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Weekender 7/30/21

July 30, 2021 Weekender No Comments

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Weekly News Recap

  • HIMSS21 attendees will be required to wear masks following CDC’s updated guidance and state and local emergency orders.
  • Two HIMSS21 exhibitors announce that they have decided not to participate based on COVID conditions in Las Vegas.
  • Cerner’s Q2 revenue and earnings beat Wall Street expectations.
  • Avera Health sells its 230-employee telemedicine services company to a private investment firm.
  • Amwell acquires a digital mental healthcare company and an automated virtual care vendor for a combined $320 million.
  • England’s System C acquires medication management vendor WellSky International and renames it CareFlow Medicines Management.
  • Clinical data and genomic platform vendor Sema4 goes public via a SPAC merger at a valuation of $3 billion.

Best Reader Comments

There is such a thing as momentum and popular sentiment. This is politics playing out in the healthcare space. Imagine that the very concept of EMRs becomes tainted. It’s a Failure and it’s No Good, Anyone Can See That. Medicine would not change and modernize in ways that it desperately needs to modernize.This is what happened to the metric system in the United States. Yet, and this is very important, the metric system only failed in the US. Why? It was a political failure. You see, the problem wasn’t the metric system. The metric system is successful everywhere that isn’t the US. And I challenge you to come up with a reason that doesn’t sound like total nonsense. For example, America is Exceptional, is a nonsense reason. Yet that’s still the comfortable go-to trope of those anti-metric proponents. Meanwhile EMR technology has a LOT more value to offer than the metric system does. (Brian Too)

Regarding McLeod: What? They are ditching Cerner after only two years being active! Such a waste of time, money, etc. (Bigdog)

Ever since the HITECH Act gave HHS authority to impose ever-increasing EHR requirements, it has seemed that ONC has continually sought additional additions to those requirements, whether they make sense or not. No one disputes that these are not good ideas, but one surely can dispute how much one can expect the industry can absorb, especially when the documentation requirements and other bureaucracy continue to increase. I don’t dispute the value, just the pace of adoption and the expectations on our providers. (Bill Spooner)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. D in Texas, who asked for a set of Big Books for her first-grade class. She reported in December, “This year has been a little different some of my students are home and some are here with me in class. We use all the technology available to help bridge the distance. The first book I read to them was our ‘Polar Bear, Polar Bear, What Do You Hear?’ I was ALONE in the room and reading to the children, it was an odd feeling, but it was so nice to have a book that the students could see the book and my expressions. With regular sized books I would have to project it and then they would not be able to see my face. As a teacher of mainly low-income students, I love being able to give my students the chance to ‘have’ something that they may only see in a store. There is just something about having a large book that literally makes the students feel like they are part of the story. Thank you again for taking the time to enhance the education of a young child.”

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Bringing home an Olympic gold medal in fencing is third-year University of Kentucky medical student Lee Kiefer. Her sister and 2011 NCAA fencing champion is an OB-GYN resident, their mother is a psychiatrist, and their father is a former Duke varsity fencing captain who is now a neurosurgeon.

The two Arkansas Children’s hospitals report that 24 pediatric patients are hospitalized with COVID-19, 50% more than any previous pandemic peak. Seven are in ICU and two are on ventilators. Half of the inpatients are aged 12 and over and are thus eligible to be vaccinated, but none of those hospitalized had been.

AdventHealth’s Central Florida Division cancels non-emergency surgeries and hospital-based outpatient procedures as its COVID-19 patient count swells to 1,000, exceeding that of the previous peak in January. Florida reported 18,000 new cases Thursday, the biggest one-day increase since January.

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In England, a husband and wife who are both doctors whose licenses have been suspended face charges of selling puberty-blocking drugs to children via their internet-only online transgender clinic. Helen Webberley, MBChB, LLM  is working from Spain in what she calls a “global” enterprise, exploiting a loophole that allows any EU doctor’s prescriptions to be filled in the UK. The website lists 35 employees. The drugs she prescribes are being used to block puberty while the young patient considers their gender options, but the psychological and growth effects of the drugs on children are unknown.

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A California cyclist who was hoping to land a spot in the Tokyo Olympics crashes on a Pennsylvania velodrome track, with his several resulting injuries resulting in a $200,000 out-of-network bill from two hospitals. Phil Gaimon was covered by two health insurance policies, but Lehigh Valley Health Network billed $152,000 for services an expert said should have cost $21,000. They billed $26,000 for a night in the ICU and $30,000 for one in the burn unit, which Gaimon said was only because the hospital had no other beds available. He lives in California, one of 33 states that prohibits surprise medical bills for insured patients, but the state’s authority applies only to in-state providers.


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Weekender 7/23/21

July 23, 2021 Weekender 1 Comment

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Weekly News Recap

  • The VA tells the House Veterans Affairs Committee that it won’t bring any more sites live on Cerner for at least six months.
  • A law firm files an information blocking complaint against a hospital, Meditech, and Ciox Health, claiming that it could not get a machine readable PDF of a client’s medical records.
  • WebMD acquires The Wellness Network
  • The New York Times says IBM Watson failed to achieve its goals of business transformation and IBM rejuvenation, noting specifically that Watson’s healthcare “moon shot” failed in multiple health systems.
  • The Senate confirms as VA deputy secretary Robert Remy, JD, whose job responsibilities include overseeing its Cerner project.
  • A study of 500 hospital websites finds that 471 of them have not posted their prices as federal transparency rules require.
  • Clinical data and registry vendor OM1 raises $85 million.
  • As HIMSS21 approaches, a COVID-19 resurgence in Las Vegas causes the Venetian, Palazzo, and Sands to again require employees to wear masks.

Best Reader Comments

If the insurance company maintains the same standard of what is medically necessary, then won’t eliminating prior authorization translate directly into increased denials? … It seems like the law ultimately makes things more convenient for providers and shifts the burden of fighting insurance companies to patients. (IANAL)

Having worked at one of the four start-ups that IBM purchased and then destroyed, it’s prime material for a case study. Bringing in IBM resources (including senior IT) that couldn’t spell healthcare and were now in charge was the beginning of the end. No ability to focus on the right problems, selling software that didn’t exist, making promises that were impossible to fulfill, etc. (tchips)

I have been an IBM “partner” in two companies, a position I would not wish on my worst enemy. “Their clients are their clients, and my clients are their clients” type of attitude. Ever since introduction 20+ years ago, I kept saying that Watson was a hammer looking for a nail. The main premise was its use in diagnostics, and I’m sorry, but well-experienced and well-read physicians can achieve similar or better conclusions than the box with the blinking lights, which at best could only suggest possible diagnoses.(Dr. Moriarity)

I think HIMSS will ultimately be at the whim of the hospitals. Should they universally re-enforce travel bans (if they haven’t already), the vendors will catch wind of it and a few of them will seize the moment as a PR opportunity to make a splashy statement about why they’re pulling out this year … Hopefully it won’t come to this and we can all enjoy the annual industry soirée safely, but I think it’s fair to say we’re beginning to see some cracks in the foundation. (LongTimeFan)

I can see imaging solutions being close to being ready [for IBM Watson-like solutions]. With a plethora of training material associated with a diagnosis, the solution could train in pretty good order. But how are you going to train it to practice oncology? (Brody Brodock)

There’s also only one vendor that can deliver basic interop out of the box with very little effort, and even richer interoperability with a some terminology mapping. Kind of sad that this project [the VA’s Cerner implementation] is doing so poorly in this area when that is allegedly why Cerner won out. (Elizabeth H. H. Holmes)

[Penalties for hospitals failing to post prices] shouldn’t be about the dollar value. If you operate in the United States, you should do your best to follow the law. What you’re seeing here is widespread malfeasance by health systems. Regulators should come down hard on them in response. (IANAL)

[IT projects reducing cost] is a goal, I think it’s somewhat dangerous to assume this in every single instance. Personally, I’ve long said that these EMR/EHR implementations often raise expectations of what can be accomplished. And those raised expectations sometimes increase rather than decrease costs. Expectations are a matter of politics. Thus, regardless of what the budget said, you may find expenditures beyond the budget. It only takes a sufficiently highly placed executive to demand that their expectations be met. (Brian Too)

Large scale project PM’ing 101 – never, ever put the software vendor in as the prime on any large contract. Especially when it involves large-scale systems integration with all kinds of third parties. At least VA is seeming to acknowledge that end goal. (John Bob


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. D in Nebraska, who asked for COVID-related sanitation supplies and health books for her Head Start class. She reported in December, “As this fall has been full of uncertainty, we have had to shift learning styles several times, but having the items from this project in my classroom has given me a small peace of mind that the kids will be safer and healthier thanks to you. Most of all, the air purifier is such a blessing. This purifier has a setting that our classroom air is recirculated once per hour. This helps myself and all the parents to know that the germs are being filtered out. Thank you doesn’t seem like enough to say, but know your generosity has definitely not gone unnoticed.”

A ProPublica review finds that 40% of the employees of nursing homes and long-term care organizations have not been vaccinated against COVID-19, which killed huge numbers of those residents before the vaccine became available. Twenty-three facilities reported vaccination rates of under 1%.

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A North Carolina doctor is named as one of the “Disinformation Dozen” who are responsible for 73% of the anti-vaccine content on Facebook. Rashid Buttar, DO posts conspiracy theory videos claiming that COVID-19 vaccines cause infertility and that wearing masks and 5G cell networks cause COVID-19. Some of the videos to which he linked generated commissions for himself. The doctor has been reprimanded twice for unprofessional conduct and cited by the FDA for illegally marketing unapproved drugs. It would be interesting to fact-check his CV, which lists impressive educational, military, and athletic accomplishments before he specialized in chelation therapy.

