News 3/13/20

Top News

A New York Times article says the use of telemedicine in COVID-19 screening and treatment is increasing.

Use of virtual visits keeps people out of the ED or medical practice waiting rooms who are either exhibiting symptoms or who are susceptible to infection.

Upfront triage also minimizes the exposure of healthcare workers and the quarantine that would result.

NYU Langone Health is encouraging its self-quarantined doctors to continue their work by offering virtual visits, while Intermountain Healthcare is considering delivering virtual care for patients who have COVID-19 and chronic medical conditions and can be safely treated at home in avoiding the exposure of traveling nurses who could spread the infection.

Reader Comments

From Andre: “Re: COVID-19. Our pediatrician’s practice has temporarily disabled appointment checking via MyChart, apparently since adding screening questions isn’t easy.” It will be a struggle to convince practices and their patients that medical office visits create risk for staff and fellow patients. This particular practice also invites patients to call in when they arrive in the parking lot, then wait for a call back to proceed directly to the exam room to avoid potential waiting room exposure.

From Jeebo: “Re: MIPS filing deadline. Have you heard anything about possible extensions?” I haven’t, but I don’t follow it as thoroughly as Dr. Jayne and others, so I will invite reader comments.

From Mitchell: “Re: Loews Hotels. Has decided not to give any refunds for HIMSS20. Seems like they are the only ones.”

From Airman: “Re: travel. Dulles is a graveyard, all international flights cancelled and business travelers on the sideline. The hotel was one-third full, restaurants were empty. It feels like 9/11 60 days out. We are headed for a major recession from what I have seen. I took this photo at 4:40 p.m., probably the busiest time of day under normal circumstances.” Layoffs have already started in all travel-dependent sectors and I’m sure restaurants and retail businesses will take a major hit as people stay home. The compound effect that in our screwy US healthcare non-system, all those folks will lose their health insurance (if they were even offered it or were able to afford it in the first place) and any diagnosis and treatment they require for COVID-19 or anything else is going to strain their own finances and the system in general. We had better keep delivery drivers for Amazon and grocery delivery services healthy since they may be our most valuable lifeline. We will have learned many hard lessons once this outbreak winds down, but some of them are for the long-term good.

From Corey Spears: “Re: ONC’s rule. Since it is waiting for final formatting, I took the liberty of creating a bookmarked version, which is much easier to navigate since there are so many internal references.” Thanks. That makes it much easier to find items other than by searching.

From Life at Veeva: “Re: working from home. My company, Veeva, is good at accommodating remote work, but also created this video to help employees who ordinarily work in our corporate offices.” The five-minute video is packed with a lot of good information, much of it instructions for those who are new to the Zoom videoconferencing app.

HIStalk Announcements and Requests

I’m pondering whether we’ll have a future shortage of asterisks needed to explain 2020 sports records that involved shortened seasons and cancelled tournaments.

Webinars

March 25 (Wednesday) 1 ET: “Streamlining Your Surgical Workflows for Better Financial Outcomes.” Sponsor: Intelligent Medical Objects. Presenters: David Bocanegra, RN, nurse informaticist, IMO; Alex Dawson, product manager, IMO. Health systems that struggle with coordinating operating rooms and scheduling surgeries can increase their profitability with tools that allow for optimal reimbursement. This webinar will identify practices to optimize OR workflows and provider reimbursement, discuss how changes to perioperative management of procedures can support increased profitability, and explore factors that can impede perioperative workflow practices.

March 26 (Thursday) 12:30 ET. “How to Use Automation to Reduce ‘My EHR is Slow’ Complaints.” Sponsor: Goliath Technologies. A common challenge is that a clinician is ready to work, but their technology is not. EHRs can be slow, logins not working, or printers and scanners are offline. Troubleshooting these end user tickets quickly is nearly impossible, especially in complex environments that might include Citrix or VMware Horizon. This webinar will present real-world examples of how leading health systems are using purpose-built technology with embedded automation and intelligence to proactively anticipate, troubleshoot, and prevent end user performance issue across their IT infrastructure and EHRs.

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

Acquisitions, Funding, Business, and Stock

Health IT and consulting company Emids announces an undisclosed investment from BlueCross BlueShield Venture Partners. The Nashville-based company was acquired by New Mountain Capital last September.

Amazon Care considers working with the Bill & Melinda Gates Foundation to deliver COVID-19 home testing kits in Seattle. Amazon has offered to come up with a logistics plan for delivery, free of charge, so that kits can be delivered within a few hours. Nose swabs in the kits would then be mailed to the University of Washington for analysis.

B.Well Connected Health raises $16 million in a Series A funding round, increasing its total to $27 million. The company offers employees of subscribing companies a personal health record that is connected to hospitals, pharmacies, lab companies, and insurers; a gamified health journey; and a digital wallet for health expenses. CEO Kristen Valdes founded the company in 2015 after several years at disease management company XLHealth, which was acquired by UnitedHealthcare for $2.4 billion.

Virtual cardiovascular care management solution vendor Heartbeat Health raises $8.2 million in a Series A funding round.

From Cerner’s investment community meeting:

• HealthIntent clients have been migrated to Amazon Web Services and Cerner-hosted CareAware customers will be migrated by the end of the year.
• 90% of the company’s total revenue is recurring or highly visible.
• Cerner expects its Works business to decline as a percent of revenues.
• Core revenue growth will decline slightly due to EHR client attrition, but that will be partially offset by global and revenue cycle.
• The company sees opportunity in the 30% of the market that runs non-current systems, most of them hospitals of greater than 200 beds.
• Soarian and Millennium assets will be combined to form a revenue cycle offering and will be accessible via APIs, with about 18 months remaining on the three-year project.
• Cerner sees three markets for data: life sciences, release of information, and payers. It says the EHR data it holds for provider clients represents one of the largest data assets in the world.
• Mass tort lawsuits that require retrieving the medical records of thousands or millions of people have resulted in Cerner signing 65 law firms as clients for its HealthHistory business, which it says grew 30-40 times its revenue in one year.
• HealtheIntent contains data from non-Millennium environments and has the advantage of refreshing itself every 17 seconds in the cloud.
• Regional IDNs and community hospitals can make money participating in clinical trials, which isn’t a strong suit of Epic since it has mostly academic medical center clients. 
• The company suggested that it will make acquisitions in the real-world evidence area.
• Cerner has not yet seen a reduction in project activity due to COVID-19 and says it’s possible that demand for its services will increase.
• The company says it is “incredibly disappointing” to lose customers to Epic, which is why creating a client success office was important. Those customers also will continue to run Cerner’s EHR for several years and will continue to use platforms such as HealthIntent and CareAware.

People

Medical University of South Carolina hires Mark McMath, MBA (Methodist Le Bonheur Health) as enterprise CIO for information solutions.

Announcements and Implementations

United Community & Family Services (CT) transitions to Epic from Greenway Health’s Prime Suite.

HIE-focused nonprofit The Health Collaborative selects Omni-HealthData’s cloud and analytics solutions.

Privacy and Security

Hackers lure employees at several unnamed companies into opening emails purportedly from Vanderbilt University Medical Center (TN) that claim to have HIV test results in an attached file, which, when opened, prompts the recipient to download malicious software. Hackers have also engineered similar phishing campaigns that prey on COVID-19 fears, referencing CDC guidelines and safety measures.

An analysis of 1.2 million Internet-connected devices in hospitals finds that 83% run on outdated software, including Windows 7 and Windows XP.

Other

An opinion piece written by two Duke informaticists says that EHRs are ill suited for the COVID-19 pandemic due to poor information presentation, complexity that causes users to delay applying much-needed updates for months, and lack of public health reporting. They recommend that hospitals:

1. Review their business continuity plan.
2. Prioritize clinical system patch updates and enforce change control policies.
3. Heighten cybersecurity vigilance.
4. Deploy mobile apps that extend EHR capability to improve productivity and to guide management of COVID-19 patients.
5. Use scribes to increase clinician efficiency.

England’s NHS ramps up efforts to offer more COVID-19 care through online consultations, given that only half of practices have telemedicine capabilities. The health service has also launched a care management service with digital-first capabilities for patients in self-quarantine, and has increased testing capabilities from 1,500 patients a day to 10,000.

The local news highlights the role the Avera ECare telemedicine network is playing in caring for COVID-19 patients virtually at 190 hospitals and 66 nursing homes across the country, particularly those in rural areas. Ten additional hospitals will go live with ECare’s services in the coming weeks.

Chilmark Research is soliciting information from companies that are offering free COVID-19 related health IT solutions.

The Onion sets the record straight on coronavirus.

Sponsor Updates

• Provider data management software vendor Phynd reports a record year, adding six new health system customers in Q4 2019.
• PatientPing launches an educational website dedicated to CMS’s interoperability and patient access rule.
• Intelligent Medical Objects releases retrospective business updates.
• Elsevier Clinical Solutions upgrades its ProspectoRx website.
• Optimum Healthcare IT publishes a case study titled “Decentralized Epic Go-Live Success at Scripps Health.”
• Ensocare Business Intelligence Engineer Matt Tweedy earns the Bob Cassling Service Excellence Award from parent company CQuence Health Group.
• EPSi Associate Consultant Zac Steele joins the 2020 Millenial Cohort of the American Enterprise Institute’s Leadership Network.
• CloudWave makes its disaster recovery solution available on Amazon Web Services.
• Masimo will integrate Imprivata’s medical device access authentication technology into its Root and Iris hospital automation platform.
• DataRobot and InterSystems partner to accelerate adoption of AI in healthcare.
• CarePort Health supports CMS’ expanded commitment to care coordination in interoperability rule.

Blog Posts

• Back to the Basics: Patient Engagement (EClinicalWorks)
• Are Your Remote Workers Working? (Goliath Technologies)
• HC-Tec COVID-19 Update (HCTec)
• What do you say to change? Bring it on. (Hyland)
• Did You Know You Can Have Clean, Current and Complete Data with the Imat Platform? (Imat Solutions)
• Four Steps to Enhancing Organization Effectiveness Through Your Analytics Strategy (Impact Advisors)
• Federal interoperability and information blocking rules finalized (Intelligent Medical Objects)

Contacts

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

Working from Home Tips from HIStalk Readers – Avoiding Feeling Disconnected

Our company uses the Google suite, so we have instant messaging. But we also have buildings in multiple states and people that work in different buildings that need to work together, so it doesn’t really matter to me if you’re in the building a town away, another state, or home.

Communicate with colleagues via MS Teams, Outlook and phone.

ideo conference, chats, texts.

Talk on the phone vs. sending an email. Once an email thread gets beyond 3-4 responses, take the conversation out of email and schedule a 15-20 minute phone conference. This will expedite problem resolution and connect you with your peers more often!

Make all of the company web meetings you can. I’m one the few who seems ok with web cam, but even without this join and talk.

My team has a group chat on Teams that is very active and we also meet frequently on webex which keeps me connected at work.

Our team does a good job of using email to communicate ongoing issues. We use this method even when in the office, since a few team members are always out of the office traveling to clients.

Lots of phone calls. Some video conferencing. My kids are grown, so I do have to make an effort to go places. I power walk every day at the end of my day, that’s solitary too. And to everyone who says work from home is less productive, this is not my experience. I closed my brick and mirror office six years ago and I often have to log in and tell my employees to log off and go do life. We only have had one who took advantage. She was fired via video, that’s was a little weird. And I had FedEx pick up her assets.

Conference calls aren’t suited well for small talk. Take 3-5 minutes at start of small calls to just check-in about life. After being remote 10+ years, I have found this to make me feel more connected, and the calls are ultimately more productive because you feel connected.

Keep Slack and Zoom online and randomly video call colleagues to check in and discuss instead of using email.

More consciously leveraged the video capabilities through webex.

Lots of phone calls! Go outside for lunch.

Enjoy the bliss of solitude!

By talking on the phone with folks. I have never been a fan of texting, I prefer a quick phone call and human voice, when possible. I also use MS Teams for chat with some of my closer team members. I also like to just call to check in and say hi once in a while, see how life is, even if I don’t need anything for work. Just like you would if in the office at a water cooler. Our team also meets for happy hour or lunch about once a quarter, sometimes more often.

It really is impossible to replace the water cooler, but you can make an effort to stay involved. If I have the time, I will more often now pick up the phone and call someone when I have a question instead of emailing because it increases the odds we will chit chat for a couple of minutes which helps me to feel more connected. Additionally, we use our cameras when we have internal meetings to help with the face to face feel. And, I schedule morning coffee with a couple of co-workers who also get to work early. Before our days start to get busy, we turn on our cameras, drink coffee, and chat like we would do in the office – mixing work and personal life into our conversations.

Conference calls scheduled at regular intervals. Avoiding breaks in between that are too small to accomplish much. I prefer a few back-to-back meetings, with larger focus blocks (an hour or longer) where I can knock out larger tasks / follow-ups without being interrupted.

I feel connected. I have trouble disconnecting from work when I am working from home. I have to leave my space and close the door to get away from work at the end of the work day in order to disconnect.

Instant Messaging. It’s up 100% of the time I’m online and helps not only with communication, but also in keeping me accountable for being at my desk instead of doing laundry, etc. Also, scheduling lunch dates with friends to get me out of the house.

We use Slack collaboration software corporate wide to ensure everyone stays connected and have some “fun” Slack rooms in addition to work focused rooms. We pay attention to who is using this tool. If someone isn’t, we find out why quickly. It’s actually a part of our quarterly reviews. We also have multiple meetings a week using video conferencing. Twice a week with the entire team. That being said, we have experienced that some folks simply do not do well long term working remotely. Managers suddenly finding themselves managing new work from home employees due to Coronavirus should be aware this can be tough for some beyond the first week, and watch for signs of disengagement.

It is difficult because you are disconnected. Setting up regular video calls with colleagues, much the same as you would at the office. allow yourself to be interrupted by calls (Zoom is particularly good for this when talking to colleagues). If you live alone, get  o the coffee shop with your laptop or pad for an hour or so each day; go for a walk; just don’t sit in the house all day every day. I also talk to myself quite a lot – but that maybe something else altogether!

Jabber/IM coworkers.

Schedule video meetings. At least one. Think of it less as a “meeting” and more of a “staying connected.” Be more deliberate about the midday, not-work time you have at work. You still need that at home, too.

Jabber, Skype, MS Teams, my phone, and email. Lots of interaction with my client and/or company.

