Home » Weekender » Recent Articles:

Weekender 9/18/20

September 18, 2020 Weekender 1 Comment

weekender 


Weekly News Recap

  • Amwell raises $742 million in its IPO.
  • Provation acquires EPreop.
  • MDLive secures investment totalling $75 million.
  • Change Healthcare announces plans to permanently close its Nashville headquarters.
  • Amazon opens up its HIPAA-compliant Alexa skill program to interested app developers.
  • Apple adds a blood oxygen monitoring feature to the newest version of Apple Watch.
  • Kaiser Permanente launches Virtual Plus, a virtual-forward health plan for members in six Washington counties.

Best Reader Comments

Over the last few years, I have seen a lot of fancy AI driven care coordination tools, I have seen commercials from payers and health systems on how they are taking better care of their members and patients. But personally (for myself and for my family), I have not seen any improvement in how care is delivered to me. I have never ever received an individualized outreach from my insurance company (AI-driven or not) or my provider regarding the risks that I may face. I still struggle on hard to navigate websites to find the right provider. I still fumble through five different patient portal accounts to keep track of my own data. Even during the last six months of COVID-19 crises, I have not received even a generic email of empathy from my current insurance provider. Is the root cause of this complete lack of consumer care the fact that in the employer-driven medical care insurance world, the only customer that insurers like UMR have to please is the benefits manager at the employer? And those benefits managers typically don’t seek feedback from employees on whether they are satisfied with the insurance options? (US_MedicalCare)


Watercooler Talk Tidbits

image

Readers funded the Donors Choose grant request of first-year teacher Ms. A, who asked for STEM resource kits for her California kindergarten class. She reports, “My students and I want to thank you for your generosity to our project, STEM in Kinder. These supplies are being used every day during our science time. My students were very excited when they first saw the supplies arrive. Once again, I cannot thank you enough for your help with this project. Most importantly, thank you so much for supporting my students and me. Especially this year it will make a huge difference in the lives of my students while they are learning from home.”

image

A veterinarian at an Illinois zoo asks a “human doctor” to perform a hysterectomy on a monkey with a rare form of uterine cancer. OB-GYN Justin Hinzman, MD performed the procedure, noting that it felt strange because the patient was the size of a human toddler.

The Philippines banned nurses from leaving the country to work elsewhere because of its own COVID-19 needs, but working conditions there are so bad that most of those whose travel was denied aren’t working as nurses anyway. The country previously encouraged them to seek overseas employment that paid multiples of what they could earn at home, allowing them to send money back to their families. They make up 4% of the US nurse total.

image

A North Dakota doctor is arrested in a prostitution sting operation at Hong Kong Spa, a massage parlor he owns. An employee says he is a “false owner” who was paid by the real owners to put his name on the business license.

image

A hospice nurse makes the wish of a 50-year-old terminal cancer patient happen when she gets a private pilot to fly him to his son’s first high school football game of the season, an away game that was too far for him to travel by car.


In Case You Missed It


Get Involved


125x125_2nd_Circle

Weekender 9/11/20

September 11, 2020 Weekender 1 Comment

weekender 


Weekly News Recap

  • Hyland will acquire Alfresco.
  • Amwell’s IPO plan values the company at $3.6 billion.
  • Zocdoc’s former CEO sues the company, claiming his co-founders and the CFO ousted him in a coup.
  • A federal court dismisses a patient’s lawsuit against University of Chicago Medical Center and Google for using his data for machine language training.
  • HIMSS confirms that a HIMSS20 exhibitor has filed a class action lawsuit against it over refund policies for the cancelled conference.
  • VA accelerates its Cerner implementation plan for VISN10 in the Midwest.

Best Reader Comments

Inviting mediocrity to find an opportunity elsewhere sounds about right to me. Of course, some people may not be the right fit for a particular job, but if you can figure out where they excel, then you have keepers. On the flip side of that equation, if you can’t manage strong talent, then maybe you need to be a better manager. I have found that when I hire good people, they get stuff done, and the impossible becomes possible with a few more weeks of effort. Think about Mayo Clinic, their administrators are docs, they are about the mission, the mission is valid and impactful, and anything that falls outside the mission is ‘reviewed’ for relevancy. They swore an oath and the oath means something. I found that same commitment in the service — plenty of people who were mediocre, and plenty of team players who strove for excellence — you weeded the bad, encouraged the mediocre, and rewarded the excellent. (Brody Brodock)

Can’t imagine having a team full of All Stars! What a headache. Someone needs to do the work and keep the ship moving. Interesting that the bribe is top salary in the industry and keep looking over your shoulder. Can’t imagine what that does for balance and family life. And, take a vacation any time you want because no one is looking. Not so fast, when you get back you find out you lost the race for “who would you fight for competition?” Absolutely crazy. There will come a time when this generation will self destruct. (William Reay)


Watercooler Talk Tidbits

image

Readers funded the Donors Choose teacher grant request of Ms. W in South Carolina, who asked for civil rights books for her elementary school class. She reported in early March, “Thank you for supporting our students in reading! Through building our classroom library, you are helping to provide texts that the students can read at their own independent level and with texts that engage them. They love reading and learning about social studies topics. With a classroom as diverse as our the Civil Rights Movement is a topic that we all care about deeply. They were so excited and proud to check out and add these new texts to their individual book boxes to read this week! Thank you once again for your love and support of our students and their love of reading!”

image

Criminal defense lawyers for former Theranos CEO Elizabeth Holmes will arrange a psychiatric evaluation that they hope to use to support a “mental disease” defense.

image

Two COVID-19 field hospitals totalling 2,500 beds that were built in less than two weeks in Wuhan, China in early February were closed one month later, along with 14 other temporary hospitals, when President Xi Jinping declared that the outbreak had ended. The two big hospitals were sealed off on April 15, with state media saying they were both full at one point and that the 1,500-bed one had treated 2,000 patients.

image

A former EVP of struggling Wheeling Hospital (WV) will receive $10 million as his whistleblower share of the $50 million that the hospital will pay to the federal government to settle charges that it paid doctors based on the value of their patient referrals. The hospital had countersued, saying that Louis Longo was also a partner with Deloitte and did not report his concerns to the hospital’s compliance officer and instead, as a bitter former executive, decided to “extort a settlement.” 

The wife of a urologist who has pleaded guilty to Medicare fraud, who was also his office nurse, is sentenced to probation for ordering employees to re-use “certain anorectal devices.”

image

Nephrology fellow Nyan Pyae, MD leaves the hospital after a 106-day COVID-19 stay, including 80 days in the ICU and 26 on ECMO. 

image

Reebok’s ad campaign for a new shoe line that is tied to the upcoming movie “Wonder Woman 1984” features real-life Boston nurses.


In Case You Missed It


Get Involved


125x125_2nd_Circle

Weekender 9/4/20

September 4, 2020 Weekender No Comments

weekender 


Weekly News Recap

  • Analytics-powered remote patient monitoring vendor Biofourmis raises $100 million.
  • Nordic lays off 72 employees.
  • The US Coast Guard goes live on DoD’s Cerner-powered MHS Genesis.
  • Personal health record and real-world evidence vendor PicnicHealth raises $35 million in Series A and B funding rounds.
  • TigerConnect acquires Adjuvant’s physician scheduling tool.
  • AMA releases CPT 2021.
  • Ascension Health announces plans to lay off 223 IT employees and outsource their jobs.
  • Konica Minolta will pay $500,000 to settle false claims act charges related to its acquired Viztek Exa EHR.

Best Reader Comments

”If Medicare requires use of something [CPT codes], it should be in the public domain, but there’s too much money and lobbying involved to make a change” nailed it. But isn’t money and lobbying so much of what has led to our great American non-system in the first place? (Kevin Hepler)

Any well-designed archive should require multi-level authentication to delete any study. Preferably this has at least three distinct administrators who all need to sign off on any deletion, even an individual one, let alone thousands. VNAs and even standard PACS archives don’t delete the data, but instead just change the pointer to the revised study it if a study is modified. That way you still have both studies saved. The disaster recovery data in the cloud should NEVER be allowed to be deleted by ANYONE under ANY circumstance. (Youshouldknowbetter)

Not sure why PicnicHealth was able to raise that kind of round as their pricing model is anything but sound. Maybe for the most worried well, Silicon Valley parents types (e.g. those with $$$ to spare) but for the vast populace, that pricing is a non-starter. (John)

InfoGard is paid to rubber stamp certifications and treats some fraud fines as the cost of doing business. I think the real story here is that HHS and the feds rely so heavily on private contractors and private industry. Teasing out why and enacting change is something not even on anybody’s radar. Fifty years ago, the feds would have just done this certification work themselves and there wouldn’t be the same mismatched incentives. Now it is outsourced three different ways, costs more, and still nothing gets done. (IANAL)

