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Monday Morning Update 10/31/22

October 30, 2022 News 1 Comment

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Teladoc Health reports Q3 results: revenue up 17%, EPS –$0.45 versus –$0.53, beating Wall Street expectations for both.

TDOC share price moved up on the news, although it remains down by 81% in the past 12 months. The company’s market cap is under $5 billion versus its all-time high of $45 billion in early 2021.

The company reports strong performance of its direct-to-consumer BetterHelp mental health business. It says it lost a former client of Livongo, which Teladoc acquired for $18.5 billion in October 2020.

Teladoc says that it is getting increased interest from organizations who want to use virtual health to manage chronic conditions at a lower cost.

Reader Comments

From Lomond: “Re: Cerner. Which of its missteps led to its sale to Oracle?” Cerner struggled with product issues (such as revenue cycle), dated architecture, and a client base that was being constantly poached by Epic. Multi-billion dollar federal contracts stretching over decades weren’t enough to keep investors excited. However, Cerner’s biggest mistakes were made by its board, who took forever to choose a successor when Neal Patterson died in 2017 despite the claimed existence of a CEO succession plan, which surely didn’t tell board members to, “Hire a low-profile CEO of a division of a foreign medical device manufacturer for his first real CEO job.” But to be fair, a lot of Cerner executives who should have been likely candidates, especially those who Neal didn’t like much, had already successfully moved on. Brent Shafer’s four years were forgettable except for the board’s capitulation to an activist investor, then the board hired as Shafer’s replacement yet another executive who had never run a publicly traded company, although maybe David Feinberg made Cerner look hipper to eventual acquirer Oracle in his fantastically lucrative few weeks as CEO. Looking ahead, I can’t think of many examples where acquired health IT companies got better running as divisions of unrelated companies whose own growth prospects were questionable, but Oracle is saying and doing all the right things so far. Boards have a fiduciary responsibility to investors and I think they chose the best available option in this case. It’s all great news for Epic, which at some point will have its own CEO succession plan tested in the same way.

HIStalk Announcements and Requests


Two-thirds of poll respondents had paid their co-pay by the time they left their ambulatory visit. My personal experience is that medical practices and clinics are much worse at upfront collection than dental practices, which always seem to know exactly how much you need to pay after insurance and nicely ask for that payment while you’re taking possession of your free toothbrush kit.

New poll to your right or here: In the past year, has a provider given you a blank paper or electronic form that asks for information they should already have on file? It is aggravating when the front desk people of a provider that you’ve been seeing all along ask for the same information that they have already collected – medical history, allergies, meds list, emergency contact, etc. – instead of populating the form and allowing you to provide any corrections or updates. Will someone actually update your EHR information correctly if your new list of allergies or meds doesn’t match what is on file? If not, are you completing the form just so the provider doesn’t have to look at the EHR?

I watched Netflix’s movie “The Good Nurse” and it was a so-so yarn about nurse Charles Cullen, who killed dozens or hundreds of hospital patients using drugs like digoxin and insulin that he obtained by taking advantage of a quirk in the Pyxis drug dispensing machine. The hospital’s stonewalling of the police investigation was a big part of the movie, but what should have been mentioned was that many hospitals were irresponsibly using Pyxis like candy machines in the early 2000s, allowing nurses to make withdrawals of unordered meds, storing drugs in shared drawers (Cullen punched in Tylenol, then took digoxin from the same shared drawer), and failing to audit what was taken versus what was charted as given. i wrote a daily report ago for my academic medical center employer years ago that identified Pyxis withdrawals of unordered meds (including logic to account for delayed order entry), and it was so lengthy that nobody would review it. Anyway, the movie recalls the 2017 case of VUMC nurse Rhonda Vaught, who overrode a drug dispensing machine safeguard to give a patient the paralyzing drug vecuronium instead of the ordered sedative Versed, after which the patient died. San Diego-based Pyxis went public in 1992, sold to Cardinal Health for $867 million in 1996, was spun off with other products into Carefusion in 2009, and then was acquired by Becton Dickinson in 2014 for $12 billion.

This is the final boarding call for companies that want to sign up as HIStalk sponsors before the spring conference season begins and you realize that your HIMSS booth doesn’t help you for the 362 other days of the year.


