Weekender 8/2/19

Weekly News Recap

• The VA opens director and deputy director positions to oversee its Cerner implementation.
• Meditech reports lower quarterly revenue and earnings.
• Cerner signs a partnership deal with Amazon Web Services.
• The country’s biggest technology companies reaffirm their commitment to healthcare interoperability.
• CMS announces a pilot project to display a patient’s claims data to Medicare fee-for-service providers.
• Surescripts says Amazon-owned mail order pharmacy PillPack accessed its patient prescription records without authorization and will turn the issue over to the FBI.
• Bain sells a majority stake in Waystar.
• Meditech celebrates the 50th anniversary of its founding this week.
• Kaiser Permanente hires its first chief digital officer.

Best Reader Comments

I’ve seen [inaccurate hospital patient records] more times than I can count. However the more the information gets used and the more visibility it has, you start to see incentives to clean up the problem. One of the strongest forces is when you see automation or analytical reporting, or any type of financial incentive. My standard line is, “no one cares about data quality so long as no one is using the data”. Also, we are very forgiving about data errors so long as only human beings are consuming that data and the data usage is transactional and episodic (e.g. a patient chart during treatment). As soon as you start comparing one patient chart to a bunch of other patient charts, in any systematic way, that changes. Eventually the Data Quality department gets involved, the line managers can’t justify or defend the bad documentation, nor can the clinicians, and some procedures to clean things up are put in place.It takes time but it’s a real thing. (Brian Too)

I’d like to understand how Cerner moving to AWS is innovative and “pretty disruptive.” (ellemennopee)

I’m not seeing the real value in the “Data at the Point of Care” project for any one provider. It appears that it only gives them data for Medicare FFS patients. Only about 60% of Medicare patients are still in FFS, and think about how any one provider’s patients come from a variety of commercial and public payers. Does it help provide better care overall if they can only use that data for a small percentage of their patient panel? Care is already delivered differently based on who the payer is due to network restrictions, coverage levels, and the payer’s unique quality measure requirements, does this just further that divide? Would be interested in providers’ thought. (SEH)

Interesting combo of news this week. Cerner encourages investors with their plans to boost earnings by selling patient data. Amazon’s PillPack and Surescripts scrap over access to patient medication data. Cerner announces partnership with Amazon’s AWS for hosting their customers’ systems. Hmmm, I wonder where my patient data is going to end up when I entrust it to a Cerner hospital? (YourRxAdsHere)

[Epic’s] implementation staff is green, inexperienced, and taught to walk the Epic Foundation line. They in no way have experience in a hospital, or in any sort of maintenance of the systems they implement … On the other hand, if I had to hire staff, I would hire any Epic employee in a heartbeat. They are hard workers, bright, and great presenters, I have nothing bad to say about any I have encountered. It’s their lack of true experience that bothers me. (IMPlement)

One of the reasons IT and hospital administration favor systems like Epic and Cerner is that they want to standardize across the health system. They don’t want an app to be able to come in and override their configuration. They want everyone in their system to be on the same software and they want one throat to choke for getting software to do what they want. This is especially true for the particulars of this period of time in healthcare, in which ensuring quality while reducing cost is on everyone’s mind. We aren’t designing aircraft or cruise ships or other innovative developments. We need good execution of the good ideas already out there at an attainable price. (WhoIsBuyingThat)

Watercooler Talk Tidbits

Readers supported the teacher grant request of Ms. D in Texas, who asked for math manipulatives  for her elementary school class following the devastation of Hurricane Harvey. She reports, “Thank you so much for all you gave to my class. The games and activities you helped bring into my class has already made such an amazing impact. We love to use them in centers and the students love to play with them, but most importantly, learn with them. Words cannot describe how much these items mean to us. We recently used the fraction cards and power pen to help compare fractions! The students loved being able to hear the sound it made when they got it correct. We will continue to use these amazing materials and games to help further their learning.”

An analysis of the Democratic presidential debates by the executive editor of the liberal magazine “The American Prospect” says the candidates are ignoring and misrepresenting the top issue of voters, which is healthcare:

It’s a very strange situation for the leaders of reforming healthcare in America are too cowardly to talk about what’s wrong with healthcare in America. We know from experience that trying to play a savvy game and keeping the hospital industry on the sidelines won’t work. The hospital industry cut a deal with President Obama to eliminate the public option last time around. They’re already funding the effort to destroy reform this time. Why won’t anyone say this out loud?

Healthcare in America costs too much. We’re having a debate over how to fix it that renders invisible the very actors who charge the prices. That’s a recipe for disaster. Someone must show a modicum of guts and describe this system as it is, before it consumes us all. So far, guts are not in evidence.

A retired doctor in Ohio gets the attention of the President when his daughter’s back surgery results in an $18,000 bill for urine drug screening that had been sent to an out-of-network lab, the same test that would have cost $100 if performed in-network. He says he is “ashamed of my profession” and notes that “almost all medical bills are paid with someone else’s money.” A Houston pain management doctor owns both the surgery center and the lab.

Missouri’s medical board places Russell Imboden, DO on probation for prescribing drugs to himself, ordering unnecessary lab tests, and treating patients with serious medical conditions with chicken bouillon, protein shakes, and controlled substances from his “cell-based regenerative medicine” clinic that focuses on “metabolic and age management medicine.” He was previously fired from a similar clinic operated by another DO that sells energy drinks, medical weight loss, homeopathic remedies, and libido enhancement.

An oral surgeon sues an anesthesiologist who supervised his Brooklyn Hospital residency for sexual harassment, claiming that the woman groped him during surgery, threatened to kill him and his mother, waved a syringe at him, and sent him messages that included text such as “How would you like my dead body on your doorstep?” and “How long do you think it takes someone to bleed out?” Pik Lee was served with a protection order and arrested, but Francisco Sebastiani says she caused his firing after he complained and then gave him a bad recommendation that lost him a residency bid.

The new Miss England starts her NHS medical residency hours after winning the pageant. India-born Bhasha Mukherjee, MBBS, age 23 – whose family moved to the UK when she was nine — will move on to the Miss World competition. She says,

Some people might think pageant girls are airheads, but we all stand for a cause. We’re all trying to showcase to the world that actually just because we’re pretty, it doesn’t end there. We’re actually trying to use our reach and influence to do something good … I couldn’t tell if I was more nervous about the competition or about starting my job as a junior doctor.

An East Cleveland, OH car mechanic whose high school GPA was under 2.0 and whose family includes two young children at home graduates from medical school this year at age 47 and is doing an emergency medicine residency at Cleveland Clinic Akron General Hospital. The ED chair says of Carl Allamby, MD, “He’s got people skills most doctors don’t start out with, that customer relations mentality from his years in business. We were blown away by him.”

In Case You Missed It

• News 8/2/19
• EPtalk by Dr. Jayne 8/1/19
• News 7/31/19
• Curbside Consult with Dr. Jayne 7/29/19
• Monday Morning Update 7/29/19

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