I find it interesting that the testing organization, (InfoGard) couldn’t ferret out hard-coded data. It is really as simple as sampling from the top n (100) plus alpha and noticing that every time you change the value for n the source system has to go back and redo their work. Or, asking the question, “Can you show me your dictionary for x in SQL?” then ask them to do a count of that dictionary and compare it to the expected value. If you are off by hundreds of thousands, then you hard-coded values. By that I mean, RxNorm has 70k? values in the in/min and brand TTY? If the solution under test can’t show an RxNorm table, or its equivalent (Medispan, First Databank, Multum) with a pretty close proximity to that number, then you have a Houston moment. This isn’t rocket surgery. That pattern of ask/fail/return with the correct answer wouldn’t pass a grade school teacher’s closed book exam sniff test. Just as it should never have passed their tests. (AnInteropGuy)

Have you invested in the Echo ecosystem from the beginning and participated in the evolution of functions that go way beyond just “features”? If so, you may know how it has enabled neurologically compromised seniors to have voice-activated and managed communication access they would not otherwise have, along with fall risk options, security, and safety, all for no additional cost beyond the acquisition of devices, plugs (flex), etc. The core premise of Halo is not simply for the worried well. I appreciate the non-screen and the investment in the core and am very much look forward to the evolving features and benefits. There are a lot of “worried well” gadgets out there (remember the HIMSS-aligned “Misfit” series). Halo is not one of them. (Smart Platforms)

[Paper forms are still used] because the UI of a typical paper form has been developed for several hundred years and the UI of your tablet was developed by some contractor who just learned “hello world.” Paper doesn’t freeze or run out of battery or break when you drop it or require an IT guy or struggle to be read by the tech averse. Plus the company pays the receptionist to sit their anyway and they are the only place in town that accepts your insurance. (IANAL)


Watercooler Talk Tidbits

image

Readers funded the Donors Choose teacher grant request of Ms. H in Michigan, who asked for math games for her readiness program for students aged four or five. She reported in early March, “The math games were used for our March into Math event that encourages parents to learn and take home math-related materials to help children continue to learn at home. This by far was the most successful mathematics event we have hosted so far. The room was completely filled. As students walked in with their parents, they immediately saw the table display of all the games and became very excited about our evening. These materials have helped us demonstrate a variety of mathematic concepts that are needed for them to be successful in pre-school as well as transitioning into kindergarten. Thank you for your support and making an impact on the lives of my students.”

CVS-owned chronic care management service Accordant apologizes to a patient who described her anxiety over COVID-19 to one of its telephone nurses, who then told the woman that she didn’t need to worry because “the CDC is lying to us and doctors are being paid to lie about COVID.”

Americans who are used to day-tripping to Mexico or Canada to buy prescriptions or medical services for much less money are “trapped in their own healthcare system” now that those borders have been closed to non-essential travel. A Texas man had dental work done in Mexico for $750 that would have cost $10,000 on this side of the border, then found that he could buy his $275 insulin for $20 there. He formerly skipped eating for days at a time to ration his insulin, calculating his lifespan at the number of days’ supply of insulin he has on hand plus three days. A pharmacy in Vancouver that has served some American customers for years is dealing with those who have been laid off, taking the distinctly non-American approach of, “We’ve sent them what they needed and we tell them, pay us when you can.”


In Case You Missed It


Get Involved


125x125_2nd_Circle

Weekender 8/28/20

August 28, 2020 Weekender 3 Comments

weekender 


Weekly News Recap

  • Amazon announces its Halo health and wellness wearable, app, and membership program, with Cerner posting its own news that it has integrated the device with Millennium.
  • Konica Minolta Healthcare Americas Inc. will pay $500,000 to settle federal false claims allegations that its former Viztek subsidiary fraudulently earned certification for its EXA EHR that allowed users to claim Meaningful Use funds.
  • The private equity owners of behavioral software vendors Qualifacts and Credible Behavioral Health announce that they will merge their respective companies.
  • CMS issues emergency regulations that require hospitals to report their COVID-19 capacity data daily to HHS to continue being paid by Medicare and Medicaid.
  • Google Cloud will invest $100 million in Amwell when the company begins public trading.
  • The VA implements patient scheduling in an Ohio facility in its first Cerner go-live.

Best Reader Comments

There are some really affordable solutions that allow patients to either pre-register online or fill out information on a tablet or other mobile device when they’re checking in. It’s more convenient for the patient and eliminates a lot of expensive data entry in the back office. You can also do things like connect to a clearinghouse to check a patient’s insurance coverage. I’m no longer surprised at how much hospitals and clinics invest in technology, but still waste time and money with manual paper processes, but it’s hard to fathom. (Greg Mennegar)

I am an Epic builder and it annoys me to no end when I pre-register and fill out all the MyChart questionnaires for an appointment at one of the “big hospitals” here in Boston only to be handed a clipboard with the same questionnaire in paper form that I am asked to fill out. I have even offered to show the front desk staff how to print out the filled out questionnaire from my chart to no avail (this has happened to me more than once and in different departments). Sometimes it is less about the lack of technology and more the lack of user training that can be the issue. (Craig Molway)

Any organization that deems it necessary to purchase higher ratings to game the system should be called out. It clearly points to an act of desperation to sell services or products that can’t stand on their own merit or reputation. This is certainly a warning sign to potential clients that an organization is willing to do all the wrong things to get a contact besides providing a high-value / quality service. (PT Franks)

I would argue that the mental / behavioral health crisis that has gained national attention to the pandemic has its roots in young people being taught that certain emotions are bad and to be avoided. If you look at metaphors, happiness is bright and full of sunshine and sadness is blue and full of clouds and rain. Who want want to admit being sad?!? To your point about the person who told you to wear a smile, it’s akin to a person asking you, “How you are?” and only wanting to hear something superficial like “good” or “not bad.” Perhaps many folks don’t have the language or skills to talk about the “bad” emotions in a meaningful way, so they choose avoidance.(Elmer Phd)

Your “compared to a year ago” poll made me smile. Exactly one year ago I was at peak misery of hot, swollen and uncomfortable, because I was nine months pregnant. I was instantly happier, healthier, and more optimistic two days later when our son was born. (What a year)


Watercooler Talk Tidbits

image

Readers funded the Donors Choose teacher grant request of first-year teacher Ms. N in Miami, who asked for engineering learning centers for her elementary school class. She reported in early March, “I work in a title one school with mostly students from low-income families and a low-income community. Getting gifts for the classroom makes them so excited to learn and come to school everyday regardless of what they face at home. When my students first saw the items that were donated they could not control themselves, they were so excited. They wanted to dive in right away! Some of their favorites are the turn and learn gears and the car building kit. Engineering time in my classroom is my favorite part of the day because it fosters their creativity and this time was made more special because of your donations!”

image

Ralph Lauren will outfit those working as “ballpersons” during the US Open with a muted uniform, with each shirt listing the name of a Mount Sinai Health System essential employee on the back. The company says bright, colorful designs didn’t seem appropriate and thinks having the names of those who have saved lives on display will celebrate the many ways in which people can make a difference. The company will also feature profiles and stories of nine of the workers on its website.

image

A team of 14 nurses, two neonatal nurse practitioners, three respiratory therapists, and a neonatologist worked through the night to care for 19 NICU babies at Lake Charles Memorial Hospital (LA) as Hurricane Laura hit with winds of up to 135 miles per hour early Thursday morning, taking out the hospital’s air conditioning and water. The team moved the babies, some of them on ventilators, to the hallway away from windows. The babies had been transferred there a few hours before when the women’s hospital was evacuated.

The CEO of Bristol Regional Medical Center (TN) resigns after accepting a cardiothoracic surgeon’s invitation to make the first incision in a patient despite having no medical training. The hospital also parted ways with the surgeon.

image

A Georgia nurse who contracted COVID-19 during a two-month assignment in New York City and then couldn’t return to hospital work because she was haunted by the experience of seeing families watching their loved ones die via FaceTime starts a company that helps businesses keep their employees safe from COVID.

image

The Washington Post profiles former Baton Rouge General Medical Center security guard Russell Ledet, who is now doing his third-year medical school rotation at the same hospital while completing his MD and MBA degrees. He joined the Navy out of high school and was convinced by his wife to go to college, where he doubled-majored in biology and chemistry while supporting his family with the security guard job. After finishing undergrad, he earned a PhD from NYU in molecular oncology, then started medical school at Tulane. He plans to earn triple board certification in pediatrics, general psychiatry, and child and adolescent psychiatry and then open a New Orleans mental health services clinic for marginalized communities. 