Some tips specifically for managers/leaders. Schedule more one-on-one meetings with your team members than you would usually have – like short (10 minute) check-ins every day or every other day – to take the place of them being able to stop by your desk or stop you in the hall with a question. Even if you are “available” via Slack or email, you will need to be more proactive about communication. All the advice about “don’t just sit around in your pajamas!” goes triple for people in leadership positions. Be able (in terms of your workspace and attire) to hop on a quick video call with your team at any point throughout the day – don’t fall into the trap of waiting until a scheduled call to pull yourself together. It will help maintain a sense of normalcy if you maintain your typical level of professionalism.

Social/catch up discussions as part of the meetings, i.e. be sure to avoid diving right into the meeting agenda before some personal discussions, to establish a sense of camaraderie.

Video-conferencing and phone calls over email as communication tools.

Chat is a good way to get in quick conversations and smiles with other remote employees. We also have an awesome internal forum called Remotely Interesting, that is geared to all remote employees. Keeps people connected with pictures of pets, daily routines, thoughts of the day, and podcasts.

Get out of the house when you can. The gym is my favorite, but with the virus going around, that’s getting harder. Walking around the neighborhood helps.

This is less of an issue for introverts ;). Use chat programs for quick questions that you would normally walk over to people’s desk for. The biggest issue I’ve seen having worked from home extensively in my past is that there are a number of managers who don’t know how to manage remote employees. Managers need to set clear expectations on what work needs to get done and by when and then trust employees to do that work without micromanaging. Have a daily check-in for the department scheduled if this is something new for you (a la a stand up in the Agile Methodology). Get a good sense of what each employee’s “blockers” are that they need resolved before they can move their work forward and work on resolving those quickly. As an employee, figure out what your own blockers are first thing in the morning after figuring out what you need to do that day and voice those items to people who can help resolve them.

Review internal websites for company updates. Listen to the radio to hear another human’s voice. Call into meetings. Video can feel awkward if the other end is not doing it, but suggest it anyway.

I try to see local teammates for lunch when possible. I try to allow time for chit chat with colleagues to keep a human element alive in our interactions.

Video chat with colleagues I’m working on projects with rather than just messaging. Also, step out of the house and work from a public space or coffee shop at least once a week if you can.

Skype and call folks on site during the day. For no reason, just to say hi or how about that Netflix show. Have coffee or lunch out with anyone at least once or twice during the week.

Use the telephone and actually make calls. IM or email enhances the disconnect. My thought is if I would have talked to them in person at work I will make an actual phone call.

To not feel disconnected from colleagues, have a “webcam always on” rule for meetings. Outside of work, you have to be more deliberate about planning. If you see an event like candle making or craft beer night that interests you, reach out to friends and invite them. Set up a standing happy hour or a night once a week where you and a couple friends rotate on who cooks and hosts. If you’re really social, go to a co-working space.

It is good to try to have your team online during a similar block of time so Instant Messaging and team meetings can keep everyone connected.

I have not found that to be a problem. My company has a large percentage of WAH employees. Either via Slack, text message, phone, or conference call, I usually speak to a couple of dozen people daily. However, I recognize that I could be the exception that does not need a lot of interactions to feel connected. I also recognize that I waste less time working from home. All of the hallway, lunchroom, water cooler chit-chat is minimized making for a much more productive day of work.

Fortunately my role has me on the phone with people all day long. I also use our internal “inmail” to touch base with my team mates and other friends in the company. However I set it on busy or do not disturb for at least two sets of two hours so I’m undisturbed.

I chat other coworkers throughout the day, hold weekly meetings with team members, and interact with others via Facebook and Twitter.

Text with colleagues… send appropriate memes. When in doubt, ask if you can have a call. I don’t find that I am any more connected with a web / video meeting” vs. phone call. Also, I like to take advantage of going for a walk in the community.

Of course it depends what you job is, but email and messaging should allow you to keep up and contribute. Texting if it is a normal activity already.

Chat with colleagues – make sore to have “adult” discussions. Maybe schedule a team meeting just to touch base.

Frequent online team meetings and a direct phone application the receives and makes phone calls that appear to originate at my office. In most cases, people I interact with don’t know or realize that I’m not in my office.

Mandate that all participants in any remote meeting have their cameras on – no excuses. This makes sure everyone comes to work in as professional a manner as they would when they come to the office.

Videoconferencing for most of my calls, lots of chat messaging throughout the day. And real person-to-person interaction – run out to get lunch at least a couple days a week to see some other humans.

I don’t. I am actually more comfortable this way. But I also spend time chatting with friends and family via the phone (remember, you can still just talk to people on them!), FaceTime / Skype, and through email and text. I’ve had some friends that were doing “digital happy hour” where they would all pour a drink (or four), get on a multi-person web conference, and just hang out. I hated it and stopped, but they’ve been doing it a few times a week for years now. Seems that they enjoy it. Use the extra time in your day (you’ll have it, I promise) to come up with something relevant to your work that actually improves connection to co-workers. Something specific. I’ve never been a “status update” person on my work, but since I’ve been home, I do it every day, and so does my entire team. It’s a cool form, it opens up discussion, it has room for non-important updates, which are usually filled with anecdotes, stories, jokes, etc. to make the others feel a bit more connected. But when we share them with each other, it does provide a bit of the Monday morning water cooler like connection to my colleagues.

Email, video capabilities within MS Teams, RingCentral or webex work well too. Take a break and hit the coffee shop or telecommute from a Starbucks of DD for an hour or two.

Requesting that people turn on video for web meetings feels much more connected than voice only. Scheduling more daily video check-ins to take the place of impromptu office chats. Go for a walk in your neighborhood and work with the windows open (weather permitting) so that you have less of a feeling of being locked away in a bunker.

Working from Home Tips from HIStalk Readers – Daily Routine

I try to sign in early and usually don’t end up taking a formal lunch. Working from home gives you the flexibility to do a little bit of everything, so be flexible. I get up and walk around, take the dogs for a walk, get some fresh air, and then crank out a project. It is very easy to start going stir crazy, especially if you’ve been on the couch for eight hours. I wake up, take a shower, grab a snack, and start working. When I need to, I take a break, run to the store, whatever. I get all work emails / notices to my cell as well, so it gives me some freedom. As long as I can get to a computer if needed, I can take care of any tasks that are needed.

Get up about the same time as usual. Follow usual morning routine. Start work at usual time. Take my usual lunch break. Work through the afternoon but take a walk in mid-afternoon. Stop working at usual time. Do not watch TV except the 30 minute noon news during lunch.

Work like crazy from dawn until mid morning, take some time to exercise on the elliptical or treadmill or outdoors, gather some nourishment, then do some household chores. Finish the day off with a flurry from 4-9.

Always, I mean ALWAYS put on shoes and a collared shirt. Make sure you’re in the mindset to work. Sweatpants doesn’t do this.

Wake up as if you are going into the office. Take a shower, dress in halfway decent clothes ,and be “in the office” early. Take a break for lunch, as usual, and work until the time you would arrive home if you are commuting. Think of the added productivity if you reduce your “commute” from, say, 30 minutes to 30 seconds!

830-5 every day.

I start work a bit earlier when working at home due to no commute, but otherwise follow the same general patterns I do at work.

I try to follow the same daily routine as if I am working in the office.

I’ve been doing this for seven years now. I get up and take a glance at IM and email just to make sure nothing urgent popped up overnight. I get dressed and actually prepare as it I might have to leave the house. I’m not in work clothes but I do style my hair. It just mentally changes my game.

Start and end at the same time. Make it clear to family and friends you are working and not to be interrupted

Wake up early, leave the house for a workout. Then get a cup of hot tea and triage messages, get a fruit-veggie smoothie and some breakfast and start highest acuity calls for the day. Take a mid-to-late afternoon break to take a walk and get away from the desk to help with transition away from work. After an evening with the family, occasionally get back online to finish anything up for the day.

Same as work. Keep the same times. Take a few more breaks since you work for a longer period of time.

Before working remotely, I’d average around 3,000-5,000 steps from being at work. After going remote, that went down to 500. I’ve had to force myself to get up such as taking some conference calls while pacing. I’ve also taken the time I used to commute and force myself to get up at the same time and exercise.

Make sure you get up and get ready for work, put on clothes, do your hair, etc.

Most important tip: don’t get sucked into doing the dishes, making shortbread, making pickles, etc.! Unless you are a chef, the kitchen is where dreams go to die.

Get up, get the kids ready for school, they are out the door at 7:35 a.m. Then I wash my face, brush my teeth, and drink a glass of cold water. Then I check my emails, LinkedIn, HIStalk, local newspaper. Around 9 a.m. I make breakfast and get back to work. To be honest, some days are so busy that I miss lunch, but usually I make a sandwich or a Trader Joe’s frozen meal. Kids get home at 3 p.m., greet them and make snacks. Back to work until 5 p.m.-ish.

When I work from home I get to work early, trading in my commute time for work time. This allows me to get off earlier, which I love. Same as when I am in the office, I start my day with coffee and email catch-up. I try to take short breaks to walk around the house for a few minutes every couple of hours in between meetings since I naturally sit more at home than when I am in the office. Since I am not eating lunch with co-workers, I will instead use the time to either take a walk or make a phone call to a friend or family member that I have put off.

I like to exercise first thing, then shower, make a real breakfast / coffee, etc. As close to my usual non-working-from-home-routine as possible. I stay in comfortable clothes, but change out of what I would sleep in, to help with the mindset / transition to focusing on work. I like to listen to the news (NPR or podcasts) while I make/ and at my breakfast to simulate a commute / transition to focusing on my day.

Dress differently, but email first when I am at my office or at my desk. I do get up to pet the dogs routinely when I am home.

Keeping office hours is key for me so my day stays on track, but also so I can take guilt-free breaks and my friends / family know when I’m available.

We require that our home-based employees work a predictable schedule that is worked out with their manager. We have multiple interactions each day with fellow team members.

Work from home, don’t live at work. You will find that you have much more time available. Tasks take less time to complete when distractions are reduced. Try to avoid the temptation of getting directly out of bed and sitting at your desk. Try to maintain personal spaces in your time that allow for breaks. It is not unusual for me to take a complete break during the day and go and do something quite different – shopping, cooking, reading, even watching sport – for an hour or so brings you back to your work refreshed.

After morning routine of getting kids to school, come home, put a load of laundry in the washer, prep my lunch, and sign on a few minutes before 8 a.m. I use productivity timers to build in breaks during the morning where I make tea, refill my water, or change over the laundry. If the weather is nice, I take a half-hour lunch, eat, and take the dog for a quick walk. After signing back on, I work through the rest of the day, taking a few breaks along the way. When I sign off at 4:30, I make notes for the next morning and shut down, including closing the door to the office so I’m not tempted to work on something later in the evening.

Treat every day like you’re going into work. Get dressed. Shower. Eat breakfast. Fix your hair. Do not get distracted by the house stuff you couldn’t do if you were at work. This is especially going to be true if the kids get stay-at-home orders from school If you’re used to a regular commute, make sure you treat that as “not at work time.” You can use that new found time to do the other things if you want.

I set an alarm and get up the same time every day. Either go to the Y or walk outside. Take a shower and get dressed when I get back. Getting dressed is key! I eat lunch and breakfast at my desk. If I don’t go for a walk in the morning, then sometimes I will take one during the day, if weather allows. I try to leave my desk and walk around the house at least every hour.

Following “normal” work hour schedule, and avoid working at all hours, since doing so implies that you’re available 24/7 and clients/co-workers begin to expect that. The biggest disadvantage of working from home is that you can’t socialize / connect with co-workers since you’re not just running into them in the hallway. Scheduling some catch up /social chatter time is always good during the phone calls, to ensure you’re in the know about the happenings that may be taking place while you’re remote.

I wake up at 6 a.m., do yoga / meditation, shower, and dress in business casual. Although it might be tempted to wear sweats at home, I’ve found that dressing professionally really helps get me in the correct headspace for work. I go to my home workspace and log in at 8.

Morning coffee, catch up on HIStalk, plan the day and hope to stick to the agenda!

Start work as soon as you can in them morning. It’s easy to fall in the habit of lounging around. And make sure you get walks outside. I aim for once in the morning and once at lunch. It’s easy to forget taking breaks and to get up and move.

Schedule times to get up and do something besides be at your computer. It’s not cheating on work; you’ll be more productive this way.

Follow the same morning routine – exercise / shower / etc. Get dressed. Don’t try to work in your PJs. It won’t work well for you. Stop promptly at the end of your day. Since you’re in the same physical space, it’s important to have that distinction.

I am not a good example! My goal is to shower by the time my husband gets home. One thing I do is prep dinner ingredients in the late afternoon to get a break from the desk and do something for me/family. I rarely eat at my desk so that I break up the day.

I schlep to work in my jammies with coffee in hand and shower at lunch time. Leave work on time and go walk the dogs! Cook for your family. You’re home! enjoy it.

I have the same routines if home or at the office.

Grab food and water and get to my computer ~5 min before my first meeting (8:30 a.m.) After the meeting, clean up from breakfast, stretch, and do any administrivia tasks while my mind wakes up. I block off after the morning meeting until lunch for my mind intensive work because I’m more awake and less likely to be distracted. On lunch, I mute all computer notifications and step away for an hour to eat, go on a walk, and clean up a bit. Post lunch I do less mind intensive things because I can’t concentrate as well. At the end of the day, I plan out what I’ll do the next day, clean up my work area and prep it for the next day (refill humidifier, clear off desk, set out anything I know I’ll use), and then I mute notifications and put my computer away. The most important part of the routine is to make yourself unavailable outside of normal working hours. This doesn’t mean turn your phone all the way off – you need a way to contact you – but you shouldn’t be checking your email / Slack notifications / work board. Set the boundaries between work and home or you’ll always feel stressed because you’re always “on.”

Try to keep the same business hour schedule as the rest of your team / company.

Wake up at 5:00. Go to the gym. Shower, breakfast, morning news. At my desk by 8:00. Work mostly all day, with no formal lunch break. Fruit and healthy grazing through the day. Workday is finished by 4:30-5:00. The biggest lesson for me was that it is important to have your workday start and stop. If you are not precise with that, your work and personal lives can get inextricably intertwined to the detriment of others in the home.

My office is upstairs, so every morning I take my purse and coffee upstairs as if I’m mentally going to work. I work from 8 a.m.- 12 noon, take one hour for lunch and do not eat at my desk – I go downstairs. I come back up promptly at 1 p.m. and then finish out my day at ~5:30 p.m. I also turn off my email notification so I’m not distracted.

