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News 8/12/20

August 11, 2020 News 10 Comments

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Providence-owned Providence Services Group acquires Meditech-focused consulting firm Navin Haffty.

Providence had previously acquired Meditech hosting and services vendor Engage, which will allow the combined companies to offer consulting, service desk, application support, staff augmentation, and technical services.

Providence also owns Epic consulting firm Bluetree and runs an Epic Community Connect hosting business.

The health system said last year that it planned to create a $1 billion business from its non-clinical investments. It  has 51 hospitals, over 1,000 clinics, and 120,000 employees.


HIStalk Announcements and Requests

Listening: new from Deep Purple, not excavated from a 1970s music vault along with related artifacts such as Hammond A-100s and Gibson SGs, but rather offering a fresh-sounding entry in the barren wasteland of new hard rock. It will be a certain nose-scruncher for most folks who were raised on Auto-Tuned singer-dancers and hip-hoppers, but let’s see how those musicians hold up after 50+ years, 21 albums, and one original member left (72-year-old drummer Ian Paice, a much lesser figure than former members Jon Lord and Ritchie Blackmore). Just turn it up to 11 and hope you end up being a cool septuagenarian like these grandpas who can take you back if you’ve been, or take you there if you haven’t. The part at 2:13 is a dead ringer for Yes’s “Starship Trooper.” 


Webinars

August 19 (Wednesday) 1:00 ET. “A New Approach to Normalizing Data.” Sponsor: Intelligent Medical Objects. Presenters: Rajiv Haravu, senior product manager, IMO; Denise Stoermer, product manager, IMO. Healthcare organizations manage an ever-increasing abundance of information from multiple systems, but problems with quality, accuracy, and completeness can make analysis unreliable for quality improvement and population health initiatives. The presenters will describe how IMO Precision Normalize improves clinical, quality, and financial decision-making by standardizing inconsistent diagnosis, procedure, medication, and lab data from diverse systems into common, clinically validated terminology.

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


Acquisitions, Funding, Business, and Stock

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Private equity firm K1 Investment Manager makes a significant investment in Rethink Autism, which offers a development disabilities platform that includes assessment, treatment planning, e-learning tools, analytics, and practice management. Rethink recently acquired pediatric therapy telehealth provider TheraWe. Rethink’s co-founders came from a company that provided labels and tags for the retail clothing industry.

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Investors are noting that the combined market value of Teladoc and Livongo has dropped nearly $10 billion in the week since the former’s $18.5 billion acquisition of the latter was announced. Above is the one-year share performance of Teladoc (blue, up 188%), Livongo (red, up 212%), and the Nasdaq index (green, up 38%). It’s uglier over the past five days, where TDOC and LVGO have dropped 25% and 19%, respectively, since the announcement. 


Sales

  • New Mexico’s largest county will implement Netsmart’s CareManager for post-incarceration population health and care management.

People

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Clearinghouse operator Jopari hires Tom Turi (The SSI Group) as chief sales and marketing officer.


Announcements and Implementations

Stanford University’s Stanford Center for Health Education launches “AI and Healthcare,” an online, four-course certification program that will be taught by its medical school faculty. Courses in the Coursera program include “Introduction to Healthcare,” “Introduction to Clinical Data,” “Fundamentals of Machine Learning for Healthcare,” and “Evaluations of AI Applications in Healthcare,” which are followed by a capstone project. The only cost specified is the $79 per course Coursera certificate fee.

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Philips announces Virtual Care Station, a telehealth environment for public areas such as stores, libraries, and universities. The company developed the technology for the VA’s ATLAS program, which offers virtual clinics to American Legion and VFW posts.


Government and Politics

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I wondered what happened to former Rep. John Fleming, MD (R-LA), who President Trump appointed to the newly created position of deputy assistant secretary for health technology in 2017. He seemed uncertain about the job when it was announced, initially stating that he was interviewing to become national coordinator, but then admitting, “I think it’s the same or a similar position – I really don’t know.” He apparently didn’t last long there – President Trump appointed him to become Assistant Secretary of Commerce for Economic Development in 2018, and then in March 2020 he was appointed Assistant to the President for Planning and Implementation. I can’t find any evidence that his former ONC position still exists. I interviewed him in January 2018.

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Cerner VP of Strategic Growth Amanda Adkins, who took a leave from the company to seek a US House of Representative seat, wins the Republican primary and vows to defeat Rep. Sharice Davids, who is serving her first term. The healthcare platform of Adkins, a former state Republican party chairwoman, supports creating a national COVID-19 response plan and says the ACA is a failed experiment that increased cost. She says healthcare should be smarter, more transparent, and more affordable, but I haven’t seen her plan for achieving that.


COVID-19

Russia approves a COVID-19 vaccine that has not undergone widespread clinical trials and for which no Phase 1 and Phase 2 clinical trials data has been published, raising concerns that President Vladimir Putin may be placing national pride and political gain ahead of consumer safety. Another theory is that Russia is trying to goad the US into rushing its own vaccines to market or to confuse the issue following its rumored disinformation campaigns. Russia says it will start vaccinating teachers and medical workers this month with Sputnik-V, the name it chose for the vaccine that reflects the world’s surprise in October 1957 that the Soviet Union had launched the first artificial Earth satellite, which triggered a space race with the US.

Former FDA Commissioner Scott Gottlieb, MD notes that the US might get just one shot (pun intended, I assume) with a vaccine in a given season since it would be difficult to mount two vaccination campaigns in a short period. He says he would not take a vaccine like Russia’s that has been tested on only a few hundred people and says Russia is certainly not ahead of the US in that regard.

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The New York Times questions whether federal government newcomer and FDA Commissioner Stephen Hahn, MD has the fortitude and political savvy to stand up for patient safety under White House pressure to release a COVID-19 vaccine quickly. Hahn is not allowed to speak to the press by phone without having HHS spokesperson and longtime Trump supporter Michael Caputo on the line. FDA has been criticized for delaying approval of alternative COVID-19 diagnostic tests after CDC’s were found defective, allowing untested antibody tests to flood the market with minimal oversight, and for granting emergency use approval – revoked three weeks later – for using hydroxychloroquine in hospitalized patients.

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California public health director Sonia Angell, MD, MPH resigns for unspecified reasons, one week after the state reported that it had underreported new cases due to a technical issue with electronic lab reports.

Mexico’s high COVID-19 death count is understated because residents are justifiably afraid of hospitals. Mexico City’s hospitals report that 40% of patients who are admitted with confirmed cases die in house and half of those deaths occur within 12 hours of admission. People who die at home aren’t tested and thus aren’t counted as being among the country’s 53,000 COVID-19 fatalities, although Mexico reported 71,000 more deaths than were expected in the spring. President Andres Manuel Lopez has urged citizens to stay home and use religious amulets instead of going to the hospital, and 70% of people say they would not feel safe taking a loved one to the hospital, some because of conspiracy theories involving genocide and organ harvesting.

An eight-state review of COVID-19 cases in nursing homes finds that higher staffing levels – but not health inspection scores or quality measure ratings – are associated with fewer cases. I would be interested in seeing an expanded analysis that considers ownership since I would bet that for-profit homes, especially those owned by private equity-backed chains, fall short in areas like staffing levels and infection control.

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One-third of polled Americans, including more than half of Republicans, say they would not take a free FDA-approved COVID-19 vaccine. On a slightly optimistic note, a 1954 survey about the then-new polio vaccine yielded about the same result.

A new study by Johns Hopkins Bloomberg School of Public Health finds that an area’s density (population plus employment divided by land area) isn’t the primary driver of COVID-19 infection rates – it’s the degree of an area’s crowding into tight spaces, such bars, restaurants, sporting and entertainment events, and beaches. The authors believe that while density increases the incidence of close contact that theoretically should increase infection rate, that isn’t the case because people who live in dense areas are better at social distancing and wearing masks. They also conclude that evidence does not exist to support the move of city dwellers and businesses to the suburbs to avoid COVID-19.

The beginning of the end may be near for the fall 2020 college football season as the Big Ten postpones all fall sports, with football to be played in the spring if at all. The other four Power Five conferences haven’t announced their plans, although insiders say the PAC-12 has also decided not to play and doubts that spring football will happen either. 

University of Florida researchers detect live coronavirus in air samples taken up to 16 feet from hospitalized COVID-19 patients, raising the possibility of air-only spread, although the low viral quantities make it unclear whether people would likely become infected. The six-foot distancing recommendation assumes that only large droplets carry the virus. 


Other

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Epic delayed its mandatory employee return to campus after the county health department warned the company that “remote work” does not mean sitting alone in private, on-campus offices as Epic had interpreted. The health department told Epic that such action might violate the county’s order. They’ve asked Epic to justify why it needs employees to work from the office starting September 21, not mentioning the first wave of returnees that was to have taken place this past Monday or the 4,000+ employees that were already working voluntarily on campus.

In the Philippines, the government-owned universal health coverage insurer says the agency is losing $50 million per week due to corruption that is enabled by weak IT systems. The anti-corruption commission says that PhilHealth’s executives and employees are filing claims for non-existent patients, while hospitals are upcoding visits to obtain higher payment and are falsely claiming to be treating COVID-19 cases to obtain emergency funds. The agency denies charges that its executives pocketed $300 million last year.

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Two former employees of Talkspace, which offers text messaging based psychiatric counseling provided by contractors, claim that the company mines session transcripts for marketing purposes. Other former employees say that the company, which was getting stung by bad app store reviews, asked employees to create fake positive reviews and gave them burner phones to avoid getting caught. Talkspace’s executives deny the claims. Some of its contract providers complain that the company advertises 24/7 therapy even though it tells them they can set their own business hours; gives users a “I need help now” button that therapists must respond to quickly to avoid having their pay docked; and advertises therapy services even though a former version of its user agreement made it clear that it offers a “therapeutic conversation” but not “therapy.” The company charges $260 per month for unlimited asynchronous message response or $396 with four live, 30-minute sessions.


Sponsor Updates

  • Health Catalyst will participate in the virtual Verity Research HCIT/Services Conference on August 12, and the Canaccord Genuity Annual Growth Conference on August 13.
  • BioWorld profiles the use of Saykara’s voice-enabled mobile AI assistant at MIMIT Health, which reports a 500% productivity boost. 
  • CareSignal and Innovaccer partner to combine population health data technology and deviceless remote patient monitoring.
  • The Chartis Group promotes Laura Stearns to VP of talent development.
  • Norway’s Directorate of Health relies on Everbridge’s Public Warning software to alert citizens traveling internationally to mitigate COVID-19 risks.

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 8/10/20

August 9, 2020 News 6 Comments

Top News

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VA OIG looks at how VA facilities and its community providers use HIEs.

The report finds that all 140 facilities have access to VA Exchange and VA Direct, but only 28 are using the latter because they weren’t offered training from DirectTrust or none of their community partners are using DirectTrust.

Twenty-two of 48 lower-acuity facilities still exchanging information via scanning, faxing, or mailing.

Users of Joint Legacy Viewer complain about cumbersome sign-on and poor data quality.

VA has 56 contracted VHIE community coordinators, but noted high turnover and engagement that “ranged from a high level of participation to little or no participation.”

OIG concludes that the Cerner implementation will improve the ease of exchange among VHA, DoD, and community providers.

The report recommends that the VA review barriers to using VA Direct, evaluate VA Exchange and VA Direct training programs, increase the number of community partners including other HIEs, and evaluate the work of the VHIE community coordinators. The VA accepted all four recommendations.


Reader Comments

From All the Marbles: “Re: newly rich Livongo executives. Does it even matter since they were all loaded before?” I’m speculating since I don’t know what it’s like having that kind of cash, but my reaction:

  • Assets, not income, makes you wealthy, since you then have financial autonomy that nobody can take from you. Whoever signs your paycheck could stop doing so tomorrow. These folks are set for life.
  • Everybody can find ways to spend ever-increasing amounts of money, but at some point pretty early in the wealth continuum, diminishing returns would kick in and the pleasure of buying a fourth house or third luxury car wouldn’t provide much of a thrill. I speculate that money makes things easier to some point, then starts making them harder and causes stress over losing a chunk of it via bad investment.
  • Self-made people with big fortunes feel the psychological need to prove that earning it wasn’t a fluke, so they rarely sit poolside like a trust fund brat knowing they can’t outspend their interest and instead try new ventures (either the rich-person’s hobby kind or something a team can run day to day for them).
  • I suspect rich, older folks realize that you don’t see hearses pulling U-Hauls, so they look for benevolent ways to publicly spend their money instead of bringing out the worst in squabbling, greedy family members.
  • Everybody has some magic number that, given their personal expenses and ambitions, would allow them to live out their days comfortably free of job worries. In that sense, just as time is money when you’re making it, money is time when you want to stop making it. That might be a $1 million net worth for one person or a $50 million net worth for another and the combination of risk taken, luck, and the time value of money is what will or won’t  you there, hopefully in time to enjoy the result. I suspect that every one of those newly minted Livongo centimillionaires passed that point long ago, so while I’m sure they are thrilled to be sitting on an even larger embarrassment of riches today than last week, it won’t change their daily lives.

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From Prime Spot: “Re: hospital parking. Lots of Twitter chatter about how it’s expensive and unfair to charge patients and families to park.” Hospital parking is always a mess, and I was shocked the first time I took a job with a health system that charged employees and even visitors for parking. My reactions then:

  • Hospitals never have enough parking due to an absurdly large number of employees, doctors coming and going, patients and visitors coming in for ambulatory services on the same campus, and car-driving salespeople running around all over the place. We did an analysis of where employees and visitors were parking off campus and it was shocking — they would walk a half-mile to park in a residential neighborhood, either to find an available space or to avoid paying.
  • Sometimes as an employee you can’t get a spot even though you’re paying monthly for one, and if you’re really unlucky, you might get relegated to offsite parking that involves a bus ride each way that isn’t nearly as nice as  its off-airport counterpart
  • Hospital and university transportation services departments, like most bureaucracies, keep finding new ways to spend money on employees, vehicles, and infrastructure because they seem themselves as generating big profit, and all of that profit comes from permits and tickets.
  • Hospital garages and parking lots are often located in areas where unrelated parking is in high demand or as part of a school where students will take up any available space, meaning that visitors wouldn’t get a spot if the per-hour charge wasn’t a deterrent to those with less motivation. Hotels charge paying guests $40-80 for overnight valet parking given the same demand with lack of alternatives.
  • Hospitals sometimes don’t own their on-campus garages or contract out parking / valet services (I always picture mob involvement).
  • It’s always funny that despite all the ways hospitals extricate money from patients under sometimes questionable circumstances, the only services for which bitter comparisons are made are parking and cafeteria.
  • I personally would avoid on-campus appointments whenever possible, foreseeing sitting in traffic amidst impatient employees and lost visitors and then hiking quickly knowing I’ll be late (assuming I even know where I’m going from the bowels of the parking garage, like the “follow the yellow lines to the blue elevator, go up one floor, then cross the annex bridge and go down one floor” kind of hospital directions). I don’t like having my first aggravating customer experience before it even begins. Buy a dying mall and stick your doctors there.

HIStalk Announcements and Requests

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HIMSS21 attendance is, for the most part, out of the control of HIMSS and instead will be driven by pandemic status, poll respondents say.

New poll to your right or here: For those assigned to work from home: would you return to campus if the company required it in the next few weeks? Basically a yes/no answer is the only one an employer will offer, so do you feel strongly enough about not returning that you’ll accept termination for refusing?

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

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Several readers saw my mention of new Donors Choose projects and sent generous donations to fund another round of them, with their dollars boosted by matching funds from my Anonymous Vendor Executive as well as third-party matching sources. Here’s what I fully funded:

  • A document camera for Ms. E’s elementary school class in Salinas, CA.
  • A webcam, laptop stand, and wireless keyboard for Ms. H’s elementary school class in Timbo, AR.
  • Lighting, headset, device mount, and easel for Mx. Smith’s third grade class in Las Vegas, NV.
  • Digital resources for Ms. G’s elementary school class in Seagoville, TX.
  • Digital resources for Ms. D’s kindergarten class in Hoskinston, KY.
  • Five headsets for Ms. S’s elementary school class in Santa Ana, CA.
  • Daily journals for online sharing for Ms. M’s second grade class in Oxnard, CA.
  • Math manipulatives for remote learning for Ms. S’s elementary school class in Waco, TX.
  • Classroom supplies for Ms. D’s middle school class in Collinsville, IL.
  • Flocabulary vocabulary learning for Ms. H’s elementary school class in Las Vegas, NV.
  • Digital resources for Ms. R’s elementary school class in Philadelphia, PA.
  • Agriculture books for Ms. J’s middle school class in Kinston, NC.
  • Math manipulatives for Ms. F’s elementary school class in Wyandanch, NY.
  • 50 take-home library books for Ms. C’s elementary school class in Calumet City, IL.
  • 25 sets of headphones for Ms. S’s elementary school class in Houston, TX.
  • A document camera for Ms. E’s elementary school class in Steelton, PA.
  • Remote video learning equipment for Ms. R’s elementary school class in Oklahoma City, OK.
  • Social distancing and teaching supplies for Ms. B’s elementary school class in Irving, TX.
  • A document camera for Ms. T’s elementary school class in Apopka, FL.
  • Sight word games for at-home use for Ms. C’s elementary school class in Hempstead, NY.
  • A webcam, microphone, and earphones for online instruction for Ms. T’s middle school class in Chicago, IL.
  • Online language proficiency tools for Ms. M’s elementary school class in Fairdale, KY.
  • Digital social studies content for Ms. K’s middle school class on Connellsville, PA.
  • Lighting for teaching virtual classes for Ms. T’s elementary school class in Mission, TX.
  • STEM kits for Ms. A’s kindergarten class in Sacramento, CA.
  • Headphones and a USB camera for Ms. N’s elementary school class in Harbor City, CA.
  • A USB headset for Ms. B’s elementary school class in Kenner, LA.
  • Take-home math materials for Ms. H’s elementary school class in Madera, CA.
  • 20 magic boards and binders for Ms. M’s elementary school class in Chicago, IL.
  • Math and science books for recording for online lessons for Ms. P’s elementary school class in Philadelphia, Pa.

