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January 3, 2019 News 6 Comments

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Alphabet’s life sciences company Verily —  the former Google Life Sciences — raises $1 billion in a new capital funding round.

CEO Andrew Conrad says that the money will prepare the company to “execute as healthcare continues the shift toward evidence generation and value-based reimbursement models.”

Some of Verily’s projects include smart contact lens, continuous glucose monitors, development of bioelectric medicines, hand tremor reduction software, retinal imaging, surgical robotics, healthcare performance measurement, risk prediction models for chronic disease management, and precision medicine.


Reader Comments

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From Dr. Demento: “Re: Annals of Internal Medicine article on machine learning and inequitable treatment. I’m wondering how you’ll respond to these, especially the editorial.” The article says that because machine learning analyzes historic data, it will perpetuate longstanding health disparities that are based on racism and classism, an issue that has arisen in other areas such as trying to predict which citizens are likely to commit crimes. The article provides a healthcare example of using ML to predict patient deterioration, which might underrepresent African American patients who were treated differently, or discharge care planning that might place too much emphasis on patients from high-income ZIP codes since they have more control over discharge conditions such as transportation, home meds, etc. I see the potential problem, but all aspects of life contain certain assumptions and biases and it’s asking a lot of a machine to somehow iron them out even though we ourselves are usually unaware of them. There’s also the issue of whether a machine is being “unfair” when it makes observations that may or may not need to consider social determinants of health instead of simply making a recommendation that works for most people. I’m all for being aware of these issues and fine-tuning the algorithms accordingly, but ML has to reflect an inherently unfair reality (see: Flint’s water crisis). I worry more about it drawing incorrect inferences because, like the humans that oversee it, the technology can’t always distinguish between correlation and causation. The bottom line is that humans should always be managing the machine, second-guessing it, and demanding transparency into how it arrives at its conclusions because we’re the adults in the room. Expecting a machine to be less biased than the human history it learns from is a nice idea and worth keeping in mind, but we’re probably a long way from making that the most important issue in machine learning.


HIStalk Announcements and Requests

HISsies ballots went out via email Thursday morning to readers who subscribe to HIStalk updates and have recently clicked the link to read new posts.

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I’ve lamented lately that healthcare providers rarely use electronic signature platforms such as DocuSign to process emailed forms, clinging instead to mailed paper copies and faxes. I received an emailed contract for a family event this week sent via ESign Genie – it’s just $8 per sender per month. It’s probably naive to think that just because providers could improve their own efficiency, delight their customers, and improve their records retention for just $8 per month that they will actually do so, but at least we customers know that if they don’t, they simply don’t care what makes life easier or better for us.


Webinars

January 17 (Thursday) 1:00 ET. “Panel Discussion: Improving Clinician Satisfaction & Driving Outcomes.” Sponsor: Netsmart. Presenters: Denny Morrison, PhD, chief clinical advisor, Netsmart; Mary Gannon, RN, chief nursing officer, Netsmart; Sharon Boesl, deputy director, Sauk County Human Services; and Allen Pendell, SVP of IS and analytics, Lexington Health Network. This panel discussion will cover the state of clinician satisfaction across post-acute and human services communities, turnover trends, strategies that drive clinical engagement and satisfaction, and the use of technology that supports those strategies. Real-world examples will be provided.

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


Acquisitions, Funding, Business, and Stock

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Medsphere acquires supply chain vendor HealthLine System a few weeks after raising $32 million that it said would be used for acquisitions.

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Epic expands sales to include dentists and life insurance and diagnostics companies as VP of Population Health Alan Hutchison says the company is “moving beyond the walls” as it seeks to create – and dominate – the single repository space for patient health data. Hutchinson adds that the company is also in talks with assisted-living and nursing home facilities.

Apple drags the stock market down after lowering revenue guidance, which the company blames on poor sales in China due to that country’s economic problems and its trade war with the US. Analysts noted that despite Apple’s blaming the Chinese economy alone, the market for expensive phones is falling apart everywhere and consumers are pushing back against the “Apple tax” in which they faithfully line up every year to pay a premium for a commodity product. AAPL shares dropped 10 percent Thursday and the company is now a long way from its recent trillion-dollar valuation, as share price has dropped nearly 40 percent since early October.

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Jvion raises a growth equity investment of an unspecified amount, led by JMI Equity. The Atlanta-based company, which last raised $9 million in 2016, seems to have evolved from a coding optimization and analytics vendor to “the market leader in healthcare AI.”

