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Monday Morning Update 11/21/22

November 19, 2022 News 12 Comments

Top News


A federal judge sentences former Theranos CEO Elizabeth Holmes to 11 years in prison on four charges of investor fraud.

A law professor concludes, “Fraud cannot masquerade as innovation in Silicon Valley.”

Theranos had raised nearly $1 billion from investors in valuing the company at $9 billion.

Sunny Balwani, former COO and a romantic partner of Holmes, is scheduled for sentencing on December 7 on 10 counts of wire fraud and two counts of conspiracy to commit wire fraud.

Reader Comments

From Les Diables Bleus: “Re: HLTH. I had a full three days of what I felt to be high-value networking — not sales, mind you, which don’t happen at conferences. It’s a good show to see what’s trending (remote point solutions and health equity) and to meet potential partners. Running into a provider was like a unicorn sighting, which is ironic since that is the HLTH mascot. It is like an all-inclusive resort in that food, drinks, and entertainment were easy to find and included. My exhibitor friends said it was easy to have a booth since HLTH manufactures it with your logo and minimal customization, puts it up, and tears it down so you don’t have to deal with shipping, Freeman, or late-night installations. I would definitely attend again purely for the networking.”

From Kitschy Kicks: “Re: HLTH. How appropriate that it was in Las Vegas, where the house always smites players who think their smarts will make them winners.” It’s a pretty good analogy that brash startups were probably emboldened by the heady atmosphere of both the conference and the Strip into thinking that they can beat the house. Companies that don’t provably solve a problem that prospects will pay for in a financially strained environment, that aren’t making money, and that took too much investor cash and have little to show for it probably don’t need to plan much for HLTH 2023.

From Been There: “Re: HLTH. Our company refuses to pay to play for sessions or articles. The challenge is when customers expect us there to support them, and when VC groups are uneducated but still influential (like former CMS execs). It’s worth a 24-hour trip to keep folks honest.” Plus your attendance entitled you to be a guest on an endless number of podcasts and video interviews that nobody will ever consume. And to hear the inspirational story, for his speaking fee of more than $100,000, of how Lance Armstrong overcame adversity (choosing to be the dirtiest doper, cheater, and bullying liar in the history of sports) to start a new and possibly related career in health and wellness investing.

HIStalk Announcements and Requests


Most poll respondents have a LinkedIn profile and 92% of them contain a headshot, more than half of which were taken professionally. Nearly 20% of the headshots are more than seven years old, so couple that with professional retouching and there’s a pretty good chance that you might need to squint to see the resemblance in person.

New poll to your right or here: Will HLTH, ViVE, and the CHIME Fall Forum have a major negative effect on the HIMSS conference? I differentiate my readership from that of other sites by the number of decision-makers who read HIStalk, an advantage that HIMSS has traditionally enjoyed in attracting exhibitors. New conferences may be poaching that desirable audience from HIMSS. The biggest threat to HIMSS is no longer the obvious one, that in-person conferences will be replaced by virtual ones (which were pretty much a complete bust during the pandemic’s darkest days), but rather that the newer conferences offer an alternative that is drawing a response.

I mentioned recently an announcement of two companies that consummated what was labeled as a “merger” even though it was obviously an outright acquisition that wasn’t called that to avoid offending the delicate sensibilities of the acquiree. Legally speaking, a merger occurs when two companies join together to form a new company, and if there’s no new company, then it is an acquisition (there’s very little “M” in “M&A.”) Even “AP Stylebook” warns reporters that true mergers of equals are nearly unknown and should be called that cautiously – PR BS aside, if it will be the same company name, CEO, and headquarters location, they bought the other company.

Mrs. H saw my mention of the Meta Quest 2 virtual reality system and got me one as a special occasion gift. It is crazy immersive and lots of fun even with the limited number of apps I have so far — mini-golf, Beat Saber, and table tennis (those last two are sweat-inducing exercise). I don’t like giving money to Facebook and they could kill off the product line as they run the company into the ground chasing a Metaverse pipe dream, but it’s fun in the mean time. I nearly face-planted when I leaned in for a table tennis shot and tried to catch myself on the realistic yet imaginary table.

I’m looking at the short list of conditions that just-launched Amazon Clinic will treat via text messaging, which includes problems such as dandruff, motion sickness, and birth control. I’m questioning how much value the messaging adds clinically over just making the drugs that are used to treat these conditions non-prescription. You could easily train a pharmacy technician to read the questionnaire results from kiosk or online entry, then hand over the meds if indicated with any appropriate instructions or warnings, which is about all online doctors would do. “Prescribing what patients ask for” is a common business model that adds little value. The new Amazon Clinic is really just Amazon advertising the services of other companies, as it does with its fraud playground of China-based sellers of electronic devices or clothing items whose disposable company names look like a cat wandered across a keyboard. 


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

Acquisitions, Funding, Business, and Stock

Business Insider reports that Amazon’s Alexa business division lost $3 billion in the company’s most recent quarter, ranks third in usage behind Google Assistant and Apple Siri, and is being hit hard with layoffs.


