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Monday Morning Update 6/1/20

May 31, 2020 News 3 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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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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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.”


Sponsor Updates

  • Datica provides EHR integration for clinical surveillance company VigiLanz’s COVID Quick Start solution, available to hospitals for free for six months.
  • The Chartis Group develops the interactive Telehealth Adoption Tracker.

Blog Posts


Contacts

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

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Monday Morning Update 5/25/20

May 24, 2020 News No Comments

Top News

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Kaiser Permanente EVP/CIO Dick Daniels announces his retirement.

Daniels joined the organization in 2008. He reports to Kaiser Permanente Chairman and CEO Gregory Adams. His retirement will be effective in mid-June.


Reader Comments

From Gary: “Re: your Top Healthcare Leader nomination. The photo you included really conveys how prestigious that award is. Still, if there was an award for someone who provides value to me as a healthcare professional, you would be on the top of my list – no joke. I have been a daily reader of your blog for as long as I can remember because you not only provide timely, valuable information but also because of the humorous notes like the above. Thank you for all you do to inform, educate and amuse.” You made my day – thanks. I’m especially contemplative and appreciative as HIStalk approaches its 17th birthday in a few days.

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From HCITMasterClass: “Re: your Top Healthcare Leader nomination. Here’s another one you might find fun.” The Healthcare Technology Report lists its “Top 50 Healthcare Technology CEOs of 2020.” This outfit isn’t as scammy as others I’ve noted and its writers appear to be closer to native English speakers than its lower-rent competitors, although it carefully protects its anonymity by offering no address or employee lists. I Google-stalked its phone number and found that the owner is ZenLeads (dba Apollo) which sells lead generation software and databases from co-working spaces in San Francisco and Phoenix. It runs a maze of publications across unrelated industries, all of which seem to issue similar “top executives” awards. My interest in crappy news and awards sites isn’t that they attempt to extract cash in playing to executive egos since that’s apparently a viable market – it’s to see which of their featured authors and award winners proudly tout their “gosh, I sure love me” accomplishment.

From Swing Bar: “Re: HIMSS. Will they make a run at your HISsies ‘worst vendor’ and “stupidest vendor strategic move’ awards over their HIMSS20 refund policy?” Quite possibly, depending on the mood of readers in early 2021 when I conduct the nominating and voting. Egotistical behavior usually has an influence, and by many reports, HIMSS is still being terse in steadfastly defending its claimed lack of flexibility in offering HIMSS20 refunds. My experience is that it is not unfortunate or self-inflicted events that harms an organization as much as a lack of humility or commitment to change in its response to the event. We will see the full impact only when the HIMSS21 site is launched, which will include the available exhibit hall space. HIMSS may even hide that Freeman-produced floor map out of fear of creating a bandwagon effect that will reduce exhibitor and attendee registrations even further. Meanwhile, Las Vegas still has hotel deals available for HIMSS21 dates while bypassing HIMSS and OnPeak, with Harrah’s going for $69, Bellagio for $199, Caesar’s Palace for $149, Flamingo for $63, Excalibur for $40, and Luxor for $53 (upcharges over the previous non-nonconference week are modest). All hotels are offering the free, flexible cancellations that HIMSS does not. The Venetian is $483 and that makes me wonder if it’s the only hotel that HIMSS has locked down so far.


HIStalk Announcements and Requests

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Only about 10% of poll respondents expect their family’s financial security to be a lot worse 18 months from now.

New poll to your right or here: What will your job look like a year from now?

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Thanks to the provider IT folks who shared their plans for returning employees to campus.


Memorial Day 2020

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People are fretting how they’ll spend their Memorial Day summer kickoff given coronavirus restrictions and concerns, but here’s an idea – use a subset of the time as it was intended to honor those who died while serving in the armed forces. You don’t have to be a fan of the military to support those who signed up voluntarily, were paid little, disrupted their families, and died carrying out the task that was assigned to them.

In Flanders Fields
By John McCrae

 

In Flanders Fields the poppies blow
Between the crosses row on row
That mark our place; and in the sky
The larks, still bravely singing, fly
Scarce heard amid the guns below.

We are the Dead. Short days ago
We lived, felt dawn, saw sunset glow,
Loved and were loved, and now we lie
In Flanders fields.

Take up our quarrel with the foe:
To you from failing hands we throw
The torch; be yours to hold it high.
If ye break faith with us who die
We shall not sleep, though poppies grow
In Flanders fields.


Webinars

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


Announcements and Implementations

FDA’s Sentinel Operations Center at Harvard Pilgrim Health Care Institute is working with TriNetX’s global health research network to monitor priority drugs that are being used for treating hospitalized COVID-19 patients, studying its real-time, de-identified COVID-19 data set to review utilization and safety of drugs being used in the field.


COVID-19

Only 60% of states report COVID-related hospitalizations, but of those that do, Florida, Alabama, Georgia, Wisconsin, Virginia, Minnesota, and Ohio are all reporting upticks. Hospitals in some large Alabama cities have no ICU beds available, while Minnesota’s COVID units are full.

President Trump vows that “we’re not going to close the country” if predictions of a second wave of COVID-19 in winter turn out to be true.

In a “good news, bad news” item, scientists say that lower levels of virus circulation in summer will push clinical trials of vaccines back into the fall.

A NEJM-published preliminary report on using remdesivir in hospitalized COVID-19 patients with lower respiratory tract involvement finds that recovery time was 11 days versus 15 for placebo. Expected death rates were 30% lower, but the study was stopped early and thus doesn’t prove that survival odds were improved. The drug’s benefit seems most significant in early-stage patients with less-severe symptoms, but study design influenced that finding as well.

A large-scale, observational study finds that widely hyped drugs hydroxychloroquine and chloroquine did not improve COVID-19 outcomes and were associated with heart rhythm problems and higher death rates, the same conclusions that previous observational studies reached.

Updated CDC guidance says COVID-19 doesn’t spread easily from touching surfaces or objects – it’s getting near your fellow humans you have to worry about.

Another round of studies finds that COVID-19 PCR tests for active infection continue to register as positive long after a recovering patient is free of infection and thus not contagious, because the tests detect dead virus. That makes clearing patients for a return to work more difficult.

Former FDA Commissioner Scott Gottlieb, MD says China is developing its COVID-19 vaccine efforts around the old-school method of using inactivated virus, while the US is focusing in newer, less-proven technology that should provide a better result. His conclusion is that China is focusing on being “first to get shots in arms” even though the resulting protection will not be broad.

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President Trump suspends travel to the US from Brazil three weeks after it became the world’s new pandemic epicenter even as its president has called COVID-19 a “little flu,”refused to implement lockdowns, and has promoted chloroquine treatments. Cities there are digging fields of mass graves and two health ministers have departed in just four weeks after conflicts with President Jair Bolsonaro. Brazil officially reports 360,000 cases and nearly 23,000 deaths, second only to the US, and a study says the real numbers likely higher than those being reported, perhaps as much as 12-fold.

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The US COVID-19 death toll will likely hit 100,000 this holiday weekend and the virus remains all around us, including at Lake of the Ozarks, Missouri, where they’re partying like its 2019. Perhaps there’s an obvious reason that we have one-third of the world’s cases and deaths. It’s not really Darwin Awards territory when these folks may walk away unharmed but kill unfortunate others due to their lax behavior.


Sponsor Updates

  • VoyageLA profiles artist and NextGate VP of Software Engineering Gevik Nalbandian.
  • Clinical Computer Systems releases the latest edition of The Critical Care Obstetrics podcast, “The Hemodynamics of Hemmorrhage.”
  • Redox releases new podcast episodes, “Exploring Healthcare Platforms.”
  • ROI Healthcare Solutions receives a Bronze Stevie Award in the 2020 American Business Awards.
  • Vocera will transition its annual stockholders meeting to a virtual event on June 5.

Blog Posts


Contacts

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

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Survey Results: Provider IT Department Plans for Returning Employees to Campus

May 23, 2020 News No Comments

Working from home and remote meetings are both still considered the norm. Only have 50% of normal occupancy of the office, and have a sign-up SharePoint so that we stay until that limit. We keep track of everyone present and which rooms they’ve used in case there’s an infection later and we need to keep track. Avoid using anyone else’s wings /floors /meeting rooms. Hand sanitizers at almost every single intersection. Everyone is required to wipe down the meeting room and/or desk before use with sanitizer, which is provided. Point person who is in charge of maintaining rules in each area. No use of refrigerators, and dishwashers have to be run at highest temperature. No external visitors unless already approved.


For the near term, we are not. We have virtualized all our contact center agents, finance, HR, marketing, IT, legal etc. As we get into a groove, we are finding that maybe not everyone returns. Also, being in the epicenter of NY/NJ, we still are very cautious. When we return (after Labor Day), it will be on a rotating basis, 2-3 days a week, to be able to do social distancing, deep cleaning, masks, Plexiglas in cubicles, not sharing of equipment, etc. Right now our focus is on returning the hospitals and physician practices to operations. And we are starting antibody testing of every single teammate, which will be completed by mid to late June – that’s 36,000 people.


We have four different office spaces. We are reviewing the spaces and will schedule staff onsite alternating 2-3 days per week ensuring social distancing. Will rotate staff weekly two days in office and three three home and than the reverse.


Bringing back while requiring masks to be worn. No travel.


My IT organization announced today that all employees will continue remote work practice until 1/1/21 at the earliest. This includes all install and go-live support and all corporate travel has been suspended until that date. The remote employees were approximately 40% of the workforce prior to the lockdown. The “bring back in” is not an issue for use today. Ask again in seven months.


Temp check when entering designated employee entrances. Must wear mask into the building. Mask must be worn when outside of office. Can remove mask if in office alone.


The IT department employees returning on-site follow the exact same protocols that all hospital and clinic employee departments follow. There is no differentiation. All employees must enter through the same designated employee entrances where temperature is checked via an infrared thermometer. Any employees (and visitors) with a temp of 100 degrees Fahrenheit or higher OR exhibit visible signs of illness symptoms are not allowed to enter the building. Employees who are turned away must contact the their supervisor and the employee health department to make arrangements for continued remote work and for X number of days away from the hospital before being allowed to attempt to enter on-site again. X changes are set according CDC guidelines.  Cloth face mask worn at all times in the hospital. The only exception is at your desk or in other areas where there are not other people or the possibility that other people would enter the area. CDC social distancing guidelines are to be observed as well.


There is nothing formal. Departments are taking it on a person-by-person basis. A big challenge is reconfiguring work areas so that workers are more than six feet away from each other. Since many have been successfully working remotely, there will be a clash of opinions about having employees return at all  (We need you back in the office. Why? We’ve been successful not being in the office.)


Bringing back 50% of staff on alternating days. Created A/B groups based on the office cubicle configuration so that no more than two employees per pod would be in on a given day. Keeping an alternating three-day / two-day bi-weekly work from home schedule. Marked off six-foot separations on the floors to indicate proper social distancing from cubicles and in conference rooms. Removed extra chairs from conference rooms and kitchen to allow only the number of individuals to conform with social distancing. Providing masks, hand sanitizer, and disinfectant wipes to staff for work space use.


Not allowed in the break room without mask and gloves on. Limit the number of people allowed in the break room at a time. Moved people around so that desks and offices create safe distances. Not everyone is allowed in the office at one time, so staggered schedule between WFH days and in office days. If you go to a hospital for more than a few hours, you WFH for 14 days.


We will continue remote work for the foreseeable future. We’ve been doing just fine being 100% remote for the past two months, so there is no rush to bring folks back into the office.


Presently evaluating how many workers we will ask to return to offices, considering office reconfiguration requirements to ensure proper social distancing. Many workers are rightly concerned with potential COVID spread. We are working to demonstrate the productivity impact of working from home, which we believe to be positive. With a large number of elderly workers, we must be concerned wit their vulnerability. As communities reopen, we have to watch for increased COVID incidence.


Schedule time for people to come to the office and remove all of their personal items and non-work items from their work surfaces to allow consistent cleaning. Extra furniture being removed. Face coverings required in common areas and screening required upon entering building. Still requiring manager approval to return to the office. We will have to have staggered start times to avoid congregation at the screening stations and staggered work days to ensure proper social distancing. That dense cube farm that seemed great is now a major liability. No personal reusable water bottles, coffee cups, etc. are allowed unless filled at home but cannot be refilled at work. Bottom line, still encouraging IT staff to stay at home unless absolutely necessary to be on campus.


Our team was almost entirely remote (almost entirely out-of-state, in fact) so we’ll see no change. Our sibling teams were more local-focused, but I expect they will drop to two or three onsite days per week, in shifts (likely in perpetuity, in my opinion).


For the most part, continuing to encourage them to work from home and limit days in the office. When in the office, they will be under the same masking policies as all staff. No in-person meetings unless social distancing can be enforced. No allowing vendors on campus unless they are required as part of installation, implementation, or service. No sales calls.


We are not actually trying to bring everyone back into the office. And we will wait until some time after the recommendations take place to do so. We are planning a very gradual increase to onsite work, starting with only coming in if needed to perform a function not able to be done appropriately remotely (where interacting with other individuals and/or equipment requires it). We’ve found that our team has been quite productive in the current mode and I see no reason to rush them back in.


We are considering 100% work from home and giving up our office space. Our employee productivity remains high, our employees are happier, and we believe it will be an advantage in recruiting new employees. We already have departments 100% remote, and more departments are considering going 100% remote.


At our organization in Colorado, we’ve been using the CareCognitics workforce assessment tool for all of our employees. This includes evaluating each employee every day for risk for COVID-19 and escalating those at risk to testing when needed. The tool also assesses the mental health state of each employee. It has escalation to HR or other supervisors as needed. The analytics back end also tells us who hasn’t done their daily assessment so we can address that with the employee. Along with daily assessments, we also have created back to work assessments for those that have been off so we can assess them before they return.


We aren’t. Honestly, we’re evaluating whether we will for a large majority or just move to mostly permanent work from home.


News 5/22/20

May 21, 2020 News 3 Comments

Top News

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Optum acquires post-acute care management company NaviHealth.

The company’s private equity owner gets $1.1 billion in cash after buying a majority stake in the company for $400 million just 21 months ago.

The deal values NaviHealth at $2.5 billion.


Reader Comments

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From Dumas: “Re: Epic’s COVID-19 immunity passport. They didn’t name the organization they are working with, but I think it’s probably Bluetree, which is owned by one of Epic’s biggest shops in Providence. They are working with Lumedic, which is also owned by Providence, to create an app that stores COVID-19 test status and immunity status that Bluetree specifically calls an immunity passport that is being considered by other organizations.” Unverified, but Lumedic has published screen shots of such a credential (above). I assume that Epic’s role is to provide results of COVID-19 diagnostic and antibody tests.

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From Serrano Seed: “Re: HIMSS20. A group of exhibitors is petitioning for a refund of exhibit space fees.” The group of a couple of dozen companies, most of which I admit I’ve never heard of, hopes to shame HIMSS into refunding their exhibitor money for the cancelled conference. I suspect their efforts will be futile since (a) big-name exhibitors aren’t included; (b) their leverage is minimal given that HIMSS already has their money and, short of legal proceedings, seems unwilling or unable to return it; and (c) the cost of every company that is listed bailing on HIMSS21 (not likely) is minimal compared to the cost of refunding all exhibitors. I suspect that their polite petition will be far less effective than an impolite lawsuit.

From Nasty Parts: “Re: IBM Watson Health. I hear they are cleaning house, with some saying up to 80% of employees have been let go and a number of products (minus the employees who support them) being sold to Vizient.” Unverified. IBM Watson Health’s PR contact did not respond to my inquiry.


HIStalk Announcements and Requests

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It’s my lucky day, y’all! I have learned from Mr. Prashant Kumar via LinkedIn that I have been “shortlisted for the Top 100 Healthcare Leaders award,” where I (fingers crossed!) will stride humbly across a Las Vegas stage later this year for my bestowment at a conference that is conveniently operated by Mr. Kumar’s employer, with my award consisting of a registration fee discount. I am especially grateful that the judges recognize my global healthcare leadership, given that I don’t actually lead anyone and despite the fact that my only job that is listed on LinkedIn is “Cynical Blowhard Healthcare IT Blogger.” Above is the upscale Wilmington, DE headquarters of the conferring organization Prism Events, in which the fate of my esteemed award rests in the capable hands of several dozen all-Indian employees who conduct their deliberations in a rented PO box.

