The Epic Sepsis Model predicts sepsis poorly while flooding clinicians with inappropriate alerts, a Michigan Medicine study concludes.
The authors note that while hundreds of hospitals are using the Epic-distributed model, the company has divulged little about its methods or its real-world performance.
They also note that at UM, clinicians would have needed to investigate 109 Epic-flagged patients to find one that required sepsis intervention.
The article warns of “an underbelly of confidential, non-peer-reviewed model performance documents that may not accurately reflect real-world model performance.”
An accompanying JAMA Internal Medicine editorial warns that Epic’s model was developed in just three US health systems six years ago and health systems should validate and recalibrate such models before implementing them. They draw the parallel that just as clinician decision support rules are reviewed by local clinicians before they are offered for use in patient care, local data scientists should evaluate any algorithms that were developed elsewhere.
From Map Bucks: “Re: pay for remote work. My health IT employer is considering adjusting pay to local conditions for those who work remotely (the company is in an expensive metro area). Does this seem OK?” It’s a complex issue. The black-and-white side of me says that companies should pay based on the job, not where the worker sits while performing it. A Dallas company might not be able to hire someone from the Bay area for what it pays locally, but that candidate always has the option to move to Texas. Companies shouldn’t pay more just because an employee chooses a long commute, a more expensive house, or to live across the state line where it costs more – that seems to be a slight creep toward socialism, as in “you need to give me a raise to perform the same work because our new child is costing us more.” I would also not put it past some employees to fake their residence to earn more, such as borrowing a relative’s New York City address. Perhaps the stickiest issue is reducing compensation for someone who leaves an expensive metro, although that doesn’t make sense to me. My hot take is that the job is worth what it’s worth and the employee is free to live wherever they want but also with the expectation that their voluntary choice doesn’t affect their paycheck.
From D.V. Wormer: “Re: Avaneer. Which problem of interoperability can blockchain really solve?” Dean Wormer, instead of being a downer who undermines the work of roomfuls of vendor marketing people, just mindlessly accept that the US healthcare system lags the civilized world in accessibility, outcomes, and cost only because we don’t use enough AI, blockchain, and robotic process automation (try not to notice that those many countries who outperform us also don’t use it and that the folks touting those technologies are the same ones who sell it). IBM is involved in Avaneer, which isn’t a strong indicator of commitment, and so far the only customers I’ve seen mentioned are also Avaneer investors. Blockchain is a hammer looking for nails that never seem to get pounded, and while healthcare has a ton of inefficiency and lack of interoperability (weren’t government-subsidized EHRs and HIEs supposed to fix those problems?), the historic safe bet is to be skeptical of companies that pre-profess their technology’s ability make it better. I’ve been in health IT enough to skew cynical, so I’ll invite more glass-half-fullers to weigh in. I’ll be as interested as the next person to see hard data from an Avaneer-using health system that saves a ton of money and passes those savings along to patients (if for no other reason, because that has never happened in our profit-motivated system).
June 24 (Thursday) 2 ET: “Peer-to-Peer Panel: Creating a Better Healthcare Experience in the Post-Pandemic Era.” Sponsor: Avtex. Presenters: Mike Pietig, VP of healthcare, Avtex; Matt Durski, director of healthcare patient and member experience, Avtex; Patrick Tuttle, COO, Delta Dental of Kansas; Chad Thorpe, care ambassador, DispatchHealth. The live panel will review the findings of a May 2021 survey about which factors are most important to patients and members who are interacting with healthcare organizations. The panel will provide actionable strategies to improve patient and member engagement and retention, recover revenue, and implement solutions that reduce friction across multiple channels to prioritize care and outreach.
June 30 (Wednesday) 1 ET. “From quantity to quality: The new frontier for clinical data.” Sponsor: Intelligent Medical Objects. Presenters: Dale Sanders, chief strategy officer, IMO; John Lee, MD, CMIO, Allegheny Health Network. EHRs generate more healthcare data than ever, but that data is of low quality for secondary uses such as population health, precision medicine, and pandemic management, and its collection burdens clinicians as data entry clerks. The presenters will review ways to reduce clinician EHR burden; describe the importance of standardized, harmonious data; suggest why quality measures strategy needs to be changed; and make the case that clinical data collection as a whole should be re-evaluated.
Acquisitions, Funding, Business, and Stock
NextGen Healthcare announces that President and CEO Rusty Frantz will leave under a “mutual separation” agreement that is effective immediately. He has also left the company’s board. Frantz did not indicate the reason for his departure, but he said in a statement that leaving the company will allow him to “put 100% of my focus on my most important priority – my family.” The company has launched a search for his replacement. Frantz took the role in June 2015, with NXGN share price increasing 5% in that time versus the Nasdaq’s 181% gain.