In Case You Missed It


Get Involved


125x125_2nd_Circle

Weekender 8/21/20

August 21, 2020 Weekender No Comments

weekender 


Weekly News Recap

  • HHS denies a Wall Street Journal report that says COVID-19 hospital data reporting will revert back to CDC’s control using a new system.
  • Bankrupt smart pill developer Proteus Digital Health sells its assets to Japan-based pharmaceutical company Otsuka for $15 million.
  • Clinical communications vendor Vocera acquires EASE Applications, which offers messaging tools to connect family members and a patient’s care team.
  • Health IT vendor TeleTracking refuses to answer the Senate Health Committee’s questions about its $10.2 million contract to develop a HHS COVID-19 hospitalization reporting database.
  • HHS CIO Jose Arrieta resigns unexpectedly after 16 months on the job

Best Reader Comments

Spoke with an MD yesterday, they’re doing pot over the phone now. Great job, telehealth, you really saved the world this time. Meanwhile, back at the facility, kidney patients are bearing a COVID burden on top of the mortality rate associated with dialysis. Point: mobile works, big brick things with windows that don’t open don’t. Disclaimer: I’m talking about patient healthcare, not funding a better grasp on a sinking anchor. (richie)

I would rather some dumb startup provide access to marijuana cards, Rogaine, birth control, contact lenses, etc. than have to wait in line behind those people in the doctor’s office. Those are mostly just doctor employment programs anyway, which they don’t need. (IANAL)

Here’s how your insurance company thinks about [telemedicine]. You know that nurse line that they run where you can call in and ask questions? What if the people on that line could write prescriptions, order and interpret labs, etc.? What percentage of doctor’s office visits could they cover? Rough guess would be 1/3 of your typical PCP visits. How much less could the total cost be for that office visit? Maybe it is 60 percent of the in-person cost, more in high rent areas or areas with limited physician supply. When an insurance company is required to spend 80 percent of revenue on claims and they optimistically have a margin of 5 percent, it is a no brainer for them to try as hard as possible to make their telehealth solution work for their consumers. I agree it doesn’t make sense for traditional fee-for-service health systems to be using telehealth. Instead, it is something that cuts the traditional health system out of the relationship because they are too expensive or their service is too bad. Which makes the idea of health systems buying telehealth services sound strange to analysts. Why would health systems want to fund their competitors unless they have no hope of putting the telehealth cat back in the bag? (Bogon)


Watercooler Talk Tidbits

image

Readers funded the Donors Choose teacher grant request of Ms. P in Texas, who asked for programmable Ladybugs for her kindergarten class. She reported in February, “These little robots are the STAR of our classroom right now. I wish that I could send you a video of the children using the ladybug robot and coding remote. The shrieks and laughter were amazing. When I sent the videos and photos to the parents, they were thrilled, as well. I can tell how meaningful it is to these parents that their children learn more and accomplish more than they were able to at their age. It is really sweet. The first time I showed the children how to use it, they thought it was pretty cool. The first time each child got to program in a code and watch the ladybug travel over the mat, THEY WENT WILD!!! It was the perfect example of how seeing something happen can be a learning experience, but actually doing something is the best way to learn. Thank you for providing this opportunity for my littles.”

image

Google launches a six-month certificate program that will prepare students for high-paying technical jobs, such as data analyst, project manager, UX designer, and IT support specialist. The company says that college is too expensive for many Americans and a diploma shouldn’t be required for economic security. Google will treat the career certificates equivalent to a four-year degree in its own hiring, will fund 100,000 scholarships to the program, and will offer apprenticeships and job search services. 

image

An Alaska doctor is indicted for $9 million in Medicaid fraud for requiring his addiction patients to undergo a urine test that he sent to a lab he owns in Tennessee, for which he billed $3,000 to $8,000 each. A cash-paying patient filed a complaint with the state’s medical board. The doctor is posting rambling videos to YouTube proclaiming his innocence in referring to himself in the third person. Bonus footage minimizes COVID-19 and the “mind control” involved in mandating mask wearing, says his tests are expensive but nothing compared to what Medicare pays for a COVID-19 admission that “in most cases, is not even as bad as a cold,” and his persecution under the Obama administration for donating money to Republicans.

Missouri’s medical board revokes the license of a 70-year-old doctor who amputated a patient’s toe on the porch of his office, a machine shed that does not have running water. He says, “Everything was absolutely perfectly sterile, out in the bright sunshine and fresh air.” His practice’s website is full of bizarre conspiracy theories, along with his offer of video counseling ($50 per 15 minutes) for marital difficulties and unruly children, also offering student tutoring at the same rate. Googling turns up previous charges for narcotics distribution.


In Case You Missed It


Get Involved


125x125_2nd_Circle

Weekender 8/14/20

August 14, 2020 Weekender No Comments

weekender 


Weekly News Recap

  • MDLive announces plans to go public early next year.
  • Health Catalyst announces its acquisition of Vitalware for $120 million.
  • Epic reverses its mandatory return to campus policy, approving working from home through at least the end of the year.
  • Waystar will acquire ESolutions, valuing the company at $1.3 billion.
  • Craneware raises $100 million for acquisitions.
  • Providence Services Group acquires Navin Haffty.
  • VA OIG recommends that the VA work on increasing its use of VA Direct and improve oversight of its VHIE community coordinators.

Best Reader Comments

The most surprising aspect of the Teladoc-Livongo deal is how investors and healthcare analysts don’t seem to understand the telehealth market. The walk-in or urgent care telehealth visit has a razor thin margin for telehealth companies. Almost 100% of the $50  fee charged to consumers goes to pay the physician labor or pay for the ads. The market is national, so any telehealth agenecy can join if they are willing to spend the ad dollars or offer slightly cheaper visits for a brief period as telehealth is uniquely price shoppable. On the other hand, your average physician is used to being protected from national competition by having a very local, captive market and they have many options when it comes to keeping their income above say 120 grand a year. Plus consumers prefer in person visits if the cost and convenience are the same, so providers always can fall back to that. It is very hard to reduce provider labor cost. So the telehealth agency gets squeezed between a price sensitive consumer, a provider who demands the bulk of the revenue from consumer, and the cost of ads which are raised by investors repeatedly dumping their money into new telehealth companies driving up demand on the ads displayed when people search video doctor. So every telehealth company that has lasted more than a few years has some strategy that gets them out of the urgent care market. (detroitvseverybody)

[Teladoc acquiring Livongo for $18.5 billion] reminds me of the post-deregulation period in the airline business, 1980s into the 1990s, when airlines fetched this kind of insane money from all over. I was there for that and it didn’t end well. (Deetelecare)

Providence Services Group now owns two MEDITECH focused service organizations while Providence is in process of migrating multiple MEDITECH hospitals to Epic. Plus, Providence is large Epic client. So basically MEDITECH helps fund a large Epic client since NHA and Engage are two of its partners. (Chris Hill)


Watercooler Talk Tidbits

image

Readers funded the Donors Choose teacher grant request of Ms. G in Ohio, who asked for white boards for her high school class in urban Cleveland. She reported in late February, “I cannot express how much these white boards have helped my students in class. We use them every day in order for them to practice different concepts in class. These white boards allow for my students to have immediate feedback in class and work through concepts even faster. They have taken pride in their work and have grown so much since having these white boards available in class. Thank you so much for allowing my students the opportunity to use these white boards every day in class.”

image

A COVID-19 hospital in India lists its challenges: relatives keep barging in rooms to bring isolated patients meals, air conditioners don’t work in the sweltering heat and humidity, new patients are housed with those known to be infected, families sit curbside with the bodies of family members waiting for funeral home pickup, and armed guards protect the hospital administrator. 

image

An Alabama neurosurgeon crashes his $200,000 sports care while doing 138 miles per hour in a 45 zone, killing his 24-year-old medical school passenger. He’s charged with manslaughter. Police say the doctor was intoxicated and suffered only minor injuries.

Chicago chose a politically connected company to develop a temporary 2,750-bed COVID-19 hospital in the McCormick Place convention center at a cost of $66 million, passing on another company that offered to do the work without fees. Federal taxpayers will foot 75% of the bill for the hospital, which saw just 38 patients. Wielding influence in the selection was the private company that oversees Navy Pier, which is run by political allies of former mayor Richard Daley.

image

A medical practice in England discovers why patients aren’t answering its phone calls – a phone system error caused its Caller ID to show the name of a massage parlor.

image

Can’t wait for Las Vegas at HIMSS21? MGM hotels is offering “Viva Las Office,” a work-from-Vegas package that includes discounted flights, rooms in the Bellagio or Aria hotels, and a personal concierge. Big cheeses can blow their company’s cash with “The Executive” package, which includes a luxe suite, $75 food and beverage credit, a discount on JSX semi-private jet travel, a day’s cabana rental, a poolside massage, and a mask and hand sanitizer. Plus you can study COVID-19 in person since 95% of new Nevada cases originated in the city, comping visitors from all over the country with yet another situation that happens in Vegas but doesn’t stay there.


In Case You Missed It


Get Involved


125x125_2nd_Circle

Weekender 8/7/20

August 7, 2020 Weekender 1 Comment

weekender 


Weekly News Recap

  • Private equity firm Blackstone acquires 75% of Ancestry for $4.7 billion, which includes the DNA information of 18 million people.
  • Teladoc reaches an agreement to acquire Livongo for $18.5 billion, digital health’s biggest deal ever.
  • Epic announces plans to return employees to campus by September 21.
  • Siemens Healthineers will acquire oncology technology vendor Varian Medical Systems, which includes several software products, for $16.4 billion.
  • Virginia will become the first state to use the Covidwise exposure notification app from Apple and Google.
  • CDC Director Robert Redfield, MD tells a House coronavirus committee that CDC was not involved in HHS’s decision to replace its COVID-19 hospitalization data system to a contractor-developed HHS system.
  • Allscripts notes in its earnings call that the US Department of State’s 450 clinicians will use its TouchWorks and FollowMyHealth systems in its role as a subcontractor.

