EPtalk by Dr. Jayne 3/12/20

The time change came and went on Sunday, but my Outlook calendar is still messed up for the week. The ET zone is once again correct starting next week, so I’ll just have to be extra vigilant for the next couple of days about making sure I’m on the right call at the right time.

My calendar was still accurate for the lunch and learn session on Wednesday with Dr. John Halamka, sponsored by Arcadia. The company rolled this over into a virtual session almost seamlessly, and a good number of people attended. For those of you not familiar with the company, they have a tremendous population health platform and have helped their customers save over $2.4 billion through 2018. The platform is mapped to over 50 EHR vendors, which is a feat in itself.

Dr. Halamka joined from the library at Unity Farm Sanctuary and talked about the concept of platforms in healthcare. Central points included the challenge of de-identifying data when creating data analytics platforms along with how to best use machine learning for early disease identification, cost reduction, and preventive intervention. There was also a good discussion of the need to use the right kinds of data sets to do investigations. For example, if you’re looking at data on Hispanic females, you probably don’t want to use the dataset for Rochester, MN if one is available that is more representative.

I got a chuckle out of the inadvertent activation of his Google Assistant while talking about their use of Google Cloud for data storage. That happens to me all the time. There was also a good discussion of strategies for delivering high-acuity care in the home, which is top of mind given the surge in COVID-19 around the globe. Mayo Clinic is apparently partnering with third parties to provide much of this infrastructure, with a pilot scheduled in July for Florida and Wisconsin. There was an audience question about how much of Mayo’s technology is homegrown versus using vendors. Mayo’s preference is to buy solutions rather than build, whenever possible.

There was a good discussion about the recent interoperability rules and the potential risks for patients managing their own data. Halamka anticipates an increase in innovation with data being under patient control. There was also a discussion about COVID-19 and Halamka voiced concerns about the number of entrepreneurs jumping on the problem. He hopes that solutions come from non-profit organizations or technology companies in support of non-profits as an alternative to profit-driven approaches to a major healthcare crisis. He also lamented the inability of solutions to determine the cost of medications based on a patient’s insurance coverage that goes to the individual plan level. There are some solutions that can get you in the neighborhood, but none that are truly accurate.

The moderator asked about the impact of AI on the animals at Unity Farm. He has 103 devices on the farm, including cameras that can monitor the impact of coyotes and other predators on its 250 animals. They haven’t gone to automated feeding yet since a major focus of the institution is care and compassion for the animals. I have enough trouble managing the handful of devices in my house, so I can’t imagine what that looks like. (If any has suggestions on why I suddenly have to reboot my laptop any time I want to print something, please let me know.) All in all it was a great call, and I appreciate Arcadia’s ability to pivot the session to a virtual format quickly.

I also made sure to honor GlobalMed’s invitation to their Wine and Whiskey Happy Hour by lifting a glass of Jameson. I was looking forward to seeing their backpack telehealth exam station, but I guess I’ll have to wait a bit.

FormFast has rebranded as Interlace Health, noting that it “started as an electronic forms company and evolved into something much more valuable.” It now defines itself (along with thousands of other companies) as “a solutions company.” They go on to state that having the word “forms” in the name was limiting the perceptions of the company. I understand it, but I’m not sure the new name helps me understand their focus on “enabling seamless data capture and information exchange among providers, staff, and patients” either.

Lest we forget there’s a world out there beyond HIMSS and COVID-19, MIPS-eligible clinicians still have until March 31 to submit their 2019 data for the Merit-based Incentive Payment System. Data can be submitted until 8 p.m. ET on that day. Data submitted by claims have been ongoing throughout the year, and practices can also login for preliminary feedback on their Medicare Part B claims measure data. Clinicians are encouraged not to wait until the eleventh hour in case they need assistance from the Quality Payment Program Service Center.

If you’re bored, you can always choose to read from the pair of final rules released this week. Do we really need to get hit by both ONC and CMS at the same time? Although there are many aspirational comments that have been made by various government folks, let’s take a look at some of them.

From National Coordinator for Health IT Don Rucker, MD: “Delivering interoperability actually gives patients the ability to manage their healthcare the same way they manage their finances, travel, and every other component of their lives.” Although patients will have greater access, that’s not going to automatically make them more capable of better healthcare decisions. Healthcare is not ordering a pizza or booking a flight to Milwaukee. And comparing it to finances? Financial literacy isn’t exactly a strong point for many in the US. We need to spend money increasing health literacy, helping people understand the consequences of unhealthy behaviors, and teaching them basic facts about their own bodies and how to keep them running in good health.

I work with patients all the time who have amazing access to their data, but no way to interpret it or really understand what it means to them. I’m sure the counterargument is that third-party apps will help with that, but how many third-party apps are really going to be around purely for altruistic purposes? They will be there to gather data to sell it to other third parties, to pitch unproven solutions to medical concerns using unregulated supplements or other dubious methods, and more.

I’ll be judging the virtual shoe contest and socktastic submissions over the weekend, so please get your entries in for consideration!

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