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Provider IT folks, help your peers by describing your department’s plan for bringing employees back to the office (or not, as the case may be), even if you’re just following organization-wide policies and would like to summarize those. I’ll post a recap this weekend. Thanks to those who have already provided some good (and sometimes surprising) ideas.


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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Amwell will use a $194 million Series C funding round to further scale its telemedicine technology and services. Reports of delays and crashing calls due to record utilization during the COVID-19 pandemic had already forced it to upgrade its hardware and software, in addition to onboarding new providers. The Boston-based company has raised over $700 million since launching in 2006.


Sales

  • The Idaho Health Data Exchange selects 4medica’s enterprise master patient index software and data-cleansing service.
  • Pathos Clinical Solutions will implement OpenText’s EMR-Link for secure EHR integration and CPOE between its lab and clinicians.
  • Sunnybrook Health Sciences Centre in Toronto signs a seven-year contract with Allscripts for managed services of the company’s Patient Flow software.
  • Texas-based GI Alliance selects Modernizing Medicine’s EHR for gastroenterology.
  • University of Alabama Birmingham Medicine will deploy sepsis-monitoring software from Ambient Clinical Analytics.

People

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EHR vendor Casamba promotes Billie Nutter to CEO.


Announcements and Implementations

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Valley Children’s Healthcare (CA) goes live on Epic with virtual support from Optimum Healthcare IT.

Engage offers a free version of its WaitTimes app customized for COVID-19 testing sites for 90 days.

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Carequality announces that 1 billion clinical documents have been exchanged via its interoperability framework since it launched in 2016. The organization will soon add image-sharing to its HIE capabilities.

Valley Community Healthcare (CA) rolls out virtual visit software from Otto Health.

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Patient engagement software vendor Conversa Health launches Employee HealthCheck, an automated COVID-19 screening app for employers that was developed with help from UCSF Health.

Flagler Health (FL) and consumer digital health company Healthfully develop a similar app that also includes virtual visit capabilities.

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A KLAS report on go-live support finds that engagement size is decreasing as the large health system market for new systems has matured. CSI Healthcare IT, Engage, and Medasource excel at executive involvement, while HCI Group and Nuance draw the most customer complaints about employee quality.


Government and Politics

HHS will award $5 million to support research into the ways healthcare organizations are responding to COVID-19, including the impact of expanded telemedicine services and digital care tools.

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HHS issues an RFI on re-developing the IT strategy behind its Strategic National Stockpile of items associated with coronavirus-like pandemics. The new strategy would include greater use of analytics to forecast requirements. Comments are due May 29.


COVID-19

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Alabama, North Dakota, and South Carolina become the first states to publicly commit to using contact-tracing technology developed by Google and Apple in their respective COVID-19 exposure notification apps.

The FDA launches a research project into the origin, treatment, and diagnostic patterns of COVID-19 using Aetion’s Evidence Platform, which aggregates data from EHRs, claims, registries, and clinical trials.

UC San Diego Health develops a remote patient monitoring program for COVID-19 patients recovering at home that includes a wearable to track vital signs, and activity and sleep levels; and an app through which they can report symptoms and communicate with their providers. The next phase of the program will use machine learning to predict a change in symptoms.

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The Atlantic reports on the CDC’s practice – and that of four states as well — of combining the results of viral and antibody tests, which produces misleading metrics that governors are using to develop their re-opening plans.

The federal government will pay AstraZeneca up to $1.2 billion for the development and delivery of 300 million doses of a COVID-19 vaccine by October.

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Officials in Iceland are underwhelmed by the impact the national contact-tracing app has had on COVID-19 containment efforts, stressing that, despite its high adoption rate, manual techniques like phone calls have been more effective: “The technology is more or less … I wouldn’t say useless. But it’s the integration of the two that gives you results. I would say it has proven useful in a few cases, but it wasn’t a game changer for us.”

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Current and former government and health system leaders collaborate on a national #OpenSafely plan that calls for, among other things:

  • Following already documented plans to open communities up after two weeks of declining case counts.
  • Ensuring adequate diagnostic testing is available.
  • Implementing contact tracing and voluntary isolation.
  • Improving and implementing safety standards and protocols.
  • Protecting populations most at risk.
  • Ensuring adequate PPE.
  • Widespread use of telemedicine.
  • Screenings and symptom monitoring.

Other

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Researchers develop a wearable they hope can successfully predict the onset of COVID-19 symptoms. The patch tracks coughing and respiratory activity, heart rate, and temperature, and then transmits the data to cloud-based data management software, where algorithms transform it into graphical summaries.


Sponsor Updates

  • Elsevier’s Clinical Path wins Best Computerized Decision Support Solution award from MedTech Breakthrough for the second year in a row.
  • Ellkay offers a customer testimonial featuring its COVID-19-related interoperability work with Acutis Diagnostics.
  • Infusion service company Option Care Health expands its use of Wolters Kluwer’s compounding compliance solutions for patient care.
  • Healthwise celebrates its 45th anniversary.
  • Omni-HealthData adds new data visualizations and interactive dashboards to its COVID-19 Resource Center.
  • InterSystems publishes a new case study, “Helping Care Teams on the Front Lines: Providence St. Joseph Health.”
  • Kyruus ProviderMatch for Consumers wins the Best Patient Registration & Scheduling Solution award from MedTech Breakthrough.
  • ROI Healthcare Solutions launches an EDI Benchmarking and Health Check Eligibility Survey for Infor (Lawson) users.
  • The Healthcare Technology Report includes Waystar CEO Matt Hawkins, AdvancedMD CEO Raul Villar, and CompuGroup Medical Chairman Frank Gotthardt on its list of “The Top 50 Healthcare Technology CEOs Of 2020.”
  • Wolters Kluwer Health will publish the American Society of Clinical Oncology’s portfolio of five medical specialty journals.
  • InterSystems adds support for AWS Graviton2-based Amazon EC2 M6g instances for IRS and IRIS.
  • Relatient expands availability of its solutions in Athenahealth’s Marketplace to include patient self-scheduling, patient intake, and secure two-way messaging.

Blog Posts


Contacts

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

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News 5/20/20

May 19, 2020 News 6 Comments

Top News

Microsoft announces Cloud for Healthcare, its first industry-specific cloud offering.

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The platform provides capabilities to deploy virtual visits, assessment chatbots, remote monitoring, referral management, patient engagement tools, and intelligent outreach.

The new Booking app in Teams allows providers to schedule, manage, and conduct virtual visits from inside Teams.

Microsoft is offering a six-month free trial of Cloud for Healthcare.


Reader Comments

From Nutter Round: “Re: Epic. I’m interested in how the company is responding to Wisconsin’s overturning of stay-at-home recommendations. Will it penalize employees who take advantage of the ‘right’ to congregate in bars?” I will invite Epic folk to weigh in, although I can’t imagine that the company is mounting an operation to surveil the after-work activities of its employees.

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From Remote No More: “Re: returning employees to in-office work. I work in the IT department of a healthcare provider in a large city. I’d like to hear how other provider IT departments are planning for such a return. No sense in planning this in a silo.” Good question, thanks. I’ve created a quick response form for provider IT department folks to anonymously describe their policies and practices for bringing remote workers back to the office. HIStalk crowdsourcing is of high value to readers who are looking for ideas, so please take a moment to respond. I’m sure we would all be interested in general hospital policies about bringing at-home workers back to the office as well.

From Long-Time Reader: “Re: not HIT related. A piece of the GI snare broke off during removal of a polyp from my duodenum. My lawyer’s GI expert says standard protocol does not requiring examining the snare afterward to see if it broke since the assumption is that the patient will just pass it anyway.” This was not an anonymous submission and therefore represents a real request for help, so GI clinicians are welcome to comment.

From Media Horror: “Re: MedTech Breakthrough Awards. Seems like yet another shady healthcare racket.” The company is suspiciously protective of its privacy given that it claims to be a marketing intelligence organization even though it seems only to dispense awards. Its minimal online presence hides everything important: physical address, executive names, telephone number, and award judging methodology. It masks its website’s domain registrar and lists no employees on LinkedIn other than the “photo not supplied” and generically named managing director James Johnson. It seems to offer no products or services beyond handing out awards. I can’t say that it’s a health IT racket, but I can say that it at least bears a strong physical resemblance to others I’ve seen that typically involve offshore companies.


HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Narrative Shift. The Herbster, WI-based company crafts written and visual narratives for companies who understand the value of generating excitement and curiosity about their products and services with prospective customers. A powerful narrative builds the brand effectively, gets the attention of prospects, and establishes stickiness with current customers. The company has 23 years of healthcare experience and thus does not require customers to educate its team or to develop their own marketing and sales deliverables. Narrative Shift is especially interested in working with new and founder-led ventures. As the company concludes, “We’ve seen too much crappy marketing and design developed for health technology companies,” motivating it to take on the mission of delivering attractive, witty, creative, and effective messaging. Thanks to Narrative Shift for supporting HIStalk.


Webinars

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


Acquisitions, Funding, Business, and Stock

Cerner joins the Fortune 500 largest US companies by annual revenue, coming in at #498. 

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PE Hub reports that Francisco Partners is looking for a buyer for medical practice scheduling platform vendor QGenda. FP made its growth investment in June 2016. The Atlanta-based company reportedly has EBITDA of $25 million on revenue of $75 million.

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Omada Health, which offers a chronic disease management platform primarily to employers, acquires digital physical therapy solution vendor Physera for a rumored $30 million. Physera has raised $10.8 million, most of it in a March 2019 Series A funding round.


Sales

  • Collective Medical is providing the technology that Cigna uses to quickly identify and manage its customers who visit an ED with symptoms of possible COVID-19 infection.

People

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Experity hires Kim Commito (WellSky) as SVP of product management.


COVID-19

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A JAMA Network editorial says that the federal government could be collecting COVID-related patient data in real time using existing EHRs and HIEs rather than emailed worksheets and anonymous digital thermometer reports, but it would first need to overcome issues such as opt-in requirements, willingness of hospitals to participate given the possible alienation of their profitable patients, and lack of a national identifier. The authors recommend creating a national health IT infrastructure that would allow real-time, patient-level data collection as has been done in other countries (including using cell phone-based location data), but with its use limited to public health emergencies.

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The geospatial expert who developed Florida Department of Health’s COVID-19 dashboard that was touted as the gold standard by the White House says she was fired after refusing to “manually change data to drum up support for the plan to reopen.” Rebekah Jones was offered a settlement to resign after disagreeing with her bosses. They had ordered her remove a column containing the date in which patients said they first experienced symptoms since some of those occurred weeks before the state officially admitted that residents had been infected. Florida’s government has declined to provide race and ethnicity case details and won’t give scientists the underlying data that the site uses to allow them to perform their own analyses, while a graph published by the Georgia Department of Health that showed a continuous case decline was found to have been sorted in descending rather than chronological order.

President Trump tells reporters that he is taking the unproven malaria drug hydroxychloroquine to prevent coronavirus infection. Asked about the medical evidence that supports his decision, he replied, “Here’s my evidence: I get a lot of calls about it.” FDA softened its previous advice immediately after the president’s statement, moving from a position that consumers should not take the drug outside the hospital setting to advising that it’s up to them and their doctor to decide.

Fluid physics researchers determine that six-foot physical distancing is adequate as long as wind speed is zero, but saliva droplets can travel up to 20 feet in even a light breeze.

Moderna reports that the coronavirus vaccine it is developing has raised antibodies in the eight patients who are receiving it, with levels comparable to those seen in recovered COVID-19 patients. Experts warn that many drug trials look good in early phases but fail quickly afterward.

A preliminary, small study in South Korea finds that recovering COVID-19 patients do not spread infection, as the virus they shed is dead. The government will therefore allow patients who have been discharged from isolation to return to work or school without obtaining a final negative test.

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COVID Exit Strategy maps the readiness of states to reopen safely based on the White House-issued gating strategy of disease spread, hospital capacity, and testing capacity.

Utah, North Dakota, and South Dakota have rolled out contact tracing apps without much success in generating participation rates of under 2%. Utah’s Healthy Together app has resulted in zero instances in which contracts were traced.

A health reform professor says she was wrong in calling for the federal government to require that private insurance pay for COVID-19 testing. Reasons: a huge number of people need to be tested, many of them retested repeatedly; providers can set whatever price they want with the cost ranging from $50 to $1,000 per test; it doesn’t help people who don’t have insurance; and insurers will need to reduce test access or raise premiums to cover the cost. She says a better approach is a testing and vaccination fund, overseen by the federal government, to provide free diagnostic and antibody tests for anyone who needs them to return to work or classes. That group could also negotiate pricing for a vaccine if and when one is developed.


Sponsor Updates

  • MassChallenge features CareSignal in its new video, “Innovation in the Age of COVID-19.”
  • Meditech AVPs Janet Desroche and Cathy Turner, RN speak with ANIA President Cheryl Parker, PhD, RN about the company’s response to the COVID-19 outbreak.
  • Experian launches an interactive US map showing populations most susceptible to developing severe cases of COVID-19.
  • MedTech Breakthrough names Kyruus Provider Match for Consumers as its “Best Patient Registration & Scheduling Solution.”
  • Vocera Vina is named “Best Overall MHealth Solution” in the MedTech Breakthrough Awards.”
  • Clinical Architecture releases the latest edition of its Informonster Podcast, “A History and Analysis of ICD-10.”
  • ConnectiveRx will participate in a virtual job fair May 27 from 8:30-10 a.m.

Blog Posts


Contacts

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

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Monday Morning Update 5/18/20

May 17, 2020 News 1 Comment

Top News

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Cerner will begin moving employees back on campus Monday, starting with 10% of its workforce and aiming for no more than 50%.

Employees will be encouraged to wear masks, fitness centers and cafeterias will be closed, elevators will be limited to two passengers, and staircases will be designated as one way.

The company says positions in its consulting and client support areas may remain virtual permanently.


Reader Comments

From Allscripts Insider: “Re: Allscripts layoffs. About 60 people on Monday, several of whom I know.” Unverified, but reported by several folks.


HIStalk Announcements and Requests

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Few poll respondents have been tested for COVID-19, although a significant percentage tried but couldn’t get access to a test. Maybe I should ask about antibody testing now that those are more widely available.

New poll to your right or here: How do you expect your family’s financial security to look on January 1, 2022 compared to the same day in 2020?


Webinars

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


Acquisitions, Funding, Business, and Stock

In Asia, health tech giant Ping An Healthcare, whose market cap is $15 billion, removes Wang Tao as chairman, executive director, and CEO.


Announcements and Implementations

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Banner Health launches chatbot-powered “virtual waiting rooms” from LifeLink to collect patient check-in information before all telehealth and in-person office visits.

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Microsoft and UnitedHealth Group offer their self-developed ProtectWell coronavirus symptom screening app, which they will use for their own employees, to all US companies at no charge.


COVID-19

Few of the 1,200 LifeBridge Health employees who have been tested for COVID-19 antibodies are positive, suggesting that most of its employees do not have immunity.

In England, BBC looks at the healthcare technologies that have changed in response to COVID-19:

  • One hospital developed a “call for help” app for ICU workers who need assistance and who otherwise would need to leave a patient’s room and use another set of PPE, with the app featuring large fonts for viewing through visors and sensitive buttons that respond to double-gloved fingers.
  • Expanded staffing of the NHS’s 111 national non-emergency medical help line.
  • Creation of machine learning models that predict demand for ICU beds and ventilators, now being extended to estimate length of stay.
  • Rapid rollout of video consults, with 88% of GP practices in Wales offering them within a month, after which their use was extended to hospitals, mental health services, and nursing homes.