Best Reader Comments

[On Epic’s mandatory return to campus] Most egregious, for a company that beat into me from day 1 that I must make clear recommendations supported by data, they have no data. They released multiple products during the pandemic while working from home. Support ticket closure rates are up 10% in some applications. They have no metric for productivity, but are willing to die on the hill of “magical, spontaneous hallway conversations.” They’ve failed to create a culture that can exist outside of their physical workspaces; I was part of the very first inter-office chat pilot at Epic – Skype in 2017 – and had to fight tooth-and-nail for its roll-out. Even during non-pandemic times, I primarily called into my on-campus meetings because getting there would’ve taken 15 minutes. This is an abject failure of leadership from Judy, Carl, and the rest of the executive team. (Ex-Epic)

Bill Gates used to say that early on in the life of Microsoft, he used to eyeball how many cars were in the parking lot when he left (which often used to be late in the evening/night) to get a sense of how hard his people were working. He later admitted that it was a rather naive and inaccurate way of measuring productivity. And that was 40 odd years ago! Well, Bill G and Microsoft grew up! Seems like Judy and Epic haven’t. (Ghost_Of_Andromeda)

[On Teladoc’s acquisition of Livongo] Mr. Tullman and Mr. Shapiro poised to cash out (again). As has been proven with Allscripts and now here, it’s easier to raise money for a startup than it is to actually run a company. (It’s All Good)

[On Teladoc’s acquisition of Livongo] No quarterly profit ever and an 18.5 billion price tag… Is there that much waste reduction in the US healthcare non-system to account for such strange valuation? (Eddie T. Head)

Siemens acquires Varian. Ggreat news for Varian shareholders. Sad to see another technology company move to non-US ownership. Will be interesting to see how things shake out when Siemens decides to “integrate” the business. (Robowriter)


Watercooler Talk Tidbits

image

Readers funded the Donor’s Choose teacher grant request of Ms. S in Philadelphia, who asked for carpet and bean bag chairs to create a reading center for her after-school kindergarten program. She reported in February, “When my students first saw the new rug and bean bags in the library area, they asked me, how did we get that in our class? Can we keep it? I answered them how Donors Choose helped us get a funder to donate what we needed. They were surprised that a stranger gave us money . They were super excited and wanted to lay down on the rug to read. We follow D.E.A.R. (drop everything and read) in our schedule. With the new cozy area, the students are more interested in literature. The students enjoy sitting in bean bags, or laying down on the rug to read. They go and pick a book of their choice and start reading enthusiastically. We also use the rug to play different games, practice the numbers and the alphabet. Sometimes, the students just lay down on the carpet to relax. When they are having a bad day, they sit in bean bags and distract their mind. It helps students to calm them down and rejoin the class group when ready. Having a cozy and safe library area has been a life-changing experience for them.”

image

Maria Fareri Children’s Hospital (NY) designates eight-year-old Jorden Hutchins as an ambassador to the hospital after he survives a COVID-19 infection with Multi-System Inflammatory Syndrome in Children, which involved being placed on a heart-lung machine, undergoing heart surgery, and having multiple strokes and kidney failure.

image

Here’s a tech tip I learned for editing a web address or any other text on the IPhone or IPad. Hold down the on-screen keyboard’s space bar until it turns gray, which turns the keyboard into a trackpad for precise cursor positioning.

image

A furloughed urology nurse in Virginia sews cloth masks and 3D-prints 800 face shields for local teachers.

SNAGHTML40ceba70

Volunteers for the non-profit Telehealth Access for Seniors are providing devices, instructions, and free tech support to seniors and low-income communities to support telehealth and digital connectivity with family and friends. Lia Rubel from Vermont (above) has collected 50 devices and raised $800 to help with the mental health of self-quarantined seniors. The organization overall has collected 1,500 used devices, $63,000 in donations, and has 315 volunteers in 26 states. The organization seeks IPhone 4 and above and second-generation or newer IPads, for which it provides data erasing instructions. Their GoFundMe has raised $29,000 so far. The founders are Yale undergrads Aakshi Agarwal, Hanna Verma, and Siddharth Jain along with high school junior Arjun Verma. Agarwal is double-majoring in molecular biology and political science, hoping to purse a law degree and then work in healthcare policy. She also co-founded a college admissions consulting service.

image

A nurse in an explosion-damaged hospital in Beirut runs to the NICU with a colleague to remove five newborns, captured by a press photographer who said that among the rubble and bodies, “The nurse looked like she possessed a hidden force that gave her self-control and the ability to save those children.”


In Case You Missed It


Get Involved


125x125_2nd_Circle

Weekender 7/31/20

July 31, 2020 Weekender 1 Comment

weekender


Weekly News Recap

  • HIMSS pushes out its 2021 conference from March to August in Las Vegas.
  • Allscripts will sell its EPSi business to Strata Decision Technology for $365 million.
  • New investment in WellSky values the company at $3 billion.
  • Irregularities are found in HHS’s $10 million contract with TeleTracking for a COVID-19 hospitalization tracking database.
  • The COVID Tracking Project says that COVID-19 hospitalization data is now unreliable, partly because of HHS’s abrupt switch to a new system and accompanying data element changes.
  • Private equity investments in Edifecs value the company at $1.8 billion.
  • A surgery journal retracts an article in which the authors created fake social media accounts to search for photos or comments by surgery residents that they deemed unprofessional.

Best Reader Comments

I couldn’t care less about what my PCP or NP is doing with their family and friends in their off time. What’s considered “professional” and “unprofessional” is a social construct and is consistently changing over time based on patriarchal or even outdated viewpoints. To this day people still consider minority hairstyles as “unprofessional.” I’m glad they retracted this ridiculous journal article. (Brooke)

Very frustrated and disappointed with HIMSS. I am a small single attender and have attempted to reach them for a refund, as a refund would be of financial help. They won’t answer a phone nor reply to email. As Mr. Wonderful would say, “You are dead to me.” (Bigdog)


Watercooler Talk Tidbits

image

Readers funded the Donors Choose teacher grant request of Ms. K in California, who asked for headphones for her middle school special education class. She reported in February, “Your generosity towards my students have made a huge impact on their learning. Being a special education teacher, I teach students with a wide range of abilities. In order to differentiate instruction and meet their individual needs, I use various forms of technology in the classroom. In my language arts class, I rely on computers for their reading intervention program and audio books. The online intervention program is individualized to work on deficits each child still has. The headphones allows my middle school students to work on phonics and reading comprehension skills at their own level and pace. These headphones are exactly what my students need to progress as successful learners.”

image

Organizers of the influential CES technology conference, which draws 175,000 attendees to Las Vegas each year, announce that the January 2021 event will be virtual only.

SNAGHTML1cc0e0c4

The Arizona Diamondback fill the empty seats for its home opener with teddy bears representing Phoenix Children’s Hospital.

image

Former pro football player Myron Rolle says it’s not yet safe for the NFL to resume play. His credentials exceed just being a retired 33-year-old player – he holds an MD degree from Florida State University College of Medicine, earned a master’s degree in medical anthropology as a Rhodes scholar, and is a neurosurgery resident at Mass General.

SNAGHTML1ccb40a6

ED physician Candice Myhre, MD plays the winning hand in the #MedBikini protest by posting a photo of herself saving a boating accident victim while wearing a pink bikini.


In Case You Missed It


Get Involved


125x125_2nd_Circle

Weekender 7/24/20

July 24, 2020 Weekender No Comments

weekender 


Weekly News Recap

  • Symplr’s owner considers selling the company at a valuation of up to $2 billion.
  • Publicly traded HCA Healthcare books a $1 billion Q2 profit, boosted by $822 million in federal CARES act stimulus money.
  • Cerner announces CommunityWorks Foundations, a fixed-fee, quickly implementable version of Millennium for Critical Access Hospitals.
  • HHS activates a new COVID-19 hospitalization data website that replaces the one that was previously operated by the CDC.
  • WellSky’s private equity owner decides not to sell the company and instead will bring in an additional investor.
  • Researchers ward that sloppy health system implementation of screening for social determinants of health could cause patient harm.