  • Redox will implement terminology solutions from Intelligent Medical Objects



Kaiser Permanente promotes Mark Simon to VP/CIO of Washington and Colorado.


Stephanie Rogers, RN, MBA (Cerner) joins Children’s Mercy Kansas City as CNIO and senior director of nursing, heath informatics, and technology.

Announcements and Implementations

Sanford Health and Fairview Health Services announce plans to merge into a 58-hospital system under the Sanford Health name and CEO.


A report by Providence’s Digital Innovation Group says that health systems should take a retail-like “digital flywheel” approach in using technology to keep in touch with people who otherwise have only infrequent encounters. The authors say the EHR is a big barrier for outreach – it requires clinician involvement, it doesn’t support all lines of business, and it doesn’t address all types of consumer interaction. They recommend an Amazon-type system that applies algorithmic personalization to data to create a digital consumer identity. They say that unlike Amazon, health systems already offer a wide variety of services and have connections to partners that they can recommend to consumers. The report says that such efforts can be profitable to health systems given the $1.2 million lifetime value of a patient and that simply being able to assign a PCP is valued at $3,000. I’m a bit skeptical since Providence and other health systems have profited nicely from selling interventional care and well-intentioned attempts to offer wellness services nearly always fail for several reasons (lack of consumer motivation, ever-changing health plans, and a lack of clinically documented effectiveness). And perhaps the biggest challenge – whether consumers really want an ongoing relationship with their local health system as they might with Amazon or Starbucks. Personally as a “no news is good news” sort, I’m thrilled not to hear from my local medical center.  

Government and Politics

Texas Attorney General Ken Paxton sends a Civil Investigative Demand letter to Epic demanding that the company explain its policies on children’s health information. He says he is following up on complaints from parents that they lost access to the records of their children who were treated at Memorial Hermann Health System once the child reached 13 years of age. The health system, which is also targeted by Paxton’s investigation, says it is not aware of any parent complaints. Paxton said in a comment about his Epic inquiries, “Too many companies are taking marching orders from the radical left, especially when it comes to their all-out assault on family values and parental rights.”

Privacy and Security

First responders in Ontario go back to paper when its IMedic software is taken offline by a cyberattack.


A JAMA Network opinion piece says that patient satisfaction surveys aren’t suitable for evaluating physician performance. The authors reference an interesting previous study in which the patients who rated doctors highest had higher costs and mortality rates. They observe that most patient survey instruments are old and weren’t designed to reward high scorers. They also note that physician panel size and workload means that one disgruntled patient can drag down a clinician’s score unfairly (see: sour Yelp whiners). They urge public and private payers to stop using patient satisfaction scores for quality assessment and payment.

A randomized clinical trial finds that patient portal messages reminding parents that their child is due for a well child visit and COVID-19 vaccinations increased the rates of scheduling both.

Sponsor Updates

  • Meditech Expanse customers in Canada can now integrate directly with digital care journey platform SeamlessMD.
  • Clearsense publishes a new infographic, “Shorten the Runway for Your Data Platform.”
  • PerfectServe announces the full integration of AnesthesiaGo with its Lightning Bold scheduling platform, and new automation capabilities for improved integration between Lightning Bolt and its clinical communication solutions.
  • EClinicalWorks releases a new series of podcasts on “Achieving Success Through Data Capture and Effective Communications.”
  • Wolters Kluwer Health will serve as the exclusive digital distributor of subscriptions to the New England Journal of Medicine, NEJM Evidence, NEJM Catalyst, and NEJM Journal Watch
  • Premier’s PINC AI Applied Sciences team partners with Henry Ford Innovations to host the inaugural Advancing Health Equity Through Innovation and Collaboration event.
  • The Dutch Ministry of Defense expands its use of Sectra’s Tiger mobile encryption system to include secure file distribution.
  • Talkdesk adds Automation Designer and Workspace Designer to its Talkdesk Builder suite of low-code and no-code customization tools for contact center development.
  • West Monroe’s Alanna Discque receives the 2022 Dallas Ft. Worth Admin Award in the Spirit category.
  • Black Book Research names Zen Healthcare IT as the top-rated healthcare IT advisor for interoperability and integration.

Blog Posts

HIStalk sponsors exhibiting at RSNA November 27-30 in Chicago include:

  • Agfa HealthCare
  • Lyniate
  • Nuance
  • Nym Health
  • OneMedNet
  • Sectra
  • Visage Imaging
  • Volpara Health
  • Wolters Kluwer Health


Mr. H, Lorre, Jenn, Dr. Jayne.
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Currently there are "12 comments" on this Article:

  1. Texas AG asking EPIC about policies with respect to Memorial Hemann inquiry is interesting as MH does not use Epic. Should they have sent the query to Oracle Cerner?

  2. The actual cloud pricing is of concern to most operating offciers who use the cloud. Huge difference between projected and actual costs. The layoffs appear to be related to QoQ numbers which wont grow at same rate when your existing customers tighten the noose around the unrealistic monthly bills. Build team gets cashback to configure expensive workloads and the operate team has to foot the bill for years !! This blackmail had to stop some where. Opex vs capex tag line seems to be on way out for cloud vendors.

