Monday Morning Update 3/22/21

Top News

VA Secretary Denis McDonough orders a strategic review of the VA’s Cerner EHR implementation. He said in an announcement that while the VA is committed to Cerner Millennium, problems with its use at Mann-Grandstaff VA Medical Center make “a strategic review necessary.”

The VA says its ongoing post-deployment analysis at Mann-Grandstaff has necessitated a rollout schedule change, although Columbus remains as the next go-live site.

The VA’s 12-week review will include optimizing productivity and clinical workflow and looking into patient-facing functions such as the patient portal, data syndication, and revenue cycle.

Rep. Cathy Rodgers (R-WA) asked McDonough last Wednesday to launch an inquiry following reports of problems with prescription ordering, the patient portal, and user training. She calls the system “broken” and suggested a review of Mann-Grandstaff staffing, productivity, staff morale, training resources, and remaining infrastructure improvements.

The GAO recommended in a report last month that the VA delay going live at additional sites until it resolves call critical problems at Mann-Grandstaff, which was its first center to go live in October. The VA responded that it agreed in principle, but would not delay further rollouts.

Cerner provided a statement in response to the VA’s review announcement, saying that it supports the decision, that the company’s priority remains veterans and delivering solutions that drive care transformation in the VA, and that it is proud of its successes that include one of the largest health data migrations in history and deployment of a joint HIE between the DoD, VA, and community partners.

HIStalk Announcements and Requests

Poll respondents handily choose insurance companies over hospitals as offering the worst customer service in healthcare. It’s interesting to me how huge, profitable companies of the recurring revenue type nearly always offer embarrassingly bad service to their paying customers – cable companies, broadband providers, cell service providers, streaming subscription companies, and banks. Shouldn’t customer service be able to scale along with other  parts of the business, and don’t these companies deploy enough analytics to understand the net present value of a customer who only needs to be occasionally helped – often because of the company’s mistake — to keep writing those monthly checks?

New poll to your right or here: Which should be done to better protect patient data? I’m sure I didn’t think of all possibilities, but I did include a “no changes needed” option and you can always vote and then click the poll’s “comments” link to add your own thoughts. I’m always surprised by how many people – some of them in healthcare – forget that the 25-year-old HIPAA, which is a HHS/CMS rule, applies only to covered entities and their business associates, and even then only if those providers submit electronic claims. Maybe a legal expert can weigh on what privacy protections the general legal system offers to the medical records of individuals – if my neighbor steals a printout of my medical records from my car seat and posts them on Facebook, do I have legal recourse?

I’m at the “go or no go” HIMSS21 decision point since it’s probably time to book travel arrangements. I’m leaning toward “go” because I should write about it regardless of how it turns out, but only if I can get a refundable lodging reservation in case the conference is cancelled. A flight on Southwest would be ideal since they would give a refund or credit if the conference isn’t held. I always get my north-south orientation of the Strip mixed up, but Google Maps tells me that the Wynn (where some sessions will be held ) is 0.8 miles from the Palazzo, meaning either queuing up for a shuttle or talking a long walk through sidewalks that are steaming with the urine of panhandlers and trying to convince yourself that 110 degrees isn’t all that bad because it’s a dry heat.

Listening: The Bengsons, an award-winning indie-folk husband and wife who debuted their latest work in a self-filmed, commissioned documentary film that was recorded in their house. It’s a refreshing counterpoint to the usual glitzy celebrity musicians (who sometimes make millions even though they don’t write songs, weren’t committed enough to learn to play an instrument, and can’t read music) in which we see them just singing and playing unadorned, with a gut-punching, powerful personal narrative from Abigail midway through that also explains her joy. This kind of performance art should be the future, even when we are once again allowed to wildly overpay for seats in which we watch a huge monitor of someone lip-synching and prancing impersonally on stage a hundred yards away. If you need something more smoothly soulful, Xavier Omär’s NPR Tiny Desk concert from last week is excellent.

Webinars

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

Announcements and Implementations

Meditech adds vaccine eligibility checking to the self-scheduling component of its patient portal.

Government and Politics

The American Hospital Association asks the Department of Justice to review the proposed $13 billion acquisition of Change Healthcare by Optum. AHA says that the deal would reduce competition in health IT sales and would give Optum’s parent company, insurer UnitedHealth Group, access to claims data that would “further increase UGH’s already massive market power.”

COVID-19

CDC reports that 31% of American adults have received at least one COVID-19 vaccine dose and 17% have been fully vaccinated, as 121 million doses have been administered. A record 3.1 million vaccinations were given Saturday.

Some areas of the country are experiencing a COVID-19 case resurgence, which experts think is due to variants that can’t be verified because less testing is being done. Former FDA Commissioner Scott Gottlieb, MD says we need better ways to link clinical outcomes with each identified variant.

The New York Times observes that the US government will soon be issued a patent for the invention that made at least five versions of COVID-19 vaccine possible, providing one last chance to pressure drug companies to expand access to poorer countries. Some countries are asking the World Trade Organization to waive patent restrictions so they can produce their own, while Russia and China are taking advantage of “vaccine diplomacy.”

A review of 62 papers that examined the use of AI for detecting COVID-19 from chest X-ray and CT images finds that every model was unsuitable for clinical use because of methodological flaws or underlying biases. The authors found that use of publicly available datasets is problematic because they often exclude groups such as children and don’t include demographic information, systems are sometimes trained on low-resolution images, timing of tests and the view chosen can affect conclusions, and doctors would rarely diagnose or differentiate COVID-19 from images alone.

Other

The commissioners of Rowan County, NC give Atrium Health 30 days to establish EHR sharing with the county’s emergency medical services department, which ended in later 2019 and left first responders with no ability to review the hospital records of transported patients for EMS quality assurance review.

Billionaire Denny Sanford, who made his fortune providing high-interest credit cards to people with poor credit scores, donates $300 million to Sanford Health for projects that include creating a virtual hospital. He has donated more than $1 billion to the health system that changed its name from Sioux Valley Hospitals and Health Systems in return.

Taiwan-based Cloudmed raises $275,000 in an IndieGoGo campaign for its ICare cardiovascular tester, which it says is the world’s smallest. The phone-paired device includes real-time reporting, data sharing, lifestyle and dietary recommendations, and on-call clinical experts. Sensors include EKG, oxygen saturation, heart rate, blood pressure, and fatigue. Campaign supporters can get the device in May for $99, two for $159, or four for $269. Its $2 per month subscription offers SOS calling, medication reminders, summary reports, measurement journals, and advanced measurements. Thanks to reader AnotherDave for sending the link.

Kaiser Heath News says that COVID-related telehealth rules for out-of-state providers could have unintended consequences if made permanent – increased provider fraud, loss of profitable patients by local providers who may stop accepting money-losing Medicaid patients, and reduced access for patients who have limited technology literacy or internet access.

Sponsor Updates

• COVID-19 Testing at Work: Seven Lessons from Leading Employers (Healthcare IT Leaders)
• The Impact of Health IT Interoperability in 2021 and Beyond (ChartLogic)
• Capnography: Key Measure for Proper Airway Placement, Return of Spontaneous Circulation, and Advanced Airway Displacement (Capsule)

Contacts

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