Getting ready like it is a usual day is HIGHLY RECOMMENDED. You don’t have to wear the best clothes, but look presentable. If you don’t, you run the risk of unexpected web / video conferences popping up and you are not looking the part. It also helps set a defining cadence just like you’d have in the office so you can more easily shut down when it is time.

Try to keep regimented; defined start / stop times

Get up, take a shower, get coffee and then go into “office.” Don’t plan to get other home tasks done during working hours.

Almost identical to my in-office routine, with the exception of no commute time.

Treat as normal work day. Take a lunch break or eat at your desk.

Same as you would with the office. Don’t break that routine – get up, prepare, and “go to work.” If your commute is longer, perhaps listen to the same radio show or podcast for the same time period. If it makes you feel better, dress the same, but I can honestly say this is the least regimented thing I stick to. Don’t stay in pajamas though — that will end badly for motivation.

Be disciplined – always create a to-do list and check things off as you go. This is even more important remotely than at the office.

In at 8 a.m. with coffee. Respond to priority emails first (I’m always checking email on my phone outside of work hours). Try to clean up my inbox as much as possible before jumping into calls. Before the end of the day, review what’s planned for the next day or two to make sure I’m prepped as needed. I’ve been working from home for almost 21 years and can’t imagine going back to an office.

Drop the kids off at daycare then come back and pour a cup of coffee, review my Outlook calendar and tasks for the day, catch up on the industry headlines, and then dive into work..

It’s as if I go to work each day, but my commute is a walk down the hall to a spare bedroom. I work only once I have taken care of my personal needs (shower, dress, eat, etc.). I take four complete breaks a day, including lunch. When I end my day, I formally end my day and do my best to disconnect from work, even if I am still playing on my computer. I actually invested in a ‘home’ computer so I can actually not feel compelled to log into anything when I am surfing, streaming, or gaming.

Get up and shower and dress casual but keep the same routine as if you were going to work. Don’t take calls in PJs.

Set a daily schedule of items to do. Take frequent breaks to get up, walk around, and go outside. Stick to my schedule, and when the day is done, close my computer and walk away. I try to think of my office space the same as a cubicle.

Working from Home Tips from HIStalk Readers – Software

Our company uses MS 365 plus a VPN for remote work. Our phone system is a ShoreTel VOIP solution. We cannot use personal systems for work.

Only that well-behaved software that can be used natively in a browser. Everything else has some idiosyncrasy. Leads to shouts of “It dropped me again.”

Whatever you use at the office. Don’t get fancy.

Skype.

Any web conference tool, favorite is Slack.

Webex works fine for meetings. ShareDrive + Teams for collaboration.

We use the same software that we use when working in the office. Only difference is a VPN connection into the office network.

We use 8×8 VOIP phones which includes IM and videoconference Internally. Externally we use GoTo products for accessing customers remotely.

Zoom is hands-down the only platform that never fails, is intuitive, and quick to get started.

My company uses Zoom for meetings. It works pretty well. We also VPN into our network.

Very enterprise specific. We use Virtual Desktops, so a remote user gets the same “computer” they have a work.

WebEx, secure text messaging,

My company recently switched to Microsoft Teams which, for me, is a must to keep in contact with my co-workers. However, it lacks some of the functionality needed for client meetings, so for those I stick with WebEx.

For our remote workforce, we use Citrix and VPN to provide remote access to all of our applications, both on premise and in the cloud. We use Okta for two-factor authentication. We use Zoom for video conferencing, and we typically supply staff with laptops and tablets with camera, audio, and some sort of headset. Those of us that use personal devices still use the same software to engage. We use Jabber for chat, but moving to a new platform for unified communications that will support mobile workers securely no matter where they are. (Dr. First Backline with RingCentral WIFI calling for clinical staff at the bedded facilities).

Slack or similar company wide collaboration software. We use Google Suite because it is easy to share / edit documents from anywhere, while still maintaining the proper permissions. And we have a Confluence based company wiki that is a key part of how we share information. We just created a Coronavirus Information page for all employees.

I use Office365 with all work files in Dropbox plus local external backup and additional cloud backup (loss of files is a disaster). The fastest bandwidth available also helps – I am fortunate to have Gigabit optical via FIOS. Meeting software is Zoom although I connect to whatever the other participants use. Most external meetings are done without video. A headset makes a huge difference.

Jabber or other instant messaging program for quick communication. Confluence for maintaining single location for file access.

Zoom. And any of the many online document collaboration systems (OneDrive or Google Docs). You have to start thinking outside the local computer and local network. Starting working on things in shared locations.

Video conference apps/software are extremely useful to feel more connected to colleagues and supervisors – I’ve used Skype, MS Teams, Zoom, and Webex, but I think Google offers something like these also.

The laptop from the client is already well outfitted. I add Toggl for timekeeping.

Zoom for meetings (less distracting in my opinion than Google meets since you can see everyone at once). If you work late, use f.lux to help your eyesight. Slack for communication (you can do a free trial).

Microsoft Office suite is my go to. Jabber for IM and phone.

Test the VPN / remote access software and web meeting software in advance of having a collaboration session. Some organizations do not have the bandwidth or licensing for all the potential remote access sessions, so be aware and have contingency plans (e.g., direct calling, call trees, sending documents in advance, use of other forms of web collaboration like Office 365). Stick with the software used by your employer that is supported and secured. You don’t want to break policy and place your company, customers, and self at risk.

The list of software I use is extensive, a blended set of local, enterprise and cloud-based applications. I also us a cobbled together unified communications system based on Microsoft.

Zoom, BlueJeans, Skype, Facetime.

Zoom – over any other web conference software.

We use MS Teams. Some of us use the video option and some of us (me and the majority of my teammates) don’t. Chrome browser.

Microsoft Teams is essential to staying connected and collaborating with my coworkers.

We use Zoom for conferences, Slack for communication, BaseCamp for project management.

Zoom and Skype for business are great for keeping in touch with your team.

Working from Home Tips from HIStalk Readers – Environment

Multiple monitors are essential and a quiet secluded space. Natural light is preferred, but supplemental ambient lighting can help. A good chair is helpful.

Lighting: natural light is best but use what you can so as not to diminish what you can see. Music: I find Jazz is best for a rationale rhythm.

Give yourself an office with a window if possible.

Separate desk location is key vs. working from kitchen table with lots of distractions. No music or TV…gotta focus!

Open desk area, lots of natural light.

I work at my kitchen table by a window which offers plenty of natural light. I listen to music when not on calls. I work in a hoodie when not on video sessions with clients.

A separate space dedicated for work. Be it a home office, or a temporary space setup to accommodate. I have found that working from the couch or recliner does not lead to me being as productive than working from a dedicated space.

Separate space, mutable phones if you have dogs or kids, conference calls can be challenging. But everyone usually pretty great about it. I have music streaming kind of low or NPR. something about the low murmur of other voices keeps me focused. Desk location is huge. I personally need to see outside so windows matter to me.

Create your own space in your house or apartment. A good spot is away from the kitchen!

An environment with natural light, perhaps by a window where you can see life outside. Make sure that if you’re taking video calls that you have good front-lighting and there is nothing crazy behind you; some people have desks that are extremely distracting and messy.

Set up an office-like experience. Have a desk and workstation away from traffic. Don’t sit on the couch or have the TV on. Use Webex or other conferencing software for meetings.

Know yourself. I need quiet, so I carve out dedicated space away from foot traffic and distractions. My wife also works from home and is productive with background television and radio.

Somewhere quiet at home. Having a desk at home works best. Avoid couch, kitchen table, etc.

Music is OK for some tasks, discouraged for others. For focused working, music without lyrics is best: Henri Texier is a favourite, also Pat Metheny, Herbie Hancock, Ahmad Jamal.

I have been working from home almost 100% for seven years now. Best environment for me is at my desk next to a large window. Sunlight lamp on (I live in the PNW). I don’t listen to a lot of music during the work day because I am on the phone a lot. I think a Bluetooth headset / earpiece is essential to being hands-free during those meetings.

For me, I need to be able to shut the door to eliminate distraction. I prefer to face the window so I have natural light and don’t feel so enclosed. Having two large monitors is a must. I love that my desk will convert from sitting to standing (you can get an add-on for your desk for under $200 on Amazon). I can get distracted easily so I do not keep a TV in my office and any music I play is “coffee shop” in nature on a low volume.

I need a space separate from my comfortable / living space – desk, kitchen table, etc., away from distractions and noise.

Desk location that is secluded. No printing unless necessary and a shredder if it is. Widescreen monitor helps with good lighting. Music is always an option. Alexa is my spell checker and office assistant for some things.

Natural light, classic music

We recommend that our employees have a dedicated office space that isn’t in their bedroom and where they can shut the door. A good internet connection is a requirement. We provide a special network device to provide the same level of security we have in our company office. Of course, we’ll flex on all things BUT security to meet special needs related to Coronavirus.

A dedicated space is ideal (if possible). It allows you to separate work from home in a way that helps with the routine. Natural light is really important, supplemented by high-temperature artificial light. Sound is very much a personal thing; sometimes none, sometimes podcasts, sometimes music – depending on the task at hand.

Natural light, instrumental / classical music, home office desk. No coffee shop background noise for me.

Anywhere can work: office, kitchen, coffee shop, co-work space, etc. You have to treat it like the office. Good headphones without anything playing are good at minimizing noises around you so leave them on even if you’re not “listening” to anything.

Plenty of light, facing window, a good chair, and proper ergonomics – a sit/stand desk if you can swing it.

Desk location with structured work hours, to ensure productivity. Of course it goes without saying that you need reliable internet access and appropriate hardware – laptop, phone (I prefer a non-mobile device for best sound quality), sound-controlled room, etc. with meeting- and communication-friendly software (Outlook). “Meeting friendly” convening software is desired, however, I haven’t yet discovered a good program / software, since Skype is not good quality.

A big monitor is cheap and essential. Plug a full-size keyboard into your laptop instead of the built-in version. Elbows at right angles to keep your wrists flat, which isn’t always possible on countertops or other non-desk surfaces. Make “going to work” like commuting, set an alarm, dress, be at your desk. I need a view to the outdoors to prevent cabin fever. Do your most important work first in the day. Stay out of the kitchen except at lunchtime and don’t eat at your desk – take lunch as an actual break.

Designate a room in your home for “work hours” and let any family / roommates know that this room is unavailable during these hours to avoid distraction. When I first worked from home years ago, I found that my significant other at the time expected me to manage household duties concurrent with the workday – this will NOT work, so set expectations early on.

I am fortunate to have a home office with a window and a door. Music is always on in the background, mostly smooth jazz to keep my mood smiling.

You to have a space where you can close the door. It helps keep everything separate. Also make sure situate yourself well for web meetings. A window behind you on a sunny day can make it hard for teammates to see you.

The couch, the dinner table, outside in non-direct sunlight during nice weather.

Set up a dedicated work space. Do what you can to make sure it’s ergonomically correct. You can end up with arm and back pain quickly.

Do not use overhead lighting. I only have a lamp on my desk and use a bulb that is near daylight colored. My desk is in a room that serves only as my office as to keep the stress contained. I have a window, which I highly recommend. I sit with my elbows at 90 degree angles and my forearms are supported by the arms of my chair. I have a docking station for my laptop and have two screens that sit at eye level.

Don’t work in your bedroom unless you must – the bed will be calling your name all day. If your bedroom is the best option, have a desk and make it feel like a work area. Also, plan your meals – prep them ahead if you can as if you were going to the office. You’d be surprised at what chunk of your time it takes to cook in the middle of the day.

Fortress of solitude, currently in the basement. Wired LAN connection. Gig speed internet service. Extra big monitor to extend to. 101 key keyboard a must.

When I am the only one home, I work in our open first floor as I feel I am not hiding in an office. It is nice to see the day. If there are others home with me I hide in my office room.

When I’m doing mind-heavy work, laptop plugged into two external monitors on a dedicated desk in a separate room. Music without lyrics or in another language so I don’t get distracted listening to the words. Lots of light but nothing hitting the screen that could distract me. When I’m doing other work/on meetings – plush rocking chair that has a small desk close by for food and drinks and surrounded by plants/out on the porch if it’s nice enough. The rocking helps me burn energy and stay focused when I’m on one of those meetings that I have to be on but I don’t have to do anything on.

Set a dedicated space that you can walk away from when not working. Natural light is the best and soft local radio station music helps keep you engaged while at home.

Ambient daylight, with my desk near the window. Winter is tough due to the short days and not much sunlight. No music. TV on, muted. Occasionally, talk radio is on as background noise.

I’ve been working from home for 11 years – I’ve set myself up with desk lighting rather than overhead, my stand-up desk faces a large window with a great view. I don’t do well with background music – it distracts me. I do make sure to have soft beds on my couch for my French Bulldogs to stay close! I also have a small mini refrigerator in my office and stock with water, snacks, etc. so I stay upstairs until lunch.

I use a dedicated space with a door that can be closed when I need to focus, lower the impact of noise from other areas of the house, and take a call or participate in a web meeting. A window and natural light can help one feel a little more connected to the world. Access to music can help some focus. Watching what you have in the background is important for web meetings. Using dual monitors is a productivity bonus and having the option for a standing desk is great too. With the standing desk, I prefer to have a padded standing area. Just like at work, focusing on ergonomics helps with productivity and the potential pains of your home work area (e.g., proper chair, chair height, desk / table height, foot rest, monitor height). I have a whiteboard that I can easily show from the webcam on my laptop but before I had that, I’d use the 3M sticky top flip charts (be sure your markers won’t bleed through to write on the wall, or if you’re concerned, use 4-5 layers).

Try to find a quiet, dedicated area, with good connectivity.

Separate work area from other daily activities. Try to make sure there is a caregiver for your children if they are also home – you can’t work and care for kids at same time. Make sure to turn off computer at end of day, otherwise, those “pings” from alerts are too tempting.

Dedicated home office with a good wired (not Bluetooth) headset.

Dedicated office space or kitchen table, with a window and soft music. No TV on.

Dedicated work space – not at kitchen table.

For heads-down work, quiet and secluded is best with no tv / distractions. If you have a desk, use it. If not, do not work somewhere where you commonly relax or recreate, as those habits will be picked up with work. For me, brighter is better, so natural light is always premium wherever I work. Quiet is also premium, so I where noise cancelling headphones a good chunk of my day. They also double as a Bluetooth headset.

Dedicated office – no distractions.

Office with a door. Dual monitors. I use my employer-provided iPhone and my own Apple AirPod Pros (the noise cancellation feature on the Pros is awesome) for all of my work calls. Wireless headset / earbuds are a must.

