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EPtalk by Dr. Jayne 6/4/20

June 4, 2020 Dr. Jayne No Comments

I attended the ONC working session on patient identification and matching on Monday. It was scheduled as a seven-hour Adobe Connect meeting, and for me, getting the most out of it in this format was challenging.

The only agenda available had been sent more than a week prior, along with my registration confirmation. It had two, three-hour blocks with the broad titles of “Challenges around Patient Identification and Matching – Boots on the Ground” and “Exploring Potential Solutions.” Under those blocks they had a list of individuals and their organizations, without a lot of detail around what they would be presenting.

According to the welcome, each presenter was supposed to have about eight minutes to speak. I tried to make my own time-boxed agenda, but it quickly was off by more than 10 minutes, so I gave up.

The first three sessions were largely review for anyone who has been dealing with this problem. Although the speakers were good, I wasn’t sure I wanted to commit a full day to gambling that I’d hear something I didn’t already know. It would have been good if the agenda included the theme of what each presenter was going to discuss so we could tune in and out in a way that made sense for us.

One of the best (or worst, depending on how you look at it) parts of some of the presentations was the inclusion of examples of how things have gone wrong due to poor matching. It’s terrible from the patient perspective, but it is useful to provide concrete examples to try to engage stakeholders who may not think matching is a priority issue.

I continue to see organizations create their own matching nightmares by deliberately creating duplicate charts for patients depending on their payment status. I worked with one client who had separate charts when the payer was employee health versus when they were using insurance or cash pay. I understand their concern about having the employer have access to sensitive medical information, but if you have an employee health department that has to certify an employee’s readiness / safety for work, shouldn’t they have all the pieces of the puzzle? I worked with another practice that had separate charts for work comp versus insurance visits for a patient, simply because they didn’t understand how to use their practice management system to set up different payers on a patient and toggle from visit to visit.

Overall, the speakers did a great job of keeping within their time block, often running shorter than anticipated. Frank Opelka from the American College of Surgeons talked about silos in surgical care. The number of tax IDs that touch a patient during a major surgery could be more than 20. That’s pretty unbelievable,  but of course is believable in healthcare.

I really enjoyed hearing from Congressman Bill Foster of Illinois, who was a co-author of legislation last year that attempted to remove the ban on activities in support of a national patient identifier. I didn’t know much about him before today, but I was impressed by his background as a businessperson and also a scientist. He worked as a high-energy physicist at the Fermi National Accelerator Lab and was part of the team that discovered the top quark. For science nerds, that’s pretty cool.

I also enjoyed Henry Wei’s explanation of “circles of trust” that evoked Robert DeNiro in “Meet the Parents.” Another great quote was David Speights from Appriss Health, who notes that regarding matching, “We’re trying to science the heck out of this.”

The bottom line for the day: Improved patient matching is a critical need, and a unique patient identifier would help and would  bring us into line with many other developed nations. A lot of smart people are working on this, but many barriers remain.

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We are all knee-deep in COVID-19 projects, dealing with furloughs and working outside our usual norms. but CMS continues its churn with various rulemaking and other activities. On May 11 they issued the FY 2021 Inpatient Prospective Payment System (IPPS) for Acute Care Hospitals and Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) Proposed Rule. That’s a lot of abbreviations right there within a single rule, but I guess calling it the IPPSAPCLCHPPSPR would be a bit much.

The proposed rule includes minimum 90-day reporting period in CY 2022; maintenance of the Electronic Prescribing Objective’s Query of Prescription Drug Monitoring Program measure as optional for five bonus points in CY 2021; renaming the Support Electronic Referral Loops by Receiving and Incorporating Health Information measure to the Support Electronic Referral Loops by Receiving and Reconciling Health Information measure; and increasing the number or quarters of electronic clinical quality measure data reporting. Comments can be submitted through 5 p.m. ET on July 10.

Speaking of COVID-19, Quest Diagnostics has received Emergency Use Authorization (EUA) approval for its self-collected COVID-19 test last week. They hope to have half a million kits available by the end of this month. Other vendors already have similar tests available, but providers aren’t falling all over themselves ordering the tests for their patients. There are serious concerns about the self-swabbing ability of patients and with the ordering and management of the tests.

Go Mississippi: The Mississippi Hospital Association is launching a state-wide health information exchange in partnership with several regional hospitals and health systems. Initial capabilities will include admission and emergency department visit notifications, along with post-acute care transfer updates. Later phases will include clinical document exchange and referral management.

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HIMSS is at it again, spending its efforts on frivolous activities such as “rebranding” rather than figuring out how to earn back trust among members and show attendees who are still smarting from financial losses. Last week they launched new branding for their regional chapters.

I really dislike it when organizations discuss their branding strategy. Branding, when done right, should be invisible to the consumer. I dislike it even more when the branding strategy is explained in buzzwords. “Our HIMSS brand architecture has been designed to do two things. First, to maximize clarity across our brand spectrum for both internal and external audiences. And second, to enable us to realize our full brand value, both now and in the future.”

I’m pretty sure most of us already recognize the HIMSS brand by its exorbitant fees and punitive housing and refund policies. Great job, marketing folks.

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Happy 17th birthday to HIStalk this week. Being part of this industry has been a wild ride at times and I’m glad to have shared the journey with the HIStalk team and all our readers.

Email Dr. Jayne.

Readers Write: Hospital Vital Signs: The EHR Doesn’t Know Everything

June 4, 2020 Readers Write No Comments

Hospital Vital Signs: The EHR Doesn’t Know Everything
By Keith Boone

Keith “Motorcycle Guy” Boone is informatics adept and SANER Project leader for Audacious Inquiry of Baltimore, MD.

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In the fight against COVID-19, it is imperative to understand and monitor the vital signs of our healthcare system – the hospitals and health systems that are playing a critical role –  to ensure that we can provide patients with unfettered care as this global pandemic plays out.

To this end, numerous agencies at the local, state, and federal levels are attempting to monitor the pulse, EKG, respiration rate, and chemical balance of hospitals across the country for a better assessment of whether the hospitals we rely on to keep people safe are themselves up to the task. This information is needed to rapidly identify the hospitals that need supportive care as they face COVID-19 head to head.

Today’s data collection efforts are focused on extracting data from the EHR, which focuses on data elements such as bed numbers and bed types, ventilator use, and death rates. While this is a great place to start, the EHR is just one critical information system within a hospital.

Similar to how the body has many flows — or as these were once explained, humors — a hospital also has a network of systems that manage its overall wellbeing and operations.

  • Asset tracking solutions monitor the physical inventory in a facility, and asset management systems can both pinpoint the location of a ventilator or anesthesia system and report its present operational status.
  • Bed management solutions help a hospital streamline patient flow, ensuring that patients are getting into beds as fast as possible. They identify if beds that need cleaning are being turned around quickly and whether patients are being discharged efficiently.
  • ICU and central monitoring solutions keep track of patient telemetry inside the ICU, bringing signals from the monitors and medical devices at the patient’s bedside to the central nursing station, possibly long before the information is available in the EHR.
  • Inventory management solutions keep track of consumable medical supplies – simple service parts such as ventilator tubing,  medicines, lab test reagents, personal protective equipment, and the cleaning and disinfectant supplies that a hospital goes through faster than your most germophobic relative.
  • Workforce management solutions track the flow of staff and are often linked with identity management solutions that grant privileges, identify credentials, and monitor access points.
  • Some hospitals have command centers into which many essential data elements flow. These have compelling visual displays, dashboards, and teams of staff who manage hospital capacity, but they are rare outside of larger academic medical centers, and even the most advanced command centers may not be able to readily share data outside their own system. 

The list goes on and on. These systems collectively determine the pulse or heart rate of a hospital.

