"HHS OIG rates HHS’s information security program as “not effective” in its annual review, the same rating it gave HHS…
News 8/12/20
Top News
Providence-owned Providence Services Group acquires Meditech-focused consulting firm Navin Haffty.
Providence had previously acquired Meditech hosting and services vendor Engage, which will allow the combined companies to offer consulting, service desk, application support, staff augmentation, and technical services.
Providence also owns Epic consulting firm Bluetree and runs an Epic Community Connect hosting business.
The health system said last year that it planned to create a $1 billion business from its non-clinical investments. It has 51 hospitals, over 1,000 clinics, and 120,000 employees.
HIStalk Announcements and Requests
Listening: new from Deep Purple, not excavated from a 1970s music vault along with related artifacts such as Hammond A-100s and Gibson SGs, but rather offering a fresh-sounding entry in the barren wasteland of new hard rock. It will be a certain nose-scruncher for most folks who were raised on Auto-Tuned singer-dancers and hip-hoppers, but let’s see how those musicians hold up after 50+ years, 21 albums, and one original member left (72-year-old drummer Ian Paice, a much lesser figure than former members Jon Lord and Ritchie Blackmore). Just turn it up to 11 and hope you end up being a cool septuagenarian like these grandpas who can take you back if you’ve been, or take you there if you haven’t. The part at 2:13 is a dead ringer for Yes’s “Starship Trooper.”
Webinars
August 19 (Wednesday) 1:00 ET. “A New Approach to Normalizing Data.” Sponsor: Intelligent Medical Objects. Presenters: Rajiv Haravu, senior product manager, IMO; Denise Stoermer, product manager, IMO. Healthcare organizations manage an ever-increasing abundance of information from multiple systems, but problems with quality, accuracy, and completeness can make analysis unreliable for quality improvement and population health initiatives. The presenters will describe how IMO Precision Normalize improves clinical, quality, and financial decision-making by standardizing inconsistent diagnosis, procedure, medication, and lab data from diverse systems into common, clinically validated terminology.
Previous webinars are on our YouTube channel. Contact Lorre to present your own.
Acquisitions, Funding, Business, and Stock
Private equity firm K1 Investment Manager makes a significant investment in Rethink Autism, which offers a development disabilities platform that includes assessment, treatment planning, e-learning tools, analytics, and practice management. Rethink recently acquired pediatric therapy telehealth provider TheraWe. Rethink’s co-founders came from a company that provided labels and tags for the retail clothing industry.
Investors are noting that the combined market value of Teladoc and Livongo has dropped nearly $10 billion in the week since the former’s $18.5 billion acquisition of the latter was announced. Above is the one-year share performance of Teladoc (blue, up 188%), Livongo (red, up 212%), and the Nasdaq index (green, up 38%). It’s uglier over the past five days, where TDOC and LVGO have dropped 25% and 19%, respectively, since the announcement.
Sales
- New Mexico’s largest county will implement Netsmart’s CareManager for post-incarceration population health and care management.
People
Clearinghouse operator Jopari hires Tom Turi (The SSI Group) as chief sales and marketing officer.
Announcements and Implementations
Stanford University’s Stanford Center for Health Education launches “AI and Healthcare,” an online, four-course certification program that will be taught by its medical school faculty. Courses in the Coursera program include “Introduction to Healthcare,” “Introduction to Clinical Data,” “Fundamentals of Machine Learning for Healthcare,” and “Evaluations of AI Applications in Healthcare,” which are followed by a capstone project. The only cost specified is the $79 per course Coursera certificate fee.
Philips announces Virtual Care Station, a telehealth environment for public areas such as stores, libraries, and universities. The company developed the technology for the VA’s ATLAS program, which offers virtual clinics to American Legion and VFW posts.
Government and Politics
I wondered what happened to former Rep. John Fleming, MD (R-LA), who President Trump appointed to the newly created position of deputy assistant secretary for health technology in 2017. He seemed uncertain about the job when it was announced, initially stating that he was interviewing to become national coordinator, but then admitting, “I think it’s the same or a similar position – I really don’t know.” He apparently didn’t last long there – President Trump appointed him to become Assistant Secretary of Commerce for Economic Development in 2018, and then in March 2020 he was appointed Assistant to the President for Planning and Implementation. I can’t find any evidence that his former ONC position still exists. I interviewed him in January 2018.