I’ve worked from home since 2014 and my best advice is to create a dedicated space for working. Ideally an office with a door so you can open it in the morning and close it in the evening, just like going to your workplace. You have to create a clear distinction between work time and personal time, and having a dedicated work space helps by creating a physical barrier.

Set up a dedicated workspace, don’t just move into a living room or kitchen. Make it a formal area in which you ‘work’ — otherwise, you may just end up being perpetually distracted. Also, consider it a commute and take the transition from home to work seriously. Take breaks. Go for a walk (alone, to maintain your distancing), do something else, stand up, the same way you’d do at an office. Fight the urge to carry your office throughout your home. Maintain your hours and normal work environment. Get a good lamp, get a good area to spread out your work. Make sure the angle of your monitor is not going to have a sun glare issue.

Sit somewhere that you can see out a window, ideally with a view where you can see people, cars, etc. going on outside. It’s easy to feel isolated when you don’t physically see any other people.

What Are Your “Working From Home” Tips?

Many people are working from home for extended periods for the first time. If you’ve done it, what advice can you offer for those doing their jobs from home for a few weeks?

News 3/11/20

Top News

ONC publishes a six-page summary of changes that were made to the draft version of HHS’s interoperability rules in producing the just-released final version that took public comments into account:

• Vendors have 36 months to release Electronic Health Information (EHI) Export that supports exporting a single patient’s data and exporting all patient data for users who are switching health IT systems.
• FHIR Release 4 was chosen as the standard for API certification.
• Health IT vendors are prohibited from restricting the sharing of screenshots and videos of their screens, but are allowed to limit such use to protect their intellectual property.
• Compliance with the information blocking provision is not required until six months after the final rule is published and timelines for assessing civil monetary penalties will be determined later.
• EHI is defined to be the HIPAA-designated record set starting in 24 months, but until then, it is the USCDI standard.
• It will not be considered information blocking to notify patients that the apps they’ve chosen may or may not follow best practices.
• An actor can require patient consent or authorization before providing access to EHI, but they must make reasonable efforts to provide a consent form.
• An actor can limit the content of its response to requests to access, exchange, or use EHI without being considered information blocking, which allows them to negotiate terms.They can also fulfill requests in an alternative manner if they have technical limitations or can’t reach terms with the requester.
• Fees may be charged for accessing, exchanging, or using EHI.

ONC will host a series of webinars that explain the new rules starting Wednesday, March 11.

I asked Cerner to provide a high-level summary of what the new regulations mean for developers:

• The appropriate open and unimpeded access, exchange, and use of EHI is firmly established. Information blocking is barred as a general rule.
• Most favored nation behaviors and use of unlevel playing fields to favor some over others for participating in health information exchange will not be tolerated by HIT vendors.
• HIT vendors will need to establish business practices that abide by five vendor-oriented exception conditions that set guardrails for fee development; non-discriminatory business practices; evaluating requests for access, exchange and use of EHI; and for responding to such requests in a good faith manner.
• HIT vendors will need to embrace the era of the API as a critical basis for interoperability going forward, whether for enabling access by patients / consumers, for exchange of EHI with other providers, and for other needs for interoperability.
• Current HIT vendors of certified HIT must keep their clients current by making available updated certified HIT capabilities for interoperability and the essential data set required for exchange (Version 1 of the US Core Data for Interoperability- USCDI) within 24 months for most requirements (36 months for EHI Export).
• HIT vendors will need to attest to HHS and their certifying body as to their compliance with conditions of certification that assure most importantly that they will not engage in information blocking, provide real world support for interoperability, and that they will support API access for all verified registered users (including developers) who seek to connect applications to said APIs to access EHI held by an HIT vendor’s certified products

Reader Comments

From Jake: “Re: coronavirus. The clinical director for a regional hospital in Oregon, which is undergoing a COVID-19 outbreak, is peddling rumors that the flu vaccine makes you susceptible and recommending $200-$500 immune system testing through her side business. Unconscionable.” Stefanie Haines – who has a BS in clinical laboratory science and a doctorate in healthcare administration – also owns the local fitness center, which is a member of a national chiropractic group that sells various snake oils, like vaccine detox. She uses her Facebook page to push debunked conspiracy theories about vaccines, promotes the fitness center’s own services, and claims that coronavirus is a deep state conspiracy that can be prevented by using her immune system tests and nutritional supplements. You will rarely be wrong if you assume that people and companies will do the most profitable thing over the right thing.

From Amtrakker: “Re: HISsies. Epic again? Seriously?” HIStalk readers did the nominating and voting as always, with me doing nothing except shelling out $99 for SurveyMonkey so I could tie ballots to the email addresses of HIStalk subscribers to prevent the ballot box stuffing that would be guaranteed with the typical online poll. I always hope for dark-horse winners to make my job more exciting than just copying Epic / Judy / John Halamka / KP / beers with Bush slides over year after year to announce the winners, but the majority rules.

HIStalk Announcements and Requests

I’ll change out this week’s poll early since folks voted quickly, in which three-fourths of respondents said HIMSS did the right thing in cancelling HIMSS20.

New poll to your right or here: To what level are you avoiding crowded places and unnecessary travel due to COVID-19 concerns? I would not want to be in the cruise industry right now – I checked a couple of websites and the discounts are massive, such as an eight-day cruise on a highly rated ship for $299. Ships are still leaving ports, even Seattle, and returning to discharge petri dish passengers to go home all over the country.

I posted a list of sponsor virtual sessions that were repurposed from the lost HIMSS20. Most of them are, like their original counterparts, scheduled for this week. It’s a good time to get some desk-side education.

It is time (pun intended) to stop with “EST.” It will be “EDT” until November 1, or just “ET” if you want to wash your hands of the distinction in favor of a year-round replacement that prevents you from embarrassing yourself.

Webinars

March 25 (Wednesday) 1 ET: “Streamlining Your Surgical Workflows for Better Financial Outcomes.” Sponsor: Intelligent Medical Objects. Presenters: David Bocanegra, RN, nurse informaticist, IMO; Alex Dawson, product manager, IMO. Health systems that struggle with coordinating operating rooms and scheduling surgeries can increase their profitability with tools that allow for optimal reimbursement. This webinar will identify practices to optimize OR workflows and provider reimbursement, discuss how changes to perioperative management of procedures can support increased profitability, and explore factors that can impede perioperative workflow practices.

March 26 (Thursday) 12:30 ET. “How to Use Automation to Reduce ‘My EHR is Slow’ Complaints.” Sponsor: Goliath Technologies. A common challenge is that a clinician is ready to work, but their technology is not. EHRs can be slow, logins not working, or printers and scanners are offline. Troubleshooting these end user tickets quickly is nearly impossible, especially in complex environments that might include Citrix or VMware Horizon. This webinar will present real-world examples of how leading health systems are using purpose-built technology with embedded automation and intelligence to proactively anticipate, troubleshoot, and prevent end user performance issue across their IT infrastructure and EHRs.

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

Acquisitions, Funding, Business, and Stock

HealthStream acquires 20-employee nurse scheduling app vendor NurseGrid for $25 million in cash. Nurses use its mobile app to manage their schedules, trade shifts, and communicate with each other, while managers use it to publish work schedules. HealthStream expects the money-losing company to contribute less than $500,000 to its revenue in 2020.

Genstar Capital recapitalizes ConnectiveRx, continuing as the majority investor and bringing in new funds as minority participants. The company has doubled in size since Genstar’s initial investment in 2015.

People

Philip Meer, MBA (Evariant) joins PatientKeeper as CEO.

Announcements and Implementations

FormFast changes its name to Interlace Health.

OptimizeRx adds COVID-19 related CDC alerts to its health network of EHR users.

Intelligent Medical Objects partners with Perspecta and the Regenstrief Institute to integrate its Precision Patient Summary with the clinical data viewers of those organizations, which includes the VA through its use of Perspecta’s HealthConcourse.

Salesforce announces enhancements to Health Cloud: provider management, provider search, provider relationships, an analytics solution for care management, and integration with Bridge Connector’s Destinations for integrating EHR data.

Parkland Center for Clinical Innovation publishes “Building Connected Communities of Care: The Playbook for Streamlining Effective Coordination Between Medical and Community-Based Organizations.”

AMA will fast track development of a CPT code for coronavirus tests.

Government and Politics

Premier expressed satisfaction with the new ONC rule, but would like to see more security and privacy requirements implemented for third-party app vendors. They are also disappointed that CMS does not go further to reduce provider burdens, particularly with the new ADT Conditions of Participation requirements and their accelerated implementation timeframe.

Other

The American College of Healthcare Executives, America’s Health Insurance Plans, American Organization for Nursing Leadership, Future of Individualized Medicine, American College of Medical Genetics and Genomics, National Comprehensive Cancer Network, Congress on Healthcare Leadership, VMed, ACC, ENDO, and several other groups join HIMSS and AMIA in cancelling upcoming conferences due to COVID-19 concerns. Massachusetts has declared a state of emergency after 51 new coronavirus cases were found, with 70 of the state’s 92 cases related to a drug company’s 175-attendee conference in Boston last month.

ICU doctors in Italy warn that government reassurances aside, conditions there have deteriorated as COVID-19 ramps up:

• Hospitals are getting dozens of admissions for fever, breathing problems, and cough each day, all with positive swabs and all being diagnosed as bilateral interstitial pneumonia.
• Up to 10% of cases are requiring ICU care for extended periods.
• Hospitals that are overwhelmed at 200% of capacity have converted all ORs to ICUs and are diverting all other emergencies, including trauma and strokes (note: Italy has more physicians and hospital beds per capita than the US).
• Hundreds of patients who have severe respiratory failure are being given nothing except a reservoir mask.
• Patients who are over 65 or who have other medical conditions aren’t even being assessed.
• The situation progressed from a few positive cases, then to some respiratory failures that took up ED resources, then to respiratory deterioration that filled ICUs.
• Staff illness made it hard to cover shifts, while mortality from other causes then spiked because of lack of resources.
• Doctors and nurses have infected their own relatives, some of whom are dying. 

Former FDA Commissioner Scott Gottlieb, MD says it’s too late for COVID-19 containment and thus contact tracing is a waste of resources, predicting that more widespread testing will reveal existing large outbreaks. He says the next two weeks will be “very difficult” and urges shutting down movie theaters and other places where people gather indoors, requiring business to offer teleworking, and slowing transportation. He also says that while coronaviruses usually don’t circulate in the summer, nobody knows about this one. He says that March and April will be tough months, but the epidemic curve could start to go down at the end of April and the situation should improve considerably by summer. He says sporting events such as the NCAA’s Final Four may need to played in empty gyms and conferences should be cancelled: “Do you want to continue to hold conferences and have to run the risk that your entire attendee list is put into a quarantine because there was someone there who is infected?” He concludes that COVID-19 is a pandemic even though WHO is “not wanting to label it yet out of some odd sense of political correctness that I can’t fully appreciate.”

Let’s clear those pre-HIMSS20 tweet buffers, folks (especially the HIMSS-employed ones).

It looks as though the “FHIR Festival” website has gone dark, which I assume is because HL7 and maybe HIMSS expressed minimal amusement at its use of trademarked terms. It was a parody site, which is legal to the extent that you can afford lawyers to argue your case. The good news is that it wasn’t really all that funny once you recovered from that initial small giggle from being caught off guard.

Sponsor Updates

• Customers of professional liability insurer IronHealth can apply their risk management reimbursement dollars toward PeriGen’s PeriWatch Vigilance early warning system for labor problems.
• Bright.md offers free coronavirus screening tool to hospitals.
• Diameter Health adds new FHIR product capabilities to its data normalization and enhancement platform to enable payers and HIEs to share larger sets of data with other healthcare stakeholders.

Blog Posts

• Back to the Basics: Patient Engagement (EClinicalWorks)
• The Importance of Requirements Management for Epic Implementations (314e)
• Throwback: Why Infection Control and Tablets Go Hand-in-Hand for Hospitals (Access)
• Evolve beyond museum relics in your practice (AdvancedMD)
• Avaya Spaces Collaboration App Offered Free to Help During the Coronavirus Outbreak (Avaya)
• HIMSS is Cancelled, Now What? Four Things Health IT Companies Should Do Right Now (Datica)
• 8 Best Practices for Working Remotely (CI Security)
• How Care Coordination Can Help Decrease Utilization (Collective Medical)
• Provider Burnout: No Silver Bullet for Change (CoverMyMeds)
• Patient Safety Awareness Week: Annual Reminder to Advance Quality Healthcare Initiatives (Capsule)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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HISsies Awards 2020 Winners

HHS, ONC Release Final Rule on Interoperability, Information Blocking, and Certification

ONC publishes its 1,244-page Cures Act Final Rule.

This story will be updated as new information is made available.

Sponsor HIMSS20 Presentations Rescheduled as Virtual

This list gives visibility to HIStalk sponsors that are presenting virtual versions of the live presentations they were scheduled to offer at HIMSS20. Sponsor events scheduled through March 23 will be included.

Submit your event here. This list will be updated as I receive new submissions.

Companies that do not sponsor HIStalk can contact Lorre about becoming a sponsor or having their webinar promoted.

Arcadia

• Wednesday, March 25, noon ET: “Central Georgia Health Network – Helping PCPs Transition to New Payment Models.”
• Thursday, April 9, 3 ET: “Community Health Plan of Washington – Capturing SDoH Data Across Community Health Centers.”
• Wednesday, April 15, noon ET: “MaineHealth Accountable Care Organization – Tackling Emergency Department Utilization with Predictive Analytics.”
• Wednesday, April 22, 3 ET: “Summit Medical Group  – Commercial Risk: Getting off to a Successful Start.”
• Wednesday, April 29, noon ET: “AMITA Health – Rewarding Value: Realigning Physician Compensation.”
• Wednesday, May 6, noon ET: “Summit Medical Group – Using Analytics to Drive Patient-Centered Post-Acute Care.”

Hyland Healthcare

• On demand: “Governance for Decision-Making, Who’s on First?”
• On demand demo: virtual demo booth.
• Thursday. March 19, 1 ET: “Reduce cost and improve clinical outcomes with Intelligent Automation.”
• Thursday, Marcy 26, 1 ET: “Six Considerations When Selecting a Content and Process Management Provider.”

Meditech

• Tuesday, March 17, 11 ET: “Introducing MEDITECH’s Labor and Delivery Solution.”
• Tuesday, March 17, 2 ET: “Take the ‘On Ramp’ to the Intersection of 21st and TEFCA”
• Monday, March 23, 1 ET: “Physician Peak Performance Program.”

