Giving a patient medications in the ER, having them pop positive on a test, and then withholding further medications because…
Monday Morning Update 5/11/20
Top News
From the Allscripts earnings call, following a Q1 report in which the company fell short of analyst expectations for both revenue and earnings:
- The company’s 22 Virtual HIMSS sessions drew 900 registrants.
- Virtual visits conducted with FollowMyHealth’s telehealth platform went from no demand to 70,000 visits in April.
- The virtual visit platform is licensed on a per-provider, per-month model, with President Rick Poulton explaining that patients are seen by their own hospital-provided doctor instead of “whoever happens to be hanging out on a couch that day.”
- 500 researchers have applied for access to its Veradigm COVID-19 research database.
- Its CarePort care transition system has tracked the care of 22,000 COVID-19 patients across settings, with early findings indicating that 10% of middle-aged hospitalized patients who are diagnosed with COVID-19 die .
- Allscripts estimates that the pandemic impacted its Q1 revenues by $7-10 million, from both lower volumes and delayed purchase decisions, and otherwise the company would have met its revenue guidance.
- Memorial Sloan Kettering Cancer Center is among the health systems that have extended their inpatient system agreements at a total value of $100 million.
- The company eliminated $75 million in annualized costs via layoffs in late March through April.
- Allscripts is reviewing its product lines to see if any non-core businesses should be sold.
- The company doesn’t expect to spend capital on acquisitions any time soon.
MDRX shares closed up 9% Friday, returning the company’s market cap to just over $1 billion. They are down 38% in the past year versus the Nasdaq’s 14% gain.
Reader Comments
From CPAhole: “Re: contracts. I’m interested in how companies and providers will change their agreements after this pandemic. The typical force majeure clause just doesn’t cut it here.” I’ll run a survey for vendors and customers to describe any changes they’ll make to agreements going forward to address issues that the pandemic has exposed — like providers being unable to pay their bills, vendors being unable to perform on-site services, or companies protecting themselves in pre-acquisition due diligence. The rarely invoked, usually boilerplated force majeure T&C will undergo new scrutiny and legal tests as pandemic-driven economic issues force vendors and customers into uncharted territory, like HIMSS citing that clause in refusing to issue HIMSS20 exhibitor refunds.
HIStalk Announcements and Requests
The idea of using tech-powered contact tracing to control the coronavirus takes a hit from last week’s poll. Two-thirds of readers (who are heavily involved in healthcare and technology) say they won’t use the Apple-Google app right away, echoing the likelihood that the US won’t see anywhere near the 60% adoption that is required for effectiveness.
New poll to your right or here: Have you been tested for active COVID-19 infection?
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Listening: Michael Kiwanuka, the British singer-songwriter who provides the haunting opening theme to “Big Little Lies,” which we’re watching on Prime Video. It’s the perfect spacey, mysterious intro to a show set on and around the beaches of Monterey, CA. It’s just as connected to the series as the use of Cecelia Krull’s “My Life Is Going On” on “Money Heist.”
Webinars
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.
Acquisitions, Funding, Business, and Stock
Atul Gawande, MD, MPH will resign as CEO of Haven Healthcare and move to a less-operational role as chairman, insiders report. The Amazon – Berkshire – JPMorgan company, which has had minimal healthcare impact since its splashy debut in January 2018, is searching for a new CEO as Gawande’s interests refocus on coronavirus policy and advocacy work. Haven COO Jack Stoddard resigned last year after nine months on the job and was not replaced.
Livongo reports Q1 results: revenue up 115%, EPS -$0.06 vs. -$0.79, beating Wall Street expectations for both. The company said in the earnings call that it has been selected by the Government Employee Health Association that provides medical and dental plans to 2 million employees. LVGO shares are up 42% versus the Nasdaq’s 11% rise since the company’s July 2019 IPO, valuing it a $5 billion. Executive Chairman Glen Tullman owns shares worth $344 million, while CFO Lee Shapiro’s holdings are worth $302 million.