Good news for patients already scrambling to pay for outrageously priced meds: Pending regulatory approval, Bristol-Myers Squibb will acquire Celgene in a $74 billion deal that will combine two of the nation’s biggest pharma companies.

HIMSS forms a media partnership with FindBiometrics, a publisher of biometric ID solution news.

A fascinating ProPublica article looks at the forced “retirement”of older employees, noting that more than half of American workers over age 50 leave jobs because of their employer’s decision, not their own, imperiling their financial planning for retirement. Notes:

  • Only 10 percent of those older employees who are pushed out find a job paying the same or more
  • Both employers and employees use the term “retirement” to save face
  • Companies pitch long-term benefits such as 401Ks and promotions even though they know full well most employees will never benefit from them
  • Employers can force older workers out the door by changing their job responsibilities, pay, hours, work locations, or annual review expectations
  • Employers use “stealth layoffs” of early retirement and eliminated positions to replace older workers with younger, cheaper employees or to offshore their jobs
  • Federal protections have been cut way back as companies – many of them publicly traded and desperately trying to prop up earnings – have made pleas to “remake their workforces”
  • Employees who refuse to relocate for job opportunities are often cast aside for more eager co-workers
  • IBM is an example of layoffs, forced retirements, and mandatory relocations that push older workers to leave – not just of those who make more money, but to skew the mix younger by ditching older workers
  • Companies intentionally skirt age discrimination laws by forcing job applicants to list their education dates (as a proxy for birthdate), hoping to avoid the high insurance premiums and perceived lower productivity of older workers
  • The article concludes that older workers need to keep up their learning (especially technology); network instead of wasting time chasing online ads; save money under the assumption that their entire earning career could be limited to the 30 or so years after college and before being forced out of the job market; and to avoid waiting too long to work for themselves instead of for someone else

People

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Zac Jiwa (MI7) joins The Karis Group as president/CEO.

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Best Buy promotes Asheesh Saksena to president of its new health division, which will focus on technology and services to help seniors age in place. The company acquired senior-focused mobile device and emergency call service company GreatCall last October for $800 million.

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NLP software vendor Talix names Bob Hetchler SVP of sales and Eileen Rivera VP of marketing. Both come from Ciox Health.


Announcements and Implementations

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Mercy Health Network selects PatientPing’s real-time patient notification service for its ACO members in Iowa.

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Health Level Seven International publishes the FHIR Release 4 standard.

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KLAS publishes Part 1 of its overview of population health management technology, noting the “good product, good relationship” vendors above and listing the weak partners as Allscripts, Athenahealth, and Philips Wellcentive. HealthEC is the only vendor KLAS calls out as excelling at providing strategic guidance. HealthEC and Health Catalyst finished tops for helping healthcare organizations negotiate value-based reimbursement contracts, while Forward Health Group finished best in ongoing optimization and training. Philips Wellcentive and NextGen Healthcare slipped year over year after acquiring their respective products, while Allscripts and Athenahealth haven’t met customer functionality expectations.


Privacy and Security

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HHS publishes cybersecurity guidelines for managing threats and protecting patients, plus technical resources and templates for healthcare organizations of varying sizes.


Other

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An NHS provider’s tweet lamenting a string of no-show patients goes viral in England, prompting many to suggest that patients be fined for missing appointments. NHS data show that missed appointments cost the national service $273 million each year and result in over 1 million wasted clinical hours.

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Nurses at Intermountain Medical Center in Utah comfort grieving families with printouts of their loved one’s last EKG enclosed in a tube with a note that reads, “May my heart be a gentle reminder of the love I have for you.”

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Eric Topol, MD pokes fun at the hype surrounding wearables, a timely observation given the many people who will likely spend the next few weeks addicted to their devices as they struggle to maintain what will soon become short-lived New Year’s resolutions.

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This question never seems to go away – is it OK that Epic (reading between the lines here) has a reputation of bringing its legal muscle to bear on anyone who uses a screenshot of its software in an research article, especially if the screen in question was built or customized by a customer? Epic, despite being full of nice people most of the time, is somewhere between rigorous and paranoid in sending the lawyers after anyone (even a customer) who says or writes basically anything about Epic’s contracts, products, project management methods, training materials, or documentation outside of an Epic-controlled environment. If you have experience with this as a provider either way, let’s hear your story.

