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From HIMSS 8/12/21

August 12, 2021 News 20 Comments

The conference was pretty dead today. Even Epic’s booth had basically nobody in it except a few employees. Some booths were already cleared out as practicality outweighed the HIMSS policy that requires booth tear-down only after the hall closes at 4:00. Everybody’s mind was on getting safely home.

Supplies of conference totes are ample if anyone needs one or 25.

Siemens Healthineers had a huge booth that was almost empty today, although I seem to recall that it had some decent traffic earlier in the week.

Thanks to Ultimate Kronos Group (UKG) for a hot doughnut that I accessorized with lava-hot pistachio sauce and tutti-frutti. NOTE: a reader found that the doughnuts were provided by InterSystems, which I should have suspected since I remember its Wall of Doughnuts at HIMSS19.

I liked this tee shirt from Vivify Health, which offers remote patient monitoring tools.

I stood in the hot, bright sun for a few minutes waiting for this rotating video display to hit the CoverMyMeds banner again after I saw it flash by. You can see the splashing of the fountain between the Wynn and Palazzo at the lower right.

I asked HIMSS for in-person attendance at HIMSS21, which they are supposed to be sending me, hopefully with an explanation of how the count was derived (registered or actually showed up to get a badge, exhibitors versus non-exhibitors, etc.) I only care about in-person, paid  attendance excluding exhibitor passes.

A-Rod has probably faced more DEA agents than the number of audience members he’ll see in his 1:15 p.m. Friday session called “Mindset of a Champion,” with that mindset apparently being that it’s OK to cheat by using performance-enhancing drugs and then lie about it as long as the personal payoff is significant. If anyone actually sticks around to hear what he has to say, please take a photo of the audience since anything other than a tiny turnout would be shocking given the time slot. I understand that he’s a celebrity entrepreneur and all, which seems easier when you start out with a few hundred million dollars, but I don’t see the healthcare connection. I’m sure HIMSS paid dearly to get Patrick Dempsey, Rainn Wilson, and A-Rod to add star power along with minimal relevance.

Someone who wasn’t at HIMSS21 tweeted that they had heard that a bunch of exhibitor staff were unmasked. I saw nothing of the sort — with maybe one or two exceptions that may well have been short term, everybody I saw was responsible. That wasn’t necessarily true outside the HIMSS velvet ropes, although even there compliance was pretty good. I got invaded a second time by someone unmasked crashing into the  hotel elevator as the door was closing (perhaps the disdain for others extends from not mask-wearing to refusing to politely wait for the next elevator), to the annoyance of the other passengers who were all masked up but trapped.

I pressed even harder against the back wall of the elevator since I had just heard from a relative who got COVID-19 during a group camping trip this week, one of at least 10 people there who have tested positive after spending time in a nearby bar. All of them had been vaccinated. The symptoms are apparently miserable, and while the odds of hospitalization or death are low for those who are vaccinated and thus have a “mild” case, the chance of experiencing long COVID symptoms is maybe 20%. Another set of relatives, a family of four who had decided that vaccination was unnecessary, just messaged that two of them have been diagnosed with COVID-19 (one of them is a child) and a third is now showing symptoms. At this point, you’re either going to get vaccinated or you’re going to get COVID, and regrets from the former are minimal while those of the latter are sometimes expressed in writing while dying on a ventilator.

A couple of folks asked about the after-hours party risk from attending HIMSS. I did not attend anything outside the conference areas and ate only at uncrowded restaurants whose tables were widely spaced, but I walked by the bar-restaurants in the Palazzo and Venetian (like Sugarcane and Chica) and they were wall-to-wall crammed with HIMSS attendees who were displaying the behavior that makes bars a hotbed of viral spread — leaned-in and loud conversations (lots of vocal cord spray), no masks, no spacing, and extended periods of close contact. That wouldn’t be too bad if it were just conference-goers of known vaccination status, but at least one of the packed venues was not closed to the public at the time. HIMSS can’t control conditions outside its boundaries, but I assume that some of those folks are going back to work at hospitals — many of them overwhelmed with COVID-19 patients — and I hope they will either get tested or isolate before going anywhere near patients or caregivers.

