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Monday Morning Update 9/7/20

September 6, 2020 News 3 Comments

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FCW reports that the VA’s implementation of Cerner’s scheduling solution in the Midwest’s VISN10 region will be followed by the full Cerner rollout there. VISN10 will go live on the VA’s 1.1 capability set for small and medium-sized hospitals.

COVID-19 has delayed developing the 2.0 set for its large centers that will go live first at Mann-Grandstaff VA Medical Center in Spokane, WA. Go-live there is set for spring 2021.

VISN10 was the first scheduling go-live because Wylie VA Ambulatory Care Center was a user of the previous Epic-powered MASS scheduling, which is being retired.

I’m assuming that this change explains the VA’s recent award of a $161 million work order to Cerner for infrastructure work in VISN10, which was announced last week without details.


Reader Comments

From Legal Beagle: “Re: telehealth medication counseling. The White House has asked the Supreme Court to reinstate a rule that requires women who are seeking pregnancy-ending drugs to make a physical visit to a doctors’ offices or clinics to pick up the pills for home use, which was a previous FDA requirement that was relaxed due to COVID-19 exposure concerns. What science exists to explain FDA’s view that only this particular drug out of thousands requires a face-to-face encounter instead of telehealth for patient safety? ACOG and others are challenging the must-travel rule, which the White House is asking the Supreme Court to overrule even pre-trial.”


HIStalk Announcements and Requests

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Poll respondent expectations for Amazon Halo are low. Naysayers say the wearable isn’t all that innovative among a plethora of fitness trackers, while one respondent provides this rather brilliant if non-cheery warning: “Imagine if you will a dystopian corporate future where one of the largest companies in the world provides all products and meals in a cardboard box left at your door, your personal data is bought and sold without your knowledge, and they provide you with faceless grey tracking bands that silently tracking your movements and health metrics. Oh wait, I’m describing Amazon today.”

New poll to your right or here, triggered by something you’ll read further down the page: Would you be comfortable working for a company that regularly fires “adequate” employees in seeking only stars?

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A reader asked me about leaving the corporate health IT world and hanging out their own shingle in areas such as marketing and PR. If you’ve done that sometime in your career, please share your experience and I’ll run the answers on HIStalk.

Thanks to the following companies that recently supported HIStalk. Click a logo for more information.

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Listening: Pentagram. I believe that “Starlady” is one of the most brilliantly written and performed hard rock songs ever, not even counting that it was recorded on a shoestring by a bunch of nobodies. I will listen to that song 10-20 times in a row every now and then just to appreciate the drumming and guitar and the way the rhythm swells and the transitions move it in different directions. Kiss’s Gene Simmons and Paul Stanley watched a mid-1970s rehearsal and decided to pass on signing Pentagram to Casablanca Records because they weren’t pretty (hello, no-makeup Gene Simmons, meet mirror) and Kiss is more of a profit-obsessed corporation than a group of inspired musicians (not to to mention the least-talented band I’ve ever seen play live). I’m due a re-watch of “Last Days Here,” a documentary about Pentagram’s rocky history and its only permanent member and modestly talented Bobby Liebling, whose mental and drug problems created a large group of alumni – 11 guitarists, nine bass players, and 11 drummers. But in the late summer days of 1976, their supernova was captured on primitive recording equipment while the world was distracted by lesser musical lights.


Webinars

September 9 (Wednesday) 1 ET: “APIs for Data Liquidity in Pandemic Times.” Sponsor: Chilmark Research. Presenters: Brian Murphy, research director, Chilmark Research; Gautam “G” Shah, VP of platform and marketplace, Change Healthcare; Drew Ivan, chief product and strategy officer, Lyniate; and Dave Levine, MD, co-founder and chief medical officer, Datica. This webinar will present the findings from a recently published research report on the state of the healthcare API market. The presenters will describe their work in deploying APIs to enable new functionality to address COVID-19. They will cover the use cases that have been most reliable for enabling effective data liquidity, how developers are using APIs to respond to the pandemic, and how different parts of the healthcare system are making APIs more widely available.