A Colorado couple will pay $5,000 more than they expected for the birth of their son under the 1970s-era “birthday rule,” which says that when parents have separate health insurance plans, the delivery cost is covered by the policy of the parent whose birthday falls earlier in the year. That is the husband in this case, whose lower-paying insurance has forced the couple to sign up for a three-year payment plan.

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Like a flight whose seats are oversold, a UK medical school offers accepted students $14,000 and a free first year of rooming if they will defer their high-demand spot for a year.

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A 96-year-old woman who is believed to be the oldest working nurse in the country retires from MultiCare Tacoma General Hospital after a 70-year career. The advice of now-retired OR nurse Florence “SeeSee” Rigney to fellow nurses is “don’t ever think that you know it all.”


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Weekender 7/9/21

July 9, 2021 Weekender 1 Comment

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Weekly News Recap

  • FDA clears AliveCor’s phone-attached EKG sensor and app to allow professionals to calculate QTc interval for diagnosis of irregular heartbeat.
  • Intelerad acquires Heart Imaging Technologies.
  • A second OIG review of the VA’s Cerner project warns again of unbudgeted infrastructure costs of several billion dollars.
  • Sophia Genetics announces IPO plans.
  • UC San Diego Health adopts the SMART Health Card.
  • Three institutions form Texas Health Informatics Alliance and announce its first conference.

Best Reader Comments

Regarding AmazonCare, calling it “value-based care” is generous. Telehealth companies used to charge per-member per-month. Insurance companies started to figure out that telehealth companies weren’t doing much. Even worse is that as the insurance companies added members, the cost to the insurance company rose linearly, but the cost to the telehealth company barely changed since so few of those members actually used the telehealth service. Insurance companies also did internal measurements on the value of “urgent care” style telehealth and realized it wasn’t really substituting for primary care visits and wasn’t driving down long term costs. In urgent care style telehealth, people use it for the sniffles, while before, they would just ride it out. Increased healthcare convenience means people use more healthcare, not less. That isn’t an interesting service for insurance companies. So about five years ago, insurance companies forced telehealth companies away from per-member per-month. Many initially tried straight charging per visit and some still do, but that style of telehealth is a race to the bottom, low-margin business. Your HR department that buys your benefits is less savvy to this stuff than insurance companies, so it is easier to make money off employers directly, but selling to them one by one requires a lot of sales people. (IANAL)

I was heavily involved in the original IBM/Epic bid for the DoD. When we lost and found out what Leidos / Cerner had bid, we were mystified. Either they had low-balled, had missed some major infrastructure pieces, or had some “secret sauce” that we just hadn’t figured out. Well, I think we’re finding there was no secret sauce involved. (Bob Smith)

[Epic Care Everywhere] internal structures and mechanisms have been built. There’s a whole support structure to enable information sharing. Therefore, when two compatible Epic HIS systems aren’t sharing data, it’s entirely a customer-side issue. Maybe they aren’t mature enough to share data (after all, I’d consider external data sharing to be an “advanced”’ HIS function, and less of a priority than internal needs and priorities). Or maybe, someone at the customer has specifically decided they don’t want to share data. After all, if setting up Care Everywhere is relatively easy and is fully vendor supported, one has to start to question what the hold-up is. (Brian Too)

I find it funny that slews of provider organizations are coming out saying sepsis AI doesn’t work because they’ve all upcoded sepsis diagnoses. Seems like some great candidates for a Medicare audit. Maybe they can use the sepsis predictor to predict overpayment! (Sepsis predictor)

The Supreme Court decision in the TransUnion case this week makes it pretty clear the lawsuit against Google isn’t going anywhere. If the court doesn’t consider you to be harmed when a credit reporting agency mistakenly informs you that you’re on the terrorist watch list, they’re definitely not going to consider you harmed by having some personal info undisclosed in a log file somewhere. (Dan)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Mr. G in Kentucky, who requested a camera for his school’s yearbook club. He reported back in December, “With school being in and out because of COVID, they have not gotten the opportunity to use it as much as they would like. However, earlier in the school year, we were lucky enough to take some action shots at a couple of our football games. This provided a great opportunity for some hands on learning with more than one student at a time. This is something that I am greatly appreciative of as a teacher! The students were able to take many great shots that will look great in our yearbook. We all thank you from the bottom of our hearts to allow us the opportunity to grow and have amazing opportunities for us to improve our school.”

I found through frustration that scanning your COVID-19 vaccination card into the HIMSS21 Clear Health Pass app works only by positioning your phone skinny side up (portrait mode) instead of the wide-side up (landscape mode) that I expected since that’s how my bank’s mobile deposits work. I finally got that to work, although the app shows my status as “pending verification” with no definition of what that means.

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A Tennessee doctor whose medical license was previously suspended for possession of controlled substances will face the state board again, this time for inappropriately administering COVID-19 antibody tests to determine whether patients are actively infected. The doctor, who had started an in-home COVID-19 testing program, was accused by patients of not wearing a mask or gloves, not performing a physical exam, and falsifying medical records in documenting work he didn’t actually perform.

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Riverside Regional Medical Center (VA) medical resident Eleanor Love, MD starts Richmond-based The Simple Sunflower, which asks newly married couples for their wedding flowers after the ceremony, repackages them into individual vases, and delivers them to hospitalized patients in Richmond, starting with those in palliative care. 


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Weekender 7/2/21

July 2, 2021 Weekender No Comments

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Weekly News Recap

  • The valuation of process automation vendor Olive reportedly reaches $4 billion following a new $400 million investment.
  • HIMSS announces COVID-19 vaccine verification and masking policies for HIMSS21.
  • The VA reaffirms its commitment to implementing Cerner while awaiting the results of an internal project review.
  • Harris acquires Ingenious Med.
  • Ireland’s health service estimates that the ransomware attack that has kept its systems down for six weeks and counting will cost at least $600 million for recovery.
  • A private equity firm acquires and combines Verisys and Aperture Health.
  • Health Catalyst announces its intention to acquire Twistle.
  • Britain’s Health Secretary Matt Hancock resigns after a tabloid runs photos of him kissing a female executive who he appointed.

Best Reader Comments

Not sure I’d put so much faith in the public market, given Doximity’s IPO valuation of $9B+ for a business not that much different in its fundamentals than the founders’ previous effort (Epocrates) which lost 75% of its IPO value and ultimately sold for ~$250M. But America loves second chances! (Debtor)

Olive’s valuation at $4B is a signal that we’re in the midst of a bubble. They were valued at $1.5B as recently as December 2020. One could argue that the $1.5B valuation was frothy. Now they claim to be worth nearly 3 times that, a mere 6 months later. I’ve seen these companies before: Raise, dilute, raise, dilute, acquire, raise, dilute, acquire, raise. The real test will be if they IPO, what valuation does the market support. The market will be more careful, and do more diligence .., Olive seems like they are somewhere in between an enterprise software company (valuation would be 5-6 times revenue) and a consulting firm (valuation would be 1-2 times revenue). I’ve looked at lost of pure SaaS companies in my day, and Olive does not deserve a pure play SaaS valuation. Unless their revenue is way above what we estimate (even with the recent tuck-in acquisitions), this $4B valuation is an outlier – and in a bubbly way. Too bad they can’t just cash in now (but not from me). (Healthcare VC Guy)

I agree that mortality probably isn’t the best measure of EMR benefit. I also agree that having EMRs, e-prescribing, electronic transmission of lab results and vaccine receipt, and an ability to do a quick pívot to telehealth have all been very important in dealing with the pandemic. I’m less convinced that quality of care has improved in general [with EHRs] and don’t believe that documentation is improved (except for being legible). However, it’s hard to figure out because there are so many confounding factors that were introduced at about the same time … Despite the hype associated with the “learning health system”, much of the data in the EMR is incomplete or inaccurate. This will become even worse with greater propagation of errors through more and more health records with the push for interoperability … Overall EMRs have probably had more benefits than negatives but it could have been and could be so much better if the focus was actually on delivering care and less of the regulatory and payment related impediments. (Clinical N Cynical)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. B in Nebraska, who is in her second year of teaching and, as she says, “still waiting to experience a ‘normal’ year.” She asked for a library of books, organizers, clipboards, earbuds, and supplies for her fourth grade class. She reports, “Our school district is using a unique model this year where we only have half of the students in-person at one time. The other students are learning at home through pre-recorded videos made by the district. The headphones allowed my students to listen to their instructional videos in peace, without any loud interruptions. The books that were provided to my students absolutely LIT UP my kiddo’s faces! They loved being able to have books of their own, since we can’t share books through my classroom library.”

NBC News covers the medical care obstacles faced by people who are too large to fit in a CT scanner or hospital gowns. One woman can’t have a cardiac ablation procedure for fibrillation because she exceeds the surgical table’s weight limit and she can’t get an MRI for the same reason, leading her to unsuccessfully to seek testing from veterinarians whose machines are sized for horses and cows.

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This is for the programmers out there. A woman’s last name of True locks her out of Apple ICloud, which mistook it for a Boolean value when she mistakenly failed to capitalize it. For disco and 1970s porn fans, her first name isn’t Andrea.

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A North Carolina nursing home suspends a nurse whose TikTok videos featured her joking about mistreating patients. She says she’s a victim of “cancel culture” since “all my videos are comedy skits.” Her GoFundMe to raise $20,000 for legal fees has yielded $170.

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A closed hospital that has been called “Kentucky’s second most haunted place” is listed for sale, with the former Hayswood Hospital (built in the early 1800s as a school, expanded to its current form in 1925, and opened as a hospital in 1931 that closed in 1983) featuring 80,000 square feet on nearly 3 acres. Locals say the building is not only full of ghosts and trespassers from outside the state hoping to spot them – especially in its former morgue on Halloween — but also asbestos that will cost $3 million to clean up to the point the $800,000 building can be torn down.


