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Weekender 1/24/20

January 24, 2020 Weekender 1 Comment

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Weekly News Recap

  • Epic updates its software to include travel screening prompts for patients who may have traveled from China or who are experiencing symptoms of the coronavirus.
  • Columbus, OH-based analytics company Aver raises $27 million in a Series C round led by Cox Enterprises.
  • Judy Faulkner urges CEOs at some of Epic’s largest hospital customers to sign a letter to HHS Secretary Alex Azar protesting the proposed interoperability rule published last year.
  • Consumer DNA testing company 23andMe lays off 100 employees as it struggles with declining sales.
  • Epic decides to stop pursuing integrations with Google Cloud based on a lack of customer interest.

Best Reader Comments

Android permissions are a good example of one software provider using imprecise permission definitions to screw over consumers and other software makers. For example, I’m trying to copy a person’s name into an app on my phone. The app wants access to my contacts to do so; it might even request that access when I install the app. Many Android app vendors use this permission to vacuum up your whole contact list and sell it to others. You and the software developer that makes your contact list application can’t do anything about this without denying access to application data.

We need to prevent a similar situation with regards to health care data. Imagine you are trying to copy a lab to a telehealth app so that you can get a second opinion. The app requests access to your Mychart; you click Accept. It pulls all of your health information, labs, provider notes, tests, genetic information, etc. The telehealth company then sells this data to IMS. IMS has a breach and your health data floats around the internet.

HHS does not have the skills necessary to define this type of access or permission system. Certainly the proposed rules do not mitigate the dangers of the above scenario. If HHS can’t get a healthcare data security policy properly defined and enforced, what are they doing trying to force providers to share their application data with others? (Burgers)

Yeah, can’t wait till the architecture is opened up and I can place orders with my ordering app. Then scans with my imaging app. Then diet orders in my patients’ favorite diet tracking app. Maybe I can review them all in a new Review app! The future! (App for that)

Think about it – the big 2-3 EHR vendors are going to use the ‘security’ (fear/doubt) angle for ever to try and keep the oligopoly and ‘money printer’ they have today. This is a very expected play. They also know the architecture of what they’ve built is archaic and if the market opens up, apps/innovation will take over the provider and even patient user experience pretty rapidly. Just do a google search and look at the 1990s user interfaces that the big 2-3 still use today! Btw, the gigabytes of data we voluntarily expose each day is significantly more than the amount of healthcare data we obsessively try and protect. (Tom Jackson)

Government and Politics are forever part of health technology, however, I am constantly irritated with the government mandated monopoly granted to the AMA. I will go out on a limb to state that at some point the defense for Surescripts will raise the AMA situation and draw comparisons. It would be delightful to see that play out. (Bill O’Toole)


Watercooler Talk Tidbits

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Citing health, safety, and security issues, the Department of Transportation proposes a ban on emotional support animals and restrictions on the types of service animals passengers can bring on board planes, limiting them to trained dogs. Association of Flight Attendants President Sara Nelson has echoed the frustrations of many a road warrior with her reaction: “The days of Noah’s Ark in the air are hopefully coming to an end.”

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Simulation in Motion Montana brings hard-to-access training to remote clinics that would otherwise likely go without. The nonprofit’s three mobile training labs cover over 100,000 miles annually to offer rural healthcare providers training for scenarios like childbirth, trauma, pediatric overdoses, and sepsis infection.

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Madison, WI landmark Ella’s Deli and Ice Cream Parlor closes after 41 years in business. Epic purchased the diner’s famous carousel along with other decorations and installed them in its lobby last year.

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The Atlantic looks at the role military hospitals and the federal government play as medical debt collectors, recounting the story of an uninsured trauma patient who was taken to Brooke Army Medical Center in Houston because there was no better place to receive care. Described as “one of the most unforgiving debt collectors around,” the federal government can mete out punitive action to patients who need the biggest breaks, withholding wages, tax refunds, or 15% of a person’s Social Security income without a court order. Data from the Defense Health Agency puts civilian medical debt to military hospitals at $198 million.