Webinars

August 19 (Wednesday) 1:00 ET. “A New Approach to Normalizing Data.” Sponsor: Intelligent Medical Objects. Presenters: Rajiv Haravu, senior product manager, IMO; Denise Stoermer, product manager, IMO. Healthcare organizations manage an ever-increasing abundance of information from multiple systems, but problems with quality, accuracy, and completeness can make analysis unreliable for quality improvement and population health initiatives. The presenters will describe how IMO Precision Normalize improves clinical, quality, and financial decision-making by standardizing inconsistent diagnosis, procedure, medication, and lab data from diverse systems into common, clinically validated terminology.

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


Sales

  • NIH will extend its use of OpenText’s Content Suite and AppWorks for electronic document management and workflows.
  • Transaction Data Systems chooses Waystar for claims processing by its independent pharmacy customers.

People

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Mee Memorial Healthcare System (CA) promotes Rena Salamacha, MS to CEO. She previously served as IT director, CIO, and chief strategy and technology officer, COO, and interim CEO.

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Lisa Crymes, MBA (Change Healthcare) joins Preventric AI as chief marketing officer.


Announcements and Implementations

Elsevier expands its integration of its ClinicalPath (formerly Via Oncology) oncology decision support tool with Epic, including launching from Epic using SMART on FHIR, applying cancer staging data from Epic, navigating within Epic, queuing up treatment within Beacon protocols to reduce manual order entry, and documenting details as a note.


COVID-19

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A New York Times analysis of CDC’s count of higher-than-expected death counts – probably caused by COVID-19 along with the situations it has created – at over 200,000 from March 15 through July 25 versus the official count of 161,000. This is a good full-impact number that would include the pandemic’s effect on stress, failure to seek medical care for other conditions, financial challenges, and failure to correctly account for deaths. I assume that it this number would also be subject to undercounting given the presumable decrease in deaths by accidents.

The field hospital created at Sacramento’s Sleep Train Arena sees just nine patients in 10 weeks, with $12 million in cost from rent paid to the Sacramento Kings, facility upgrades, and payment to 250 staffers. One traveling nurse company billed $428,000 to provide five pharmacists and five pharmacy technicians. Those involved say there was never a real plan on how to integrate with possibly overburdened hospitals and the state admits that it should have used local data to determine how to set up its 15 field hospitals.

Bill Gates says US COVID-19 tests are “complete garbage” because of delays in getting results, suggesting that paying companies for them only if the results come back in 24-48 hours would “fix it overnight.” He is optimistic overall, however, predicting that diagnostic and therapeutic innovation in the “rich world” will end COVID-19 by the end of 2021, with the rest of the world following a year later. However, he says it will take years to bring the global economy back to the levels of early 2020. He also notes that he would want remdesivir or dexamethasone today if hospitalized for coronavirus, but in 2-3 months the tool chest will expand with other antivirals and antibody therapy.

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It’s been a busy COVID-19 week for one Georgia high school:

  • The school suspended two students for taking a photo that showed a packed school hallway and sharing it to social media.
  • After a national outcry, the school lifted the suspensions.
  • Six students and three employees reported to the school that they had tested positive.
  • Two brothers who reported experiencing symptoms were found to have gone to school Monday without wearing masks or social distancing, with a family member saying they didn’t realize the severity of the virus and weren’t encouraged to wear masks.
  • The school moved to distance learning only for Monday and Tuesday while awaiting the results of contact tracing. They have told parents that they will notified Tuesday evening whether in-person instruction will resume.

Other

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Epic changes its Monday mandatory return to campus, allowing employees who feel that their personal situation makes it unwise for them to return safely to campus to continue to work from home while Epic awaits further guidance from the county health department. Epic says Cleveland Clinic, a public health expert, and an epidemiologist are reviewing Epic’s plan, which originally called for bringing the first group of employees back to their offices on Monday and all employees working on campus by the end of September except for those at high risk, who could request an extension through November 2.

China’s Communist Party newspaper warns readers to “beware of health-tech firms’ snake oil,” which is pretty good advice. Its points, as written by a health policy lecturer in the London School of Economics:

  • Big US tech companies have promised that analytics and AI will reduce costs and improve outcomes, but individual patient data is subject to subjective clinical judgment and is often plagued with missing records and lack of standardization.
  • Those big US tech companies don’t know much about healthcare, and they rarely back up their black box algorithms with studies that prove their value.
  • Predictive models are only as good as the data they are given, and since their assumptions are based on what is already know, they are best at reviewing the past and present rather than predicting the future.
  • AI developers are, intentionally or not, just as biased as the rest of us, and using current healthcare data makes those systems prone to replicating past failures and successes.
  • Hospitals and regulators shouldn’t just turn over patient data to developers – they should be actively involved in the design and deployment process.

Sponsor Updates

  • The Dealmakers Podcast features PatientPing co-founder and CEO Jay Desai.
  • Pure Storage’s Pure Good Foundation celebrates its fifth anniversary and announces that it has raised $2.3 million for charitable contributions.
  • The Voice First Health Podcast features Gabe Charbonneau, MD and his use of the Saykara AI Assistant.

Blog Posts


Contacts

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

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News 8/7/20

August 6, 2020 News 11 Comments

Top News

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Blackstone will acquire a 75% stake in Ancestry for $4.7 billion, giving the private equity firm access to the company’s DNA information on 18 million people.

The genealogy company, which launched a consumer DNA testing service last year that it has expanded to include genetic health risks and insights, reports annual revenue of over $1 billion.

Ancestry was valued at $3 billion in 2017 and considered running an IPO twice since then, but faced slumping sales as both it and competitor 23andMe laid off employees. 23andMe has sold the genetic data of its customers to drug companies for clinical studies, an area in which Ancestry lags.


Reader Comments

From Bug Frowner: “Re: Epic’s return to work requirement. Ignores its county’s public health order.” Dane County, Wisconsin’s July 7 emergency order says business “should, to the greatest extent possible” facilitate remote work to minimize in-office presence. Epic is therefore not specifically breaking any law that I can see since the wording is more of a recommendation. I would struggle to return to campus work as an Epic employee if I were high risk and otherwise fastidiously isolating, but we all know that bosses make the rules and our choices are to comply or leave. Media coverage has, as it often does, lapsed into the sensationalistic in portraying the complaints of a tiny percentage of Epic employees as a topic for heated debate into which Internet cheap-seaters feel the need to insert themselves. More interesting to me is that Epic says that only 24 of its employees have tested positive, which seems like a tiny number out of 9,000+ mostly young employees, but I assume they haven’t yet mass tested the folks who will be returning to campus. Judy Faulkner has said the company is working on immunity passport capabilities for its EHR, so maybe they’ll run employee antibody testing even though that has limited value outside of healthcare provider organizations given relatively low overall infection rates.

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From Al Lewis: “Re: Livongo’s sale for $18.5 billion. The entire employer community doesn’t even spend $18.7 billion on diabetes-coded admissions. Not even close. Nor have they claimed to reduce that one item, the item that should concern employees the most. And they never explained why they want everyone to test multiple times a day when Choosing Wisely says most Type 2 diabetics are more likely to harm themselves than benefit through overtesting. Meanwhile, as I will be posting in a few hours, the price of insulin is skyrocketing thanks to greedy PBMs and employers aren’t doing a thing about it.” I interviewed Al Lewis, who I titled “workplace wellness skeptic,” a few months ago and asked him for reaction to the acquisition news.

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From Donor Here: “Re: matching Donors Choose funds from Tyson Foods and your Anonymous Vendor Executive. Is that still available?” Donors Choose still lists 24 unfunded projects for which Tyson Foods is matching donations 10-to-1 and I still have ample matching funds available from my Anonymous Vendor Executive. Many other projects offer 2x or 3x matching from companies and organizations, which is still a lot of bang for the buck. I just received an email today from middle school science teacher Ms. W in Washington, for which our $32 donation (which was then matched 10 to 1) bought distance learning tools (microphone, graphics tablet, lighting, and a camera mount) as well as a 15% optional donation to fund the work of Donors Choose.  She told me this morning that her school just announced 100% distance learning to start and she will immediately use the new technology to retool her her hands-on science classes for home learning. Donation instructions:

  1. Purchase a gift card in the amount you’d like to donate.
  2. Send the gift card by the email option to mr_histalk@histalk.com (that’s my Donors Choose account).
  3. I’ll be notified of your donation and you can print your own receipt from Donors Choose for tax purposes.
  4. I’ll pool the money, apply all matching funds I can get, and publicly report here which projects I funded, including teacher follow-up messages and photos.

From Live Longo Glen Tullman: “Re: Teladoc acquring Livongo. Paid too much, in a hurry to cash in some of its own overpriced shares.” My thoughts on the deal:

  • This is the third-largest acquisition of a US company this year. Teladoc will give $0.592 of its shares plus $11 in cash ($159 per share) to buy Livongo.
  • I don’t get the synergy, other than that both companies have to keep employers and insurers subscribing for services their constituents may not use and that may provide minimal benefit.
  • The implicit market value of the combined money-losing companies is an eye-popping $37 billion, nearly double that of Cerner.
  • TDOC’s market cap is $16.5 billion, nearly quadruple that of a year ago, on just $716 million in annual revenue. LVGO’s market cap is $1.5 billion, eight times that of September 30, 2019 on $207 million in revenue (selling price is 90 times revenue).
  • Shares of both companies regained some of their losses Thursday after dropping hard after Wednesday’s announcement.
  • LVGO’s Q2 earnings report from Wednesday went mostly unnoticed in the acquisition news, but the company had a good quarter, with revenue up 125%, adjusted EPS $0.11, beating expectations for both.
  • Livongo’s executives will pocket fortunes from the acquisition just 12 months after its IPO. Lee Shapiro’s shares are worth around $860 million, Glen Tullman’s around $700 million, and Zane Burke (who joined as CEO just 19 months ago) holds shares worth around $160 million.
  • I’m skeptical in general about early-stage companies that sell services through employers and insurers with unproven promises about saving them money, so I’ll simply say (a) good job Livongo for convincing Teladoc of predicted synergies, and (b) good job Teladoc for riding the likely temporary share price bump even as virtual visits slack off and health systems launch their own competing offerings to diversify. I don’t see the value for shareholders, patients, or the healthcare system in general, but then again I’m not a centimillionaire stuffing wads of investor cash down my pants. 

Webinars

August 19 (Wednesday) 1:00 ET. “A New Approach to Normalizing Data.” Sponsor: Intelligent Medical Objects. Presenters: Rajiv Haravu, senior product manager, IMO; Denise Stoermer, product manager, IMO. Healthcare organizations manage an ever-increasing abundance of information from multiple systems, but problems with quality, accuracy, and completeness can make analysis unreliable for quality improvement and population health initiatives. The presenters will describe how IMO Precision Normalize improves clinical, quality, and financial decision-making by standardizing inconsistent diagnosis, procedure, medication, and lab data from diverse systems into common, clinically validated terminology.

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


Acquisitions, Funding, Business, and Stock

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Nuance announces Q3 results: revenue down 10%, adjusted EPS $0.19 versus $0.20, beating analyst expectations for both. The company said in the earnings call that it has signed pilot agreements for its Dragon Ambient Experience with WellSpan, Boston Children’s, Children’s Atlanta, and Lehigh Valley.

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CVS Health beats analyst expectations for Q2, reporting a 3% increase in revenue and adjusted EPS of $2.64 vs. $1.93. Utilization of telemedicine services through its Aetna network and MinuteClinics jumped over 700% during the quarter as patients stayed away from in-person office visits.

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Cerner and VC firm LRVHealth invest $6 million in Xealth, a Providence Health & Services spin-off that has developed software to help providers find and prescribe digital health apps and programs.

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Digital point-of-care prescription savings vendor OptimizeRx reports Q2 results: revenue up 25%, and adjusted EPS of $0.02 versus $0.09, beating analyst expectations for both.

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CPSI announces Q2 results: revenue down 10%, EPS $0.12 versus $0.12, beating analyst expectations for earnings but falling short on revenue.

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Signify Research says the crown jewel that Siemens Healthineers gets in its $16.4 billion cash acquisition of Varian Medical is the latter’s oncology software business, which has $600 million in annual revenue with an 18% year-over-year-growth. The report notes that oncology is positioned at the convergence of EHR, lab, radiology, and surgery systems and the need to collaborate for diagnosis and treatment creates complicated workflows. Elekta is Varian’s chief competitor in that area. Siemens Healthineers is focused on three digital areas — imaging AI, advanced imaging hardware, and lab diagnostics. Siemens Healthineers, spun  off from Siemens AG (which still owns 85% of its shares), is among a small group of medical technologies that have more than $20 billion in annual revenue, possibly coming in at #3 behind Medtronic and Johnson and Johnson.


Sales

  • Michigan Medicine selects Mach7’s enterprise imaging technology. 
  • CPSI selects cloud services from Google Cloud.
  • The Iowa Health Information Network selects PDMP connectivity, analytics, risk assessment, and patient support technology from Appriss Health.

People

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LexisNexis Risk Solutions promotes Josh Schoeller to CEO of its healthcare business.

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Industry long-timer Andrew Eckert (Acelity) joins medical claims company Zelis as CEO. Eckert has held leadership positions at Eclipsys, TriZetto, and Valence Health.

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Justin Manning (Nordic) joins Evergreen Healthcare Partners as principal consultant and VP of medical device and data integration.


Announcements and Implementations

UHIN adopts NextGate’s enterprise master patient index across its HIE network in Utah.

Redox announces GA of Data on Demand, giving developers the ability to query any EHR or health data sources via the company’s API.

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AHRQ publishes an electronic patient-reported outcomes toolkit.


Government and Politics

Politico reports that the VA will re-commence its EHR overhaul with a rollout at an unnamed facility in October. The conversion from VistA to Cerner was halted earlier this year as VA facilities focused on preparing for and treating COVID-19 patients. The VA has switched its go-live plans from facilities in bigger metropolitan areas to those in smaller cities in the Pacific Northwest and Midwest, citing a lack of access during the pandemic to clinical experts who had been expected to help with system customizations for the larger facilities.

Politico also reports that two senators have introduced legislation that would make the post office’s address matching software available to EHRs via API for patient identification and matching.


COVID-19

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An Ohio Department of Health contact tracing graphic shows how one infected church service attendee spread the virus to at least 91 people in five counties in less than three weeks. The graphic was tweeted by Ohio Governor Mike DeWine, who announced Thursday that he has tested positive for COVID-19 as part of the screening for his now-cancelled Thursday greeting of President Trump in Cleveland.

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Virginia launches the Covidwise app, becoming the first state to launch an exposure notification app using technology from Apple and Google. The app notifies users if they come into contact with other users who’ve tested positive for COVID-19. Some public health experts have questioned the effectiveness of such apps, citing low and thus ineffective adoption rates, privacy concerns, false alarms, and a lack of nearby testing capacity.

University of Miami Health System launches a remote patient monitoring program for discharged COVID-19 patients using TytoCare home health devices.

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The Harvard Global Health Institute and Google Cloud develop COVID-19 Public Forecasts, a free planning resource that offers healthcare workers 14-day projections of cases, hospitalizations, and deaths by county and state.

An MRI review of 100 recovered COVID-19 patients who had no pre-existing cardiac conditions — most of them who had experienced only minor COVID-19 symptoms and recovered at home — finds that 78% have cardiac involvement and 60% have ongoing myocardial inflammation. The authors conclude that cardiac involvement is unrelated to COVID-19 severity and warn that undetected inflammatory disease may present a large health burden in people who think they got over COVID-19 without incident.

The National Institutes of Health forms the Medical Imaging and Data Resource Center, which will use AI and machine learning to develop new diagnostic tools clinicians can use to better care for COVID-19 patients.

The New York Times explains how the US uniquely failed to control COVID-19:

  • A tradition of prioritizing individualism over government restrictions, which has also saddled the country with a world-lagging and unequal healthcare system.
  • Lack of effective travel restrictions in excluding from the ban the family members of American citizens and permanent residents returning from infection-ravaged areas, failing to address the infection’s spread to Europe promptly, exempting the UK from travel limitations, and failing to create a quarantine process.
  • Lack of state travel restriction enforcement.
  • Testing delays caused by the CDC’s distribution of faulty tests that it insisted be used over tests that were developed in other countries.
  • Commercial labs charging patients for COVID-19 testing, which discouraged their use.
  • Conflicting public mask advice from WHO and CDC, some of that based on the need to prioritize the limited supply of them for healthcare workers, and allowing masks to be turned into a political symbol with partisanship as its most accurate predictor.
  • The push by federal and state governments to reopen the economy with the virus still uncontrolled, which caused outbreaks afterward and provided only a brief recovery as personal fear and unemployment caused people to limit spending anyway.
  • Mixed and confusing messages from political leaders and partisan news media, including distributing medical misinformation and expressing unwarranted optimism.

Other

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HIMSS hires a second Australian Digital Health Agency executive as CIO Ronan O’Connor joins former CEO Tim Kelsey. O’Connor’s new role was not specified, but Kelsey became SVP of HIMSS Analytics International in January 2020.

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HIMSS will continue to publish the mobile health app best-practices guidelines of Xcertia, a now-dissolved project of HIMSS, the American Medical Association, the American Health Association, and DHX Group. The Xcertia standards body was formed in December 2016, last updated its guidelines in February 2019, and then went silent shortly afterward. The organizations haven’t announced why they pulled the plug. The three principals of non-profit app curation organization DHX Group seem to have moved on to other projects.

The local paper says that at least 13 Epic employees claim that the company has demoted team leads who expressed concern about its plan to bring employees back to campus, which Epic denies.

European Union authorities will investigate Google’s acquisition of Fitbit, worried that Google will target ads based on the user fitness data that Fitbit collects. Google says it has no such plans and has offered to sign a contract that limits its use of the data. A consumer group concludes, “It is hugely important that the E.U. carries out this in-depth examination because wearable devices like Fitbit’s could in future give companies details of essentially everything consumers do 24/7.”