Cerner VP of Strategic Growth Amanda Adkins, who took a leave from the company to seek a US House of Representative seat, wins the Republican primary and vows to defeat Rep. Sharice Davids, who is serving her first term. The healthcare platform of Adkins, a former state Republican party chairwoman, supports creating a national COVID-19 response plan and says the ACA is a failed experiment that increased cost. She says healthcare should be smarter, more transparent, and more affordable, but I haven’t seen her plan for achieving that.
COVID-19
Russia approves a COVID-19 vaccine that has not undergone widespread clinical trials and for which no Phase 1 and Phase 2 clinical trials data has been published, raising concerns that President Vladimir Putin may be placing national pride and political gain ahead of consumer safety. Another theory is that Russia is trying to goad the US into rushing its own vaccines to market or to confuse the issue following its rumored disinformation campaigns. Russia says it will start vaccinating teachers and medical workers this month with Sputnik-V, the name it chose for the vaccine that reflects the world’s surprise in October 1957 that the Soviet Union had launched the first artificial Earth satellite, which triggered a space race with the US.
Former FDA Commissioner Scott Gottlieb, MD notes that the US might get just one shot (pun intended, I assume) with a vaccine in a given season since it would be difficult to mount two vaccination campaigns in a short period. He says he would not take a vaccine like Russia’s that has been tested on only a few hundred people and says Russia is certainly not ahead of the US in that regard.
The New York Times questions whether federal government newcomer and FDA Commissioner Stephen Hahn, MD has the fortitude and political savvy to stand up for patient safety under White House pressure to release a COVID-19 vaccine quickly. Hahn is not allowed to speak to the press by phone without having HHS spokesperson and longtime Trump supporter Michael Caputo on the line. FDA has been criticized for delaying approval of alternative COVID-19 diagnostic tests after CDC’s were found defective, allowing untested antibody tests to flood the market with minimal oversight, and for granting emergency use approval – revoked three weeks later – for using hydroxychloroquine in hospitalized patients.
California public health director Sonia Angell, MD, MPH resigns for unspecified reasons, one week after the state reported that it had underreported new cases due to a technical issue with electronic lab reports.
Mexico’s high COVID-19 death count is understated because residents are justifiably afraid of hospitals. Mexico City’s hospitals report that 40% of patients who are admitted with confirmed cases die in house and half of those deaths occur within 12 hours of admission. People who die at home aren’t tested and thus aren’t counted as being among the country’s 53,000 COVID-19 fatalities, although Mexico reported 71,000 more deaths than were expected in the spring. President Andres Manuel Lopez has urged citizens to stay home and use religious amulets instead of going to the hospital, and 70% of people say they would not feel safe taking a loved one to the hospital, some because of conspiracy theories involving genocide and organ harvesting.
An eight-state review of COVID-19 cases in nursing homes finds that higher staffing levels – but not health inspection scores or quality measure ratings – are associated with fewer cases. I would be interested in seeing an expanded analysis that considers ownership since I would bet that for-profit homes, especially those owned by private equity-backed chains, fall short in areas like staffing levels and infection control.
One-third of polled Americans, including more than half of Republicans, say they would not take a free FDA-approved COVID-19 vaccine. On a slightly optimistic note, a 1954 survey about the then-new polio vaccine yielded about the same result.
A new study by Johns Hopkins Bloomberg School of Public Health finds that an area’s density (population plus employment divided by land area) isn’t the primary driver of COVID-19 infection rates – it’s the degree of an area’s crowding into tight spaces, such bars, restaurants, sporting and entertainment events, and beaches. The authors believe that while density increases the incidence of close contact that theoretically should increase infection rate, that isn’t the case because people who live in dense areas are better at social distancing and wearing masks. They also conclude that evidence does not exist to support the move of city dwellers and businesses to the suburbs to avoid COVID-19.
The beginning of the end may be near for the fall 2020 college football season as the Big Ten postpones all fall sports, with football to be played in the spring if at all. The other four Power Five conferences haven’t announced their plans, although insiders say the PAC-12 has also decided not to play and doubts that spring football will happen either.
University of Florida researchers detect live coronavirus in air samples taken up to 16 feet from hospitalized COVID-19 patients, raising the possibility of air-only spread, although the low viral quantities make it unclear whether people would likely become infected. The six-foot distancing recommendation assumes that only large droplets carry the virus.
