Monday Morning Update 1/31/22
Politico reports that Crisis Text Line, a non-profit that uses big data and AI to provide text-based behavioral support, shares its anonymized text conversations with a for-profit spinoff that sells customer service software.
Experts question whether the data could be re-identified. They also note that its 50-paragraph disclosure form allows user data to be shared without further user consent, including with Facebook Messenger.
Crisis Text Line’s founder and former CEO has said that text conversations are predictive of self-harm – “numbs” and “sleeves” is 99% predictive of cutting, while chat terms “sex,” “oral,” and “Mormon” indicates that the user is questioning whether they are gay.
The service offers help for COVID-19, anxiety, eating disorders, depression, suicide, and self-harm. It triages texters based on suicidal risk from their first few messages, moving “code orange” texters to the top of the queue in reaching them in an average of 39 seconds.
From Undulation: “Re: DoD database. Three DoD doctors testified that data from its Defense Medical Epidemiology Database contains ICD codes that document massive side effects from COVID-19 vaccines. They cite numbers so extreme that I suspect they arise from database and/or EHR issues – as compared to five-year averages, an 300% increase in cancers, 269% increase in myocardial conditions, and a 1,000% increase in neurological conditions. I can’t find any fact checks on this.” I don’t know anything about DoD databases, but I’ll invite those who do to weigh in. The hearing was convened by Senator Ron Johnson (R-WI), whose chosen “second opinion” physician panelists are often labeled as misinformation spreaders.
HIStalk Announcements and Requests
About one-fourth of poll respondents who didn’t attend HIMSS21 plan to go to HIMSS22, while 80% of those who attended HIMSS21 will be back this year.
New poll to your right or here: What is your ideal way to make a health-related appointment? I read a New York Times article today about restaurants that have stopped answering phones, believing that it’s more efficient for customers to message them via Instagram or other means instead of taking up employee time to speak to them in real time (some have also decided that a web page is unnecessary). Reader comments were fascinating: some claimed ageism by restaurants that only want young customers for whom actually speaking to someone has become an inconvenience, many don’t like giving big tech sites even more clout, and others said that this change (along with delivery services, ghost kitchens, etc.) will kill the industry since cooking at home is better and cheaper once the social aspects have been eliminated. Some comments wisely questioned why restaurants can’t have a regularly updated, non-social media page that shows wait time since that’s often what people want to know. A wonderfully sarcastic reader opined, “Many folks nowadays cannot handle phone calls because it requires immediate listening, thinking, and responding skills. Texting, email and app driven activities provide a buffer for the slower witted and conformist lot.” Anyway, my take is that the market will sort itself out it always does, and a restaurant that misjudges customer preferences will either reverse course or close. Ditto patient scheduling, at least to the extent that the healthcare market is actually competitive.
Home tech tip: Mrs. HIStalk wanted to stream a movie from the 2022 Sundance Film Festival and bought a ticket, but Roku’s Online Festival Screenings app geoblocked us for some reason. Ten seconds of Googling alerted me that Roku devices now support AirPlay, which I didn’t know, so we streamed perfectly from her IPad to the Roku and TV.
Welcome to new HIStalk Platinum Sponsor Nym Health. The New York City-based company translates clinical language into accurate, compliant medical billing codes within seconds, automating revenue cycle management for healthcare providers. Combining computational linguistics and clinical intelligence, Nym’s autonomous medical coding platform is reducing costs and improving payment cycles for healthcare providers across the United States. Along with over 96% accuracy, Nym delivers comprehensive, audit-ready, traceable codes for full transparency. The Nym platform’s clinical language understanding engine processes over three million charts annually in more than 90 emergency department and urgent care settings. Thanks to Nym Health for supporting HIStalk.
I found this YouTube interview with Nym Health founder and CEO Amihai Neiderman, who explains the company’s technological approach to medical coding.
