Monday Morning Update 8/22/22

Top News

VA data obtained by FedScoop under the Freedom of Information Act shows that the VA has had a least 45 days of Oracle Cerner downtime and 498 major incidents since its first rollout in September 2020.

The VA itself was responsible for one-third of the incidents.

The system issues caused 930 hours of incomplete functionality, 103 hours of degraded performance, and 40 hours of compete downtime.

The VA lists five medical centers as being live on the Oracle Cerner system — Spokane, WA; Walla Walla, WA; Columbus, OH; Roseburg, OR; and White City, OR. It has paused deployments that were scheduled for 2022 until next year.

VA Secretary Denis McDonough said in response to the FedScoop report, “The bottom line is that my confidence in the EHR is badly shaken … the system is not meeting those goals and needs major improvement. We at VA could not be more frustrated on behalf of Veterans and providers, and we’re holding Cerner, Oracle, and ourselves accountable to get this right.”

HIStalk Announcements and Requests

The employers of most poll respondents haven’t had big layoffs in the past year.

New poll to your right or here: Would you post a “looking for work” article on LinkedIn if you needed a job? I’ve seen a ton of those lately and I would do the same – there’s no shame in seeking the next gig and LinkedIn’s reach is broad, although of unknown effectiveness.

The weather looks good for this week’s Epic UGM, with daytime highs barely reaching 80 and nicely cool, campfire nights in the high 50s. A few HIStalk sponsors updated me on what they’ll be doing there, so check that out. Your photos and reports are welcome.

Welcome to new HIStalk Platinum Sponsor KeyCare. The newly launched company offers health systems access to a network of independent virtual care providers via its Epic-based platform, avoiding the challenge of overwhelmed internal providers and third-party telehealth vendors that use poorly integrated technologies. Health systems can easily augment their care teams, optimize capacity, and enhance their digital front doors by partnering with a nationwide network of virtual care groups, while patients can schedule appointments with virtualists from the health system’s MyChart portal or call center. Encounters are then documented in KeyCare’s Epic system, ensuring a seamless experience. The company’s first customer is BHSH Spectrum Health West Michigan Division, which says the service provides patient convenience while ensuring robust data sharing and streamlined clinical workflows. KeyCare and Spectrum Health will present details of their work at Epic UGM this week. KeyCare’s founder and CEO is industry long-timer Lyle Berkowitz, MD, aka DrLyle. The company just announced a $24 million Series A funding round. Thanks to KeyCare for supporting HIStalk. 

Webinars

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

Acquisitions, Funding, Business, and Stock

Idaho Health Data Exchange files Chapter 11 bankruptcy after federal and state funding dries up, leaving it $4 million in debt. IHDE, which was created in 2008, says it will reduce costs and move toward heavier use of subscription and user-based fees. 

Announcements and Implementations

NHS will pilot the use of smart glasses by home care nurses, hoping to reduce nurse administrative work by sending visit transcription to the EHR and offering them a way to obtain instant second opinions virtually. The software was developed by physician-launched Concept Health, which offers virtual and augmented reality based programs for remote consultation, chronic condition recovery, pulmonary rehab, relaxation, pain relief, and fall prevention.

Government and Politics

The Federal Trade Commission says that hospital mergers that are approved by states under Certificates of Public Advantage – state laws that shield hospital mergers from federal antitrust enforcement – usually don’t improve quality, increase employee compensation, improve access, or lower costs. FTC notes that most of the hospitals that sought COPAs to accomplish a merger ended up creating a single-hospital monopoly and that competition is the best way to improve cost and quality.

Privacy and Security

Novant Health sends 1.3 million letters to patients whose information it shared with Facebook via the Meta Pixel website visitor tracking tool. Novant says it implemented the technology in May 2020 to track the effectiveness of its marketing campaign for the use of Epic MyChart to boost virtual visits, adding that Facebook received more information than the health system intended because Novant configured the tracking tool incorrectly. Novant says it may have sent email addresses, phone numbers, IP addresses, emergency contact lists, appointment types and dates, and button clicks and freetext entries. Website The Markup told several hospitals in May 2022 that they were sending PHI to Facebook, after which Novant and some other named health systems removed it. Novant says it asked Meta Facebook about removing the information of its patients, but the company never responded.