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Pediatric surgeon Robert Parry, MD has gained quite the following as a post-op bandage artist at Akron Children’s Hospital in Ohio. He explains his technique: “I use Telfa dressings (not an ideal art medium) and cut out the outline of the image freehand. Then I color it in using Sharpies. It doesn’t go directly on the wound — it’s protected by a Tegaderm (plastic) dressing. I’ve operated on more than 10,000 children, and all of them that needed a dressing got a drawing. From tiny newborns that weigh less than a pound to fully grown young adults. And I can’t recall anyone not enjoying it — no matter how old they are.”

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@Farzad_MD clarifies an earlier tweet about Epic’s billboard placement in Washington, DC. Meanwhile, Politico reports that Epic CEO Judy Faulkner has said she might sue HHS if they move forward with publishing the interop rules she has so publicly objected to.


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Weekender 1/17/20

January 17, 2020 Weekender No Comments

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Weekly News Recap

  • Masimo buys NantHealth’s Connected Care business for $47 million in cash.
  • ONC publishes a draft of its “2020-2025 Federal Health IT Strategic Plan” for public comment, due March 18.
  • Physicians spend 16 minutes per encounter doing EHR work, according to a Cerner study that reviewed client data from its Lights On Network.
  • Medsphere raises $40 million in new funding to support growth and pursue acquisitions.
  • R1 RCM acquires SCI Solutions for $190 million just days after SCI announced its acquisition of Tonic Health.
  • Former US Senator Bill Frist, MD launches CareBridge, a Nashville-based technology company that will use an initial $40 million in funding to improve home healthcare.
  • Teladoc will acquire telehealth platform vendor InTouch Health for $600 million in cash and TDOC shares.

Best Reader Comments

We are in the strangest time in my career, with so many mergers and acquisitions by competitors and VC firms. I started as a consultant on Millbrook/Paradigm PM and MedicaLogic/Logician EMR which became the initial GE Centricity suite, on two separate platforms smushed together. Now that product line has been acquired again. I also work with another full PM/EMR that was just acquired by a competitor who is owned by a VC. The mission of a VC is different than the traditional EMR vendor, so we’ll see how it shakes out. In the more than a decade GE had Centricity, changes were made for mandatory programs, but there was never any real product development after the acquisition. That’s always the fear, your EMR will be acquired at some point, by whom and why will dictate if the product continues to be developed or not. Everyone is for sale for the right price at the right time. (PM Consultant)

While non-competes are largely not legally enforceable – they are enforceable in operational practice. Epic practices this, or at least used to, by restricting UserWeb access, access to resources, or just general threats to the consulting firms that work with them. In this David vs Goliath fight of worker rights and hiring freedom, Epic is a Goliath that doesn’t look like it’s found a worthy David to keep it in check. It continues to not only hurt and frustrate their own employees, clients, and partners, but it also hurts local businesses in the Madison area. These local groups constantly deal with the Ex-Epic people starting jobs to only leave after a year to chase the consulting money increasing their turnover and decreasing their ability to hire reliable staff and hurting trust in hiring anything from Epic. (Epically Annoyed)

In the case of Epic, you’re now limited not only by your own non-compete, but the separate agreements that Epic has made with the various consulting firms. For instance, I left Epic in 2018 with a 1 year non-compete. When my year was almost up, I started reaching out to various hospitals and consulting firms. I heard back from several of the bigger consulting firms saying that they couldn’t even begin conversations about employment until I had been away from Epic for 1.5 years.