Cleerly, which applies AI to coronary imaging to predict heart attacks, launches itself with a $43 million Series B funding round. Founder and CEO James Min, MD was a professor of radiology and medicine at Weill Cornell Medical College, where the company’s technology was developed.
RCM services vendor Services Solutions Group, formerly the services division of NThrive, renames itself to Savista.
- Arkansas Pediatric Clinic chooses Emerge data conversion and integration solutions for its migration to Athenahealth.
- FirstLight Home care joins Dina’s digital home care coordination network.
- The Ohio State University Wexner Medical Center will offer Type 2 diabetes patients access to Teladoc Health’s Livongo for Diabetes Program.
Industry long-timer Tim Knoll, MBA (PatientSafe Solutions) joins healthcare staff safety technology vendor Strongline as VP of sales.
Glytec hires Nausheen Moulana, MBA, MSEE (Kyruus) as CTO.
Ascend Medical hires Michael Justice, MBA (Trinisys) as CTO.
Meera Kanhouwa, MD, MHA (Deloitte) joins Ernst & Young Global Consulting Services as executive director in digital health. Her experience includes 10 years as a US Army ED physician with deployment during Operation Desert Storm.
Announcements and Implementations
Amazon launches AWS Healthcare Accelerator, a four-week virtual program for 10 startups that will learn about using AWS to develop healthcare solutions.
A new KLAS report on population health management technology vendors finds that Arcadia, Epic, and Innovaccer stand out.
Government and Politics
A federal appeals court rejects Stanford Healthcare’s argument in a $500 million Medicare billing fraud case involving records Epic-enabled upcoding and unbundling of charges.The complaint says that Stanford doubled its Medicare revenues without increasing its expenses, which the complaint says could only be done by creative coding.
In Australia’s New South Wales, NSW Health will receive $105 million from the state’s digital services initiative for the first phase of its EHR replacement project, with additional funds budgeted from its COVID-19 relief package to expand telehealth and to improve integration between ambulance services and hospital EDs.
KHN notes that big US health systems are opening medical facilities in other countries, such as Cleveland Clinic spending $1 billion to open a clinic across the street from London’s Buckingham Palace Garden that will offer only profitable elective surgeries and treatments in hopes of attracting American expatriates and rich Europeans. The article questions why those systems, which don’t pay taxes, are allowed to pursue such aggressive international business moves.
- Healthcare Growth Partners advised Medullan on its sale to ZS.
- University of Texas as San Antonio joins Optimum Healthcare IT’s healthcare IT apprenticeship program.
- Premier announces the 2021 winners of its Breakthrough Awards.
- Goliath Technologies offers a free Citrix Health Check.
- KLAS recognizes Arcadia as a leader in market energy and customer experience in its “2021 Population Health Management Overview” report.
- TeleConsult Europe selects enterprise imaging from Agfa HealthCare.
- Azara Healthcare names George McGovern (MedTouch) VP of finance and Charlene Grasso (Cambridge Consultants) director of HR.
- The local news profiles CareSignal’s partnership with Americares and the Greater Hickory Cooperative Christina Ministry to serve vulnerable populations.
- Cerner shares a new client achievement, “South Miami-Dade hospital reaches HIMSS Stage 6, 7 and wins Enterprise Davies Award in same year.”
- Ellkay will exhibit at the virtual AHIP Institute & Expo June 22-24.
The following HIStalk sponsors have been recognized in Black Book’s latest customer satisfaction ranking of financial software solutions:
- Enterprise patient identifier solutions – Experian Health
- Patient payment technology – Waystar
- Revenue recovery & accounts receivables solutions – Change Healthcare
- Enterprise resource planning – Symplr API Healthcare
- Hospital claims management systems – Experian Health
- Scoring well in quality measures has just become more difficult (AdvancedMD)
- KLAS Research: Arcadia Stands Out Among Peers in Delivering Comprehensive Population Health Management Out-Of-The-Box Functionality (Arcadia)
- Glassdoor Names Jeremy Schwach a Top CEO (Bluetree)
- Leading Through Change in Healthcare Technology Management (CereCore)
- Want to Succeed at Value-Based Care? Launch a Chronic Care Management Program (ChartSpan)
- The Key to Denial Management in Healthcare: Intervene on the Front End (RCxRules)
- Childbirth: A Mother’s Joy and Too Many Others’ Nightmare (Obix Perinatal Data System, developed by Clinical Computer Systems)
- Campus Update: Immersing Ourselves in Local Art (CoverMyMeds)
- Learn How Analytics Can Help Pinpoint Length of Stay Opportunities (Dimensional Insight)
- Improving Patient Safety Series: Data Truncation and Special Characters (EClinicalWorks)