Best Reader Comments

Interesting that in late 2019 CPSI commented that Cerner was competing less aggressively in their market. Then mid-2020, Cerner comes out with a streamlined install for that market. (PeanutGallery)

Opposition to a national identifier is deeply rooted in the American psyche. It might be easier to amend the constitution to eliminate the electoral college than to get a national ID. To be technically feasible a national ID would need to be provided at birth and be (unlike SSN) unique and immutable. Countries in Europe have had systems for this for many years and they work well. In Sweden the “personnummer” is assigned at birth and used everywhere. (Richard Irvin Cook)

It could also be a federated national ID. Each state has an unique ID and identity database. If you are receiving care in X state, your provider queries X state system for matching info based on your ID. Recognizing your ID is from a separate state, your state queries the other states database through a federal broker. The feds don’t see the data, just the ID and a random sample of enough of the query to make sure everybody is following the rules. Data updates are propagated only to those states that have queried for the ID before. If you don’t leave your state, the feds never see your ID or any query info for you. System is bootstrapped based on voting/drivers Id cards. Verification and resolution of identity info takes place at the resident’s state level. Federal block grants conditional on the performance of the states identity system. Health providers keep their own records clean as they are already supposed to. (Boondogle)

The interoperability problem is as Kevin identified, but a significant part of that is also the fact that the solutions do not interpret the data the same way; by schema, domain, structure, dictionary, enumeration, workflow, etc. So in handing your thumb drive over to them, they have no way to bring that data into their system. Unless, it is the same system, configured the same way, with the same dictionaries, and, and, and… (Brody Brodock)


Watercooler Talk Tidbits

SNAGHTML6f85a9d

Readers funded the Donors Choose teacher grant request of Ms. W in Texas, who asked for hands-on learning activities for her pre-kindergarten class. She reported in late February, “I cannot begin to express how grateful we are to have received these items. These resources have made small groups a blast. The interaction between the students and the various activities are very useful. We are able to provide differentiated activities for them. The reactions was priceless as we opened the box. The new materials even improved some behavior issues. We had a brief lesson on how to take care of our items and how to properly use them.“

image

NBC News profiles the “recharge rooms” of Mount Sinai Health System (NY), which give stressed employees a place to relax in a simulated beach or forest. The doctor who came up with the idea provides advice on doing the same thing at home – designate a no-phone sanctuary space, add some artificial plants and aromatherapy diffusers, use noise-cancelling headphones if living in close or noisy quarters, and reserve the bed for sleeping only.

image

COVID unit Nurses at 198-bed Virtua Marlton Hospital (NJ) are summoned to a Zoom work meeting, where they are surprised to be treated to a personal concert from country star Tim McGraw as part of Spotify’s “The Drop In” series.

A former sales rep for drug maker Novartis AG who turned whistleblower against his employer for bribing doctors to prescribe its products will get $109 million as his share of the company’s $678 million settlement.

image

A suppose this supports the “less is more” theory. A nurse in Russia who reported to work in a coronavirus unit wearing only underwear beneath her see-through PPE because it was too hot gets a job as a TV weather presenter on top of a previously signed sportswear modeling contract. She says she still wants to be a doctor.

image

Employees of Stony Brook Southampton Hospital (NY) who are looking for storage space in an old dialysis unit storeroom are startled to find a “King Tut’s tomb” of more than 100 works of art that had been donated by some of the world’s most renowned abstract expressionist artists in the 1950s through the 1980s. The lithographs, drawings, and wood block sculptures – many by artists who lived and worked in the Hamptons back when it was cheap — could fetch up to $1 million to benefit the hospital and the local history museum. A frequent donor was Willem de Kooning, who spent a lot of time in the hospital as a patient in the 1970s due to various alcohol-fueled mishaps, including falling down stairs and passing out in a snow bank.


In Case You Missed It


Get Involved


125x125_2nd_Circle

Weekender 7/17/20

July 17, 2020 Weekender No Comments

weekender


Weekly News Recap

  • Congressional Democrats criticize HHS for issuing a no-bid, $10.2 million contract in April for developing a hospital bed and supply tracking database to TeleTracking Technologies, the Pittsburgh-based hospital equipment and bed tracking vendor.
  • Cerner and Epic delay their return to campus.
  • Athenahealth renames its Centricity product line to AthenaIDX.
  • University of California Health uses de-identified patient data from its Epic system to create a database for COVID-19 treatment research.
  • Fax machines are part of a broken data system that is impeding US coronavirus response.
  • Amazon will conduct a health center pilot with primary care service provider Crossover Health.
  • A KLAS report on pediatric practice ambulatory EHRs names PCC as the clear leader.

Best Reader Comments

At Epic, we used to spend 6-8 months documenting current-state workflows and gathering current-state documentation so that the customer could translate into their own system. Again, customers pushed back (well, probably mostly executives who were on the hook for cutting checks) on the amount of time we spent on the early phases of the implementation where little “visible” results were being made. The implementation methodology continued evolving and cutting out more of the customization steps in favor of more expedited and less expensive installs. This gets the system live faster, but with less customization. There are cons to this, but there are actually many pros to this as well. (HITPM)

Being familiar with some of the events and people that encouraged Epic to become the Marine Drill Sergeant, it wasn’t really how Epic wanted to do things, it was initially customer demand (Kaiser made some strong suggestions, and one Kaiser executive in specific had some….issues) and then some pretty drastic personnel mismanagement in response to the 2007-2008 economy. (Guy M. Fay)

[On Athenahealth renaming the former GE Healthcare Centricity products to AthenaIDX] I’m sure the programmers GE laid off really appreciate that homage. (IDXreturns!)

[On HHS changing hospital COVID resource reporting databases] Is this even the problem space that this company is in, with only 15 or 20 positions open how are they able to take this project on? Awarding a 10 million dollar no bid project in April, 75 days ago, and turning it on with 2 days notice is plain and simply not going to work. I don’t even believe it is intended to work. I do believe there is a desire to further politicize data to obfuscate the current state of the epidemic. (AnInteropGuy)

I personally buy “The One Minute Manager” by Ken Blanchard for all of my new managers. The book offers simply and practical advice for managers. The initial version was published in 1982. (Shaun Priest)


Watercooler Talk Tidbits

image

Readers funded the Donors Choose teacher grant request of Ms. C in Kentucky, who asked for LEGOs to help her fourth graders develop science, math, and engineering skills. She reported in February, “Thank you so much for your amazing donation to our classroom. The LEGOs have been and will continue to be utilized in so many ways in our daily instruction. Obviously most of my kiddos love playing with LEGOs so these have allowed me to include a fun and engaging morning “tub” or center to our stations. I have used them and will continue to use them to help students have a better understanding of fractions. We are able to count the circles on the tops and create equivalent fractions. We can also use the pieces to add and subtract fractions as well as see why it is important to have like denominators when adding and subtracting fractions. I have also allowed students to get creative and use them to build things.”

image

Residents of a nursing home in England that is closed to visitors entertain themselves by recreating classic album covers from The Clash, David Bowie, and other musicians. Here’s a cultural teaching point, from me after reading a Twitter comment that surely the residents have never heard of The Clash – “London Calling” was released more than 40 years ago in 1979 and lead guitarist Mick Jones is now 65, so let’s not picture today’s nursing home residents hepping to Cab Calloway.

A 29-year-old mental health counselor in New York City whose household income is $22,500 describes the stress involved with owing nearly $300,000 in student loans as she continues her studies to earn a PhD.

image

Two New York doctors rig app-powered cellular walkie talkies targeted to kids to allow families to speak to isolated patients any time they want without exposing employees who would otherwise be setting up video chats. The app allows multiple people to contact the patient through the single device they have. The hospital developed a disposable casing so the devices can be reused. The devices cost $50 plus $10 per month for cellular service, and for kids, they include real-time GPS tracking, geofencing, playback of missed messages, and voice commands.

image

In Virginia, a physician assistant is fired after a black patient who suffers from anxiety and PTSD asked her about a Confederate flag he saw on her wall during a virtual visit, after which she adjusted her camera, told the patient he was seeing things that weren’t there and was paranoid, and doubled his sedative dose.

In England, Queen Elizabeth II knights Captain Sir Tom Moore, aka World War II veteran Captain Tom, who at 100 years of age hoped to raise $1,000 for NHS by walking laps around his garden in return for the health system saving his life and ended up generating $40 million in donations. Captain Tom holds two Guinness World Records – one for fundraising and another for being the oldest person to chart a #1 song in the UK for “You’ll Never Walk Alone,” performed with singer Michael Ball and the NHS Voices of Care Choir.


In Case You Missed It


Get Involved


125x125_2nd_Circle

Weekender 7/10/20

July 11, 2020 Weekender No Comments

weekender 


Weekly News Recap

  • Health Catalyst will acquire Healthfinch for $40 million in shares and cash.
  • A Health Affairs blog post calls for ONC to start measuring the impact of the interoperability requirements of the 21st Century Cures Act.
  • VA seeks robotic process automation to import patient documents from external providers into VistA and Cerner.
  • Walgreens will spend $1 billion over the next five years to open VillageMD primary care clinics in up to 700 of its stores.
  • Informatics pioneer Octo Barnett, MD dies at 89.