National Decision Support Company (Change Healthcare)

• On demand: “Clinical Laboratories at a crossroads: The Value of Decision Support in Building an Effective Lab Stewardship Program.”

OptimizeRx

Thursday. March 19, 3 ET: “Learning Together: Navigating the COVID-19 Pandemic.”

Relatient

• Thursday, April 23, 2:30 ET: “Achieving Patient Engagement in a Mobile-First Market.”

Spok

• Wednesday, March 18, 1 ET:  “Virtual Tour of Spok Go.”

StayWell

• Monday, March 23, 2 ET: “Fueling the FHIR: FHIR Readiness Best Practices.”

Vocera

• Tuesday, March 31, 3 ET: “Protect the Safety and Well-Being of Your Staff and Patients.”

Monday Morning Update 3/9/20

Top News

HHS will apparently release its new interoperability rules Monday morning.

Details will be provided to stakeholders in a 9:30 a.m. ET conference call with Secretary Alex Azar, Deputy Secretary Eric Hargan, CMS Administrator Seema Verma, and National Coordinator Don Rucker.

Reader Comments

From ItsMoreThanAGig: “Re: HIMSS20. As a HIMSS staff member, I can verify how incredibly difficult this decision was today and how painstakingly careful our leadership was in fact-gathering, deliberation, etc. As our CEO said on a call today, it is ‘heartbreaking’ for all of us at HIMSS, and that truly is the case. When you work your a** off for an entire year — sacrificing evenings and weekends away from family to build out programming, communications, logistics — it’s exactly that: heartbreaking. However, we’re optimistic about the opportunities that this situation leaves us with in the form of virtual presentations. Lots to figure out in the near future. But as a HIMSS insider, I can honestly say we really do put the best interest of our members and attendees first before profit or otherwise. We all BELIEVE in the mission of HIMSS and the power we can hold in numbers.”

From Jenga: “Re: HIMSS20. What will you miss most from the cancellation?” I will most miss being able to write about what I see and hear from the viewpoint of a normal attendee. I enjoy my normal routine of summarizing news and adding occasional pity asides or experience-based insight from the cheap seats the rest of the year, but I get just this once annual chance to roam around and describe what it’s like to be at the conference. I would always get giddy with fatigue from heading straight from the convention center to the keyboard and then staying up until midnight or 2 a.m. putting it all down on the screen sitting alone. I have fallen asleep from exhaustion at the keyboard a few times, but that’s part of the fun of living a fantasy of free-form, rules-free pseudo-journalism that can be simultaneously bizarre and informative. I may have to take a writing class or something to channel my modest creativity.

From Implore Me: “Re: HIMSS20. What will the impact be on the organization?” Brutal, I suspect, given that the annual conference contributes about one-third of HIMSS’s total revenue per my recent analysis. HIMSS made just under $1 million in profit in its most recent tax year,  and the annual conference brought in about $15 million in profit on $30 million in revenue. The cancellation will likely spill over into its second-biggest revenue source of publishing. I don’t know what kind of insurance HIMSS carries for operating the conference, but I doubt it covers lost profits. There’s also the unknown downstream effect on HIMSS21 attendance and exhibition for two reasons: (a) the uncertainty is now obvious and those who feel wronged by the cancellation, for whatever reason, may carry their displeasure over to HIMSS21; and (b) exhibitors may decide, with a year off to think about it, that the cost of participating in the HIMSS conference may or may not be justifiable in their particular case. I don’t agree with everything that HIMSS does, particular when it strays into areas that don’t seem appropriate for a non-profit member organization, but it would be sad to see HIMSS marginalized by circumstances beyond their control. You have to have attended lame and now-dead competing conferences like MHealth and TEPR to realize how easily poor execution can turn into a death spiral. Ordinarily HIMSS would this week allowing companies to start begging for good booths at HIMSS21 with the assurance that the good ones would all be taken immediately, but I doubt that’s the case now.

From Chevy De Novo: “Re: HIMSS20. There’s a COVID-19 health concern, but just 11 US deaths out of 352 million people, and we do nothing about flu that kills 15-30K. The sky is falling even though Florida has just two cases and Orlando brings in more than 100K people per day to the theme parks alone. The ramifications of cancelling are far and wide. Startups were counting on HIMSS to jumpstart their business, and many won’t be in business by year’s end having spent half or more of their marketing budgets on this non-show. Non-refundable airfares, hotels, booth shipping and setup, ad revenue from journals who now have no HIMSS coverage to leverage ad sales against, and the list goes on. HIMSS didn’t have a choice because if it didn’t cancel, people would say they put profits first. Now they will catch flack anyway, especially since they are not refunding registration fees are instead applying credits to HIMSS21. I would not have wanted to make the call, but I would have said let the show go on, and if you choose to cancel your booth space, don’t ask us for money back. Now HIMSS is majorly screwed and may even face lawsuits, which could have long-term ramifications for the organization. It’s going to get ugly.”

From Back Home: “Re: HIMSS20. This hotel cancellation link appears to still be alive.” The OnPeak HIMSS20 refund request form is still online, but I don’t know if submissions are being monitored.

From YooHoo: “Re: HIMSS. It is reminding people about ‘not using their brand.’ Apparently they aren’t keen on ‘Virtual HIMSS’ and speakers and exhibitors trying to salvage the investment they made in HIMSS20.” HIMSS is right to ask people to avoid using its trademarked name in their unsanctioned activities, no matter how well intended (‘Virtual SXSW’ would be equally poorly received by the group whose name is being used by others). Luckily nobody needs to apply the HIMSS name to market their virtual activities. UPDATE: HIMSS has announced that it will resurrect its previous “Virtual HIMSS” efforts from years ago in offering some HIMSS20 sessions online.

From Ja Rule: “Re: FHIR Festival. Good joke!” Someone with a few dollars and a good sense of humor launches a website for “FHIR Festival, The HIMSS20 Alternative,” in which Ja Rule will take President Trump’s speaking slot and Elizabeth Holmes will be in the house. I would have added some caustic wit about selfie-obsessed influencers since we have those, too, and I suspect that some of those are being paid as they were for the Fyre Festival. HIMSS was probably wise to not take Fyre Festival’s “Let’s just do it and be legends, man” approach.

From Epic Trench Warrior: “Re: Epic banning customers from using automation software. Epic supports customers doing RPA work with several vendors, such as Olive. But Epic has seen some real disasters, such as 40,000 patient records corrupted by a vendor’s script that damaged med lists and took thousands of hours of Epic and customer time to clean it up. They have also had vendors use brute force techniques that create exceptionally high system loads. Epic requires the third party and customer to sign off acknowledging  the risks, obligations, and safeguards. They also ask the third parties not to patent a combination of on-screen steps that simply mimic what an Epic user would do and then sue Epic or a customer if someone else develops a similar script. And of course Epic does not steal their scripts.”

HIStalk Announcements and Requests

The most recently used patient engagement technologies are almost everything except online or app-based education, telehealth, and care team collaboration (ignore the displayed percentages because the polling tool counts votes rather than individuals with multiple-answer responses).

New poll to your right or here: For those who had planned to attend HIMSS20: was cancelling it the right call?

Thursday was the busiest single day in HIStalk history by far, with 32,907 page views in 25,631 unique visits. I’m honored that people came to me when looking for HIMSS20 news, although I’m not exactly proud of achieving a success metric due to an unfortunate incident.

I published great responses to my exhibitor survey about the HIMSS20 cancellation. Lost in the shuffle of the cancellation was my earlier health system survey about coronavirus precautions – I’m still interested in what’s happening out there.

I enjoyed the later sunset on Sunday but was still feeling robbed of the extra hour when it occurred to me – not attending HIMSS20 will give me an entire week back.

Webinars

March 26 (Thursday) 12:30 ET. “How to Use Automation to Reduce ‘My EHR is Slow’ Complaints.” Sponsor: Goliath Technologies. A common challenge is that a clinician is ready to work, but their technology is not. EHRs can be slow, logins not working, or printers and scanners are offline. Troubleshooting these end user tickets quickly is nearly impossible, especially in complex environments that might include Citrix or VMware Horizon. This webinar will present real-world examples of how leading health systems are using purpose-built technology with embedded automation and intelligence to proactively anticipate, troubleshoot, and prevent end user performance issue across their IT infrastructure and EHRs.

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

Sales

• Jefferson Community Health and Life chooses Cerner Millennium via CommunityWorks. The 17-bed critical access hospital is apparently paper-based today.

Announcements and Implementations

HIMSS will develop a special virtual edition of HIMSS20 and is asking members which sessions they would like to see.

A new KLAS report on AI in imaging finds that use has accelerated, with nearly half piloting or using imaging AI, others saying they are close to deployment, and deeper adoption expected as radiologists and cardiologists begin to see the value. IBM Watson Health is most often mentioned as being well positioned, with Aidoc and Nuance gaining the most mindshare. Providers place great weight on the references of colleagues when making purchasing decisions.

Government and Politics

Cerner Chairman and CEO Brent Shafer expresses the company’s support for HHS’s interoperability rules. He says,

The passage of these rules has become needlessly controversial, opposition stemming largely by businesses that have financial interests at stake. This is especially frustrating as most healthcare providers, polled by Reaction Data, predict favorable impact from the rules’ release. Now is the time to support the government’s role as an enabler of private sector innovation and competition in its efforts to ensure patients’ rights to access their information … We strongly oppose any business practice that willfully prevents the flow of information. We believe empowering consumers is the right thing to do. We welcome the innovation that will be unleashed by open and interoperable healthcare data. As technology advances, there are new opportunities for digital products to support providers and individuals in managing their health and wellbeing. We encourage the immediate release of the ONC and CMS interoperability rules because healthcare is too important to stay the same. And we believe that in a seamless and connected world, everyone thrives.

Other

A reader says two Orlando organizations that might be able to use donated conference items are Boys & Girls Club of Central Florida and Orlando Day Nursery. Repurpose that booth swag, y’all.

AMIA cancels its 2020 Informatics Summit that was scheduled for March 23-26 in Houston due to coronavirus concerns. AMIA is considering offering panels and presentations virtually on the original dates. Its Clinical Informatics Conference May 19-21 in Seattle is still on for now. 

An American Hospital Association-commissioned  presentation to hospitals warns that COVID-19 could create a disease burden 10 times that of flu in the US, with 96 million cases, 4.8 million hospital admissions, 1.9 million ICU admissions, and 480,000 deaths (the timeline was not provided). Stats I’ve seen suggest an unfathomably rapid ramp-up, to the worst-case point that we’ll run out of hospital and ICU beds in the next few weeks. Meanwhile, CDC advises people over 60 and those with underlying health problems to avoid crowds, including traveling by air, attending movies and concerts, and going to church. The novelty of reporting the number of US cases, the number of states that have reported deaths or declared public health emergencies, and countries that are sealing off borders thinking they can create an infectious disease moat should be wearing off almost immediately as the new status quo. Let’s hear more about what experts are learning as they study more cases and how hospitals are preparing for the ample challenges they face.

The Far Side was right: we need this.

Weird News Andy apologies for titling this story “Domo Arigato Mr. Roboto” since it’s a Japanese name referring to China, but at least he welcomes our robot overlords. China deploys robots to combat COVID-19, using them to disinfect, take temperatures, and to perform dangerous cleaning and food preparation jobs.

Contacts

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

HIMSS20 Cancellation Impact for Exhibitors

My survey question: What impact will the conference’s cancellation have on your organization, in terms of expense, strategy, marketing, etc.?

Looking to the positive innovation that can come from this crisis. We all have our HIMSS routine and must get creative this year to turn this negative into the next generation. Whether it be virtual solutions, care management platforms, or new ways to connect and learn from each other, now is the time. New ways of working are essential. HIMSS in its current form may be the old model. Excited to design the future.

Will definitely reduce investment for any other conferences for remainder of 2020. It was laughable that HIMSS sent an email to us this week asking if we wanted to meet to discuss exhibiting at Health2.0 in the fall. Unlikely, on the heels of us wasting >33% of our promotion budget on HIMSS20. This is much harder on small to medium companies like ours. Which is why big companies could drop out, but not small.

I will be very interested to see how this plays out contractually — refunds, HIMSS points, etc. It would be nice if HIMSS found a way to reward those of us who remained committed up to cancellation — perhaps those who pulled out lose 50% of their HIMSS points, or something.

Rescheduling high value meetings is the first priority. Prior to HIMSS officially cancelling, about half of our meetings had cancelled on their own (and we were on the cusp of just pulling out all together) so that process had already begun, but logistically it will not be without challenges.

Figuring out what / how we will be reimbursed. Besides HIMSS sponsor / booth costs and the associated hotel costs, there’s also misc vendor costs that we contract for separately (build, hardware, set up etc.). I’m guess we’re SOL on those, but the hardest part is just not knowing what HIMSS will do as we await their “14 business days” to figure it out.

Generally deciding if we’re going to sponsor HIMSS going forward. For one, I’m very concerned about their long-term financial viability following this unfortunate series of events, and two, could this be the year vendor marketing execs decide enough is enough with the exorbitant exhibitor costs and take that $$$ for something else?

Frankly, we are trying to figure that out. We weren’t told yet what refunds are available for hotel rooms for example. We had an expensive event scheduled and aren’t sure yet how they will work with us on cancellation at the venue. Airfares are the worst –change fees at best. It’s a real financial loss.

Simply put, it’s devastating. In stark reality, some individuals at my company will lose their jobs. HIMSS represents a significant portion of our overall strategy, so the direct impact to sales and budget isn’t recoverable this year. I am likely to be one of those individuals.

Months of planning and work has been lost, with only limited elements able to be reconfigured for digital or virtual consumption within the small window of time HIMSS attendees’ attention will turn to #virtualHIMSS20, not to mention the lack of budget available to spend on the digital promotion required to capture that attention. Similarly, HIMSS is where we conduct a signification portion of partner networking at scale, which has been completely wiped out.

It is completely unclear if any sunk costs will be refunded and the likelihood of other upcoming healthcare conferences — such as ACHE Congress and Beckers — being cancelled means additional devastation for our company’s budget and ability to make sales this year. Because the cancellation came so very late, the vast majority of our expense cannot be recovered in any way and it’s unlikely new revenues will be generated in time to keep our 2020 strategy from collapsing.

While trying to keep perspective and recognizing first that we must do no harm in healthcare, today was especially hard and the situation is now bleak.

We’re rallying to host as many of our scheduled events as online options during the original event days. We want to make good use of the time and expense paid to prepare, regardless of sponsorship fees that are in flux.