Other
Epic delayed its mandatory employee return to campus after the county health department warned the company that “remote work” does not mean sitting alone in private, on-campus offices as Epic had interpreted. The health department told Epic that such action might violate the county’s order. They’ve asked Epic to justify why it needs employees to work from the office starting September 21, not mentioning the first wave of returnees that was to have taken place this past Monday or the 4,000+ employees that were already working voluntarily on campus.
In the Philippines, the government-owned universal health coverage insurer says the agency is losing $50 million per week due to corruption that is enabled by weak IT systems. The anti-corruption commission says that PhilHealth’s executives and employees are filing claims for non-existent patients, while hospitals are upcoding visits to obtain higher payment and are falsely claiming to be treating COVID-19 cases to obtain emergency funds. The agency denies charges that its executives pocketed $300 million last year.
Two former employees of Talkspace, which offers text messaging based psychiatric counseling provided by contractors, claim that the company mines session transcripts for marketing purposes. Other former employees say that the company, which was getting stung by bad app store reviews, asked employees to create fake positive reviews and gave them burner phones to avoid getting caught. Talkspace’s executives deny the claims. Some of its contract providers complain that the company advertises 24/7 therapy even though it tells them they can set their own business hours; gives users a “I need help now” button that therapists must respond to quickly to avoid having their pay docked; and advertises therapy services even though a former version of its user agreement made it clear that it offers a “therapeutic conversation” but not “therapy.” The company charges $260 per month for unlimited asynchronous message response or $396 with four live, 30-minute sessions.
Sponsor Updates
- Health Catalyst will participate in the virtual Verity Research HCIT/Services Conference on August 12, and the Canaccord Genuity Annual Growth Conference on August 13.
- BioWorld profiles the use of Saykara’s voice-enabled mobile AI assistant at MIMIT Health, which reports a 500% productivity boost.
- CareSignal and Innovaccer partner to combine population health data technology and deviceless remote patient monitoring.
- The Chartis Group promotes Laura Stearns to VP of talent development.
- Norway’s Directorate of Health relies on Everbridge’s Public Warning software to alert citizens traveling internationally to mitigate COVID-19 risks.
Blog Posts
- The Importance of Collaboration for Epic Implementations (314e)
- Reduce Operating Costs and Total Cost of Care with the Right EHR (AdvancedMD)
- Summer Reading Part 2: Creating harmony and reducing TCO in Imaging IT (Agfa Healthcare)
- Blueleaf Banter: Driving Cost Savings Through EHR Innovation (Bluetree)
- Curbing COVID-19-Related Alert Fatigue (Capsule)
- Henry Ford Health System’s Experience During COVID-19 Surge (CarePort)
- Bringing Speed and Accuracy to Practice Quality Reporting (ChartLogic)
- FHIR Patient Access: Health Plans Between a Rock and a Hard Place (Diameter Health)
- Data Analytics and the Fight Against COVID-19 (Dimensional Insight)
- National Health Center Week: Continuing the Legacy (EClinicalWorks)
Contacts
Mr. H, Lorre, Jenn, Dr. Jayne.
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I’m afraid that there is a serious error in today’s HISTalk. Yes, Deep Purple started in 1968 and yes John Lord is dead and Ritchie Blackmore is playing the lute at renaissance fairs BUT every Purple fan knows the real line up was the MK II line up of 1972-5 (Machine Head, Smoke on the Water, Made in Japan, et al) which then reformed in 1985. Ian Paice was in MK II as was bassist Roger Glover, but singer Ian Gillan is the classic Purple voice and sounds pretty good at 74! So 3/5ths of the classic lineup banging away nearly 50 years later. PS guitarist Steve Morse is a huge upgrade on Blackmore….
Oh no, I have made an even worse error! Deep Purple Mk II was of course 1969-73 when Gillan and Glover left
Has any beginner rocker NOT played “Smoke on the Water”? And Steve Morse is one of my favorite guitarists. I used to follow him with the Dixie Dregs, and saw him solo as the opener for the McLaughlin/Di Meola/de Lucia “Friday Night in SF” tour. The audience insisted that Morse play with the trio, and he didn’t disappoint.
“… and one original member left (72-year-old drummer Ian Paice, a much lesser figure than former members Jon Lord and Ritchie Blackmore)”
Not to mention Ian Gillan, who was Jesus on the Jesus Christ Superstar soundtrack.
