Weekender 1/24/20

Weekly News Recap

• Epic updates its software to include travel screening prompts for patients who may have traveled from China or who are experiencing symptoms of the coronavirus.
• Columbus, OH-based analytics company Aver raises $27 million in a Series C round led by Cox Enterprises.
• Judy Faulkner urges CEOs at some of Epic’s largest hospital customers to sign a letter to HHS Secretary Alex Azar protesting the proposed interoperability rule published last year.
• Consumer DNA testing company 23andMe lays off 100 employees as it struggles with declining sales.
• Epic decides to stop pursuing integrations with Google Cloud based on a lack of customer interest.

Best Reader Comments

Android permissions are a good example of one software provider using imprecise permission definitions to screw over consumers and other software makers. For example, I’m trying to copy a person’s name into an app on my phone. The app wants access to my contacts to do so; it might even request that access when I install the app. Many Android app vendors use this permission to vacuum up your whole contact list and sell it to others. You and the software developer that makes your contact list application can’t do anything about this without denying access to application data.

We need to prevent a similar situation with regards to health care data. Imagine you are trying to copy a lab to a telehealth app so that you can get a second opinion. The app requests access to your Mychart; you click Accept. It pulls all of your health information, labs, provider notes, tests, genetic information, etc. The telehealth company then sells this data to IMS. IMS has a breach and your health data floats around the internet.

HHS does not have the skills necessary to define this type of access or permission system. Certainly the proposed rules do not mitigate the dangers of the above scenario. If HHS can’t get a healthcare data security policy properly defined and enforced, what are they doing trying to force providers to share their application data with others? (Burgers)

Yeah, can’t wait till the architecture is opened up and I can place orders with my ordering app. Then scans with my imaging app. Then diet orders in my patients’ favorite diet tracking app. Maybe I can review them all in a new Review app! The future! (App for that)

Think about it – the big 2-3 EHR vendors are going to use the ‘security’ (fear/doubt) angle for ever to try and keep the oligopoly and ‘money printer’ they have today. This is a very expected play. They also know the architecture of what they’ve built is archaic and if the market opens up, apps/innovation will take over the provider and even patient user experience pretty rapidly. Just do a google search and look at the 1990s user interfaces that the big 2-3 still use today! Btw, the gigabytes of data we voluntarily expose each day is significantly more than the amount of healthcare data we obsessively try and protect. (Tom Jackson)

Government and Politics are forever part of health technology, however, I am constantly irritated with the government mandated monopoly granted to the AMA. I will go out on a limb to state that at some point the defense for Surescripts will raise the AMA situation and draw comparisons. It would be delightful to see that play out. (Bill O’Toole)

Watercooler Talk Tidbits

Citing health, safety, and security issues, the Department of Transportation proposes a ban on emotional support animals and restrictions on the types of service animals passengers can bring on board planes, limiting them to trained dogs. Association of Flight Attendants President Sara Nelson has echoed the frustrations of many a road warrior with her reaction: “The days of Noah’s Ark in the air are hopefully coming to an end.”

Simulation in Motion Montana brings hard-to-access training to remote clinics that would otherwise likely go without. The nonprofit’s three mobile training labs cover over 100,000 miles annually to offer rural healthcare providers training for scenarios like childbirth, trauma, pediatric overdoses, and sepsis infection.

Madison, WI landmark Ella’s Deli and Ice Cream Parlor closes after 41 years in business. Epic purchased the diner’s famous carousel along with other decorations and installed them in its lobby last year.

The Atlantic looks at the role military hospitals and the federal government play as medical debt collectors, recounting the story of an uninsured trauma patient who was taken to Brooke Army Medical Center in Houston because there was no better place to receive care. Described as “one of the most unforgiving debt collectors around,” the federal government can mete out punitive action to patients who need the biggest breaks, withholding wages, tax refunds, or 15% of a person’s Social Security income without a court order. Data from the Defense Health Agency puts civilian medical debt to military hospitals at $198 million.

Pediatric surgeon Robert Parry, MD has gained quite the following as a post-op bandage artist at Akron Children’s Hospital in Ohio. He explains his technique: “I use Telfa dressings (not an ideal art medium) and cut out the outline of the image freehand. Then I color it in using Sharpies. It doesn’t go directly on the wound — it’s protected by a Tegaderm (plastic) dressing. I’ve operated on more than 10,000 children, and all of them that needed a dressing got a drawing. From tiny newborns that weigh less than a pound to fully grown young adults. And I can’t recall anyone not enjoying it — no matter how old they are.”

@Farzad_MD clarifies an earlier tweet about Epic’s billboard placement in Washington, DC. Meanwhile, Politico reports that Epic CEO Judy Faulkner has said she might sue HHS if they move forward with publishing the interop rules she has so publicly objected to.

In Case You Missed It

• News 1/24/20
• EPtalk by Dr. Jayne 1/23/20
• News 1/22/20
• Curbside Consult with Dr. Jayne 1/20/20
• Monday Morning Update 1/20/20

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