Sponsor Updates

  • InterSystems launches T2020, the latest version of its TrakCare EHR, which includes COVID-19 functionality, an enhanced user experience, and a unified workspace for patient records and documentation.  
  • Cloud Computing Outlook names Goliath Technologies a Top Virtualization Solutions Provider.
  • HCI Group Chief Digital Officer Ed Marx publishes a new book, “Healthcare Digital Transformation: How Consumerism, Technology, and Pandemic are Accelerating the Future.”
  • Spok announces that all 20 adult hospitals and all 10 children’s hospitals named to US News & World Report’s 2020-21 Best Hospitals Honor Roll use Spok clinical communication solutions.
  • Saykara’s voice-enabled mobile AI assistant  is named as a healthcare innovation awards finalist.

Blog Posts


Contacts

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

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Teladoc To Acquire Livongo for $18.5 Billion

August 5, 2020 News 4 Comments

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Virtual care provider Teladoc Health will acquire chronic condition management app vendor Livongo in a deal that values the company $18.5 billion, the companies announced this morning.

The announcement characterized the transaction as a merger, but the deal is structured as an acquisition. The combined companies will operate under the Teladoc name, Teladoc CEO Jason Gorevic will continue in that role, and Teladoc’s board chair will also remain in that role.

The share price of both companies dropped sharply midday Wednesday following the announcement. Both have seen their shares run up by multiples so far in 2020.

The companies expect their combined revenue to reach $1.3 billion in 2020. Teladoc just reported Q2 revenue of $241 million, up 85% as virtual visits increased by 203%.

Neither company has ever booked a quarterly profit. Teladoc went public in 2015, Livongo in 2019.

News 8/5/20

August 4, 2020 News 16 Comments

Top News

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Siemens Healthineers will acquire radiation oncology technology vendor Varian Medical Systems for $16.4 billion.

Varian’s software offerings include treatment planning, treatment delivery, QA, image sharing, patient-reported outcomes, and the Aria oncology information system.


Reader Comments

From Spoofer: “Re: LinkedIn. It’s turning into Facebook now that Microsoft owns it.” I steer clear of LinkedIn except when looking up someone’s title or job history for the “People” section, but I have noticed that is becoming a home for folks (many of them salespeople) who believe themselves to be inspirational or instructional. It’s also drawing in users who litter it Facebook-like with personal musings, political commentary, and of course endless pitches for their employer or themselves.


HIStalk Announcements and Requests

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Tyson Foods offered a $10 match for each $1 donated for specific Donors Choose projects, so I put my Anonymous Vendor Executive’s money to work in fully paying for these requests, most of which involve the rapid transition to remote learning. Donors Choose also sent me a note observing that this is the eighth consecutive year that HIStalk readers have supported classrooms, funding 631 projects that have impacted more than 50,000 students. I’ve already heard from several of these teachers:

  • A camcorder for virtual learning and an air purifier for Coach H’s high school class in Sebastopol, MS.
  • Online materials and lessons for Ms. D’s middle school class in Fort Smith, AR.
  • A GoPro camera for virtual physical education and dance classes for Coach K’s elementary school class in Fort Smith, AR.
  • Five Amazon Fire tablets and cases to replace the book corner activity that was cancelled because of COVID for the elementary school class of Ms. C in Nebo, KY.
  • Two Chromebooks for Ms. P’s elementary school class in Forest, MS.
  • Two Chromebooks for Ms. W’s elementary school class in Forest, MS.
  • Classroom library supplies, organizers, clipboards, pads, pencils, cushions, earbuds, and file folders (which are no longer allowed to be shared) for the elementary school class of Ms. B in Omaha, NE, who is a second-year teacher.
  • 30 headphones for Ms. S’s elementary school class in Vicksbug, MS.
  • Bean bag chairs, dry erase boards, pencils, gloves, Play-Doh, balance balls,fidget toys, lanyards, pillows, charts, learning resources, and a long list of supplies for the elementary school class of Ms. R in Omaha, NE, who is a first-year teacher.
  • 60 social emotional learning lesson books for Ms. S in Madisonville, KY, who is an elementary school counselor.
  • An IPad, tripod, and tablet mount for the elementary school class of Ms. C in Lake, MS, who will create an online library of instructional videos for absent students or if the school closes due to COVID.
  • A yearbook camera and all supplies for Mr. G’s middle school yearbook club of gifted and talented students in Madisonville, KY.
  • Two IPads and a webcam to teach virtual learners at Ms. G’s elementary school class in Forest, MS.
  • Supplies for at-home learners of Ms. D’s second grade class in Portland, ME.
  • Math materials for Ms. P’s elementary school class in Sterling Heights, MI.
  • 30 sets of headphones and 20 water bottles to allow Ms. J’s first grade school class in Chicago, IL to practice healthy behaviors.
  • Digital and online learning resources for Mr. V’s high school class in Lake, MS.

Webinars

August 19 (Wednesday) 1:00 ET. “A New Approach to Normalizing Data.” Sponsor: Intelligent Medical Objects. Presenters: Rajiv Haravu, senior product manager, IMO; Denise Stoermer, product manager, IMO. Healthcare organizations manage an ever-increasing abundance of information from multiple systems, but problems with quality, accuracy, and completeness can make analysis unreliable for quality improvement and population health initiatives. The presenters will describe how IMO Precision Normalize improves clinical, quality, and financial decision-making by standardizing inconsistent diagnosis, procedure, medication, and lab data from diverse systems into common, clinically validated terminology.

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


Acquisitions, Funding, Business, and Stock

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Medicare and Medicaid reimbursement services vendor Centauri Health Solutions acquires Applied Revenue Analytics, which offers business intelligence solutions.


Sales

  • The US Department of State medical health units will implement Allscripts TouchWorks and FollowMyHeath, with the company serving as a subcontractor to MicroHealth. MicroHealth co-founder and CEO Frank Tucker served as a physician assistant, platoon leader, preventive medicine officer, and healthcare administrator for the US Army, CTO for Tricare, deputy CIO for the US Army Office of the Surgeon General, and an adjunct professor for several universities including the bioinformatics program of the Uniformed Services University of the Health Sciences. He has earned three master’s degrees (including in Physician Assistant Studies) and a doctorate of health science. The State Department chose the company for a $250 million project to manage the PHI of overseas government employees in 2019.

People

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Brown & Toland Physicians (CA) hires Anne Barr, MBA (Counterpoint Advisors Network) as CIO.

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Tom Foley (Cerner) joins AMD Global Medicine as VP of growth.

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Ellkay hires Marc Probst, MBA (Intermountain Healthcare) as CIO.

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Leidos promotes Liz Porter, MBA to president of its health group.

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Amwell hires Serkan Kutan (Haven) as CTO.

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Raymie McFarland (Glytec) joins glycemic management software vendor Monarch Medical Technologies as president and CEO.


Announcements and Implementations

Surescripts announces two new network capabilities for specialty pharmacies, a Medications Gateway that gathers information from the patient’s EHR and electronic prior authorization.

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PerfectServe announces GA of Patient and Family Communication, which delivers health updates to patients and caregivers; provides a virtual room with appointment reminders and mobile check-in; supports video visits; and provides a patient inreach module for responding to on-call patient needs with direct messaging and video. Development of the system was driven by customer feedback during COVID-19.

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Vyne renames its dental practice data exchange systems that were formerly sold under the NEA nameplate (claims processing, electronic claims attachments, and encrypted email) as Vyne Dental.

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Imprivata publishes a digital identity framework that offers health systems advice on creating an identity and access management strategy.

Black Book surveys find that lack of interoperability has detracted from COVID-19 care and that progress has stalled, partly due to CMS’s delayed enforcement of rules. Nearly all respondents say COVID-19 clinicians don’t get complete patient records and most say manual processes fall short in submitting pandemic information to public health agencies. Another survey of 324 COVID-diagnosed patients finds none of them had their full patient record available electronically when seen by their COVID treatment provider.

Canada’s Health Sciences North goes live on Agfa enterprise imaging at 15 sites.

North Carolina’s state HIE NC, HealthConnex, goes live on real-time event notification built on Audacious Inquiry’s Encounter Notification Service.


COVID-19

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CDC Director Robert Redfield, MD tells a House coronavirus committee that CDC wasn’t involved in HHS’s decision to move COVID-19 hospitalization data from the CDC’s system to HHS Protect. He says he was told only after the decision was made and did not discuss it with Vice-President Pence or HHS Secretary Azar. Redfield says it was the right decision since the driving factor was the need to track remdesivir supplies.

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“CBS This Morning” runs a news item about Epic employees who are worried about the company’s return to campus. CBS News obtained an Epic employee survey in which several hundred respondents (out of Epic’s 9,000+ employees, which CBS labels a “backlash”) expressed concerns. Epic sent an employee email Monday night saying it will bring in national experts to review its plan, also noting that 24 employees have tested positive for COVID-19, with none of those cases being attributed  to Epic. Epic will require its Wisconsin employees to return to campus on September 21.

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Ellen MacKenzie, PhD, dean of the Johns Hopkins Bloomberg School of Public Health, says that COVID-19 is providing a lesson to “invest in public health or else” in failing to be prepared for the next crisis, concluding, “We cannot let the legacy of a public health crisis be the devaluing of public health itself.”

President Trump says that it is unreasonable to compare the US’s COVID-19 death rate per population to that of other countries with lower numbers, saying, “You have to go by the cases … we’re first, the best … you’re not reporting it correctly … because we do more tests, we have more cases … death is way down from where it was.” He concluded, “They are dying, that’s true. And it is what it is. But that doesn’t mean we aren’t doing everything we can. It’s under control, as much as you can control it.”

New York City’s health commissioner Oxiris Barbot, MD resigns, saying Mayor Bill de Blasio has underused the department’s disease control expertise. A notable example was his reassignment of contact tracing responsibility to Health + Hospitals. She also created controversy in COVID’s early days by urging residents to visit restaurants and festivals as usual and said in a press conference that masks should be work only by those showing symptoms of infection. NYC Health + Hospitals Chief Population Officer Dave Chokshi, MD, MSc has already been chosen to replace her.

Rutgers University’s football program has 28 COVID-infected players and employees who have tested positive after several players attended an on-campus party. Meanwhile, 18 players and coaches of the Miami Marlins baseball team have tested positive and the team admits that it played a game on July 26 knowing at that time that four players had tested positive. Thirteen players and staff of the St. Louis Cardinals tested positive in the past week.

San Antonio Metro Health removes 619 COVID-19 cases from Sunday’s count after finding duplicate entries as it prepared to switch to a new contact tracing system. The agency says the data it receives from labs, hospitals, and doctors, as well as for people who have been tested in multiple locations, may contain misspellings, dates of birth, or different street abbreviations That can cause the same patient to be reported as multiple cases.

Delays in receiving COVID-19 testing results, caused by basic supply shortages and lack of a national strategy, are hampering the efforts of businesses and schools to reopen to employees and students who test negative. Delays of several days to weeks render the tests pointless.


Other

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The New York Times examines whether telemedicine is here to say, raising these points:

  • CMS’s coverage will end when the pandemic is no longer a declared public health emergency unless Congress passes legislation making it permanent.
  • Insurers haven’t yet committed to paying for telemedicine visits comparably to in-person ones and may view telemedicine as a way to pay less.
  • The cost and quality of telemedicine remains unproven for managing chronic conditions.
  • Many or most patients prefer or require in-person visits.
  • Insurers worry that telemedicine will increase visits without improving patient health, raising costs unnecessarily.
  • Telemedicine may provide justification for doctors to bill phone calls that weren’t charged before, such as providing lab results or advising a patient to come in to the office.

A federal judge denies the plaintiff’s request to move a privacy lawsuit against UPMC to state court. UPMC is accused of sharing patient data with third parties for marketing purposes without their consent. The judge says the the lawsuit was correctly sent to federal court because UPMC was participating in HITECH.

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In Argentina, an apparent server configuration error exposes the information of 115,000 people who had applied for COVID-19 quarantine exemptions. Researchers found that they could use basic information that had been exposed (ID number, gender, and phone number) to email the “circulation permit” to any email address. The exposed database was almost immediately attacked – but not disabled – by a “Meow bot” that finds and destroys exposed online data, speculated to have been created by a vigilante security expert who was annoyed by administrators who fail to secure online databases.


Sponsor Updates

  • Bret Kinsella of Voicebot.ai hosts a podcast with Saykara founder and CEO Harjinder Sandh to talk about the company’s AI assistant for physicians.
  • CareSignal and Innovaccer will partner to offer their remote patient monitoring and population health data technologies, respectively.
  • ESolutions and Homecare Homebase collaborate to help home health agencies manage CMS Review Choice Demonstration.
  • The Voicebot Podcast features Saykara founder and CEO Harjinder Sandhu.
  • Surescripts earns Black Book’s #1 ranking in patient data exchange and interoperability.
  • Fortified Health Security publishes its “2020 Mid-Year Horizon Report” on the state of cybersecurity in healthcare.
  • QliqSoft incorporates Elsevier’s Interactive Patient Education with its Quincy chatbot and Virtual Visit software.

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 8/3/20

August 2, 2020 News 5 Comments

Top News

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From the Allscripts earnings call, following the posting Q2 results that sent shares up 19% on Friday:

  • The $365 million sales price of EPSi to Strata Decision Technology represents 7.5 times trailing 12-month revenue at 18.5 times adjusted EBITDA.
  • The company sold no new Sunrise systems, although some existing customers extended their agreements.
  • Allscripts will migrate the 450-clinician US Department of State medical units to a cloud-based version of TouchWorks and FollowMyHealth.
  • CarePort is managing 40% of post-acute transitions in the US, with 18 million referrals per year.
  • Allscripts says that while lower patient volumes and the DoJ settlement caused Q2 revenue to drop year over year, those headwinds will have smaller impact going forward.
  • The company says that while it isn’t actively considering selling other parts of “the portfolio,” its data analysis and care coordination systems do more business outside the Allscripts EHR customer base and could stand on their own.
  • Pressed by an analyst who observed that the company boosted its quarterly margin by cutting R&D to a level lower than that of competitors such as Epic, Allscripts says it moved work to its offshore employees and downsized its project management offices.

Reader Comments

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From Anita Bath: “Re: HIMSS21. Odd that they still haven’t tweeted out that the date has changed.” I didn’t see any mentions on their so-called news site or HIMSS.org (except they’ve added it to the “Events” page) and no actual announcement was made on the conference website, which contains a mix of HIMSS20 and HIMSS21 references. Urgency is minimal since we’re a year away, but let’s hope communication and transparency improves compared to how the cancellation was mishandled. My primary PR advice would be to explain the often-repeated claim that the HIMSS contract prohibits it from offering refunds to attendees and exhibitors – why would HIMSS sign that, and with whom? (my interpretation is that the contract doesn’t require it to provide refunds, which is a vastly different issue). I’m not getting my $895 registration fee back regardless, so given that sunk cost and the fact that I would rather visit Baghdad than Las Vegas in the similar August weather, I will evaluate all over again whether it’s worth it. HIMSS has a big job in trying to drum up the bandwagon effect that makes HIMSS21 seem like a can’t-miss event, which is challenging because we will have already missed it for 30 months and ROI was questionable even before the unexpected contemplation period. And of course there’s the possibility that our coronavirus mess will still be keeping people home even a year from now, especially those from the entire rest of the world that has handled it better, and Las Vegas visitors will probably find COVID to be an exception to the “what happens in Vegas stays in Vegas” mantra for bad behavior. The HIMSS21 floor plan shows 1,249 booths booked by about 350 vendors so far, including the usual big footprints of Cerner, Epic, Allscripts, EClinicalWorks, InterSystems, and Change Healthcare.

From Nick Rails: “Re: HIMSS. They have a long dry spell until August 2021, when the next bolus of revenue comes in.” I’m pretty sure exhibitor and attendee count will be down a lot, and some of those who show up will be applying credits for money they gave HIMSS years before. I expect all member organizations (especially the majority that, unlike HIMSS, gave full refunds for their cancelled conferences) to downsize while simultaneously strong-arming vendors to spend more money to offset those losses. That could create a downward spiral wherein the provider members (the “ladies” in the “ladies drink free” model of attracting those who are willing to pay for access) get so tired of being hit on that they stop coming.

From Long Memory: “Re: Strata. I seem to remember Allscripts suing them at one point over EPSi, which Strata is now acquiring.” Allscripts sued Strata Decision Technology in June 2016, claiming that the company hired former Allscripts Chief Marketing and Strategy Officer Dan Michelson as CEO in 2012 and then used confidential Allscripts information to displace Allscripts-owned EPSi from KLAS’s #1 spot with Strata’s StrataJazz. I don’t know how that lawsuit turned out, but Strata will now own EPSi. Those with long industry memories will recall that Eclipsys acquired EPSi in early 2008 for $53 million in cash.

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From Florida Unmasked: “Re: Baptist Health Jacksonville. Over 1,100 beds, signed with Epic last week. Didn’t see it here, so maybe it’s off-the-recordish.” Verified – they signed last week. Epic will displace Cerner.


HIStalk Announcements and Requests

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Most poll respondents aren’t worried about career time bombs that are ticking away somewhere online, although it’s interesting that more folks worry about public information than social media posts. Probably because they can control the latter but not the former, which makes Google stalking unchallenging.

New poll to your right or here: Which factor will have the greatest impact on HIMSS21 attendance?

Pondering: why do company executives who boast that they have “right-sized” their business never take the blame for wrong-sizing it in the first place?


Webinars

August 19 (Wednesday) 1:00 ET. “A New Approach to Normalizing Data.” Sponsor: Intelligent Medical Objects. Presenters: Rajiv Haravu, senior product manager, IMO; Denise Stoermer, product manager, IMO. Healthcare organizations manage an ever-increasing abundance of information from multiple systems, but problems with quality, accuracy, and completeness can make analysis unreliable for quality improvement and population health initiatives. The presenters will describe how IMO Precision Normalize improves clinical, quality, and financial decision-making by standardizing inconsistent diagnosis, procedure, medication, and lab data from diverse systems into common, clinically validated terminology.

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


Acquisitions, Funding, Business, and Stock

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Meditech reports Q2 results: revenue down 3.4%, EPS $0.88 versus $0.44. Product revenue declined 22%, but net income increased to $33 million.