Gillan technically wasn’t an original member, having joined in 1969 in the band’s second year as part of the Mark IIa lineup, but given that this configuration created “Machine Head,” I would count him also. However, I have some loyalty to the singer he replaced, Rod Evans, not only because Evans later made a really bad decision to cash in on the band’s name that got him sued and sent him out of the limelight to become a hospital respiratory therapy director, he rocked out for one of my favorite under appreciated bands in Captain Beyond, which had some former Iron Butterfly guys.
Blackmore was good in Rainbow, a nice stop midway along his journey from searing Deep Purple rocker to “wouldst milady fancy a turkey leg” Renaissance Fair lutey flutey noodling.
British rock and progressive rock is just amazing, I realize as I think about how many of those musicians and bands have stood the test of time.
Epic is a great company, like GE, Burroughs, Blockbuster etc. Unfortunately they are locked into a late ‘70s playbook which will not serve them well in a post COVID world.
While Epic is a great company, like GE, Burroughs, etc. they are locked into a late ‘70s playbook which may not serve them well in a post COVID world.
Grandpa, get off the computer
I don’t know whos’ m&a book was blank or how many rails they did, but that livongo deal? burnin’up the cash (sorry T-head fans). donors choose would have been the better bet.
Providence Services Group now owns two MEDITECH focused service organizations while Providence is in process of migrating multiple MEDITECH hospitals to Epic. Plus, Providence is large Epic client. So basically MEDITECH helps fund a large Epic client since NHA and Engage are two of its partners. Also, Will be interesting to see what happens when John Haffty decides to retire since he is the one that built the company and established the customer relationships.
The most surprising aspect of the Teladoc-Livongo deal is how investors and healthcare analysts don’t seem to understand the telehealth market. The walk-in or urgent care telehealth visit has a razor thin margin for telehealth companies. Almost 100% of the 50 dollar fee charged to consumers goes to pay the physician labor or pay for the ads. The market is national so any telehealth agenecy can join if they are willing to spend the ad dollars or offer slightly cheaper visits for a brief period as telehealth is uniquely price shop-able. On the other hand, your average physician is used to being protected from national competition by having a very local, captive market and they have many options when it comes to keeping their income above say 120 grand a year. Plus consumers prefer in person visits if the cost and convenience are the same, so providers always can fall back to that. It is very hard to reduce provider labor cost. So the telehealth agency gets squeezed between a price sensitive consumer, a provider who demands the bulk of the revenue from consumer, and the cost of ads which are raised by investors repeatedly dumping their money into new telehealth companies driving up demand on the ads displayed when people search video doctor.
So every telehealth company that has lasted more than a few years has some strategy that gets them out of the urgent care market. One strategy is to go to a commercial health plan and negotiate a subscription price based on the number of people on the plan. Another is to sell to employers who have ASOs or handle funding their employer provided health plans themselves. These employers look at their claims data and see a few categories that make the bulk of their expenses: ED visits, chronic conditions, cancer/an employee with a kid with a disease. Telehealth is well positioned to reduce employer expenses in the first two categories. This is the livongo-teladoc play. Other strategies include focusing on a narrow vertical that you can scale. For example, focus on men’s health in a way that allows you to bundle a mail order pharmacy in while getting cheaper ads by being targeting ads in places men would see but don’t have a lot of other eyeballs to raise ad prices (like men’s fitness magazines, etc.)
“Cerner VP of Strategic Growth Amanda Adkins, […] says healthcare should be smarter, more transparent, and more affordable, but I haven’t seen her plan for achieving that.”
Gee, where have we heard that before? Oh right, the GOP. And didn’t they try to Repeal & Replace, only to Fail and Fail Hard?
Just because you know the talking points doesn’t make you smart, or a Doer, or much of anything really. I wish citizens would stop letting pols get away with vacuous statements that are little more than hot air. And the history on this subject hasn’t been kind to the GOP talking points. Remember “who knew healthcare was hard?” Remember Paul Ryan? Remember the mad scramble to assemble a Repub healthcare bill, and it became obvious they knew everything about what they were Against, and precious little about what they were For?
We are healthcare. By far the vast majority would support substantive plans to make healthcare “smarter, more transparent, and more affordable.” That shouldn’t even be a partisan objective. But for the GOP of all people to make empty statements on the subject, is just too much.