While a hospital’s EHR system may be considered the brain of an organization by many who think about hospital information systems – and that’s probably not a bad analogy – a critical failure in any one of these other systems can be debilitating to hospital operations. Though EHRs may be the highest level as the most business-critical decision-making element of a hospital, they cannot track all the functions of an organization that are essential for efficient and prolonged patient surge operations.

To truly understand the health of a hospital and its level of readiness for taking in a surge of critically ill patients requires tracking more than just what is going on in its brain. In our analogy, the heart, the lungs, and liver represent a hospital’s staff, supplies, and equipment. All of these are tracked by other systems.

Some of these systems connect to the EHR, and extracting data via the EHR rather than from the system directly is possible. However, in these instances, speed and clarity may be sacrificed for simplicity. The originating systems often know something well before it is shared with the EHR, just as your stomach responds to food without your brain having to decide how to handle it. Some of these data sources may have no direct connection to the EHR at all, yet their importance to the overall vitality of the system remains undiminished.

As we experience our 100-year pandemic event, the healthcare industry is learning that it didn’t think of everything that hospital leaders might need to know considering equipment or critical supply or staffing shortages. The magnitude of this response has drawn national attention to the critical infrastructure deficiencies in our healthcare, public health capacity, and surveillance systems.

But a silver lining in this endeavor is the rapid progress that is being made by passionate and committed individuals and organizations coming together to solve these complex data sharing and interoperability challenges. HL7 International is doing a tremendous job supporting their members by enabling the secure and rapid transfer of information about hospital bed capacity and availability of critical resources during public health emergencies. From May 13-15, they held a virtual connectathon to demonstrate projects in development. It is promising to see such rapid progress being made through data standardization using FHIR-based APIs.

As an industry, we need to support standards across the many information systems inside a hospital. We need to expose the critical vital signs these systems have to hospital leaders so they can work with public health and emergency response agencies to ensure that appropriate measures are being taken to address this pandemic. While we don’t yet have a consistent approach to sharing data from disparate sources within the healthcare system, it can be achieved.

Morning Headlines 6/4/20

June 3, 2020 Headlines No Comments

R1 Announces Agreement to Acquire Cerner RevWorks

RCM company R1 will acquire Cerner’s RevWorks RCM outsourcing business in a transaction valued at $30 million.

VA Likely Can’t Debut EHR Until the Fall

Politico reports that congressional sources say the VA likely won’t relaunch roll outs of its new Cerner system until the fall, giving it more time to focus on caring for COVID-19 patients.

Change Healthcare Inc. Reports Fourth Quarter and Full Year Fiscal 2020 Financial Results

Change Healthcare reports Q4 results: revenue up by 1%, adjusted EPS $0.42 vs. $0.37 beating both revenue and earnings expectations.

Morning Headlines 6/3/20

June 2, 2020 Headlines No Comments

Central Logic Announces Strategic Investment from Rubicon Technology Partners

Private equity firm Rubicon Technology Partners takes a majority position in patient access center platform vendor Central Logic.

Netsmart Expands Coding and Billing Service Offerings with Acquisition of QIRT

Netsmart acquires post-acute and behavioral consulting firm Quality In Real Time, adding the company’s OASIS, MDS, and coding and advisory consulting services to its McBee business.

Wellbox Acquires Oculus Health’s CCM Services Business

Chronic care management and remote patient monitoring company Wellbox acquires the CCM division of Oculus Health, which will now focus on the development of AI-powered, patient relationship management software.

News 6/3/20

June 2, 2020 News 5 Comments

Top News

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Private equity firm Rubicon Technology Partners takes a majority position in patient access center platform vendor Central Logic.

Terms were not announced, but pre-deal rumors suggested a deal value of $110-125 million. The company had previously raised $14 million.

I interviewed President and CEO Angie Franks four months ago.


HIStalk Announcements and Requests

This week marks HIStalk’s 17th birthday. I put together a snapshot of that summer of 2003 last year just to remind long-timers what was happening in the health IT world back then:

  • Some big healthcare names were George W. Bush, Tommy Thompson, Tom Scully, Dennis O’Leary, Erich Reinhardt, Linda Kloss, Anthony Principi, and Neal Patterson.
  • Hospitals were struggling with early CPOE implementations.
  • Kaiser Permanente had just chosen Epic.
  • Cerner had just made its first UK sales and opened its new headquarters.
  • HIMSS offered HIMSS03 in San Diego (with keynotes from Jeff Immelt, Rudy Giuliani, and Patch Adams) following Summer HIMSS in Chicago and also launched Solutions Toolkit, the predecessor to HIMSS Analytics.
  • Computers ran Windows XP while users licked their wounds caused by Windows ME and awaited / dreaded the promised magic of Windows Vista as the effects of the “every other Windows release sucks” rule were about to be felt.
  • People sent messages on BlackBerry devices and talked on the Nokia cell phones that dominated the market four years before the IPhone came out.
  • Companies such as MercuryMD, Misys, First Consulting Group, Per-Se, IDX, Healthlink, Quovadx, Alaris, and Sentillion were making a few sales.
  • Health IT news came slowly and with little critical review other than from expensive, low-circulation newsletters such as “Inside Healthcare Computing” and “HIS Insider.”

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Readers whose primary news interest is one or a handful of companies occasionally ask for a separate “news feed” for just those companies. That’s not practical to do since each HIStalk news post contains a lot of unrelated news items to support convenient reading, but this sample page shows the most recent news mentions of Cerner (just as an example) that I’ve copied/pasted into a single page with original dates. It wouldn’t be too hard to keep company-specific pages updated, and the bonus to readers is that instead of just being a bunch of low-quality stuff from around the web, it would just be those stories that I’ve already vetted as being worthy of a news post mention. Let me know if you would find this useful, and if so, for which companies. I won’t bother creating more work for myself if it isn’t important to someone.


Webinars

June 10 (Wednesday) 1 ET. “COVID-19: preparing your OR for elective surgeries.” Sponsor: Intelligent Medical Objects. Presenters: Janice Kelly, MS, RN, president, AORN Syntegrity Inc.; David Bocanegra, RN, nurse informaticist, IMO. The presenters will cover the steps and guidelines that are needed for hospitals to resume performing elective surgeries and how healthcare information technology can optimize efficiencies and financial outcomes for the return of the OR.


Acquisitions, Funding, Business, and Stock

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Change Healthcare acquires retail pharmacy technology vendor PDX for $208 million.

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Healthcare Growth Partners polls 80 private equity funds about COVID-19’s impact, concluding that those investors are slightly bullish on health IT for the long term compared to the overall market. About 25% of the firms are either pausing activities until the market stabilizes or are waiting to see how COVID-19 plays out, but companies are not generally targeting distressed or discounted opportunities. Many of their portfolio companies are applying for federal relief programs, delaying payables, and seeking additional capital. Most respondents expect a full economic recovery to be unlikely until a COVID-19 vaccine is introduced. All expect to continue closing deals, although half will be looking harder at pricing or strategic value.

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NextGen Healthcare reports Q4 results: revenue up 1%, adjusted EPS $0.20 vs. $0.23, swinging to a GAAP loss that fell short of Wall Street expectations but still beating revenue expectations.

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Netsmart acquires post-acute and behavioral consulting firm Quality In Real Time, adding the company’s OASIS, MDS, and coding and advisory consulting services to its McBee business.

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Konica Minolta Precision Medicine acquires Backpack Health, which offers a personal health record and anonymized research data collection app.

Canada’s Well Health completes its acquisition of Indivica, which serves 1,900 primary care clinics in Canada and represents Well Health’s seventh EHR vendor acquisition.

Allscripts names retired KPMG executive Beth Altman to its board.


Sales

  • North Central Health Care (WI) will implement Cerner’s Behavioral Health EHR in three multi-specialty behavioral facilities.
  • Northwestern Memorial HealthCare (IL) chooses Visage Imaging’s Visage 7.
  • Hospital Sisters Health System will use Empiric Health’s AI-driven analytics to address unwanted clinical variation, mining operative notes with natural language processing to form surgical cohorts to identify outliers.

