Monday Morning Update 7/13/20

Top News

A KLAS report on pediatric practice ambulatory EHRs names PCC as the clear leader.

PCC and Athenahealth scored well in product robustness and value.

The report says that PCC significantly outperforms other vendors in relationships with its personal approach, proactive support, and hands-on executive involvement.

Reader Comments

From Livongo and Prosper: “Re: CEOs. In 7.5 years as CEO of Allscripts, Paul Black has taken the stock from $13 to $6.50 per share with a $1B market cap. In one year, Glenn Tullman has Livongo’s stock at $108 with a market cap of $10B. Black helped push Tullman out and now Tullman is laughing all the way to the bank. How does Black still have a job?” I’ll offer these points in resisting the urge to oversimplify the situation:

• Tullman had Allscripts in a complete mess during the last few years of his tenure, including making questionable acquisitions, infighting with Eclipsys loyalists after buying that company, taking a snake oil sales approach to milking the Meaningful Use cow, fumbling clownishly over the MyWay EHR, claiming that the company’s science fair of acquired old products were integrated by definition since they all ran Microsoft SQL, and desperate suing its own customers and prospects that had chosen competing products.
• Black’s performance has been more measured, but not very inspiring or visionary. He, too, was at the helm during some major corporate gaffes, such as making a deal with equally desperate NantHealth, announcing but never actually selling the Avenel EHR, and buying Practice Fusion with the full knowledge that it was waiting for the DOJ hammer to fall for helping drug companies push opioids inappropriately. He’s made some potentially good decisions that have taken the company outside its core EHR business in hoping to avoid getting squashed by the Epic juggernaut and strong ambulatory competitors, but I can’t recall hearing anything all that exciting about TouchWorks and its stablemates in years.
• Livongo is surfing on a sea of employee health hype that it’s hard to see lasting forever, especially given the failure of similar companies to prove their value via unbiased outcomes studies. Tullman has deep experience in working the stock market, having taken Allscripts through a Series J funding round or something like that before going public, so he’s in his element as Livongo board chair.
• Black is better than Tullman was in always announcing something new that makes it hard to judge apples-to-apples quarterly company performance, usually an acquisition that promises fresh opportunities in some hot sector.
• Allscripts wasn’t much of an innovative development shop under either CEO and has exhibited little in the way of vision or passion.
• Tullman mostly stuck to EHRs and related technology during his Allscripts days, while Black favors buying distressed health IT merchandise to wring out a few drops of profit while hoping to sell the customer base something else.
• We don’t know how much of either company’s success is due to its highest-ranking executive. Neither Tullman nor Black were board chair of Allscripts while serving as CEO. Tullman is board chair at Livongo but not CEO. Nor do we know that Allscripts would perform any better under a different CEO who doesn’t control the board. You can do only so much while investors are staring you down quarter by quarter and most of your products are in mature markets that have strong competitors.
• My conclusion is that only some degree of a publicly traded company’s performance can be attributed to the CEO. Tullman was damaged goods after the board put the company out of its misery by firing him, but he has certainly made a better name for himself after founding Livongo, which surprised me.

HIStalk Announcements and Requests

It’s 55-45 on my poll asking whether it’s OK for an employer to fire someone for off-work action or social media posts that don’t result in legal charges. Commenters point out that free speech protection in the First Amendment applies only from the actions of government, not employers, and employers are free to send an employee packing for nearly any reason that doesn’t violate Equal Employment Opportunity requirements. My definition of “OK” was intentionally fuzzy since company reasons for termination can be equally so, but the bottom line is that people lose their livelihoods every day for reasons that may have little to do with job performance.

New poll to your right or here: Which of these activities have you performed on a mobile device in the past year?

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

People

Mick Brown (Change Healthcare) joins post-acute telehealth provider Third Eye Health as VP of strategy for health systems and ACOs.

COVID-19

The US has nearly 52,000 people hospitalized with COVID-19, approaching April’s peak of 60,000 and nearly doubling the June 15 count. Texas has 10,000, California 8,000, and Florida 7,000. Florida reported 15,300 new cases on Sunday. Deaths have finally taken a national upturn as expected from the case and hospitalization counts, now standing at 134,000. Nursing homes are once again being hit hard, with some reporting dozens of deaths and residents making up 40% of the COVID-19 deaths in Texas.