Exchange-traded funds provider Global X ETFs launches the Global X Telemedicine and Digital Health ETF (EDOC) that will invest in telemedicine, analytics, connected health, and administrative digitization. The top percent holdings among its 40 investments are Ping An Healthcare, M3, Alibaba Health, Nuance, Teladoc Health, Veeva, Tandem Diabetes Care, Dexcom, Agilent Technologies, and Insulet. Also in its portfolio are Livongo, Cerner, Premier, R1 RCM, and Allscripts. I may start tracking the fund’s performance versus market indices, especially if I can set up some kind of portfolio tracker to monitor the share performance of the individual holdings.

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Vocera announces Q2 results: revenue up 6%, adjusted EPS $0.10 versus $0.07.

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Telemedicine and prescription drug vendor Lemonaid Health raises $33 million in a Series B funding round, increasing its total to $55 million.


People

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Bruce Brandes, MBA (Avia) joins Livongo as SVP of directed virtual care.


Announcements and Implementations

Researchers who reviewed TriNetX’s research database found that cancer screenings fell 90% in the first four months of 2020 compared to 2019.


COVID-19

A new CDC projection shows 20,000 more US COVID deaths in the next three weeks, raising the total to 173,000.

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Data scientist Youyang Gu, MEng, whose online pandemic tracker has been among the most accurate, believes that the US has passed its peak of cases and expects daily deaths to top out this week. He warns, however, that many states ignore CDC’s reporting guidelines for “probable deaths,” which could skew his model. He expects to see 230,000 US deaths by November 1. Deaths are increasing most in Florida, Texas, and Mississippi, while cases are increasing most in Missouri and Oklahoma.

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A YMCA sleepaway camp in north Georgia sees a COVID-19 outbreak in its first few days of operation, with 76% of campers and staff whose test results were reviewed by CDC showing positive. The camp took several precautions, including requiring campers to show proof of negative test results, but did not mandate mask-wearing, housed campers 15 to a cabin, and led groups in singing and cheering.

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NPR calls out more problems with HHS’s COVID-19 hospitalization data switchover from CDC’s reliable system to a new $10 million one built by contractor TeleTracking. Hospital-submitted information appears to go live immediately before being QA’ed, sometimes with obvious errors, and HHS has backtracked on its original promise of updates multiple times per day to committing to only a weekly refresh. Hospital capacity information on HHS Protect Public Data Hub was last updated July 23 as I look just now 10 days later. Among several state-level anomalies, NPR found that CDC’s old system showed that 24% of Arizona’s inpatient hospital beds were occupied by COVID-19 patients, but the new system shows 42% occupancy even with 82 fewer patients, and Colorado’s state dashboard lists 341 hospitalized patients on July 30 versus HHS’s 491. 

Major League Baseball faces the possibility that its just-started season may end quickly as a second team cancels games after players and staff test positive for COVID-19. Meanwhile, 27-year-old Red Sox pitcher Eduardo Rodriguez, who returned after a “mild” case of COVID, is out for the season due to COVID-caused myocarditis in a reminder that “recovering” from COVID doesn’t necessarily mean a return to previous health. 

Recreational boat-owning Americans are sneaking across the border to Canada and turning off their transponders like drug dealers, as locals decry having people from the “biggest Petri dish in the world” going ashore into their otherwise protected communities with no masks or distancing. Eighty percent of Canadians want the border to remain closed to Americans, who are seen as widely ignoring rules of personal responsibility.


Other

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Systems of Samaritan Medical Center (ME) remain down from a July 25 malware attack.


Sponsor Updates

  • Redox releases a new podcast, “EConsults and Coping with the Year 2020 with Gil Addo of RubiconMD.”
  • Customers give Spirion their highest ratings in Gartner’s latest report on enterprise data loss prevention solutions.
  • Netsmart lists 16 hospice and palliative care organizations that recently signed for its EHR.

Blog Posts


Contacts

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

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News 7/31/20

July 30, 2020 News 2 Comments

Top News

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HIMSS reschedules its HIMSS21 conference to August 9-13 in Las Vegas. It was originally planned for March 1-5.

HIMSS22 reportedly remains on schedule in Orlando for March 2022, just seven months later.


Reader Comments

From Pearl Drops: “Re: HIMSS21. In August? In Las Vegas? Really?” My reaction:

  • Assuming the event actually happens a year from now, it will have been 30 months since the last live HIMSS conference. Relevance is a crapshoot given the ill will created by the HIMSS20 refund policies, the pandemic’s financial impact on exhibitors and attendees, and the many months everybody will have had to decide whether they should just show up lemming-like as usual or instead look harder at ROI. People have learned to live without restaurants, sports, and concerts in their absence with potentially permanent impact, so a full-fledged return to conference life is far from assured. 
  • The email says HIMSS22 will remain on track for March in Orlando, which would mean doing it all over again just seven months later, so the fatigue factor could be significant.
  • The revenue hit to HIMSS is surely monumental just from timing alone, not even considering a likely big drop-off in exhibitor and registrant revenue.
  • The timing of HIMSS20 could not have been worse for HIMSS since it coincided with the early start of a long pandemic, thus impacting at minimum both HIMSS20 and HIMSS21. RSNA20 moved to a virtual event in losing one live conference, but its 2021 conference will take place as planned unless 2021 is a full-year scratch, in which case HIMSS will be in even more trouble.
  • I visited my least-favorite city of Las Vegas in late June a few years back to scout HIStalkapalooza venues, and it was nuclear hot even then. I swear my flip-flops started melting while walking to the pool, which was steamier than any hot tub should be. Miserable outdoor heat is good for exhibitors and casinos, however.

From Concision: “Re: health IT articles. Have you noticed how long they take to get to the point and start off reciting the obvious?” I have. Writers are either short on skill or long on vanity when they can’t lead off with compelling information and instead meander around before making some questionably valuable point. I turned down a lot of Readers Write articles because of my #2 test (after #1, “don’t pitch your company”) – if three randomly chosen sentences don’t contain anything insightful or fresh, or if the opening sentences stiffly recap universally known facts, then you’re wasting the time of readers.

From Vaporware?: “Re: DoD. Fascinating update from Cerner earnings call, and a reminder that the CommonWell Vaporware Alliance was formed in March 2013 to address the DoD’s expressed desire for an interoperable EHR.” Cerner mentioned in the earnings call that DoD and the VA launched a joint HIE in April and will connect to CommonWell later this year.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Everbridge. The Burlington, MA-based company is the global leader for integrated critical event management (CEM) solutions that automate and accelerate organizations’ operational response to critical events to help keep people safe and businesses running faster. More than 1,200 hospitals rely on the Everbridge CEM Platform to deliver resilience on an unprecedented scale. With COVID-19, Everbridge is helping hospitals to safely resume care and establish a new normal with a robust risk mitigation and emergency response platform that offers automated contact tracing and wellness checks, safe and secure telehealth, critical events management platform, incident management response for cybersecurity risks, and digital wayfinding with blue-dot turn-by-turn navigation. Thanks to Everbridge for supporting HIStalk.


Webinars

August 19 (Wednesday) 1:00 ET. “A New Approach to Normalizing Data.” Sponsor: Intelligent Medical Objects. Presenters: Rajiv Haravu, senior product manager, IMO; Denise Stoermer, product manager, IMO. Healthcare organizations manage an ever-increasing abundance of information from multiple systems, but problems with quality, accuracy, and completeness can make analysis unreliable for quality improvement and population health initiatives. The presenters will describe how IMO Precision Normalize improves clinical, quality, and financial decision-making by standardizing inconsistent diagnosis, procedure, medication, and lab data from diverse systems into common, clinically validated terminology.

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


Acquisitions, Funding, Business, and Stock

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Allscripts reports Q2 results: revenue down 8.6%, adjusted EPS $0.18 versus $0.17,  beating Wall Street expectations for both.

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Allscripts will sell its EPSi business unit to Roper Technologies-owned Strata Decision Technology for $365 million.

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Cerner reports Q2 results: revenue down 7%, EPS $0.44 versus $0.39, beating consensus earnings expectations but falling short on revenue. From the earnings call:

  • The company says its revenue came in lower than expected because the pandemic impacted sales or timing of some low-margin offerings, such as technology resale and billed travel.
  • Q3 revenue expectations have been reduced because of divested businesses and a larger-than-expected pandemic impact, but the company expects earnings to grow due to cost reduction.
  • The company says it won’t cut R&D spending.
  • Cerner says that while virtual go-lives work for simple implementations, the future model will be a hybrid, with fewer people on site who are supported centrally, which also reduces billable travel for the client. The company notes that employees are 25% more productive working remotely because avoiding two half-days of travel during the work week means they have five days billable per week instead of four.
  • Cerner is looking beyond its Amwell virtual visit partnership to virtual hospitals and ICUs that would involve its CareAware platform.
  • An analyst asked about a $35 million acquisition that he saw on the cash flow statement, which Cerner says was for a cybersecurity company that it can’t talk about otherwise.
  • Cerner is interested in acquisitions related to research data and analytics.
  • The grating phrase “new operating model” thankfully wasn’t uttered even once.

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Teladoc Health reports Q2 results: revenue up 80%, EPS -$0.34 versus –$0.41, beating revenue expectations but falling short on earnings. Expenses increased 63%, mostly in marketing, sales, technology, and acquisition costs, and the company projects a loss per share of $1.36 and $1.45 for the year.

Private equity firms TA Associates and Francisco Partners invest in healthcare clearinghouse operator Edifecs at a valuation of up to $1.8 billion.

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Private equity firm Leonard Green & Partners acquires a stake in WellSky from TPG Capital that values the company at over $3 billion.

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Ciox Health acquires NLP vendor Medal to enhance its real-world data business for drug companies and researchers with information extracted from unstructured EHR data. 

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NantHealth acquires OpenNMS, which offers an open source network management system.

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In-hospital specialty care telemedicine provider SOC Telemed merges with Healthcare Merger Corp. in a complicated transaction that will create a Nasdaq-listed company that values SOC at $720 million.


Sales

  • Australian Capital Territory government chooses Epic for implementation across Canberra’s public hospitals and community health centers in a 10-year, $80 million contract.
  • Summit Healthcare announces several new clients for its Summit All Access for web-based and mobile information sharing, including ADT notification, community data sharing, and downtime data access.
  • Franciscan Health chooses Accruent’s Connectiv software, based on ServiceNow, to manage its facilities and biomedical assets and devices.

People

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David Tucker. MHA, MBA (Huntzinger Management Group) joins 314e as VP of sales and client services.


Announcements and Implementations

WebPT adds 1,700 clinics to its rehab therapy platform in the first half of 2020 as the company rolled out a virtual visit system, a digital patient intake feature to minimize waiting room contact, and increased use of its patient relationship management solution. 

Diameter Health releases its turnkey FHIR Patient Access solution that allows payers to comply with CMS requirements that they give members access to their data using FHIR standards.

Goliath Technologies creates a managed service offering for remotely monitoring the availability of applications running under Citrix and VMware Horizon, which allows clients to make sure users aren’t having problems accessing business applications from home or other offsite locations.

InterSystems lists how its TrakCare health information system has been globally deployed in response to COVID-19, including rollout of a screening module that was installed on site in Beijing early in the pandemic, connecting labs and temporary hospitals in Madrid, creating interfaces between new COVID-19 testing machines to its lab system in 48 hours, and implementing TrakCare Lab Enterprise for the 118 COVID-19 labs of the UAE’s Pure Health in two weeks.

Premier enhances its crisis forecasting and planning technology to predict a given hospital’s COVID-19 patient census in near real time.

DirectTrust releases the draft of its Trusted Instant Messaging+ standard for testing.

Aiva offers customers of its in-room patient communication system – which is powered by voice assistants such as Amazon Alexa and Google Assistant — with caregiver-to-caregiver technology from Hillrom’s Voalte.

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Cerner will add Nuance’s virtual assistant technology to Millennium, allowing users to navigate by voice for chart search, order entry, and scheduling. 

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Intelligent Medical Objects launches IMO Precision Normalize, which standardizes diagnosis, procedure, medication, and lab data from diverse systems into common, clinically validated terminology.


Government and Politics

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An NPR investigation into HHS’s awarding of a $10 million contract to health IT vendor TeleTracking for a COVID-19 hospitalization data collection system finds several irregularities:

  • HHS first said the contract was sole source, but now says it was competitively bid among six companies that it declines to name using criteria that it declines to list.
  • The process HHS used to award the bid is normally used for innovative research, not the development of government databases.
  • TeleTracking’s CEO is a long-time Republican donor who is loosely connected to a company that financed billions of dollars worth of Trump Organization projects.
  • The contract ends in September and TeleTracking says it hopes for an extension, which could cost millions. The current contract is 20 times larger than all of TeleTracking’s previous federal contracts combined.

COVID-19

The US now leads the world in number of COVID-19 deaths per day, averaging over 1,000 and most recently hitting nearly 1,500 as total US deaths crossed the 150,000 mark. The US has less than 5% of the world’s population, but nearly 25% of its COVID-19 deaths.

An HIStalk reader reports that their large Texas hospital has been forced yet again to change COVID-19 testing platforms due to a nationwide supply shortage, leaving clinicians and the IT folks scrambling. Delayed results force clinicians to assume that the patient is positive, which requires them to needlessly use PPE that is also in short supply.

The COVID Tracking Project says COVID-19 hospitalization data is now unreliable, partially due to HHS’s no-notice switch to a new reporting system:

  • Some states can’t report their data at all, some hospitals have stopped submitting data, and hospitalizations don’t always line up with local case counts.
  • HHS and state-reported hospitalization information is sometimes dramatically different, with HHS oddly reporting higher numbers much of the time.
  • HHS collects information of all COVID-19 hospitalizations, including suspected cases, but some states report only those cases in which COVID-19 is the primary diagnosis.
  • States that collect information from state hospital associations may not be reporting numbers from the VA or other federal hospitals.
  • Each state decides on its own which information to make public on dashboards and reports, which then feeds national dashboards such as that of the COVID Tracking Project.
  • Case, testing, and death data remain accurate because the information was not affected by HHS’s change.

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University of Colorado School of Medicine describes in a JAMIA article how it applied informatics interventions to meet UCHealth’s COVID-19 challenges, drawing on the relationships its doctors and nurses have with frontline staff and their experience in leading change. The team:

  • Used an electronic teaching tool to ramp up EHR training for nurses who were being prepared for inpatient roles.
  • Developed an electronic training guide for volunteer clinicians that included embedded videos and linked resources that covered, EHR, rounding, and common patient conditions.
  • Created new Epic-based pathways using AgileMD that included proning, clinical trials, convalescent plasma, antivirals, anticoagulation, intubation checklist, septic shock, and hyperinflammatory response treatment.
  • Added “indication for use” to discourage unapproved use of hydroxychloroquine and azithromycin.
  • Created a Virtual Health Command Center to train clinicians on its Epic-integrated Vidyo virtual visit system in two weeks.
  • Coordinated with the patient experience team to present training webinars on conducting video visits, including non-verbal communication and reflective listening.
  • Partnered with Masimo to deploy a wearable device for discharged patients to monitor respiratory rate, heart rate, and pulse oximetry.
  • Redeployed tablets to COVID-19 units to minimize staff exposure, to provide remote translator service, to help the palliative care team convene videoconferences with patients and families, to present group therapy for psychology and rehab, and to capture audio and video from non-networked monitors so that nurses can listen for alarms from the nursing station (pictured above).
  • Created a Microsoft Teams collaboration site for regional intensivists, which then led to creating a public website for community providers.
  • Developed logic for three levels of COVID-19 chart alerts based on patient check-in information.
  • Developed note templates to store patient advance directive status in a central location.
  • Helped nurses who were not able to work in the hospitals to use Epic Secure Chat to follow patients and then update their families, who were not allowed to visit.
  • Created a scoring tool to ration therapy if needed.
  • Studied EHR data for information that could be predictive of hospitalization rates. 

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Yale New Haven Hospital describes how it customized Epic’s antimicrobial stewardship module for COVID-19, developing patient lists, assessment tools, and a handoff process, all to support reviewing a large number of patients quickly and to optimize their management.

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Former FDA Commissioner Scott Gottlieb, MD raises an interesting economic point.

Wolters Kluwer Health uses clinical search activity in its UpToDate reference, along with online and mobility data, to predict COVID-19 outbreaks in specific areas.

Seventeen University of Florida Health anesthesiology residents and one fellow contract COVID-19 after attending a party that was attended by 20-30 residents. The health system refused to acknowledge either the outbreak or the party in inappropriately citing HIPAA.

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Former Republican candidate for President Herman Cain dies at 74 of COVID-19, for which he tested positive nine days after attending President Trump’s June 20 Tulsa rally without wearing a mask even though he was a Stage 4 colon cancer survivor.

The House of Representatives requires members to wear masks following the COVID-19 diagnosis of Rep. Louie Gohmert (R-TX), who previously refused to wear a mask for protection against the “Wuhan virus” and then speculated after testing positive that, “I can’t help but think that if I hadn’t been wearing a mask so much in the last 10 days or so, I really wonder if I would’ve gotten it.”

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Amazon Prime Air drone engineers design NIH-approved face shields that Amazon will sell at cost to frontline workers, saving them at least one-third over other reusable face shields at $2.65 each. The company is also offering an open sourced design package for 3D printing and injection molding.

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A Vanity Fair investigative report finds that a White House panel led by Jared Kushner developed a national COVID-19 testing strategy and ordered 3.5 million China-produced tests for $52 million from a company connected to the ruling family of the United Arab Emirates, but the tests were contaminated and unusable. The group’s national testing strategy was never announced and testing responsibility was eventually moved to individual states, to the group’s surprise. It called for federal distribution of test kits, oversight of contact tracing, lifting contract restrictions on where doctors and hospitals send tests so that any laboratory could perform testing, reporting all test results to a national repository as well as state and local health departments, and rapidly scaling up antibody testing to support returning employees to work. It also proposed establishing a “national Sentinel Surveillance System” with real-time identification of hot spots. The plan lost favor with President Trump, who insiders say was worried that more widespread testing would increase case counts that would harm his re-election chances. He favored optimistic coronoavirus models from Deborah Birx, MD that were eventually proven to be wildly wrong. The report also found that one member of Kushner’s team argued that a national plan would squander the political opportunity to blame Democratic governors of states that were being hit hardest early in the pandemic.