Something to consider for HIMSS22 or other conferences that limit attendance to vaccinated people. Require exhibitors sign a form that they won’t have after-hours events unless they are held in venues that are closed off to the general public (in Orlando, unlike Las Vegas, I believe that HIMSS controls the entire hotels). Arrange some kind of dining options that don’t require exiting the vaccination bubble — discounted room service, outside food delivery with conference rooms for group eating to scratch the socializing itch, or ballroom-type food service accessible only by badge — and include bar service. Leave the bubble if you want, but you aren’t required to given provided options. Feeding attendees in the exhibit hall like an extended happy hour would be a win-win with exhibitors. Basically to keep live conferences from becoming superspreader events and thus risking cancellation, you have to control more than just the meeting rooms and give your attendees easy ways to avoid people who are unmasked and possibly unvaccinated. And perhaps give them an easy way to take a COVID test before  they return to work. News item: RSNA just announced that it will require vaccination and masks.

A couple of companies ask Lorre to stop by to say hello and she wants me to give a shout-out specifically to Nordic, who welcomed her like a queen when she dropped by wearing her now-vintage HIStalk tee shirt. Nordic has been a longtime supporter and several of its executives rushed over to chat and make her feel welcome.

I got an overview of Telemedicine 911, which allow telemedicine providers whose patient experiences an emergency during their session (like a heart attack or stroke) to get in direct connection with the patient’s 911 emergency services dispatcher and send details or patient background. The nurse practitioner who was working in the booth said she once had a patient say they intended to harm themselves during a telehealth visit, she asked the patient if it was OK if she sent some help, and she got in direct contact with the 911 team in the patient’s local area so they could respond.

The folks at PORTL got in touch after I mentioned that their hologram technology was interesting, but nobody would explain it in the booth of its partner Avaya. They offered a private showing that I declined, but here’s a video of how University of Central Florida’s medical school is using it to allow students to diagnose 3D patients. The technology has been used for the Emmys red carpet and for musical performances.

I’ll be back to normal posting this weekend, where I’ll ask for feedback about both versions of HIMSS21. HIMSS22 is just seven months away.



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Currently there are "20 comments" on this Article:

  1. Telemedicine911 seemed like a good product but the CEO should stay home next time. I stopped not at the booth but staples aside to listen to a voicemail where he went in for hard sell. I tried to be nice and say no thanks. He was not having it. Hire someone who can sell and stay home next time.

  2. Mr. HIStalk – are you still able to wander HIMSS hallways anonymously or do people actually know who is Peter Parker?

    • I wander around anonymously and aimlessly. I think I talked to two people who know me as Mr. H during HIMSS21, which along with my intentionally low-level badge title means that I get ignored by some booth folks who I can scold in that day’s recap. I’m a mystery shopper rather than an attention-seeker.

  3. I have to admit I had the glazed donut with raspberry. yum. The treats were sponsored by Intersystems (not UKG). I made the mistake at first, too. Intersystems had one of those booths with only chairs and tables and some Intersystem tchotchkes.

  4. “the chance of experiencing long COVID symptoms is maybe 20%”??? This exaggeration, along with your unwavering belief that masks protect you in anything other than a minuscule manner, makes reading these HIMSS updates even more depressing and sad.

    • Here’s the NEJM-published study of long COVID from breakthrough cases as published two weeks ago. It’s not perfect — it involved a few hundred vaccinated healthcare workers in a single hospital Israel, but 19% had long COVID symptoms that lasted at least six weeks:

      https://www.nejm.org/doi/full/10.1056/NEJMoa2109072?query=featured_home

      I think plenty of studies have proven the value of masks in preventing COVID spread, although the weaknesses there are type of mask (cloth masks works for droplets, less so for aerosolized particles that is turning out to be a more important factor) and how the mask is fitted and worn. My take is that even if masks are only 10% effective, that’s reason enough to make the tiny effort, however effective it may or may not be, to protect others who are high risk or who can’t be vaccinated, such as children. It’s an ounce of fabric, after all. What peer-reviewed research would you cite as evidence that mask-wearing is futile?

      • “…even if masks are only 10% effective…” Imagine if pregnancy prevention products were only 10% effective. That would not be acceptable to the customer base. I cannot understand why 10% effectiveness of masks is acceptable.

        • That was a hypothetical, (I believe) the UNC and Duke studies show that depending on the mask they are 90+ to 40% effective.