Due to these newer agreements between Epic and the consulting firms, I essentially had an additional non-compete that extended beyond the one I signed when I was hired. Furthermore, preventing employment conversations to even start until the wait period ends just adds extra time beyond the non-compete that you will most likely remain unemployed since you can’t get a jump start on the process. (Ex-Epic Chiming In)

If Cerner received top marks for IT hospital support, then I cannot imagine how bad it really is out there. Cerner IT support is about as helpful as the worse DMV experience you can imagine. I am a front line MD, and if they are the benchmark, then we need a whole new paradigm. EHRs are an abomination and the support of them is equally terrible. CMS and Congress did patients and MDs a HUGE disservice by enabling this artificial market for Cert EHR and its resultant disaster we all live in today. It has set back REAL innovation in EHR/HealthIT at least a decade, maybe 20 years. I’m not sure how many more articles, research, studies, etc we need to show that the current crop of EHRs are almost criminal in terms of safety, security, outcomes, burden to MDs nursing, and the ridiculous buzzword care (MACRA, ACO, Value based care) are complete and utter nonsense and HORRIBLY expensive and causing devastating damage to the practice of medicine. When will we learn that Washington DC’s policy wonk, non practicing CMS staff have NO idea how to practice medicine safely, securely, and with the help of customized technology. We do NOT need more program changes unless they are…hey…we only make a mess of things…we are getting out of the way of physicians and IT and let them actually work together instead of the data click driven nightmares they continue to pile on to us. Its time to just say no to all of this. Stop trying to fix the unfixable. When will we learn that when government runs healthcare it turns into the VA and postal service combined. (meltoots)


Watercooler Talk Tidbits

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GoodRx co-founder Stephen Buck (who also happens to be co-founder of a wine tour and experience company) turns his attention to cancer survival rates with the launch of CancerSurvivalRates.com. Using public data from the National Cancer Institute, the site offers survival rates of up to five years based on a cancer patient’s stage, grade, time since diagnosis, and histology. Buck, who bootstrapped the project with co-founder Omar Mehmood, would like to eventually sell the site to Google: “It would be ideal to maintain as a free public resource that comes up when someone searches on Google.”

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Mona Siddiqui, MD announces she will step down from her position as chief data officer within HHS. HHS CIO Jose Arrieta, who has also claimed the role of CDO under the ambiguously structured Foundations for Evidence-Based Policymaking Act, says he will hire the agency’s “first” CDO. Politico reports that she will become a VP at Humana.

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Chiropractor Gregory Johnson, DC credits his practice’s surge in popularity to Youtube, where he has gained an online following of “crack addicts” who have traveled far and wide to take advantage of his signature spine realignment known as the “Ring Dinger.” Johnson earns around $20,000 each month for the 10-minute videos he makes with his cell phone’s camera and a selfie stick.

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Goop just keeps going: Netflix will release “The Goop Lab” next week. Billed as a “docu-series,” the six episodes are, according to one critic, a thinly veiled infomercial for Gwyneth Paltrow’s pseudo-scientific lifestyle brand.

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Just what every Oscar winner wants: Academy Awards swag bags will offer urine sample collection devices and genetic testing kits to select nominees. No word yet on whether or not Goop will include one of its wacky products.


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Weekender 1/10/20

January 10, 2020 Weekender No Comments

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Weekly News Recap

  • EHR/PM vendor CareCloud, which has raised over $150 million from investors, sells itself for $17 million in cash and $41 million in total consideration.
  • Premier delays efforts to find a buyer for the company while it sorts out how its health system shareholders will respond under a new owner.
  • A high-profile project in which healthcare super-utilizers are given more aggressive care is found to have no impact on the readmission rate when studied in randomized controlled trials.
  • Healthgrades acquires Evariant.
  • Non-profit accreditor URAC acquires the programs of ClearHealth Quality Institute.
  • Nurses top Gallup’s annual list of most honest and ethical professions by far in Gallup’s annual poll of most honorable professions, with doctors, pharmacists, and dentists also finishing in the top five spots.
  • AMIA fires President and CEO Doug Fridsma, MD, PhD after five years.
  • England’s NHS receives $50 million in funding to implement single sign-on in its facilities to save clinician time.