Sales
- Willis-Knighton Health System (LA) chooses CloudWave’s OpSus Healthcare Cloud for hosting its Meditech Expanse system that is being implemented.
People
Nordic promotes John Manzuk to SVP of managed services delivery.
COVID-19
A New York Times report finds that virus-wary Americans had already slowed their spending, traveling, and dining out before lockdown orders were issued, raising the strong possibility that state re-openings won’t restore the pre-pandemic economy as businesses and potential customers remain unconvinced that it’s safe to conduct person-to-person business.
FDA Commissioner Stephen Hahn, MD, NIAID Director Anthony Fauci, MD, and CDC Director Robert Redfield, MD are self-quarantining for 14 days after being exposed to Vice-President Pence’s spokesperson Katie Miller, who has tested positive for COVID-19.
The Department of Justice charges Henry Gindt II with selling stolen COVID-19 test kits directly to patients for up to $200 through his YouHealth website, then failing to provide the test results. Gindt’s LinkedIn says he was a co-founder of President Trump’s Office of American Innovation, where he says, “Key wins included combining the electronic medical records (EMRs) of Department of Defense and VA employees and soldiers.”
A researcher identifies what he says is a flaw in India’s government-mandated COVID-19 contact tracing app – which uses both GPS and Bluetooth — that allows him to identify the location of all infected users. The government requires all employees and military members to use Aarogya Setu, as well as people who live in containment zones and those who are returning from other countries. The app presents a chatbot-powered symptom checker and travel history questionnaire and health authorities track answers in a database and contact those who might be infected.
NYC Health + Hospitals investigates ED nurse Lillian Udell, who recorded her co-workers talking about shortages of PPE. The health system says she violated HIPAA even though no patients were shown. Another nurse whose PPE pleas on “60 Minutes” earned the praise of the hospital’s president said of Udell’s case, “I feel like a lot of hospitals are using HIPAA almost under the guise of patient protection and safety, and privacy safety. But really it becomes more apparent to me, at least, that HIPAA is kind of being used to gag people. We’re all experiencing the most difficult working conditions we’ve ever faced. And everybody who is speaking out is doing so to advocate for patients, ultimately. It looks like hospital administrations tend to run to HIPAA for their protection, not so much patient protection.”
Other
Kaiser Health News notes that at least half of the top 10 recipients of HHS’s emergency provider funding have either paid criminal penalties or settled billing fraud charges in the past. Florida Cancer Specialists & Research Institute, which hasn’t started paying its recently imposed $100 million federal penalty for anti-competitive practices, got $67 million in federal bailout money. Experts observe the irony of health systems being paid at rates that are based on their Medicare billing when they were also accused with falsely inflating their Medicare bills through fraud and abuse. Other health systems that are in the top 10 that have paid to settle fraud charges are Dignity Health, Cleveland Clinic, Memorial Hermann, and Mass General.
A display company in Colombia offers small hospitals an $85 cardboard patient bed that, if the occupant dies, converts to a casket.
Sponsor Updates
- PatientKeeper supports healthcare workers at Portsmouth Regional Hospital.
- MDLive reports significant growth of its behavioral health business as its virtual therapy service provides safe, timely access to care during the pandemic.
- Clinical Computer Systems, developer of the Obix Perinatal Data System, releases a new edition of its Critical Care Obstetrics podcast, “Sepsis Simplified.”
- RxVIP Concierge offers CareSignal’s COVID Companion text-messaging app through its new “Stand Up to COVID19” patient initiative.
- Relatient joins the Cerner App Gallery with mobile-first self-scheduling and waitlist solutions.
- T-System offers DrFirst’s telemedicine software to its urgent care and emergency department customers.