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Weekender 6/25/21

June 25, 2021 Weekender No Comments

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Weekly News Recap

  • Health Catalyst announces its acquisition of Twistle.
  • Doximity shares surge on their first day of NYSE trading, valuing the company at $7 billion.
  • Tegria acquires KenSci.
  • Researchers say that Epic Sepsis Model performs poorly in identifying potential cases of sepsis.
  • GE Healthcare names Pater Arduini as its next president and CEO.
  • England’s NHS publishes a draft patient data strategy.
  • NextGen Healthcare announces that President and CEO Rusty Frantz will leave the company.
  • Amazon announces a four-week, virtual AWS Healthcare Accelerator program for startups.
  • California launches a digital COVID-19 vaccination record system.
  • ONC invites colleges and universities to apply for its $80 million public health IT workforce program.

Best Reader Comments

As former CIO, I am wondering if all of the billions (trillions?) spent on EMRs, etc. have really improved care / outcomes. Based on the very simple measure of life expectancy, I would say no. I am sure that billing and documentation has improved and the industry has amassed warehouses full of data for interesting studies. I know that I will be critiqued for use life expectancy as the single measure, but it is easily available and is a fundamental outcome. This should be embarrassing for a country that already had the highest cost and low life expectancy compared to other advanced economies. (Former CIO)

If you step outside the hyped world of AI/ML, a hospital system would not implement a new clinical protocol (for example, if this were a written risk-stratification model for sepsis) without it first being testing, validated, published, and even then they usually want to wait for the Professional Societies to back the protocol before widely accepting and integrating it into practice. Please explain then why hospitals are just blindly accepting these AI/ML algorithms, when there is already a standard for approving clinical decision-making tools? I suspect a large part of the issue here is that there is still not enough medical involvement / integration into the IT/IS departments at many hospitals. Their governance models still view IT and the EHR as a cost center and not a strategic asset to the organization, and think the enhancements that are being added during EHR upgrades are all functionality updates, when in fact they are slipping more and more clinical content and tools into the upgrades. (HITPM)

Coming from the overhyped world of AI/ML, I would tease apart validation of the model and validation of protocol. No model will be 100% accurate, so validating a model comes down to “sufficiently accurate” (trading off precision and recall) and some sort of explainability. In our work on sepsis models, we achieved AOC over 0.8 with the ability to see precisely which parts of the medical record led to the conclusion. We did not commercialize it, not because it was invalid, but because it needed to drive a clinical protocol that added value. And that’s the issue. First, practitioners’ intuitive sense is really good, so any model has to find marginal incremental cases that they’d miss. Second, you need to design, validate, and implement a clinical protocol for what to do when the model alarms. This has a poor ROI. (Dan G)

They [Doximity] display pharmaceutical ads to doctors. Similar to how Practice Fusion made money, but Doximity has lower risk because ad fraud is harder to bring lawsuit or regulatory action against compared to pushing oxy via EHR decision support. (IANAL)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. C in Mississippi, who asked for an IPad and accessories to allow her to create videos of her classroom instruction for students who need extra review or if COVID-19 forced her school to close. She reported in December, “Thankfully we have not had to teach virtually so far, but having an IPad makes it possible for me to record classes that students can use for review if they need extra help on a particular objective. I enjoy having a fun way to intervene with struggling students by having them play educational games on the IPad that reinforce and review skills we are learning each day. School has changed so much this year and technology has become such an important part of our school day. Thank you for making this project possible.”

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Casamba founder and executive chairman Ronnie Amrany buys a waterfront house on Hollywood, FL that sets the record for the highest price paid in that area at $6.9 million. Net Health acquired the therapy EHR vendor in March 2021.

Eleanor Slater Hospital (RI) COO/CFO Christopher Feisthamel takes advantage of an obscure state HR law to avoid repeat attempts to lay him off. Rhode Island’s “leave to protect” provision allows a state employee to hold up to three state jobs at the same time, and if fired from one, they can return to their previous job and “bump” whoever holds it. More than 1,600 state employees have leave-to-protect status, making it hard to fire them.

St. Vincent Hospital (MA) bans activist members of the Catholic Worker Movement from hospital property after they perform an “exorcism of the demon of corporate greed” in the lobby against hospital owner Tenet Healthcare to support striking nurses.

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In India, friends of a man who was receiving COVID-19 vaccine record a video showing a distracted nurse removing a disposable syringe and injecting it without first drawing up the vaccine. Nobody noticed until one of the friends looked at the video later. The nurse has been removed from duty and the man will be brought back to receive his first dose.


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Weekender 6/18/21

June 18, 2021 Weekender 4 Comments

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Weekly News Recap

  • Former Athenahealth CEO Jonathan Bush launches health developer platform vendor Zus Health with a $34 million Series A funding round.
  • Google Health is reportedly downsizing.
  • A Wall Street Journal report says that Apple’s plan to run a wearables-focused virtual primary care service hasn’t been successful and the company is shifting its emphasis to selling Apple Watch.
  • ONC publishes the first draft of its patient address standardization specification.
  • AMA says EHRs should not present drug company advertising.
  • Ambulatory surgery center software vendor HST Pathways acquires patient price transparency vendor Clariti Health.
  • A security services vendor COO is indicted on federal charges of launching a cyberattack against Gwinnett Medical Center (now Northside Hospital Gwinnett).

Best Reader Comments

Doesn’t look like the stock market has given up on CERN yet. Still near all time highs. (Bob)

I found the prices published by a health system I currently have a billing dispute with. Will be interesting to see what they say when I ask them why my insurance company’s payment was insufficient for the services they provided when it is 4x the minimum negotiated charge. (Price Transparency?)

While the [DoD and VA Cerner] systems may be of the same origin, they are not the same today, and so there is that specific problem of non-identical systems. Additionally, the origin data is not anywhere near identical in schema, dictionary, enumeration, etc., so that will be a broader problem. Lastly, they haven’t exactly settled the solutions at this point, so they are driving at a moving target. Failing early might not be a bad strategy, but if someone isn’t setting that expectation, then someone is going to be mighty surprised in very short order. (AnInteropGuy)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. M in Kentucky, who asked for a license to a learning platform to use in both in-person and remote classes. She reports, “”Your donation of the Nearpod Learning Platform has made a huge difference in the learning process for my English as a Second Language (ESL) students. Through this platform I have been able to modify their assignments to enable them to express their learning through drawing, matching, games, and voice recordings in addition to the tradition format of typing. The difference has been so great that my administration purchased Nearpod for the rest of our school. Now ALL students, not just ESL students are going to benefit. Thank you for helping me start this movement and show other how everyone can learn with the right tools and support.”

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The charity RIP Medical Debt buys and forgives $278 million of hospital debt from Ballad Health, relieving the medical payment obligations of 82,000 low-income patients that in some cases go back decades. The charity says it works directly with hospitals that can turn bad debt into revenue without pursuing aggressive collection, address a major social determinant of health, and refine their charity care programs.

A federal court sentences a New York doctor to 57 months in prison for taking drug company bribes in return for prescribing Subsys fentanyl spray. Jeffrey Goldstein, DO took $200,000 in “speaking fees” for giving slide sessions for which attendee sign-in sheets were often forged and enjoyed an evening at a strip club in which drinks and lap dances were provided by company reps. He was the sixth-highest subscriber in the speaking program, generating $800,000 in sales in a single quarter of 2014 versus prescribing the drug just once before signing up for the speaking program. Federal agents also reported that during the speaking events, Goldstein drank heavily and used marijuana and cocaine with his staff. 

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An Alabama nurse is fired and may have lost his license after he is shown in TikTok videos he posted as “@conservativecoy1776” where he says that COVID-19 isn’t dangerous and Anthony Fauci was paid to create it, claims that racism is an overreaction to what was actually a small number of slaveholders, and laughs at video of a patient who cried after receiving a high doctor bill in saying, “Hey, buddy, you better get used to saying that s***.” He made the mistake of recording some of his videos in a hospital room wearing his employee badge, which identified him and his employer, Baptist Health in Montgomery.

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Emory University apologizes to a medical school applicant it rejected in 1959 with the explanation that the school was not authorized to admit “a member of the Negro race.” Marion Hood, MD says it was OK because he experienced discrimination every day and didn’t really expect Emory to admit him, but he was accepted and graduated at Loyola and then returned to Atlanta to open an OB-GYN practice that he ran for 34 years until he retired in 2008. Emory won its challenge of Georgia’s segregation laws in 1962 and admitted its first black student the next year. 


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Weekender 6/11/21

June 11, 2021 Weekender No Comments

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Weekly News Recap

  • Iodine Software acquires ChartWise Medical Systems.
  • Cerner eliminates 500 positions.
  • Amazon announces significant growth and external customer interest in its Amazon Care telehealth service.
  • Ciox Health announces its intent to merge with Datavant in a deal valued at $7 billion.
  • Definitive Healthcare, which acquired HIMSS Analytics in 2019, prepares to go public.
  • RCM vendor Craneware enters an agreement to acquire pharmacy software vendor Sentry Data Systems.
  • SAIC announces plans to acquire government health IT contractor Halfaker and Associates.
  • UF Health Central Florida’s two hospitals go back to paper following a May 31 ransomware attack.