Watercooler Talk Tidbits

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HIStalk readers funded the Donors Choose teacher grant request of Mr. K, who asked for programmable drones for his New Jersey elementary school class. He reports, “I love being able to use technology to supplement and enhance my teaching experiences with my students. These drones are doing this for my students! I continually see my students working together on the touch interface of the iPad to program the drone in order to learn the basics of computer programming. With a programmable drone, my students are exposed to a level of computer science that they otherwise would not have access to.”

Healthcare imaging startup Lyfebin exposes thousands of medical images by improperly securing an Amazon Web Services storage bucket full of DICOM files. The company claimed it was phony patient data used for testing, went silent when pressed further, and then threatened to sue TechCrunch for writing about the issue.

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A medical staffing company takes down a job ad that said of the Arizona hospital for which it was seeking applicants, “Women don’t do well here” after a social media backlash.

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Atlanta Hawks basketball player Trae Young donates $10,000 to retire over $1 million in medical debt for Atlanta-area patients through RIP Medical Debt, which buys portfolios of bundled medical debt on the secondary debt market for pennies on the dollar. It’s beginning to feel like the most prevalent health insurer other than Medicare is GoFundMe.

San Francisco workers who are ancient by tech company standards – over 35, but some as young as in their 20s – are boosting their youthful, high-energy images by undergoing plastic surgery, Botox treatments, facelifts, fillers, and ab sculpting to compete with newer, younger co-workers. Some of them bring in app-filtered photos or pictures of social media influencers to show doctors how they want to look. A  female sex therapist who offers charm coaching for men whose 16-hour workdays preclude cultivating relationships says it’s ironic to see men being forced to “play the game women have always had to play to get what they want.”

Kaiser Health News notes that high-deductible health insurance plans hurts rural hospitals disproportionately because patients there have lower incomes. The deductible is applied to the first site of care, so the bigger hospitals that receive those patients when transferred get their full payment while the local hospital struggles to collect the deductible. A rural Colorado hospital says the only available plan option for local employers carries a $10,000 deductible, meaning that patients go into bad debt the first time they use it for a serious problem.

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A hospital whose life flight helicopter was mistaken as a drone by Facebook users who then urged people to shoot it down asks residents to please avoid doing so.


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Weekender 12/20/19

December 20, 2019 Weekender No Comments

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Weekly News Recap

  • The National Academy of Medicine publishes an overview and recommendations for the use of artificial intelligence in healthcare.
  • LifeLabs, Canada’s largest lab testing company, admits that it paid a hacker’s ransom to recover its systems in an October breach that affects 15 million patients.
  • Amazon Web Services adds ICD-10 and RXNorm linking to its Amazon Comprehend Medical natural language processing service.
  • HIMSS hires Tim Kelsey, CEO of the Australian Digital Health Agency, for an SVP of analytics job.
  • Hackensack Meridian Health, New Jersey’s largest health system, admits that it has paid a ransomware hacker to regain access to its systems.
  • A Florida pain management chain pays $85,000 to settle HIPAA charges that it ignored a patient’s request to send an electronic copy of their medical records to a third party.
  • Partners HealthCare announces a five-year, $100 million digital health initiative.

Best Reader Comments

The data quality problems occur because of the vendors, the practices, the clinicians, and external bias generators (Insurance, MU, etc.) These causalities all have an impact to the data at its source. Extracting data and transforming it only makes the data worse. And I find that most people working the data do not consider the source, or the destination of the data,  to understand how it was created and what the requested usage is. Lots of problems to be solved here before we start thinking that AI can create”‘whirled peas.” (HITInteropGuy)

As a parent of a teenager with type 2 diabetes using the Dexcom continuous glucose monitor synced to my iPhone, please alert your readers that this monitor does not sample blood glucose levels. In fact, it is measuring interstitial fluid ( lymphatic fluid) glucose levels and there’s quite a delta in the reading accuracy, especially during large swings. We had to stop using it because of his sports and my obsession watching his glucose levels fluctuate on a minute by minute basis.(El Comandante)