Other

Nacogdoches Memorial Hospital (TX) and Cerner agree on partial payment to settle the $20 million the hospital owes for an implementation it delayed repeatedly and finally cancelled.


Sponsor Updates

  • Diameter Health launches FHIR Patient Access to help payers comply with federal regulatory requirements to provide members with access to their health data using FHIR standards.
  • TriNetX will conduct a medical record review of 200 hospitalized COVID-19 patients to create a dataset that can be used to support drug treatment and vaccine research.
  • InterSystems introduces a new credentialing program for its products and technologies.
  • Fortune profiles the way in which Jvion re-focused its CORE technology to develop a COVID-19 community vulnerability map.

Blog Posts


Contacts

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

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News 7/29/20

July 28, 2020 News 2 Comments

Top News

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Withings raises $60 million in a Series B funding round led by Gilde Healthcare. The investment will go towards building out its Med Pro division, which offers remote patient monitoring devices to programs run by providers, payers, and employers.

The company pivoted largely from consumer wearables to medical-grade products when several of its original founders and investors re-acquired it from Nokia in 2018.


Webinars

August 19 (Wednesday) 1:00 ET. “A New Approach to Normalizing Data.” Sponsor: Intelligent Medical Objects. Presenters: Rajiv Haravu, senior product manager, IMO; Denise Stoermer, product manager, IMO. Healthcare organizations manage an ever-increasing abundance of information from multiple systems, but problems with quality, accuracy, and completeness can make analysis unreliable for quality improvement and population health initiatives. The presenters will describe how IMO Precision Normalize improves clinical, quality, and financial decision-making by standardizing inconsistent diagnosis, procedure, medication, and lab data from diverse systems into common, clinically validated terminology.

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


Acquisitions, Funding, Business, and Stock

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Transformative raises $1.7 million to further develop and gain FDA clearance for software that can predict cardiac arrest in pediatric patients. The company plans to eventually launch similar capabilities for other life-threatening conditions.

Connecticut Children’s Medical Center and consulting firm Guidehouse will launch an RCM software and services company for pediatric healthcare facilities.


Sales

  • Allegheny Health Network (PA) selects prescription-savings software from Medicom Health.
  • Sana Behavioral Hospitals (AZ) will implement Medsphere’s CareVue EHR and RCM Cloud technologies.
  • Cooper University Health Care (NJ) selects Nuance’s Dragon Ambient EXperience, which includes app-based virtual assistant and clinical documentation capabilities.

People

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Tim Conroy (Refocus Data) will join Cary Medical Center (ME) as CIO.

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Optimum Healthcare IT names Brenda Ashley, RN (Impact Advisors) VP of its Last Mile Training program.

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Don Pettini (Change Healthcare) joins Trio Health as CTO.


Announcements and Implementations

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The University of California, Irvine Medical Center equips its new 16-bed unit with EHR-integrated digital whiteboards and interactive bedside technology from Sonifi Health.

In Chicago, the Midwest Institute for Minimally Invasive Therapies implements Saykara’s voice-enabled, mobile AI assistant for physician charting.

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Summit Healthcare announces GA of All Access software to help providers better comply with CMS Conditions of Participation and access data during downtimes.


COVID-19

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Texas health officials who approved the $295 million purchase of contact-tracing software from MTX Group say they are now running into technical difficulties that prevent its widespread use. Workers hired to help with the Texas Health Trace program have reportedly been left with little to do, citing confusing instructions and, presumably, poor training.

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The New York Times paywalls what is presumably a profile of disgraced vascular surgeon Sapan Desai, MD, PhD one of three collaborators that put together an influential COVID-19 treatment study published and then retracted by The Lancet and New England Journal of Medicine after fault was found with underlying data provided by Desai’s now-shuttered company Surgisphere.

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Clinicians at Yale New Haven Hospital in Connecticut share how they repurposed their Epic system’s antimicrobial stewardship module to care for a surge in COVID-19 patients.

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XPrize launches a six-month Rapid Covid Testing competition that will award $5 million to teams that develop faster, cheaper, and easier to use COVID-19 testing methods.


Other

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HIMSS is considering a new date for HIMSS21, currently scheduled to take place March 1-5 in Las Vegas. The society has promised more concrete details by the end of the week. Should the conference be pushed out to August, we’ll get to enjoy average daily temperatures of around 104°. UPDATE: a reader forwarded an email HIMSS reportedly sent to exhibitors confirming a new HIMSS21 date of August 9-13. I’ve asked HIMSS to confirm.


Sponsor Updates

  • The Chartis Group promotes Mike D’Olio to director.
  • Cumberland Consulting Group achieves HITRUST CSF certification to further mitigate risk in third-party privacy, security, and compliance.
  • Dina wins the 2020 Transition of Care Challenge put on by Tulane Health System and the New Orleans Business Alliance.
  • OptimizeRx makes its digital health information, including prescription savings and treatment information, available through Change Healthcare’s Intelligent Healthcare Network.
  • Hillrom integrates its Voalte clinical communication platform with Aiva’s voice assistant technology.
  • Health Catalyst makes available financial impact recovery applications to help providers manage elective backlogs and evaluate performance.

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 7/27/20

July 25, 2020 News 3 Comments

Top News

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The Journal of Vascular Surgery apologizes for and retracts an article titled “Prevalence of unprofessional social media content among young vascular surgeons.” Some doctors complained that the article was discriminatory and should not have passed peer review.

Three male screeners created fake Facebook, Twitter, and Instagram accounts to search postings from graduating vascular surgery residents – who had not given permission to being reviewed — that contained content they determined was unprofessional and possibly eventually career-damaging.

“Clearly unprofessional” content included posting profanity or making offensive comments about colleagues, work, or patients. Being photographed with alcoholic drinks, making controversial comments, or wearing inappropriate attire were considered “potentially unprofessional.” 

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Doctors protested with social media posts of themselves wearing swimsuits and drinking margaritas tagged #MedBikini.


Reader Comments

From Twitterati: “Re: digital health startup. An author asked people on Twitter to say what that means to them. You?” The “startup” part leads me to assume that the company has attracted investors, which means they have some (likely overstated) degree of revenue, customers, and future prospects, but also suggests that it is still in need of someone else’s money to shed the “startup” label and make predictable profits, probably from a business model in which someone other than patients pays since the users themselves rarely see enough value in digital health products to want to spend their own money. That depends, of course, who is labeling a company as a startup – fanboys, founders, or excessively exuberant media? Equally soft is “digital health,” which is often in the self-serving eye of the beholder, like badly aging companies in the early 2000s that suddenly declared themselves dot-coms because they put up a website. I have zero experience working in digital health or for startups, but I would be embarrassed as a CEO to hide behind either label in trying to earn a trophy for participating.


HIStalk Announcements and Requests

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Getting a haircut tops the list of COVID-risky activities that poll respondents undertook in the past month, followed by eating inside a restaurant and attending gatherings. My only transgression was a one-time lunch with a visiting relative in an admirably cautious restaurant, but it was less enjoyable than I expected beyond the nostalgia factor now that I’ve learned to enjoy eating entirely at home.

New poll to your right or here, paying homage to those #MedBikini folks — which existing online information, if any, do you fear could eventually harm your career?

A relative of mine was struggling to pay for her $1,300 per month injectable medication, so her doctor sent her prescription to a legitimate, customer-centric pharmacy in Canada that is best known for providing insulin at a fraction of US prices. They shipped the same brand-name medication for $400.


Webinars

August 19 (Wednesday) 1:00 ET. “A New Approach to Normalizing Data.” Sponsor: Intelligent Medical Objects. Presenters: Rajiv Haravu, senior product manager, IMO; Denise Stoermer, product manager, IMO. Healthcare organizations manage an ever-increasing abundance of information from multiple systems, but problems with quality, accuracy, and completeness can make analysis unreliable for quality improvement and population health initiatives. The presenters will describe how IMO Precision Normalize improves clinical, quality, and financial decision-making by standardizing inconsistent diagnosis, procedure, medication, and lab data from diverse systems into common, clinically validated terminology.

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


Acquisitions, Funding, Business, and Stock

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Israel-based StuffThatWorks, which combines crowdsourcing and AI to give actionable data to people with chronic diseases, raises $9 million.

Haemonetics sells its blood banking and hospital software business Inlog Holdings France SAS to a private equity firm.


People

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Industry long-timer Steve Pratt of S&P consulting died on July 16 at 60.


Announcements and Implementations

UPMC implements RxRevu’s SwiftRx Direct patient cost transparency technology, which will allow its doctors to review lower-cost prescription alternatives based on real-time access to the patient’s benefits through UPMC Health Plan.

PatientKeeper develops a FHIR-based, Cerner-embedded version of its physician charge capture software, working with Baystate Health’s TechSpring innovation center.

Redox adds access to 500,000 Carequality-enabled physicians to its network, allowing Carequality participants to join the network, exchange clinical summaries, use a simple API to integrate participants and providers, and onboard quickly without going through Carequality’s certification process.


COVID-19

FDA gives emergency use authorization to LabCorp’s home collection COVID-19 PCR test for use in symptom-free people and to be used in pooled sample testing.

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An overwhelmed hospital on the US-Mexico border says that it has formed an internal committee that will decide whether a given COVID-19 patient is treated or sent home to die. It is fascinating to see how ill-prepared or unwilling our health system is to move a patient from an overwhelmed public hospital to available beds in private hospitals and even emergency COVID field hospitals. The percentage of patients who die in the same hospital that they were originally admitted to must be huge since transferring elsewhere, even when medically possible or advisable, has always been  an option that is rarely exercised by either hospital or patient.

CDC issues a strong call to reopen schools two weeks after President Trump criticized its original recommendations as “very tough and expensive.” Insiders say an HHS working group included some of CDC’s original recommendations, but put the mental health-focused Substance Abuse and Mental Health Services Administration in charge of the guidance while excluding the participation of CDC, which was determined to be overly cautious about viral spread. Harvard’s Ashish Jha, MD, MPH says the new document contains no clear information about the risk to students and school staff and does not include a strategy for preventing infection via screening and testing.

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The NFL’s only physician player, Kansas City Chiefs right guard Laurent Duvernay-Tardif, MD, becomes its first player to announce that he will sit out the 2020 season, explaining, “Being at the front line during this offseason has given me a different perspective on this pandemic and the stress it puts on individuals and our healthcare system. I cannot allow myself to potentially transmit the virus in our communities simply to play the sport that I love. If I am to take risks, I will do it caring for patients.” Staying on the sidelines will cost him $2.6 million in salary.


Other

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Georgia State University describes how its nursing faculty quickly moved the clinical experience component of its program online using the VSim for Nursing simulator from Wolters Kluwer, which it uses over videoconferencing to allow students and faculty to work together.


Sponsor Updates

  • Saykara’s founder and president are interviewed about the future of AI in healthcare and its use in the company’s speech-recognition powered physician charting app.
  • Premier Inc. recommends FDA and DEA reforms to prevent drug shortages.
  • Redox Product Designer Nick Hatt will present a session, “Making the Healthcare Developer Experience Awesome to Achieve Interoperability,” during the virtual API Days New York event July 28-29.
  • InterSystems introduces an exam-based certification program for HealthShare Health Connect HL7 Interface Specialist and IRIS Core Solutions Developer Specialist.
  • Relatient publishes a new case study, “University Physicians’ Association Increases Patient Payments 43% with Mobile-First Billing.”
  • Summit Healthcare hires Kyle Madden as a regional sales manager for the West Coast.
  • Waystar appoints retired Xerox CEO Ursula Burns to its board.

Blog Posts


Contacts

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

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News 7/24/20

July 23, 2020 News 5 Comments

Top News

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Clearlake Capital Group considers selling provider management, credentialing, and payer enrollment technology vendor Symplr, which it acquired in 2018 at a $550 million valuation. Reports suggest it hopes to sell at a $2 billion valuation.


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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At-home, blood-testing kit startup Tasso will use some of a $17 million Series A funding round to develop a companion app that will help users share their data with providers. The Fred Hutchinson Cancer Research Center is using Tasso’s devices in a COVID-19 antibody testing study, enabling patients to stay at home instead of traveling to a clinic.

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For-profit hospital operator HCA Healthcare made more than $1 billion in Q2 profit, boosted by $822 million in federal stimulus money from the CARES act for pandemic relief. HCA says it received a total of $1.7 billion in CARES act funds.

Insurer software vendor HealthEdge acquires The Burgess Group, which offers a payment integrity system.


Sales

  • BJC Healthcare (MO) selects Patientco’s patient payment technology and services.
  • DFW Faith Health Collaborative (TX) will implement cloud-based referral and case management software from Pieces.
  • University Clinical Health (TN) selects InteliChart’s patient portal, intake, and communications technology.
  • Guadalupe Regional Medical Center (TX) will work with Pelitas to develop and deploy virtual patient intake capabilities.
  • Oklahoma State University Medicine will work with TeleHealth Solution to staff virtual physicians at five hospitals in rural parts of the state.

People

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Central Logic hires Jeanne Rogers (RevSpring) as VP of sales.


Announcements and Implementations

Cerner announces CommunityWorks Foundations, a fixed-fee, cloud-based version of Millennium for Critical Access Hospitals that can be brought live in six months.

Novant Health (NC) implements Epic test automation with help from Santa Rosa Consulting.

VCU Health (VA) launches a remote patient monitoring program for post-acute care patients using telemedicine software from Dictum Health.

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WakeMed (NC) adds MapQuest technology from Comtech Telecommunications to its Epic MyChart app to better enable patients to find and check in to EDs.

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Franciscan Missionaries of Our Lady Health System (LA) goes live on Kyruus ProviderMatch for Consumers, giving patients a more efficient way to find and schedule appointments with providers that meet their needs.

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Allscripts-owned precision medicine software vendor 2bPrecise announces v3.0, which allows oncologists to assess patient risk for secondary cancers as well as family risk.

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A new KLAS report on health IT vendor performance in responding to COVID-19 finds that the most relied-on health system solutions are virtual care, acute care EHR, and analytics. Vendors who are outperforming their historical satisfaction ratings during the pandemic are CareCloud, Cerner, IBM Watson Health, Philips, RxStrategies, and WellSky, while the worst-performing vendors are Agfa HealthCare, Allscripts, and EClinicalWorks. Budget-strapped health systems report significant budget cuts, but most say they will continue to invest in new technology as new demands arise. Above is the right upper quadrant (higher overall satisfaction, higher COVID satisfaction – click to enlarge).


Government and Politics

HHS will form the National Testing Implementation Forum to gain private-sector feedback on COVID-19 testing and diagnostic efforts, with a particular focus on supply chain issues.


COVID-19

The COVID Tracking Project reported 70,000 new cases on Wednesday, as hospitalizations neared the all-time peak at 60,000, and 1,126 new deaths were reported for the day. The US now has over 4 million cases, up 1 million in the past 15 days.

The federal government will pay $2 billion to order 100 million doses of a COVID-19 vaccine from joint developers Pfizer and BioNTech, with the deal being conditional on the vaccines being proved safe and effective by earning FDA’s approval.

States are looking for alternatives to the two big lab testing companies, especially Quest Diagnostics, that are taking a week or more to deliver results, which at that point are mostly irrelevant for diagnosis or surveillance.  Quest says it is bottlenecked by a global shortage of testing machines and reagents.


Other

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Only in America. The father of a University of Colorado Boulder college senior verifies that her hospital, surgeon, and clinic are within his insurer’s network before sending her off for outpatient meniscus repair. The for-profit HCA hospital billed $96,000, for which it accepted $3,200 from the insurance company and $360 from the family as payment in full. Then the father got a $1,170 bill from an out-of-network, independent surgical assistant that the surgeon had brought along. Most interesting is that use of such out-of-network, unlicensed assistants is so profitable that private equity is buying up the companies that provide them, following the playbook of (a) seeking situations where the patient doesn’t have a choice; and (b) making sure not to accept insurance so they can charge the patient directly for whatever amount they want.


Sponsor Updates

  • IT and cloud managed services vendor SSI selects Goliath Technologies to support its go-to-market service and strategy.
  • Relatient joins post-acute care EHR vendor Casamba’s partner network.

Blog Posts


Contacts

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

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News 7/22/20

July 21, 2020 News No Comments

Top News

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HHS activates a new COVID-19 hospitalization data website that replaces the one that was previously operated by the CDC.

HHS says CDC’s old system collected data from just 3,000 of the country’s 6,200 hospitals, but the new one will report information from 4,500 hospitals that are submitting information using HHS’s newly mandated HHS Protect system.

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AMIA publishes an open letter that expresses dismay that HHS moved hospital COVID-19 reporting from CDC’s National Healthcare Safety Network (which AMIA’s letter incorrectly referred to as National Health and Security Network) to HHS Protect, saying that a pandemic isn’t the best time to go live on a new, untested system. It also questioned the requirement that hospitals provide 20 new data elements explaining why they are needed or how they will be used. 

More than 100 healthcare-related groups asked in a letter to Vice-President Pence, Coronavirus Task Force Response Coordinator Deborah Birx, MD, and HHS Secretary Alex Azar that the administration reverse its decision and leave data collection and reporting to the CDC. AMIA signed that letter as well.


Reader Comments

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From Surly Bonds  of Mirth: “Re: AMIA’s open letter about COVID-19 hospital data reporting. This just-published piece explains why open letters are pointless.” An opinion piece in The Atlantic says that “the genre of open letters should die” because they are generically written with the dead language that is required to get more signatures; signers should just publish their own individual opinion instead; and such letters appear cowardly in a “safety in numbers” sort of way. AMIA labeled its editorial as an “open letter” but it really isn’t — it wasn’t addressed to a particular person or organization and it wasn’t signed, so it’s just an uncredited editorial. 


HIStalk Announcements and Requests

It must be tough sledding out there for ad-supported websites given that I can’t view many of them on my IPad all of a sudden because of errors caused by their increasingly intrusive pop-up ads and embedded video. The home page of one site I used to look at occasionally has six ad zones, pop-up ad video, an overlay banner, and a long list of graphics-heavy sponsored content articles. Clicking on an individual article brings up a ton more of the same, plus it displays comments from an ad-supported service that throws up still more ads. Safari crashes about 50% of the time, especially if I dare touch the screen during the many seconds it takes for the junk to fully load. To further diminish the signal-to-noise ratio are “sponsored content” articles, where the site owner sells editorial space for puff pieces from companies that are labeled “partners” to make selling out seem less odious. Facebook and Twitter have endless faults, but I admit that I spend more time checking them than crudely monetized websites that offer little value amidst the electronic shrieking, low-value content that is memorable only because it is so poorly written.