People

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Cerner hires Jerome Labat (Micro Focus) as CTO.

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Sandy Phillips (Analytic Intuition) joins HIE Networks as CIO.


Announcements and Implementations

Epic partners with its local county agencies to implement Coordinated Care Management, a technology platform that streamlines healthcare and community services to address social determinants of health. Epic is waiving part of its license and implementation fees.

A study finds that 88% of acute hospitals send information to HIEs at the patient’s transition of care, but only 56% of inpatient psychiatric units provide that information electronically.

Surescripts releases Real-Time Prescription Benefit for Pharmacy, which allows pharmacists to advise patients on out-of-pocket costs and alternatives using pricing, coverage, and prior authorization information from the patient’s insurance.


COVID-19

CMS reports that COVID-19 has hit US nursing homes hard, with the first publicly announced count (which is likely underestimated) count showing 60,000 confirmed cases and 26,000 deaths, with 450 staff members also dying of the infection. Meanwhile, USA Today analysis of state-reported data that, unlike CMS’s numbers, includes assisted living facilities places the number of deaths at nearly 41,000.

A WHO-conducted meta analysis of 172 studies confirms that frontline medical workers should be wearing N95 masks, which offer 96% protection against coronavirus versus 77% for surgical masks. Eye protection appears to offer additional benefit. For public spaces, distancing of at least three feet and wearing of cotton masks were associated with protection. Experts are frustrated CDC was slow to recommend masks and later downgraded its recommendation of N95 masks to surgical masks on the basis of supply rather than effectiveness.

A China-based manufacturer of N95 masks misses a deadline for earning US federal safety certification, voiding its $1 billion deal with the state of California for which it has already been paid $495 million. The company was supposed to provide 300 million masks, but NIOSH turned down its certification due to “concerning” issues with its design, manufacturing, and quality inspection. Electric vehicle manufacturer Build Your Dreams opened a plant in China in March that it said would allow manufacturing 5 million masks and 300,000 bottles of disinfectant per day, leading to a deal with the state that critics called “secretive.”

Experts remind that temperature checks aren’t very useful for COVID-19 screening since most patients who test positive don’t have fever, especially before they start showing symptoms.

White House coronavirus testing czar Admiral Brett Giroir has been reassigned back to his regular HHS job as of mid-June and will not be replaced.

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The state of Nevada contracts for COVID-19 testing from G42, an artificial intelligence company whose ToTok messaging app is used to spy on civilians in the United Arab Emirates. University Medical Center is performing tests provided by G42 and is considering using its product for population health management and genomics studies. ToTok became popular in UAE because the country bans Internet calls and the app provides a seemingly government-approved way to conduct video and text chat, which security experts say is the government’s covert way of getting users to install spyware voluntarily instead of hacking their phones.


Sponsor Updates

  • Collective Medical end users can now sponsor home health organizations to rapidly onboard and begin collaborating on care for shared patients.
  • Impact Advisors is recognized in KLAS’s }Clinical Optimization Services 2020” report.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

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Morning Headlines 6/2/20

June 1, 2020 Headlines No Comments

Change Healthcare pays $200M+ for pharmacy IT firm

Change Healthcare acquires PDX, a Texas-based developer of enterprise pharmacy management software, analytics, and clinical technologies, for $208 million.

NextGen Healthcare, Inc. Reports Fiscal 2020 Fourth Quarter and Year-End Results

NextGen reports Q4 2020 results: revenue up by 1.3%, EPS $0.20 vs. $0.23, missing earnings expectations but beating on revenue.

Cerner Names New Chief Technology Officer

Jerome Labat (Micro Focus International) joins Cerner as CTO.

Tia gets over $24 million to build a network of holistic health clinics and virtual services for women

New York City-based Tia will use a $24.75 million Series A funding round to expand its virtual and brick-and-mortar clinical services to new markets.

Curbside Consult with Dr. Jayne 6/1/20

June 1, 2020 Dr. Jayne 2 Comments

This week’s tour through the virtual physician lounge brought news of additional departures among my physician colleagues. Although several were accelerations of planned retirements, others were not only unplanned, but unwelcome.

A local physician group decided to lighten its headcount by nearly 50 physicians. Their selections seem to have been made along economic lines, with primary care and non-procedural specialists hardest hit. Those who have the ability to drive surgical volumes or high-revenue procedures seem to have been spared. The majority of physicians who were terminated were over 55 years old, and a good number of them are planning to just stop practicing because they feel the prospects of finding a job at that stage of their careers are slim. Several of the younger physicians are also planning to hold off on looking for new positions, opting to assume stay-at-home parent roles instead.

For those who had planned to retire but accelerated their timelines, COVID-19 played a significant role. The financial impact caused intense pressure, especially among the smaller primary care practices that tended to run month-to-month with their finances. Even if they could return to seeing patients, some were concerned they would be unable to get the personal protective equipment needed to run their practices safely or to pay the exorbitant prices being asked.

Others were concerned about their own health. New data from the Centers for Disease Control shows that COVID-19 has killed more than 300 health care workers in the US and sickened 66,000. Those are scary numbers. For those who have the resources to leave the industry, I can’t blame them.

The idea of bringing home COVID-19 to a family or loved one is another influencing factor. The University of Arkansas for Medical Sciences (UAMS) recently surveyed their caregivers to assess acute stress among health professionals. Staff returned over 800 responses in early April and the University used those responses to help shape its response. The top fear identified was the need to keep family members safe after caring for patients who are suspected or confirmed to have COVID-19. The lack of personal protective equipment was another major factor, with one respondent using “PPE” 25 times in their response.

The university responded to those concerns by discussing PPE status in their communications, in addition to statistics on ICU beds and ventilators. Although that may have been reassuring to their clinicians, I know that when my own organization discusses its PPE status, I’m not terribly reassured.

An interesting finding in the survey was that many respondents felt that the pandemic increased their sense of purpose, reminding them of why they chose healthcare as a career. I know I personally am tired of hearing “that’s what you signed up for” when I try to talk about the stresses of in-person care with non-medical friends. Actually, no I didn’t sign up to care for patients during a global pandemic with inadequate protective gear. I didn’t sign up for fighting a forest fire while wearing flip flops.

“What I signed up for” was in fact gone by the time I got there. We all know that the idea of an old-timey family physician who sees patients across their lifespan was killed off by the insurance industry, constant switching of plans by employers, and market consolidation by hospitals and health systems. I’m lucky that I found something else to fall in love with that actually exists, and that’s clinical informatics. But I digress.

Digging deeper into the Arkansas data, the UAMS associate dean for faculty affairs is quoted in the AMA article as saying, “The vast majority of people in our organization – about 62% – felt valued by the organization. So that was important for us to hear too.” Certainly, that’s a majority, but I’m not sure I’d call it a vast majority, since 38% of the people don’t feel valued. That’s a big chunk of individuals who are likely carrying some resentment and bitterness.

He goes on to say that, “If there is one bright side of this crisis, it is that people will now value healthcare workers more and recognize the values and risks associated with our practices.” I’m not sure I’m seeing that where I live, where some of my colleagues have been told that they and their families are not welcome in their houses of worship due to concerns about infection risk.

I’m also starting to see some divisiveness among my colleagues. There is definitely some survivor guilt among those who kept their jobs while their partners and colleagues were terminated. There is also quite a bit of mudslinging against practices that are offering antibody testing, since the CDC doesn’t recommend it for individual patients, but plenty of practices are doing it in an attempt to shore up the bottom line.

