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Monday Morning Update 9/24/18

September 23, 2018 News 8 Comments

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Memorial Sloan Kettering Cancer Center leadership defends itself to its employees following reports that it gave for-profit AI startup Paige.AI exclusive access to its 25 million pathology slides in return for an equity stake for itself and several MSKCC executives (in essence, profiting from the work of its pathologists and the property of its patients instead of by creating new intellectual property). The health system explains that:

  • It is sharing only de-identified patient data and not actual slides (note: the Paige.AI partnership announcement specifically says it gained “exclusive rights to MSK’s library of 25 million pathology slides” that are “accompanied by de-identified pathologic and clinical annotation”)
  • The relationship between its executives and the company was vetted for conflict of interest
  • Board members and faculty who received equity won’t participate in company decisions
  • They’ll kick back some of the proceeds to the pathology department

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MSKCC’s recent bad press – including unreported conflicts of interest by a since-resigned key researcher who was raking in drug company money and skepticism about its relationship with IBM Watson Health – add it to the list of health systems whose high-falutin’ patient care proclamations fail to hide the fact that it often acts like any other self-enriching business whose own interests come first. It paid its CEO $6.7 million (plus he gets a company house), its CIO $1 million, and its chief fundraiser $1.4 million, according to its most recent tax forms.

In case you missed it, sick and frightened cancer patients are a highly profitable widget in this country. As is typical in healthcare, nebulous consent forms allow their data to be sold to any willing buyer without their permission or benefit.

ProPublica notes that its report didn’t create the MSKCC Paige.AI controversy – it was MSKCC’s own pathologists who complained that their work had been taken for the benefit of top MSKCC brass. Surprisingly, they didn’t complain that Paige.AI’s business model requires the company to characterize the work of human pathologists as subjective, error-prone, and inefficient compared to allowing a computer to do their work.

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MSKCC’s former pathology department chair Marc Rosenblum, MD wrote the most brilliantly sarcastic internal email I’ve ever seen last month (subject: “Department: Fleece(d)”) in offering suggestions to hold a Paige.AI naming contest with stock options as a prize to “fully embrace the entrepreneurial tenor of our times;” to create a department logo to “trumpet where we’re going” that would look good on a Patagonia fleece; and to create a department fight song. 


HIStalk Announcements and Requests

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Poll respondents are skeptical about the population health benefits of the Apple Watch’s EKG recording capability.

New poll to your right or here: would you be OK with having your social media activities monitored for health research or to trigger personalized health improvement suggestions? I admit I’m fascinated by the human aspect of expecting an insurer to cover huge financial risk while denying them relevant information, which then goes back to the argument about universal healthcare, under which such lifestyle forensics would be unnecessary since the entire country would make up the risk pool. Life insurers are allowed to require medical exams, getting auto insurance involves having your pre-existing condition (driving record) examined initially to set premium prices and having that price jacked up (or the policy cancelled) following a paid claim, and all forms of business insurance (malpractice, cybersecurity, etc.) come with the expectation of allowing the insurer to assess their risk by inspecting sensitive records. Only with health insurance are we offended at the idea that insurers need to learn more about our health before agreeing to pay to maintain it, an expectation that has risen due to out-of-control hospital and drug costs in the absence of political will to address the issue.


Webinars

September 26 (Wednesday) 12:30 ET. “How to Ensure Patient Records are Always Available.” Sponsor: Goliath Technologies. Presenter: Goliath Technologies engineering staff. This webinar will discuss how an early warning system can help your organization ensure your EHR systems and patient records are always available. You’ll also learn how to proactively anticipate, troubleshoot, prevent, and resolve end user experience issues before users or patients are impacted.

Previous webinars are on our YouTube channel. Contact Lorre for information.


People

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Mazars USA promotes Gil Enos to leader of its healthcare consulting group.


Announcements and Implementations

Wolters Kluwer Health launches a new version of its Sentri7 clinical surveillance solution.


Other

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Researchers question whether it’s a good idea to apply Cambridge Analytica-type social media “digital phenotyping” to target people for population health interventions. They note that such activities incur the risk of public backlash (when social media users realize they’re being monitored and controlled) and having those users go underground by avoiding using words that all out their health-harming practices.

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An oncologist’s Wall Street Journal op-ed piece ponders the dilemma in which drug companies charge whatever high prices the market will bear irrespective of their actual research and manufacturing costs and the extent to which the drug improves an individual’s health, noting that the US is the only country that approves marketing of drugs without negotiating the allowed selling price:

The extraordinary cost of these treatments presents a tragic dilemma: We may soon have a miracle drug for cancer whose cost, when multiplied across the population that needs it, could bankrupt the country. Consider what would happen if the new drugs were used to treat 250,000 cancer patients per year—just 40 percent of the Americans who die annually from cancer. At $373,000 per patient, a Kymriah-type immunotherapy treatment would increase drug spending in the US by approximately $93 billion a year. This would mean an almost 20 percent increase in the country’s total annual drug spending—for just one drug. To put that figure in perspective, it amounts to $300 per American, or $500 if we include associated medical services.

Why we should have been lawyers: a Georgia jury awards the family of a baby whose penis was injured during a midwife’s circumcision $30 million.