Best Reader Comments

With all of this money being poured into startups by VCs and PE and everyone promising a better widget to do X, how would patients (or consumers of health care) respond if they were to be asked this (Reagan) question – “Are you better off today than you were four years ago?” Is care more accessible? Valuable? Equitable? Cheaper? Safer? (Ghost of Andromeda)

I do worry about the monetization of the healthcare and the drive for young practitioners to get the best specialty. Some, I am sure are just drawn to that specialty, others are drawn to the compensation. The monetization goes up and down the stack, from VCs purchasing rural hospitals so they can overcharge for labs, to purchasers of EHRs so they can overcharge the clinics, to hospital administrators who have forgotten that a hospital is for patient care, not for generating an insurance bill or funding a collections company. (J Brody Brodock)

From a medical output standpoint, the most productive primary care practices probably have less than five providers. Technology provides little to no benefit. Practices get larger so that they can negotiate with insurance. The dynamics are different for single and multi speciality and hospital owned of course. We shouldn’t raise the compensation for primary care. We shouldn’t raise the compensation for anyone in medicine. We should lower barriers so that there is more competition. (IANAL)

One of the truisms I was told a long time ago by family medicine founding fathers is that primary care has always failed to compete adequately in the American way of doing things. Our commitment to patient care — our mensch-like attitudes to do good on local scales one case at a time, coupled with our lower incomes has kept primary care physicians from putting the same amount of money and time resources into changing the system as our specialist colleagues. That has only been exacerbated by the lobbying dollars of the pharmaceutical and insurance firms along with the large organized health care industry in general to take advantage of primary care physicians as malleable, low-cost solutions. Bluntly put, while we are doing our quarterly CME questions for our 2.5 points, thereby allowing our leaders to justify their latest layer of obfuscation without real change, we could have been communicating and networking with others. (Kevin Hepler)

If we are being completely honest, it’s about, how do we make the field of medicine more attractive to clinicians? And all of that adds up to going back in time. Society has already chosen, and mostly, society doesn’t care. (Brian Too)

Bold of Ascension to so immediately follow Baylor Scott & White, without even waiting to pick up some lessons learned. The latter has, at the most generous, an extremely bumpy year ahead as it tries to recover from its continuing hemorrhage of experienced Epic employees (retained and outsourced alike) and astonishing lack of due diligence (as admitted by its leadership). I suppose if more organizations outsource, analysts will be more persuadable that this is the way of the future instead of temporary insanity and attempt to stick it out. Can’t we just have nice things? (formerly BSW)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. M in Kentucky, who asked for an inspiration board for her kindergarten class. She reports, “Thank you for your generous donation to this project. Our Royal Imagination Station is so helpful for easy access and viewing from anywhere in our classroom. It is so handy to move the board throughout our classroom, so that every learner can easily see the display. My learners use it daily for creating anchor charts, practicing letter writing, phonemic awareness for letters and sounds, and reviewing previous learning materials (as a reference tool). We will enjoy this useful tool for many years to come.“

Dartmouth’s medical school apologizes and drops its threats of expulsion against 17 students who it had claimed cheated on an online exam by looking up answers. The university secretly monitored the use of its learning management system by test-takers by reviewing its activity log after the fact, but the Canvas tool was not designed for that purpose and a New York Times review found that the software’s automated background activity can mimic user interaction.

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In the UK, a liver surgeon who was suspended in 2017 for using a surgical laser to burn his autograph into patient organs is allowed to practice again.

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MIT Technology Review takes a look at the vaccine waitlist site Dr. B, which collected 2.5 million signups from people who hoped to be matched to leftover vaccine doses. The site, which was founded by Zocdoc founder and former CEO Cyrus Massoumi, refuses to say whether anyone actually found vaccine after signing up and how their data will be used or sold (the site is not a covered entity, so users enjoy no HIPAA protections). The site had agreements with just two vaccination sites in the entire US when it went on a PR blitz in March, but accepted signups nationally. Meanwhile, Dr. B has at least 56 employees, many of which have a background in politics, and it has acquired similar services. Massoumi unsuccessfully sued Zocdoc last year claiming that he was ousted by his conspiring co-founders in 2015. UPDATE: the company provided this response:

Dr. B was launched at the height of the COVID crisis to get vaccines into as many arms as possible and we have saved lives through this effort. While we have already sent more than 1.1 million notifications to users about available vaccines, we don’t track when shots have been received. User privacy is our top priority and Dr. B never rents or sells user data. At any time, users can also ask to stop receiving notifications and also completely purge their data from Dr. B.

The New York Post says that insurer Clover Health has become a “meme stock” whose share price swings wildly based on the whims of Reddit “WallStreetBets” traders, also noting that the company’s two co-founders – who became billionaires when Clover Health went public via a SPAC — bought three non-profit New Jersey hospitals and converted them to for-profit CarePoint, with one of them earning the distinction as the most expensive hospital in America. The hospitals, which dropped insurance contracts so they could bill ED visits at out-of-network rates, charged one teacher $9,000 to apply a bandage to her cut that required no stitches. Day-trading Redditers got interested in Clover Health shares when a short-selling analyst claimed that the company is inflating sales.

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An anti-vaccine doctor and nurse who were brought to an Ohio health committee meeting as expert witnesses who oppose business or the government requiring COVID-19 vaccination argue that not only have COVID-19 shots killed 5,000 people, they also magnetize recipients. The nurse dramatically proclaimed to state legislators, “Explain to me why the key sticks to me,” sticking with her script even as the key failed repeatedly to stick to her neck. Both healthcare professionals cited as their information source “pictures all over the Internet.”

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Sentara Albemarle Medical Center (NC) celebrates its longest-tenured employee, 82-year-old Willie Mae Overton, who started working at the hospital in 1961.

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A military publication profiles 30-year-old Nevada Air Guard 1st Lt. Caleena Longworth, MD, whose youthful appearance and spring graduation from medical school earned her the nickname “Baby Doc.” She completed medical school in working around her COVID-19 deployment, where she was involved with testing and vaccination. 


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Weekender 6/4/21

June 4, 2021 Weekender 3 Comments

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Weekly News Recap

  • Ascension begins its mass layoff of remote IT employees with 82 workers in Indiana, whose jobs will go to offshore outsourcers.
  • CareCloud acquires Santa Rosa Staffing from MedMatica Consulting Associates.
  • Ensemble Health Partners acquires automated patient engagement software company Odeza.
  • Scripps Health starts notifying 147,000 patients that ransomware hackers offloaded their data.
  • A review finds that healthcare AI design is nearly always flawed by lack of large-scale training and external validation.
  • England’s Clarity Informatics is acquired by Agilio Software.
  • Epic begins bringing employees back to campus and announces an in-person UGM 2021 for vaccinated attendees.
  • Doctors in England warn consumers about NHS Digital’s plan to extract the GP clinic data of 55 million people to create a de-identified research database.
  • Doximity announces IPO plans.
  • Virtual care company Babylon Health will reportedly go public via a SPAC merger that will value the company at $3.5 billion.

Best Reader Comments

The Meditech database literally cannot contain French language data as there is no support for the various accented characters. Thus you also have the issue of, the portal may be in French, but the data will all be English. The net result? No matter how technically good this portal effort was, it’s a kluge solution. Citizens using it will see an awkward mix of English and French content. (Brian Too)

I am always amused when someone assumes that they can take software that was built specifically in one language, for that language, and somehow migrate it to other languages. Software localization and translation are non trivial things, with considerations for everything from how dates are represented to how the thousand marks are “ticked.” “All your bases are belong to us” anyone? I even had a group tell me that they were going to sell to the Japanese market because that market used English. The idea died quickly with the purchase of a Japanese keyboard and switching to Romanji that ‘looked like English’ but was UTF16 character based. (AnInteropGuy)

Has any clinician had a positive experience with Doximity? It seems like they make their money off recruiter spam and fake clicks on their ads. (IANAL)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. B in Louisiana, who asked for a USB headset for her class of first graders, half of whom will be in the classroom and the others on virtual connections. She reports, “The headset has provided me the opportunity to keep the two types of learners separate. My coworkers complain that the background noise is an issue for the learners at school and at home. My virtual students can unmute and ask me questions without my in person students getting distracted. More importantly, the virtual students, who already have the distraction of being at home, do not have to hear the constant commotion of the classroom. For me personally, I had such anxiety to start this year; the year of the unknown and how to make all this work. The headset is not only comfortable, but has made teaching much easier.”

VA OIG says an Arkansas VA hospital should have done more to oversee a pathologist whose alcoholism has been blamed for at least 600 major diagnostic errors, including some that were related to cancer. The facility did not act on complaints that he was working while intoxicated, even after he failed a blood alcohol test. He received a 20-year prison sentence.

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The British Indian Nurses Association, which was formed last year to support nurses from India who take jobs with NHS, offers virtual COVID-19 care training for nurses who are still in India.

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A nurse in England who publicly claims that NHS is a “death squad” that is murdering vulnerable patients with COVID-19 vaccine, that no vaccine has ever been proven safe or effective, and that COVID-19 is caused by 5G telephone signals loses her nursing license for spreading disinformation. Former NHS nurse Kate Shemirani, who appeared publicly and on videos while wearing scrubs and a stethoscope and touting her nurse background, now calls herself an “aesthetic nurse practitioner.” She previously said that the people who accuse her being wrong or lying are mostly”overweight, envious nurses” who are jealous of her appearance.

Northwell Health Nurse Choir receives accolades for its performance on “America’s Got Talent.”


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Weekender 5/28/21

May 28, 2021 Weekender No Comments

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Weekly News Recap

  • Ireland’s health system says it may be weeks before it goes back online following a May 14 ransomware attack.
  • McKesson will combine RelayHealth and two of its other businesses under the CoverMyMeds organization and name.
  • VA OIG says the VA’s $16 billion Cerner implementation budget failed to include up to $2.6 billion in required infrastructure upgrades.
  • Google will develop algorithms for HCA Healthcare using HCA’s patient data.
  • Iodine Software acquires Artifact Health.
  • Weight loss app vendor Noom raises $540 million in new funding at a $3.7 billion valuation.
  • Bassett Healthcare will outsource analytics, IT, and RCM to Optum, which will take on 500 Bassett employees.
  • Zocdoc fixes a software problem that exposed patient data.
  • FBI says that at least 16 US healthcare and first responder networks were attacked by Conti ransomware in the past year.