BizDev outreach becomes MUCH more costly for small / medium businesses if we have to travel prospect by prospect.

It was tough to find out we aren’t able to share with and learn from so many others face-to-face in Orlando this year. That being said, we fully appreciate the willingness of HIMSS and its supporting sponsors and vendors to put public safety first, and ultimately, do the right thing.

One of the many traits I love about healthcare is that it fosters a never-ending conversation through seemingly infinite channels. Speaking for our company, we’re more excited than ever to actively participate in those conversations around improving the patient journey across all touch points for hospitals and health systems—whether that’s in the exhibit hall, through digital programs, or in the media. And when we do connect, we’ll have the “HIMSS20 that never was” as common ground.

Clearly 90% of the expense of HIMSS will be non-refundable and it will deliver 0% of its already-questionable value.

As a software vendor, IMO, the ROE on HIMSS is always questionable. We’ve been exhibiting at HIMSS for 20 years and ultimately decided that we could find value in the show two ways: 1) visiting with existing customers; and 2) guiding well-known, already-engaged prospects just a bit further towards a decision. The neophyte exhibitors show up with their order pads ready to go, thinking they will find new, qualified prospects and actually close business. With a typical 6-to-72 month sales cycle for healthcare software, at best new vendors will find a few folks kicking tires and they can fill the very top part of the sales funnel with the quality of leads likely not much better than an electronic form on their website saying, “Contact us to learn more about our solution.” Why else attend every year?

As a very long-term vendor with Round 1 booth selection priority, the HIMSS policy of “points reset” if you skip a year is the death knell for future years. Meaning, skip HIMSS once and you lose all of your seniority. Moving to the back of the line for booth location would make the entire show ROE much worse. Being on the main aisle next to the big boys dramatically helps in trying to find a few unknown prospects. As you often say, HIMSS is a boat show paid for by exhibitors and enjoyed by attendees as a chance to network. With the HIMSS organization so deeply dependent on the show for revenue, I expect there will be some very difficult business decisions for them in the near future.

We have mixed feelings about the cancellation of HIMSS20. On one hand, we’re disappointed that we won’t see our good friends, clients, colleagues, and competitors as we all gather to make the state of healthcare even better. We’re also disappointed that we won’t be able to showcase our latest innovations that we were excited to share and have spent lots of time and money getting ready to showcase. On the other hand, we’re grateful that HIMMS has taken this bold step to keep everyone safer.

The financial impact is high in terms of investment — both financial and the investment of time of our resources — all of which to date is not recoverable. We will wait the 14 days to see what HIMSS will do in terms of booth electrical, rigging, hanging sign, utilities as well as registrations and booth space. I suspect they will defer it all to next year, which is a great solution for them and cuts down on the administrative overhead, but for those already deciding not to go next year, this is not optimal.

It’s a double whammy. Lack of lead generation + costs we can’t recover.

We had spent the last 3-4 days “figuring out how to make lemonade” in terms of a smaller audience. Because we do a lot of business with other vendors, we had an opportunity to focus on those vendors (probably similar in size to us) that did attend.

Costs for sure we won’t recover: 1) Marketing contractor expense for the year-long HIMSS 2020 planning activities. 2) Cost of new banners / signage this year. Really glad we didn’t go with those expensive light boxes! 3) Shipping costs for booth furnishings. 4) Hotel / flights? We had access to a separate condo and were told that WILL be refundable. So that is some positive news.

That being said, I think it was the right call. I just wish they’d made the call sooner when honestly many of us felt this was going to be the eventual outcome. Those few days of delay cost us several thousand dollars on top of all the other unrecoverable expenses. Hoping that booth fees are rolled over to next year. If we can’t get booth fees credited or rolled over, we will very likely not do a booth next year at all.

We are ultimately happy with the decision to cancel. It was an inevitable public health risk, so we feel relieved for the Orlando community, attendees, fellow exhibitors, and our own team members.

The big loss from not having HIMSS is the industry impact. The conference typically sets the major trends for the year for health IT. It’s also our big opportunity to see diverse provider organizations face to face to hear their pain points and be inspired for innovation to address them. We need to take the momentum going into HIMSS20 planning and put that toward how we can directly impact this massive public health crisis.

We did not invest a lot this year, so not much sunk cost loss. We were going to present in a partner booth and am thinking about taking advantage of the open calendar to do a webinars instead. I expect we will have a similar sized audience with ability to share, record, promote, etc. So for us, small vendor, little impact.

HIMSS is the ONLY organization that demands full pre-payment of each exhibitor’s entire hotel reservation. We do not yet know what HIMSS and the hotels will do with these funds for folks who have not yet arrived. Installation staff (MarCom, tech) who are already on site are being told that, even though they have used two room nights– the industry-standard room night deposit– by checking out early, they will forfeit the complete prepaid amount. For a some of our staff, that is five to eight room nights wasted, at $175 per night plus tax. We are being told there is no option to reschedule use of those room nights.

No other conference group, not RSNA, not ACC, etc. instructs the housing bureau to instate such a money-banking policy. The money for entire hotel stays, not standard two nights, has been in HIMSS hands for months, behaving like a financial institution rather than a health industry association. This is simply an unnecessary hardship to foist on the exhibitors who fund these meetings, and an unseemly way for HIMSS to earn some interest.

Working to recreate the types of important feedback and research that we were going to conduct from a product perspective. A lot of this is solvable, but don’t have a great way to recreate the experience of someone walking up and having the type of unstructured interactions that HIMSS affords.

We used to be one of the top 20 exhibitors in terms of space (cost). We stopped exhibiting a few years ago and scaled back our attendees to less than 10. We have found the conference too big, too broad, and unproductive in generating real leads. This year for us, the impact of a cancelled HIMSS is likely some lost travel expenses.

News 3/6/20

Top News

HIMSS cancels HIMSS20 at the recommendation of its medical advisory panel. The panel advised HIMSS that frequently updated coronavirus reports from WHO and CDC were making it hard to predict the risk to attendees, plus many of those attendees are frontline healthcare workers who would be taken away from their jobs to attend.

CHIME events scheduled for next week are also cancelled.

HIMSS20 will not be rescheduled due to the logistics involved. HIMSS will provide updates on any reimbursement of registration and hotel expenses. Exhibitors will be contracted with further information about their exhibit contracts.

HIMSS does not plan to make the scheduled sessions available virtually. It is working with the White House to make the contents of President Trump’s scheduled speech available.

HIMSS21 will be held in Las Vegas March 1-5, 2021.

Reader Comments

From HIMSSHappy: “Re: HIMSS20. Anyone know where I can get several thousand backpacks cheap?” Hopefully whoever was providing them can find schools in Orlando or in their home city to donate them. That’s a lot of backpacks. I’m getting reports that companies are donating their HIMSS20 items to Orlando area schools, homeless shelters, or other organizations, which is a great way to repurpose hand sanitizer, wipes, and other useful items. I will publicize the contacts for organizations interested in accepting these donations if someone knows. I would also like to shine a favorable light on companies that make these donations, so let me know.

From Denote This: “Re: HIMSS20. Imagine the economic effect on Orlando.” It will be significant, especially for those people who are in the service industry and are paid – probably not very well, possibly on contract – to staff the convention center, hotels, restaurants, bars, and meeting venues that were booked up with HIMSS20 business that now won’t need them. It’s not just HIMSS20, though, or not even just conferences in general. COVID-19 could be a bigger killer to businesses than to people with supply chain interruptions, reduced travel, lost work time, people staying home to care for kids whose school is cancelled, etc. Not to mention the inevitable stacks of provider bills that will be generated by any resulting healthcare encounter. 

From Bellboy: “Re: HIMSS hotels. We’re already seeing fallout on getting refunds with finger-pointing between OnPeak and the hotel. I called OnPeak, they told me to call Hilton Orlando, they sent me back to OnPeak. It’s a complete mess, possibly newsworthy, and I’m sure thousands of others are experiencing the same.” I’ll invite readers to share their experience or suggestions.

From EHR Guy: “Re: hospital in Dubai. Decided to replace Meditech with Cerner. This is ironic since this customer had Meditech for years and only made this move when 2019 was the best year for Meditech in years with more than 30 hospital wins while Cerner lost 9,000 beds.”

HIStalk Announcements and Requests

Wednesday was the busiest day in HIStalk history by far, with my server refusing new connections at some points due to overload. The final count was 24,385 page views in 19,697 unique visits. Thursday’s total might beat it – I’ll let you know.

I assumed that I would eat the pre-paid expense for my Orlando Airbnb condo next week from cancelling on short notice, but I checked the site on the off chance that I might get a little something back. I was surprised to be immediately credited $821 of my $915, which was everything except the service charge (in other words, Airbnb kept its full share, but the host got nothing). Hopefully those who booked hotels through HIMSS or otherwise will fare equally well. I might have taken an Orlando vacation if I was paying for the condo anyway, posting write-ups and photos from the convention center and Pointe Orlando of the “what might have been” category. It would be kind of bittersweet to be there, actually.

I’m really happy I decided to end HIStalkapalooza a few years back. Tight contracts for the facility and band would have left me destitute next week, sitting alone in the House of Blues enjoying a one-person buffet, drowning my sorrows at the open bar, and listening to Party on the Moon imploring me to get up and dance.

We’re in uncharted waters in skipping a HIMSS conference, so I’m interesting in hearing from companies that were exhibiting – what effect will the cancellation have on your organization in terms of expense, strategy, marketing, plans for HIMSS21, etc.? Some vendors spend the majority of their marketing money and effort on the HIMSS conference and I’m wondering what they do now. At least the big announcements that always hit on the first conference day will get more attention.

Meanwhile, if you’re an HIStalk sponsor and are taking your HIMSS20 presentations virtual, let me know and I’ll put together a schedule or something. We’re also ready as always to take on new sponsors or webinar presenters given that the HIMSS20 won’t be providing the expected exposure. 

Webinars

March 26 (Thursday) 12:30 ET. “How to Use Automation to Reduce ‘My EHR is Slow’ Complaints.” Sponsor: Goliath Technologies. A common challenge is that a clinician is ready to work, but their technology is not. EHRs can be slow, logins not working, or printers and scanners are offline. Troubleshooting these end user tickets quickly is nearly impossible, especially in complex environments that might include Citrix or VMware Horizon. This webinar will present real-world examples of how leading health systems are using purpose-built technology with embedded automation and intelligence to proactively anticipate, troubleshoot, and prevent end user performance issue across their IT infrastructure and EHRs.

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

Acquisitions, Funding, Business, and Stock

The bio of MDLive CEO Rich Berner has been removed from the company’s executive page, apparently confirming his unannounced departure as reported here last week. The bio of board chair Charles S Jones now has the CEO title added.

American Well will announce Tuesday that it is changing its name to Amwell, which is what most people call it anyway. 

Ro, formerly known as Roman — which started off selling Viagra and Rogaine by mail — a service in which it will provide 500 common generic meds for $5 per month, including shipping. That doesn’t seem sustainable, at least until it makes a big splash that results in someone overpaying to acquire the company, but meanwhile it’s a direct shot at PillPack, Walmart, and others.

Allscripts announces Veradigm AccelRx, a software solution for specialty medication management.

Sales

• Cerner awards Vecna Technologies a contract to integrate its patient self-service platform with the VA’s Cerner EHR. Vecna offers self-registration and scheduling, express check-in, tablet registration, and workflow administration.

People

Urgent care EHR/PM vendor Experity hires Kernie Brashier (Payspan) as CTO.

Travis Bond (CareSync) joins muscle pain app vendor Fern Health as CEO.

Jon Scholl, president of the health group of Leidos, will leave the company to perform church service and mission work.

Announcements and Implementations

Wolters Kluwer will integrate its data quality solutions with SAS Health’s analytics platform to drive the use of real-world evidence for life sciences.

PerfectServe releases a new version of its cloud-based Nurse Mobility solution that includes a VoIP dialer for voice communication, creating a single inbox for all calls, secure messages, and integrated alerts.

Other

Mount Carmel Health System (OH) will pay a $400,000 fine to the state board of pharmacy for allowing overrides to its medication dispensing cabinets that resulted in 25 patient deaths from narcotics that were ordered by one of the hospital’s intensivists. The doctor is awaiting trial on 25 counts of murder, two pharmacists were fined for verifying his fatal doses of fentanyl without question, and 25 nurses face disciplinary action.

The Economist says that COVID-19 is boosting China’s use of telemedicine, with some platforms reporting a tenfold increase due to full hospitals, fear of infection, and government encouragement. Some telemedicine vendors are winning over the public by offering free online consultations.

Sponsor Updates

• Healthcare Growth Partners publishes its “Health IT February 2020 Insights.”
• Frost & Sullivan honors Greenway Health with its North American Ambulatory Revenue Cycle Management Customer Value Leadership Award.
• Healthcare Growth Partners advises AlertMD in its acquisition by Evercommerce.
• Lightbeam Health Solutions releases a new edition of its “Pop Health Podcast.”
• Redox releases its latest podcast featuring Regina Holliday and the Walking Gallery.
• Surescripts issues a statement regarding COVID-19.

Blog Posts

• Redefining Clinical Integration: Leveraging Performance Improvement Work to Improve Coordination Across Care Settings (Ensocare)
• Three essential ingredients for a healthy payer-provider relationship (Experian Health)
• Helping businesses and schools stay connected in response to Coronavirus (Google Cloud)
• Patient portal best practices (Greenway Health)
• 6 Ways Your Healthcare System Should Use Content as a Service (Healthwise)
• Healthcare providers can do more in the cloud (Hyland)
• HIMSS20 – Be The Change (Optimum Healthcare IT)
• RISE Nashville 2020: Providing Health Data Clarity and Confidence (Imat Solutions)
• Imprivata OneSign 7.1 Introduces Secure Walkaway Technology (Imprivata)
• Care Navigation is Everyone’s Business (PMD)
• More than medical coding terms – This is IMO (Intelligent Medical Objects)
• Patient Access & COVID-19: 4 Critical Steps Health Systems Should Take Now (Kyruus)
• Witnessing the Dawn of Healthcare’s Consumer Revolution (Loyale Healthcare)
• Not every EHR deserves an “F” for usability (Meditech)
• How to Design an Effective Clinical Measurement System (And Avoid Common Pitfalls) (Health Catalyst)
• 6 Ways to Increase Patient Retention at Your Physical Therapy Practice (MWTherapy)
• Virtual Care: A New Frontier for Post-Acute Providers (Netsmart)
• Clinical Services 101: How to Successfully Grow Your Business (Omnisys)
• A new way to work: How to enable effective remote collaboration amid the coronavirus outbreak (OpenText)
• How to Compete with Retail Health Clinics (PatientBond)
• Make Your Self-Service Payment Rate Leap (Patientco)
• Thanks, Hospitalists (PatientKeeper)
• Three Questions with SailPoint Board Member Tracey Newell (SailPoint Technologies)
• Prescription Price Transparency: Good for Patients, Good for Health Plans (Surescripts)
• Hospital Marketing with Algorithms: Aim Higher than Netflix (SymphonyRM)
• Founder Letter: Social Media Madness: 5 Points to Help PT Practices to Win More Patients Online (WebPT)

Contacts

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

HIMSS Cancels HIMSS20

HIMSS announces that it has cancelled the HIMSS20 conference, following recent coronavirus reports from WHO and CDC.