Eric Rosow reminded me in our conversation about the amazing vision of medical records pioneer Larry Weed, MD, which was well captured in his 1971 grand rounds presentation at Emory University, where he spoke eloquently without using notes. I was so taken by re-watching the primitive video recording that I transcribed the whole 53 minutes’ worth for posterity. For those who find a fascinating but long read daunting, here are some quotes, which were so far-reaching that whiz-bang app developers and freshly graduated medical students should still be inspired from them today.
- We really aren’t taking care of records — we take care of people. We’re trying to get across the idea that this record cannot be separated from the caring of that patient.
- You can’t look at the management of a single problem without knowing the context. What are all the problems?
- The practice of medicine is the way you handle data and think with it. The way you handle it determines the way you think.
- If you can’t audit a thing for quality, it means you do not have the means by which to produce quality … If you can’t evaluate what you’re doing, then there’s a very serious possibility that you do not know what you’re doing.
- Under pressure, if you let people get data in a Sherlock Holmes way, they get so they get less and less data, have more and more intuition, draw conclusions more and more prematurely, and get people into more and more trouble.
- This profession truly is a cottage industry, everybody wandering around defining his own game. And when you’re allowed to define your own game, you’re a fool not to define it in a way that you’re always the victor. Of course the medical profession gets the appearance of being arrogant and independent. Anybody that’s been allowed to define his own game all his life, that’s conducive to arrogance.
- The Lord and the chiropractors can get 85% of these people better. The only reason you run these fantastic establishments is to get that other 10%.
- You have to be ruthless with [the doctor] if he does not keep the problem list up to date so that anyone in seconds can be in context and make intelligent decisions.
- When someone says “I take care of that patient. I’m her doctor.” that’s fraudulent. No one points to a Pontiac and says, “I made that car.” A system makes that car.
- We’ve got to fix the system so that students are much more ashamed of being imprecise and dishonest than they are of being unsophisticated.
- Good medicine is a careful, rigorous inching your way towards a more and more secure position. A final diagnosis is a myth.
- In no place in American records do we have an organized approach to what we’re going to tell the patient.
- I’ve yet to have a doctor say to me, I was so busy I didn’t have time to order anything. He’s always so busy he didn’t have time to find out anything, but he’s always got time to order something.
- A doctor has to be a guidance system. He is not an oracle that knows answers. Once he accepts the concept of being a guidance system, then he knows that the data system is the basis from which all his work must take place.
- Art is Hemingway, three weeks on a single paragraph. It’s Bach recording in detail everything he did a couple hundred years ago so we can hear it today. It’s not a scribble in the middle of the night. It’s not saying, “I took good care of her,” leaving absolutely no trail for us to ever find out whether you did or did not. We debase the word art itself when we call what we’ve been doing art. And it’s not science.
February 9 (Wednesday) 1 ET. “2022 – Industry Predictions and Medicomp Roadmap.” Sponsor: Medicomp Systems. Presenters: David Lareau, CEO, Medicomp Systems; Jay Anders, MD, chief medical officer, Medicomp Systems; Dan Gainer, CTO, Medicomp Systems. The presenters will provide an update on the health IT industry and a review of the company’s milestones and insights that it gained over the past two years. Topics will include Cures Act implications, interoperability, AI, ambient listening, telehealth-first primary care, chronic care management, and new Quippe functionality and roadmap.
Previous webinars are on our YouTube channel. Contact Lorre to present your own.
- Mayo Clinic chooses Oracle Fusion Cloud Applications Suite (ERP, supply chain, and HR) and Oracle Fusion Analytics.
Cleveland Clinic hires Rohit Chandra, PhD (Sunshine) to the newly created role of chief digital officer.
Patient payments and engagement platform vendor Millennia names Ankit Sharma, MBA (NThrive) as chief data and analytics officer.
Privacy and Security
The New York Times says the government of China is using its digital COVID-19 pass as a “potent techno-authoritarian tool” to control its citizens – tracking them, restricting their movements, and locating fugitives and dissenters. The government was already tracking people by cell phone, but the app also allows them to control travel by using unspecified criteria to change the app’s health code from green to yellow.