Best Reader Comments

The new interoperability regulations that were promulgated in March are like any other regulations, they are only as good as the enforcement actions that will be taken. Thus, while it is fine to have a wish list of those things ONC should track, more importantly is simply enforcing the regs as they stand. Of course, putting on my cynic hat, I see this article from academics as a lead up to a research grant from ONC to support an academic endeavor to measure these metrics. (John)

Those proposed metrics are a bit confusing to me. Measuring things that aren’t in the rule as a way of implicitly adding the things we all wish were actually in the rule (but aren’t) doesn’t seem right. (Brendan)

The main barrier to telehealth is financial. I work for providers who are using telehealth extensively for med refills and wellness visits, and it has been working well. They and their patients want to continue using it, but the insurers continue to waffle on payment policies and suggest that they will only pay for online visits during the pandemic. Of course practices are preparing to bring patients back in whenever possible under those conditions. (Amanda B)

I work in mental health and much of what we do can be delivered quite well by telehealth and often by phone for patients without the ability or devices to do telehealth. The vast majority of our patients do not want to come into the office and the vast majority of our clinicians do not want to sit in a small poorly ventilated office where there is a risk of COVID transmission. However, our organization is strongly encouraging us to see more patients in person because the rates for phone calls are less than telehealth or face-to-face and because the insurers are already jerking us around on reimbursement with the likelihood of additional payment-related travails from insurers and CMS down the road. (RightOn)

Unfortunately, your assessment of telemedicine is spot on. Absent a significant change in healthcare and healthcare delivery in this country, profits ($) will continue to drive behavior, despite the fact that we have the worst outcomes on a number of measures of health and healthcare in the world (including our management, or lack thereof, of COVID-19. (Michael J. McCoy, MD)

Dr. Jayne, I am so embarrassed and ashamed of our healthcare system as I read what you are experiencing in the trenches. We are about four months into this Coronavirus pandemic. I was a little more forgiving (but not much) in March since supposedly this virus caught us off guard. But now? Really? After working in healthcare since the 1970s, I have no words anymore. Just tears. (JT)

Two ways to do something, the right way and again. Allscripts has showed a willingness to take the second option as a standard practice. So, until that stops, they will lose customers. Remember the business model is to buy startups and then promise to integrate them, while not requiring them to integrate. (AnInteropGuy)


Watercooler Talk Tidbits

image

Army veteran Richard Rose III of Port Clinton, OH died July 4 of COVID-19 at 37, with his previous Facebook posts in which he disdained wearing masks and checked in at crowded bars and parties now forming his obituary. He said just before he died that he probably caught the virus at the party on the upper right. Meanwhile a 30-year-old man who intentionally exposed himself to the virus by attending a COVID-19 infection party dies of it, telling his hospital nurse, “I think I made a mistake. I thought this was a hoax.”

image

A Vice article describes how biomedical technicians are buying non-working, 20-year-old ventilators on Ebay, then using a handmade dongle to program around manufacturer protections so they can fix them. They can then sell the repaired device to US hospitals to meet COVID-19 demand. Newer models validate the identity of the repair tech to make sure they’ve paid the manufacturers’ $10,000 to $15,000 fee that allows them to bypass the anti-repair technology, so the market is in older machines that don’t have that protection. Ventilator manufacturers say their machines are complex and they need to limit who can work on them, while hospitals say it’s their own liability if their highly trained technicians make a mistake, which has apparently never resulted in a manufacturer lawsuit. Hospitals also note that manufacturers wouldn’t sent techs onsite in the early days of COVID, so they were stuck with machines they needed that were awaiting repair.

image

A Nebraska ED nurse renders aid at a two-car accident that she encountered on her way to her daughter’s wedding.


In Case You Missed It


Get Involved


125x125_2nd_Circle

Weekender 7/3/20

July 3, 2020 Weekender No Comments

weekender 


Weekly News Recap

  • WellSky’s private equity owner considers selling the company at a valuation of up to $3 billion.
  • Epic will delay the return of employees to campus by month following a local uptick in COVID-19 cases, but says it is impossible to maintain its culture when employees are working from home.
  • UCSF pays ransomware hackers $1.14 million to regain access to its medical school servers.
  • A cybersecurity firm reviews Internet traffic of six Fortune 500 healthcare companies and finds significant security exposure and hacks in progress.
  • Telehealth visit counts have steadily declined since their mid-April peak, dropping from 14% of all visits to less than 8% as the availability of in-person visits returned.
  • Smartphone urinalysis company Healthy.io acquires competitor Inui Health, formerly known as Scanadu, for $9 million.

Best Reader Comments

CMS continues to blast out information like nothing else is going on in the world. Can you spell TONE DEAF???? (JT)

As to definitions, we use these. Telemedicine is doctor to doctor consults, e.g. suspected stroke patient at rural hospital. Telehealth is doctor to patient, omni-channel, asynchronous and synchronous. Virtualcare / health is telehealth combined with remote patient monitoring. (John)

Often the more important distinction is telehealth / medicine vs. virtual care. The former generally implies synchronous communication to replace an in office visit (whether via video, voice, or real-time chat). While the latter brings in asynchronous communication via chat with different care providers, data from connected devices (scales, blood pressure, SpO2, EKG, spirometers) and find a way to present it to the care team and integrate into the EHR that makes care more efficient. (Greg Chittim)

I’ve been using virtual health as the umbrella term that includes (1) telehealth (which involves any modality- video, phone, messaging) between a provider and a patient; (2) eConsult, which is any modality between two providers; and (3) autonomous health, which is any modality between a computer and a patient. My gut is that we will get to a new baseline of 20-30% of telehealth visits assuming reimbursement continues to be at least close to parity in a FFS system. And for healthcare systems in a capitated model, we may see much more. (Lyle Berkowitz)

I am afraid you are too correct in your assessment of the veracity of some state data. We can look at the assertions and testimony of Rebekah Jones, the Florida state chief data scientist who describes the manipulation of data as an example. There are other states that appear to be in similar states of data invalidity for political purposes. This is on top of the problems with data quality that are just inherent to EHR information. I am not sure how to see these trends and infection byproducts in a single EHR, unless that is a combinatorial EHR (acute, ambulatory, ED, etc.) or through a data aggregator. If our testing was both active and historical (covid markers) then we could tag patients then watch their subsequent treatments, Dx, and Rx — maybe through case reporting? But again, if you take that route then you have to trust the health departments to not be influenced by politics. (Brody Brodock)


Watercooler Talk Tidbits

image

The Alabama Board of Nursing investigates a complaint brought against a nurse who shouted “Heil Hitler” to the Mobile, AL city council meeting and then threatened its members as they approved a mandatory mask-wearing ordinance. A councilman replied nonchalantly, “Good gracious alive. Heil Hitler?”

SNAGHTML25cacf86

A newly graduated nurse who had just left her wedding with her new husband “went into nurse mode” when she stopped to render aid at the scene of an auto accident while still wearing her gown.

image

An unnamed female CEO of a Detroit health IT company pays $3.5 million in cash for a Sarasota, FL condo.

Twitter and JPMorgan Chase will remove the common programming terms “master,” “slave,” and “blacklist” from their source code following complaints from black engineers. Twitter will also replace “grandfathered” and “dummy value.” 

image

In England, a five-year-old boy who just learned to walk on prosthetic legs following amputation raises $1.5 million so far (versus his goal of $600) in a 10K walking challenge for Evelina London Children’s Hospital, which saved his life as an abused, weeks-old baby. He was inspired and congratulated by 100-year-old World War II veteran Captain Tom, who raised $40 million for NHS charities by walking 100 laps around his garden.


In Case You Missed It


Get Involved


125x125_2nd_Circle

Weekender 6/26/20

June 26, 2020 Weekender No Comments

weekender


Weekly News Recap

  • Kaufman Hall spins off its enterprise performance management software division as Syntellis Performance Solutions.
  • Public health officials in Austin, TX blame COVID-19 case counts that vary wildly by day on labs that are sending test results by fax.
  • The American Hospital Association loses its bid to stop the federal government from requiring hospitals and insurers to publish their negotiated prices, but will appeal.
  • Massachusetts eHealth Collaborative shuts down after 15 years.
  • CMS begins publishing a monthly Medicare COVID-19 Data Snapshot.
  • CMS announces the creation of CMS’s Office of Burden Reduction and Health Informatics.
  • Russian President Vladimir Putin calls for the healthcare system there to roll out out digital systems and to use artificial intelligence.

Best Reader Comments

While in theory I like the idea of requiring hospitals and insurers to publish their prices, I’m somewhat skeptical of the actual benefit this may provide to patients. To the majority of patients in this country who are insured by a commercial payor or CMS, unless the anticipated out of pocket costs are also provided, I suspect the published price itself will be ineffective in driving patients to lower cost alternatives … with health system monopolies and the ubiquity of employer-provided health insurance, patients simply don’t have much of a choice either where they get their care or who their insurance provider is, which will only cause prices to continue to rise. (Dr. Gonzo)

Administrator Verma’s heart seems to be in the right place and the tweets carry a lot of bite. But I am skeptical that asking current health systems players to take on the role of addressing social and economic factors of their patients is going to work. Those who know the system know very well that American health system has had its knee on the neck of racial minorities and economically disadvantaged for a long time. You don’t get to be a part of $4,000,000,000,000 annual industry without shattering a few million middle class dreams. (SeismicShift)

I would question how many companies are as worried now about how to “strategically reallocate those unused marketing dollars” but rather how to use those funds to meet a demanding payroll and to stay afloat until the markets are open and the economy levels out. (Just Wondering)

Healthcare is but one symptom of a system ripe for correction. What can we say about the richest nation in world history with currently 48 million of us lacking nutritious food on a regular basis, including 16.2 million children? USA needs to look long and hard at its fantasy that we all are existing on a level field. (Kevin Hepler)


Watercooler Talk Tidbits

image

Readers funded the Donors Choose teacher grant request of Mr. H in Georgia, who asked for a robotic center for his school’s media center. He reported in February, “Thank you for your generous donation. It has truly exposed boys and girls in a variety of grade levels to how coding can be a fun learning experience. We have built the robots, practiced building block languages, and have even implemented different movements with the Kamigami Robots. An activity the students always look forward to in the program is playing tag with the robots. Each student has to use the coding language to try and disable the other robot in a specific time session. I am working to continue to create authentic and innovative activities that will promote their knowledge of computer science. The smiles on the students’ faces would not have been possible without your support.”

image

Dermatologist and YouTube star “Dr. Pimple Popper” Sandra Lee, MD unsuccessfully tries to hide her social media tracks after insulting nurses everywhere.