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Physicians who have continued to work or who have recently returned are still scrambling for strategies to protect themselves from the pandemic. I was excited to hear about a technology effort for early detection. Although it won’t prevent COVID-19 infection in an individual, it may help reduce the spread, identifying early disease since we don’t get to quarantine when we’re exposed. Investigators at Florida Atlantic University’s Schmidt College of Medicine are hoping to use a smart ring to identify physiologic changes that could indicate COVID-19 infection. It’s part of a larger effort led by the University of California San Francisco looking at both frontline healthcare workers and the general population.

They’re using the Oura smart ring to track heart rate, temperature, movement, and sleep data, which they meld with daily surveys in an attempt to predict sickness. It looks a bit like a wide, flat wedding band. Although a smooth surface is probably the least of the evils for hygiene purposes, it would be better to not be worn on the hand at all since being jewelry-free is recommended for those caring for COVID-19 patients.

The study will also follow participants with weekly viral testing, although they’re fortunately using a saliva-based test developed in-house rather than the dreaded nasopharyngeal swab. They will also receive antibody testing twice during the 12-week study. Maybe Oura could acquire some technology from the folks at now-defunct Ringly. I still love my bracelet even though most of the features are no longer supported.

How are you coping in the post-COVID world? Do you feel valued by your employer? If you were terminated, would you stay in healthcare? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 6/1/20

May 31, 2020 Headlines No Comments

Onduo Appoints Verily’s Dr. Vindell Washington as Interim CEO to Lead Next Phase of Growth

Virtual diabetes clinic vendor Onduo names Vindell Washington, MD, MHCM as interim CEO.

Arterys Raises $28 Million to Accelerate the Delivery of Medical AI to Practices Around the World

Web-based medical imaging company Arterys raises $28 million in a Series C funding round and appoints co-founder John Axerio-Cilies as acting CEO.

Haemonetics Announces Sale Of U.S. Blood Donor Management Software Solution Assets To The GPI Group

Hematology technology vendor Haemonetics sells some of its blood center donor management systems to Italy-based GPI Group and its US software subsidiary Hemasoft.

Monday Morning Update 6/1/20

May 31, 2020 News 9 Comments

Top News

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Virtual diabetes clinic vendor Onduo names Vindell Washington, MD, MHCM as interim CEO.

Google’s Verily hired the former national coordinator for health IT as chief clinical officer early this year.

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Verily and France-based drug maker Sanofi formed Onduo as a joint venture in 2016 with a $500 million investment, A December 2019 restructuring eliminated most of the stake of Sanofi, which said it had invested too much in the business as it was ending development of diabetes and cardiovascular drugs due to poor sales.

Onduo’s customer base is employers and health plans.

Onduo founding CEO Josh Riff, MD, MBA “is leaving to pursue other early-stage entrepreneurial opportunities.”


Reader Comments

From Greg: “Re: US withdrawal from WHO. What impact will this have on licensing ICD-10, for which WHO holds the copyright?” WHO authorizes the US government to modify the ICD-10 data set (created for mostly public health and research purposes) to develop our ICD-10-CM (for our unique use of it as a billing tool). I don’t know the terms of the agreement, although I found online references to “member states” only. If WHO wanted to be petulantly punitive, and if the licensing terms allow it, they could create a near-shutdown of US healthcare with the stroke of a pen. Meanwhile, some countries are already using ICD-11, which has been out for two years, although its official effective date is January 1, 2022 (HHS has said we’ll consider it here for 2025 or 2027). Bottom line: I don’t know, but I suspect federal officials haven’t even thought about that.

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From Dazed and Confused: “Re: journalistic style. Is it ‘health care’ or ‘healthcare?’” I use the rules of the “AP Stylebook” for journalists with few exceptions, but one of those is that I write “healthcare” as a single word. I don’t have a strong feeling either way , but the one-word variant saves space without sacrificing (although I acknowledge that “medicalcare” or “hospitalcare” don’t work). I also really dislike AP’s 1950s-style state abbreviations (“Conn.”) so I use the shorter USPS abbreviations instead (“CT.”) The most important takeaway is that every site should have its own consistent standards, ideally with 95% of them from the Stylebook and the rest customized for defensible reasons. I spend extra effort making HIStalk deceptively easy to read and understand, even as I acknowledge that I’m an outlier when most online content ranges from annoyingly sloppy to unintelligible.

From Creative Juice: “Re: Change Healthcare and TriZetto. Hearing any rumors?” I am not, but maybe someone out there is.


HIStalk Announcements and Requests

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Two-thirds of poll respondents expect their working conditions to be better a year from now, with most of them expecting to remain with their current employer.

New poll to your right or here: what is your preferred work location?

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Welcome to new HIStalk Gold Sponsor Ingenious Med. The physician-founded company has, since 1999, helped health systems and physician groups (70% of the country’s largest health systems and physician management companies) strengthen their revenue cycle, gain data-driven insights, extend EHR functionality, align with quality measures, and optimize workflows with mobile and web solutions. Health system offerings include revenue optimization (clinician charge capture, physician performance dashboards, coding tools); data intelligence (benchmark management, disparate data connection, automatic capture and processing of patient and charge data); and value-based alignment (flagging patients for quality measures, care team coordination, MIPS registry). ROI is 13-15x, with a $30,000 annual revenue increase per physician. Health IT long-timers make up the company’s entire executive team, including CEO Nimesh Shah and founder and chief medical officer Steven Liu, MD. Thanks to Ingenious Med for supporting HIStalk.

I found this Ingenious Med overview on YouTube.

I’m looking for a few folks who interact with us occasionally on behalf of HIStalk sponsors to give us feedback. Contact Jenn if you are our contact for a sponsoring company and can spare a few minutes by email.


Webinars

June 10 (Wednesday) 1 ET. “COVID-19: preparing your OR for elective surgeries.” Sponsor: Intelligent Medical Objects. Presenters: Janice Kelly, MS, RN, president, AORN Syntegrity Inc.; David Bocanegra, RN, nurse informaticist, IMO. The presenters will cover the steps and guidelines that are needed for hospitals to resume performing elective surgeries and how healthcare information technology can optimize efficiencies and financial outcomes for the return of the OR.


Acquisitions, Funding, Business, and Stock

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Hematology technology vendor Haemonetics sells some of its blood center donor management systems to Italy-based GPI Group and its US software subsidiary Hemasoft.

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Siren, which manufactures fabric that is embedded with medical monitoring sensors, raises $12 million in a Series B funding round. The company’s first product is a wirelessly connect temperature monitoring sock for patients who are a risk for diabetic foot ulcers.

India’s securities and exchange board warns Tata Consultancy Services that the company should have prominently disclosed to investors in 2016 that it had been assessed a $940 million penalty in a trade secrets lawsuit that was brought by Epic (the judgment was later reduced to $420 million as required by Wisconsin’s judgment caps). TCS disclosed the value of the judgment only in the contingent liabilities section of its financial results report, which Sebi says did not provide adequate notice to investors. Epic’s lawsuit accused TCS employees who were contracting with Kaiser Permanente of misrepresenting themselves as KP employees, which allowed them to use Epic’s UserWeb to download proprietary information that Epic says was intended to jumpstart development of a competing system.


Announcements and Implementations

Netsmart launches a COVID-19 Mobile Screening Solution that helps organizations screen employees, clients, and visitors with questions about travel, existing health conditions, symptoms, and any previous test results.


COVID-19

AdventHealth sues an attorney who it said kept a $2 million fee after failing to provide a promised 10 million N95 masks for $57.5 million.

Broad COVID-19 screening of patients who visited Seattle Children’s Hospital for a blood draw for any reason finds that 1% were positive in April in a sharp uptick from March as the outbreak spread. Most patients had no symptoms but developed a robust immune response, suggesting that a vaccine could be successful.

Israel starts closing schools that have spikes of new COVID-19 infections, as a single student infects over 100 people. The government will close 17 schools and start issuing fines for violating policies regarding distancing and wearing masks. The country has had 284 COVID-19 deaths in 17,000 cases. Meanwhile in Indonesia, the world’s fourth-most populous country, a full-blown outbreak is underway even as the government relaxes restrictions to restart the economy and citizens flout travel rules to gather for Ramadan.