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Former National Coordinator David Blumenthal, MD, MPP and his brother, Senator Richard Blumenthal, JD (D-CT) warn that COVID-19 contact tracing – whether by app or by human contact tracers – is intrusive by definition, as identifying contacts requires reviewing social media posts, text messages, credit card statements, and other personal records. They say that while the notification system that Apple and Google are rolling out limits contains privacy-preserving technologies, the US is overdue for a federal consumer privacy law. Senator Blumenthal and several other Democratic senators and representatives introduced on Thursday the Public Health Emergency Privacy Act, which would require individuals to opt in, require that data that is collected for pandemic efforts be deleted afterward, and prohibit using the data for purposes outside of public health.

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FDA orders the shutdown of a broadly supported Seattle COVID-19 population testing program pending federal government review. Seattle Coronavirus Assessment Network ran afoul of FDA by telling participants the result of their tests, which places the program within the realm of diagnostic – rather than surveillance – testing, requiring a different FDA group to review the safety and accuracy of its at-home collection kits. A predecessor program that identified the first US cases of COVID-19 infection using patient swabs from a previous flu study was ordered closed by federal and state officials because the researchers did not have patient consent for the new use of their samples and their lab was not certified for diagnostic testing.

New York City Mayor Bill de Blasio chooses Health and Hospitals to run the city’s COVID-19 contact tracing program instead of the Health Department, which has extensive experience in doing the same work for tuberculosis and HIV. Health and Hospitals CEO, Mitchell Katz, MD had previously urged the mayor to avoid mitigation measures, arguing that most people recover and will then contribute to herd immunity. Katz’s predecessor says, “Just because they both have ‘health’ in the name doesn’t mean they’re in the same business … this is a job for the Health Department.”

Former FDA Commissioner Scott Gottlieb, MD notes that the pandemic has slowed dramatically in the US after a long plateau, a trend that could be boosted by seasonality as summer sets in. Cases are declining or flat in most states, but a handful have an expanding case count and relaxation of mitigation steps will cause growth. He also notes that 40% of states don’t report COVID-related hospitalization, so the national count is incomplete.


Sponsor Updates

  • Health Catalyst appoints Mark Templeton (DigitalOcean) to its board.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, releases the latest edition of its Clinical Concepts in Obstetrics podcast, “Team Skills.”
  • Spirion raises over $9,000 for local restaurant workers impacted by COVID-19 closures through its This One is On Us restaurant relief program.
  • StayWell publishes a new infographic, “Content marketing strategies to recharge from COVID-19.”
  • Surescripts publishes a new report, “Pharmacist Perspectives on the Specialty Fulfillment Process.”
  • TriNetX adds the Brazil-based Techtrials integrated, real-world dataset to its global health research network.
  • Vocera publishes a new CNO Perspective, “Nurses Have Stepped Up. Now It’s Time to Support Them as We Move Forward.”

Blog Posts


Contacts

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

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News 5/15/20

May 14, 2020 News 9 Comments

Top News

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Cerner announces that its annual conference, scheduled for October 12-14, will be conducted as a virtual event.

The conference, one of Kansas City’s largest, is among 78 that have cancelled so far during the pandemic. City officials estimate that the cancellations will cost the local economy $137 million in lost hotel room bookings alone.


HIStalk Announcements and Requests

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Welcome to new HIStalk Gold Sponsor Pure Storage. The Mountain View, CA-based, NYSE-traded company gives technologists their time back. Pure delivers a modern data experience that empowers organizations to run their operations as a true, automated, storage-as-a-service model seamlessly across multiple clouds. One of the fastest-growing enterprise IT companies in history, Pure helps customers put data to use while reducing the complexity and expense of managing the infrastructure behind it. Healthcare organizations enjoy always-available EHR information with always-on encryption and quality of service, with no performance impact and no tuning required. Virtual desktop infrastructure applications are accelerated with <1 ms latency and 99.9999% FlashArray availability. With a certified customer satisfaction score in the top one percent of B2B companies, Pure’s ever-expanding list of customers — which includes Atlantic Health System, Carilion Clinic, and Intermountain Healthcare – are among the happiest in the world. Thanks to Pure Storage for supporting HIStalk


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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Health Catalyst reports Q1 results: revenue up 28%; EPS -$0.06 vs. -$0.23, beating analyst expectations for both. The company said in the earnings call that uptake of its free, rapidly developed COVID-19 analytics package is strong, including its patient and staff tracking solution and capacity planning tool. Health Catalyst expects its professional services revenue to dip due to hospital financial challenges and says it may discount those services as a long-term partner. The company will consider acquisition of capital-struggling startups that have developed apps that could help hospitals with revenue, cost, or clinical quality.

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Health IT entrepreneur Tim Peck, MD launches Curve Health to help hospitals and nursing homes coordinate and manage patient care. Peck’s previous venture, Call9, shut down last summer after raising $34 million with help from investors that included 23andMe’s Ann Wojcicki and Ashton Kutcher.


Sales

  • Boston Children’s Hospital will implement KyruusOne provider data management and Kyruus ProviderMatch for Consumers.

People

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Wolters Kluwer moves Stacey Caywood, MBA, who is CEO of the company’s Legal & Regulatory division, to CEO of its Health business. She replaces health IT long-timer Diana Nole, MBA, who has joined Nuance as EVP/GM of its healthcare division.

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Trinity Health names Eileen Matzek, MBA (Amita Health) as CIO of Loyola Medicine (IL).

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Recently hired Haven Healthcare COO Mitch Betses will manage the company’s operations until a replacement is found for Atul Gawande, MD, who confirms that he will step down as CEO and transition to board chair. Betses is a pharmacist and has spent most of his career as EVP of CVS Health.

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Nordic promotes Sriram Devarakonda to advisory services managing director and practice leader; Ian Mamminga to SVP of managed services solutions; and Andy Mueller to SVP of managed services operations.


Announcements and Implementations

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True Women’s Health (MI) deploys a menopause virtual care and support app that it built using OptimizeRx’s RMDY digital health tools. The app provides educational videos, trackers, surveys, coaching and telehealth consults, appointment scheduling, and progress and symptom tracking.

NHS Trusts in southwest England will set up a temporary hospital using Epic software from Royal Devon and Exeter NHS Foundation Trust.

Change Healthcare offers de-identified COVID-19 claims data for analysis of disease progression, intervention effectiveness, and overall health system impact.

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HBI Solutions develops an EHR-friendly fall risk assessment algorithm for elderly patients.

Meditech adds Apple Health support to Magic and Client/Server, making the app usable by all of its customers.


Government and Politics

Thirty amicus briefs were filed from both sides of the political aisle with the US Supreme Court on Wednesday in support of the Affordable Care Act, which Republican state attorneys general and the White House are seeking to repeal. Economic scholars warn of the damage that would be caused by eliminating what could be the only health insurance option that is available to the 37 million newly unemployed Americans, along with the many billions of dollars worth of uncompensated care that struggling hospitals would be forced to provide.


COVID-19

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The New York Times looks at why some city hospitals were being overwhelmed with COVID-19 patients even as others had 3,500 open beds, sometimes under the same corporate umbrella of Health & Hospitals. Governor Andrew Cuomo concludes, “We don’t really have a public healthcare system. We have a system of hospitals.” Load-balancing challenges include moving unstable patients and overcoming the hospital ethos of treating every patient who arrives there. The state basically took over capacity and transfer management to fix the problem of competing, brand-obsessed “independent duchies” that couldn’t overcome their cultural differences to work together voluntarily.

Experts question the accuracy of COVID-19 testing numbers given the lack of federal reporting guidelines. Some states track the number of samples rather than the number of patients, some do not report racial or ethnic breakdown of cases and deaths, and others have switched methods midstream to make past versus present comparisons impossible. Virginia just started combining the results of viral tests and antibody tests, which is indefensible statistically and epidemiologically but expedient politically, with the chief of staff of the state’s Democratic governor (a pediatric neurologist) explaining that Virginia wants to move ahead of other states in its number of tests per capita. Virginia joins Colorado and Arizona in using the questionable numbers to justify re-opening and to allow bragging on improving testing numbers that still lag much of the developed world.

A study finds that just 4.4% of the population of France, which was hit hard by COVID-19 with 27,000 deaths, has been infected, making it unlikely that countries can reach herd immunity to avoid a second wave of infection as social restrictions are eased

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CNBC interviews Epic CEO Judy Faulkner, who made these points in response to some inexpert questions:

  • Epic customers have increased their telehealth business by an average of 100-fold, with some going from 20 daily visits to 8,000.
  • The company analyzed its database of 100 million patients to see if any of 30 targeted drugs might protect patients against COVID-19, finding that none did. They will next look at outcomes from convalescent plasma therapy, the use of remdesivir, and whether patients who recovered from COVID can become infected again.
  • Faulkner says, “We were actually the originators of interoperability” in the early 2000s, first among Epic users, then with all EHR users via Share Everywhere.
  • Epic is working with an unspecified group to develop a phone-based “immunity passport” that indicates that the user has tested positive for COVID-19 antibodies (though the unmentioned challenge is that nobody has proven that the presence of those antibodies ensures immunity and quality of the tests is all over the place in the absence of FDA approval of the predominantly China-developed tests).
  • Asked about whether Epic will develop contact tracing phone apps, Faulkner cited a healthcare blog’s poll (presumably the one I just ran on HIStalk) that showed two-thirds of people wouldn’t participate.

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The state of Utah opts for contact-tracing app technology from Twenty, a social media startup that pivoted from developing a meet-up app to the Healthy Together app in just three weeks. Once out of beta, the app will become part of the state’s contact tracing program.

23andMe enlists hospitals to help it recruit patients for a study of severely ill COVID-19 patients. The consumer genetics testing company hopes to find genetic correlations that could explain why some patients become sicker than others.

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Collective Health, which offers insurance administration tools for self-funded employers, develops an evidence-based return-to-work app that performs worker risk assessment, screening, and testing.  The company notes that the app protects employees because their information isn’t shared with their employer, who only sees a completed “pass” that can be used to allow the employee to return to work.

Kaiser Health News shares a story of a restaurant worker who tested positive for COVID-19 in late March, after which her co-workers were notified immediately that they should self-quarantine. The woman’s second job was as a cafeteria cashier at University of Washington Medical Center, which did not notify co-workers or even require the infected employee to wear a mask while working. Employees of other hospitals say they either aren’t notified or aren’t told who the infected co-worker is, which means they don’t know the extent of their exposure.

President Trump tells employees of a medical equipment distribution center Thursday that COVID-19 testing is “overrated” in suggesting that the US’s world-leading number of cases is due to over testing. He said, “When you test, you have a case. When you test, you find something is wrong with people. If we didn’t do any testing, we would have very few cases.”

Australia’s NSW Health reduces patient wait time to receive negative COVID-19 test results from several days to several hours by using a text messaging bot to send them electronically to those who opt in.

Former National Coordinator CEO Farzad Mostashari, MD and former CDC Director Tom Frieden, MD, MPH say in a CNN editorial that the crisis-created bias toward action is encouraging tech companies like Apple and Google to push proximity-based contact tracing apps as an “overreaction of surveillance,” as low usage could then encourage the next step of hiding the apps or coercing users to run them. They say tech companies should improve the accuracy of information they allow on their social media platforms, open up access to de-identified user data to help public health officials understand the response to shelter-at-home and distancing strategies, and support human contract tracers, all while “first doing no harm.”


Other

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Strata Decision Technology’s newly launched National Patient and Procedure Volume Tracker shows that 55% fewer Americans sought hospital care in March and April at the 51 health systems studied. Some areas with the largest drops potentially involve life-threatening problems, such as cardiology and oncology. Volumes dropped by more than half for congestive heart failure, heart attacks, and strokes, raising again the ongoing question of what is happening with those patients. The health systems that were studied reported a staggering average revenue drop of $1.35 billion each in the two-week study period.

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Akron Children’s Hospital (OH) will use a $1 million donation to endow the country’s first chair in telehealth, to be held by CMIO and oncologist Sarah Rush, MD.


Sponsor Updates

  • Ellkay’s LKCOVID-19 lab connectivity package that supports testing, results, and state reporting processed 1.6 million COVID-19 tests in April.
  • Hyland offers free subscriptions to its ShareBase cloud-based sharing and collaboration tool.
  • Imat Solutions releases a new podcast, “Reliance EHealth Collaborative Leverages IMAT for COVID-19 Response.”
  • Veradigm will incorporate Specialty Patient Enrollment software from Surescripts into its AccelRx specialty medication fulfillment solution.
  • Optimum Healthcare IT publishes a white paper titled “ Targeted Training: Promoting EHR Efficiency.”
  • A 2020 US EMR Market Share report from KLAS highlights Meditech as one of two EHR vendors that saw significant market share growth in 2019.
  • Wolters Kluwer Health releases a new report, “Next-Generation Nurses: Empowered + Engaged.”

Blog Posts


Contacts

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

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News 5/13/20

May 12, 2020 News No Comments

Top News

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The American Medical Association publishes privacy advocacy principles that address the reluctance of some patients to share information with their physicians over fears that data brokers and technology companies will misuse it. The AMA is targeting third parties that gain access to patient information, but that are not covered entities that are bound by HIPAA. Some of its points:

  • People should be told before their data is collected how it will be accessed, used, disclosed, or processed, along with the purpose that is involved and any secondary use by others.
  • They should be able to opt out of having their data sold or shared.
  • They need to be able to protect and share information at a granular level instead of at the document level.
  • They should be able to direct a provider to delete their data throughout its ecosystem, including when an entity closes or is acquired.
  • People should be able to download their information in machine-readable form.
  • A patient’s data should be used to train algorithms only when the patient has opted in.
  • Medical records apps should allow users to add annotations to their copy of the record.
  • Notices of privacy practices should be written at an elementary school reading level and avoid ambiguous terms such as “we may share this data with our partners to improve quality.”
  • Entities should make their de-identification processes publicly available.
  • FTC should be empowered to define unfair data processing practices, minimum privacy and security standards, and minimum data elements for specific purposes. It should also be given authority to establish fines that are based on level of disregard or knowing conduct.

Reader Comments

From Amazon Primate: “Re: Atul Gawande. Surely he is getting fired and not just stepping back from Haven.” I was puzzled when the three sprawling corporations chose the high-profile Gawande because of his lack of experience running a big company and his insistence on keeping his day jobs as an author and surgeon, so Haven seemed more like an ivory tower Boston think tank than a hard-charging startup (the company is a non-profit, after all). The real question is, what expectations do Haven’s joint venture owners – Amazon, Berkshire Hathaway, and JPMorgan Chase – have for the company now that it has paddled along seemingly aimlessly for two years? Everybody (except Optum) wanted it to be a disruptor in prescriptions, primary care, analytics, and insurance, but its announced purpose was simply to lower healthcare costs for those three companies alone, not to barge belligerently into the swanky country club of healthcare’s good old boys to benefit society. I would be wary of any company that can’t even pick a name for itself in its 14 months. Haven’s chances would probably have been better if it was Amazon alone running the show, although Amazon’s PillPack hasn’t exactly kicked a dent in the healthcare universe.


HIStalk Announcements and Requests

I’m probably the only Gmail user who didn’t already know this, but I discovered today that an email that has been routed to the Social or Promotions category tabs can be dragged and dropped onto the Primary tab. This is good for me since I usually mass delete everything that isn’t in the Primary tab, but sometimes I want to use an email from there as a reminder (like some site having a sale).


Webinars

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


Acquisitions, Funding, Business, and Stock

In the Netherlands, Gilde Buy Out Partners will acquire medical software vendor Corilus from its private equity owner.


Sales

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  • In the Netherlands, Franciscus Gasthuis & Vlietland goes live on contact-free continuous monitoring from EarlySense, whose system tracks 100 data points per minute using a sensor placed under the patient’s mattress. A wall-mounted display outside the patient’s room, plus the lack of sensors and wires that require adjustment, minimizes caregiver contact with isolated patients.
  • Guam Hospital Authority chooses Medsphere’s CareVue EHR. I believe it will replace Cantata Health’s Optimum system.
  • Connecticut Children’s Medical will implement Keriton Kare’s breast milk management system.
  • Baystate Health (MA) integrates HCPro’s clinical document improvement physician query templates in Artifact Health’s mobile platform. 