The US Consulate issues a “health alert” that a hospital in Los Cabos, Mexico preys on Americans patients by demanding upfront payments, overcharging them, and refusing to release their medical records. Mexican Consulate, you know what to do.
- Divurgent gives their Managed Services customers access to Zendesk’s service desk solutions.
- OptimizeRx will sponsor DigiPharma Connect February 27-March 1 in Savannah, GA.
- Olive publishes a new analysis, “How the pandemic and supply chain challenges have impacted surgical supplies.”
- Symplr announces a golf sponsorship program with four top-ranked professional golfers.
- Protenus will sponsor the HCCA Managed Care Compliance Conference in Phoenix January 30-February 1.
- Relatient’s Dash patient engagement platform achieves certified status for information security by HITRUST.
- The Pharmacy Podcast Network features Surescripts VP and CMIO Andrew Mellin, MD in “Welcome to the 21st Century for Specialty Pharmacy I UN-Scripted by Surescripts.”
- False Claims Act and MAOs: Important Takeaways for Provider Groups (RCx Rules)
- Should Doctors Care About Your Address? (Nordic)
- Software in Cash-Based Practice, Part 1: Setting Up for Patient Care (WebPT)
- Notes from the Field: Perspective on the NACDS Regional (OmniSys)
- My Top 5 Reasons for Conducting Ongoing Continuous Risk Analysis (Clearwater)
- How to Avoid Stark Law and Anti-Kickback Statute Penalties (Symplr)
- Easing Nurse Burden and Exhaustion Through Technology (Vocera)
- Are We Breaking Up? Requesting a Second Opinion from Your Provider Without Ruining Your Relationship (PMD)
- Accelerate Your Analytics Journey with Insights (Premier)
- Voice assistants in healthcare: Why & how to use them (Sonifi Health)
- What is change management in healthcare? And why should you pay attention to it? (Spok)
- 9 Reasons to Focus on Patient Experience in 2022 (Well Health)
Mr. H, Lorre, Jenn, Dr. Jayne.
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Re: Dr Weed’s observations on Medicine, what’s a Pontiac?
Seriously, thanks for sharing. Good stuff.
“Symplr announces a golf sponsorship program with four top-ranked professional golfers.”
What’s the over/under on this company primarily selling to C-suite who’ll salivate at the idea of playing with pro-golfers, while their hospital workers are underpaid, overworked, and quitting in record numbers?
Seems a bit tone deaf to sponsor some professional athletes right now. Why don’t you donate that money to a worthy cause? Oh, wait, I know why. It won’t get you that shiny C-level face-time that you need to sell you stuff. There we go.
Uh, yeah… Selling things is how companies stay in business. Which lets them pay the people who make the products you medical people like to buy and use. (Sorry for the snark, but really, how do you think we evil vendor people buy food and such?? Spoiler: it’s with money.)
Agreed. Don’t blame vendors for how your organization procures supplies. For the most part, they’re doing what you implicitly tell them to do. If your org buys software based on attending cool golf games, vendors are going to schedule a lot of cool golf games.
This is in response to the Reader Comment about the root cause of the Department of Defense ICD data that were cited by 3 “whistleblowers” (Samuel Sigoloff (DO), Peter Chambers (DO/PHD), and Theresa Long (MD/MPH)). In December claimed that the DOD data shows shows the Covid vaccine is killing our service members (for example: 1000% increase in neurological disease). Their claim has been amplified across the internet by conspiracy sites, and of course they’ve been given a public hearing by US Senator (Ron Johnson, R-WI).
I’m the one who submitted the Comment, and today Politifact explained what happened: The DOD said that the 2016-2020 numbers used to determine a 5-year average were underreported. As someone who works with databases, this isn’t surprising to me: Database issues occur all the time. But what is surprising is that the 3 whistleblowers didn’t do even the most basic of checks, such as checking the prevalence of the conditions in the baseline! Instead they just looked at the percent change and then jumped to conclusions. Hugely irresponsible!