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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WellSky’s private equity owner changes its mind about selling the company and instead brings in a new unstated investment from another private equity firm.

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Goldman Sachs issues an almost unheard-of “sell” rating to shares of Allscripts, which it says has an unfavorable health IT market position and questionable growth prospects. MDRX closed down 8% Tuesday versus the Nasdaq’s 1% loss following the announcement. The company will announce Q2 results next week.


Sales

  • Home health, hospital, and infusion provider Evolution Health chooses Dina’s Staff Screening and Check-In solution to automate its employee wellness and health screening process.

People

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Cerner hires Peter Liebert, MS, MPA, MSc (California State Guard) as VP/CISO.

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Mental health digital engagement vendor JourneyLabs hires Tim Bush (GE Healthcare) as CEO.

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Ellkay promotes Shreya Patel to chief innovation and product officer and Ajay Kapare, MBA to chief strategy and marketing officer.


Announcements and Implementations

In England, Clinical Architecture is added to the supplier suite of the Greater Manchester Digital Platform, which is part of the national Local Health and Care Record program.

Rush University Medical Center (IL) develops Agile Adapt for its COVID-19 response, using its long-time vendor CipherHealth’s patient engagement and communication platform to flex ICU capacity, coordinate with media, support family-patient communication, coordinate with community-based servicers, support critical staff, monitor patients across all settings, and anticipate care needs.


Government and Politics

Medicare’s Part A trust fund, which pays for inpatient care, could run out of money as early as 2022, as swelling unemployment ranks have reduced payroll tax contributions and Congress tapped Medicare’s reserves to fund COVID-19 relief this past spring.

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The defense department’s DARPA contracts with Duality Technologies to develop a privacy-preserving analytics that allow ML models to be trained without exposing personally identifiable information, such as in studying DNA attributes and COVID-19 symptoms.


COVID-19

CDC antibody testing analysis covering 10 states finds that the number of people infected with COVID-19 in the US is 2-13 times the reported rate, but those numbers are still far too low to confer herd immunity. Mississippi’s infections are an estimated 13 times the reported rate, meaning that the state has no way to find the asymptomatic spreaders and making distancing and mask-wearing even more important. Researchers emphasize, however, that US coronavirus testing is still in disarray, some commercially available tests are unreliable, and “convenience testing” is inherently biased, with results that are not necessarily generalizable.

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President Trump restarted regular COVID-19 briefings Tuesday evening without the presence of the coronavirus task force or any health expert. The President admitted that the “China virus,” which he also called “the plague,” will probably “get worse before it gets better,” but pledged to provided states with needed supplies and touted the likelihood of quick vaccine development and distribution. He also said that tests are being rolled out that can deliver results in 5-15 minutes, which should alleviate the testing backlog. He also said “we did a lot of things right” in keeping deaths so far at 140,000 instead of “double, triple, or quadruple” that number. Reading from prepared remarks, the President said, “As one family, we mourn  every precious life that has been lost. I pledge in their honor that we will develop a vaccine and we will defeat the virus … my administration will stop at nothing to save lives and shield the vulnerable.”

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The New York Times looks at a temporary COVID-19 hospital in Queens that cost $52 million (with a potential final tab of $100 million to federal taxpayers) but treated just 79 patients because of bureaucracy and turf battles. The city decided after the fact that patients would receive better care at crowded existing hospitals; the state didn’t operate a centralized program to transfer patients out of overwhelmed hospitals; the field hospital wasn’t equipped to accept ED patients; it couldn’t use its own ambulances to pick up transfers from hospitals since those facilities have exclusive agreements with specific ambulance companies; and doctors at public hospitals were told not to transfer patients out because the hospitals would lose revenue. The field hospital’s doctors were paid up to $732 per hour to complete paperwork and computer training with few patients to see, while one nurse practitioner says she felt guilty being paid $2,000 per day to look at Facebook.  

Facebook suspends the 10,000-member group account of Unmasking America, which calls masks a form of enslavement, claims that masks limit oxygen intake, and advertises the sale of fraudulent “face mask exempt cards.”


Other

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Medical practices in Germany are locked out of reviewing payer claims and encounter data for eight weeks because the security certificate of an in-office hardware component had expired. Global IT firm T-Systems, a subsidiary of Deutsche Telekom (which is not related to US health IT vendor T-System), was forced to send technicians to 80,000 practices since they were unable to apply the software update remotely. The article was written by former CMS Innovation Center health IT lead Lisa Bari, MBA, MPH.

University of Pennsylvania medical school researchers say that screening patients for social determinants of health hasn’t improved outcomes, but may have created patient harm from sloppy implementation. The authors note that assigning untrained health system employees to fire off a list of privacy-encroaching standardized questions to patients could cause them trauma, discrimination, and legal consequences, not to mention that health systems may be setting unrealistic expectations in asking about needs they can’t fulfill. The authors advise health systems to perform an initial screening with a tablet-based app that allows easily data collection and aggregation, then follow up with a personal conversation when indicated. They also warn that more widespread SDOH screening may cause a rise in mandatory government reporting — for deportation or child welfare investigation, for example – and allow data-driven discriminatory practices, such as diverting ED patients to less-expensive care or allowing insurers to cherry-pick lower-risk patients.

A survey finds that few Americans think its OK for hospital-employed doctors to ask patients for hospital donations, for hospitals to pass patient names along to their fundraising office, or for the fundraising office to perform financial background checks to target wealthy prospective donors. All of these actions are legal, however. Respondents were split over whether a million-dollar donor should get room upgrades, fast-tracked appointments, and their doctor’s cell phone number.


Sponsor Updates

  • Capsule Technologies receives an Authority to Operate declaration from the Defense Health Agency for its clinical surveillance and medical device connectivity technologies.
  • Central Logic will host the virtual Summit on Healthcare Access and Orchestration September 15.
  • The Chartis Group promotes Melissa Anderson to director.
  • Jvion becomes a founding member of the AIMed Community Group.
  • OptimizeRx appoints former Walgreens Boots Alliance President and CEO Greg Wasson to its board.
  • CareSignal publishes a case study titled “How UnityPoint used CareSignal to Remotely Monitor COVID-19 Patients Safely from their Homes.”
  • Collective Medical partners with Fallon Health to support better transitions of care for its high-risk members.
  • Clinical Computer Systems, Inc. launches Obix BeCa fetal monitor in a cooperative agreement with Huntleigh Healthcare Limited, in which CCSI will be the sole US distributor.

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 7/20/20

July 19, 2020 News 1 Comment

Top News

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Hospital associations in Missouri and Kansas warn that HHS’s abrupt change in hospital reporting leaves them unable to update their state COVID-19 dashboards and planning data.

HHS gave just a few days’ notice for hospitals to send data to the new HHS Protect portal, whose required data elements differ from those that had been sent to CDC’s National Healthcare Safety Network.

The hospital associations say they don’t have access to HHS Protect.

The National Governors Association has asked the White House to delay the new hospital data submission requirements for 30 days.


Reader Comments

From Former KP: “Re: Kaiser Permanente and Epic. I was a KP IT executive at the time, and while Cerner may have made such an offer of basically free software in return for CERN shares (which I would not have been aware of in my role), the selection team of IT and clinical leaders made a single recommendation of Epic. The business case was developed exclusively on Epic for inpatient, outpatient, and all related specialty areas.”


HIStalk Announcements and Requests

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Most poll respondents have done something health-related on a mobile device in the past year, most commonly collecting fitness tracker information, sending a message to a provider, or viewing their medical records as extracted from a provider’s EHR.

New poll to your right or here: which activities have you undertaken in the past month?


Webinars

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


People

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Hattiesburg Clinic (MS) promotes CMIO Bryan Batson, MD to CEO.

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Keith Hepp, SVP/CFO at The Health Collaborative and and board chair of the Strategic Health Information Exchange Collaborative, died last week.


COVID-19

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COVID-19 hospitalizations are closing in on April’s record, although a lower percentage of admitting patients are ending up in the ICU. US deaths are at 142,000.

The White House blocks CDC officials from testifying this week at Congressional hearings about how to safely reopen schools.

A report from the National Academies of Science, Engineering and Medicine says that elementary school and special needs children should return to in-person education, but with group activities minimized, physical distancing enforced, surgical masks worn by all teachers and staff members, and cloth facemasks worn by all students. The report did not address the question of the community viral level threshold that would make it unsafe for schools in specific areas to reopen.

CDC will change its recommendation that COVID-19 patients be retested before ending their isolation. White House testing coordinator Admiral Brett Giroir, MD says retesting is not medically necessary and is overwhelming the country’s testing system. CDC will recommend that isolation end when the patient has not experienced symptoms for at least three days, provided that at least 10 days has elapsed since they first experienced symptoms.

FDA gives emergency use authorization to Quest’s PCR test for pooled samples that contain up to four individual swab specimens, allowing more people to be tested while using fewer resources. If the pool is positive, the individual tests are re-run individually to determine which pool members are positive.

A New York Times investigation says overly rosy COVID-19 projects by White House Coronavirus Task Force Coordinator Deborah Birx, MD encouraged President Trump to prematurely pursue reopening with lax thresholds and to push coronavirus response from the White House onto individual states. Birx convinced staffers from her White House office that the virus was fading, leaving only “embers” to fight as she relied heavily on assumption-laden models didn’t take lifting of mandates into account. She believed the US would mirror Italy, which was entirely wrong as that country’s residents were compliant with stay-at-home orders and distancing as many Americans started ignoring them as early as late April.  

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Former TV game show host Chuck Woolery, whose Sunday tweet accused clinicians and others of lying about COVID-19 to hurt President Trump’s re-election chances — a tweet that was then retweeted by the President — takes down his Twitter in announcing a few hours later that his son has tested positive. A spokesperson for the former “Love Connection” host says Woolery is “taking a break from the abuse he has received from thousands of intolerant people.”


Other

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I missed this earlier. Two BYU professors, one in nursing and one in IT, develop a homegrown, $20 open source Bluetooth stethoscope that allows clinicians to listen to a patient’s heartbeat at up to 50 feet away while still wearing PPE. The 3D-printed device also records the audio for later review. Commercial devices perform similar functions for several times the price.

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In England, paramedic Danny Hughes provides a video example of using real-time transcription such as Google Live Transcribe (for Android only) to communicate with the hearing-impaired when the speaker’s mask prevents the patient from reading their lips.

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Maryland’s attorney grievance commission reviews a complaint against a high-profile medical malpractice attorney who was recorded by the FBI as he told University of Maryland Medical System that he would keep quiet about deaths and other problems in its transplant program if the health system paid him a $50 million consulting fee. Attorney Stephen Snyder, who learned about the problems in representing malpractice clients, says he himself is the victim because of his offer to “help prevent any future tragedies.”  


Sponsor Updates

  • OptimizeRx hires Dina Smyth as customer success manager.
  • Pivot Point Consulting releases a new podcast, “How Healthcare Data Can Be Used to its Fullest Potential.”
  • The Edison Awards features Vocera Chief Marketing Officer Kathy English in its latest podcast.

Blog Posts


Contacts

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

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Cerner News

July 19, 2020 News No Comments

Politico reports that the VA will re-commence its EHR overhaul with a rollout at an unnamed facility in October. The conversion from VistA to Cerner was halted earlier this year as VA facilities focused on preparing for and treating COVID-19 patients. The VA has switched its go-live plans from facilities in bigger metropolitan areas to those in smaller cities in the Pacific Northwest and Midwest, citing a lack of access during the pandemic to clinical experts who had been expected to help with system customizations for the larger facilities. (8/7/20)

Cerner and VC firm LRVHealth invest $6 million in Xealth, a Providence Health & Services spin-off that has developed software to help providers find and prescribe digital health apps and programs. (8/7/20)

Nacogdoches Memorial Hospital (TX) and Cerner agree on partial payment to settle the $20 million the hospital owes for an implementation it delayed repeatedly and finally cancelled. (7/31/20)

Cerner will add Nuance’s virtual assistant technology to Millennium, allowing users to navigate by voice for chart search, order entry, and scheduling. (7/31/20)

Cerner reports Q2 results: revenue down 7%, EPS $0.44 versus $0.39, beating consensus earnings expectations but falling short on revenue. From the earnings call:

  • The company says its revenue came in lower than expected because the pandemic impacted sales or timing of some low-margin offerings, such as technology resale and billed travel.
  • Q3 revenue expectations have been reduced because of divested businesses and a larger-than-expected pandemic impact, but the company expects earnings to grow due to cost reduction.
  • The company says it won’t cut R&D spending.
  • Cerner says that while virtual go-lives work for simple implementations, the future model will be a hybrid, with fewer people on site who are supported centrally, which also reduces billable travel for the client. The company notes that employees are 25% more productive working remotely because avoiding two half-days of travel during the work week means they have five days billable per week instead of four.
  • Cerner is looking beyond its Amwell virtual visit partnership to virtual hospitals and ICUs that would involve its CareAware platform.
  • An analyst asked about a $35 million acquisition that he saw on the cash flow statement, which Cerner says was for a cybersecurity company that it can’t talk about otherwise.
  • Cerner is interested in acquisitions related to research data and analytics.
  • The grating phrase “new operating model” thankfully wasn’t uttered even once. (7/31/20)

Cerner announces CommunityWorks Foundations, a fixed-fee, cloud-based version of Millennium for Critical Access Hospitals that can be brought live in six months. (7/24/20)

Banner Health signs up for Cerner’s revenue cycle system, expanding its Millennium implementation. (7/17/20)

Cerner says it will keep employees working from home for at least several more months, pushing back its phased plan to bring up to 50% of employees back to office-based work. (7/17/20)

A new KLAS report that looks at advanced users of clinical communications platforms finds that Epic, Halo, and TigerConnect have the greatest breadth of workflows; PerfectServe and Telmediq have fewer workflows and are more widely used in inpatient settings; and Cerner, Hillrom (Voalte), Mobile Heartbeat, and PatientSafe Solutions focus on inpatient settings and have less use in outpatient. Cerner and Epic have tight integration with their own EHRs, as Epic Secure Chat provides fully embedded functionality and Cerner offers CareAware Connect Communications as a separate app. (7/8/20)

The White House’s 2021 budget request includes $105 billion for the VA, including $4.9 billion for IT and $2.6 billion (versus $1.5 billion this year) for its Cerner project. (7/8/20)

Cerner conducts another round of layoffs, this time involving 100 employees. The nails-on-blackboard corporate phrase “new operating model” was uttered yet again as an explanation. (6/24/20)

The VA gives Cerner a $99 million task order for sustainment support of hardware and software associated with its $10 billion EHR modernization project. (6/12/20)

A GAO review finds that the VA has implemented effective configuration decision-making in its Cerner implementation by holding national workshops and creating 18 EHR councils, but needs to improve representation at local workshops. The report also notes that while the VA and DoD both user Cerner, coordination is needed to allow sharing of information and tasks, such as VA’s requirement to maintain durable orders for life-sustaining treatment across patient encounters that is not supported by the DoD’s Cerner configuration. (6/8/20)

Congressional sources say the VA probably won’t restart its Cerner rollout until the fall because of COVID-19 demands. (6/5/20)

RCM company R1’s shares jumped over 9% on the news that it will acquire Cerner’s RevWorks business in a transaction valued at $30 million. As part of the deal, Cerner will offer R1’s software and services to customers and prospects. In an April 2019 earnings call, company reps said RevWorks had grown stagnant, contributing $200 million in annual revenue. Cerner had been using its RevWorks offerings “to more tightly align the client to Cerner” for additional sales of its software and services. (6/5/20)

North Central Health Care (WI) will implement Cerner’s Behavioral Health EHR in three multi-specialty behavioral facilities. (6/3/20)

Cerner hires Jerome Labat (Micro Focus) as CTO. (6/3/20)

Forty-nine municipalities in Sweden’s Västra Götaland region will implement Cerner Millennium. (5/29/20)

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. (5/29/20)

Cerner joins the Fortune 500 largest US companies by annual revenue, coming in at #498. (5/20/20)

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. (5/18/20)

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. (5/15/20)

News 7/17/20

July 16, 2020 News 6 Comments

Top News

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Congressional Democrats criticize HHS for issuing a no-bid, $10.2 million contract in April for developing a hospital bed and supply tracking database to TeleTracking Technologies, the Pittsburgh-based hospital equipment and bed tracking vendor.

HHS has ordered hospitals to submit their COVID-related capacity, patient count, and supply information to the TeleTracking system, called HHS Protect, instead of the CDC’s National Healthcare Safety Network (NHSN), starting this past Wednesday. The administration says CDC’s database is outdated and requires manual entry that delays analysis.

CDC Director Robert Redfield, MD said Wednesday that CDC provided input into developing HHS Protect, which previously accepted both data that was submitted directly from hospitals as well as extracts from NHSN. Redfield says that requiring hospitals to send their data directly to HHS Protect will reduce duplicate reporting, help HHS make quick field changes, and allow CDC to focus its system on capturing reports from nursing homes.

Redfield says that CDC and state and local health agencies will have access to HHS Protect, adding that CDC will continue to provide daily updates and dashboards. Several outside sites use CDC’s dashboard for modeling, such as school reopening readiness.

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Meanwhile, CDC’s hospital capacity dashboard went offline on Wednesday, the final day in which hospitals could submit data to NHSN.

UPDATE: HHS Assistant Secretary of Public Affairs Michael Caputo said Thursday afternoon that HHS has ordered CDC to restore the COVID-19 hospital dashboards that CDC “withdrew from the public Wednesday.” However, the dashboard indicates that information will not be updated after July 14.


Reader Comments

From Data Deliverance: “Re: HHS changing hospital-submitted operational data from CDC to HHS. The new database isn’t publicly visible. Can the public use other dashboards, such as the one from Johns Hopkins?” HHS collects daily hospital reports about beds, ventilators, cases, admissions, ED visits, remdesivir inventory, and details about staff and PPE shortages. Most of this information has minimal overlap with the infection dashboards published by Hopkins and other sites that I assume use data that hospitals have submitted to state health departments.