September 17 (Thursday) 1 ET. “ICD-10-CM 2021 Updates and Regulatory Readiness.“ Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, VP of global clinical services, IMO; Theresa Rihanek, MHA, RHIA, mapping manager, IMO; Julie Glasgow, MD, clinical terminologist, IMO. IMO’s top coding professionals and thought leaders will review additions, deletions, and other revisions to the 2020 ICD-10-CM code set that will be critical in coding accurately for proper reimbursement.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Shares in the exchange traded fund Global X Digital Health & Telemedicine underperformed the broader market in the past month, slipping 1.9% as the Nasdaq index rose 4.2% and the S&P 500 was up 3%.

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Shares in videoconferencing tech firm Zoom run up 41% after the company reports strong, pandemic-fueled revenue and earnings, making the company worth more than IBM and increasing the value of shares held by its founder-CEO to $20 billion. I wouldn’t be a buyer given low switching costs and barriers to entry, questionable future demand, and the target on its back that comes with sudden, unplanned ubiquity, but maybe my lack of vision is why I’m not wealthy. A $10,000 investment in ZM on March 6 would be worth more than $32,000 today, or $40,000 had you sold last Tuesday.


Sales

  • Holy Redeemer Health System expands its partnership with Dina to connect its hospital and home care agencies and organize and empower its post-acute, home and community-based care providers.

COVID-19

Several drug companies that are working on a COVID-19 vaccine will sign a pledge that they will release a vaccine only after data exists to prove that it meets efficacy and safety standards, seeking to reassure the public that White House pressure to get a vaccine on the market before the election won’t affect their science. President Trump suggested Friday that he is involved in the regulatory process, saying that a drug companies have told him that vaccine approval would take 2-3 years under a “a more typical kind of president.”

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The FBI warns University of North Carolina and other universities that state-sponsored cyberhackers from China, Russia, and Iran are targeting their COVID-19 research data. China is using information taken from the World Health Organization to choose targets and is also using its US university research partnerships to collect information, while China and Russia are using social media to spread disinformation about the virus to fuel the US anti-vaccine movement.

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The state of Utah paid $3 million plus $300,000 per month to a small technology firm to develop its Healthy Together contact tracing app that is being used by just 200 people, even after the state shut down its primary but most controversial feature of user location tracking. The primary business of year-old tech firm Twenty, which developed the app, is an meet-up app that targets Millennials. Both founders are BYU graduates.

The WHO says new evidence shows that severe and critically ill COVID-19 patients should be treated with steroids such as dexamethasone, hydrocortisone, and methylprednisolone as a standard of care in first-line treatment. 


Other

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I read an interesting article on the culture of Netflix, which the company makes sure that prospective employees understand before hiring on. Some points:

  • The mission, vision, and value statements of most companies are ignored. They demonstrate their actual values by who they reward and who they fire.
  • Netflix encourages independent decision-making, shared information, plain speaking, and the avoidance of rules in creating dream teams of people, valuing people over process.
  • Good employees listen before reacting, think clearly under pressure, and are concise and articulate in speech and writing.
  • Employees are expected to say what they think if it’s in the best interest of the company, even if it is uncomfortable, and are expected to say things about co-workers only if they would be willing to say them to their faces.
  • The dream team concept means that “we give adequate performers a generous severance package” so they can replace them with a star. They suggest that people who value stability, seniority, and companies that are willing to work around ineffective performance look elsewhere.
  • Netflix has a team, not a family, since families include unconditional love and life-long attachments that teams do not. They say, “Unconditional allegiance to a stagnant firm or to a merely adequately performing employee is not what we are about.”
  • Managers run the “keeper test” to decide who to retain – which if their employees would they fight to keep if they were considering leaving the company?
  • The company does not hire “brilliant jerks” since the cost to teamwork is too high.
  • Netflix does not give raises, but instead surveys the talent market and pays at the top end of what employees could make elsewhere since “the market for talent is what it is” and “your economic security is based on your skills and reputation, not on your seniority at one company.” They encourage employees to interview for jobs outside the company and share what they learn with their managers.
  • The company observes that as companies get bigger, they place too much emphasis on process, the average talent and passion level slips, and they then throw more management at the pockets of chaos that result and stifle creative thinkers who question the status quo.
  • All company documents are published for everyone to read and comment on.
  • The company does not implement spending controls, contract signing controls, and policies for travel, entertainment, and gifts, assuming that employees will use good judgment and seek advice as needed.
  • Netflix has no vacation policy except to take one when needed.
  • Employees get to choose the mix of salary versus 10-year fully vested stock options for their salary. Employees who leave keep the full value of their options.
  • Netflix has seen a few examples of employees abusing their freedom, but avoids over-correcting because most employees can be trusted.
  • Decisions are made by one assigned “captain” instead of committees that are slow and diffuse responsibility and accountability.
  • The company does not believe in executives who remain immersed in deep product details or micromanagement, instead priding itself on how few decisions senior managers make.