HIMSS President and CEO Hal Wolf said in a statement, “We recognize all the hard work that so many have put into preparing for their presentations and panels that accompany every HIMSS conference. Based on evaluation of evolving circumstances and coordination with an external advisory panel of medical professionals to support evidence-based decision making, it is clear that it would be an unacceptable risk to bring so many thousands of people together in Orlando next week.”

The advisory panel said that risk could not be assessed due to frequent coronavirus updates. It also expressed concerns about taking healthcare workers away from their jobs.

This is the first time the annual conference has been cancelled in its 58-year history.

All CHIME-related events scheduled for the week are also cancelled.

A cancellation FAQ says:

• The White House was not involved in the decision. HIMSS will work with the Office of the President to share the content of President Trump’s speech.
• The conference will not be rescheduled.
• HIMSS is working with hotels to address reimbursement. Airline travel will not be reimbursed.
• Updates on registration refunds will be issued within 14 working days.
• Exhibitors will be contacted with further information about booth contracts.
• HIMSS has no plans to make sessions available virtually.

HIMSS20 Exhibitor Cancellations 3/4/20

HIMSS just updated its exhibit hall assignment system. There’s no easy way to see who is missing, but looking up empty booths against other announcements allows finding them in most cases. Some of those in the large booths (20×20) that won’t be there are below.

It should be noted that the cancelling exhibitors represent a tiny fraction of the 1,300 and that most of those cancelling are global technology firms rather than health IT vendors. Exhibitors are free to make their own decisions for their own reasons that go beyond the “bandwagon effect” of just doing what others do.

Those who are electing not to participate are no doubt performing their own notification to customers and scheduled booth visitors.

Accenture
Amazon
ATT
Audacious Inquiry
Butterfly Network
Change Healthcare (anchor exhibitor)
Cisco
Cognizant
Ctrl Group
Connection
DaVita
Decisio Health
DellEMC
Deloitte
EClinicalWorks (anchor exhibitor)
Elsevier
Fora Health
Google Cloud
Greenway Health
Hillrom
HL7
HP
Humana
IBM (anchor exhibitor)
Infor
InstaMed
Intel
Kyruus
Lumiata
Lyft
MDClone
Medicomp
Meditech
Microsoft
MITRE
Modernizing Medicine
NetApp
NextGen Healthcare
NTT Data
Nutanix
OpenText
PointClickCare
Pure Storage
Quil Health
Rauland
ResMed
Roche
Salesforce
SAP
SAS
Siemens Healthineers
SOC Telemed
Spacelabs
TriNetX
Validic
Veritas
Visage Imaging
Vocera
Wolters Kluwer
Workday
Zoom Video

I’ll add to the list as I manually look up the empty booths or hear details from readers.

Some vendors moved within the hall, in some cases giving up big booths in favor of small ones. It may be that HIMSS is rearranging booths to make the empty ones less noticeable and exhibitors choosing smaller spaces for a reduced staff presence.

Readers have told me (unconfirmed) that registrants from these provider organizations won’t be allowed to attend:

Cleveland Clinic
Intermountain Healthcare
Jefferson Health
Kaiser Permanente
MedStar
Memorial Sloan Kettering
Multicare
Providence
Seattle Children’s
Tampa General
UNC Health Care

News 3/5/20

I don’t ordinarily post news on Wednesdays dated tomorrow, but HIMSS20 interest is high and I sense that readers are looking to stay connected. I’ll cover just a few miscellaneous items today and do a full news post on Thursday as usual.

Reader Comments

From Need to Stay Anonymous: “Re: HIMSS20. HIMSS asked our national, well-known company not to publicize or reveal that we aren’t going to HIMSS20, but rather to say that ‘we are participating at a reduced level’ if asked and without making any public statements. The concern is the optics – HIMSS can’t cancel because this is their main (almost only) revenue stream and having ONC and President Trump means the HHS people are forced to attend. The organizations I know will set up their booths, let them be empty, and attend only the panels where they are presenting and then leave.” Unverified.

From HISJunkie: “Re: HIMSS20. Could this be the beginning of the end for HIMSS? When all those companies that canceled look back in 10 months and see that not attending had little or no impact on real sales, why sign up for 2021?” Emails I’ve had with a few companies indicate that they aren’t pulling out only because they are afraid their competitors won’t and thus will gain competitive advantage. I don’t know if that competitive pressure to have a bigger booth, louder parties, and in-booth celebrities will carry over to HIMSS21 following a muted HIMSS20. Either way, I feel sorry for the HIMSS folks on the ground in Orlando who are dealing with day-to-day coronavirus updates, complaints from people who want the conference postponed or cancelled, setting up in-venue screening stations and clinics, and working through the security implications of having a sitting President kick off the conference. A HIMSS conference always requires a ton of work starting months or years in advance, but imagine this year with the added uncertainty of whether it will go on (which seems set in stone at this point) and the financial impact if it doesn’t.

From Not the Black Plague Yet!: “Re: HIMSS20. Rumors abound that payers are cancelling. If Big Tech and Big Insurance aren’t going and pressure is on Big Delivery to not go, then I think HIMSS is being disingenuous to small and mid-market vendors if their customers and prospects won’t be there. Cancelling or postponing is the right thing to do.” I don’t think HIMSS will cancel at this point barring some state or federal mandate, but they will still be left dealing with high-paying exhibitors who may not be happy with their ROI if attendance is off, exuberance is tempered by on-site health precautions, or attentions are distracted with new interoperability regs and worries about hospital employers and family back home. But I don’t think that preventing exhibitor disappointment should be the go-no go driver.

From Ponzu: “Re: HIMSS20. This is a needed call to take it virtual – it would be less cost and less time away from work for attendees, lowered carbon emissions, and of course infection related concerns would disappear.” The challenge is the bottom line of HIMSS since virtual conferences are hard to monetize. HIMSS tried virtual conferences a few years ago in a weird Second Life sort of way and they flopped. A conference without a cash register-ringing exhibit hall and in-person networking is really just a bunch of webinars that draws much less interest and money. People say they attend HIMSS for education, but even the in-person version would die out if it weren’t for parties, the exhibit hall boat show, and the chance to run around with colleagues and job-hunt at employer expense. The idea of a virtual conference is commendable, but not realistic under the HIMSS business model. And let’s not minimize that threat to HIMSS – if you like what HIMSS does in general, realize that its ability to continue doing so is highly dependent on offering a financially successful annual conference.

From USS MDRX: “Re: Allscripts. Stock hit a 10-year low today. How does the board allow this management team to remain in place when Cerner recently hit an all-time high?” MDRX shares closed down 8% Tuesday after the company reported losing $182 million on the year, flipped from black to red for the quarter, and announced significant inpatient attrition. They’re down 32% in the past year vs. the Nasdaq’s 15% gain and Cerner’s 28% increase. Ten-year performance finds that both the Nasdaq index and CERN shares gained around 250%, while MDRX was down 64%. The market cap of Allscripts is $1.2 billion.

From Chaminade: “Re: HIMSS20. Are you still going?” I’m still going. I see little health risk, although if HIStalk suddenly goes dark because I’ve become a COVID-19 fatality, then I hereby grant permission to make fun of my poor choice. My biggest worry is that everyone will be preoccupied and morose to the point that the conference won’t deliver even the modest benefits we usually see, although I will have plenty to observe and write about for those who are left home. I’m on text at 615.433.5294. I might need to find a Freddy Krueger glove or tie one hand behind my back to override my handshaking reflex.

HIStalk Announcements and Requests

I enhanced the menu system at the top of the HIStalk page with a more user-friendly floating version. This will allow me to reduce some of the sidebar items.

My unscientific, unvetted snap poll that was targeted at HIMSS20 registrants finds that 30% plan to attend the President’s opening keynote on Monday. An interesting 7% say they had already cancelled their attendance plan even before his speaking slot was announced, while 12% say they won’t attend the conference because he is speaking. I’m in the 10% category of not arriving in time to be there, especially given the resulting likely delays in local travel and convention center security.

Snap survey for health system employees: what is your employer doing in response to coronavirus concerns? IT-specific actions are especially welcome.

Lorre will be untethered from a HIMSS20 booth for the first time in years, so she is willing to drop by the booths of prospective HIStalk sponsors for a quick chat. Contact her to make arrangements. She is thrilled to be able to eat lunch and take bathroom breaks that aren’t dependent on finding visitors who are willing to cover our booth.

Webinars

March 26 (Thursday) 12:30 ET. “How to Use Automation to Reduce ‘My EHR is Slow’ Complaints.” Sponsor: Goliath Technologies. A common challenge is that a clinician is ready to work, but their technology is not. EHRs can be slow, logins not working, or printers and scanners are offline. Troubleshooting these end user tickets quickly is nearly impossible, especially in complex environments that might include Citrix or VMware Horizon. This webinar will present real-world examples of how leading health systems are using purpose-built technology with embedded automation and intelligence to proactively anticipate, troubleshoot, and prevent end user performance issue across their IT infrastructure and EHRs.

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

Acquisitions, Funding, Business, and Stock

SymphonyAI Group acquires advanced visualization and AI-driven technology vendor TeraRecon. SymphonyAI’s several companies include precision oncology vendor Concerto Health AI.

Other

I received these unverified reader reports about HIMSS20 attendance:

• VMware supposedly won’t attend.
• Microsoft is reportedly debating internally whether to attend.
• Providence and Multicare reportedly will keep registrants home.
• An anonymous reader says their healthcare organization has suspended all business travel for four weeks.
• Medicomp will not exhibit (that comes from Medicomp directly).
• HP is reportedly not exhibiting.
• MITRE is said to have cancelled attendance plans. (update: now verified via Twitter).
• Cleveland Clinic reportedly won’t participate.
• A reader says EClinicalWorks is notifying people who are scheduled for meetings that it won’t attend.

Interesting: the American Physical Society physics group cancelled its 10,000-attendee annual conference the day before it was set to begin in Denver this past Monday. I can’t imagine traveling there and then scrambling to find early flights back home. It’s different than HIMSS, though, in that many of its attendees are coming from outside the US, including CDC Level 3 warning countries.

HIMSS20 gets a mention in a New York Times article titled “What Happens in Vegas if No One Stays in Vegas?” Conferences drive one-third of the revenue of hotel chains that now have uncertain futures. A tech conference scheduled for next week in San Jose, CA will bar residents and recent visitors of China, South Korea, Italy, and Japan and requires attendees to bring passports that will be checked for recent travel. They will check attendee temperatures via “passive scanning,” have banned handshakes, and mandate that each attendee wash their hands before each session, apologizing in advance for the lines that will result. Analysts say Las Vegas is particularly at risk for conference-related business downturn.

I’m wondering about the “passive temperature screening” that this conference will use and wondering if HIMSS will roll it out. It has a lot of false positives and negatives from what I’ve read, but high readings just mean someone will be pulled aside for a manual temperature check. The real fun begins if your temperature is elevated there as well, when I assume you would be escorted off to an onsite clinic and maybe quarantined.

The leader of the World Health Organization team that spent two weeks in China studying that country’s COVID-19 response makes interesting points:

• He says containment is still possible for countries that act quickly, but that requires speed, money, imagination, and political courage. He says COVID-19 isn’t a global pandemic, but rather a series of outbreaks that are occurring globally.
• So far, it doesn’t appear that we’re seeing just the tip of the iceberg, although that could change with more widespread testing. Reported cases in China are trending down fast and hospitals have empty beds.
• The fatality rate seems to be 1-2% (recent reports suggest a higher rate).
• Kids get flu, but don’t seem to get COVID-19 or serve as carriers. An untested theory is that children gain immunity from being exposed to four milder coronaviruses. Still, he says you have to close schools if disease clusters pop up, and that’s a big problem because half the local work force has to stay home with them.
• Most of the infection clusters occur in families, not hospitals, restaurants, prisons, or other public sources.
• China almost immediately moved 50% of its medical care services online to allow people to stay home.
• Fever clinics geared up for rapid screening, with CT lung scans being run at up to 12 per hour versus the US rate of one or two per hour. Swab test time was reduced to four hours so people could be quickly isolated.
• China changed its best hospitals to address only COVID-19, moving other patients out to routine care hospitals.
• He says, “China is really good at keeping people alive,” noting the quality of hospitals and the extent of equipment they have.
• The lack of universal healthcare in the US will “wreak havoc” because people will not have the money to seek treatment or to take time off from work and will remain carriers. Testing is free in China and the government covers all costs beyond insurance.
• Technology is important in China’s response because they are tracking all 70,000 cases, they have moved schooling online, people who track contacts use online forms instead of paper, and rural areas of the country have rolled out 5G.
• He concludes when asked if such measures would work in the US instead of China, “There has to be a shift in mindset to rapid response thinking. Are you just going to throw up your hands? There’s a real moral hazard in that, a judgment call on what you think of your vulnerable populations. Ask yourself: Can you do the easy stuff? Can you isolate 100 patients? Can you trace 1,000 contacts? If you don’t, this will roar through a community.”

I missed that Atrium Health made an official announcement recently about its move to Epic. Its Navicent Health locations in Georgia will go live in 2021 and other locations through 2023.

Meanwhile, for something completely different, HIMSS defines “digital health” (much-needed Oxford commas mine):

Digital health connects and empowers people and populations to manage health and wellness, augmented by accessible and supportive provider teams working within flexible, integrated, interoperable, and digitally-enabled care environments that strategically leverage digital tools, technologies, and services to transform care delivery.

Contacts

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

News 3/4/20

Top News

Allscripts announces Q4 results: revenue up 2%, adjusted EPS $0.17 vs. $0.18, falling short of Wall Street estimates for both.