A couple sues OB/GYN John Boyd Coates, MD after discovering that he, rather than an anonymous sperm donor, is the father of their 41 year-old daughter. The discovery came to light after their daughter received results from a consumer genetics test. Coates delivered the baby girl himself in 1977.


Sponsor Updates

  • ROI Healthcare Solutions publishes its 2018 highlights.
  • Cerner adds prescription pricing and benefit information from CoverMyMeds to e-prescribing workflows within its EHR.
  • Healthcare Growth Partners publishes its December Health IT Insights.
  • Nordic posts a podcast titled “Preparing for changes to value-based care reimbursement in 2019.”
  • AdvancedMD publishes a case study featuring Surgical Specialists of Jackson (MS).
  • Atlantic.Net announces GA of its Windows Server 2019 Datacenter Cloud Serve OS for use in its Public Cloud.
  • Datica releases its new book, “Complete Cloud Compliance: How regulated companies de-risk the cloud and kickstart transformation.”

Blog Posts


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Currently there are "6 comments" on this Article:

  1. re: Epic screenshots. I used an Epic screenshot at an academic conference a year or two ago , and didnt realize I needed to clear it. A few weeks after the conference, I heard from our Epic rep who asked me to remove the screenshot from my slides that were up on the conference website. She was very polite, helpful and clear in explaining the policy, and there were no threats. I took the screenshot down so not sure what would have happened if I had refused.

    Of note, I was at a different conference a few years back and Karen DeSalvo (when she was at ONC) was in the audience. The speaker said that they couldn’t show screenshots because the vendor wouldn’t permit it (it was obviously Epic). Dr. DeSalvo asked about that during the questions and said she was going to investigate if that was legitimate or information blocking.

  2. Epic with little to no data management tools or know how is going to integrate multiple domains of data. Sounds like more vaporware.

  3. Epic doesn’t have an IP leg to stand on for the screenshot restriction, but I believe they started putting this into their contracts a while back that the organization wouldn’t allow it from their employees, and it probably hits their “good install” metrics if they do.

  4. Epic screenshots and tangent markets…
    The screenshot issue is ironic. As I recall around 2000 Epic settled (for millions $$)
    a lawsuit that IDx had filed against them which stated Epic had stolen screenshots and documents from the UW Medical foundation.

    As for Epic moving into tangent markets for LTC, mental health, etc. It will be very interesting to see how they go about this. Develop or buy? Considering that there are many successful vendors that ‘own’ these markets they sure do not have the time to develop…so will they break-down and buy? Secondly I think that the sales argument that the organization will want to buy from a single vendor will not carry as much weight as it did selling within the hospital.

    Or, maybe they can accelerate their development by ‘borrowing’ an LTC/behavioral vendors screens! If your a vendor in these markets with a master client that runs Epic…better lock it down.

  5. Epic protecting their screen shots . . . irony indeed. I know that Epic copied a complex screen layout field for field from a smaller niche competitor in order to try to steal the customers. There’s no way they came up with the same design on their own. They’ve been replicating that same vendor’s functionality piece by piece over the years.

  6. Re: “…provider’s tweet lamenting a string of no-show patients…”

    My patience and sympathy for gripes concerning No Shows is sharply limited. OK, yeah, it’s socially poor form and it has economic and medical consequences. I’ve now observed the social niceties of Medicine.

    Yet when those same providers are asked to explain, justify, or even quantify wait times, they cannot. Or will not. Or we receive a long list of excuses as to why the poor on-time performance of clinicians exists. With no solutions offered, not ever. Can anyone say they have not waited in a reception room, for an appointment that didn’t start on time? Often by an hour or more?

    The NHS had solid data on the economic dollar value and the wasted clinical hours. Now ask them what the economic dollar value and wasted citizen hours are of appointments that didn’t start on time. Do I hear crickets? What about Adverse Medical Events caused by appointments that were postponed? Haven’t we all heard of incidents where even getting an appointment takes an astonishing lead time? More crickets?

    I’m not picking on the NHS either, this problem seems to be extremely wide-spread. Clinicians like to argue these issues when it puts them in a good light. Put the shoe on the other foot and suddenly they are running for the exits.

    What I’m saying is, arguing this entirely from the Clinicians point of view weakens and degrades the credibility of the point. If you want credibility regarding No Shows, you had better discuss what the patient experience is too.







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