          Indoors, that is significant. Wearing a bandana is probably 10% effective — wearing the right mask, properly fitted, is far more effective — facts, not conjecture. My dislike of your posts is that you are casting sideways dispersions against something that you are not producing studies to malign — the very thing you are claiming everyone else is doing through fear and ignorance. You are spreading ignorance

          https://news.unchealthcare.org/2020/12/research-ranks-various-mask-protection-modifications-against-covid-19/
          https://today.duke.edu/2021/06/research-finds-masks-can-prevent-covid-19-transmission-schools

          These are one earlier study and one recent study.

          So I believe what MH is saying is that even a 10% increase in surety is an adjustment to the risk model — which is what we need to be looking at — situations of risk and how we can mitigate them. He is quite capable of speaking for himself of course.

          Sure, my body armor won’t protect me from a leg or arm wound — so I shouldn’t wear that gear in the field? I doubt you would not find a soldier who would buy that argument.

  5. While I am sorry to hear about your relatives, I would like you as a physician to take this opportunity to track those family members. What you state is the classic headline. They’re infected or positive. Fine, but who ends up really sick? Let’s do some math here:

    19 vaccinated 10 infected – camping – outside a lot or huddled all together in the same tent?
    4 unvaccinated 3 infected – no idea where they got it, could have been anywhere from anyone vaccinated or unvaccined – not a great trial group but it is what it is.

    Now, let’s add some context and not play CNN, NBC etc – let’s break it down by age, weight, smoker, vapor, other issues whether genetic or other that seems to be a factor see how they do. Hopefully well for all.

    Thank you

    • And here’s the problem, I already have a dislike. Don’t dislike because you are ignorant or afraid, instead wait for the facts.

      • Last Comment: 9 dislikes and counting. Why? Now I’m a reasonable guy (I have all my vaccinations save for this EUA massive clinical trial, y’know why, because I had COVID, age 51 avg weight, non smoker was exhausted for 2 days otherwise thought it was sinus. All the rest of my household close contact tested negative, and/or they have anti-bodies. Oh and my physician believes in natural immunity and treatments – (see CDC therapeutics) which it appears some healthcare organizations are not implementing and leaving people to die. Hmmm….The 9 dislikes are either all blocking their ears, ignorant, never question anything, are wondering “gee I thought the vaccine protected more than just me – that’s what the highway sign said”, apparently are not wondering why when vitamin D levels are at an all time high in this country we have new wave, it ain’t just the unvaccinated folks otherwise you’d seen this before and are not thinking, herd immunity is impossible since even your cat can get COVID. That’s right folks this virus needs hosts and does not contain itself to humans. It is not going anywhere. To sum up, I am not anti-vax, get it if you want, I will wear a mask when asked and acknowledge that there are reasons for many not too get this vaccine, and it has nothing to do with protecting others. Maybe they just can’t. Are you going to hide from children, all the unvaccinated? You can, but as proven in this story and for facts in the original FDA filings as well this last round of CDC recommendations it does not matter.

    • I think your analysis is appropriate. Most infected people do fine and may not even know they were infected. The vaccines are still working mostly as was optimistically predicted before the delta variant, although we still don’t know to what extent a vaccinated person can spread infection, the breakthrough infections have gone a bit higher than predicted, and delta’s r0 is so high that it has rewound us back to the pandemic’s early days, not to mention that a high rate of spread raises the chances that a new variant will emerge that is “resistant” to the vaccines. That’s a risk to everyone, not just those primarily unvaccinated people who are infected and occupying hospital and ICU beds.

      There’s also the issue of location. We can say that some counties, states, cities, etc. have a high infection rate / case count, but still aren’t overwhelmed in hospitals and aren’t seeing deaths skyrocket. The highest-vaccinated states are doing a lot better than the lowest, but I wonder if a chunk of the problems seen in Florida, Texas, and Nevada aren’t because they get a lot of tourists and have residents for whom “home” is somewhere else that demands frequent travel. The models can’t necessarily predict that impact, either in the states they visit or the states they return to. And we should remember that the virus came here via international travelers, most countries can’t get vaccine because we locked up supplies (even though we’re throwing it out here for lack of takers), and you really can’t completely seal the border, so we can’t just let Africa suffer and trust that the virus will respect our border.