In Russia, a nurse whose hospital employer reprimanded her for showing up for work in a see-through PPE gown with a sports bra and short underneath because she was getting overheated lands a modeling contract.

Columbia University ED doctors describe how to tame your email inbox using crisis resource management techniques:

  • Have one person summarize multiple status reports into a single email that is sent at the same time each day and with the same subject, format, and section headings.
  • Include the titles of everybody who is sent a group email or is added to thread.
  • If a recipient is being included just as an FYI for one message in a thread, use BCC so they don’t get future group messages.
  • Don’t just make broad requests for help – assign tasks to specific individuals with timelines and expectations on reporting back. Otherwise “email is commonly abused as a tool for putting work on somebody else’s desk without having to confirm that they can take it on.”
  • Add action requests to the subject line in brackets “[respond EOD].”
  • Ask why you are being added to an existing email chain and what expectations are involved.
  • Use the SBAR concept (situation, background, assessment, recommendation) to make communications concise.
  • Encourage people to speak frankly.

The former CEO of Union General Hospital (GA) and one of its doctors are sentenced to federal prison for their roles in scheme in which the doctor prescribed the CEO 15,000 doses of opioids in return for being paid for additional hospital work and being placed on its board.

A Colorado anesthesiologist gives up his medical license and serves 30 days in jail after turning off all the patient monitors in a hospital’s recovery room with a rant about how the noise creates alarm fatigue for nurses, then choking a nurse who told him to leave the machines alone.


In Case You Missed It


Get Involved


125x125_2nd_Circle

Weekender 6/19/20

June 19, 2020 Weekender 1 Comment

weekender


Weekly News Recap

  • Health Care Service Corporation, the country’s fifth-largest insurer, will create a Payer Platform to connect its health plans to Epic-using health systems.
  • Epic cancels UGM 2020.
  • Proteus Digital Health, once valued at $1.5 billion, files Chapter 11 bankruptcy.
  • Walmart acquires the technology assets of online pharmacy CareZone for a rumored $200 million.
  • Surgisphere, the tiny company whose questionably sourced aggregated EHR data was responsible for two major research article retractions, appears to have shut down.
  • Milliman acquires Wisconsin-based employee health monitoring technology vendor Healthio.

Best Reader Comments

I can’t help but wonder how this will affect minor telephone calls with doctors. In the past, I would occasionally call a doctor on the phone to check in on a test result or ask about a medicine and so on. These were relatively quick, focused calls for which there was no charge. But going forward, if telehealth becomes an accepted modality for paid services, what’s to stop a doctor from billing me for each of those calls? (Ben)

If you want providers to do something, you have to pay for it. I’ve got some nice cushy corporate insurance, so I can get my PCP to throw in a couple of freebie phone calls after he’s price gouged me on a few visits. If I had an ACA exchange plan, I doubt I’d get the same level of customer service. I’d rather the billing for telehealth and chat services gets formalized so that the people on government or skimpy plans can push for and get it. Otherwise it’s just going to be a perk for good employer plans, which means it won’t affect anything. (IANAL)

I am appreciative that CMS has relaxed some of the constraints for telehealth services billing during the pandemic but those rules were inane restrictions to begin with. Why should a patient ever have been precluded from getting telehealth at home, simply because they don’t live in a designated rural area? (ValueBasedSkeptic)

As to the hype around value-based payments, we’ve lived through this before with different names and slightly different variants. Improving quality sounds great, but we still can’t define or measure quality well, even for very clear-cut conditions. We’ve spent untold money and efforts on quality measures with lots of content from CMS, NQF and others. Yet for some specialties, there are few if any viable measures. Whether it’s framed as improving population health or some other positive sounding initiative, the main goal has always been shifting costs onto the backs of providers. (ValueBasedSkeptic)


Watercooler Talk Tidbits

SNAGHTML3eb5e5d

Readers funded the Donors Choose teacher grant request of Ms. H in North Carolina, who asked for game buzzers and wobble cushions for her fifth-grade ADHD students. She reported in February, “My students come in every day begging to use the wobble cushions, as well as wanting to know if we will be playing a game with the buzzers. We will continue using these resources daily in our classroom until the end of the school year. I know my future students will be just as excited next year using the wobble cushions and game buzzers.”

Federal authorities arrest a Chinese citizen at LAX as he attempts to board a flight to China, charging him with obtaining a UCSF post-doctoral fellowship position so he could record lab layout details that could be replicated in China. The man, who turned out to be a major in the People’s Liberation Army, admitted that he had been stealing information in his year of employment there. His laptop contained UCSF study information and he had wiped his WeChat phone messages right before arriving at the airport. He is charged so far only with visa fraud.

SNAGHTML3fcf442

Four ICU nurses sue Landmark Hospital (GA), claiming that the hospital ordered them to perform COVID-19 test swabbing incorrectly to ensure that the tests would come back negative.

image

NASA’s next Mars rover, scheduled for launch on July 20, will bear a plate that honors those who are on the COVID-19 front lines.


In Case You Missed It


Get Involved


125x125_2nd_Circle

Weekender 6/12/20

June 12, 2020 Weekender 1 Comment

weekender 


Weekly News Recap

  • A new investment in workforce management software vendor QGenda values the company at $1 billion.
  • Conversa, PatientPing, Wellsheet, and Kyruus announce significant new funding.
  • Only three states have committed to using COVID-19 contact tracing apps from Apple and Google.
  • GAO says the VA is doing a good job of getting clinicians involved in its Cerner implementation, but suggests choosing broader representation at its local workshops.

Best Reader Comments

If the medical record is not reconciled, then the source system is part of the problem. However, I have yet to see a system that has entanglement of the data that has been exchanged. Meaning that if Clinic A provides a referral for a preliminary diagnosis and the specialty adjusts the diagnosis and adds a new diagnosis, is the provider notified? That is the goal of 360x, but how many have implemented it — Cerner, Epic ? (Brody Brodock)

Once there are only a few EMR vendors left, then you can start telling your customers that they can’t do the thing in a way that prevents interoperability. The government could mandate that the EMR companies provide interoperability, but it either won’t work or will drive certain EMRs out of business. The situation is FUBAR in that respect. The problem is that healthcare delivery and organizations just aren’t that standardized and process oriented. They’ve never been exposed to the sort of environment that produces that. What we need isn’t a technology standard, it’s a process standard. As an example, accountants use GAAP so that they can calculate the revenues, losses, etc. for their company. When someone tells me their GAAP deferred revenue, I know what they mean and how they calculated it. When someone tells me that a patient has an active medication in their chart, I don’t have a good idea about what that means. (IANAL)

Due to my own illness that I’ve been dealing with for a decade plus, during the COVID surge, I’ve had five telehealth visits, one with PCP, others with specialists. Each started right on time, each accomplished what was needed effectively and efficiently. I dread the thought that there may be a retrenchment of telehealth and I’m forced back to in-person visits. I will resist. (John)

I’ve been in healthcare tech for over 30 years, sat on the HIMSS board, and been a member until 2016 when I came to the decision that HIMSS only cares about three things, money, promoting its own agenda, and removing alternate opinions from the dialogue. Until its membership and that of the vendor community wakes up and understands that those simple truths about what motivates HIMSS or its current leadership, nothing will change. I agree with HIStalk that HIMSS more than likely cannot afford to refund the money it collected without digging deep into the leadership’s compensation and its political machine lobbying Capitol HSill. It is my belief that its time to abandon HIMSS and allow it to either make it as a for-profit organization, which is what it really is verse it hiding under the veil of a non-profit, which it hasn’t been for decades. The educational aspects of HIMSS can be easily replaced by regional groups who can provide localized and national educational content by collaboration and by working with vendors who in lots of instances will pick up the costs. The vendors can form their own association with dues and hold an annual conference that they own, manage, and set the time and place. This would reduce costs all the way around facilitate greater transparency. (HIMSS Insider)

I’m pretty comfortable with a hospital firing a nurse who openly wishes for the death of people she doesn’t like. She is not able to fulfill her job functions. Not only did they do the right thing in firing her, if I were them, I’d also go back and do detailed reviews of all patient cases that she handled to look for irregularities or disparities in the care (“care”) she provided to people — before someone recognizes her as having been on a care team responsible for them or for a family member and starts asking questions about a bad outcome. (HIT Girl)


