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EPtalk by Dr. Jayne 7/26/18

July 26, 2018 Dr. Jayne No Comments


The American Medical Informatics Association announces the launch of its Fellowship program (FAMIA)  for recognition of professional achievement and leadership in applied informatics. The FAMIA designation will be inclusive, recognizing physicians, nurses, pharmacists, and others working in the realm of clinical informatics. Fellowship candidates must demonstrate eligibility in education, certification, experience, AMIA membership, and AMIA engagement as well as through peer recommendation and commitment to future activity in clinical informatics.

I’m qualified except for the AMIA “engagement” part. I wonder if being the anonymous face of clinical informatics for thousands of readers would qualify under the “other contribution by petition” category? Applications close September 3 and require a $200 application fee.


New Medicare cards are on the way, with mailings complete in Delaware, the District of Columbia, Maryland, Pennsylvania, Virginia, and West Virginia. Patients in those states who haven’t received their cards can sign into www.MyMedicare.gov to confirm the mailing and print a card. I still get questions from practices that are confused about what to do when the new cards start coming in, so make sure your organization has a plan and that it’s well socialized.

Physicians who participated in the 2017 Merit-based Incentive Payment System (MIPS) program are now able to review their CMS-calculated scores and feedback reports. Penalties and incentives based on the data will impact Medicare payments for services rendered in 2019. Providers who have concerns about their performance data can request a targeted review from CMS. Common reasons for review include errors in data submission; physician eligibility issues; problems with the alternative payment model participation list; or issues with previous eligibility.


For a long time, my laptop would give me trouble when I tried to use the camera during conference calls, so I got in the habit of not using it. It’s probably a good thing, since my work-at-home schedule sometimes involved prolonged wearing of pajamas, followed by workout clothes, followed by wet hair. I did get my camera issues resolved and have been trying to make a point of having more of my calls with video.

I’m always worried I will do something dumb because I’ve forgotten that I’m on camera, but I’ve seen enough botched video lately to know that I probably look good by comparison. This week’s highlight reel: a call with someone who immediately got up from the computer and walked away, but insisted he was there reading the materials I was showing; camera angles that gave me a great view of one client’s nasal passage; and my favorite – someone trying to take a call from his boat, resulting in plenty of squinting against the sun and ambient noise from seagulls.

I was glad I wasn’t on camera for one call (the client doesn’t do video, so I don’t feel obligated to do it, either) because I am not sure I could have kept a poker face after hearing this quote from a newly-minted VP of operations: “I assigned this to you because I didn’t know who else to give it to.” I’m betting it didn’t build confidence among his new direct reports, so we’ll be doing some coaching on that approach later.

I was recently asked to provide a reference for a former colleague as she looks for a new position. Her hospital was acquired by a large corporate organization and the entire IT team was cleaned out. She’s applying at one of the only hospitals in our region that is still independent. I was surprised to receive a web link from the hospital, leading me to provide the reference through a short survey. It didn’t appear to really provide a mechanism to provide a peer reference vs. an employer one and gave no opportunity for narrative comment. I was forced to choose “yes” or “no” to a “would you rehire?” question despite not having been her supervisor.

I suspect that the HR department involved is just using these “references” as a check-the-box step rather than using them for actual content. It’s unfortunate, because she was great to work with and I think she would be an asset to anyone, but didn’t have a mechanism to share that information.


My office pre-books their order for flu vaccine as soon as our distributor will take it and requires all employees to receive vaccination as a condition of employment. Since we’re just about six weeks out from the start of the vaccination season, I was glad to see that the CDC’s Advisory Committee on Immunization Practices (ACIP) has included nasal flu vaccine in this year’s recommendations. There are quite a few people who are reluctant to have a shot but will accept the risk of a live (although modified) vaccine up their nose.

Last year’s flu season was particularly gruesome, and I hope we have an easier time this season. ACIP also delivered new guidelines on anthrax vaccine for post-exposure prophylaxis and updated recommendations on HPV, mumps, zoster, and pneumococcal vaccines. EHR vendors, start your engines – it’s time to update your logic. EHR clients should make sure they’re taking updates so that they have the best information available in their systems. I would estimate that more than half of the clients I work with don’t take regular updates to their systems unless they’re automatically applied in the background.

I was hanging out on a conference call the other day, waiting to figure out whether my client was just late or was going to no-show. I came across this site offering lab coats “for the perfect poise” that will ensure that “customers are enabled with confidence and grace through its sophisticated but classy appearance.” They ought to be pretty enabling since they start at $178 and run to $340. I found several other sites with pricey coats, and although they were more stylish than what I usually buy, given the things that are occasionally splashed on us at the office, I think I’ll stick with my $25 version.

I’m not sure whether it was worse for him to no-show or to have to endure the call I was on next, which featured an attendee who was doing the “I’m on two calls at once” routine but had the other call on speaker so that everyone else could hear it. Unfortunately I wasn’t the host and my client thought it was OK, so I was forced to play along. I still struggle to understand how someone can think they are able to meaningfully participate in two calls.


Given challenges in staffing and an overall nursing shortage, one hospital has come up with an innovative solution for staff retention. Pediatric nurses at Mercy Children’s Hospital can opt for a “seasonal staffing” program that allows them to work nine months out of the year but maintain their full-time benefits while taking summers off. The move addresses low census issues during the summer while expanding time off to travel or care for children out of school for the summer. Hospital leaders also hope it will allow nurses to recharge and return to work with “excitement for nursing.”

Having grown up as the child of a teacher, there’s something to be said for being able to have family adventures when school is out for the summer, even if there’s a chance your mom might want to leave you at a scenic overlook because you’re a grumpy pre-teen.

What’s your favorite childhood vacation memory? Leave a comment or email me.

Email Dr. Jayne.

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