Other

Amazon Care nurses say they were surprised by some of the company’s decisions in running a health business virtually. Examples:

• Home care nurses were asked to dispose of medical waste at home and to use blood centrifuge machines in their cars.
• The company didn’t collect patient emergency contact information until clinical staff told them it was necessary.
• Amazon chose a “bargain basement” off-the-shelf EHR instead of waiting for a vendor to develop a custom one and equipped nurses with wireless stethoscopes that didn’t always work.
• Nurses were sent to see patients in hotel rooms and at street protests without tracking their locations or giving them emergency button software.
• They struggled to keep up with state-specific telehealth regulations and worried about outcomes from the company’s use of untrained contract nurses.
• They worried about the cultural divide between nurses and Amazon employees, one of whom reportedly told a telehealth nurse that they were considered “the warehouse workers of Amazon Care.”

A Wall Street Journal report describes the drug overdose death of a pre-med student who obtained Adderal from online mental health provider Done. Points:

• Companies such as Done generate prescriptions for stimulants such as Adderal after video calls that list as little as 10 minutes and pressure their contracted clinicians to issue prescriptions if patients seek them.
• The patient, who lived in a sober-living house, didn’t disclose his drug addiction history to Done’s nurse practitioner. He relapsed shortly afterward and died of a drug overdose.
• The nurse practitioner was new to the company and had little experience with ADHD. She says she checked California’s prescription drug monitoring database as required by law, but didn’t notice the patient was  prescribed Suboxone by a rehab center.
• The company, which was started by a former Facebook executive who has no medical background, considered firing the nurse practitioner because she was supposed to name a supervising physician as state law requires and had failed to do so.
• Done’s clinicians are paid $10 per month for each monthly renewal, with one of them saying that she made $20,000 per month cranking out refill prescriptions at 30 seconds each.
• The company responded to complaints about its practices from the patient’s mother by saying that it offers only a technical platform that matches patients to medical professionals, with no responsibility for any prescriptions that result.

Sponsor Updates

• Optum publishes a new success snapshot, “Regional One amplifies utilization review effectiveness with Optum Case Advisor.”
• Surescripts releases a new episode of its There’s a Better Way: Smart Talk on Healthcare and Technology Podcast, “The Giant Sequoia as a Metaphor for Advancing Interoperability.”
• Vocera publishes a new white paper, “Smart, connected hospital framework.”
• Ragan honors Well Health VP of People Marissa Morrison with a Platinum HR Award in the Future Leaders category.
• Verato will exhibit at the Civitas Networks for Health Annual Conference August 21-24 in San Antonio.

Blog Posts

• Telehealth Grants: The What, Where and Why (Pivot Point Consulting)
• Hospital Call Center Software: How to Solve the Top 3 Issues (PerfectServe)
• Physician Documentation Improvement Software Helps Bellin Health Improve RAF Score by 16 Percent (Premier)
• Five Ways to Ease Difficult Conversations About Transitions in Care (Quil)
• 6 Overwhelming Statistics That Illustrate the Staffing Challenge RCM Leaders Are Up Against (RCxRules)
• How health systems accelerate their RPM strategies with Redox (Redox)
• 10 ways digital signs can improve your hospital (Sonifi Health)
• Applying Blueprints to Revenue Cycle: How Christus Health Elevates Future-State Operations (Tegria)
• Understanding the financial impacts of clinical communication and collaboration (TigerConnect)
• 5 Ways to Retain Rehab Therapy Staff in 2022 and Beyond (WebPT)
• The Future of Healthcare: Acute-at-Home (Zynx Health)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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