From the earnings call:

• The company expects to recover half of the $145 million it paid to settle Practice Fusion’s Department of Justice charges from “a variety of escrows and insurance policies” and will make installment payments through 2020.
• CEO Paul Black, when asked about potential opioid liability risk beyond the Practice Fusion settlement for pushing opioids at order entry in a contract with OxyContin’s manufacturer, said the company doesn’t know, but “so far, so good.”
• President Rick Poulton says that acute care client attrition will reduce 2020 revenue by $50 million. Black says talks with other clients who say they’re leaving represent another $30-40 million over several years.
• Allscripts will hire a corporate transformation consulting firm to review efficiency, resource alignment, and decision-making structure over the next 10-12 weeks.
• Non-EHR business represents 20% of the company’s revenue.
• Veradigm business results have been softer than expected.
• Poulton agreed with an analyst’s observation that the company’s free cash flow numbers are “pathetic” and hopes to improve them with the transformation initiative.
• Poulton will permanently add the CFO role to his president title with the resignation of Dennis Olis after two years on the job. 

Reader Comments

From CoronaHIMSS20: “Re: Confirmed that Intermountain Healthcare is pulling all their staff back. Our contact there said to expect the same of other provider organizations, both from a practical view plus the optics involved. Siemens has also told its employees that they have pulled out of HIMSS and that all activities must be performed remotely if possible.” A reader told me that Partners HealthCare is also keeping its folks home. Lumiata has also cancelled as an exhibitor. We won’t really know the extent of the no-shows until we get to Orlando because most organizations won’t bother making an announcement. There’s no registration refund, just a rollover to HIMSS21 registration fees, so even HIMSS won’t know how many no-shows to expect if people don’t bother until later. It will certainly be a different environment than in years past. The burning question: will MedData have scones?

From Humana Insider: “Re: HIMSS20. Humana just banned any non-essential travel within the US for the entire month of March. That includes conferences such as HIMSS, so I’m assuming their 20×20 booth will be impacted.”

From Critical Juncture: “Re: HIMSS20. My doctor advised me not to attend due to a chronic health condition that raises my COVID-19 risk. All of my requests to cancel my HIMSS-booked hotel have been rejected even though they say they are making accommodations (no pun intended).” 

From Game Afoot: “Re: HIMSS20 exhibitor cancellations. You should squat in the vacant Cisco booth, planting your Smokin’ Doc standee dead center and see if anyone notices or cares.” I received zero ROI from exhibiting, so I’m not sure I would bother even if some cancelling company donated their space. Perhaps an impromptu HIStalkapalooza-lite could be held there in silent concert mode, where we all wear headsets and dance frantically to a soundtrack that puzzled observers can’t hear. I could charge for the headsets, “curate” the tracks as the hipsters say, and donate the proceeds to Donors Choose.

From Elucidator: “Re: President Trump at HIMSS20. Politics aside, should they have invited him?” Every conference would love to have a sitting President show up to validate its existence and the importance of its attendees, and I’m sure HIMSS has extended the same invitation every year regardless of who occupies the Oval Office. I’m hoping (but not betting) that political ugliness will be absent from both sides of the podium since the keynote is supposed to inspire rather than leave attendees arguing with each other. Trivia: HIMSS will now have had two of three impeached US presidents as their keynote speaker, a record that will stand unless someone holograms Andrew Johnson. Here’s my plea – for whoever introduces the President (Hal Wolf, probably), please just get him up there without the usual beaming, glad-handing, and nervous delight at being in the rarefied air of a celebrity who just wants you to shut up and let him speak. I hate it every year when someone from HIMSS takes obviously excessive pleasure in rattling off an overly long and fawning introduction, hand-shaking (or perhaps elbow-tapping this year) with an ear-to-ear fanboy grin, and then inserting themselves into a post-talk analysis or lame fireside chat.

From Derek Smalls: “Re: HIMSS20. Almost all related attendee expenses are non-refundable, including registration fees that just roll over to HIMSS21. Not everyone wants to head to Las Vegas next year, and vendors will go nuts if they cancel HIMSS20 since some of them invest 50% or more of their marketing budget on just this one show. Meanwhile, Orlando theme parks remain open and draw 100,000 visitors per day, European Congress of Radiology is making no change to its March 11-15 meeting in Vienna, and we’ve had two people out of 328 million die in the US from not very many confirmed cases.” It was just announced that ECR 2020, which draws 20,000+ attendees, has been postponed until July 15-19. For HIMSS, the common answer is “stay home if you aren’t comfortable with the risk,” but I wonder how that plays when your employer is an exhibitor and you’re scheduled to work the booth? I also question the “frequent handwashing” recommendation given the large percentage of “healthcare” guys I see in the convention center’s men’s restroom who bolt for the door afterward without a sink stop, including some whose pre-departure position was sitting.

From Bonhomme: “Re: HIMSS20. If a guest in the hotel I’m staying in becomes symptomatic, could they quarantine the whole hotel? What if an attendee is found to have COVID-19 – could they quarantine the whole convention center as in the Diamond Princess?” Beats me, although Florida’s governor just declared a public health emergency after two state residents tested presumptively positive for COVID-19. Let’s hope we’re better at treatment than surveillance because we’ve certainly fumbled that. Meanwhile, I’m thinking about all the employees of Orlando hotels, restaurants, the airport, and the convention center itself who not only have crossed paths will people from everywhere in the past couple of weeks, but who also in many cases can’t afford to miss work.

From DontCoughOnMe: “Re: Amazon Web Services. Pulled out of HIMSS20 citing COVID-19, but wondering if it was related to the Trump announcement, Bezos, DoD, etc.” I think Amazon implemented a company-wide travel ban before the President Trump announcement.

From Dr. Karma: “Re: [executive name omitted.] Fired from [company name omitted] for sexually harassing a small group sales rep. Here’s the email sent to the company.” It doesn’t feel fair for me to name the individual and company over a personnel issue, especially when the email didn’t specifically say why the person was fired. Still, he was indeed let go, an presumably for good reason.

HIStalk Announcements and Requests

I created a PDF version of my HIMSS20 guide that lists what my sponsors are doing, giving away, and presenting. Download it, print it, whatever works for you.

I planned my HIMSS conference travel this year around an “arrive late and leave early” goal, so I won’t be attending Monday’s events, including the President’s speech. Maybe someone can record it for me. Good luck if you are traveling to Orlando Monday afternoon like me since airports and local roads are going to be disrupted by the President’s visit.

HIStalk drew over 16,000 page views in 13,000 unique visits on Tuesday, the second-highest total in 16 years. The Department of Defense selection announcement on July 30, 2015 generated a few more page views, but with fewer visits, so you could argue that Tuesday was the busiest day ever.

Snap poll for HIMSS20 registrants: will you attend President Trump’s keynote on Monday? I’ve disabled poll comments since I’m not interesting in fomenting disharmony, just curious about how attendees will respond to a newly added session on an odd conference day.

I’m worried about how the opening keynote by the President will set the mood of HIMSS20 when attendees are already in a down mood over COVID-19 fears, new HHS regulations, and a scaled-back conference. Opening keynotes have always been collegial, self-congratulatory, and boring in having some vendor suit babbling on to a restless crowd that is checking their watches, ready to sprint to the exhibit hall opening in a feeling of unity and purpose. It won’t be the same if we start with oppressive security precautions, protests, attendees screaming in each other’s faces, angry heckling, and watching people get removed to the cheers of others. Not to mention that the open bar is next up and there’s nothing like alcohol to stir up the political blood sport. You just know that someone’s MAGA hat will trigger an incident that will end up as cellphone video news.

The list of announced HIMSS exhibitor cancellations that I’ve heard:

Amazon Web Services
Cisco
HL7
Humana
Intel
Lumiata
Salesforce
Siemens Healthineers
TriNetX

Webinars

March 4 (Wednesday) 1 ET: “Tools for Success: How to Increase Clinician Satisfaction with HIT Solutions.” Sponsor: Intelligent Medical Objects. Presenter: Andrew Kanter, MD, MPH, FACMI, FAMIA, chief medical officer, IMO. Dr. Kanter will explore how striving to achieve the Quadruple Aim (by focusing on the provider experience) can improve clinician satisfaction and population health needs while also reducing per capita healthcare costs. Attendees will learn how to set providers up for success with new technology, the potential unforeseen consequences of purchasing without the clinician in mind, and the factors that are critically important to clinicians who are using new health information systems.

March 4 (Wednesday) 1 ET: “Healthcare Digital Marketing: Jump-Start Patient Discovery and Conversion.” Sponsor: Orbita. Presenters: Victoria Petrock, MBA, MLIS, principal analyst, EMarketer; Kristi Ebong, MBA, MPH, SVP of corporate strategy, Orbita. Does your digital front door capture consumers who search for health-related information one billion times each day? Do you have actionable steps to convert them into patients? Do you understand voice and chat virtual assistants? The presenters will explore the consumer challenges involved with finding, navigating, and receiving care, discuss why healthcare marketers need to embrace conversational voice and chatbot technologies, and describe how new technologies such as conversational micro-robots can improve engagement.

March 26 (Thursday) 12:30 ET. “How to Use Automation to Reduce ‘My EHR is Slow’ Complaints.” Sponsor: Goliath Technologies. A common challenge is that a clinician is ready to work, but their technology is not. EHRs can be slow, logins not working, or printers and scanners are offline. Troubleshooting these end user tickets quickly is nearly impossible, especially in complex environments that might include Citrix or VMware Horizon. This webinar will present real-world examples of how leading health systems are using purpose-built technology with embedded automation and intelligence to proactively anticipate, troubleshoot, and prevent end user performance issue across their IT infrastructure and EHRs.

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

Acquisitions, Funding, Business, and Stock

Patient engagement and payment solutions vendor RevSpring acquires Loyale Healthcare, which offers patient financial engagement technology.

Sales

• Saudi Arabia’s King Faisal Specialist Hospital & Research Center chooses TransformativeMed to improve EHR workflow and care quality. The hospital will work with the company to develop apps for thrombolytics, oncology, congestive heart failure, and other conditions and will assist other hospitals in implementing the system. 
• Continuing education and patient engagement solution vendor MedBridge will expand its integration to EHRs using Redox’s health integration platform.

People

Ed Marx (Cleveland Clinic) joins The HCI Group as chief digital officer.

OptimizeRx promotes Todd Inman to CTO.

The SSI Group hires Diana Allen, PhD (Culbert Healthcare Solutions) as president and CEO, replacing Jimmy Lyons.

Announcements and Implementations

Holy Name Medical Center (NJ) develops Harmony EHR — powered by Medicomp’s Quippe Clinical Data Engine — to replace the multiple EHRs used in its ED, ambulatory, and inpatient settings. Harmony EHR, which will be made commercially available later, will be demonstrated at Medicomp’s Booth # 3559 at HIMSS20.

Nuance and the American Medical Association will run a pilot test to see if their combined technologies – Nuance’s DAX ambient clinical intelligence and AMA’s IHMI clinical knowledge graph – can reduce burnout-causing documentation burden.

First Databank rolls out an Alexa service that allows consumers to ask questions about commonly prescribed medications, including side effects and drug interactions, in both English and Spanish. I tried it this morning and it was pretty cool – I asked, “Alexa, what is amoxicillin used for” and it gave a nice summary, leading off with “According to First Databank …” I then asked, “Alexa, who is First Databank” and it gave a consumer-oriented summary.

Privacy and Security

Walgreens says a bug in its mobile app allowed users to see the personal information of other users, such as name, prescription information, and shipping addresses over a week-long period in January 2020.

Other

The government of China requires citizens to use a smartphone app that decides whether they should be quarantined for COVID-19, but a New York Times analysis found that it also sends the user’s location and ID to local police for tracking. The Alipay Health Code app uses unspecified big data to assign a user QR code that is green (unrestricted movement), yellow (seven-day quarantine), or red (14-day quarantine). More than 50 million people signed up in Zhejiang Province alone, with one million of them getting yellow or red codes. Employers and housing units are denying entrance to holders of red codes and nobody has explained what it takes to make the red code go away.

In similar news that could make a great episode of “Black Mirror,” South Korea is deploying apps that use government data to show details of nearby confirmed COVID-19 patients, including date the infection was confirmed, the patient’s demographic data, and their location history. One of the apps issues a smartphone alert if the user gets within 100 yards of a location that has been visited by a COVID-19 patient.

HL7 withdraws from HIMSS20 due to COVID-19 concerns. First-time exhibitor TriNetX also announced that it won’t attend, as have Salesforce, Intel, Cisco, Amazon, and Siemens Healthineers. 

Apple will pay $500 million to settle a class action lawsuit that accused the company of intentionally slowing down older IPhones to compel users to buy new ones.

Families in Australia who receive a government childcare subsidy struggle to cover daycare costs after an error in the country’s Centrelink social security payments system cuts off payments to families of children it incorrectly thinks have not been vaccinated, which is a condition of the program.

The COO of Cape Fear Valley Health makes an interesting comment at a gala of one of its hospitals, as reported by the local paper for some reason: “There are just awesome people here, and very resilient folks here, and you have been through a lot of things through natural disasters. And if you work in the hospital, you know that one of those is Epic, our new electronic medical record. That was tough as well.”

Sponsor Updates

• Four strategically aligned healthcare technology venture capital funds invest in CareSignal, previously Epharmix, two of them being customer-partners.
• Nuance will partner with the American Medical Association to combine and test their respective technologies in an effort to reduce documentation burden.
• King’s Daughters Medical Center (MS) reduces ED length of stay by one hour with Meditech Expanse.
• Datica features Greenway Health CMO Geeta Nayyar, MD in its latest “4×4 Health” podcast.

Blog Posts

• How Eva, the eClinicalWorks Virtual Assistant, is transforming the office visit (EClinicalWorks)
• Targeting the Leading Threats to Health (EClinicalWorks)
• Why Extensive Testing is Non-Negotiable for EHR Interface Implementations (314e)
• Managing a Successful General Practice Office (AdvancedMD)
• Why Remote Work is More Important Today than Ever (Avaya)
• Four Cybersecurity Trends for 2020 (Burwood Group)
• 3 prerequisites to health IT innovation (Nordic)
• Defining and Tracking Quality with Your SNF Partners (CarePort Health)
• Health IT Spend: Takeaways for Health System Leadership (CereCore)
• EHRs: A Source of Burnout & Optimization Strategies (Collective Medical)
• Improving Provider Workflows for Specialty Medications Through Technology (CoverMyMeds)
• Top Advantages of Big Data in the Healthcare Industry (Dimensional Insight)

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