To use an old internet meme, I want a pony. Guess what, I don’t have a plan, I don’t have a ranch, I don’t have any history with animal husbandry, I don’t have the money, I’m allergic to horses, and I’m a city boy to boot. Looks like I won’t be getting a pony!
We live in a time where people can’t even agree on basic facts of our shared reality because we’ve enabled corporations and governments to manipulate our information sources. Substance doesn’t sell. People are shockingly uninformed about how the government and economy impact their day to day life. There is the well documented “I love the ACA, but I hate Obamacare!” phenomena.
We have a massive data collection and advertisement industry that depends their ability to legally extract all kinds of data because of a click-through terms of service, sell that data to anyone they want, and then charge advertisers for real estate where they can use that data to target you. And while that targeting can be benevolent, it’s more often to convince you to vote for something against your best economic or health interest, spread incorrect information, buy something you don’t need, or strengthen your prejudice against a group of people.
The companies that perpetuate this have market caps larger than most countries. They will use their ability to control information to ensure the system stays rigged in their favor. And charlatan politicians will continue to be elected.
I don’t know where this is all going but my guess is it will end up something between Idiocracy and The Time Machine.
I was thinking about, what would it take for me to take a right wing healthcare plan seriously. What would move the subject beyond just political hot air?
Here’s what I’d need.
1). I don’t want proposals from one person. These might have been good enough in the past, but after the debacle of 2017, they aren’t good enough now;
2). I need to see a fairly detailed plan, and I need to see strong agreement from an entire group of Republicans. Let’s set the minimum group size at 20 just to get things started;
3). There need to be some senior politicians and/or some healthcare specialists in that group. An obscure group of back-benchers won’t do; a GOP proposal has to have some chance of growing and becoming party policy;
4). The policy field is no longer empty. The Repub plan has to explain in some convincing way, why it is better than the ACA. Thus, “it’s not Obamacare” just doesn’t cut it;
5). Trade-offs are fine, but call them out and explain them. A strong proposal from a strong team doesn’t need to hide behind slogans.
There. That would make me take GOP healthcare proposals seriously.
It doesn’t matter to the Republican party what voters think. Their electoral strategy isn’t to get more votes, it is to make the other side have less votes.
Republican failures on healthcare affects their credibility which affects ability to form coalitions between the interests of party elites. To get a bill through, the party has to at least broker a deal and extract compromises from different Republic elite interest groups like particular business interests, general investor protection groups like the chamber of commerce, or religous leaders. It’s harder to get those interests to compromise when you have a history of failing to follow through.
Yeah, it’s pretty obvious that the GOP strategy is explicitly not to have any kind of healthcare strategy to reduce their defensive surface area. They know the poll poorly on healthcare, and they have no interest in talking about it, let alone releasing coherent policy proposals. They’ll mouth some words about prescription drug prices, “free market”, “innovation”, and “future cures” (completely ignoring the affordability of “Today” cures like insulin). And 60 million people will vote for it, many of them non-college educated whites who themselves use Medicaid or Medicare.
I can’t disagree that voter suppression is a major strategy of today’s GOP.
Having said that, my post was built around the attitude that “you cannot change another but you can change yourself”. Thus my minimum requirements are MY standard, not the GOP standard.
And to reply directly to your concern, do you think that a Republican party who’s only concern is voter suppression, will meet my minimum standard for a healthcare proposal? I sure don’t! So there’s no danger in setting out a minimum expectation.
If the political Right want a path back to sanity on healthcare (and possibly other matters), then even the opposition could potentially play a role there. Refuse to play along with the trolling. Decline to debate provocateurs. Point out obvious attempts to suppress the vote.
In the specific matter at play here, I demur to fall for a pretty empty talking point by Amanda Adkins. Thus it doesn’t matter to me, at all, if she manages to come up with a healthcare plan, with no wider support or acceptance from her political colleagues.
As I’ve laid out, the GOP has already fallen into the trap common to opposition parties. They opposed the party in power and that united them; however they never did the hard work of defining what they actually stood for. Beyond sloganeering, I mean. Therefore when they gained power, they were unprepared to write and pass healthcare legislation.
I’d heard Henry Ford was asked why he made autos, without concern for detractors and transport experts of the time, and he’s to say “if I listened to them I would have built a faster horse”.
I think this somehow associates with the healthcare industry, where providers want to go fast, and this system isn’t it. I’m optimistic that viruses will force change in a system that cannot change itself; and per chance, to dream.