Announcements and Implementations

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A new KLAS report looks at how inpatient EHR vendors are using AI. Epic is the only vendor with a significant number of live sites, with over 100 customers using its Cognitive Computing Platform for predicting readmissions, patient risk, mortality, ED, at-home fall risk, sepsis, hospital-acquired disease and patient deterioration. Epic’s customers choose its platform to avoid bringing in another vendor and report that it is easy to deploy its machine learning models. Customers who are accustomed to Epic’s out-of-the-box model report slightly lower satisfaction, often because they haven’t addressed the operational challenge of acting on its recommendations. Cerner has a handful of customers live on HealtheDataLab, which is a self-development toolkit rather than a package of pre-built models.

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Yale New Haven Health System goes live on Capsule’s Ventilated Patient Surveillance workstation to monitor COVID-19 patients. The enhancement to Capsule’s Remote Surveillance application – which YNHHS uses for its InSight Tele-ICU program – monitors streaming data from ventilator and escalates events to clinicians. The hospital’s temporary ICU rooms don’t always have hall windows, so the workstation allows monitoring medical devices in the absence of direct visibility. Capsule is offering clients free licenses for at least six months.


COVID-19

In the UK, NHS and researchers analyze the de-identified records of 17.4 million adults using the OpenSAFELY analytics platform. They found that COVID-19 patients are more likely to die if they are of Asian or black ethnic origin, poor, male, or have uncontrolled diabetes or severe asthma. The study notes that the higher mortality rate of people who are not white and who live in deprived areas cannot be attributed to co-morbidity, validating policies that protect the highest-risk residents. The OpenSAFELY team developed the platform in five weeks with no funding, running its analysis within the platform of EHR vendor TPP’s SystmOne.

Seniors who are worried about the reported poor outcomes and long-term consequences of being placed on a ventilator are adding “no intubation” statements to their advance directives. Experts admit that ventilator survival rates are low, but add that study methodologies have been inconsistent, some hospitals in other countries were overwhelmed and that likely made deaths more likely, and healthy adults fare better than those who have debilitating chronic conditions, making the intubation decision for a given individual less clear.

New York City hires Salesforce to create its contact tracing program, which includes a call center, CRM system, and a case management system to augment the work of 2,500 contact tracers.

Stanford University psychiatry professor Keith Humphreys, PhD says that public health experts are overly optimistic in thinking that the US can match the contract tracing success of other countries. He says US residents aren’t deferential to government authority, they closely guard information about where they live and work, and they probably won’t stay home for 14 days just because a health worker asks them to. He urges officials to consider what will happen if people refuse to be tested or defy orders to isolate, predicting that we’ll end up with a Swedish coronavirus policy (voluntary measures only) not because we chose it, but because we couldn’t agree on an alternative.

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Researchers find that a symptom checking app that is being used by 2.5 million people in the US, UK, and Sweden can determine with 80% accuracy whether a user has COVID-19 based on just their age, sex, and presence or absence of four symptoms: loss of taste or smell, persistent cough, fatigue, and loss of appetite. COVID Symptom Study found that the loss of taste and smell was the strongest predictor and was rarely wrong, having been reported by two-thirds of the 15,000 app users who eventually tested positive.

Wuhan, China discovers six new cases of COVID-19, and as a result, will test every one of the city’s 11 million residents over a 10-day period. The US has administered 9 million tests in total with 25,000 new cases per day and a world-leading 80,000 deaths. We have more new cases per million residents per day at 76 as a real-time measure of infection spread, with Russia, the UK, and Sweden trailing not far behind.

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Mercy Health Hackley Campus fires Justin Howe, RN 10 days after he spoke to a newspaper about the hospital’s failure to provide PPE and its ban on employees bringing in their own masks. The hospital claims that Howe, who is president of the nurse’s union local, violated HIPAA by accessing medical records inappropriately.


Other

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The Indianapolis business paper profiles startup Olio, whose mobile app is used by nursing homes to alert hospitals that a patient they have transferred there needs assessment or treatment, potentially avoiding an automatic trip to the ED.

Beth Israel Deaconess Medical Center describes how its clinicians were overwhelmed by its move to telehealth visits because tasks that were previously performed by medical assistants before the physician entered the exam room — measuring vital signs, documenting the chief complaint, reconciling medications, and managing prescription renewals – became the physician’s job. BIDMC created a pre-visit survey via OpenNotes that patients were invited to complete via a patient portal message, with their entries then being saved in the EHR for pre-visit review or copying and pasting into the note.

I don’t think I’ve ever heard of the Future of Health conference, but if you have and you care, it will go virtual for the September 23-25 event at a registration cost of $995 for providers (free for those who are willing to sit through six virtual company pitch sessions, which I’m guessing is all of the provider attendees). Maybe demand is unmet for the chance to stare at a monitor and webcam all day, or to hang out in a virtual exhibit hall.

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Weird News Andy urges readers to spare the rod. In Israel, a construction worker who felt OK after he fell from a second-floor walkway realizes from the reaction of bystanders that a metal rod had penetrated his head. Surgeons removed the rod and were surprised to find afterward that the man seems to be fine, with no damage to his speech or ability to walk.


Sponsor Updates

  • Datica releases a new episode of its 4×4 Health podcast, “Working in Healthcare: Vasanth Kainkaryam.”
  • Black Book Market Researchers publishes the third installment of its survey series gauging consumer attitudes towards seeking medical care during the pandemic.
  • ConnectiveRx SVP of Business Development John Herley wins PM360’s Elite Sales MVP Award.

Blog Posts


Contacts

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

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Monday Morning Update 5/11/20

May 10, 2020 News 6 Comments

Top News

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From the Allscripts earnings call, following a Q1 report in which the company fell short of analyst expectations for both revenue and earnings:

  • The company’s 22 Virtual HIMSS sessions drew 900 registrants.
  • Virtual visits conducted with FollowMyHealth’s telehealth platform went from no demand to 70,000 visits in April.
  • The virtual visit platform is licensed on a per-provider, per-month model, with President Rick Poulton explaining that patients are seen by their own hospital-provided doctor instead of “whoever happens to be hanging out on a couch that day.”
  • 500 researchers have applied for access to its Veradigm COVID-19 research database.
  • Its CarePort care transition system has tracked the care of 22,000 COVID-19 patients across settings, with early findings indicating that 10% of middle-aged hospitalized patients who are diagnosed with COVID-19 die .
  • Allscripts estimates that the pandemic impacted its Q1 revenues by $7-10 million, from both lower volumes and delayed purchase decisions, and otherwise the company would have met its revenue guidance.
  • Memorial Sloan Kettering Cancer Center is among the health systems that have extended their inpatient system agreements at a total value of $100 million.
  • The company eliminated $75 million in annualized costs via layoffs in late March through April.
  • Allscripts is reviewing its product lines to see if any non-core businesses should be sold.
  • The company doesn’t expect to spend capital on acquisitions any time soon.

MDRX shares closed up 9% Friday, returning the company’s market cap to just over $1 billion. They are down 38% in the past year versus the Nasdaq’s 14% gain.


Reader Comments

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From CPAhole: “Re: contracts. I’m interested in how companies and providers will change their agreements after this pandemic. The typical force majeure clause just doesn’t cut it here.” I’ll run a survey for vendors and customers to describe any changes they’ll make to agreements going forward to address issues that the pandemic has exposed  — like providers being unable to pay their bills, vendors being unable to perform on-site services, or companies protecting themselves in pre-acquisition due diligence. The rarely invoked, usually boilerplated force majeure T&C will undergo new scrutiny and legal tests as pandemic-driven economic issues force vendors and customers into uncharted territory, like HIMSS citing that clause in refusing to issue HIMSS20 exhibitor refunds.


HIStalk Announcements and Requests

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The idea of using tech-powered contact tracing to control the coronavirus takes a hit from last week’s poll. Two-thirds of readers (who are heavily involved in healthcare and technology) say they won’t use the Apple-Google app right away, echoing the likelihood that the US won’t see anywhere near the 60% adoption that is required for effectiveness.

New poll to your right or here: Have you been tested for active COVID-19 infection?

Thanks to the following companies that recently supported HIStalk. Click a logo for more information.

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Listening: Michael Kiwanuka, the British singer-songwriter who provides the haunting opening theme to “Big Little Lies,” which we’re watching on Prime Video. It’s the perfect spacey, mysterious intro to a show set on and around the beaches of Monterey, CA. It’s just as connected to the series as the use of Cecelia Krull’s “My Life Is Going On” on “Money Heist.”


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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Atul Gawande, MD, MPH will resign as CEO of Haven Healthcare and move to a less-operational role as chairman, insiders report. The Amazon – Berkshire – JPMorgan company, which has had minimal healthcare impact since its splashy debut in January 2018, is searching for a new CEO as Gawande’s interests refocus on coronavirus policy and advocacy work. Haven COO Jack Stoddard resigned last year after nine months on the job and was not replaced.

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Livongo reports Q1 results: revenue up 115%, EPS -$0.06 vs. -$0.79, beating Wall Street expectations for both. The company said in the earnings call that it has been selected by the Government Employee Health Association that provides medical and dental plans to 2 million employees. LVGO shares are up 42% versus the Nasdaq’s 11% rise since the company’s July 2019 IPO, valuing it a $5 billion. Executive Chairman Glen Tullman owns shares worth $344 million, while CFO Lee Shapiro’s holdings are worth $302 million.


Sales

  • Willis-Knighton Health System (LA) chooses CloudWave’s OpSus Healthcare Cloud for hosting its Meditech Expanse system that is being implemented. 

People

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Nordic promotes John Manzuk to SVP of managed services delivery.


COVID-19

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A New York Times report finds that virus-wary Americans had already slowed their spending, traveling, and dining out before lockdown orders were issued, raising the strong possibility that state re-openings won’t restore the pre-pandemic economy as businesses and potential customers remain unconvinced that it’s safe to conduct person-to-person business.

FDA Commissioner Stephen Hahn, MD, NIAID Director Anthony Fauci, MD, and CDC Director Robert Redfield, MD are self-quarantining for 14 days after being exposed to Vice-President Pence’s spokesperson Katie Miller, who has tested positive for COVID-19.

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The Department of Justice charges Henry Gindt II with selling stolen COVID-19 test kits directly to patients for up to $200 through his YouHealth website, then failing to provide the test results. Gindt’s LinkedIn says he was a co-founder of President Trump’s Office of American Innovation, where he says, “Key wins included combining the electronic medical records (EMRs) of Department of Defense and VA employees and soldiers.”

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A researcher identifies what he says is a flaw in India’s government-mandated COVID-19 contact tracing app – which uses both GPS and Bluetooth — that allows him to identify the location of all infected users. The government requires all employees and military members to use Aarogya Setu, as well as people who live in containment zones and those who are returning from other countries. The app presents a chatbot-powered symptom checker and travel history questionnaire and health authorities track answers in a database and contact those who might be infected.

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NYC Health + Hospitals investigates ED nurse Lillian Udell, who recorded her co-workers talking about shortages of PPE. The health system says she violated HIPAA even though no patients were shown. Another nurse whose PPE pleas on “60 Minutes” earned the praise of the hospital’s president said of Udell’s case, “I feel like a lot of hospitals are using HIPAA almost under the guise of patient protection and safety, and privacy safety. But really it becomes more apparent to me, at least, that HIPAA is kind of being used to gag people. We’re all experiencing the most difficult working conditions we’ve ever faced. And everybody who is speaking out is doing so to advocate for patients, ultimately. It looks like hospital administrations tend to run to HIPAA for their protection, not so much patient protection.”


Other

Kaiser Health News notes that at least half of the top 10 recipients of HHS’s emergency provider funding have either paid criminal penalties or settled billing fraud charges in the past. Florida Cancer Specialists & Research Institute, which hasn’t started paying its recently imposed $100 million federal penalty for anti-competitive practices, got $67 million in federal bailout money. Experts observe the irony of health systems being paid at rates that are based on their Medicare billing when they were also accused with falsely inflating their Medicare bills through fraud and abuse. Other health systems that are in the top 10 that have paid to settle fraud charges are Dignity Health, Cleveland Clinic, Memorial Hermann, and Mass General.

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A display company in Colombia offers small hospitals an $85 cardboard patient bed that, if the occupant dies, converts to a casket.


Sponsor Updates

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  • PatientKeeper supports healthcare workers at Portsmouth Regional Hospital.
  • MDLive reports significant growth of its behavioral health business as its virtual therapy service provides safe, timely access to care during the pandemic.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, releases a new edition of its Critical Care Obstetrics podcast, “Sepsis Simplified.”
  • RxVIP Concierge offers CareSignal’s COVID Companion text-messaging app through its new “Stand Up to COVID19” patient initiative.
  • Relatient joins the Cerner App Gallery with mobile-first self-scheduling and waitlist solutions.
  • T-System offers DrFirst’s telemedicine software to its urgent care and emergency department customers.

Blog Posts


Contacts

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News 5/8/20

May 7, 2020 News No Comments

Top News

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Allscripts announces Q1 results: revenue down 3%, adjusted EPS $0.09 vs. $0.16, missing Wall Street expectations for both.

MDRX shares dropped 6% in after-hours trading immediately following the announcement after closing up 6.5% on the day. The company’s market capitalization is $952 million.


HIStalk Announcements and Requests

I fixed HIStalk’s mobile layout, also adding an option to place an icon on your device’s home screen to enable one-click access.


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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Shares of embedded communications technology vendor Twilio, which Epic recently chose to power its telehealth offering, rose 25% Wednesday after  the company reported a Q1 revenue increase of 57% to $365 million. The company also raised Q2 revenue guidance by another 35%. Twilio is valued at $22 billion.

The US Court of Appeals upholds a district court’s dismissal of a class action lawsuit against EClinicalWorks in which the estates of two deceased patients claimed that errors in ECW’s system displayed incomplete or inaccurate patient data to providers. The appeals court says the plaintiffs lacked standing to sue because they provided no proof that anyone was harmed.

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CVS Health announces Q1 results: revenue up 8%, EPS $1.91 vs. $1.63, beating analyst expectations for both. The retailer saw a 600% jump in telemedicine visits through its MinuteClinics, part of an overall spike in its digital services that helped the essential business realize first-quarter sales of $67 billion.


Sales

  • Perry Community Hospital will use remote cardiac and respiratory monitoring software from Coala Life to launch a remote monitoring program for its patients in rural Tennessee.

Announcements and Implementations

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CarePort Health releases an interoperability solution that meets CMS’s Conditions of Participation requirement that hospitals send ADT notifications to primary care physicians and post-acute care providers.

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Premier adds perinatal quality analytics to its QualityAdvisor improvement software.

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LogMeIn releases a healthcare edition of its GoToMeeting videoconferencing platform that meets HIPAA requirements by offering a Business Associate Agreement, with a cost of $16 per user per month for unlimited sessions and minutes.

Intelligent Medical Objects releases an open source standardized terminology package for COVID-19 that allows aggregating and sharing patient problems, procedures, and labs information.


People

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Experity names Callan Young (Anaplan) SVP of marketing.

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Wil Lukens (CenTrak) joins Critical Alert as VP of sales.

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Wolters Kluwer Health hires Frank Jackson (Prognos Health) as VP/GM of its Health Language business.


Government and Politics

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HHS awards $583 million to 1,400 federally-funded health centers to help them expand COVID-19 testing.

HHS publishes a list of the 142,000 healthcare providers that received money from the $50 billion HRSA Provider Relief Fund, in which money was paid based on their Medicare net patient revenue. The median payment was $9,600, the average $142,000. The top 10 recipients are:

  1. Dignity Health ($180 million)
  2. Cleveland Clinic ($103 miliion)
  3. Stanford Health Care $(102 million)
  4. Memorial Hermann Health System ($92 million)
  5. NYU Langone Health ($92 million)
  6. County of Los Angeles ($81 million)
  7. HMH Hospitals $(77 million)
  8. Florida Cancer Specialists and Research Institute ($67 million)
  9. Memorial Hospital for Cancer and Allied Diseases ($64 million)
  10. Massachusetts General Hospital ($58 million)

HHS OIG creates freely available statistical tools for analyzing prescription claims data to identify patients who are at risk of opioid misuse or overdose.