Best Reader Comments

PE has absolutely brought a net negative in terms of societal value – they have sucked dollars out and devastated so many major areas of our society and economy – newspapers, retailers, housing stock, emergency rooms, ambulances and now of course, hospitals. And VCs are not too far behind. But as the guy says in the documentary – hey, don’t blame them for taking advantage of the way rules of the game are set up. Of course, no one says the quiet part aloud – that these guys are also actively funding politicians who block any changes to rules of the game. (Ghost of Andromeda)

Buried in an Epic EHRN.org study published today, Epic now has data on over 100 million people in Cosmos. (EHRN Watcher)

Looks like a net shift of ~30,000 beds from Epic to Cerner in the United States. I think it raises a couple of questions – although # of hospitals are still roughly similar does this put a dent in the narrative that Epic and Cerner are the two biggest fish in the sea? Seems like Epic is starting to pull away on this one. Perhaps the DoD and VA contracts may have been a bit of a poison pill for Cerner. (EHRMusing)

I don’t think it is reasonable to expect health insurance or health insurance tech startups to be profitable before they are at national scale. There are high costs to enter that market. To my mind, there are two Medicare Advantage strategies that potentially could work. First is that mega health systems are well positioned to offer MA plans but don’t have the organizational competence to do it. Bright is sort of going for that. Second is for the insurer to successfully insert themselves between the patient and the interaction with the high cost healthcare system, then guide the patient to lower cost alternatives. If there aren’t lower cost alternatives available in the market, the insurers should provide them. This is a little bit of Devoted Health’s strategy and a bit of UHC’s strategy. (IANAL)

Does Cerner currently have an employee exodus? That seems to be a concern at the hospital organization I work with. Lots of turnover in IT. Can’t imagine it wouldn’t also apply to vendors, especially if one is struggling. How is Cerner doing? And Meditech? And Epic? Or what about Allscripts? I’m definitely concerned for our own turnover, but am much more scared.if our vendor is also losing people we work with. (Neil’s Parking Lot)

For all those who are vaccinated, what’s the concern by August whether there are people on the [HIMSS21] floor that are not? I have an idea. “Let’s assume attendees are stupid and will all require vaccinations. Then we will tell them if they present a topic, they need a face shield to protect vaccinated people from vaccinated people. Oh, and we can’t have the vaccinated people too close, so we’ll spread out their booths. Then, cocktail hours in booths, oh no, we can’t have that. Push them outside in the August Las Vegas temps and they can drink warm wine and beer to go along with to go bags. They can shout at each other six feet away. Plenty of business will get done there. Oh and we won’t tell them that we cannot require the support staff, Venetian employees, and anyone else that will be on prem to be vaccinated.” Never mind what everyone does on their own time in casinos, bars, restaurants and god knows where in Vegas. But, we are protecting them and others.” LAUGHABLE – who’s falling for this stuff? (Mike_T)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. M in California, who asked for a headset and webcam for teaching her transitional kindergarten students virtually, She reports, “Thank you for helping this old teacher ( I didn’t think I was old until we started Distance Learning) get hip with new technology! Having a extra webcam that I can use as a document reader really helps my instruction daily. I can Zoom with students on one screen and share the work with the camera. This is especially important with our littlest learners when we are learning how to write our letters. Students learn so much through teacher modeling, I can model how to color in the lines, write from top to bottom and read from left to write. So much learning fun. Thank you!”

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Doctors in India threaten to sue a politically connected, billionaire yoga guru who told followers that “allopathy [medicine] is a stupid and bankrupt science,” claimed that medicinal treatment has killed more people in India than oxygen shortages and COVID-19, and questioned why doctors get sick if medicine is so efficient. He also recorded a video mocking people who were desperately searching for oxygen cylinders for their relatives who were dying of COVID-19, urging them to “just breathe the free oxygen.” His company sells a COVID-19 cure that is made up of three herbs, falsely claims that the product has been cleared for use by WHO, and when threatened with charges for misleading claims, instead convinced the BJP government to distribute 100,000 of his kits as an immune booster. 

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A new book called “Women in White Coats” looks at the “she-doctor” panic of 1869, when students of Woman’s Medical College of Pennsylvania attended a medical lecture at Philadalphia’s Pennsylvania Hospital. They were forced to enter via the back stairs; subject to curses, thrown objects, and tobacco-spitting by the 300 male medical students in attendance; and were stoned by the male students as they left while someone played the taunting military discharge song “The Rogues March.” The county medical society had previously barred women from attending public teaching clinics or joining medical societies.

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The husbands of two IT employees of Children’s Healthcare of Atlanta go into renal failure within days of each other, requiring a transplant from someone other than their wives due to blood type mismatch. The employee were sharing their stories with each other when they realized that they were each a match for the other’s husband, so they donated kidneys that were successfully transplanted.


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Weekender 5/14/21

May 14, 2021 Weekender No Comments

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Weekly News Recap

  • Patient payments platform vendor Cedar announces that it will acquire competitor OODA Health for $425 million.
  • ONC will spend $80 million of American Rescue Plan funds to train public health professionals to modernize the public health data infrastructure.
  • “Hospital at home” and decentralized clinical trials platform vendor Huma raises $130 million.
  • Mayo Clinic and Kaiser Permanente make a rumored $100 million investment in Medically Home.
  • Regulators in England block Imprivata’s planned acquisition of digital identity vendor Isosec.
  • Amwell’s Q1 results send shares down sharply as investors fear a growth slowdown.
  • CPSI acquires TruCode.
  • Aetion, which offers a real-world evidence platform for drug companies and payers, raises $110 million.
  • “Hospital-at-home” company Huma raises $130 million.
  • Walmart Health acquires telehealth provider MeMD.
  • Health Catalyst’s Q1 results beat expectations.

Best Reader Comments

So what should Cerner do, though? They have some market issues because the largest potential or current customers have attached medical groups and those medical groups drive customers to Epic. The customers that don’t fit that description are substantially more price sensitive. With their current product and a replacement market, they need to have significantly lower costs to win deals. Their strategy now seems to be slowly cut costs and lose customers until they are a government contracting company. They should have kept going on the RCM, support, data sales, analytics on the theory that the EHR is sold closer to at cost and they make it up on services. Make a couple acquisitions (Athena) and they could have a strong alternative to play against Epic’s weaknesses. That would have required looking further ahead than the next couple quarters. (IANAL)

That’s been our experience as well at Parkland and broadly with Dallas County, TX public health department. Specifically related to COVID-19, we were strategically able to utilize ML derived insights to improve many aspects of COVID-19 related workflows including patient triage, testing site optimization, identification of COVID-19 hot spots, and vaccination prioritization and understanding of herd immunity to just name a few. And we continue to build on it to help with other public health issues such as access & equity, other communicable diseases etc. AI/ML is a useful tool and is constantly getting better and when aligned with strategic goals and with the right moral compass can be really useful. (Vikas Chowdhry)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. J in North Carolina, who asked for a library of books for her middle school agricultural education students. She reports, “My students have learned so much about Theodore Roosevelt, Milton Hershey, and Temple Grandin this semester. It has tied in with our current curriculum related to natural resources (Roosevelt), food science (Hershey), and animal science (Grandin). Students were able to listen and watch recordings of me reading the book (to assist students with reading challenges) in order to gain more understanding about the individuals and the industries they impacted. We were able to have meaningful discussions about each book. This was an eye-opening experience for some of these students.”

I don’t actively solicit Donors Choose donations since you can donate to them directly without my involvement, but if you want to donate and have matching funds applied from my Anonymous Vendor Executive, do this:

  • Purchase a gift card in the amount you’d like to donate.
  • Send the gift card by the email option to mr_histalk@histalk.com (that’s my DonorsChoose account).
  • I’ll be notified of your donation and you can print your own receipt for tax purposes.

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Former Collective Medical executive Kat McDavitt, along with the Sharp Index, has started Mothers in Medicine, a fund that provides frontline healthcare workers who are struggling to pay for childcare with grants of $1,000 per child. She welcomes donations, volunteer help, and stories from clinician mothers.

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A former Indiana sinus surgeon who hid out in the Italian Alps for three years to dodge healthcare fraud charges but was eventually arrested and sentenced to seven years in federal prison turns up in Florida after his release after five years, where he is trading in cryptocurrency and selling yoga classes so customers can get “hot chicks” and “look great naked.” His license was permanently revoked in 2005 and 300 of his patients shared in a $55 million medical malpractice settlement. He vanished from a yacht in the Greek Islands in 2004, abandoning his family and leaving them $6 million in debt to hide out in a tent in the mountains, where he was later turned in by his Italian girlfriend after he was featured on “America’s Most Wanted.” His practice had been profitable – he commuted from Chicago to the working class suburbs of Indiana via chauffer-driven limousine, sent a different chauffeur back to Chicago at lunchtime to bring him his favorite sushi, lived in a five-story townhouse worth $3 million, and owned the 80-foot yacht from which he intentionally vanished.

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Employees of Swedish Medical Center (CO) throw a prom for 18-year-old Miracle Manzanares, who missed her own event while being hospitalized for 10 weeks with serious burns. She will be discharged soon.


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Weekender 5/7/21

May 7, 2021 Weekender No Comments

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Weekly News Recap

  • Walmart announces that it will acquire telehealth provider MeMD.
  • Cerner begins an external search to replace Chairman and CEO Brent Shafer, who will leave the company.
  • Systems at Scripps Health remain down from a ransomware attack.
  • R1 RCM will acquire VisitPay for $300 million in casb.
  • Connecticut launches a statewide HIE.
  • CareCloud agrees to pay $3.8 million to settle federal charges that it paid kickbacks to customers who recommended its EHR to prospects.
  • Ascension Technologies files paperwork indicating that it will lay off 651 IT employees in the fall as it outsources their jobs.