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CNET describes Sutter Health’s use of EICUs in two hubs to scale up services to handle up to 600 patients to meet any COVID-19 surge. It also observes the geographic opportunities, such as Emory Healthcare’s use of intensitivists in Western Australia to monitor its patients in Georgia. Sutter says that development of the EHR was the most important for their EICU program, followed by increased bandwidth, high-definition cameras, and cheap LCD monitors.


Sponsor Updates

  • Opus Research recognizes Nuance as a leader in its “Intelligent Authentication and Fraud Prevention Intelliview Report.”
  • Consulting and managed services firm IntraSystems will offer its customers Citrix app monitoring solutions from Goliath Technologies.
  • OpenText publishes a new study, “Hybrid Cloud Enables Agile Content Management and Collaboration.”
  • Pure Storage names Jason Rose (SAP) chief marketing officer.
  • Spirion launches new compliance and analytics products to simplify compliance with expanding privacy laws and regulations.

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Currently there are "3 comments" on this Article:

  1. Netflix and “adequate employees”…
    This corporate philosophy cannot be ‘one size fits all’. The Netflix approach can work great in a small start-up firm, but becomes too problematic as a company grows beyond mid-sized. No leader can handle 1,000+ all stars. A good leader in a large organization needs a mix of talents and capabilities. In larger organizations there is a role for ‘adequacy’, which I define as someone that does good job on a reliable basis but on occasion needs some help. On the other hand I have seen many large organizations become mired in adequacy (mediocrity). The Healthcare IT world is replete with examples. IMHO neither extreme is a viable long term workable model.

    The manager of a baseball team or coach of a football team needs some journeymen players just as much as he needs some all stars.

    In my experience people should work for organizations that fit their personality and expectations, just as much as employers should hire ‘good fits’ for their culture. I commend Netflix for broadcasting their culture, although I understand why some would feel it is unfair. If that culture doesn’t fit your psyche then did don’t apply. From the other side, as Netflix becomes a larger firm full of ‘all-stars’ keeping on course will get ever more difficult.

  2. Can’t imagine having a team full of All Stars! What a headache. Someone needs to do the work and keep the ship moving. Interesting that the bribe is top salary in the industry and keep looking over your shoulder. Can’t imagine what that does for balance and family life. And, take a vacation any time you want because no one is looking. Not so fast, when you get back you find out you lost the race for “who would you fight for competition?” Absolutely crazy. There will come a time when this generation will self destruct. I’m of the opinion that people are good, they want to do a good job and they want to make more money. Pretty simple approach to life. I’m afraid gifted staff are going to come to a place where they ask, “Is that all there is?” Sad state of affairs. Who could make up this stuff? Speaks volumes about where personal mission, vision and values fit into the equation.

    • I have heard a lot about Netflix, and it reminds me of my time at HP. They seem to have embraced the idea that if you hire the right people, they will get it done. I haven’t owned stock in years, (sold my HP, but probably should consider netflix — I have the sense that they will adapt to any situation that confronts them.

      Inviting mediocrity to find an opportunity elsewhere sounds about right to me. Of course, some people may not be the right fit for a particular job but if you can figure out where they excel then you have keepers. On the flip side of that equation, if you can’t manage strong talent then maybe you need to be a better manager. I have found that when I hire good people, they get stuff done, and the impossible becomes possible with a few more weeks of effort.

      “The difficult takes 4-6 weeks, the impossible a couple weeks more.”

      Think about Mayo Clinic, their administrators are docs, they are about the mission, the mission is valid and impactful, and anything that falls outside the mission is ‘reviewed’ for relevancy. They swore an oath and the oath means something.

      I found that same commitment in the service, plenty of people who were mediocre, and plenty of team players who strove for excellence — you weeded the bad, encouraged the mediocre, and rewarded the excellent.

      Just a thought…







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