23andMe, Ancestry.com, and MyHeritage have denied any involvement. Privacy experts have been quick to point out that law enforcement can access genetic information from these companies.

It’s all about perspective.

In Case You Missed It

• News 4/27/18
• EPtalk by Dr. Jayne 4/26/18
• HIStalk Interviews Kevin Fleming, CEO, Loyale Healthcare
• News 4/25/18
• Readers Write: How AI and Blockchain Can Combine to Benefit Population Health
• Curbside Consult with Dr. Jayne 4/23/18
• Monday Morning Update 4/23/18
• What I Wish I’d Known Before … Taking College Courses While Still Working Full Time

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