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A fun Bleacher Report profile of Laurent Duvernay-Tardif, MD – who is also a right guard for the Kansas City Chiefs who signed a five-year, $41 million contract extension with $20 million guaranteed last year – reveals interesting facts:

  • He made good money at 12 years old selling pesto that he made himself, explaining that it had to be very good since “I wasn’t cute enough to get any sympathy purchases.”
  • His parents took the children on year-long sailing trips carrying only rice and canned vegetables to show them that money isn’t all that important.
  • The Quebec born Duvernay-Tardif graduated from McGill University’s medical school even though he spoke only French and all his classes were conducted in English, so he played lecture recordings at half speed while looking words up in a dictionary.
  • He was on call on NFL draft day, so he gave his phone to a nurse and asked her to say yes to any team that drafted him while he participated in an emergency C-section.
  • He is only the 10th player ever drafted by the NFL from a Canadian college and the first active doctor to be on a team’s roster
  • The NFL denied his request to add “MD” after his last name on his jersey, which he says is OK since “my name is Duvernay-Tardif, and it’s plenty long enough like that.”
  • He explanations the motivation required to master two difficult professions: “My biggest fear is doing nothing. When you start downsizing your expectations of what you can do with your time, it’s hard to go back. If I spend an offseason doing nothing, I don’t know if that drive will come back. That scares me more than anything.”

Sponsor Updates

  • Lightbeam Health Solutions launches the Pop Health Podcast with an initial episode on gaining patient buy-in for chronic care management.
  • MedData and Experian Health will exhibit at the HFMA Region 7 Conference September 26-28 in South Bend, IN.
  • Kansas State University’s College of Engineering names Netsmart its 2018 Company of the Year.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the CSO HIMSS Leadership Symposium September 28 in Cincinnati.
  • PreparedHealth will exhibit at the Regional DV-NJ Chapters HIMSS Conference September 26-28 in Atlantic City.
  • The SSI Group will exhibit at the HFMA South Texas and TAHFA Fall Symposium September 23-25 in San Antonio.
  • Surescripts and ZappRx will exhibit at the NASP Annual Meeting & Expo 2018 September 24-26 in Washington, DC.
  • TriNetX will host TriNetX Summit18 September 25-26 in Boston.
  • Vocera will exhibit at the Illinois Health and Hospital Association Leadership Conference September 25 in Lombard, IL.
  • Consulting Magazine names Huron a “Best Firm to Work For” for the second consecutive year.
  • Wellsoft will exhibit at Emergency Nursing 2018 September 26-29 in Pittsburgh.

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Currently there are "8 comments" on this Article:

  1. I give kudos to Laurent Duvernay-Tardif, but in fact he has not mastered two difficult professions. He has one profession, and playing football is not it. The word profession is overused.

  2. Thanks for calling me out on that, which is entirely appropriate since I’ve preached several times about people who appropriate the term “professional” to describe whatever endeavor someone pays them to undertake. My definition of a professional includes these criteria, of which a professional athlete meets none (unless their contract’s “moral character” clause is interpreted to meet the last one):

    a. requires profession-specific education
    b. requires ongoing profession-specific education
    c. involves licensure, certification, or other demonstration of competency to the public
    d. involves an oversight or regulatory body of similarly practicing peers
    e. involves a body of literature and research specific to the profession
    f. includes only those people who agree to follow agreed-on professional ethics

    • I think you’re being pretty harsh athletes. Using your metrics:

      a. Athletes are required to know a great deal about their sport, including detailed rules, plays, and history. Any professional athlete has a large amount of profession-specific education behind them.
      b. Sports are constantly evolving. Any athlete that doesn’t have an ongoing profession-specific education, including keeping up to date on rules, play styles, and movements from other teams, will soon find themselves severely behind the rest of the competition.
      c. Athletes demonstrate competency to the public every game they play.
      d. Every sport has oversight from player’s unions, owner’s groups, and the league itself.
      e. I’ll give you this one, as many athletes do not directly contribute to literature or research about the profession, although their data is vital to ongoing research about the sport.
      f. Every major sports league has a conduct policy that requires players to adhere to professional ethics. Some leagues (NFL) have pretty bad records of enforcing those standards, but that doesn’t make the players any less “professional.”

      Saying that athletes aren’t professional is just petty.

      • I’ll beg to differ. “Education” refers to specific academic training terminating in a degree and “demonstrating competency” involves external certification, both initial and ongoing (such as passing an exam, having professional experience vetted, etc.). “Oversight” refers to a body of peers who create and enforce professional behavior as defined by the profession itself. Saying someone isn’t a “professional” just means their job does not include these characteristics — it’s an objective assessment, not a subjective judgment (all doctors are professionals, by definition, while no CIOs are, but neither judges their character or capabilities). We’ve taken the term to be a vague compliment.

        Your A through C would apply to anyone who competently holds any job, which was the original poster’s complaint about using the “professional” label” when it doesn’t apply, though I acknowledge that the popular definition (as opposed to the correct one) makes everybody a professional just because they have a job. Using the word correctly isn’t petty — it’s an objective definition, not a slight. Based on the definition, the universe of professionals isn’t huge, and doesn’t include a “used car professional” or “nail care professional” no matter how good a job those people do.

        • You’re right, petty isn’t the right word. Deciding your definition of professional is the correct one instead of the definition used by the Oxford English Dictionary or the Merriam-Webster Dictionary isn’t petty, it’s conceited. I guess we can put Mr. HIStalk in the ranks of Shakespeare on the shortlist of people who get to define what a word means.

          By your narrow definition, I withdraw my complaint about athletes getting short shrift.

  3. “His parents took the children on year-long sailing trips carrying only rice and canned vegetables to show them that money isn’t all that important”….I don’t know of sailing trips that don’t involve serious money, especially year-long trips.

    He’s an interesting story, yet I do find while he tries to present humility and sincerity, I believe he may be a bit out of touch and potentially very impressed with self to not understand some other realities.
    So, he left an internship to play football? Residency? Board Certified?

  4. I think that you’re missing a completely separate path for being a professional and having a profession. In sports, the distinction is one of professional vs. amateur – and in this case, the profession is the activity vs. perhaps a hobby. For an athlete, a profession is merely what a professional does.







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