Weekender 6/25/21

Weekly News Recap

• Health Catalyst announces its acquisition of Twistle.
• Doximity shares surge on their first day of NYSE trading, valuing the company at $7 billion.
• Tegria acquires KenSci.
• Researchers say that Epic Sepsis Model performs poorly in identifying potential cases of sepsis.
• GE Healthcare names Pater Arduini as its next president and CEO.
• England’s NHS publishes a draft patient data strategy.
• NextGen Healthcare announces that President and CEO Rusty Frantz will leave the company.
• Amazon announces a four-week, virtual AWS Healthcare Accelerator program for startups.
• California launches a digital COVID-19 vaccination record system.
• ONC invites colleges and universities to apply for its $80 million public health IT workforce program.

Best Reader Comments

As former CIO, I am wondering if all of the billions (trillions?) spent on EMRs, etc. have really improved care / outcomes. Based on the very simple measure of life expectancy, I would say no. I am sure that billing and documentation has improved and the industry has amassed warehouses full of data for interesting studies. I know that I will be critiqued for use life expectancy as the single measure, but it is easily available and is a fundamental outcome. This should be embarrassing for a country that already had the highest cost and low life expectancy compared to other advanced economies. (Former CIO)

If you step outside the hyped world of AI/ML, a hospital system would not implement a new clinical protocol (for example, if this were a written risk-stratification model for sepsis) without it first being testing, validated, published, and even then they usually want to wait for the Professional Societies to back the protocol before widely accepting and integrating it into practice. Please explain then why hospitals are just blindly accepting these AI/ML algorithms, when there is already a standard for approving clinical decision-making tools? I suspect a large part of the issue here is that there is still not enough medical involvement / integration into the IT/IS departments at many hospitals. Their governance models still view IT and the EHR as a cost center and not a strategic asset to the organization, and think the enhancements that are being added during EHR upgrades are all functionality updates, when in fact they are slipping more and more clinical content and tools into the upgrades. (HITPM)

Coming from the overhyped world of AI/ML, I would tease apart validation of the model and validation of protocol. No model will be 100% accurate, so validating a model comes down to “sufficiently accurate” (trading off precision and recall) and some sort of explainability. In our work on sepsis models, we achieved AOC over 0.8 with the ability to see precisely which parts of the medical record led to the conclusion. We did not commercialize it, not because it was invalid, but because it needed to drive a clinical protocol that added value. And that’s the issue. First, practitioners’ intuitive sense is really good, so any model has to find marginal incremental cases that they’d miss. Second, you need to design, validate, and implement a clinical protocol for what to do when the model alarms. This has a poor ROI. (Dan G)

They [Doximity] display pharmaceutical ads to doctors. Similar to how Practice Fusion made money, but Doximity has lower risk because ad fraud is harder to bring lawsuit or regulatory action against compared to pushing oxy via EHR decision support. (IANAL)

Watercooler Talk Tidbits

Readers funded the Donors Choose teacher grant request of Ms. C in Mississippi, who asked for an IPad and accessories to allow her to create videos of her classroom instruction for students who need extra review or if COVID-19 forced her school to close. She reported in December, “Thankfully we have not had to teach virtually so far, but having an IPad makes it possible for me to record classes that students can use for review if they need extra help on a particular objective. I enjoy having a fun way to intervene with struggling students by having them play educational games on the IPad that reinforce and review skills we are learning each day. School has changed so much this year and technology has become such an important part of our school day. Thank you for making this project possible.”

Casamba founder and executive chairman Ronnie Amrany buys a waterfront house on Hollywood, FL that sets the record for the highest price paid in that area at $6.9 million. Net Health acquired the therapy EHR vendor in March 2021.

Eleanor Slater Hospital (RI) COO/CFO Christopher Feisthamel takes advantage of an obscure state HR law to avoid repeat attempts to lay him off. Rhode Island’s “leave to protect” provision allows a state employee to hold up to three state jobs at the same time, and if fired from one, they can return to their previous job and “bump” whoever holds it. More than 1,600 state employees have leave-to-protect status, making it hard to fire them.

St. Vincent Hospital (MA) bans activist members of the Catholic Worker Movement from hospital property after they perform an “exorcism of the demon of corporate greed” in the lobby against hospital owner Tenet Healthcare to support striking nurses.

In India, friends of a man who was receiving COVID-19 vaccine record a video showing a distracted nurse removing a disposable syringe and injecting it without first drawing up the vaccine. Nobody noticed until one of the friends looked at the video later. The nurse has been removed from duty and the man will be brought back to receive his first dose.

In Case You Missed It

• News 6/25/21
• EPtalk by Dr. Jayne 6/24/21
• News 6/23/21
• Curbside Consult with Dr. Jayne 6/21/21
• Readers Write: Addressing the Public “Infodemic” Spurred by COVID-19
• Readers Write: Don’t Cut Corners in Hybrid Cloud Protection
• Monday Morning Update 6/21/21

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