I believe one of the unstated goals of the Meaningful Use program was to reduce the number of EMRs available by creating a certification process that required significant development investment. The ONC was clearly aware that interoperability was hard, and that by reducing the number of EMRs, it becomes less of a burden. The result was a reduction in the total number of ambulatory EMRs as smaller players couldn’t afford to develop the required capabilities.A conspiracy theorist might posit that this also aligns with the fact that smaller EMR companies are not funding campaigns and lobbying efforts. The benefit of MU primarily accrued to the large EMR vendors. (Notmeaningless)

I don’t know how it is in the EMR space; I’m in the imaging space, but there the smaller players sometimes can and do develop the required certification capabilities. The hurdle is often in another place entirely — they can’t afford to invest in the certification process. That being said, not every smaller player is good in terms of capabilities. Some are downright terrible. So certification has its place, if done right. (Clustered)

Interesting that OTTO was headed by ex-Epic Sarah Green. Also another Ex-Epic just became CEO of IDX, an AI diagnostics company. Curious how many other old colleagues are now in C-Suites. (AnotherExEpic)

If this is how data ownership should work, why would this be limited to only healthcare? Credit rating agencies make huge amount of money buying, aggregating, and selling data about your credit worthiness. Online data brokers make even more money collecting and selling data about your online habits. Assuming that our society decides that “data about me” is automatically “data that belongs to me” for healthcare, does it stop there? Why would “data about my body” be more sacred than “data about my habits”? (TH)


Watercooler Talk Tidbits

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I received generous Donors Choose donations from Mark, Dana, Friend at Impact, and the IT directors of Atlantic Health System (NJ), which with matching funds from my Anonymous Vendor Executive and other sources fully funded these teacher projects, all of which involve schools in high-poverty areas:

  • Math manipulatives for Ms. O’s kindergarten class in Creedmoor, NC
  • Math manipulatives for Ms. P’s elmentary school class in Minneapolis, MN
  • A learning table for Ms. H’s elementary school class in Philadelphia, PA
  • Codable Legos for the coding club of Mr. M’s middle school class in San Diego, CA
  • Lego sets for the fourth grade class of Ms. C in Williamsburg, KY
  • Flexible seating for Ms. A’s kindergarten class in Cape Coral, FL
  • Copy paper, composition books, and cleaning wipes for Ms. C’s elementary school class in Hempstead, NY
  • Math tiles for Ms. S’s elementary school class in Woodside, NY
  • Learn to Code Ladybug for Ms. P’s kindergarten class in Dallas, TX
  • STEM Lego sets for Ms. G’s elementary school class in Baltimore, MD
  • Math manipulatives for Ms. M’s elementary school class in Yakima, WA
  • A field trip to the Discovery Lab for Ms. M’s elementary school class in Tulsa, OK
  • Programmable robotics kits for Ms. D’s elementary school class in Tamarac, FL
  • Five tablets and cases for Ms. M’s elementary school class in Magnolia, MS
  • Two Chromebooks for Ms. M’s elementary school class in Miami Gardens, FL
  • A Viewsonic projector and bluetooth speaker for Ms. P’s elementary school class in Baltimore, MD
  • Three laptops for Ms. C’s elementary school class in Washington, DC
  • STEAM sensory tiles for the children with disabilities elementary school class of Ms. A in Staten Island, NY
  • Video production equipment for Ms. M’s middle school class in New Cumberland, WV
  • Accommodations for a field trip to Washington, DC for the fifth grade class of Ms. C in Brooklyn, NY

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Surveyed doctors and nurses say that “Scrubs” and “ER” are the most realistic medical TV shows. They note that unlike what other shows portray, doctors don’t really cover everything from surgery to OB, they don’t sprint through the ED doors to meet ambulances, and they don’t usually respond to emergency cases with an insightful diagnosis of some weird problem and instead focus on stabilizing the patient.