Best Reader Comments

Re: Epic’s growth in Canada from three hospitals in 2016 to 146. A significant portion of that will be due to the Alberta market. Alberta has Meditech implemented (understand though that the legacy picture is fragmented into an approx. three-way tie). Alberta will never upgrade to Meditech Expanse. Instead, Epic has won the entire province. Wave 3 of a 9 wave Epic implementation project was recently completed. (Brian Too)

So Brent Shafer has accomplished what during his time as CEO? Decimated all the upper level management with his cronies who now need replaced, made all the good worker bees leave by withholding raises and layoffs, lost some huge clients while not making many new sales, underperformed for the shareholders with regards to the stock price, not made any progress on meeting existing promises to clients, not made any progress on new markets. I think Brent’s Cerner legacy is that he made life moderately worse for everyone involved except his pocketbook, but at least he didn’t implode the company. (IANAL)

Similar finance-driven decisions are made not only for support, but also for the building of software at your vendor. The more mature the product, the more likely that offshoring the build might actually result in cost savings. In the startup world, it never works because the instantaneous iterative nature of early-stage software development can’t survive the communication barriers. (mburke)

So many questions are still being asked about HIMSS21. If we show up to exhibit, who will be attending the conference for us to present to? If we get a meeting room, would attendees feel comfortable meeting up in there since it’s a closed-in space with not great ventilation? If we host an event outside of conference hours, who would show up? Will the whole conference primarily be vendors? It’s really hard to justify the ROI and it doesn’t seem like it’s going to be any easier to make that decision as the conference gets closer unless we specifically ask our target audience if they will be there. (Michelle)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. S, who asked for headsets for her students as her Houston elementary school moved to online. She reported in November, “Your generous contributions have made it possible for the students and I to communicate with each other … One of my students, Tracy, told me, ‘Now, I feel like I am part of the class.’” Ms. S also passed along a letter from one of her students:

My teacher says you’re the one who got my class headphones. I just wanted you to know how thankful I am! And pretty much all my class. I don’t really know who you are but for now on, I’ll remember that you made my classroom happy. And come on, when my teacher said there was headsets, I was shocked! I already knew it wasn’t from my school. And honestly, if you didn’t give my class headsets, I’m pretty sure we would have to bring headsets to school. I just wanted you to know how thankful my class is because of you!

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Reader Eric’s generous donation to my Donors Choose project, with matching funds from my Anonymous Vendor Executive and other sources, allowed me to fully fund these teacher requests:

  • Math stations for Ms. N’s second grade class in Tyler, TX.
  • Math games for Ms. G’s elementary school class in Chicago, IL (her response is above).
  • Math picture books for Ms. F’s elementary school class in Norfolk, VA.
  • Math activity tins for Ms. S’s head start class in Provo, UT.
  • Math tools for Ms. C’s second grade class in Los Angeles, CA.
  • STEM activity tubs for Ms. M’s first grade class in New York, NY.
  • Science tools for Ms. M’s kindergarten class in Nashville, MI.
  • Lesson plans and materials for Ms. I’s sixth grade class in Arlington, TX.
  • Lesson plans and materials for Ms. N’s elementary school class in Fresno, CA.
  • Summer practice reading and math books for Ms. R’s elementary school class in Philadelphia, PA.
  • Digital learning resources for Ms. E’s first grade class in Houston, TX.
  • Interactive math whiteboards for Ms. M’s middle school class in Pharr, TX.
  • A collection of 100+ books for the book vending machine project of Ms. H in Columbus, OH.

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Crocs will give away 50,000 pairs of shoes this week in bringing back its “Free Pair for Healthcare” program during National Nurses Week.

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The Indianapolis TV station profiles 61-year-old Jeff Bick, who was looking for something meaningful to do after taking early retirement from Eli Lilly after 30 years, so he spent three years in nursing school and is now working as an RN at Riley Children’s Health. He explains, “I wasn’t ready to retire by any means. I figured I was good for another 10 or 12 years, so what could I do that would be meaningful? My wife and I both feel like we’re lifelong learners, so you keep, you know, you keep looking for challenges. You keep looking for things that make life an adventure.”

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A hospital in Senegal builds a new maternity and pediatric building, courtesy of charitable donations and pro bono architectural services, for just $2 million. One of the designers didn’t feel right about designing a hospital for doctors and patients they had never met in an area they had never visited, so they held meetings with doctors, employees, and patients to reach an ideal design for the 150-bed addition. It emphases patient and family comfort and passive cooling. The U-shaped bricks were developed by the architect and cast on site. The contractor took it upon himself to expand the idea of testing the bricks by erecting a test wall and instead built an entire building in a small village so it could be used as a school.


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Weekender 4/30/21

April 30, 2021 Weekender No Comments

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Weekly News Recap

  • Vocera acquires PatientSafe Solutions.
  • Halma acquires PeriGen.
  • Allscripts Q1 beats on earnings, misses on revenue.
  • Caresyntax raises $100 million.
  • Lyniate acquires Datica’s integration business.
  • VisuWell fires its CEO over a video showing his altercation with a male teen who wore a dress to their prom.
  • J2 Global will split into two publicly traded companies, one being its Consensus EFax business.
  • Accolade will acquire PlushCare for $450 million.

Best Reader Comments

I have experience with Dell offshored health IT staff. All I can say is that you get what you pay for. If you want to pay 1/4 for folks that really don’t understand what you are getting at and then re-do it because of said lack of comprehension, then it’s a good model. Half my job is interpretation between clinicians that have needs but don’t really “get” the system, and the techies who can’t grasp why solution XYZ won’t fit the needs of that clinician. Add a foreign culture and language in the middle, and it’s complicated. (PennyWisePoundFoolish)

Why would we let anyone else dictate anything around our patient experience? We required the tele platform to give us a webpage that we host and can then use it to serve up our own patient educational material and other messaging. Plus, we actively monitor to ensure that the patient isn’t spending any meaningful time on the “waiting room” page. Patient experience has to be valued and protected! (DA)

I don’t think consumer driven is even needed, just competition. For a starting point, the ACA exchange in New York State is as competitive as the health insurance marketplace can be. There is even a pretty legally simple model to scale it up. Take away tax subsidies for employer provided healthcare, make any healthcare benefits transferable to the exchange (like the Harris plan), then provide large income based subsidies for purchases on the exchange. Low wage employers will jump at the chance to shift the healthcare responsibility into the state. High income earners and unions won’t fight it since it is providing another option for them rather than taking something away. Employers will eventually stop offering core health insurance as a benefit and everyone will purchase their plan on the market. It isn’t the best outcome ever but it is competitive and it is achievable. (IANAL)


Watercooler Talk Tidbits

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Readers funded toe Donors Choose teacher grant request of Ms. H, who asked for math flashcards and unifix cards for her third-grade class in the Central San Joaquin Valley of California. She reported in November, “This 20 year veteran teacher became a first year teacher all over again this year through the implementation of distance learning. This has been the most challenging time in teaching that I have ever experienced. One of the biggest hurdles I’ve had has been finding creative ways to engage children in online learning. Any teacher worth their salt knows that math manipulatives are a key component to a successful math lesson with young children. The stackable counting cubes that I was purchase with your donation have been such a gift. The kids love having something familiar and fun to ‘play’ with and I love that we have been able to use the cubes to teach place value, regrouping, and now multiplication and division. I also love that it allows the kids to handle something besides their computer for a little while.”

Joe Rogan, who was accused of being reckless in telling tens of millions of his podcast listeners that young, healthy people don’t need to receive COVID-19 vaccine, clarifies that he is not qualified to offer medical advice: “I’m not a doctor. I’m a f_ing moron.” He says he’s aware that the vaccine protects other people as well as the recipient, but says “that’s a different conversation.”

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A doctor in India urges people to get vaccinated while showing the sweaty effect of wearing PPE for 15 hours of rounding. 

A nurse sues Normal Regional Hospital (OK) for firing him for posting on Facebook that a black murder suspect should be hung. The nurse says he isn’t a racist, and in fact some of his best friends are black, and that he was fired because he’s a Republican.

In Texas, the mother of a two-year-old girl who has been hospitalized for most of her life with a heart condition wages a legal battle with the hospital over stopping care it says is futile because she will never recover. The state has spent $24 million in Medicaid funds on her hospitalization.

The New Yorker describes the lonely job of medical interpreters, who work from their homes in translating conversations often involve end-of-life decisions related to COVID-19, sometimes with patient family members who live in other countries. 

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The government of Japan responds to the concerns of a nurse union about the medical resources that will be consumed by the daily testing of athletes in the 2020 Summer Olympics in Tokyo, whose year-delayed start is July 23. Japan has vaccinated just 1% of its citizens and 75% of residents don’t think the Games should be held this summer. Officials will decide in June whether spectators will be allowed.


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Weekender 4/23/21

April 23, 2021 Weekender 1 Comment

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Weekly News Recap

  • Home monitoring platform vendor Current Health raises $43 million in Series B financing.
  • Consumer data aggregation vendor Seqster raises $12 million in a Series A round.
  • Hospital operators HCA and Tenet beat Wall Street estimates on quarterly revenue and profit.
  • FDA says it will use the term “MIMPS” (medical image management and processing system) instead of PACS in referring to medical imaging systems.
  • Cedars-Sinai is using facial recognition software to identify patients with a history of violence or drug fraud.
  • FCC will open applications for its $250 million COVID-19 Telehealth Program on April 29.
  • FTC warns businesses that using or selling AI algorithms that are racially based or discriminatory – intentionally or not – violates federal law.
  • FDA excludes eight software functions that previously invoked its regulation as a medical device.