America’s push to get students back in school will be a global experiment since no other country has every tried to institute a return to campus during raging coronavirus outbreaks.

The White House reportedly canceled the scheduled media appearances this week of Anthony Fauci, MD after he disputed President Trump’s assertion that a lower death rate shows US progress, which Fauci he called a “false narrative” that could lead to complacency. Fauci says he hasn’t spoken to the President since early June.

Morgues in parts of Texas and Arizona are full and refrigerated trucks are being set up there.

The federal government sends an Army medical task force and HHS disaster response team to Houston.

Atlanta will reactivate a 200-bed COVID-19 field hospital at the Georgia World Congress Center after closing it in May after it had treated just 17 patients. The state has also contracted with Piedmont Healthcare to add 100 ICU and surgical beds to deal with the COVID-surge. Both actions came after health system CEOs urged the governor to help them continue their profitable elective surgeries. 

More than two dozen Mississippi state senators, its lieutenant governor, and its House speaker test positive for coronavirus after weeks of close-quarters meetings in which most or all of them ignored mask recommendations.

Intensivist Nick Mark, MD describes the problems with using the benign term “ICU capacity”:

• Critically ill patients go to the nearest hospital, so statewide figures mean little if the nearest available ICU beds are hundreds of miles away.
• Higher ICU census is associated with worse outcomes.
• ED boarding of patients waiting for ICU beds have an increased risk of death because EDs don’t have the staffing ratios and facilities needed for long-term patient care.
• COVID-19 patients need much longer stays than the ICU average of around three days, tying up beds for a long time and more likely to need ventilator support.
• ICU capacity is often calculated across all types of beds (medical, surgical, cardiac, burn, trauma, and even pediatric) and in some cases count PACU beds as ICU.
• Not all ICUs can provide interventions such as negative pressure rooms, dialysis, and ECMO and other interventions for acute respiratory distress syndrome.
• Step-down rooms can be “upleveled” into an ICU, but skilled staff will be in short supply. ICU staffing is based on an expected occupancy of around 60%.
• Burnout, PPE shortages, and healthcare worker infection are likely with expanded ICUs.

I missed this earlier: hospitalist and CMIO Dirk Stanley, MD, MPH lays out how to determine COVID-19 status from a patient’s EHR. Thanks to @CraigJoseph for tweeting the link.

Other

A former VP of finance for an Atlanta medical device packaging company pleads guilty to trashing the company’s computer systems after being fired, which he accomplished by using a phony logon that he had created beforehand. The company distributes PPE, shipments of which were delayed due to deleted data from its ordering and fulfillment systems.

Sponsor Updates

• Selling Power includes Nuance as a “Best Company to Sell for” on its annual list.
• PatientPing publishes a new e-book, “CMS’s E-Notifications CoP: The Route to Compliance.”
• Black Book Research publishes a new report, “Exploring Physicians’ Perspectives on How COVID-19 Changes Care.”
• Pure Storage publishes a case study, “St. Joseph’s Health achieves speed and reliability with Pure Storage.”
• Redox releases a new podcast, “The Digital Episode of Care with Bronwyn Spira of Force Therapeutics.”
• The Journal of Psychopharmacology publishes an article on a study of comparative rates of delirium of various types of AHTs that used real-world data from TriNetX.
• Vocera releases a new Caring Greatly Podcast, “Physician Suicide and the Impact of COVID-19 – Pamela Wible, MD.”

Blog Posts

• Put contact center technology at the heart of your customer experience (OpenText)
• Hospitals Need Secure Text Messaging-Plus to Support “Mobilized” Clinicians (PatientKeeper)
• Untapped Potential: Telehealth in Rural and Underserved Communities (PMD)
• The Challenge with Scaling Clinical Best Practices During a Pandemic (Premier)
• Overview of Nordic’s Patient Access Solution (Nordic)
• COVID-19 Has Transformed Healthcare – and Exposed Where More Change is Needed (Surescripts)
• CMS Offers MIPS Flexibility in Light of COVID-19 (WebPT)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.