COVID-19

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The White House rejects CDC’s recommendations — which it commissioned — on when and how state and local officials should allow business owners, restaurants, schools, and churches to reopen. “Guidance for Implementing the Opening Up America Again Framework” was supposed to have been published Friday, but the public health agency’s scientists were told it “would never see the light of day.” The White House repeated in a Wednesday briefing that states are responsible for their own COVID-19 response.

A Premier survey finds that hospitals will need to expand their COVID-19 testing capacity by more than 200% to even partially resume full services. The hospitals say they are constrained by lack of testing reagents (41%) and swabs (40%). Most hospitals hope to screen employees for coronavirus symptoms before resuming non-emergency procedures, but just 32% say they have enough COVID-19 tests for frontline workers, so most will limit testing to those employees who exhibit symptoms.

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Government officials in the UK consider rolling out “immunity passports” to qualifying individuals as part of forthcoming plans to ease the country’s lockdown. The digital certificate would incorporate facial biometrics and antibody test results into an app that employees could use to gain entry into their workplaces.

NIH launches a study to determine whether the low number of reported cases in children is due to natural immunity or infection without symptoms.

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The US — unlike Italy, Spain and China —has not seen a significant decrease in daily new cases following the infection’s peak, which occurred here on April 26, causing former FDA Commissioner Scott Gottlieb, MD to warn that the virus could continue as a “slow burn of infection across the country … we still have a lot of infection.”

Axios reports that some White House officials believe that COVID-19 death counts are being inflated because hospitals get paid more for treating coronavirus patients. Other insiders believe the actual number is lower because presumptive cases are not being verified by autopsy, also noting that data reporting standards are not uniform.

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An MIT Technology Review article says epidemiologists and public health experts struggle to draw population-level conclusions from COVID-19 testing results, as each state sets its own standards for data collection and reporting. Some states still accept provider reporting via fax and Excel. The results of at-home tests won’t necessarily be reported to the state at all, and those tests have varying accuracy. The authors recommend using CDC’s FHIR-based tool to report directly from EHRs and non-profit Logica has developed an open source interoperability platform for health system COVID-19 reporting. Experts say that it would be ideal if the federal government took the lead on public health data efforts, but that isn’t likely to happen.

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Johns Hopkins University updates its COVID Control study app, in which volunteers submit their temperatures and any symptoms daily to detect outbreaks.

In England, Imperial College epidemiologist Neil Ferguson — whose group’s prediction of massive numbers of COVID-19 deaths in the absence of mitigation strategies led the UK and US governments to implement drastic measures — quits his UK government advisory role after a newspaper reports that he broke the stay-at-home rules he advocated by allowing his girlfriend to visit him. Complicating the issue is that both Ferguson (called “Professor Lockdown” there) and his girlfriend are married to other people, each of them have children at home, Ferguson has tested positive for coronavirus, and the woman says her husband is showing symptoms.


Other

Germany-based hospital and dialysis center operator Fresenius is hit with a ransomware attack. US and UK government cybersecurity centers warned Tuesday that state-sponsored hacking teams are targeting organizations that are involved in COVID-19 response.

A JAMIA-published study looks at how Mayo Clinic’s move from Cerner to Epic affected its patient satisfaction scores, concluding that the scores dropped significantly and didn’t return to previous levels for 9-15 months. Areas most affected were access, wait time, and receiving information about delays. Satisfaction dropped before go-live, which the authors hypothesize was due to schedulers using two systems and implementing new processes as well as pulling team members offline for training.

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In England, anonymous artist Banksy creates a painting for Southampton General Hospital depicting a child replacing his superhero dolls with one of a nurse.

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Good tweet.


Sponsor Updates

  • Goliath Technologies releases a new video, “How to Reduce Barriers to Clinician Satisfaction with Cerner.”
  • Wolters Kluwer Health launches a Rapid Onboarding module in Lippincott Procedures to help hospitals prepare nurses for COVID-19 care.
  • Impact Advisors hires James McHugh (Guidehouse) as managing director.
  • Intelligent Medical Objects releases a new e-book, “Leveraging the EHR for effective clinical workflows.”
  • InterSystems releases a new PulseCast podcast, “Don Woodlock: Capturing Cleaner Data Across the Care Continuum.”
  • Spok supports and honors nurses during Nurses Week.
  • The local paper profiles the Western PA Home & Community Task Force’s use of CarePort Health’s Guide technology, which helps connect hospitals with best-fit, post-acute care facilities for their patients.

Blog Posts


Contacts

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

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News 5/6/20

May 5, 2020 News 3 Comments

Top News

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Change Healthcare acquires ERx Network for $213 million.

The pharmacy claims and e-prescribing network reports $67 million in annual revenue.


Reader Comments

From Staying At Home Marketer: “Re: HIMSS conference. We learned this year that many people can work entirely from home, including doctors doing telemedicine. This could be the year that we learn the same about physically attending the HIMSS conference.” That could be the case. Vendors are (or will be) looking for new ways to reach prospects that go beyond the exhibit hall and its associated cost, and the exhibit hall is what powers not only the conference, but HIMSS itself. The conference will probably remain a big deal for those vendors who continue to participate even with its reduced critical mass, but others (especially those with shallower pockets) have a chance to even the playing field now that we’ve skipped a HIMSS conference and nobody is traveling. I’m hearing from companies that are interested in sponsoring HIStalk that I didn’t expect, although I’m losing some financially concerned ones as I assumed would happen. It will be interesting to see which companies benefit from adversity-forced strategic moves that go beyond trying to hunker down waiting for the old normal to come back.

From Opening Up: “Re: contact tracing. Technology could lead us out of this crisis.” Hardly, at least in terms of information technology in this country. We don’t have the discipline (and maybe rightfully so) to hide in our caves in hopes that someone will develop a vaccine or effective treatment. However, we trailed the world with our lackadaisical, “it will never happen here” approach to the virus while it was still potentially containable, so now the infection rate is out of control to stay, we’re a long way from herd immunity if there even such a thing with this bug, and you can’t contact-trace the entire country’s movements even with an app. Still, we need to use whatever tools we have available. I think we’re at a point, right or wrong, where we’re so anxious to get back to normal that we are willing to accept the inevitable casualties that will result (assuming it is someone else or their family, of course). It’s a good time to not be old, poor, or sick as we accept herd thinning as the acceptable price of avoiding an economic Stone Age. I’m struggling to find the right answer, or maybe struggling with the knowledge that any choice will kill people.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Infor. Infor Healthcare connects the business of healthcare with the mission of healthcare. Its healthcare operations platform elevates ERP to a strategic resource, enhancing delivery across the care continuum by delivering clinically connected capabilities that improve cost, quality, and outcomes. By bringing together supply chain management, finance, human resources, time and attendance, asset management, location-based intelligence, interoperability, and analytics, Infor gives healthcare organizations an industry-specific alternative to traditional enterprise resource planning (ERP) software. Thanks to Infor for supporting HIStalk.

HIStalk had some flaky moments on Monday during a denial-of-service attack that tied me up from Sunday morning until Monday night. I’m still doing some mostly unrelated cleanup that I discovered while figuring out the problem. One of those involves issues with the HIStalk display on mobile devices, which remains a work in progress since the original development company has abandoned the product I was using.

I caught up unexpectedly with Justen Deal (now Justen Burdette), who readers may remember as the 20-something Kaiser Permanente IT employee who in 2006 warned the organization about the uncertain of costs and stability of Epic, which was replacing a $440 million custom-written IBM system. Epic seems to have turned out fine at KP, so for the “everybody lived happily after” ending, Justen is living in Hawaii as CEO of mobile wireless provider Mobi.


Webinars

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


Acquisitions, Funding, Business, and Stock

Kaufman Hall acquires the Connected Analytics business of Change Healthcare for $55 million. The business generates $65 million per year.

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In Australia, clinical intelligence vendor Pacific Knowledge Systems will acquire Pavilion Health, which offers cloud-based coding and auditing tools.

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CPSI announces Q1 results: revenue up 1%, EPS $0.28 vs. $0.24, beating Wall Street expectations for both.  


Sales

  • Orthopedic telemedicine provider OrthoLive chooses Ellkay to bring the EHR information of its patients into its telehealth app.
  • Cooper University Health Care (NJ) chooses Accruent’s Connective healthcare technology management and Medical Device Security Analyzer as it brings its outsourced HTM program in-house. 
  • UK-based medical chat, telemedicine, and appointment scheduling app vendor Babylon Health — whose NHS rollout as the tech platform for GP at Hand created a company valuation of $2 billion — gains its first US client in Mount Sinai Health Partners Provider Network (NY).

People

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Impact Advisors hires James McHugh, MBA (Navigant) as managing director.


Announcements and Implementations

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CareMesh offers state and local public health departments free use of its National Provider Directory.

A Black Book survey names Allscripts as the top-rated inpatient EHR vendor in community hospitals.

Nebraska Health Information Initiative goes live with a COVID-19 cases and results dashboard, powered by NextGate’s EMPI, InterSystems HealthShare, and KPI Ninja Universe.

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Epic says that 3,000 patients of Community Health Network (IN) have used its MyChart COVID-19 symptom checker.


COVID-19

A COVID-19 model from Johns Hopkins Bloomberg School of Public Health predicts 3,000 US deaths per day and 200,000 new cases per day by June, but the school says those numbers are for a preliminary, FEMA-commissioned analysis rather than a final forecast. Hopkins adds, however, that the death count will rise significantly as governors reopen states despite meeting none of the federal criteria for doing so, such as a declining case count. Those numbers would represent an increase in daily deaths of 71% and an increase in daily new cases of 700%.

FDA says it will tighten its minimal requirements for companies to sell COVID-19 antibody tests, noting that the rush was on in mid-March to get some idea of population spread, but now the tests are being used to make individual decisions. FDA says companies are selling fraudulent tests, claiming their tests are FDA approved or authorized when they are not, and are marketing their tests inappropriately for at-home use. FDA will now require companies to submit their emergency use authorization requests, along with validation data, within 10 business days, and has also issued specificity and sensitivity thresholds for test developers.

Pfizer launches human trials of four variations of its COVID-19 vaccine, with the company saying that a successful candidate could be given clearance for emergency use or accelerated approval in the fall. Pfizer, like Moderna, is basing its vaccine on messenger RNA, a method that has never been used to develop an approved vaccine. More than 100 vaccines are being developed and 20 are expected to reach human trials this year. Initial tests involve patient safety.

Preliminary contact tracing studies suggest that most coronavirus transmission occurs by close, prolonged contact with someone who is experiencing symptoms. The highest risk factors were household contact, transportation, and dining, with family gatherings and church services giving high infection rates and those over age 60 at higher risk. Children are often infected, but do not seem to be driving outbreaks. The virus seems to spread best in cramped, poorly ventilated areas, such as homes, nursing homes, restaurants, and public transportation.

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A survey finds that two-thirds of Americans don’t believe that reported COVID-19 death counts are accurate. Forty percent of Republicans think the death count has been overstated, while 63% of Democrats believe the actual death count is higher than the official number. Overall trust in federal government has dropped to 38% and more than half of those surveyed are worried that schools won’t reopen in the fall and that food shortages will develop in the next month.  

WHO warns that government reopenings don’t change the fact that coronavirus is still a global health emergency, as case counts are rising rapidly in poorly prepared Africa and South America.

Axios notes that COVID-19 has placed most clinical drug trials on hold, especially those that involve hospitals, and pharma startups face uncertain timelines, a need for more venture funding, and a requirement to conduct studies in multiple locations to avoid having a study halted due to a local outbreak. 

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Johns Hopkins Bloomberg School of Public Health’s Center for Health Security recommends healthcare system changes that will be needed to address the pandemic, saying that the changes will cost billions but “certainly cost less than the trillions now being spent because our public health and healthcare system was not prepared or equipped for this pandemic.” Among them:

  • The federal government should create an information sharing system to allow states and hospitals to work together to obtain PPE and medical supplies and improve its medical supply chain tracking and coordination. .
  • Congress should create legislation to increase domestic production of PPE.
  • Hospitals should buy more reusable devices in their respirator purchases, such as elastomeric face masks and PAPRs.
  • Hospitals should not resume full services until ED visits, ICU census, ventilator use, and PPE use either plateau or return to pre-COVID levels.
  • Hospitals should give every admitted patient a rapid COVID test to detect asymptomatic carriers.
  • HHS should track hospital financial losses and establish short-term bridge funding for hospitals that are in danger of imminent collapse, while CMS should provide financial incentives for those that achieve specific goals for preparedness and infection prevention.
  • Regulatory limits of professional licensure, certification, and scope of practice should be relaxed, including extending cross-state licensure beyond the compact-signing states.
  • Barriers to conducting telephone or video encounters should be removed – state and federal regulations, HIPAA, and reimbursement that is lower than for in-person visits.
  • Congress should use its emergency regulatory authority to authorize clinicians to work at top of license.
  • Healthcare organizations should consider offering hazard pay to employees who are involved in direct COVID patient care and offer mental health counseling to all employees.
  • Congress should make sure that all COVID-related costs are covered under the CARES Act, should require companies to provide 10 days of sick leave for all employees, and develop a plan to give Americans access to affordable healthcare insurance.
  • Healthcare facilities should make significant investments in telemedicine, payers should pay them at the same rate as for in-person visits, and HHS and professional societies should publish guidance and best practices.
  • EHRs should be searchable by public health personnel to aid situational awareness.
  • The US needs to review hospital surge capacity given the existence of market forces that have driven down staffed bed levels.

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MIT scientists develop STOPCovid, a one-hour, $10, minimal handling COVID-19 diagnostic test that offers 97% sensitivity and 100% specificity, requires no special instrumentation, and appears to work well with saliva samples. The FDA has not yet reviewed the test, but the project invites COVID researchers to request a starter kit, hoping to expand test-trace-isolate measures that are required to re-open society.

Sources say President Trump is shutting down the coronavirus task force, sending its responsibilities to FEMA. The frequency and length of the group’s meeting have already been reduced.


Sponsor Updates

  • A Dimensional Insight survey finds that EHR analytics tools deliver lower user satisfaction than both analytics-specific platforms and in-house solutions, with more than one-third of users reporting slow queries and inadequately robust capabilities.
  • Nordic posts a podcast titled “Rise in telehealth sessions alone won’t create great patient experiences.”
  • AdvancedMD publishes a new e-book, “Telehealth: The Ultimate Guide to Maximizing Revenue, Keeping More of What You’re Paid, and Thriving Through Thick and Thin.”
  • Dimensional Insight publishes a new report, “How Satisfied are Healthcare Organizations with EHR Analytics?”

Blog Posts


Contacts

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

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Monday Morning Update 5/4/20

May 3, 2020 News 2 Comments

Top News

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A Duke University-convened expert group lists short-term actions that can be taken to improve interoperability and data exchange for containing COVID-19. It recommends that:

  • Commercial labs and point-of-care test manufacturers should record patient demographics along with COVID-19 samples and add the information to their reports to enable contract tracing, and CMS should use payment adjustments to give them incentive to do so. This information would include patient name, date of birth, gender, race/ethnicity, contact information (address and/or telephone number), and the identifier that was used in collecting the sample (such as medical record number). This capability could be brought online quickly by using the existing clinical query function of CommonWell, claims clearinghouses, or other information service providers.
  • State and local health officials should define a minimum data set for COVID-19 containment as part of participating in clinical data exchanges. Limited public health resources precludes developing API-driven data feeds, so existing intermediaries should be used instead, such as Health Gorilla or the PULSE system that is supported by the Sequoia Project and Audacious Inquiry. 
  • Federal, state, and local officials should enhance their use of the National Syndromic Surveillance Program.

Reader Comments

From Marshall: “Re: Greenway Health. A rumored RIF of up to 10% of their workforce Thursday.” Unverified, but reported by several readers.