  3. Re: mergers vs aquisitions. Couldn’t agree more. I worked at McAuto/McDonnell Douglas Health Systems for quite a while. Years ago when McDonnell Douglas and Boeing “merged” the only visibile thing left of Mac was the logo (Boeing liked it more than their’s I guess) and the pension liability of former employees like me. I still collect a monthly pension payment (now a monthly annunity payment) from them even though I never worked for Boeing.

    • I chuckled at the “delicate sensibilities of the acquiree” comment.

      Having been through a couple of these myself, it’s nearly always the case that the larger entity takes control and winds up dictating the way the merger happens. And if it’s not the size that is controlling, then it’s who put up the money to make the buyout happen.

      Even when you have a setup where the terms are that the smaller company will be a wholly-owned subsidiary and the original leaders stay to lead that subsidiary? It rarely endures for the long term.

      As for not offending those delicate sensibilities? That is mostly ineffective. The people being sidelined know that it’s happening. There may be some modest value in not being too crude about the power dynamic. Beyond that though, they know, and they aren’t happy.

  4. Didn’t Memorial Herman just sign with Epic as part of they move from Cerner? How could Epic block acces to their patient records!?

  5. Any mention of Ken Paxton should mention that he is currently under felony indictment, yet somehow also allowed to be Texas’ top cop.

    • Also good to mention in this case that Memorial isn’t live on Epic (I think they only purchased it recently), so not sure how Epic’s policies have much to do with the potential complaints.

      • There’s a disconnect between state regulations and the real world regarding adolescent medical consent.

        The state says, the parent consents for adolescent medical care and has access to the records of adolescent care, except for a few categories of care where the minor may consent on their own behalf.

        I’m sure there’s a well meaning bureaucrat somewhere who is convinced that in the typical case, an adolescent visits the doctor without adult accompaniment and signs their own consent forms, and these are the visits that need data segmentation. Easy peasy.

        But more typically, there were five minutes inside an otherwise routine well person visit where the adolescent wanted to talk about a confidential topic, and depending on your EHR, the data segmentation for those five minutes vs the rest of the office visit is somewhere between difficult and impossible.

  6. In regards to VR apps, I highly recommend you pick up The Climb 2. It’ll both give you a workout and provide some beautiful views that are useful in fighting off the winter blues.

  7. Texas AG is a partisan political office.
    Ken Paxton (republican) recently won reelection.
    He has previously made the stance of his office that gender-affirming care for minors is child abuse.
    He is generally onboard with current “anti-woke” sentiment in the republican party.

    Some others in the thread have questioned “why Epic and not Cerner?”

    Something to consider:
    We don’t know that nothing was sent to Cerner – the news article about demanding info from Epic is based on a press release from the AG’s office.

    The press release is largely a vehicle for Paxton to yell about corporations kowtowing to “the radical left”. Press release: https://texasattorneygeneral.gov/news/releases/paxton-expands-investigation-companies-denying-parents-and-guardians-access-their-childrens-medical

    So if you want to do a little political grand-standing as part of investigation by putting out a press release that has names that can be blamed, you need to choose a name that can wrapped up in your accusation neatly if possible, and preferably a name whose use won’t come back to bite you.

    With that in mind:
    Larry Ellison (Oracle Cerner) is well known to give to Republicans and Judy (Epic) is known to give to Democrats.
    FEC records: https://www.fec.gov/data/receipts/individual-contributions/?contributor_name=Ellison%2C+Lawrence&contributor_name=faulkner%2C+judith&contributor_employer=Oracle&contributor_employer=Epic&two_year_transaction_period=2022&min_date=01%2F01%2F2021&max_date=12%2F31%2F2022

    So the short version, is for press release purposes, Epic is a better target for a republican official than Cerner.
    For investigative purposes, both Epic and Cerner have been widely used in Texas so they should have sent letters to both (assuming a legit investigation and not simple political posturing) but even if they did send letters to both, that doesn’t mean they’d put a press release announcing it.

    • Mr. Paxton’s fulsome use of Right Wing talking points, hotbutton words, and rhetorical flourishes betrays his true motivations here.

      You know, I’d be willing to have a discussion about when and how a child’s health records should become private to them, and restricted from their parents. But that wasn’t Mr. Paxton’s agenda, was it? No, he wanted to take a swing at those “many companies”. He also wanted the publicity that comes from picking this fight.

      The only reason to restrict access to a health record is concern for the child, their rights and interests. It’s pretty telling that while Mr. Paxton bloviates on about “family values and parental rights”, he entirely omits the child’s best interests.

      In Mr. Paxton’s world, the parents are always the best (and indeed only) answer. Except for Mr. Paxton himself, who feels free to tell families (including all parents) what is best for them.

      A 13-year old is no longer a child; neither are they an adult. Just as teenagers grapple with defining themselves and separating their identity from their parents, society grapples with how to treat them. Too much independence and the adolescent will too likely fail. Not enough independence and they are too likely to have maturity problems.

      None of this is of interest to a politician who wishes to carry on about “woke corporations”.

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