From Epic Historian: “Re: Kaiser Permanente. Early on they were considering both Cerner and Epic. Cerner offered a complex plan to rebate KP the software cost in the form of Cerner company shares, basically giving them the software for free (UPMC may have fallen for this). KP decided to pick Cerner for inpatient and Epic for outpatient (since it was already being used in some regions), and they asked Judy end Epic to run the integration. She told them to forget it, just use Cerner because one vendor is better than two. KP realized what she was saying and took Epic even though the inpatient system was pretty untested back then.” Unverified, but fascinating. This was in response to an email conversation I had with EH in which I described one instance (there were actually two, but I just now remembered the second) in which we as a big health system seriously pondered whether it would be cheaper to buy our fading vendor of choice as a company instead of their product, or if we did buy the product, whether our contractual demands that they were desperately willing to accept might drive them out of business anyway.

From Kay: “Re: HIStalk. I’ve enjoyed most of the 50-year career I’ve had in health IT and am lucky to have found something I loved. I’m finally retiring and will miss the industry and the wonderful people. You have made a huge difference to me and how I was able to do my job. You are the best. Ever. I want to thank your family for sharing you with us. By the way, I’m not retiring from reading your blog. Stay safe and well and clever and endlessly interesting.” I excerpted some of Kay’s comments, without including personal details, purely to thank her for those thoughts (hold on, got something in my eye here) and to wish her a happy retirement as an industry pioneer, a concept that I hope she celebrates both as the beginning of a fresh chapter as well as a reward for completing the previous one. I’m always uplifted to hear from someone who has enjoyed their career and their simultaneous personal life that raced by while they were pursuing it – it’s a lot easier to continue gratification than to catch up from deferring it.


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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Digital access and care navigation company Gyant raises $13.6 million in a Series A investment round. The company launched a COVID-19 digital screening tool several months ago with development help from investor Intermountain Healthcare that has since been deployed by 16 healthcare organizations.

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Boston-based care coordination software startup Cohere Health launches with a $10 million Series A funding round. The company offers care paths, care journey recommendations, and physician behavior change. CEO Siva Namasivayam, MS, MBA was previously CEO of SCIO Health Analytics and an executive with Perot Systems.

Cerner says it will keep employees working from home for at least several more months, pushing back its phased plan to bring up to 50% of employees back to office-based work.

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The six-month health IT review of Healthcare Growth Partners says that while COVID-19 has accelerated the shift to “hospitals without walls,” M&A transaction activity has slowed a bit and will likely stay that way through the end of this year, although not as much as in other industries. Underlying health IT investment sentiment remains strong among private equity firms. Private equity investors generally see COVID-19 as neutral with regard to valuations. The most common COVID-19 strategies that companies are using include applying for federal government relief (40%), accessing additional capital (30%), and delaying payables (30%). Many of them are furloughing or laying off employees or imposing pay cuts.


Sales

  • Banner Health signs up for Cerner’s revenue cycle system, expanding its Millennium implementation.
  • Boulder Community Health (CO) will implement data and analytics, RCM, and care coordination services from Optum.
  • Virginia Mason Health System (WA) will use supply chain services and cost-management analytics from Premier.
  • Parkview Medical Center (CO) will go live on Epic through a software-sharing arrangement with UCHealth.

People

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Appriss Health promotes Krishan Sastry, MBA to president and CEO. He replaces Michael Davis, who will remain as executive chair.

Tom Underman (Accuray) joins Loyale Healthcare as VP of enterprise sales.


Announcements and Implementations

Banner Health implements acute-care telemedicine capabilities developed by VeeMed and Intel across its 28 hospitals.

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Phynd Technologies announces GA of advanced provider search capabilities for patient-facing hospital websites and internal directories.

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Vanderbilt University Medical Center profiles its Clickbusters campaign to reduce alert fatigue from Epic-generated best practice advisories. The program, operated by Vanderbilt Clinical Informatics Center, has reduced the nearly 500,000 weekly generated alerts by 10% and has set a goal of having users act on the recommendations 30% of the time instead of the current 8%. VUMC has also added a feature to allow clinicians to score their satisfaction with individual alerts and add suggestions for refining them that are sent to a review team.

Urgent care provider Remedy is working on virtual care solutions with Redox, one of 13 virtual care customers Redox has added to its network since March in a 46% increase.

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A new KLAS report on legacy data archiving finds that Harmony Healthcare IT and MediQuant have a record of satisfying customers that have complex needs, while Triyam and Ellkay customers report getting their projects finished on time and with good communication. Sites that used MediQuant, Galen Healthcare, and Harmony Healthcare IT reported more delays, but some of those customers say it was their own lack of planning and expectation-setting that extended their timelines.

Athenahealth renames its Centricity product line to AthenaIDX, which includes Centricity Business (AthenaIDX), Centricity EDI Services (AthenaEDI), and Centricity Group Management (AthenaIDX). The product line has a long but tortuous history — the former IDX developed and sold the systems for years, GE Healthcare acquired IDX for $1.2 billion in 2005, GE Healthcare sold part of that business to private equity firm Veritas Capital in mid-2018 for $1.05 billion, Veritas named the acquisition Virence Health Technologies a few weeks later, and Veritas acquired Athenahealth for $5.7 billion a few months later and combined it with the Virence product line under the Athenahealth brand.


Government and Politics

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An HHS OIG audit finds that CMS Administrator Seema Verma inappropriately spent millions of taxpayer dollars on contractors — some of them connected to Republican loyalists — who she engaged to polish her public image. CMS had paid more than $5 million to the contractors at above-market rates – up to $380 per hour — before halting the program following Politico’s investigation. CMS has 235 FTEs in its Office of Communications. Politico previously reported that Verma had directed contractors to craft her speeches, book her media appearances, obtain invitations for galas, and work to get her included on “Power Women” lists. HHS accepted the inspector general’s recommendations, but Verma disputed the findings and scolded OIG for investigating her when CMS is dealing with coronavirus. HHS Assistant Secretary for Public Affairs Michael Caputo, an advisor to President Trump, responded that the White House has confidence in Verma, but not his own department’s inspector general. Note: that acting inspector general is Principal Deputy Inspector Christi Grimm, who drew the White House’s ire and the nomination for her replacement in April after HHS OIG published results of a 300-hospital survey that indicated widespread shortages of PPE.


COVID-19

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Oklahoma Governor Kevin Stitt, who was among the majority of attendees of President Trump’s June 20 rally in Tulsa who refused to wear masks, becomes the first state governor to test positive for COVID-19. He attended state meetings unmasked after being tested while awaiting results, forcing state and local officials who were exposed to him to begin their own testing and self-isolating.

New research using EHR data finds that, contrary to previous speculation, blood type has little impact on COVID-19 susceptibility or outcomes.

University of California Health uses de-identified patient data from its Epic system to create a database for COVID-19 treatment research.

The UK’s cybersecurity center warns that a Russian hacking group is targeting COVID-19 vaccine research and development organizations in the US, UK, and Canada to steal their intellectual property.

White House Press Secretary Kayleigh McEnany says in a press briefing on school reopenings that “the science should not stand in the way of this.”

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In Bangladesh, a hospital owner is arrested for selling migrant workers certificates that they tested negative for COVID-19 without actually testing them. He sold 10,000 of the $59 certificates that allowed his untested customers to work in Europe as restaurant workers and grocery store clerks. The hospital owner, who sports a long criminal record, was arrested while trying to cross the border into India dressed as a woman.  Two other doctors were previously arrested in Bangladesh for issuing thousands of phony certificates.


Other

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A small survey of health systems by The Chartis Group finds that 40% expect it to take at least a year to return to pre-pandemic patient volumes, and that 45% will reduce expenses by at least 10% during that time.

Weird News Andy acknowledges that stories like this are hard to swallow. Japanese doctors resolve a woman’s throat irritation by removing a sashimi-transmitted parasitic worm from her tonsils. You’re welcome for me not showing you the photo.


Sponsor Updates

  • Frost & Sullivan recognizes Wolters Kluwer Health as a Frost Radar global leader in AI for healthcare IT.
  • Healthwise names Cydni Waldner (Hawley Troxell Ennis & Hawley) general counsel.
  • Hyland Healthcare partners with Life Image to optimize data and imaging access between providers and patients.
  • The Philadelphia Business Journal honors InstaMed CFO Frank McAnally with its CFO of the Year Award.
  • Black Book ranks Imprivata as the top company for client satisfaction for identity governance solutions.
  • Redox has increased its roster of virtual care customers by 46% over the last several months.
  • Loyale Healthcare parent company RevSpring integrates Loyale’s payment facilitator program with its Merchant Services offering.
  • PMD adds a Web-based telemedicine option for patients who lack access to or don’t feel comfortable using mobile devices.

Blog Posts


Contacts

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

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News 7/15/20

July 14, 2020 News 8 Comments

Top News

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A New York Times article says that a broken data system — which often includes fax machines as a primary means of communication — is hampering US COVID-19 response.

The article notes that:

  • Nearly all lab results were reported digitally to public health departments before the pandemic, but a shortage of testing capacity and high payments brought in new lab companies that aren’t set up for public health reporting and they insist on using fax.
  • Washington State’s health department brought in 25 National Guard members to perform manual entry of information that is not being sent electronically.
  • The public health department of infection hotbed Harris County, TX was overwhelmed when its fax machine was “just shooting out paper” when a lab faxed hundreds of pages of test results all at once.
  • Information that is sent outside of data feeds – by phone, email, snail mail, and fax – is often duplicated, sent to the wrong recipient, or missing important patient information. Nationally, 80% of test results are missing demographic information and half don’t have addresses. New federal guidelines, which recommend but don’t require that senders include such information, don’t take effect until August.
  • Reporting test results in Austin, TX requires reviewing 1,000 faxes per day that arrive on average 11 days after the test was taken, making the results worthless for contact tracing. The health department is telling people who are experiencing symptoms to just assume that they are positive.

In related news, the White House is considering asking governors to send the National Guard into hospitals to help them collect daily COVID-19 information about patients, supplies, and capacity. The American Hospital Association is not happy with this news, saying that hospitals have cooperated with “evolving data requests” and suggesting that the Guard’s expertise could be better used elsewhere.


Reader Comments

From Livongo vs. Allscripts: “Re: CEOs. Tullman’s big mistake was keeping his existing executive team with the Eclipsys acquisition, and they didn’t understand the acute market. Black’s dbMotion acquisition was a disaster since it sold only to existing customers and many of them have dumped the whole thing for Epic. Black also purchased garbage products from NantHealth right after its owner bought Sunrise for his Verity hospital chain, after which Allscripts sunset the products and Verity filed bankruptcy and bagged out of the contract. The Healthgrid acquisition was good, but the McKesson acquisition was a disaster, sending the Paragon customers who could afford to switch to competitors. The Practice Fusion acquisition fueled Veradigm, which has done well, but it cost them $160 million in DOJ fines plus legal fees. I haven’t seen any announcement of new Sunrise or TouchWorks sales for a long time. Bottom line is that the industry seems to trust Tullman more than Black and somehow the board has for some reason allowed Black to remain after seven-plus years as the stock dropped 50%.”

From Gerald Aldini: “Re: management. I’ve been offered a promotion that would place me over my co-workers. Good idea or not?” Becoming the boss of your peers is certainly awkward, but more importantly, are you a builder or a leader? Which makes you prouder, sequestering yourself to create something amazing or being in charge of people who do so under your guidance? Rules-breaking artists won’t likely be happy taking a rules-enforcing job supervising other artists, regardless of the expanded authority, office, and paycheck that comes with that responsibility. I’ve had quite a few conversations with management peers over the years in which we secretly expressed a longing to return to our happy days of headphones-on programming, where our cubicles were a secret doorway to a universe of our own creation and we left our work problems behind when we headed home. Take the management job if you get that same satisfaction from convincing or coercing people to do what you want instead of what they want and love conference room arm-wrestling with peers over resources and priorities. One more piece of advice, which I took myself when I begrudgingly accepted a health system promotion from doing what I loved to taking a promotion doing something I didn’t even like — a co-worker will probably take the job if you don’t, so reporting to a former peer may be more distasteful than the other way around even if you don’t really relish the new job.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Jvion. The Suwanee, GA-based company delivers clinical AI solutions that allow providers and payers to manage unforeseen health risks, improve health outcomes through personalized recommendations, improve patient and member engagement, and reduce costs. These go beyond simple predictive analytics and machine learning to identify at-risk patients who are likely to benefit from specific interventions. The company’s product has been deployed by 300 hospitals across 50 health systems that report an average 30% reduction in preventable harm and annual savings of nearly $14 million. Specific use cases include hospital-acquired conditions, healthcare-associated infections, readmissions, bedside patient rescue, discharge optimization, patient experience, oncology care, and behavioral health. The company just released its solution suite for payers, which includes population health, cost and utilization management, behavioral health, and member activation and engagement. The company was recently featured in a New York Times article for its COVID-19 employer recovery package that predicts exposure and infection risk. Industry long-timer Jay Deady is CEO, so thanks to Jay and to Jvion for supporting HIStalk.

I found this recent YouTube video in which Duke University Health System’s chief analytics officer describes how the health system uses Jvion to manage falls and allocate resources.

Listening: new from Everybody Loves an Outlaw, a Texas duo who can crank out Janis Joplin-like blues. I’m not a fan of slide guitar and handclapping bar songs so I pass on those, but their moodier songs hit the spot. I’m fascinated that Taylor kept laying down tasty guitar licks as Bonnie practically mounted him lustily on camera at the 2:20 mark before she redirected her passion back to the song “I See Red,” which describes killing a philandering lover.


Webinars

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


Sales

  • FDA licenses access to the TriNetX global health research network for its Sentinel Program, which will give it access to de-identified, real-world data for monitoring the use and potential shortages of critical COVID-19 drugs.
  • In England, the National Institute of Health and Care Excellence and Flatiron Health will study real-world evidence from Flatiron Health’s EHR database starting with a comparison of predicted versus actual survival outcomes. NICE produces evidence-based guidance for the National Health Service.

People

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Chris Belmont, MBA (The HCI Group) joins Memorial Hospital at Gulfport as VP/CIO.

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Direct Recruiters, Inc. promotes Kasey Kaiser and Josh Olgin to partner.

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Apervita hires industry long-timer Miya Gray, MS (BrainScope) as SVP of customer success.

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Meta Healthcare IT Solutions founder and CEO Sal Barcia, RPh, MS announces on LinkedIn that he is leaving the company after 29 years.


Announcements and Implementations

Surescripts announces that 21 healthcare organizations are live on its Clinical Direct Messaging service for transmitting Electronic Case Reporting of COVID-19, with another 18 sites in progress.

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Amazon will conduct a health center pilot with primary care service provider Crossover Health, which will operate 20 Neighborhood Health Centers in five cities that will serve Amazon employees and their families. The first center will open in Las Colinas, TX and will offer extended hours to accommodate employee work schedules.


COVID-19

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The White House orders hospitals to bypass CDC in their COVID patient data submissions, telling them to send their daily Excel files instead to CDC’s parent HHS to track hospital capacity, resources, and PPE availability. People sometimes forget that the sprawling HHS bureaucracy includes the alphabet soup of OCR, ONC, AHRQ, CDC, CMS, FDA, and NIH.

A CDC editorial in Tuesday’s JAMA Network calls for universal wearing of masks, saying that “the public needs consistent, clear, and appealing messaging that normalizes community masking” as a civic duty.

Quest Diagnostics admits that its average turnaround time for COVID-19 results has increased from 4-5 days two weeks ago to more than seven days now. The company also warned investors that Q2 revenue will be 6% lower because it is performing fewer more lucrative tests during the pandemic.

In one city in India, COVID-19 patients will be required to use city-issued electronic token to be admitted to private hospitals, whose beds the city wants to reserve for patients who have symptoms. Private IT firms developed the technology that an around-the-clock city team will use to assign tokens that contain a specific bed number.

In what could be a preview of sending kids back to school, a New York mom who kept bringing her child to an in-home daycare while waiting to receive her own COVID-19 test results spreads the infection to at least 16 people in four families, including six children, a sibling, seven parents, and two grandmothers. The mom was tested on a Tuesday and continued to bring her child to daycare every day until she received her results on Friday. She apologized for ignoring the quarantine, saying she had nobody else to care for her child, who also tested positive.

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The public health department of Catawba County, NC does an amazing job of contact tracing in showing how a 20-person, mask-free family gathering led to 14 infections, with those symptom-free folks then spreading COVID to at least 41 people over just 16 days, including a bunch of co-workers, some beach trip companions, an 85-year-old neighbor, and some children. It’s probably safe to assume that the spread has gone further since.

Four former CDC directors say in a Washington Post op-ed piece that public health faces two opponents – COVID-19 as well as political leaders who are determined to undermine CDC’s work. They particularly dislike the White House’s threat to weaken CDC’s return-to-school guidelines, saying that “the only valid reason to change released guidelines is new information and new science, not politics” and observing that disdain for policies and practices that worked all over the world has led the US to have 4.4% of the world’s population but nearly 25% of its coronavirus infections.

Israel reports that 47% of the people who were diagnosed with COVID-19 last month were infected in schools, following a sudden decision to reopen them.

In Florida, Sunday’s huge jump to 15,300 new COVID-19 cases on Sunday may be due to Florida Department of Health data reporting backlogs. A Virginia lab that performs 10,000 to 13,000 tests every day for Florida residents says it can’t explain how state data showed 52,000 results from it on Sunday, of which 7,000 were positive, both numbers representing around half of the state’s total. Still, 16% of the state’s tests were positive, which indicates an increasing infection spread.

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The Texas Tribune reports that hospitals are turning away COVID-19 patients and holding up ambulances for up to 10 hours at their EDs due to a lack of capacity.

A CNBC article describes why Israel was so successful in the initial phase of the pandemic before fanning a viral resurgence by opening too soon:

  • Universal healthcare coverage is offered, sold by four competing non-profit insurers, They all use the same technology, making public health surveillance easy.
  • The country created a predictive model to identify high-risk people, then sent them SMS and phone messages and doctors to offer them telemedicine and home care.
  • The largest of the insurers sent daily symptom questionnaires to members to identify potential hot spots early.