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From Dill Fighter: “Re: Apple-Google contact tracing. I will address some misconceptions. The proposal mirrors the CDC in triggering notification only if you have spent at least 15 minutes within six feet of someone who is infected, so just walking by or checking out in a store won’t count. People won’t need to enable them since it will be built into the OS. Users don’t necessarily need to enter their own positive results – providers could enter them in a HIPAA-complaint way, such as entering only the Bluetooth ID of the phone.” My responses, adding to my initial comments:

  • I missed the minimum time of contact specification, which according to Apple, requires 5-30 minutes of contact (the exact threshold must be defined by the public authority, which is responsible for analyzing the data). I assume that contact must be constant rather than cumulative.
  • Apple and Google acknowledge that the six-foot range is a best guess based on Bluetooth signal strength and how the phone is being held. It will be thrown off if the phone is stored in a purse or backpack.
  • Phone users don’t need to download the app, but they need to opt in when it is installed via an OS update. They can opt out or uninstall the app later, which may well happen if the app eats up battery power in the background.
  • The user needs to manually install a second app that will be developed by their local public health authority (how that authority does that development isn’t clear). That authority sets the distancing rule and manages the entry of positive results, and without their app, the Apple-Google one does nothing. Apple and Google are suggesting that a future release of their app will eliminate the requirement of installing a public health app, although I haven’t seen a description of how that will work.
  • It’s the user’s job to enter their own positive result using the public health service’s app. I haven’t seen any suggestion that the app will support providers doing it for them.
  • Singapore saw barely more than single-digit adoption of its national contact tracing app. The country’s director of digital services, which developed the TraceTogether app, warns that they use it only to support manual contact tracing and it’s naive to see it as a replacement. He adds that “you cannot ‘big data’ your way out of a ‘no data’ situation,” such as the Washington state choir in which 45 of 60 members were infected despite distancing appropriately, likely because their singing projected respiratory particles further, and phone-based contact tracing would have missed that.

From HIMSSanity Cured: “Re: HIMSS. I don’t know about anyone else, but my consumption of HIMSS products and services is, and always has been, zero other than attending the conference.” Same here – I have no touch points with HIMSS other than the conference. I don’t read its publications, watch its webinars, attend its other events or local chapter meetings, pay for its certifications, follow its twitterati, view its endless ads, or participate in its plea for vendor-enriching government handouts (excuse me, “advocacy.”) I don’t say this as some kind of vindictive reaction to HIMSS policies and actions – I just don’t need anything that HIMSS offers and I don’t even think about the organization until it’s time to sign up for the conference (or not, as the case increasingly may be). They are just another vendor who I might contact in the unlikely event that I need something they offer. That’s just my opinion as a member, although even as a member I can’t say I’m thrilled at a lot of what HIMSS undertakes that seems more appropriate for a vendor than a member organization.

From Audioslave: “Re: podcast. Here’s a good one on public health.” I don’t listen to podcasts or watch videos that could have been presented as written articles instead. I know people have fun screwing around with their microphones and recorded video calls instead of writing, but they’re wasting my time to save theirs. I’ve done a zillion interviews and can say with confidence that skimming one in 45 seconds and reading the interesting parts more carefully is a lot more efficient than listening to a 30-minute conversation, especially when the questioner’s vanity prattling eats up an unreasonably high percentage of total run time. 


HIStalk Announcements and Requests

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A surprisingly large number of poll respondents have experienced some form of virtual visit since the pandemic broke out 100 years ago in mid-March, with video visits leading the pack. A couple of folks said that the video interface failed and the fallback was a phone call, while one also questioned the how good of replacement those visits can be when they offer only conversation and observation without the clinician being able to use a stethoscope or hands-on techniques.

New poll to your right or here: Will you use the COVID-19 contact tracing app from Apple and Google as soon as it becomes available?

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I wonder if masks could be made from a clear but comfortable fabric so we don’t all wander around in public looking like bank robbers in Westerns? If not, here’s my Plan B: custom-printed masks where buyers can insert a headshot so that the outside of the mask looks like what is underneath (hello, CVS and Walgreens photo departments). We “Arrested Development” fans will be celebrating Cinco de Cuatro on Monday, so I confess that I was inspired by George Michael’s muscle shirt.


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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Meditech reports Q1 results: revenue up 24%, EPS –$0.69 vs. $0.97, swinging from a quarter-over-quarter profit of $36 million to a loss of $26 million due to COVID-related stock losses and a decline in product bookings. Product revenue rose 77% and service revenue was up 3% in a quarter that was good for the company in the health IT market, but not so good in the stock market.

Spok reports Q1 results: revenue down 11%, EPS –$0.24 vs. $.04.


Government and Politics

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President Trump nominates a replacement for the HHS principal deputy inspector general who interviewed hospitals about their COVID-19 concerns and reported their experience with shortages of coronavirus-related supplies and diagnostic tests. The President accused HHS career official Christi Grimm, MPA, who started working for OIG in 1999, of being politically motivated. The President has nominated as her replacement Jason Weida, JD, an assistant US attorney in Boston. 


COVID-19

CMS issues another round of COVID-19 regulatory waivers that include:

  • Physical therapists, occupational therapists, and speech language pathologists can provide Medicare telehealth services.
  • Hospitals can bill Medicare for services that are provided remotely by hospital-based practitioners.
  • Evaluation and management services can be delivered to Medicare patients via telephone.
  • Behavioral health and patient education services can be provided by telephone and will be paid at the same rate as for office and outpatient visits.
  • Medicare will pay for COVID-19 tests that are ordered by any healthcare professional, not just a physician, who is authorized by state law.
  • Pharmacies can operate pharmacist-staffed drive-through testing sites if they are enrolled by Medicare as a laboratory.
  • Hospitals will be paid separately for performing COVID-19 testing as the only service to a particular patient.
  • Medicare and Medicaid will pay for certain FDA-authorized serology tests.
  • Hospitals can increase COVID-19 beds without reducing their payments for indirect medical education, while inpatient psychiatric and rehabilitation hospitals can admit more patients without reducing their teaching payments.
  • Hospitals will be paid at OPPS rates for outpatient services such as wound care, drug administration, and behavioral health that are delivered in temporary expansion locations, such as parking lot tents, converted hotels, and patient homes.
  • Long-term acute-care hospitals will be paid at higher Medicare payment rates for accepting acute-care hospital patients.
  • Nurse practitioners, clinical nurse specialists, and physician assistants can order home health services, establish and review plans of care for home health patients, an certify and re-certify patients for home health services.
  • Physical and occupational therapists can delegate outpatient maintenance services to assistants.
  • Applications for new ACOs will not be accepted until 2021, but those whose participation is expiring this year can extend for another year.

Analysis of TriNetX’s global health research network finds that patients aged 30 to 50 make up 26% of all strokes among patients who tested COVID-positive, versus the typical rate of 11% in non-infected patients in that age group.

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The US is betting big ($483 million) that a coronavirus vaccine can be developed by messenger RNA drug company Moderna, which has never brought a product to market, hasn’t had any of its nine vaccine candidates approved by the FDA, and has never had a product reach the third phase of clinical trials. Even the company’s former chief science officer / R&D president is shocked by the huge amount of funding the government is providing. Nature magazine criticized the company for having failed to publish a single peer-reviewed paper about products it was touting to investors, likening it to Theranos. Moderna’s market cap has risen to $16 billion.

FDA gives Gilead emergency use authorization to distribute remdesivir for severely ill COVID-19 patients, also allowing five-day use for non-intubated patients instead of the usual 10 days, which will extend the drug’s supply. Gilead is donating its entire inventory of the drug, 1.5 million vials, to the federal government, which will oversee its distribution.

New research indicates that blood pressure drugs in the ACE inhibitor category, contrary to early concerns, do not affect coronavirus infection or outcomes.

A New York City nursing home admits that 98 residents of the 705-bed facility have died from presumed coronavirus infection.

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A Brigham & Women’s ED doctor warns that it’s not reasonable to compare deaths from COVID-19 versus influenza – COVID-19 deaths count only patients who tested positive or met specific diagnostic criteria, while flu deaths are estimated using a model that adjusts for assumed vast underreporting (I admit that I did not know this). Example: CDC estimate 2018-29 US flu deaths at 26,000 to 53,000 even though just 7,200 deaths were confirmed. Applying that same underreporting assumption to COVID-19 suggests that it could have already killed 600,000 people in America (versus the official count of 68,000), and even then we are early into a pandemic that may or may not weaken in the summer.

Former FDA Commissioner Scott Gottlieb says that we may hit 100,000 US deaths from COVID-19 by June and that cases are still rising in 20 states, indicating that mitigation steps didn’t work as well as expected.

Meanwhile, the number of confirmed cases seems to have hit a stubborn plateau, leading to the possibility that a “second wave” won’t happen in the winter because the first one won’t actually have ended by then, especially with relaxed mitigation measures that the virus has waited out (late May is likely the new March as the April mitigation indiscretions kick in as active infections and hospitalizations). Seasonality remains the best (but uncertain) hope for a summer break. Curve-flattening was successful only in extending the time period in which the same number of people get infected, are hospitalized, and die, but otherwise the virus is still out there just like before.

China’s state media creates a video that makes fun of the US’s coronavirus response. Meanwhile, a Department of Homeland Security report says China intentionally hid the extent of the pandemic so it could hoard drugs and supplies, as evidenced by unusual import and export numbers.


Other

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Epic launches Epic Health Research Network, a public-facing site in which Epic’s customers can post their observational findings about COVID-19 or any other topical issues in health and public health.

UK Prime Minister Boris Johnson and his fiancé give their newborn son the middle name of Nicholas in honor of two doctors by that name who treated Johnson for COVID-19 last month.


Sponsor Updates

  • Clinical Computer Systems, developer of the Obix Perinatal Data System, releases the latest edition of its Critical Care Obstetrics Podcast, “Indications for Intubation.”
  • OpenText’s information management solutions are now available as fully managed services on AWS.

Blog Posts


Contacts

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

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News 5/1/20

April 30, 2020 News 7 Comments

Top News

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Health data and software company Arcadia acquires assets of the Massachusetts EHealth Collaborative, including technology and customer accounts.

MAeHC President and CEO Micky Tripathi, MPP, PhD will join Arcadia as  chief alliance officer while continuing his roles with Argonaut, Sequoia, CommonWell, HL7, HL7 FHIR Foundation, and CARIN Alliance.


Reader Comments

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From VCU Observer: “Re: VCU Health’s rip-and-replace of Cerner with Epic on May 1. At least one board member says the project hasn’t been approved nor the implementation costs outlined. The expenditure, rumored to be hundreds of millions of dollars more than Cerner’s upgrade bid, doesn’t make sense at this time.” Unverified. VCU announced a mid-2021 go-live when they chose Epic in December, which seems challenging given limits on travel and in-hospital presence for the all-important initial planning and on-the-ground design meetings.

From PPP Shooter: “Re: paycheck protection plan loans. The Small Business Administration has clarified that publicly traded companies, as well as the portfolio companies of private equity funds, are prohibited from receiving PPP loans and must pay them back by May 7 if they received them. Hundreds of publicly traded companies received these loans and the PE firm clarification may cause problems for the health IT world.” SEC filings indicate that 220 public companies need to return $870 million that they received before the rule was changed, with more that are likely still be disclosed since SBA has refused to release a list of the companies that received money. Publicly traded health IT company Castlight Health received the maximum loan of $10 million, but says it will return it.

From Pickle Bickering: “Re: contract tracing by smartphone app. Is it worth the privacy intrusion?” Apple and Google are doing exactly what big tech companies always do when barging into healthcare with minimal knowledge — they are thinking that a cool app can fix everything. App-based contact tracing is doomed to fail, in my opinion, and not just because of privacy issues:

  • Not all Americans own smart phones and carry them at all times. Children, for example, appear to be significant spreaders and will become more so when schools and daycares reopen, but few of them will be carrying a contact-tracing app on a phone.
  • Many people won’t use tracking apps because they don’t know they exist, don’t derive any personal benefit from their use, or refuse to be tracked regardless of privacy assurances. There is no way that Americans will accept an opt-out model in which they default to being users and also no way that a significant percentage will otherwise opt in.
  • These apps have never worked in a country where their use was voluntary, nor rolled out late in a country whose initial COVID-19 response was as indecisive as ours.
  • Accuracy is questionable. The six-foot range will flag contacts between cars, on opposite sides of plastic shields in stores, and where physical protection is in place and makes virus spread unlikely. I’m not confident that a record of whom I’ve passed within six feet of is all that useful in controlling coronavirus spread.
  • Users are expected to manually enter their positive COVID-19 test result for the benefit of others who will then be notified. Then, unlike in other countries, it’s up to those people who get the “you’ve been exposed” warnings to take action since they are not identifiable.
  • Contact tracing requires having a strong system of 14-day quarantine in place, such as providing private living space and checking up on self-monitoring. We can already guess that many nursing home residents, mass transportation riders, homeless people, prisoners, and laborers who live in employer-provided dormitories are infected, but any isolation is voluntary and limited by their resources.
  • The bottom line: this sort of contract tracing works only if at least two-thirds of Americans use the app and we roll out widespread COVID-19 testing to identify those who are infected but symptom-free to catch potential spreaders early. Even then our society, as it returns to being mobile, will make it nearly impossible to address the potentially hundreds of people that someone could pass near in the days or weeks before they receive a positive test result.

From Looking For Answers: “Re: Clarify Health Solutions. Laid off 70 employees, about 40% of its workforce, on March 19. KKR gave it a bridge loan instead of agreeing to a Schedule C. I’ve seen nothing online, but a former colleague who used to work there told me.” Unverified. I don’t think I’ve ever heard of this particular analytics vendor, which has raised $63 million, almost all of that in a September 2018 Series B round by KKR. The company announced a couple of COVID-19 apps less than a week after this rumored layoff. 


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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Mayo Clinic (MN) will invest in Current Health and work with the company to develop COVID-19 predictive and remote monitoring technologies.

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From the Cerner earnings call:

  • Chairman and CEO Brent Shafer says he is pleased with the productivity and performance of its 27,000 employees after the majority of them moved to working from a virtual environment.
  • The company expects the VA and DoD to revise their timelines due to COVID-19 and Cerner has factored that into its guidance.
  • Cerner expects a slight drop in next-quarter bookings, but says clients are generally moving ahead and it won’t be a lot different than usual, especially since unlike the 2008 market crash, health systems were doing fine financially before coronavirus and stimulus money will help get them back on their feet.
  • President Don Trigg says the federal government’s role of top regulator and payor will expand due to COVID-19 and health system consolidation will accelerate and extend into ambulatory practice.
  • Clients are starting to ask about getting into the queue for services that will be in high demand.

Sales

  • Penn State Health selects RCM software and services from R1 RCM.

Announcements and Implementations

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A new KLAS report on US hospital EHR market share finds that Meditech Expanse is drawing new interest from customers outside its usual small-hospital base, with a new 400+ bed health system sale in 2019 giving the market a chance to see how Expanse scales. Meditech won about half the decisions made by its legacy customers in 2019, and half of its losses came from product standardization and provider M&A. Cerner saw its first-ever decrease in market share after losing four big clients in 2019, with its losses most often due to customers who standardized on Epic and those who were frustrated with Cerner’s revenue cycle management solution. Epic has grown to cover 40% of US acute care beds, with its new wins split between new decisions and standardization and acquisitions. Allscripts continues to steadily lose market share, with 2019 losses of customers of Sunrise (eight), Paragon (16), and Horizon (seven). Small, standalone hospitals were left with few choices after Athenahealth exited the inpatient market, with Cerner CommunityWorks and Meditech Expanse coming closest to meeting their needs.

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Epic will embed telehealth into its EHR using Twilio Programmable Video, which is also used by Kaiser Permanente,  MDLive, Doctor On Demand, and several health systems. Investment firms are already warning companies like Teladoc that their reach into academic medical centers may be constrained with the availability of an Epic-embedded virtual visit platform that is staffed by a hospital’s own clinicians.