Welcome to new HIStalk Platinum Sponsor Censinet. The Boston-based company’s cloud-based RiskOps platform and collaborative risk network transforms cybersecurity and enterprise risk in healthcare with the fastest assessment results, most coverage, and best overall experience at a fraction of the cost. Its digital catalog includes 9,500 assessed vendors and 34,000 products and services, offering automated risk ratings and corrective action plan generation to streamline identification and remediation of risks with pre-built workflows. An example is generating a list of vendors and products that have access to PHI but aren’t covered with a business associate agreement. The company offers healthcare organizations no-cost access to its RiskOps for HICP, which simplifies the implementation and assessment Health Industry Cybersecurity Practices. Censinet RiskOps enables health systems to create long-term vendor partnerships, resulting in fewer vulnerabilities, reliable patching, and better performance and compliance overall. Thanks to Censinet for supporting HIStalk.

Here’s a video featuring Censinet founder and CEO Ed Gaudet, who describes the company’s philosophy and product.


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

Acquisitions, Funding, Business, and Stock

Investor-backed HLTH says it has 9,400 registrants so far for its conference, which will be held November 13-16 in Las Vegas. I was surprised to see HIStalk list as a media attendee since none of us are going.


  • Three university hospitals in France choose Sectra’s digital pathology solution.



Hearst hires Atti Riazi (Memorial Sloan Kettering Cancer Center) as CIO.

Announcements and Implementations

SNOMED and LOINC will collaborate to standardize health data terminology, distribute their content together, and reduce duplication.


Fresh Tri, whose app promotes healthy habit formation, updates its system with improved onboarding, new algorithms to match users to behaviors, and new behaviors to support condition and disease management. Walmart licenses the app for free use by its 1.6 million employees.

Spok’s annual healthcare communications survey finds that the top obstacle in hospitals is budget and resources. Smartphone use for clinical communications dropped slightly for the first time, possibly because hospitals are issuing wi-fi phones instead of asking employees to use their own devices.

MUSC Health and MetroHealth launch Ovatient, a non-profit company and care model that will provide virtual and in-home care. The health systems say they hope that Ovatient can match the convenience and experience that non-traditional providers are delivering using digital tools.

Government and Politics

National Oceanic and Atmospheric Administration confirms that it plans to go live on Oracle Cerner next year, although under the Department of Defense’s MHS Genesis project rather than the VA’s as initially reported. NOAA has 24 clinicians.

Privacy and Security

A review finds that Canada’s Newfoundland and Labrador Centre for Health Information was warned that its 40-year-old Meditech Magic system was vulnerable to hackers a year before a fall 2021 ransomware attack exposed patient information and caused treatment delays. NLCHI has been recommending for years that the province issue a tender to replace Magic, with one study projecting that a move to Meditech Expanse would cost $85 million over 10 years, but would more than pay for itself.



Congratulations to New Jersey health IT consultant Eric Finkelstein, who has broken a Guinness world record for eating at the most Michelin-starred restaurants in 24 hours. He was able to obtain reservations at 18 of New York City’s best restaurants, traveling between them by Citi Bike bicycle and using a body cam to prove his accomplishment in wolfing down each place’s fastest-prep menu items, sometimes in less than two minutes. He spent $500 on his latest Guinness accomplishment, which also includes visiting all Citi Bike docks, making the longest table tennis serve, and building a flag out of 20,000 ping-pong balls.

Sponsor Updates

  • First Databank helps extend adoption of NCPDP’s National Facilitator Model, which will allow pharmacies, prescribers, and government agencies to access real-time information on prescriptions, testing, and immunization.
  • PeriGen CEO Matthew Sappern appears on Alldus International’s AI in Action Podcast.

Blog Posts

The following HIStalk Sponsors will exhibit at and/or sponsor AMIA 2022 November 5-9 in Washington, DC:

  • Clinical Architecture
  • First Databank
  • Intelligent Medical Objects
  • InterSystems
  • Meditech
  • Oracle Cerner
  • Wolters Kluwer Health


Mr. H, Lorre, Jenn, Dr. Jayne.
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  1. Upvote for Living Colour. And I had lost track of them too, after their initial breakout success. "Cult of Personality"…

  2. The part that Gurley totally missed, and I as many others lived thru it, was that in the early 2000's…

  3. Does use of the "cloud" infrastructure mean that Oracle's newly transformative platform will be vaporware like many of Cerner's previously…

  4. To Code Spewer (above): 100% agree re CASE tool hype/hope, and long known - sadly ignored by IT - reality…

  5. Four points - 1. Is an "Epic" possible in today's regulatory world? 2. How many EHRs were there in 2009?…

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