Watercooler Talk Tidbits

image

Readers funded the Donors Choose teacher grant request of Mr. H in California, who asked for a computerized scientific calculator for his high school class. He reported in mid-February, “Because of your donations, my students will be able to learn about how an advanced graphing calculator works and get experience using this technology that will be an important aspect of their future math classes. Our school does not have the resources to provide all teachers with class sets of graphing calculators, but with this project, I can begin to teach students about how to use this advanced technology and provide exposure to it they will remember in their future math classes. In order to support future students in STEM subjects, students need to be familiar and have experience using technology and your donations have made that possible in my classroom.”

image

Creation and operation of a 1,000-bed COVID-19 field hospital in the New Orleans convention center cost $192 million, three-fourths of that provided by federal taxpayers. Occupancy peaked in early April with 108 patients and officials kept extending the contract even as patient count dwindled. Nurses who had nothing to do were paid $243 per hour with a guaranteed 98-hour workweek with time-and-a-half for overtime. The bored staffers volunteered to leave, but were told that it was a government contract and to keep showing up to sit around.

image

Healthcare staffing provider TeamHealth fires ED doctor Steve Huffman, MD, who is also an Ohio state senator, who asked during a public hearing on racism, “Could it just be that African Americans or the colored population do not wash their hands as well as other groups?” He defends his question as relevant to public health, and while admitting that he worded his question awkwardly, says “colored population” seems to be interchangeable with “people of color.”

Michigan’s Medicaid medical director is reprimanded and fined after admitting that he did not use the state’s prescription drug monitoring program system when prescribing opioids in his private practice.

UF Health Jacksonville suspends a 72-year-old doctor following complaints that he groped female patients, stashed money in their underwear, and undertook his examination of a 70-something woman’s neck mole by kissing it.

image

NBC News finds that Facebook’s feel-good TV ads that featured members of its Groups expressing support for healthcare and other frontline workers was faked, with none of the feature postings coming from actual Groups. Facebook admits that it mocked up the posts using stock photos and its own employees posing as group members, which it says was due to privacy concerns. The non-fake “Cheers For the Frontline!” group, unlike its happy TV counterpart, is struggling with spammers and trolls.

image

Doctors remove a mobile phone charging cable from the urethra of a man who told them, unaware of the anatomical impossibility of his declaration, that he swallowed it. Trust me that you do not want to watch the doctor’s Facebook-posted video of the removal procedure.


In Case You Missed It


Get Involved


125x125_2nd_Circle

Weekender 6/5/20

June 5, 2020 Weekender 2 Comments

weekender


Weekly News Recap

  • Amwell files IPO documents.
  • Two major medical journals retract influential coronavirus-related articles that analyzed encounter data from Surgisphere, a tiny company whose capabilities and transparency were questioned by experts who found flaws in the articles.
  • R1 acquires Cerner’s RevWorks RCM outsourcing business for $30 million.
  • Private equity firm Rubicon Technology Partners takes a majority position in patient access center platform vendor Central Logic.
  • Change Healthcare acquires retail pharmacy technology vendor PDX for $208 million.
  • Virtual diabetes clinic vendor Onduo names former National Coordinator Vindell Washington, MD, MHCM as interim CEO.
  • Tested hospital EHRs failed to flag potentially harmful medication ordering problems one-third of the time.

Best Reader Comments

[Dr. Jayne] wrote that “a unique patient identifier would help and would bring us into line with many other developed nations.” I think this is a notion that is still up for debate. In fact, the first session of the day spoke to what an identifier gets you and its limitations. Yes, other nations have patient identifiers, but these nations are also single-payer (national health systems). So it’s a bit apples and oranges. (Catherine Schulten)

The new CEO and outside investors have had Cerner on a track to shed low margin business units, such as RevWorks. The Cerner revenue cycle software solutions all remain, an organization just can’t outsource their rev cycle staff and leadership to Cerner RevWorks anymore. They can still do that with companies such as R1 and other RCM organizations. (Dodele)

If the WHO is only feeling mildly petulant, they could simply charge the US for continued access to the ICD an amount comparable to the totality of what we were paying as members. That way WHO efforts will remain financially supported in coping with the pandemic and they won’t have to be bothered with dealing with chaotic input, conspiracy theories, etc. from the US leadership. (WHO fan)


Watercooler Talk Tidbits

SNAGHTML79b29954

Readers funded the Donors Choose teacher grant request of Ms. W in Texas, who asked for microscopes for her third grade class. She reported in February, “With the gift of handheld microscopes, my students were able to dig deeper into understanding how soil is created and the difference between soils from multiple regions. When they actually saw the tiniest of sand crystals that are broken down from larger rocks and bits of leaves and decaying animals of the humus layer, they experienced for themselves the learning that is required of them by the state. When students are involved with their own learning, they take ownership of that knowledge which gets ingrained deeper with that experience than just the surface. It also gave them a glimpse into what scientists really do when conducting science experiments. It is for this reason I believe they need first hand experiences with first class tools. Your donation has helped put these tools into their hands. Without a doubt, you have aided in inspiring future scientists to dream big. Thank you.”

Amazon-owned Whole Foods fires an employee who was keeping a running online count of COVID-19 cases in the company’s stores. Katie Doan was dismissed for “time theft,” which she says involved a 45-minute panic attack. Her list shows 340 workers who have tested positive and four who have died. 

SNAGHTML79cec81d

Workers are finishing transformation of the long-shuttered, 4,500-bed Cook County Hospital in Chicago into hotels and medical offices. The developer says the building is 550 feet long but only 80 feet wide, which he says is “like a 50-story building on its side.” The renovation is part of a $1 billion project that includes apartment construction.

Northwest Mississippi Regional Medical Center fires a nurse whose Facebook rant against protesters concluded with, “It is time we take this country back from you animals so be very careful about what your next step is because it can lead to 6 feet under! Trump is fixing to put your asses in jail or a grave. I hope it is the latter of the 2.” Most shocking is that she didn’t use the two key strategies for people who confidently espouse a position but then regret it when public reaction hits their personal bottom line: (a) claim that their account was hacked; or (b) compose a suddenly literate, thoughtful post about why their original comments were misunderstood and don’t define their consistently saint-like behavior. On the other hand, I’m not sure I’m comfortable with the “cancel culture” of firing someone for comments they make off the clock and unrelated to their jobs purely out of employer embarrassment (I say that as someone who was nearly fired from my hospital job for honestly and anonymously reporting vendor cluelessness in my early HIStalk days).

image

A Florida celebrity plastic surgeon self-styled as “Dr. Miami” offers drive-through Botox treatments. He says the mobile facial injections make perfect sense in pandemic times, but his website makes it clear patients will need to come inside for his $13,000 Brazilian Buttlift, his $10,000 breast augmentation, and $7,500 nose job. It would be interesting to compare his career to whatever he told Washington University in St. Louis School of Medicine to convince them to give him an incoming class spot. Most of his celebrity patients are D-list stars of sleazy reality shows, he wrote a kids’ book titled “My Beautiful Mommy” that pushed elective plastic surgery, and he took heat for a song and video he commissioned titled “Jewcan Sam (A Nose Job Love Story)” that promised Jewish high school boys the chance at romance if they “get their nose circumcised.”

image

ESPN will award Quebec-based Kim Clavel, RN with the Pat Tillman Award for Service. She took a leave from her nursing job last year to pursue a pro boxing career, after which she won the NABF flyweight championship. She is now working as a night-shift nurse at retirement and elder care centers.

image

A mother and daughter who graduated from different medical schools this year are matched to residency programs at LSU Health. This is apparently the first time that a parent and child graduated medical school in the same year and then were chosen for residency at the same site. The Ghana-born mother – who is also a RN and family nurse practitioner  — also holds three master’s degrees in nursing, health administration, and leadership.


In Case You Missed It


Get Involved


125x125_2nd_Circle

Weekender 5/29/20

May 29, 2020 Weekender No Comments

weekender


Weekly News Recap

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

Best Reader Comments

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

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


Watercooler Talk Tidbits

image

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

SNAGHTML55dc906a

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

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

image image

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

image

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

image

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

image

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


In Case You Missed It


Get Involved


125x125_2nd_Circle

Founding Sponsors


 

Platinum Sponsors


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Gold Sponsors


 

 

 

 

 

 

 

 

 

 

 

Reader Comments

  • IANAL: Your employer/insurance wants to decrease your use of healthcare so that they don't pay as much. Sending you advertising...
  • Jayne HIStalk MD: Good question - it was an evening appointment (which I thought was odd in the first place) on a night I have a standing ...
  • John Lynn: I hate the automatically scheduled appointment like that too. Although, I'm more intrigued how you knew that an appoint...
  • US_MedicalCare: Re: Dina Spotlight I clicked through Dina's spotlight and that triggered a chain of thoughts that I don't have any answ...
  • Mr. HIStalk: I haven't seen it mentioned in the Bob Loblaw Law Blog....

Sponsor Quick Links