Critical access hospital Macon Community Hospital (TN) goes live on Cerner in a go-live that Cerner managed remotely.

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Allegheny Health Network’s Saint Vincent Hospital (PA) implements virtual ICU software and support from Mercy Virtual.

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Greenway Health announces GA of GRS Express, a suite of expedited RCM services to help practices maintain cash flow.

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EPSi announces GA of COVID-19 Planning Analytics to help providers anticipate ICU capacity, financial burdens, and the impact of resuming elective procedures.

QliqSoft will incorporate the Suki voice-enabled digital clinical assistant in its telemedicine platform to create medical notes and perform tasks such as EHR information retrieval.

Reliance EHealth Collaborative is developing COVID-19 use cases via data management, analytics, and reporting from IMAT Solutions.


Government and Politics

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HHS awards $20 million to six organizations to help them expand telemedicine access.


COVID-19

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Conflicting studies on the use of remdesivir came out Wednesday following several incidents in which leaked information found its way to mainstream media headlines. Preliminary results from a government-run trial showed patient time to improvement was 11 days versus 15 days for placebo, which meets the NIH study’s endpoint, but the drug did not provide a statistically significant improvement in survival rate. Almost simultaneously, results of a peer-reviewed study performed in China showed no benefit from using remdesivir. Experts say the benefit isn’t necessarily how well remdesivir works, but a reminder that the virus has vulnerabilities that can be exploited incrementally to improve outcomes even in the in the absence of a blockbuster drug, as was the case with HIV/AIDS.

NIH announces a $1.5 billion challenge for rapid deployment of coronavirus diagnostic tests.

A Kaiser Health News article observes that hospital information that is stored in proprietary, siloed EHRs cannot support hospitals sharing their COVID-19 treatment experience. Experts say everybody knew from the early days of the $36 billion Meaningful Use program that hospitals were seeking systems to optimize billing, not public health. Health Catalyst CTO Dale Sanders was quoted in the article as saying that CDC should have developed a coronavirus data collection plan, with standardized terminology, that would have allowed hospitals with non-interoperable EHRs to look at the big picture (Health Catalyst is a member of the COVID-19 Healthcare Coalition that is trying to assemble information for real-time support). Public health systems are also often unable to accept electronically submitted information, requiring hospitals to complete manual forms that can take up to 30 minutes to complete and often even then with missing information.

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Most of the tent hospitals that were expensively built to provide services to an expected crush of COVID-19 patients are scheduled for closure, having seen few patients:

  • New York is shutting down two tent hospitals that didn’t see a single coronavirus patient, having spent $350 million in federal taxpayer money to plan and build temporary facilities. The only field hospital that saw patients, at Javits Center, will close Friday after treating 1,000 patients in the 4,000-bed facility.
  • Chicago’s pared-back, $64 million, 500-bed hospital at McCormick Place has treated only 12 patients.
  • Detroit’s 1,000-bed convention center hospital has seen just 36 patients and is scheduled for closure.
  • Philadelphia will close its 200-bed temporary hospital in two weeks. It has never had more than six patients at a time.
  • New Jersey’s four field hospitals totalling 1,000 beds have treated 346 patients.
  • The temporary hospital that was set up in the New Orleans convention center is averaging 100 coronavirus patients.
  • The Navy’s 1,000-bed USNS Comfort will leave Manhattan this week to return to its home port of Norfolk, having treated just 182 patients.

The Atlantic says Georgia’s rush to reopen businesses is an experiment “to find out just how many individuals need to lose their job or their life for a state to work through a plague” given that Georgia is moving forward despite meeting none of the accepted testing and infection success benchmarks. On the other hand, the article fails to note that the same number of people are likely to die either way, just over longer periods, unless we complete a technological Hail Mary in the form of a vaccine, effective treatment, or a sound containment containment strategy.


Privacy and Security

The New York Times says Europe’s world-leading GDPR privacy rules are falling short of expectations because of small national data protection budgets, lack of enforcement, and tech company pushback. The only tech company to have been penalized is Google, which paid a relatively paltry $54 million versus the law’s maximum of 4% of global revenue. Public experience with GDPR has been mostly negative as web users are forced to click through countless pop-up consent windows.


Other

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Regions Hospital (MN) works with Medtronic to develop software that allows providers to remotely monitor and adjust ventilators. Regions providers say the software, which went from concept to implementation in just 10 days, has cut down on in-room visits to COVID-19 patients by 50%, and helps conserve PPE. Several other hospitals are also piloting the technology.

Experts say it’s not the imagination of Zoom users that the videoconferencing app leaves them anxious, unable to think clearly, and tired — the app’s bandwitdh-conserving degradation of video quality leaves the brains of users to fill in the image’s gaps, especially in trying to analyze poorly rendered or out-of-sync facial expressions. Telephone calls, oddly enough, offer a more natural feeling of presence and engagement.


Sponsor Updates

  • Elsevier adds resources for biomedical and scientific researchers to its free Coronavirus Research Hub.
  • The Chartis Group publishes a new paper, “After the Surge: Five Health System Imperatives in the Age of COVID-19.”
  • InstaMed releases the 10th edition of its “Trends in Healthcare Payments Annual Report.”
  • InterSystems makes available the latest version of its HealthShare suite of connected health solutions, including capabilities to support final federal interoperability rules.
  • Engage announces feature updates for its Wait Times app.
  • Impact Advisors publishes a white paper titled “COVID19 Federal Stimulus Package – Impact on Providers.”
  • HBI Solutions names Jackie Porter, BSN, RNC-E (Syapse) client success director.
  • Meditech highlights the successful utilization of its virtual visit functionality at Citizens Memorial Hospital (MO), Grand View Hospital (PA), Avera Health (SD), and Mount Nittany (PA).

Blog Posts


Contacts

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

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News 4/29/20

April 28, 2020 News 9 Comments

Top News

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VA OIG evaluates the VA’s now-postponed first Cerner go-live at at Mann-Grandstaff VA Medical Center (WA) that was scheduled for March 28, 2020, observing:

  • The VA assumed that access to care would drop 30% for 12-24 months after go-live based on the Department of Defense’s Cerner experience. However, planned mitigation actions were not completed due to the VA‘s lack of guidance and budget constraints for adding employees, expanding clinical space, expanding clinic hours, and extending appointment times.
  • The VA could not alleviate potential backlogs by referring patients to community providers because the hospital is already falling short of VA standards in that area, with a backlog of 21,000 open consults and an average wait time of 56 days. Employees were asked to work 8-10 extra hours per week to manually copy and paste information from one system to another to process the consults.
  • VA and Cerner concluded in July 2019 that some EHR capabilities would be missing by the March go-live, including requesting online prescription refills via MyHealtheVet, which presented a patient safety risk. The VA decided to turn off access to prescription refills in Cerner’s HealtheLife patient portal because it did not meet VA standards.
  • Hospital staff would have needed to enact 84 mitigations for the 62 systems that were at moderate to high risk of being unavailable.

Reader Comments

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From AnotherDave: ”Re: Scanadu. Too bad it fizzled now that there’s a run on pulse oximeters. I pulled my First Edition from its paperweight duties and it still works. I bought it for $149 in the early bird Indiegogo deal in 2013, finally received it in February 2015, and the company’s business plan fell apart in May 2017 when its investigational study was shut down. With the right investment and re-branding, it would be a Handy COVID-19 Screener.” I never quite saw the appeal of the Scanadu gadget, maybe because the Tricorder references got old fast, it didn’t do a whole lot, and early digital health fanboys were practically mounting it in lustful consummation of their naiveté-fueled enthusiasm. The company said FDA required it to brick the device because it was part of a Scripps study that had ended. Crowd-funders got nothing and weren’t happy about it. Founder and CEO Walter De Brouwer went on to launch Doc.ai, which allows researchers to conduct medical studies via the smartphone of participants. Meanwhile, Scanadu renamed itself as Inui Health in late 2018, launched an FDA-approved app for in-home urinalysis, and then pretty much went nowhere.

From Mo Money: “Re: stock market. Good time to invest in health IT companies?” I don’t buy or recommend health IT stocks because that seems like a conflict of interest, but I’ll instead offer my long-held opinions about investing in general:

  • No investment performs better in the long term than stocks, and long-term investing is where you accumulate net worth (which is the only personal financial metric that matters – it’s what you own that counts, not what you make).
  • Markets have always eventually roared back after an emotion-driven downturn. The first time that doesn’t happen will be the end of American society, in which case your mattress full of cash won’t buy you anything important anyway.
  • You have to buy dispassionately and stay in the market regardless of the ups and downs, which are just bumps in the road. Discipline pays.
  • Define your specific goals (“getting rich” doesn’t count). It’s always a balance between reward and risk, and your tolerance and timelines for the former drive the required degree of the latter.
  • The time value of money is powerful. The investment decisions you make in your 20s and 30s, even with small amounts of money involved, will far outweigh the decisions you make in your 50s and 60s.
  • Don’t look at your portfolio value more than one per quarter, rebalance holdings to meet your chosen model, and don’t change your plan just because it’s up or down. Especially if you, like me, would feel anxiety or depressive remorse in having lost money (I swear I was the only person who was buying high and selling low during the dot-com boom).
  • Buy mutual funds, index funds, or an investment company’s trading model. The odds that you will out-earn experts with your consummate stock-picking skills are minimal. Take a look at how well health IT stocks have performed against the Nasdaq index or S&P 500 in the long term before you get excited about applying your industry knowledge to stock picking.
  • Don’t be influenced by people who brag about their investing home runs since it’s their batting average that matters (it’s more “Moneyball” getting on base frequently than striking out consistently while waiting to send the next shot over the fence).  
  • Buying IPO shares means someone who knows a whole lot more about the company than you is anxious to unload.
  • Don’t overload on your own employer’s shares in your 401(k). Not only are you are overexposed from a portfolio standpoint, any employer stumbles will probably bite you doubly hard as both an investor and an employee. 
  • Stocks are worth what the market thinks they are worth, which may not track well to intrinsic valuation or reasonable expectations. No amount of stock-picking analysis will change that, and those who believe differently are efficiently separated from their money over the long haul. No formula, no matter how elaborately conceived, can take human foibles into account, and stock price is set by greed, fear, and hopes of finding a greater fool.

HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Spirion. The St. Petersburg, FL-based company has since 2006 offered accurate data discovery and classification solutions that give customers in several industries unparalleled data privacy, security, and regulatory compliance. Spirion’s platform gives healthcare organizations full visibility into their structured and unstructured data, both network- and cloud-based, to allow designing protection and monitoring without human effort or error. Spirion for Healthcare is a PHI management and data loss prevention tool that focuses exclusively on data at rest, which represents 100% of large breaches. Its rules-driven, sensitivity-tunable AnyFind technology uses contextual search discovery to find data sources such as payment card industry (PCI) data, PHI, and personally identifiable information no matter where it exists, while Sensitive Data Engine allows creating data deeper definitions to locate proprietary and unique organizational information. The company offers data security teams free 60-day use of Sensitive Data Manager during the COVID-19 crisis, also extending to stay-home employees free use of a Data Discovery Agent to identify the existence sensitive personal information on their computers. Thanks to Spirion for supporting HIStalk.

I found this Spirion 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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Cerner reports Q1 results: revenue up 2%,adjusted EPS $0.71 vs. $0.61, beating earnings expectation but falling short on revenue. The company expects the biggest COVID-19 financial hit to occur in Q2, after which project and sales activity will improve if pandemic-related restrictive measures are relaxed. 

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UnitedHealth Group’s Optum division is reportedly negotiating a $470 million acquisition of AbleTo, which offers virtual visits for behavioral care with its network of therapists and coaches. The company, which targets payers and employers, had previously raised $47 million through a Series D round, with Optum Ventures being one of its most recent investors. 


Sales

  • OU Medicine (OK) chooses Artifact Health’s mobile physician query platform to drive complete and comprehensive patient chart information.

People

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Nicklaus Children’s Health System (FL) hires David Seo, MD (University of Miami Health System) as VP/CIO.

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Nephrologist Burton “Bud” Rose, MD, who created the industry-standard UpToDate computerized medical reference in his basement in 1992, died of COVID-19 last week at 77.


Announcements and Implementations

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A new KLAS report on ambulatory revenue cycle management services finds high customer satisfaction with Athenahealth, R1 RCM, and Bolder Healthcare, while EMDs, CareCloud, and Greenway Health experienced a significant drop in satisfaction over the past year. Six of the eight reviewed firms were acquired in the past few years, some with positive results (Allscripts, Athenahealth, Bolder, and R1) and one showing a significant decline in satisfaction (EMD’s 2019 acquisition of Aprima, with 80% of the latter’s former clients expressing dissatisfaction since). KLAS concludes that third-party players are gaining traction and raising the customer satisfaction bar as disruptive new entrants.

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Another KLAS report suggests how health IT vendors should conduct business during COVID-19:

  • Sell the customer what they need to become successful (prescriptive sales) instead of allowing them to pick and chose products and services themselves.
  • Pass on sales that are not a good fit to avoid future reputation damage.
  • Have account managers proactively reach out to customers to help them understand the company’s vision and the product’s impact.
  • Empower lower-level employees to solve customer problems.
  • Create contingency plans to avoid support disruptions that could be caused by COVID-19 impact on offshore support resources.
  • Drive adoption through training.
  • Use internal expertise to guide customers instead of just giving them data or new reports.

Oneview Cloud for COVID-19 is being used for virtual care and virtual visitation in the coronavirus units of four New York City teaching hospitals.

A TransUnion Healthcare analysis of 500 hospitals finds that visit volume declined 32-60% in March.

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GuideWell launches COVID-19 Health Innovation Collaborative, which seeks solutions that address the categories of COVID-19 self testing, virtual in-home care, protection of clinical staff, reduction of social isolation, and home delivery of food and supplies to at-risk populations. The application deadline is May 8.


COVID-19

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Overall fatality rates compared to pre-pandemic numbers suggest that coronavirus-related deaths are up to 60% higher than official counts. New York City averages 6,000 deaths from mid-March to late April, but had 27,000 in the same period this year versus the 17,000 deaths that were officially attributed to confirmed or probable coronavirus.

Sixty Mayo Clinic physician volunteers are helping manage New York City’s COVID-19 ventilator patients remotely using an audiovisual connection and access to New York-Presbyterian’s Epic system. The doctors note that COVID-19 is like prolonged respiratory failure with unusual twists, such as blood clots and kidney failure.

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EHR vendor Kareo becomes one of the first companies in Southern California to offer free COVID-19 antibody tests to its employees and their families, with 40 of the 415 who were tested in a drive-through program showing antibodies that indicate previous or current infection. Of the 15 who showed a possible active infection, only one had symptoms. The company hopes the testing will give employees peace of mind and help it transition back to on-premises work.

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Vice-President Pence was allowed to violate Mayo Clinic’s campus mask-wearing requirements during his visit there Tuesday, even as he met with employees and a patient who all wore them. Senior White House officials have never been shown wearing masks in public or in photo opportunities. Mayo said they told Pence’s team about the policy and referred further questions to them.

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Quest Diagnostics announces availability of a $119 COVID-19 antibody test via its QuestDirect service that does not require a prescription, although purchasers must visit a Quest draw station to provide a blood sample. Public health officials again warn that nobody knows what the presence of coronavirus antibodies means with regard to immunity.

Former FDA Commissioner Scott Gottlieb, MD says in a Wall Street Journal op-ed piece that the US must create a COVID-19 vaccine because the country that does so will inoculate its own citizens first to restore its economy and gain global influence.

A New York Times report says that China’s factories have reopened, but job losses, reduced wages, and people staying home to avoid infection have left its economy sputtering from low consumer spending.


Other

Patients complain that they are being unexpectedly charged for virtual visits despite political proclamations and insurer announcements of waived co-pays and deductibles for COVID-related services, mostly because of the fragmented health system. Among the issues:

  • Some doctors and insurers are charging patients upfront for the full cost of the virtual visit even when it is covered by insurance because insurers aren’t paying and the cash-strapped practices are anxious to collect revenue immediately.
  • 100 million people get their insurance from employers that are self-insured and the big insurers don’t control the telemedicine benefits in that case.
  • Insurers have waived patient charges only for in-network doctors.
  • Some practices are charging for routine telephone calls now that Medicare and insurers are paying for virtual visits in all forms.