Other

Two people file a class action lawsuit against Teladoc Health, claiming that telehealth company hired a marketing firm to make robocalls that pitched Teladoc’s $30 monthly membership plan, which in their case involved dozens of calls made to their numbers that they had listed on the Do Not Call registry.

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An observational and interview study of IT-involved people in nine healthcare organizations characterizes in broad terms how they see the relationship they have — or want to have — with their EHR vendor, with these categories:

  • Marine drill sergeant. Healthcare organizations with limited knowledge or discipline expect their EHR vendor to force them to follow a standard implementation or configuration, especially if they have struggled previously with a heavily customized system that reflected illogical workflows.
  • Mentor. The client wants the vendor to make non-binding recommendations based on their experience with other customers.
  • Development partner. An organization that sees itself as an innovator chooses an EHR vendor that can develop new features to support their experimentation.
  • Seller. The customer just wants to buy a system with minimal ongoing vendor contact.
  • Parasite. A vendor with one dominant customer neglects its other customers to the detriment of both the vendor and the singularly important customer.

My take on this: the above EHR vendor categories highlight the industry’s change in which early (and mostly failed) inpatient EHR vendors encouraged customers to make programming demands to support their often illogical processes in the “we are special” heyday. It’s pretty remarkable that Epic has made the “marine drill sergeant” vendor role not only acceptable, but desirable (although Meditech arguably developed that role). Nobody would have predicted that young, healthcare-inexperienced EHR vendor employees could convince C-level executives with decades on the job to re-examine their processes that were often in place only because the hospital’s managers had never worked elsewhere and didn’t know any better. Epic’s brilliance is bribing clients (in the form of rebates) to follow best practices, applying pressure at the CEO/CFO level where those big checks made out to Epic are signed, and gaining buy-in for massive organizational changes using go-live pressure that keeps the customer from noticing that their long-protected Band-Aid is being ripped off.

Epic publishes yet another press release, which makes me wonder what’s changing in Verona since they had never run any until recently.

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Tweet of the day.


Sponsor Updates

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 7/13/20

July 12, 2020 News 1 Comment

Top News

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A KLAS report on pediatric practice ambulatory EHRs names PCC as the clear leader.

PCC and Athenahealth scored well in product robustness and value.

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The report says that PCC significantly outperforms other vendors in relationships with its personal approach, proactive support, and hands-on executive involvement.


Reader Comments

From Livongo and Prosper: “Re: CEOs. In 7.5 years as CEO of Allscripts, Paul Black has taken the stock from $13 to $6.50 per share with a $1B market cap. In one year, Glenn Tullman has Livongo’s stock at $108 with a market cap of $10B. Black helped push Tullman out and now Tullman is laughing all the way to the bank. How does Black still have a job?” I’ll offer these points in resisting the urge to oversimplify the situation:

  • Tullman had Allscripts in a complete mess during the last few years of his tenure, including making questionable acquisitions, infighting with Eclipsys loyalists after buying that company, taking a snake oil sales approach to milking the Meaningful Use cow, fumbling clownishly over the MyWay EHR, claiming that the company’s science fair of acquired old products were integrated by definition since they all ran Microsoft SQL, and desperate suing its own customers and prospects that had chosen competing products.
  • Black’s performance has been more measured, but not very inspiring or visionary. He, too, was at the helm during some major corporate gaffes, such as making a deal with equally desperate NantHealth, announcing but never actually selling the Avenel EHR, and buying Practice Fusion with the full knowledge that it was waiting for the DOJ hammer to fall for helping drug companies push opioids inappropriately. He’s made some potentially good decisions that have taken the company outside its core EHR business in hoping to avoid getting squashed by the Epic juggernaut and strong ambulatory competitors, but I can’t recall hearing anything all that exciting about TouchWorks and its stablemates in years.
  • Livongo is surfing on a sea of employee health hype that it’s hard to see lasting forever, especially given the failure of similar companies to prove their value via unbiased outcomes studies. Tullman has deep experience in working the stock market, having taken Allscripts through a Series J funding round or something like that before going public, so he’s in his element as Livongo board chair.
  • Black is better than Tullman was in always announcing something new that makes it hard to judge apples-to-apples quarterly company performance, usually an acquisition that promises fresh opportunities in some hot sector.
  • Allscripts wasn’t much of an innovative development shop under either CEO and has exhibited little in the way of vision or passion.
  • Tullman mostly stuck to EHRs and related technology during his Allscripts days, while Black favors buying distressed health IT merchandise to wring out a few drops of profit while hoping to sell the customer base something else.
  • We don’t know how much of either company’s success is due to its highest-ranking executive. Neither Tullman nor Black were board chair of Allscripts while serving as CEO. Tullman is board chair at Livongo but not CEO. Nor do we know that Allscripts would perform any better under a different CEO who doesn’t control the board. You can do only so much while investors are staring you down quarter by quarter and most of your products are in mature markets that have strong competitors.
  • My conclusion is that only some degree of a publicly traded company’s performance can be attributed to the CEO. Tullman was damaged goods after the board put the company out of its misery by firing him, but he has certainly made a better name for himself after founding Livongo, which surprised me.

HIStalk Announcements and Requests

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It’s 55-45 on my poll asking whether it’s OK for an employer to fire someone for off-work action or social media posts that don’t result in legal charges. Commenters point out that free speech protection in the First Amendment applies only from the actions of government, not employers, and employers are free to send an employee packing for nearly any reason that doesn’t violate Equal Employment Opportunity requirements. My definition of “OK” was intentionally fuzzy since company reasons for termination can be equally so, but the bottom line is that people lose their livelihoods every day for reasons that may have little to do with job performance.

New poll to your right or here: Which of these activities have you performed on a mobile device in the past year?


Webinars

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


People

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Mick Brown (Change Healthcare) joins post-acute telehealth provider Third Eye Health as VP of strategy for health systems and ACOs.


COVID-19

The US has nearly 52,000 people hospitalized with COVID-19, approaching April’s peak of 60,000 and nearly doubling the June 15 count. Texas has 10,000, California 8,000, and Florida 7,000. Florida reported 15,300 new cases on Sunday. Deaths have finally taken a national upturn as expected from the case and hospitalization counts, now standing at 134,000. Nursing homes are once again being hit hard, with some reporting dozens of deaths and residents making up 40% of the COVID-19 deaths in Texas.

America’s push to get students back in school will be a global experiment since no other country has every tried to institute a return to campus during raging coronavirus outbreaks.

The White House reportedly canceled the scheduled media appearances this week of Anthony Fauci, MD after he disputed President Trump’s assertion that a lower death rate shows US progress, which Fauci he called a “false narrative” that could lead to complacency. Fauci says he hasn’t spoken to the President since early June.

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Morgues in parts of Texas and Arizona are full and refrigerated trucks are being set up there.

The federal government sends an Army medical task force and HHS disaster response team to Houston.

Atlanta will reactivate a 200-bed COVID-19 field hospital at the Georgia World Congress Center after closing it in May after it had treated just 17 patients. The state has also contracted with Piedmont Healthcare to add 100 ICU and surgical beds to deal with the COVID-surge. Both actions came after health system CEOs urged the governor to help them continue their profitable elective surgeries. 

More than two dozen Mississippi state senators, its lieutenant governor, and its House speaker test positive for coronavirus after weeks of close-quarters meetings in which most or all of them ignored mask recommendations.

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Intensivist Nick Mark, MD describes the problems with using the benign term “ICU capacity”:

  • Critically ill patients go to the nearest hospital, so statewide figures mean little if the nearest available ICU beds are hundreds of miles away.
  • Higher ICU census is associated with worse outcomes.
  • ED boarding of patients waiting for ICU beds have an increased risk of death because EDs don’t have the staffing ratios and facilities needed for long-term patient care.
  • COVID-19 patients need much longer stays than the ICU average of around three days, tying up beds for a long time and more likely to need ventilator support.
  • ICU capacity is often calculated across all types of beds (medical, surgical, cardiac, burn, trauma, and even pediatric) and in some cases count PACU beds as ICU.
  • Not all ICUs can provide interventions such as negative pressure rooms, dialysis, and ECMO and other interventions for acute respiratory distress syndrome.
  • Step-down rooms can be “upleveled” into an ICU, but skilled staff will be in short supply. ICU staffing is based on an expected occupancy of around 60%.
  • Burnout, PPE shortages, and healthcare worker infection are likely with expanded ICUs.

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I missed this earlier: hospitalist and CMIO Dirk Stanley, MD, MPH lays out how to determine COVID-19 status from a patient’s EHR. Thanks to @CraigJoseph for tweeting the link.


Other

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A former VP of finance for an Atlanta medical device packaging company pleads guilty to trashing the company’s computer systems after being fired, which he accomplished by using a phony logon that he had created beforehand. The company distributes PPE, shipments of which were delayed due to deleted data from its ordering and fulfillment systems.


Sponsor Updates

  • Selling Power includes Nuance as a “Best Company to Sell for” on its annual list.
  • PatientPing publishes a new e-book, “CMS’s E-Notifications CoP: The Route to Compliance.”
  • Black Book Research publishes a new report, “Exploring Physicians’ Perspectives on How COVID-19 Changes Care.”
  • Pure Storage publishes a case study, “St. Joseph’s Health achieves speed and reliability with Pure Storage.”
  • Redox releases a new podcast, “The Digital Episode of Care with Bronwyn Spira of Force Therapeutics.”
  • The Journal of Psychopharmacology publishes an article on a study of comparative rates of delirium of various types of AHTs that used real-world data from TriNetX.
  • Vocera releases a new Caring Greatly Podcast, “Physician Suicide and the Impact of COVID-19 – Pamela Wible, MD.”

Blog Posts


Contacts

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

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News 7/10/20

July 9, 2020 News 7 Comments

Top News

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A Health Affairs blog post calls for ONC to start measuring the impact of the interoperability requirements of the 21st Century Cures Act, using these initial metrics:

  • The percentage of patients that can gain timely access to their common clinical data set information via an API.
  • Whether a given EHR vendor allows patients to write their personally generated data to their systems via an API, as well as the percentage of their provider customers that have enabled at least one of those APIs.
  • The percentage of care transitions and referrals in which a summary-of-care record was exchanged via API.
  • The number of third-party apps that can connect to each EHR, along with the number of apps that are actually being used by patients and providers.
  • The EHR vendor’s availability and provider’s use of an API that supports bulk data transfer.
  • The number of information blocking reports on ONC’s website by actor as well as the resulting determination of each complaint

Reader Comments

From Tele Say What?: “Re: telemedicine. The number of visits are dropping, which does not make sense after everyone said COVID experience would make it the standard.” It’s a good time to cynically remind everyone to follow the money since healthcare is not a consumer-driven or even a clinician-driven industry. Stacking up patients in a long hall of always-filled exam rooms is not only more efficient for the provider, it supports upselling opportunities that can’t happen over a video connection. Patients also feel shortchanged if their visit doesn’t result in a prescription or an order for lab or imaging, which presents telehealth with the classic last-mile problem. Yet another issue is that while coronavirus may have temporarily forced bricks-and-mortar providers to send patients to national telemedicine practices who have their own doctors, those providers aren’t about to permanently give up their brand identity and the recurring revenue stream that each patient represents. Buildings, people, and human contact are differentiators that keep patients happy and profitably captive. The pandemic has proven that healthcare, education, and work life can be temporarily shifted online out of necessity, but it has not proven that the virtual alternative is ideal or likely to be sustained.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor eSolutions. The Overland Park, KS company offers best-in-class Medicare and Multi-Payer revenue cycle management, workflow automation, and analytics that help providers get paid quickly and accurately. Its 1,000-plus hospital and health system customers see a 20% reduction in problematic claims in the first 30 days and a 22% reduction of days in A/R within six months. The company processes 164 million claims annually, connects directly to 5,500 payers, and completes 500 million eligibility transactions annually with the fastest response time. It has racked up a 95% customer retention rate over in its 20-year history. ESolutions just announced that its Medicare electronic submission of documentation tool supports CMS’s new requirement for obtaining prior authorization for five types of surgery in hospital outpatient departments. CEO Gerry McCarthy’s first job out of college was in health IT and he’s still here nearly 30 years later with an impressive track record of leadership and company success. Thanks to eSolutions for supporting HIStalk.

I asked some folks to help me put together a media kit for companies that are interested in sponsoring HIStalk and probably think twice after seeing the primitive one I unskillfully cobbled together years ago. There’s a link on the top menu.


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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Analytics vendor Health Catalyst will acquire Healthfinch, which automates physician EHR workflow. SEC filings indicate a purchase price of $40 million in cash and shares.

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Doctor on Demand raises $75 million in a Series D investment round that brings its total funding to $236 million.

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Truepill announces a $25 million funding round and the launch of an integrated telemedicine service that will leverage the company’s in-house EHR. The B2B online pharmacy powers fulfillment for brands like GoodRx, Nurx, and Hers.

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For-profit Cancer Treatment Centers of America, which operates five hospitals and five outpatient centers, is evaluating buyers who appear willing to acquire the company at a valuation exceeding $1 billion. Six potential bidders are involved, insiders say, and two of them are private equity firms that are teaming up with huge, not-for-profit health systems (that is certainly interesting). The company started out in 1988 by embracing an out-of-network model for out-of-state residents, but has moved to an in-network model with health system partnerships.

Scotland-based charge master and cost management systems vendor Craneware reports $71 million in annual sales, the same as last year even though revenue took a Q4 hit due to COVID-19’s effect on its US customers. EBITDA for the year was up $500,000 to $24.5 million.


Sales

  • Peninsula Regional Medical Center (MD) will implement tele-neurology software and services from SOC Telemed.
  • SCL Health (CO) selects patient access and provider data management software from Kyruus.
  • Philips signs a 10-year, $100 million contract with the VA to expand development of its Tele-Critical Care Program.

People

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Silver Cross Hospital (IL) promotes Teresa Andrea, MSHA, RN to VP/CIO.

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Bryan Humbarger (AliveCor) joins digital health vendor Eko as SVP, commercial.

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Appriss promotes Krishnan Sastry to president and CEO.

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The Chartis Group promotes Shawna Schueller to VP of practice operations.

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Michele Morton, MS, RN (SCIO Health Analytics) joins HealthMyne as chief marketing officer.

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Reimbursement software vendor Alpha II hires Todd Doze, MBA (TransUnion) as CEO.


Announcements and Implementations

The VA launches the Veterans Data Integration and Federation Enterprise Platform using HealthShare data aggregation software from InterSystems.

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After a pandemic-induced two-month delay, University Health System in San Antonio will go live on its $170 million Epic project this weekend.

Henry Schein Medical integrates its VisualDx clinical decision support system with Medpod’s telemedicine solutions, for which it is the exclusive distributor.

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KLAS looks at bidirectional interoperability between smart IV pumps sold by BD and ICU Medical and EHRs from Cerner and Epic. ICU has 26 organizations live on interoperability and offers strong project guidance, while BD’s 104 live organizations benefit from standardized implementation but don’t always get help with non-standard problems. Epic and Cerner users wish they would make smart pump interoperability a priority with more timely updates, better documentation and verification workflows, and actionable reports, with the sites that are happiest being those who use their own employees to drive improvements and write reports.


Government and Politics

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The VA issues an RFI for a robotic process automation tool that can help import external patient documents into its EHRs (both VistA now and Cerner later). The VA has suffered from a huge backlog of external documents since 2014, when veterans were allowed to seek care outside the VA and those external providers often provided only paper copies of the resulting patient records. The VA is looking for a system that can handle internal folders, email, fax, paper, electronic exchange, and API access to its referral management system.


COVID-19

It’s like COVID déjà vu from March, as the country’s many hotspots are one again reporting PPE shortages, lack of testing supplies, long delays in receiving test results, and lack of available ICU beds.

Arizona reported 4,000 cases and a shocking 35% test positivity rate as the US reported more than 60,000 new cases on Wednesday. Florida reported 9,000 new cases, a 19% test positivity rate, and 120 new deaths. Hospitalizations have more than doubled over the past four weeks in several states, including Texas with 4.8 times the previous number and excluding Florida, which does not report hospitalizations. Mississippi says five of the state’s largest hospitals, including University of Mississippi Medical Center, have no available ICU beds.

PPE shortages are forcing neurologists, cardiologists, and oncologists to leave their offices closed and their patients without care. AMA President Susan Bailey urges the White House to invoke the Defense Production Act for PPE and to develop a coordinated national strategy. Caregivers are being ordered to see COVID-19 patients even though no N-95 masks are available and a Houston hospital has told its doctors to reuse single-use masks for up to 15 days.

Sacramento County, CA closes five COVID-19 testing sites because they can’t get basic test supplies. They’ve asked Quest Diagnostics for help, but the company says it is already at capacity. The county says that’s OK anyway since it’s taking 8-9 days to get results back from tests that are perform several days into the suspected illness, making testing pointless – someone with a known positive result would be quarantined for just 14 days, meaning they would complete their isolation (assuming they do it) before seeing their results.

Vice-President Pence says CDC it will soften its just-published school opening guidelines after President Trump scolded CDC on Twitter for being too tough, then threatened to cut off funding for schools that don’t reopen by fall. CDC Director Robert Redfield, MD later clarified, however, that CDC won’t change the recommendations, but instead will provide additional guidance.


Other

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We should do this in the US. Volunteers at Glasgow, Scotland’s 50-year-old, donation-supported charity Hospital Broadcasting Service work from home 24 hours per day playing music, offering friendly talk, and dedicating songs to patients that they or their love ones have requested by text message or email. Listen live and you might hear some surprisingly contemporary music as I did. On-demand video streaming, podcasts, and generic satellite radio leave me feeling disconnected with the world, which is nice sometimes but not always, and it must be worse when confined alone in a hospital bed with too much time to assume the worst.


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  • Kyruus obtains recognition from Avia for its enterprise-wide patient access platform.
  • Wolters Kluwer Health announces that Clinical Effectiveness CEO Denise Basow, MD has been ranked among the Top 25 Women Leaders in Healthcare Software of 2020.

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Reader Comments

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