A Washington county’s public health department reports that its workers are being threatened on social media, have had their home addresses posted online, and been the target of suggestions that they be assaulted. Fringe elements make their job of containing the pandemic harder, they say, especially following big budget and staffing cuts in 2008, and they wish people understand that they do contact tracing all the time to combat cases of food poisoning. I can’t imagine working as a contact tracer in today’s environment.


Other

Hospital EHRs are doing a better job of identifying potentially harmful medication ordering errors – their scores on simulation testing have improved from 54% in 2009 to 66% in 2018 — but advanced clinical decision support lags and overall results vary among hospitals that use the same EHR. The authors conclude that EHRs are nearly universally deployed in hospitals, but they still fail to meet federally endorsed health IT safety measures 30% of the time, leading to a recommendation that hospitals perform their own CPOE safety tests annually and share the results with their vendor.

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A brilliant summary of the now-virtual American Society of Clinical Oncology annual meeting.


Sponsor Updates

  • Central Logic CEO Angie Franks and Banner Health Senior Director of Transfer Services Charley Larsen are interviewed about the Arizona Surge Line public health project.
  • The local news covers the implementation of Meditech’s Virtual Visit software at several Canadian hospitals.
  • A Forbes Technology Council post features Greenway Health Chief Technology & Innovation Officer Kali Durgampudi.
  • Loyale Healthcare makes available to its customers two RevSpring solutions – Talksoft patient messaging and IVR Advantage.
  • OmniSys, the National Community Pharmacists Association, and the Association of Diabetes Care & Education Specialists launch an initiative to help small business independent pharmacies offer the National Diabetes Prevention Program to people with prediabetes.
  • OptimizeRx will present at the virtual William Blair & Company’s annual Growth Stock Conference June 10.
  • Pure Storage announces first quarter fiscal 2021 financial results.
  • Forbes features ROI Healthcare Solutions in an article on COVID-19’s impact on IT.
  • The Puget Sound Business Journal profiles TransformativeMed.
  • The Wall Street Journal features TriNetX VP of Clinical Sciences Jennifer Stacey in an article on AI’s role in understanding heart disease in COVID-19 patients.
  • Wolters Kluwer Health wins a Bronze Stevie Award from the American Business Awards for its Care Without Judgement video series.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

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Weekender 5/29/20

May 29, 2020 Weekender No Comments

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Weekly News Recap

  • Bright.md, Orbita, Oncology Analytics, MDMetrix, and Higi announce new funding rounds.
  • Healthcare associations take a huge revenue hit as their conferences move to virtual.
  • China’s expansion of its COVID-19 contact tracing app with new functions raises privacy concerns.
  • ONC funds The Sequoia Project to continue as the Recognized Coordinating Entity for TEFCA for a second year.
  • The National Institutes of Health issues an RFI on digital health solutions that can help it build a central data hub for COVID-19 researchers.
  • Central Logic is reportedly nearing a $100 million-plus acquisition.
  • Kaiser Permanente EVP/CIO Dick Daniels announces his retirement.

Best Reader Comments

KLAS: Is it me or does it seem odd to rank vendors based on such small sample sizes? n = 6 is not exactly a big sample when considering there are ‘000s of hospitals in the USA to award top spot. I suppose at least they front up to the fact by publishing sample sizes as opposed to most obtuse and ropey awards out there. (Plucky Brit)

As one of the couple dozen companies sending a petition to HIMSS, I’ll just say that some large companies (some very large) who were originally signatories to the petition have dropped out, possibly when they saw their logos on the letter. Regardless, HIMSS should continue to be made aware just how unhappy the industry is about their actions. (Ed Chung)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. M in Texas, who asked for programmable robots and board games for her kindergarten and first grade technology classes. She reports, “Having Kinderbot and Botley have allowed them to have first hand experience with block coding. They immediately wanted to get to know them by name and play with them. Their colorful appearance was visually engaging and the child friendly buttons made it easy to use. This allowed them to be more actively engage in learning and feel successful as they completed an assignment. Again, we greatly appreciate your donation! It has opened my students’ desires to learn more about coding, and it has allowed them to feel successful and more willing to challenge themselves. Thank you!”

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Novant Health is running 10 test flights of drones each day, using the 11-foot aircraft to deliver PPE to one of its hospitals in exploring the option for future health crises.

A Texas doctor recommends that residents change their face masks for summer, choosing lighter masks “much like men in North Texas change their cowboy hats in style during the summer.”

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A Texas woman is arrested for threatening an Ecuador-born medical resident (who has been treating COVID patients) and her husband with a hammer in Houston, where she ran after them on the street screaming, “You Mexicans, get out of my f—ing country.” Her family, many members of which are Latino, say she was drawn to extremist political beliefs and possibly experienced mental decline after losing her job as a nuclear medicine technologist and medical sales specialist. Her resume says she is “HIPPA certified.”

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London doctors are using Microsoft’s HoloLens 2 mixed reality headsets with Remote Assist 365 software to conduct virtual rounds on COVID-19 patients, reducing PPE usage by sending in just one doctor whose encounter can be broadcast to other team members who are away from the bedside. The system also displays diagnostic images and lab results.

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A Las Vegas couple is charged with $13 million in Medicaid fraud after posting social media photos of their private jet, piles of newly delivered Tiffany boxes, an Aston Martin, and a Bora Bora vacation. The wife started a fake home health company, cross-checked obituaries against North Carolina’s Medicaid eligibility tool, and then back-billed those accounts for fictitious charges. The husband’s Instagram is full of biblical quotes about honesty and hard work.

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Three boys in Bolivia are discharged from a week-long hospital stay after they provoked a black widow spider to bite them in hopes of gaining Spiderman-like powers.


In Case You Missed It


Get Involved


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Morning Headlines 5/29/20

May 28, 2020 Headlines No Comments

Bright.md Brings in Strategic Investors as It Closes Oversubscribed $16.7 Million Series C Round

Care automation vendor Bright.md raises $16.7 million in a Series C funding round, bringing its total raised to $29 million.

Orbita Raises $9M to Accelerate Conversational AI Solutions in Healthcare and Life Sciences

Healthcare AI company Orbita raises $9 million in a Series A funding round.

Oncology Analytics Raises $28 Million Series C Financing Led by Baird Capital

Oncology Analytics raises $28 million in a Series C funding round.

News 5/29/20

May 28, 2020 News 2 Comments

Top News

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Retail health kiosk company Higi raises $30 million in an investment round that includes financing from Babylon Health, the high-profile, UK-based telemedicine vendor that has strong ties to the NHS.

Babylon Health CEO Ali Parsa plans to integrate his company’s software and services with Higi’s Smart Health Stations.


Reader Comments

From B4 You Leap: “Re: work from home. Your editorial on reader comments related to office space was great. I am surprised that in everyone’s haste to make working from home a permanent lifestyle change, none have considered the many downsides. Most notably, outsourcing. Sure if you bring an A game every day, all the time, you are probably safe. You are probably also the top 15 percent of everyone working. For the rest, when you are perpetually remote and providing detailed performance metrics of your productivity, you have given every outsourcer a blueprint of what exactly you do and how much it costs for you to do so. I’d like to believe that our employers also place value on the intangible benefits and loyalty of long-term employees. But I doubt it.” I agree. Employee-manager relationships are likely to be devalued in the ongoing absence of an interpersonal connection. I’ve managed a few higher-level IT folks who worked permanently and by choice from my health system’s far-flung hospitals, and while they loved keeping distant from the day-to-day corporate politics and developed closer relationships with their appreciative users that the rest of us envied, they weren’t fully participative in our decisions that involved them and they were never promoted because that would have required them to relocate to the corporate office. I also agree that remote workers may be more susceptible to having their work seen as a commodity. Remember that the so-called “gig economy” sounded entrepreneurial and worker-focused until it became clear that driving for Uber or delivering DoorDash was a regular job with all the good parts skimmed off.