Best Reader Comments

There are many ways to find out if a supplier/vendor has positive references and can deliver. Just ask for a full list of their clients contracted with during a period of time and randomly call. Don’t let the vendor just give the references as that will prove nothing. Just do some routine homework. (Bigdog3011)

I’m more optimistic about Oscar selling consumer facing software to insurers and doing some outsourced business process for insurers than I am about Oscar as an insurance company. (IANAL)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Coach K, who has been teaching PE at his Arkansas school for 25 years. He asked for a GoPro camera to make exercise videos for his 625 K-6 students whose classes are being held both in-person and online. He reports, “I simply cannot begin to express our gratitude that has resulted from your selfless giving. Oftentimes, our students come from very poor backgrounds and rarely do we have the resources like the GoPro camera to help our students learn. Because of your gift, we were able to use the camera and tools that you sent to make our virtual lessons more clearly to our students. Donors like you are the real champions of public education. You see the need and rise to the occasion time and time again. Our students were thrilled when the box arrived and they knew that we would continue to make Physical Education together because we had the necessary tools that once were lacking. Again, thank you for your kindness and generosity.”

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Massachusetts General Hospital will proceed with a delayed $1.9 billion project to build new patient towers that will net the hospital 94 new beds beyond its current 1,043.

Ohio police arrest a nephrologist who physically attacked a cardiologist in St. Elizabeth Boardman Hospital (OH) who had accused him of inappropriately discontinuing a patient’s medication. A nurse and another hospital employee had to break up the fracas.

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A federal judge orders a Spokane, WA neonatologist remain in jail on charges of several crimes he tried to arrange on the dark web. Ronald Ilg, MD tried to hire someone to kidnap his wife for a week so he could travel to Mexico with his girlfriend, offering $40,000 in bitcoin for someone to take on a “rush job” that involved giving his wife daily doses of heroin and planting used needles with her DNA so he could frame her. He offered a bonus if the kidnapper could convince her to drop her divorce proceedings, move back in with him, have sex with him at least three times in a two-week period, and promise to keep quiet about the kidnapping. The doctor had allegedly previously tried to hire someone on the dark web to break the hands of a former employee for $2,000. Meanwhile, the girlfriend who accompanied him to Mexico said the doctor forced her to sign a master-slave contract in her own blood and gave police a recording she had made of the doctor beating her. After being questioned, the doctor was found unconscious in his house next to a suicide note, but he was OK. Police obtained evidence of the money transfers from Coinbase and found his dark web name and password written on a sticky note in a search of his house, which they used to read his messages.

In Italy, a 67-year-old hospital employee is being investigated for skipping work for 15 years, having been paid $650,000 despite never having showed up to his newly assigned job. Police say the employee threatened his manager to stop her from disciplining him, and when she retired, nobody noticed his absence. Police are also investigating six managers of the hospital as part of an investigation into absenteeism and fraud in Italy’s public sector, which includes women clocking in their husbands and employees punching in before heading out for a day of shopping or napping.

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A Florida nurse inadvertently broadcasts herself giving a patient a gluteal injection while waiting on her Zoom-based grand theft case to begin.


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Weekender 4/16/21

April 16, 2021 Weekender 13 Comments

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Weekly News Recap

  • Digital health vendor K Health, insurer Anthem, and investment firm Blackstone form Hydrogen Health.
  • CHIME will integrate its Spring Forum into Vive, an annual health IT event it will co-host with the HLTH conference beginning next March.
  • Mayo Clinic launches Remote Diagnostics and Management Platform.
  • The VA reaffirms that it will not bring its second Cerner site live in Columbus, OH until it has completed a strategic review of the project and shared the results with Congress.
  • AI solutions vendor Olive acquires Empiric Health, which offers AI-powered surgical analytics software.
  • Google will conduct a user feedback study as it prepares to develop a consumer-facing health record tool similar to Apple’s Health Record app.
  • Microsoft announces that it will acquire Nuance in a deal worth nearly $20 billion.
  • HHS extends TeleTracking’s COVID-19 hospital operating data collection and reporting for a third six-month term.
  • US News & World Report highlights the legal efforts of Hoag Memorial Hospital Presbyterian to leave the 51-hospital Providence system, with a key issue being clinical standardization as enforced by configuration of Epic.

Best Reader Comments

I think this acquisition makes a lot of sense for Microsoft. The future is not on a mouse and keyboard, it’s voice control and augmented reality. There will be an exciting opportunity to integrate this with the Holo Lens which as far as I can tell is one of the more mature AR gadgets out there. When you pair Dragon + Holo Lens + Hey, Epic! and other types of integrations, you have the potential for a must-have product for certain types of providers. As others noted, this will be yet another reason for existing customers to adopt Azure and/or Azure AD. Azure AD identity integration is going to play a bigger role in healthcare consolidation than people realize. Managing healthcare user identities for external users and mergers is a PITA and Azure AD helps reduce the complexity quite a bit. Dragon can now bolt right on to that. (Elizabeth H. H. Holmes)

I would add that Cortana hasn’t been well received by the market, so picking Dragon’s voice rec is a nice cherry on top of the reasons you state. They may not plan to sell a lot of the standalone product, but adding underlying technology to their stack is appealing. The talent acquisition is also nice. (Jim)

If they are paying 14 times rev for Nuance AND they manage to get almost all the Nuance revenue into the Azure “bucket” AND revenue to Azure is more profitable than the rest of MSFT and bumps up overall market cap, can they mark this whole thing as a win by adding more to MSFTS market cap? (Matthew Holt)

Re: Hoag. A hospital in Orange County (with cash–rich patients who are willing to come up out of pocket to pay for healthcare) has more ability to consumerize healthcare and give patients every option and ultimately, deliver what the patients want. Providence has facilities that can’t do that. But does that really change the ‘standard’ of care? (ellemennopee87)

Raise your hand if you’d like to see the data use agreement for Google’s PHR (I say this while realizing I’ve turned over 90% of myself to them already). The portal is like the only thing about healthcare I enjoy. Seems like another PHR failure in the making. (Android user)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. W in Washington, who asked for a microphone, drawing tablet, ring light, and phone video stand for creating online lessons for her elementary school class. She reported last winter, “Beginning the school year remotely was difficult, but thanks to your help, my students have been performing to their very best online. My science classes have become familiar with Microsoft Teams, and have been working with Class Notebook (a version of One Note) specifically for science. This program has allowed for easy access to and organization of class notes and activities. Implementation has been so successful that I plan on going paperless for the majority of class activities for years to come. Being able to provide my students with high quality recordings, in which multiple screens can be viewed simultaneously, has been a blessing this year. The audio and visual quality of the content I can deliver has improved immensely with these items, and has helped our English language learners as well as special needs students to succeed in this new environment. I can’t wait to share these tools with students once we are able to meet in person in the classroom.”

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Montefiore Hospital (NY) implements sleep pods that allow frontline workers to relax and energize. The HOHM pods, which are reserved via a tablet app, offer a massage chair, a privacy curtain that blocks sound, and a charging station.

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Police bodycam video captures officers shooting a patient dead in the ED of Mount Carmel St. Ann’s Hospital (OH). Miles Jackson, 27, struggled with officers who felt a gun in his pants that had been missed in an incomplete pat-down. Jackson said he would comply with commands to put his hands up but was scared the officers would shoot him, after which an officer took him down with a stun gun and he was then shot by multiple officers after his gun discharged. Westerville’s police chief says he has “concerns that warrant further review.” Jackson had been taken to the ED after being found unconscious of a suspected drug overdose in a car and was being arrested in the ED on outstanding warrants.

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Police charge a 31-year-old South Florida Botox clinic nurse practitioner with anonymously calling two elderly women and convincing them to wire her $20,000 to help one of their relatives that had been injured. She was also charged with drug trafficking when the arresting officers found 170 pounds of marijuana in her apartment.

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The local paper profiles LaVonne Smith (at left above), who just retired as IT director of Tomah Health (WI) after a 40-year career, 36 of which was spent in IT after she was drafted from the admissions department in 1985 to help implement the hospital’s first computer system. The health system went live on Epic in 2017.


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Weekender 4/9/21

April 9, 2021 Weekender No Comments

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Weekly News Recap

  • KKR acquires a majority interest in behavioral health EHR/PM vendor Therapy Brands.
  • Firefly Health raises $40 million.
  • A magazine article questions the claims and effectiveness of behavioral therapy apps.
  • Massachusetts General Hospital will collaborate with drug manufacturer AstraZeneca on digital health solutions for disease management.
  • The Indian Health Service seeks help with developing a strategic plan for IT.
  • Bright Health acquires Zipnosis.
  • The federal government’s information blocking and EHR transparency rules take effect.
  • A two-system study of EHR usage finds that ambulatory physicians spend five hours on the EHR for each eight hours of scheduled clinical time.
  • Bank of America acquires AxiaMed.

Best Reader Comments

I can’t believe after all these years I am still downloading summaries from patient visits that tell me nothing I didn’t know before walking in the door. I already know my Rx med, patient medical / surgical history, VS, etc. What I WANT is a summary of what the doc and I discussed because I don’t always remember all the details and occasionally have needed to refer to it. This is NOT what was intended when this whole notion of implementing EHRs (not to mention paying docs for doing that!) was first started. (JT)

Standardize and automate. Do as much of this as you can, and no more. (Brian Too)

I don’t understand why these health insurance + digital whatever always go for the low cost market. In the Firefly Health article, they say their cost is so much lower (doubtful). But I imagine the people who would want a digital insurance care plan are not the same people who are looking for bargain basement health insurance. (IANAL)

In primary care at least, so much easier when the horse brought doc to the house where they stayed until the crisis resolved. The physician was not interrupted at all. As a country doc by training, I knew we were going down a slippery slope when consultants started saying that all patients needed to be in gowns before doc would encounter them. And now, it is all about productivity first rather than quality. (Kevin Hepler)


Watercooler Talk Tidbits

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Readers provided the New York elementary school class of Ms. F with hands-on math kits, from which she created individualized math toolboxes to accommodate COVID-19 requirements. She says, “Thank you so much for donating to my classroom and supporting us for this year and years to come. We use our materials for math on a day to day basis. It truly has helped us transition to a new type of learning. Thank you so much for all of your help. My students are so grateful as well, they are still talking about the kind person who has helped out and donated to us in a time of need. Thank you so much for everything! We appreciate you.”