      We are also entering a period of uncertainty as schools reopen for the fall semester, with or without masks and mandatory staff vaccinations. Fall also brings a heavier load of conferences, concerts, and sporting events.

      I am cautiously optimistic about the family members who have been vaccinated, although I would be more confident if their vaccine hadn’t been the J&J one that looked like the best version early on. The closest relative (the camper, who was likely infected in a gathering in a nearby bar that the group walked to) seems to have had her fever break, which is a little bit early on the timeline (likely infected on Saturday, fever broke Thursday, maybe a couple of days earlier than you would expect and maybe because of her vaccination if indeed her other symptoms start to improve). Classic presentation — heavy chest, muscle ache, loss of taste and smell, etc. Hopefully it will remain a “mild” infection, but even then it’s pretty miserable, and she’s trying not to think of the long COVID possibility.

      I think many more of us will see the virus forcefully invaded our circle of family and friends. Those days of not knowing anyone who has had it are probably limited.

      Post HIMSS21, it would seem prudent to get a BinaxNow home antigen test ($10 from Walmart.com with two-day delivery or available in drugstores), isolate until Monday or Tuesday, then take the test, and if it shows positive, confirm with a PCR test and then obviously act accordingly. Or get a PCR test directly, but that’s more of an effort and some areas are once again seeing shortages and results reporting delays. Still, I feel pessimistically certain that we will see some attendees unknowingly spread the infection they picked up in Las Vegas, although we don’t do enough contact tracing to assure that the rest of us will hear about it.

      • Thank you sir, good response, but please be careful with “That’s a risk to everyone, not just those primarily unvaccinated people who are infected and occupying hospital and ICU beds”. CDC Morbidity and Mortality Weekly Report Jul30 – Barnstable cty MA – “Five were hospitalized; as of July 27, no deaths were reported. One hospitalized patient (age range = 50–59 years) was not vaccinated and had multiple underlying medical conditions.†† Four additional, fully vaccinated patients§§ aged 20–70 years were also hospitalized, two
        of whom had underlying medical condition”. Again, I am a fan of your blog.

        • I would be cautious about extrapolating hospitalization data from a single county of 200,000 residents that has vaccinated 75% of its residents. Reason: you expect a higher percentage of vaccinated patients simply because there are more of them. Example: if vaccination has worked so well that low case counts resulted in just 10 people are hospitalized and they were all vaccinated, 100% of them would be considered breakthrough infections even though that phenomenon is still rare and the vaccine is still delivering remarkable results.

          Fully vaccinated people make up from 0.1% to 4.7% of all COVID-19 admissions looking at individual states. Vaccinated people represent 2% to 5.6% of total COVID-19 deaths. In the example of Massachusetts, less than 2% of the hospitalizations and deaths involve vaccinated people, meaning that 98% of the worst outcomes involve people who hadn’t received the vaccine. Unvaccinated people in Massachusetts are admitted to the hospital at 39 times the rate of vaccinated people on a per-100,000 basis, while the death rate per 100,000 people is 22 times higher for the unvaccinated.

          Basically, just about everybody (in the 98 or 99% range) who is admitted to the hospital with COVID-19 or dies of it hasn’t received the vaccine. I haven’t looked up the hospitalization and death rate caused by the vaccines themselves, but I would guess it’s a tiny fraction.

          • I keep seeing people reference these numbers and can’t figure out why they think it’s intellectually honest. The pandemic raged without the vaccines existing and by the time they were widely available the normal cold/flu season was over, so your single digit percentage hospitalization/death rates look great when (I’m guessing) 80-90% of covid cases had already happened in individuals who never would have had the chance to get a vaccine. I’m very, very interested in this upcoming winter and I imagine the people referencing these numbers today won’t feel silly for being wrong/misleading. The vaccines “work”, sure, but not nearly as well as people imagine, and not nearly enough to end the pandemic, even with high vaccination rates. Lies, damn lies, and statistics.

  6. I love how a lot of “sophisticated” experts went to HIMSS…do as I say not as I do. Maybe if its so bad, these healthcare executives should have stayed home?

  7. To quote the venerable Martin Seamus McFly – “Doc, we gotta go back [to a time when COVID hadn’t infected the comments section of HISTALK]!”







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