Weekender 9/27/19

Weekly News Recap

• FDA releases draft guidance explaining how it will determine if a clinical decision support software product should be regulated as a medical device.
• Emids is acquired by a private equity firm.
• Prescription discount service GoodRx adds virtual visits.
• Amazon launches a virtual medical clinic for its Seattle-area employees.
• China’s Ping An Good Doctor reaches 300 million registered users of its online healthcare platform.
• CHIME, AMIA, and other groups ask Congress to address specific information blocking issues and to extend the timeline for enforcement.
• University of Kentucky HealthCare diverts patients over several days after a registration system update causes a system crash.
• Campbell County Health (WY) diverts patients following a ransomware attack.

Best Reader Comments

If your organization is resistant to change (like most acute orgs) and not receptive of feedback (like most places with bad politics), you should probably keep your mouth shut. If you can’t, you should quietly leave. If you want to be a hero, volunteer after work or donate some money to a good cause. In general, sacrificing yourself on the molehills of office politics is a bad way to achieve moral goals. (DifferentIndustry)

One thing that always startled me as a someone who entered healthcare from a different field is how low quality healthcare management is. In private practice, you often have MDs trying to be managers. A general manager at McDonald’s has more well- developed management skills than these people. Sometimes they eventually realize that they don’t have what it takes and cede the role to a clinic manager or the practice is small enough that everyone learns how to work around them. The acute side is where you get real pathological relationships due to the scale, low pay for middle managers, and lack of competitive pressure. Every office has politics, but if people are incentivized to backstab, they will backstab. (Diseased)

Re: downloading health data. One more manifestation of the consistent phenomenon (see: open notes, patient portals) that patients are less fascinated by their heath data than we imagine. Most find this information to be either unpleasant, confusing, inaccurate, or some combination of these. A small core of patients find access to be essential, but it is a very small fraction. Assuming that all patients want to see their info makes us think we are failing. But maybe we need a different denominator.(Andy Spooner)

If I may, I’d like to add my two cents about why patients don’t download their data. I, for one, do download my data, especially the visit summary. But it is usually a waste of time and paper/ink because the substance of the discussion I had with my provider(s) is rarely reflected in the note. It’s more of a CYA note so pretty useless to me if I want to go back and try to see what the doc said in past visits. I even had a couple of physicians who dictated their notes AFTER I downloaded the note so the only thing entered in the visit note was PMH, Meds, VS, etc. Very disappointing. (Eyes Wide Open)

Watercooler Talk Tidbits

In England, twins who were mistakenly assigned the same NHS number at birth 37 years ago still have problems booking services, getting the right meds, and following up on appointments whose reminders are sent to the other sibling. NHS says it can’t talk about individual cases, but the problem is most likely to happen when patients share a last name, data of birth, and address.

A woman receives 500 letters at her home address from UnitedHealthcare that are addressed to “State of Maine DHHS.”

ProPublica congratulates itself on its story about non-profit Methodist Le Bonheur Healthcare’s aggressive pursuit of unpaid hospital bills in which it sued 6,500 patients, many of them living in poverty. The hospital was shamed by the report into offering more generous financial assistance, eliminating court-ordered interest on medical debt, and eliminating attorney fees. The feel-good story ignores the obvious – patients who didn’t pay their bills now don’t have to (unlike many patients before them), the hospital will surely find other ways to squeeze money out of patients once the headlines fade, and the problem of super-high hospital bills remains. The pea has simply been moved under a less-noticeable shell. Interesting facts from the health system’s tax forms:

• It paid its current CEO $1.6 million and its “senior advisor” and former CEO $1.3 million in its most recent tax year.
• The CIO was paid $469,000, the CTO made $337,000, and the chief health information officer earned $370,000.
• Cerner was among its five highest-paid vendors, with $13.3 million in maintenance costs for the year.

The stored stem cells of 56 cancer patients at Children’s Hospital Los Angeles are lost when the hospital’s freezer fails. CHLA apologized for the failure and for sending the notification letters addressed to the children instead of their parents. On a positive note, they bought a new freezer.

A Staten Island doctor is arrested for trading opioid prescriptions for sex, with 20 of his patients filling prescriptions for 100,000 oxycodone tablets.

Former San Diego Chargers team doctor David Chao, MD  — an orthopedist whose history includes DUIs, a DEA investigation, 20 malpractice lawsuits, and a revoked medical licensed that was stayed in a settlement – launches a subscription football injury service called the Injury Index for gamblers under his moniker “Pro Football Doc.”

A New Zealand woman credits her throat cancer recovery to a retired New Jersey pediatrician and cancer survivor who gave her a second opinion on Facebook. Sajjad Iqbal, MD wrote a 2017 book titled “Swimming Upstream: My Struggle and Triumph Over Cancer and the Medical Establishment: New Hope in Cancer Treatment.”

In Case You Missed It

• News 9/27/19
• EPtalk by Dr. Jayne 9/26/19
• News 9/25/19
• Curbside Consult with Dr. Jayne 9/23/19
• Monday Morning Update 9/23/19

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