Weekender 4/10/20

Weekly News Recap

• The COVID-19 global tracking website that was put together in a few hours by a first-year Johns Hopkins graduate student is drawing one billion page views per day.
• Allscripts lays off staff and cuts costs.
• HIMSS revises its “no exhibitor refunds”policy for HIMSS20 and offers a 25% credit that can be applied to the next two annual conferences.
• Despite an ongoing lack of COVID-19 testing nationally, hospitals aren’t using the available capacity of independent labs because they don’t have EHR ordering and results interfaces.
• Duke’s Margolis Center for Health Policy, along with two former FDA commissioners and former National Coordinator Farzad Mostashari, MD, proposes a national COVID-19 surveillance system.
• AMA publishes a physician guide for implementing virtual visits.
• FCC publishes details of its $200 million COVID-19 Telehealth Program.

Best Reader Comments

Health systems are giving themselves gold stars for upping their stats on virtual visits, which I can’t help but find to be a tad disingenuous. Using the example from the Epic post, one organization had only 200 televisits during ALL of last year and are now counting 12,000 in just one week! Wow, except I’m not really feeling the celebration here. This success happened only because health systems were finally forced into telling their patients about the option that was probably there all along (it certainly was for Epic users). (Telehealth Princess)

The reason people didn’t do telemedicine before is because it wasn’t reimbursed at the same rates, or at all, in many cases. In addition to the obvious public safety advantages of video visits right now, insurers and CMS have agreed to broadly reimburse these services. On top of that, the government is also throwing money at hospitals to purchase telemedicine technology. The comparison to Napster is interesting. Healthcare does have a similar pricing and delivery problem that the music industry had. I wonder if some facilities will go the way of Tower Records in the coming future. So far “online doctor” services that attempt to bypass traditional payment models haven’t been particularly successful. We’ll see if that changes. (Elizabeth H. H. Holmes)

It sounds like Allscripts did a graduated pay cut. Meaning if two people are in the same role and the first employee makes more than the second, the first employee took a larger pay cut. Is that true? Doesn’t that punish harder working or more experienced or more talented employees assuming those people would be the one Allscripts would have originally given raises? (IANAL)

There will be titanic shifts across the whole economy that will reverberate for the rest of the year or even longer. Lots of docs are laid off already — the surgicenters are closed and many may not reopen.The disruption has only started. For many younger medical professionals who have never experienced a shrinking economy, the experience it will come as a shock that “MD” or “RN” does not means monotonically increasing wealth and well being. For anyone who remembers the 1990s, it is just a reminder of what we already knew. (Richard Irvin Cook)

In our county, a single for-profit health system owns the hospital and all urgent cares in the county. Last week, my wife had all of the symptoms of COVID-19 and she began to decline. I took her to the ED, and the note said that she was suspected of having COVID-19. The interesting part is they didn’t test her for COVID — their protocol was not to test anybody unless a positive test would change the treatment course. Instead of a single test, the did a CXR, metabolic panel, and a Chem 7. The Medicare reimbursement rate for a CDC COVID test is around $35.91, while my wife’s visit rang up $4,000. From a revenue perspective, it seems far more lucrative to not test for COVID-19. (Jim Bresee)

Watercooler Talk Tidbits

Readers funded the Donors Choose teacher grant request of Ms. S in New York, who asked for a VersaTiles math practice set. She said a few weeks ago, “The impact that these math VersaTiles have had on my children is immeasurable. It has allowed me to target weaknesses in individual students and help them understand the concept to mastery. The children are so focused on the task and so interested in the activities that the success rate has been through the roof. This has allowed those children who struggle, to move on to the next concept as they have now built that foundation. They have proven to be equally engaging and successful for those students who need to be challenged to do more. We will be forever blessed with your love and support.”

In Mexico, a man in a grocery store throws hot coffee on a nurse who was wearing scrubs as he shouts, “You’re going to infect us all.” Another nurse had an egg thrown at her as she waited for a ride, while residents of one small town threatened to burn their local hospital down if it treats any COVID-19 patients.

A South Carolina ED nurse isolates herself by sleeping in a RV in her back yard that was provided by RVs 4 MDs, which helps healthcare workers find a place to stay during the pandemic.

A hospital in Thailand fits newborns with face shields to protect them from coughing or sneezing that could contain coronavirus.

Pharma bro and Turing Pharmaceuticals profiteer Martin Shkreli offers to apply his drug development expertise to search for COVID-19 treatments in return for a three-month furlough from his seven-year securities fraud sentence.

Intensivist Julie John, MD makes a goodbye video for her children after coming down with severe COVID-19 symptoms at home and declining to call 911 because she didn’t want the presence of paramedics or the possibly being intubated to frighten her young children. She is recovering in quarantine, but even after 14 days the infection still leaves the 38-year-old doctor her feeling like she’s a 90-year-old woman with emphysema.

In Case You Missed It

• News 4/10/20
• EPtalk by Dr. Jayne 4/9/20
• News 4/8/20
• Curbside Consult with Dr. Jayne 4/6/20
• Readers Write: Strained but Secure
• Monday Morning Update 4/6/20

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