Blog Posts
- Request telehealth and COVID-19 lab payer matrix (Nordic)
- Healthcare’s COVID-19 Recovery Plan is Beginning to Take Shape and Patient-Friendly Tech is Center Stage (Loyale Healthcare)
- Recognizing the not-so-everyday heroism of nurses (Meditech)
- Nurses Week 2020: Perspectives from two nurses (Spok)
- The Healthcare Analytics Adoption Model: A Roadmap to Analytic Maturity (Health Catalyst)
- Why Patient Identity Management Matters Now More Than Ever (NextGate)
- Creating a Successful Virtual Care Platform (Netsmart)
- How long will providers be able to tap into CARES uninsured reimbursement benefit for COVID care? (Experian Health)
- ONC Final Rule Addresses Concerns with Requirements, but Only Provides 6 Months to Comply. (Pivot Point Consulting)
- 5 Warning Signs Your Answering Service Might be Hurting Your Practice (PerfectServe)
- CMS Hospice Relief (QliqSoft)
- What April’s Consumer Search Behavior is Telling Us About Coronavirus & How to Prepare for Recovery (Kyruus)
- How to request and offer help when capacity demands change. (Redox)
- Why Identity? (SailPoint)
- Interoperability Creates Healthcare for (All) the Ages (Surescripts)
- The Power of Virtual Patient Connections During COVID-19 (Vocera)
- Communication: The Secret to Staying Viable in Uncertain Times (WebPT)
Contacts
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How can anyone believe this line? “Our first quarter results show continued strength in new bookings, which reflects the confidence our clients have in our solutions,” commented Paul M. Black, Allscripts Chief Executive Officer. Bookings were down from $286MM to $205MM. This is a sinking ship although they do have a few loyal customers
Could not agree more. Allscripts went from rudderless under the former founder to below the water line under Paul Black’s “leadership”. Their attempt to pretend to be relevant , purchasing absolute scam companies, NantHealth , a pathetic use of a “sad puppy” close promising their new and Industry first AI product to be released soon if clients would stop leaving. Several years later that product could only be given away to an existing client. Their client base is hostage based and not NEW.
Ah, that scammer selling fake #COVID-19 tests. Guy says he founded “Trump’s Office of American Innovation”. Given the caliber of people in the administration, I ask you, how unlikely is that?
Hospital systems have invoked HIPAA and patient privacy protection for years. First to stall sharing of data across competing systems, then to keep it from patients as patients might release it to wild, or in recent case, nefarious 3rd Party apps, re the new interop rules.
And now this, to keep frontline healthcare workers from expressing their concerns about inadequate supplies of PPE.
Is there anything administrators at health systems won’t use HIPAA for to protect their own self interests?
RE: Haven. Could it be that healthcare is a much harder nut to crack than what Amazon, JP Morgan, and Berkshire care to admit? I am not saying that we cannot get better at delivering care and reducing costs, as that is obvious. However, how many more outside healthcare initiatives will we endure to get to the same result? Asking for a friend.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a ubiquitously overused excuse for inaction and unwarranted “privacy” protection. And it is definitely a favorite blocking tactic of hospital administrators, especially witless ones. I have been told at my bank and grocery store that rule or policy was for preventing a potential HIPAA violation. Just for giggles, I generally ask the earnest clerk/cashier: “Who is the covered entity in question?” or “Which of the 18 protected health information identifiers are being exposed?” When they admit they don’t know what I am talking about, I explain that they obviously do not understand the HIPAA law.
Out of morbid curiosity, I clicked the link to see what “NYC Health + Hospitals” is claiming violated HIPAA in the recording that ED nurse Lillian Udell’s shared with the on-line news source “The Intercept”. Unbelievable. One of the interviewees mentioned a fellow fallen nurse who was also a patient. The statement was: “If we had the government behind us, to provide us the resources that we need, I think Ms. Ocran would probably still be alive.” That statement is directly followed in the recording by CBS news footage that uses Ms. Ocran’s full name. Her family had already given interviews (and presumably permission to use her name) to CBS and the New York Post. The Washington Post published a profile on Freda Ocrans on May 2, 2020. Clearly, this ER nurse did not violate patient privacy. SMH