A New York Times article warns that parents are postponing well-child checkups for fear of COVID-19, leading to concerns that reduced immunization will cause outbreaks of measles and whooping cough. Pediatric EHR vendor PCC found from the records of 1,000 independent pediatricians that MMR vaccinations are down 50%, diphtheria and whooping cough 42%, and HPV 73%.

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Physician and author Sid Mukherjee, MD writes in The New Yorker that the US healthcare system caused several issues in our coronavirus response:

  • US medical infrastructure fell apart in failing to inventory adequate supplies of PPE and a Strategic National Stockpile that saw its role as supplementing, rather than meeting, state and local public health emergency needs.
  • Testing failed because of the CDC’s distribution of faulty COVID-19 tests, the FDA’s requirement that only CDC tests be used (instead of the WHO tests that the rest of the world uses), and CDC’s distribution of tests only to military, state, and public health labs that perform a tiny fraction of all testing. The author notes that South Korea has so many test kits that it is exporting them to the US, which they did by quickly identifying potential vendors, certifying their products, and turning their factories loose to meet demand.
  • FDA’s process for validating diagnostic tests that had been developed by other labs was inefficient, with criticism then causing it to overshoot in allowing 90 companies to sell antibody tests even though FDA has reviewed only four. 
  • The value of distributing real-time, anecdotal treatment findings via social media and preprints was obvious though imperfect.
  • Vital drugs fell in short supply because their low profit margins left manufacturers complacent and some of them are made in single factories that were disrupted, such as by Hurricane Maria in Puerto Rico.
  • The “market-driven, efficiency-obsessed culture of hospital administration” caused leaders to fail to account for “organizational survival time” in the absence of a functional supply chain and the time required to recover from such disruption afterward.
  • The difficulty of searching for information in EHRs and the time required to obtain institutional approval to do it left researchers flying blind. The author says that EHRs “actively obstruct patient care” and are bound by proprietary interests and privacy rules from delivering their potential as a searchable national repository of real-time, de-identified patient data that could be used as a “storm-forecasting system” for research and treatment dissemination.

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In colorful COVID-19 political news, Grants, NM Mayor Martin “Modey” Hicks (D) defies state law in allowing gun stores and golf courses to reopen, concluding, “We’re not doing it no more” and that “that business, by God, is essential to that individual.” Governor Michelle Lujan Grisham says she may file a cease-and-desist order since it is “like opening up a public pool and having a pee section.” The mayor has ordered businesses to call 911 if the governor’s “Gestapo” shows up over a “little bug.“ He then told reporters he was heading off for a round of golf, and finding the course closed, fired the city manager.


Sponsor Updates

  • Audacious Inquiry will work with HL7 International to develop an HL7 FHIR implementation guide as part of their work with the SANER project.
  • CRN gives Avaya a five-star rating in its annual Partner Program Guide.
  • Black Book’s latest survey finds that Evident’s Thrive EHR has earned top client ratings in small hospital EHR user satisfaction for the tenth consecutive year.
  • Murray County Medical Center (MN) and TCare implement CareSignal’s COVID-19 Companion text messaging app.
  • Wolters Kluwer launches virtual conferences to support medical societies amid COVID-19 meeting cancellations.
  • CereCore congratulates its Epic team on helping HCA Healthcare expand its telehealth capabilities.

Blog Posts


Contacts

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

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Monday Morning Update 4/27/20

April 26, 2020 News 11 Comments

Top News

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Epic CEO Judy Faulkner discusses possible post-coronavirus healthcare changes in a Business Insider interview:

  • Some hospitals and medical practices will file bankruptcy, as she notes that Epic customers have reported revenue declines of up to 55%.
  • Mergers, acquisitions, and layoffs are likely, especially as small providers are purchased by large health systems that have greater financial reserves.
  • Video visits and at-home monitoring are here to stay.
  • Public health surveillance and the associated standardized data requirements will be a focus.

Meanwhile, Epic offers customers COVID-related applications with no charge for licenses, implementation, and support during the pandemic:

  • Bugsy Infection Control for infection tracing.
  • MyChart Bedside for communicating with isolated patients.
  • Remote Monitoring.
  • Secure Chat.
  • Transfer Center.
  • Willow Inventory for tracking PPE.
  • Rover for handheld nurse charting.
  • Nurse Triage.
  • MyChart, with no per-patient cost for new sign-ups.

HIStalk Announcements and Requests

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Poll respondents didn’t express a lot of positive thoughts about HIMSS, with transparency, value, and humility being the attributes they chose least often. I’m guessing that much of the ill will was caused by vendors and registrants who lost money from HIMSS20 refund decisions, but I also speculate that significant dissatisfaction and resentment has existed for years but has been masked by high HIMSS conference attendance numbers, which may have not been accompanied by any particular love or respect for HIMSS as an organization versus as an unavoidable vendor that runs the industry’s de facto gathering. Some respondents provided their own negative terms instead of choosing from the positive ones I listed. I doubt that any of us could come up with easy fixes, even if HIMSS were to agree that its past missteps require correction.

New poll to your right or here: Which types of virtual visit have you had since mid-March?

Listening: new from Delanila, moody, sultry alt pop fronted by composer Danielle Eva Schwob with the topical title of “It’s Been A While Since I Went Outside.” She filmed the official video (“visual poem”) herself in a COVID-emptied Manhattan. Her entire catalog under this name is just four singles, but all are magnificent and immediately addictive. I’m also enjoying the new, posthumously released single from Chicago rapper Juice WRLD, whose lyrics in “Righteous” (“taking medicine to fix all the damage”) foretold his drug overdose death in December 2019 at 21 years of age at Midway International Airport, when he downed of handfuls of pills to hide them from federal agents who were searching the private jet on which he was traveling (successfully, as it turned out) for the drugs and guns that were on board. Lastly, if you’re looking for a song that will burrow into your brain like toxoplasmosis, try “The Other Girl,” which sounds like Taylor Swift but is actually country pop singer Kelsea Ballerini with singer-songwriter Halsey (the latter’s first musical posting in 2012 was a parody of a Swift song, so there you go). 


Webinars

April 28 (Tuesday) 1 ET: “COVID-19: Managing an evolving patient population with health information systems.” Sponsor: Intelligent Medical Objects. Presenters: Julie Glasgow, MD, clinical terminologist, IMO; Reeti Chauhan, senior product manager, IMO. IMO recently released new novel coronavirus descriptors to help clinicians accurately record diagnoses and also created free IMO Precision COVID-19 Sets to help identify and analyze patients with potential or documented infection. The presenters will discuss these new tools and describe how to use them optimally.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

Vocera announces Q1 results: revenue up 15%, adjusted EPS –$0.14 vs. –$0.17, beating Wall Street expectations for both. 

Amazon surveys its sellers about their health plans, creating speculation that it will offer health coverage.


Sales

  • Tift Regional Medical Center (GA) goes live on LiveProcess Emergency Manager to power its virtual command center.
  • Commonwealth of Massachusetts will offer free virtual visits to uninsured state residents who have COVID-19 symptoms or have been identified through contract tracing, powered by virtual care provider Doctor On Demand.

People

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Eric Rose, MD (Intelligent Medical Objects) joins the VA’s Office of Health Informatics as chief terminologist.

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New Jersey Innovation Institute hires Jennifer D’Angelo (Bergen New Bridge Medical Center) as VP/GM of healthcare.


Announcements and Implementations

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In Australia, Queensland Health cancels its laboratory information system replacement contract with Sunquest after two years and having spent $24 million of the $43 million original contract award. It will instead upgrade its Auslab system that Sunquest was intended to replace.

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Cerner offers health systems and researchers free access to the de-identified data of COVID-19 patients for developing epidemiological studies, clinical trials, and medical treatments. 

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Waystar launches an analytics and business intelligence module ahead of schedule to support the coronavirus-driven decisions healthcare organizations are making.


COVID-19

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Researchers study the 14 available coronavirus antibody tests on which the hopes of reopening the US economy rest. Only three of the 14 tests — many of which are manufactured in China — delivered consistently reliable results, and none were perfect. All but one test sometimes gave false positive results (which could lead someone to think they are immune when they are not), the tests performed better when the patient had been infected for longer periods, and none of the tests have been approved or studied by the FDA. Meanwhile, an urgent care center near me is pitching COVID-19 testing for $40 cash plus the cost of the video visit, the latter of which is covered my many insurance plans for coronavirus screening. The unstated important point of all this is that (a) we have zero evidence that even correctly resulted seropositivity means that someone is immune, and (b) even if they are immune, we don’t know for how long. We could kill people by sending them back to work or causing them to throw coronavirus caution to the winds by assuming that past exposure indicates immunity. What we don’t know about this virus is nearly everything, except that it spreads and kills people with ruthless efficiency.

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A Stanford seroprevalence study – which was was already being widely questioned for recruiting self-selected users via Facebook and going straight to a press release with no peer review — takes another hit when BuzzFeed News finds that the physician wife of the lead author recruited participants via a wealthy school’s listserv, skewing the demographics of participants. The preprint article estimated that up to 81,000 people are infected in Santa Clara County versus the officially reported 956, which would indicate a much lower death rate than previously believed. Another author is maverick Stanford researcher John Ioannidis, MD, DSc, of which an expert concludes may be “so attached to being the iconoclast that defies conventional wisdom that he’s unintentionally doing horrible science.” He and another of the paper’s authors had previously questioned in a Wall Street Journal op-ed piece and in several Fox News appearances whether the threat of COVID-19 is overblown.

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Facebook is offering users a coronavirus symptom survey that was created by Carnegie Mellon University, with results from 1 million users per week being sent directly to CMU for predicting disease spread and county-by-county impact. The first set of results will be published Monday. The map above indicates percentage of people with symptoms in each county (the redder, the worse), but I noticed that the symptom map allows showing percentage of people with symptoms by hospital referral region, which is useful in hospital planning (Rapid City, SD is about to get hammered).

US nursing homes have seen more than 10,000 deaths related to COVID-19, and nine of them that experienced coronavirus outbreaks that triggered “immediate jeopardy” federal citations were found to have significant problems meeting basic health standards – lack of PPE, failure to enforce physical distancing of residents, inadequate staffing, and failing to recognize and react to coronavirus symptoms. Routine federal inspection of nursing homes was stopped on March 20. They complain that federal help has been non-existent as hospitals received all the focus. More than half of reported COVID-19 deaths in some states were nursing home residents.

The Economist warns that governments are borrowing money at a level not seen since the end of World War II despite a dramatic drop in taxes collected, piling up coronavirus-related debt from issuing stimulus money and relief checks for people and businesses. The authors conclude that such spending is sensible in trying to forestall further economic slump — especially in the lower-risk US as the world’s reserve currency and with low interest rates — but working down the 1945 debt all over the world required high taxes on capital, the benefit of inflation, and a baby boom that was accompanied by higher levels of education. The authors also expect that the public — especially senior citizens who vote against politicians who attempt to limit entitlement spending — will demand higher levels of healthcare spending.

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Former CMS Acting Administrator and United States of Care founder Andy Slavitt lists his takeaways after talking nearly non-stop to to scientists from all over the world:

  • Making effective, breathable, and even fashionable masks available at low or no charge to the entire US population could protect us (at worst) or eradicate the virus (at best) due to the power of exponential math of the infection rate. Masks, rather than a vaccine or therapy, may be the silver bullet.
  • We will solve the shortages of tests, ventilators, and hospital beds.
  • Individual immune response rather than the strain of the virus may drive COVID-19 outcomes.
  • Creating an effective vaccine by 2021, proving that it is safe, and then manufacturing and distributing it to the entire globe involves many challenges.
  • Even in the absence of a vaccine, COVID-19 could be managed as a chronic disease.
  • A vaccine may only be partially effective or may offer partial inoculation, in which case it could still be used in healthcare workers and high risk people.
  • We need to produce so much PPE that a glut is created, taking profiteers out of the picture.

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VA officials reverse their previous insistence that it is providing adequate PPE even as employees stated otherwise. VA Executive in Charge Richard Stone, MD says FEMA ordered the VA’s vendors to redirect its shipment of 5 million masks to FEMA for restocking the emergency stockpile, forcing the VA to limit employees who work directly with COVID-19 patients to one mask per day, while other employees who delivered food and medications to COVID wards received only one mask per week, with orders to staple the straps if they broke. The VA says that 1,900 of its own employees are sick with COVID-19 compared to the 6,300 infected veterans it has treated. The VA did not have enough tests for its employees until recent weeks, but its absenteeism rate is still tracking below the normal average at 4% as poorly equipped employees keep showing up for work.

White House officials are discussing plans to replace HHS Secretary Alex Azar, sources say, following widespread criticism of the federal government’s early response to the pandemic and misstatements to the White House about Azar’s reported demotion of HHS vaccine expert Rick Bright, PhD. 


Other

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Something triggered a memory of XG Health Solutions, the Geisinger analytics and consulting spinoff that was splashily introduced in 2015 without much buzz since, The company apparently closed its doors last summer (shutting down instead of selling out for even a “better than nothing” price is a key indicator of spectacular failure). I attended their HIMSS15 launch and concluded:

From the hallway conversations I heard and my own opinions, here are the positives: Geisinger has developed a lot of expertise and content that’s less ivory tower than most big academic medical centers, they put some thought into involving the patient in the use of their apps, and the SaaS-based subscription means new best practices can be put into place quickly. Negatives: the company has significant venture capital ownership (they aren’t Geisinger, in other words), you might suspect that Geisinger applied soft pressure to the newly named EHR vendor partners to get on board with uncertain future commitments, and so far they’re a company that hasn’t done much to dent the market other than to do Geisinger stuff and make announcements. Success in commercializing hospital software is elusive, and while Version 1.0 is easy, it’s Version 2.0 that gets ugly with upgrades, design decisions, and testing. The first non-Geisinger betas will be important. 

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Best tweet of the weekend, although “other” would have been a lot more sarcastically effective and epidemiologically accurate than “only.”


Sponsor Updates

  • Impact Advisors publishes a white paper titled “The Future of EHR Implementation Post-COVID.”
  • Experian Health’s MyHealthDirect scheduling solution is now available in the Epic App Orchard.
  • Health Catalyst makes COVID-19 insights derived from its Touchstone platform of 80 million de-identified patient records available to customers, hospitals, public health authorities, governments, and biopharma working on treatments.
  • NextGate publishes a new white paper, “Why Patient Identity Management Tools are Critical for COVID-19 Surveillance.”
  • KLAS includes Nordic solutions in its latest report, “COVID-19 Technology and Services Solutions Guide.”
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, releases the latest edition of its Critical Care Obstetrics Podcast, “Team Skills Simulation Training.”
  • PerfectServe congratulates customer Prisma Health on FDA approval of its VESper ventilator expansion device.
  • Experity will host a virtual job fair May 2 from 9am-noon CT.
  • Patient engagement vendor Relatient joins the Epic App Orchard.
  • ROI Healthcare Solutions announces comprehensive EDI optimization offerings for Info users.
  • Summit Healthcare publishes the “Galway Clinic Success Story: Solving Complex Interoperability Needs with the Latest in Integration Technology.”
  • In Europe, Synteract leverages the TriNetX platform and COVID-19 Rapid Response Network to find and enroll patients for coronavirus clinical trials.

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Reader Comments

  • James E Thompson, MD: Re "didn't sign up for," I totally agree. But I have also seen a genuine appreciation of those in the trenches, so I hop...
  • Your memory isn't right: The judge threw out the trade secret claim. The case was settled out of court, no one won anything. Especially IDX who...
  • HISJunkie: RE:"Epic’s lawsuit accused TCS employees who were contracting with Kaiser Permanente of misrepresenting themselves as ...
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  • Robert D. Lafsky M.D.: Yes all wrong. But some are useful....

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