From Kermit: “Re: HIPAA. A PA GOP spokesperson cites HIPAA to justify not telling representatives about a fellow lawmaker’s positive COVID diagnosis.” It’s the now-common, ugly admixture of science and politics as Democratic members accuse the Republicans of intentionally hiding the positive COVID-19 test of State Rep. Andrew Lewis. Lewis says he immediately self-isolated even before his test result arrived and he then provided the information that officials needed to conduct mandatory contact tracing. All of that sounds rational until you get to the House Republican spokesperson, who declared, “I know you guys know that in the media, but HIPAA limits exactly what anyone can say about a co-worker’s medical history.” It would be great if HIPAA really was what people misbelieve it to be. 

Dear people of the US, especially those who work in marketing: you are unfortunately and perhaps unknowingly displaying your ignorance or indifference (or your Arizona or Hawaii residency) when you list your pre-November event with a time zone qualifier that contains the letter “S” (like EST). We are on “daylight” time (EDT) for the next several months, so anything with an “S” is wrong except for events in those two non-DST states. I truly don’t understand why this is so hard to comprehend or remember, and yet the jarring prevalence of this error suggests that it is. Just use ET, CT, MT, or PT year round and you’ll look smarter.


HIStalk Announcements and Requests

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Welcome to new HIStalk Gold Sponsor Health Data Movers. The company, which was founded in 2012, offers services related to EHR implementation, optimization, and interoperability, specializing in Epic implementations, data conversions, and product development. Some of its notable Epic successes include helping clients with EpicCare Ambulatory, Phoenix, Healthy Planet, Beacon, Kaleidoscope, Resolute HB, and Resolute PB. It partners with the top health systems, medical device companies, and digital health vendors to move healthcare data in putting patients first. Thanks to Health Data Movers for supporting HIStalk.


Webinars

June 10 (Wednesday) 1 ET. “COVID-19: preparing your OR for elective surgeries.” Sponsor: Intelligent Medical Objects. Presenters: Janice Kelly, MS, RN, president, AORN Syntegrity Inc.; David Bocanegra, RN, nurse informaticist, IMO. The presenters will cover the steps and guidelines that are needed for hospitals to resume performing elective surgeries and how healthcare information technology can optimize efficiencies and financial outcomes for the return of the OR.


Acquisitions, Funding, Business, and Stock

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Care automation vendor Bright.md raises $16.7 million in a Series C funding round, bringing its total raised to $29 million.

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Healthcare AI company Orbita raises $9 million.

Oncology Analytics raises $28 million in a Series C funding round.

Clinical operations improvement startup MDMetrix raises $1.1 million as it accommodates increasing demand for its COVID-19 Mission Control technology. The company spun out of Seattle Children’s hospital in 2016. CEO Warren Ratliff is the co-founder and former COO of Caradigm, which GE Healthcare sold off in pieces between 2017 and 2018.


Sales

  • Forty-nine municipalities in Sweden’s Västra Götaland region will implement Cerner Millenium.
  • Sanford Health (SD) signs a contract with Sectra for cardiology-focused enterprise imaging software.
  • Pittsburgh-based ClinicalConnect HIE selects real-time, patient event alerts from Secure Exchange Solutions.
  • LabCorp’s drug development business, Covance, will use Medable’s digital clinical trials platform to enroll and manage patients.

People

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John Kelly (Cigna) joins PatientKeeper as CTO.

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Tom Barnett (University of Rochester Medical Center) replaces retiring Beverly Jordan as VP/CIO at Baptist Memorial Health Care (TN).

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3M Health Information Systems promotes Mark Endres to VP of international business development.


Announcements and Implementations

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Propeller Health receives FDA 510(k) clearance to connect patients using AstraZeneca’s Symbicort inhaler to its digital health technology, which delivers analytics on medication usage via sensors and an accompanying app. The company was acquired by ResMed for $225 million in late 2018.

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Waiting room content company Outcome Health emerges from media hibernation to announce GA of its Virtual Waiting Room, which gives providers the ability to show patients custom media while they wait for video appointments to begin.

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Consumer health advocate CARIN Alliance launches My Health Application, a website that helps visitors choose an aggregation tool for their clinical, coverage, and payment information.

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Revenue cycle and workflow management platform vendor ESolutions offers providers free use of a new Medicare Beneficiary Identifier lookup tool for claims reimbursement.


Government and Politics

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The National Institutes of Health issues an RFI on digital health solutions that can help it build a central data hub for COVID-19 researchers. The NIH is especially interested in wearables, smartphone apps, and new ways to analyze and aggregate de-identified data for population health management efforts.


COVID-19

Herd immunity is unlikely to deter the spread of COVID-19 any time soon, according to several studies in which even areas with heavy infection rates (and thus heavy death counts) have mostly single-digit percentages of people testing positive for antibodies versus the 60% that would be needed to inhibit the virus’s spread. Only 20% of people have tested positive for antibodies in New York City even after 200,000 cases, 51,000 hospitalizations, and at least 16,000 deaths.

In more negative herd immunity news, only half of polled Americans say they will volunteer to receive a COVID-19 vaccine if one is developed, with around one-third of poll respondents saying they aren’t sure. Groups with the highest “I’m definitely not getting it” percentage are blacks and Republicans. Just 20% of those polled expect to see a vaccine made publicly available in 2020.

Former CDC director Tom Frieden, MD believes that the key to saving lives during and after the pandemic is found in reporting deaths of all causes weekly, protecting healthcare workers and the most vulnerable, ensuring that non-COVID-19 care is available and accessible, and managing safe re-openings to make sure communities don’t fall into poverty and poor health.

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Cerner develops COVID-19 re-opening and social distancing projections for 60 countries using data from sources that include CDC, Johns Hopkins, Definitive Healthcare, and the COVID Tracking Project.


Other

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Modern Healthcare notes the steep revenue declines that healthcare associations are experiencing as their conferences move to a virtual format. RSNA will lose 45% of its total revenue from its just-announced cancellation of its November meeting, MGMA says it generates 80% less revenue from virtual versus in-person conferences, HFMA’s cancelled live annual conference contributes one-third of its total revenue, and HIMSS declined to comment. It’s interesting that HIMSS and RSNA were by far the most dependent on meeting revenue, but HIMSS made 70% more money on its conference than RSNA’s.


Sponsor Updates

  • Ellkay offers a testimonial from LetsGetChecked CEO Peter Foley about the companies’ efforts to expand access to COVID-19 testing at home.
  • Greenway Health CMO Geeta Nayyar, MD appears on the HIT Like a Girl podcast.
  • The National Committee for Quality Assurance names Imat Solutions a beta testing partner for its ECQM Certification Program.
  • Optimum Healthcare IT publishes a case study titled “Multi-Facility Integrated EHR and Technology Implementation & Training at Tower Health.”
  • Meditech will host its 2020 Nurse Forum online June 17-19.
  • T-System earns the top client experience ranking for emergency department information systems for the sixth year in a row, according to a new Black Book survey of 1,100 end users.
  • Omni-HealthData wins Best Overall Healthcare Data Analytics Platform in the MedTech Breakthrough Awards for the second year in a row.
  • The Chartis Group publishes a new paper, “Telehealth: Current Trends and Long-Term Implications.”

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

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EPtalk by Dr. Jayne 5/28/20

May 28, 2020 Dr. Jayne No Comments

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Memorial Day in the US looked a lot different this year to most of us. I hope people were able to have some thoughtful time about the challenges our nation has faced in the past. Although the National Cemetery Administration didn’t allow “public” groups to place flags in the National Cemeteries as we usually do, I was glad to see that the 3rd US Infantry Regiment was able to take care of Arlington National Cemetery. I found this picture with a great piece featuring quotes and remembrances to honor those who died for our freedom.

