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EPtalk by Dr. Jayne 2/20/20

February 20, 2020 Dr. Jayne 6 Comments


I’m all about the data, but I’m not happy to have been faked out by this year’s influenza numbers. We were lulled into a sense of hope by what appeared to be an early peak followed by a decline in flu cases, only to have a second (and higher) peak.

To date, there have been 26 million cases of influenza and 14,000 flu-related deaths, including 92 children. We’ve been seeing a lot of influenza pneumonia in the practice and I’ve just about washed all the skin off my hands. I hope we start to see the end of this soon. Everyone’s keyed up about COVID-19, but few average people are aware of how many people influenza kills each year.

I had a chance to connect with a colleague who lives in Taiwan and who was looking for in the trenches commentary on what people in the US think about COVID-19. He and his family have battened down the hatches for the most part and his children’s school is closed until the end of the month as a precaution. Fortunately, he telecommutes to a job in the continental US, so his livelihood hasn’t been impacted. He’s going to keep me posted from the man on the street perspective as the situation unfolds.

It’s definitely starting to get interesting at work, as we are having difficulty with supplies that typically originate in China, including masks, gowns, and other disposable sterile supplies such as staple remover kits. Fortunately, we have a good stock of standard surgical instruments that can be autoclaved for sterilization, so it’s just a question of shifting to that workflow. Nothing beats a good pair of precision surgical scissors from Germany, so I’m not complaining.

Based on the flu and COVID-19, I expect to see an increase in vendors at HIMSS selling supplies to keep the workplace safe, including washable keyboards, touchscreen covers, sterilization carts, and more. I haven’t received any mailings from them or invitations to any booth events, so if you’re in this part of the industry and you’re not strutting your stuff, you might be missing out. I enjoy touring all the booths that have practical items to promote and aren’t just full of buzzwords and the stuff of pipe dreams. If you have something cool for us to check out, drop us a line and let us know your booth number. We’ll do our best to make it by.


For a while, I was doing quite a bit of consulting around Patient-Centered Medical Home, so I spent a lot of time on the National Committee for Quality Assurance (NCQA) website. That business kind of died down and I drifted away, so I was happy to be drawn back by their involvement in the pursuit of Natural Language Processing. Their recent blog covers NCQA’s efforts to convene a NLP working group to help them explore how the technology can be used for quality measurement and reporting. The group includes representatives from Apixio, UPMC, and Wave Health Technologies.

The working group is focused on approaches to ensure that data generated from NLP is accurate. It plans to work toward developing a standard for validating NLP data. Since the working group is vendor focused, NCWA will be running parallel meetings with an independent advisory panel that includes NLP experts and researchers who will also weigh in on the potential validation model. I’ll definitely be keeping an eye on their work and how it might impact frontline clinical organizations.

I recently caught up with a vendor friend to talk about their strategy for the new Evaluation & Management coding guidelines that will come into play in 2021. The guidelines are designed to allow physicians to be paid without the onerous documentation they had to do in the past, which theoretically would allow vendors to tailor their clinical documentation to the actual clinical scenario rather than allowing physicians to bill at the highest level possible. I’m looking forward to not having to do more of a Review of Systems than is actually relevant for the visit and to writing notes that are closer to “Strep: Penicillin” than to the multi-page nonsense we generate today. I hope multiple vendors are looking at ways to make documentation easier as well as more coherent.

Time to “Ditch the Disk” in healthcare. Various tech leaders are encouraging the healthcare industry to move beyond CD-ROMs and make sharing images as easy as sending a text message. The task force meets every few months and looks at ways to improve the process. My organization burns an incredible number of discs every month and I’m sure they wind up in piles at patients’ homes, so I’m all for it.


I’m excited to report that readers are responding to my plea for pre-HIMSS shoe shopping tips. Apparently Jeffrey Campbell boots come highly recommended, with one reader noting “I have three of these…  I can even wear them with a broken toe.” That’s high praise indeed. I’m disappointed they don’t have them in my size in the red and blue snake pattern, because they’d be perfect for my upcoming trip to Washington, DC. A little bird told me you can sometimes find them on third party sites, so I’ll have to check them out. I definitely need something comfortable because I’m going to be hitting all the military memorials with a group of Honor Flight veterans.


Another reader recommends Irregular Choice, saying, “My artist sister is obsessed, and I am tempted to peruse their men’s section for the show floor.” I was completely blown away by their creations, especially the Muppets and Disney options. If I had an endless shoe budget, I could definitely go crazy there.

Good luck on your HIMSS prep. As usual, I’ll be on the lookout for the best reader footwear (both shoe and sock varieties). Will your shoes make the hall of fame or the hall of shame? What are your other favorite sites for awesome shoes? Leave a comment or email me.


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Currently there are "6 comments" on this Article:

  1. Hi Dr. Jane –

    If you can wear tennis shoes – check out HOKA. I ran wayyyy too much when I was younger and my knees don’t take it so well any more. But when I wear these (and run on astroturf at the park) I’m pain free. They’re extra cushion and performance design so if you’re going to be on your feet all day -https://www.hokaoneone.com/womens-view-all/

    WARNING – they’re not inexpensive so you may have to add laser hair removal to your practice, add retail vitamin sales, or go into orthopedics 😉 I’m cheap as all get out but they’re worth it for me and I can run a little bit again… My beautiful wife says we’re getting an elliptical and I guess I’ll get used to that too. https://www.hokaoneone.com/womens-view-all/

  2. Hi Dr. Jane –

    I can’t recommend shoes, but. . . the next best thing is a great pair of socks and we have lots of them. I wanted to post a pic of them but this email post won’t allow it, we will be at HIMSS wearing them. Let me know where I can send a pair to you:)



  3. I heard from someone in Thailand as well who said our church has changed church services on Sunday from 2 hours to 1 and that they aren’t to use the building for anything other than that 1 hour church service. He also said they cancelled some of the other regional events that happen every 6 months. Both out of an abundance of caution since I think he said there were only 3 reported cases in the country, but they do have a lot of chinese visitors.

    I’m working on the worst shoes category.

  4. Dr. Jayne: I am a Type 1 diabetic, so I use special extra-depth shoes prescribed by a physician, with custom inserts measured by a certified prosthetics consultant. The brand is called Dr. Comfort. You can actually buy non-customized versions of these shoes (without the custom inserts) via the Dr. Comfort website. They are moderately expensive, but still affordable. These are the most comfortable and durable shoes I’ve ever had, but there is not much of a fashion sense in this brand. Happy walking!

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