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The Department of Defense profiles Army Captain Tineisha Nagle, MSN, APRN, who was deployed under a FEMA program to support ICU staff at Yuma Regional Medical Center (AZ). She graduated from the United States Naval Academy with a degree in ocean engineering and then earned bachelor’s and master’s degrees in nursing, served 12 years in the Marines including deployment to Iraq as a lieutenant, and recommissioned to the Army Reserves, where she is completing her first year as a critical care nurse.

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A Minnesota hospital nurse who was fully vaccinated for COVID-19 in January is stuck in quarantine in a Playa del Carmen, Mexico hotel room after testing positive in preparing for her trip back home from vacation. She is restricted to a small room that is guarded around the clock, but at least she bought the hotel’s $30 insurance policy that covers room and meals for 14 days for guests who test positive.

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A Michigan baby who is nearly two years old goes home for the first time, having spent her first 694 days hospitalized in the pediatric cardiothoracic ICU with a congenital heart condition that required four open heart surgeries. It’s probably best to focus on the feel-good aspect and not the size of the University of Michigan bill or who ultimately will pay it.


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Weekender 4/2/21

April 2, 2021 Weekender 1 Comment

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Weekly News Recap

  • HIMSS acquires healthcare supply chain-focused SCAN Health.
  • Cerner finalizes its $375 million acquisition of Kantar Health.
  • VA Secretary Denis McDonough expresses concern about productivity at its first live Cerner site and the possibility that the project’s cost could exceed its $16 billion budget.
  • Net Health acquires Casamba.
  • MTBC rebrands to CareCloud, taking the name of a previous acquisition.
  • The Department of Justice asks for more information about Optum’s proposed $13 billion acquisition of Change Healthcare.

Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. M in Illinois, who asked for Mini Magic Boards for online sessions of elementary school class. She reports, “This fun and engaging writing tool has been used during our remote learning lessons and during our preschoolers’ asynchronous time as well. They really love to use it, as it gives them an opportunity to practice their writing skills beyond a pencil and paper. We’ve used it to practice writing numbers, letters, their name, drawing shapes, and more. It has made a big difference during our lessons and students have shared photos of how they’ve been using it at home as well. Thank you again for helping us get this writing tool in our preschoolers’ hands and get them excited about learning remotely.“

The one consistent aspect of the US healthcare non-system is maximizing profit. A nine-state group of anesthesiologists sues UnitedHealthcare, claiming that the giant insurer used its clout to steer surgeons away from using the group’s services. United responded by saying that the private equity-owned US Anesthesia Partners, which is not in United’s network, was demanding to be paid double or triple the median rate. The practice countered by claiming that the insurer’s parent company UnitedHealth Group offers its own medical services,  has 50,000 physicians on staff, and holds partial ownership of Sound Physicians, an expanding business that offers emergency and anesthesiology services.

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Adam Litwin, MD,  who served prison time 20 years ago for impersonating a surgical resident for several months at UCLA Hospital – he forged prescriptions, although he didn’t participate in surgeries – fails to match for medical residency for the second time following his 2018 graduation from a for-profit medical school in the Caribbean. One factor in his getting caught at UCLA was that he wore a white jacket adorned with a silk-screened image of his own face, which he claims other doctors envied. Googling “Saint James School of Medicine” turns up fascinating stories from former students and a published US residency match of 6% to 20% over several years.

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A former Atrium Health paramedic who is awaiting trial for fatally poisoning his wife with eye drops he had added to her glass of water is arrested for intentionally setting fire to an in-flight medical helicopter, which was forced to make an emergency landing. Josh Hunsucker refused to give permission for his wife’s body to be autopsied and quickly cashed out her life insurance, but a blood sample that was taken for her organ donation was found to have high levels of tetrahydrozoline, the decongestant in Visine that apparently triggered his wife’s heart attack due to her previous heart problems. Authorities think he was copying a murder in which a former VA nurse killed her husband with Visine two years after he recovered from an injury sustained when she used a crossbow to shoot an arrow into his head.

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Jacksonville, FL police arrest a man who was injecting people with Chinese-labeled Botox while drinking malt liquor and champagne, posing as an oral surgeon at an advertised a “Botox and Bubbles” event at an aesthetic spa. At least his price was right – he charged $350 versus the typical $1,200 cost. Googling “Botox & bubbles” turns up thousands of similar events at aesthetic practices, although they are focused on marketing the service rather than delivering it on the spot.


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Weekender 3/26/21

March 26, 2021 Weekender 1 Comment

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Weekly News Recap

  • Amwell’s Q4 and fiscal year numbers, along with anemic projections for 2021, send shares down.
  • Bankrupt Astria Health again blames Cerner for its financial problems in bankruptcy court, saying the company overstated the integration between Millennium and its revenue cycle offerings that caused collections to plummet.
  • Providence spinout DexCare raises $20 million.
  • Data and analytics vendor Komodo Health raises a $220 million Series E funding round.
  • Appriss acquires PatientPing for a reported $500 million.
  • Aggregation and analytics vendor Evidation Health raises $153 million.
  • VA Secretary Denis McDonough orders a 12-week strategic review of its Cerner implementation following reports of problems at its first live site, Mann-Grandstaff VA Medical Center.
  • AHA asks the Department of Justice to review Change Healthcare’s $13 billion acquisition by Optum.

Best Reader Comments

[Re: Amazon’s virtual health business] Local primary care physicians / groups may be able to use this as a platform to deliver virtual health services (Amazon seller services model). If the movement towards loosening state-based licensing requirements continues to gain steam and results in long-term policy changes (Amazon might put some lobbying dollars behind it), this particular play can have a real impact in addressing clinical resource shortages, especially in rural and underserved areas. (Vikas Chowdhry)

[On Ro] They say, ‘Oh, healthcare is a $4 trillion market – it’s so massive.’ But that’s the worst thing in the entire world; it’s awful how large it is. And I think what we have the opportunity to cut it in half with technology.” So, watch out world! Ro is out to cut healthcare by $2 trillion. He further claims that: “While Ro doesn’t work with insurance currently, Reitano points out that he’s not against the concept entirely” (thank for letting us exist, exhaled UnitedHealthCare, Anthem, Aetna, Cigna and Humana) …  I wish I had the [misplaced] confidence of a well-connected, well-funded white male. (Ghost of Andromeda)

We obsess a little too much over legislating privacy around PHI versus privacy in general. (James E. Thompson, MD)


Watercooler Talk Tidbits

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Readers funded the teacher grant request of Ms. L in California, who asked for a library of 22 books for her class of 3-6 year olds with Autism Spectrum Disorder. She reports, “These books will be used for virtual story times and small group lessons via zoom. Additionally, they will possibly sent home for parents to read to their children. Eventually when school reopens in a face-to-face manner, we will finally be able to read our stories as an entire class. We thank you for your donations and passion for helping students learn to love literacy.”

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Industry long-timer John Hummel died on March 20 at 67. He had served as SVP/CIO of Sutter Health, CIO of California Prison Healthcare Receivership, CTO of Dell Perot Systems, and CISO of Tahoe Forest Hospital District and Taos Health System.

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Bobby Brown, MD, a four-time World Series winner with the New York Yankees who left the game at 29 to pursue a career in cardiology and then returned as American League president for 10 years, died this week at 96. He also served in the Navy in World War II while completing his pre-med work, then was recalled for the Korean War, where he served as battalion surgeon. He was the last surviving Yankee of the 1940s. He told his future wife how to introduce him to her parents: “Tell your mother that I’m in medical school, studying to be a cardiologist. Tell your dad that I play third base for the Yankees.”

The Defense Health Agency updates its RFI for a cloud-based veterinary EHR that will replace its custom-built system that manages medical records, scheduling, billing, and inventory for 140 DoD facilities. The new system must interoperate with its Cerner EHR for humans, the Air Force’s Working Dog Management System, and the military’s animal disease surveillance and laboratory systems.

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A man who lived for 35 years since the age of 15 thinking he would die any time of a brain cancer that is usually quickly fatal discovers from old medical records that he was diagnosed incorrectly. Jeff Henigson was contacted last year by a neuropathologist who saw his story on BBC News and told him that he had seen just three cases of anaplastic astrocytomas where the patient beat the expected bleak life expectancy of 2-3 years, and two of those cases involved an incorrect diagnosis by a pathologist. Henigson dug through his old paper medical records that his mother had kept, in which two pathologists from local hospitals declared his tumor benign, but a second opinion in 1986 from an unnamed prominent institution concluded that he had a different kind of tumor that was aggressive and likely to be fatal. Based on that faulty diagnosis, he endured surgery and months of brain radiation and chemotherapy that left him with permanent hearing loss, vision problems, epilepsy, and lung problems.

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A painting by reclusive street artist Banksy that honors NHS frontline COVID-19 workers sells for $23 million, with the proceeds going to Southampton Hospitals Charity. The price, at 10 times the pre-auction estimate, is the most ever paid for a Banksy work.


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Reader Comments

  • Mark Hochhauser: Regarding a minor's ability to consent, consider the reading grade level of the patient portal Terms and Conditions. The...
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