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It’s nearly impossible to keep up with my inbox lately, so I was glad that the announcement for the ONC Virtual Working Session on Patient Identity and Matching on June 1 caught my eye. Feedback gained from the meeting will inform ONC’s report to Congress. Nearly all of the organizations I work with struggle with patient matching, and the problem frequently leads to patient safety issues (missing data, erroneous data) or excess costs (repeating tests because they’re not in the right chart). Participants are encouraged to discuss their insights into existing challenges and innovations that can help. I’m registered and hope to see you there.

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Another inbox item that caught my eye covered Google’s efforts to help COVID-19 responders find hotel rooms. The recently-launched feature allows searches to be filtered for hotels that offer “COVID-19 responder rooms.” I tried a couple of searches to see what the special rooms might include – discounted price, quiet floor, consolidated part of the hotel, etc. – but all of them just said “contact the hotel for details.”

I was dabbling in telemedicine prior to the pandemic, and then things got real very quickly. Patients were scrambling to understand whether they had been exposed and trying to obtain refills from medications they would usually obtain from doctors whose offices were suddenly closed.

As offices reopen in my area, volumes are trending back to the baseline. I chuckled when I saw the headline of this op-ed piece, “Telemedicine Tales: Let’s Reschedule When You’re Not Shopping.”  Especially when wait times were long, it wasn’t unheard of for calls to connect when patients were somewhere other than at home, but fortunately I didn’t encounter some of the situations described by the author, including the “telephone encounter plus scalp exam” that resulted when a patient couldn’t resolve a camera angle issue. I completely agree with his assertion that he is “looking forward to the time when patients and doctors can determine whether in-person, video, or telephone visits best meet their mutual needs rather than having this dictated by public health emergencies or inflexible payment rules.”

Physicians in my area are sharply divided on whether telemedicine is going to be the wave of the future or the proverbial flash in the pan. There are some significant data points coming out of institutions like NYU Langone Health, which recently published in the Journal of the American Medical Informatics Association. They saw 683% growth in virtual urgent care visits and 4,345% growth in non-urgent virtual visits between March 2 and April 14. Most of my physician friends have enjoyed being able to see their patients virtually and be paid, especially when performing services that were previously uncompensated under traditional fee-for-service reimbursement models.

Those owning their own practices were happy with the flexibility, but employed physicians were a little less thrilled, depending on the arrangements. One large health system made the physicians physically come to the office to perform telehealth services, stating that it is required by HIPAA.

Speaking of large health system response to COVID-19, we’re not out of the woods yet for PPE. At my workplace, each employee has been issued four masks that they are expected to rotate on a daily basis and can only replace masks when the straps break or when they are visibly soiled. Apparently Missouri-based Mercy isn’t doing quite so well, with workers reporting that they’re wearing the same masks three shifts in a row. Competing health systems in the region are sterilizing masks daily. Most of the physicians I know still report a critical shortage of PPE and many are wearing non-medical respirators, such as those used for woodworking. Now that businesses are reopening and even more people need masks, the problem is worsening for some types of PPE, including surgical masks and gloves.

A recent Perspective piece in JAMA Internal Medicine describes some of the tensions found in expanding hospital volumes. It looks at the difference between making the hospital safe and making it feel safe, which aren’t always the same thing. I’ve experienced this in my own practice. Patients who acted shocked when I was masked during flu season and asked if I was afraid of catching their cold have become patients who file a complaint if they see a staffer removing their mask to grab a quick drink of water.

The author describes a new world where services that were previously in demand are no longer in demand and the importance of creating an appearance of safety. He notes the fine line between how new routines and procedures are presented, and whether they create an appearance of safety or danger that might cause hospitals to “inadvertently scare away the patients who need them.”

He closes by noting the difference between his weekend errand-running and life in the hospital with its critical care tasks. These are the skewed realities that many of us are living with every day, when we go from 12 hours of hazmat duty to hearing people complain about masks at the supermarket. Some days it’s surreal.

I see a lot of masks and gloves on the ground at retail locations, and at the same time, my office is limiting workers to one surgical mask per shift if they elect to not wear one of the four provided N95s. It’s a jarring visual and I certainly understand why many healthcare workers are seeking care for anxiety and acute stress reactions. This may be our new normal, but it doesn’t quite feel routine just yet.

The bottom line is that healthcare is still in crisis mode, but it feels like the rest of the world has moved on, especially when you see the videos of debauchery at some of the country’s lakes and beaches.

Is there anyone who is not operating under crisis standards of care? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 5/28/20

May 27, 2020 Headlines No Comments

Babylon Health Leads a $30M Series B in US health kiosk operator, Higi 

UK-based virtual care company Babylon Health takes a stake in Higi’s $30 million funding round.

NextGen Healthcare Announces the Launch of NextGen® Advisors

NextGen Healthcare launches an advisory service that will be led by CMO Betty Rabinowitz, MD.

Propeller Health Receives FDA Clearance to Connect Patients Using the Symbicort Inhaler to its Digital Health Platform

Propeller Health receives FDA clearance to connect patients using Symbicort inhalers to its digital health technology, which delivers analytics on medication usage via sensors and an accompanying app.

Morning Headlines 5/27/20

May 26, 2020 Headlines No Comments

China’s Virus Apps May Outlast the Outbreak, Stirring Privacy Fears

China’s continued use of its COVID-19 contact tracing phone app raises concerns that the government will make it an ongoing standard since features unrelated to COVID-19 are being added even as the pandemic’s impact wanes.

This Seattle startup just raised $1.1M from Vulcan, others to help hospitals care for COVID-19 patients

Clinical operations improvement startup MDMetrix raises $1.1 million as it accommodates increasing demand for its COVID-19 Mission Control technology.

ONC and The Sequoia Project Announce RCE Efforts Will Continue Into Second Year

ONC provides $1.1 million in funding to engage The Sequoia Project to continue as the Recognized Coordinating Entity for TEFCA for a second year.

News 5/27/20

May 26, 2020 News 4 Comments

Top News

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China’s continued use of its COVID-19 contact tracing phone app – which assigns users color codes that permit or deny them access to stores and public transportation — raises concerns that the government will make it an ongoing standard since features unrelated to COVID-19 are being added even as the pandemic’s impact wanes.

A Communist Party secretary says his city’s app should be an “intimate health guardian” that is “loved so much that you cannot bear to part with it.”

Officials in Hangzhou are considering using the app to assign a “personal health index” that is based on the user’s sleep, exercise, and smoking and drinking. Other cities are trying to keep users running the apps by giving them access to store coupons and the ability to schedule hospital visits.

Another region is using the app to assigned an “honesty health code” in which party officials will downgrade the user’s normal green code to yellow or red based on “whether your party spirit is healthy.”


Reader Comments

From Stayin’ Alive: “Re: returning to campus. At our place, there’s a generational gap. Younger leaders are pressing for more remote work with adequate monitoring. The older guard want butts back in seats, but can’t explain the why, other than that healthcare is unique. We’ve supported applications and other technology remotely for three months, but nobody can explain why that can’t be sustainable.” Management is always challenged to quantify the deliverables of most employees, whether they’re sitting in a cubicle or at their dining room table (and of course to justify their own existence as overseers). That’s why a lot of performance reviews end up being based on subservience, peer likeability, and creating the image of efficiency and expertise even when it doesn’t exist. Old-school managers were taught to use oppressive practices to make their least-productive employees behave themselves in the absence of willingness to terminate them, coupled with the feel-good idea that every employee should be treated the same. Everybody can point out the employees who contribute disproportionately and anchor the boat for everybody around them, so it’s crazy not to reward them with looser oversight, more self-direction, a few nice perks, and a more collegial interpersonal approach. It’s a lot easier to keep them than replace them.

From Home Office Space: “Re: working from home. What do you expect to see as the downside of that as a permanent arrangement?” The lack of ability to raise the knowledge level of less-experienced employees via face-to-face conversations, serendipitous break room encounters, and interpersonal dynamics. Another is the difficulty creating a culture as happens in all-travel consulting firms. It’s exactly the same as in online education – both are good for self-directed, experienced people or for relatively short terms, but not a good substitute for those who are trying to work their way up. It will be interesting to see how job promotions are doled out now that face time has been replaced by FaceTime.

From John: “Re: scam award emails. Here is another, the third I’ve received in a week, all from different organizations. Desperation?” This one came from International Forum on Advancements in Healthcare, which offers “the most-awaited healthcare conference” in Las Vegas in December. This is yet another offering from Prism Events, a think tank of diligent India-born workers who occupy a rented PO box in a rundown house in Wilmington, DE. The “manager of speaker outreach” who sent John an unsolicited email asking for his phone number (while not providing her own) says in her LinkedIn that her job is to sift through other LinkedIn profiles to create nominees for “Top 100 Leaders” and “Top 50 Companies.” A ton of folks have slapped this made-up award on their LinkedIn, which would be reason enough for me to not hire them even if I was otherwise inclined. I am always shocked at how many people – many of them light on education and upward job mobility – who will plaster all kinds of eye-rolling certifications, awards, and obviously inflated job descriptions on their LinkedIn.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Halo Health. The Cincinnati-based company’s cloud-based Halo Clinical Communication Platform (the company was formerly known as Doc Halo) reduces care delays and clinician burnout via unified clinical communication (secure messaging, VoIP calling, mobilization of critical alerts, and advanced clinical workflow that incorporates on-call scheduling). Real-time integration includes EHR, PBX, PACS, LIS, and middleware. Halo Health is offering urgent deployment of its secure messaging for COVID-19 efforts at no charge for up to six months and offers a best practices guide and webinar, with customer examples including anesthesia intubation, virtual care teams, clinical team mobilization, SNF messaging, and instant notification of test results. CEO and co-founder Jose Barreau, MD is board certified in internal medicine, hematology, and medical oncology and is passionate about addressing the need for clinicians to improve care through better communication, while co-founder and CFO Alessio Nasini is an industry long-timer with Merge Healthcare. Some of its customers are Atrium Health, Henry Ford Health System, and Trinity Health. Thanks to Halo Health for supporting HIStalk.

I found this new Halo Platform explainer video on YouTube.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Insiders report that an unnamed private equity firm will acquire patient transfer management platform vendor Central Logic for more than $100 million. I interviewed President and CEO Angie Franks in late January.

ONC provides $1.1 million in funding to engage The Sequoia Project to continue as the Recognized Coordinating Entity for TEFCA for a second year.


Announcements and Implementations

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A new KLAS report on clinical optimization services – which it defines as workflow refinement, application enhancement, and clinician training – places “2020 Best in KLAS” winner Chartis Group as #1, with both Chartis Group and Nordic also earning client nods for deep Epic expertise.

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A UPMC cardiologist’s app that generates a post-visit summary using AI-extracted speech finds new use in telehealth visits, where patients are more likely to forget their session details due to technology and proximity distractions. Doctors use the Abridge service by calling the patient using an assigned phone number, after which the call is recorded and the medically relevant portions are transcribed and made available to the patient. Patients can use the app directly for in-person and telehealth visits. UPMC-owned Abridge plans to to send the information to the EHR in its next phase.

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Philips earns FDA’s 510(k) clearance for its wireless, wearable biosensor for measuring vital signs for patients who are in lower-acuity hospital rooms. The five-day disposable patch collects respiratory and heart rate every one minute and integrates with the company’s analytics software for early warning of deterioration, including in COVID-19 patients, where it reduces the use of PPE.


COVID-19

Premier Inc. and 15 of its member health systems acquire a minority stake in Prestige Ameritech, the US’s largest surgical face mask manufacturer. The company manufactures its products in Fort Worth, TX and sells only to US customers. The US sources 80% of its masks from China and Southeast Asia, complicating the supply chain.

A pre-print study finds that coronavirus levels in a given city’s sewer sludge is highly correlated with the days-later COVID-19 epidemiological curve hospital admissions.

A CNN report concludes that “the world sacrificed its elderly in the race to protect hospitals” as nursing mortality home death rates are finally starting to surface. Countries in Europe are reporting that from one-third to more than half of their total COVID-19 deaths occurred among elderly residents of care homes as testing capacity was insufficient, national guidelines were lacking, and those facilities were given low priority for PPE and support for absent employees. Employees at a New York City state-run veteran nursing home defiantly publish a Memorial Day list of the nearly 50 of its 250 residents that died of COVID-19 in a four-week period through late April.

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An interesting observation by former CMS Acting Administrator Andy Slavitt. The pandemic and its death toll are, for most of us, an abstract concept of someone else’s problem.

A JAMIA-published article finds that the biggest problem with local, state, and federal public health agencies using hospital data to manage the pandemic is that most of those agencies aren’t capable of receiving electronic data. I might point out, however, that the underlying data came from surveyed hospitals who rarely self-identify as interoperability obstructers.

Data from China, which has largely defeated coronavirus if their reported numbers are to believed, suggests that patterns of lower subway ridership and higher levels of online collaboration have persisted, suggesting that work is changing there.

The latest projection from the most accurate US COVID-19 prediction model says the current death toll will rise from today’s 100,000 to more than 200,000 by September 1, which I note is pretty close the 220,000 low-end number that was projected early in the pandemic by the Imperial College group to much skepticism. Photos from this past weekend of beaches and bars packed with non-mitigating celebrants should encourage bettors to choose the “over.” It’s also important to note that our antiquated and politically manipulated methods of counting at the state level mean the real death count is a lot higher than the official numbers. Meanwhile, Brazil’s daily COVID-19 death count exceeded that of the US for the first time this week, as the country reported 807 deaths in 24 hours versus 620 in the US.

Texas Governor Greg Abbott defends issuing a $295 million, 27-month contract – paid for by federal taxpayers – to a little-known company that will perform COVID-19 contact tracing. Salesforce tech firm MTX Group, which has 200 mostly India-based employees, refuses to provide details on the similar work it claims to be performing for several other states and was allowed to redact its own state contract before it was released to the press.


Other

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The New York Times reports that 20 large health systems received $5 billion in federal bailout grants even as they were sitting on $100 billion of stockpiled cash. The article highlights Providence Health System, which received $509 million from the fund that was intended to keep health systems solvent even though Providence invests in hedge funds, runs two venture capital funds, and works with private equity firms as it banks $1 billion in annual profit. The quickly designed bailout program assigned payouts that were based on Medicare payments for 2019, meaning most of the money went to big, profitable systems instead of struggling community hospitals that are quickly depleting their modest cash reserves. According to Health Care Institute President Niall Brennan, “If you ever hear a hospital complaining they don’t have enough money, see if they have a venture fund. If you’ve got play money, you’re fine.”


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Morning Headlines 5/26/20

May 25, 2020 Headlines No Comments

With an ex-Uber exec as its new CEO, digital mental health service Mindstrong raises $100 million

Mindstrong. a Silicon Valley-based startup that has developed a teletherapy app for patients with severe mental illnesses, raises $100 million in a Series C funding round.

Castlight Health Launches New Solution For Safely Navigating Workforce Health and Re-entry Strategies Addressing COVID-19

Employee health management software company Castlight Health will introduce a COVID-19 screening, assessment, symptom management, and contact tracing app for employers next month.

Oregon’s Tracking Of Hospital Safety Equipment Rife With Holes

Healthcare workers in Oregon claim hospitals are neglecting to accurately document their PPE needs via the state’s HOSCAP reporting system, leaving some facilities without adequate supplies.

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