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The families of people who die at home in France must have a doctor’s signed death certificate before moving the body, but a shortage of GPs willing to travel to the homes of patients they don’t know for a flat rate of $110 means families often must leave the body in their homes for several days. Some towns have passed laws that make dying at home illegal.

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A start-up in England invents a toilet with an “inconveniently sloped” seat that intentionally makes users uncomfortable after five minutes, citing the employer productivity benefits from shortening the average 28-minute bathroom break. This if anything proves that it’s time to make “Office Space 2.” Or to launch a startup selling corporate-issued diapers.

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Twitter hackers post flashing strobe light GIF images to followers of the Epilepsy Foundation, apparently hoping to induce seizures. I’m beginning to think that humans are too evil to allow anonymous public postings.

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A Harvard Medical School analysis of US doctor traffic tickets finds that psychiatrists are the most likely to be caught for “extreme speeding,” while cardiologists are the most common Ferrari-driving specialty.

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A teenager who was hospitalized with lupus during Christmas two years continues her annual tradition of creating Christmas tree kits for kids at UC Davis Children’s Hospital. She and her family brought 60 sets of decorated trees to the hospital.


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Weekender 12/13/19

December 13, 2019 Weekender No Comments

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Weekly News Recap

  • Hackensack Meridian Health (NJ) brings its clinical systems back online after a downtime of several days, rumored to be the result of a ransomware attack.
  • Former Outcome Health EVP Ashik Desai pleads guilty to wire fraud and agrees to cooperate with prosecutors.
  • Emergency medical services technology company ESO acquires trauma registry software vendors Clinical Data Management, Lancet Technology, and Digital Innovation.
  • Proteus Digital Health’s previously announced restructuring will include eliminating 292 jobs and closing several facilities by January 18.
  • The DoJ will look into Google’s $2.1 billion acquisition of Fitbit for possible antitrust violations.
  • Partners HealthCare (MA) will spend $100 million on a five-year digital health initiative focused on developing self-service technologies for patients.
  • BJC HealthCare (MO) lays off 200 employees as it outsources some IT services to an unnamed managed service provider.

Watercooler Talk Tidbits

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The DoJ charges 10 former NFL players for alleged fraud after they filed nearly $4 million in claims for medical equipment that was never purchased or received through a health reimbursement account plan set up for former athletes. Claims were filed for hyperbaric devices, ultrasound equipment used for imaging on pregnant women, and electromagnetic therapy devices used on horses.

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Former debt collection agency employee Shaunna Burns takes to TikTok to share advice on dealing with medical debt collection. In just a few weeks, she has gained over 100,000 followers and over 1 million likes. “The fact that there are people out there thinking debt equals deadbeat … debt doesn’t equal deadbeat,” she says. “I’m not a deadbeat, and I have great credit, and I’m still having to deal with debt collection. I literally spent hours a week fighting with insurance companies over stupid bills that shouldn’t have been charged … having to do all that is annoying and frustrating, and I thought if I could help one person [with the TikToks], it would be worth it.”

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Zuckerberg San Francisco General Hospital notifies 1,174 patients of a months-long privacy breach resulting from employees who failed to shred patient-identifying meal tray tickets, instead throwing them away in regular garbage bins.

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Harvard Medical School geneticist George Church develops dating app technology designed to pair users based on their DNA. Church says the app could help wipe out inherited diseases.

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Advocate Children’s Hospital  (IL) launches the Santa Connection program with help from Burwood Group and Cisco.


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Weekender 12/6/19

December 6, 2019 Weekender No Comments

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Weekly News Recap

  • Premier is reported to be working with bankers in seeking a sale of the company.
  • Waystar acquires Recondo.
  • John Halamka, MD announces that he will become president of Mayo Clinic Platform in January.
  • Agfa is negotiating the sale of its Europe-focused healthcare and imaging IT business to Italy-based clinical software vendor Dedalus for more than $1 billion.
  • Cerner names Amazon Web Services as its preferred cloud, AI, and machine learning provider.
  • A server problem causes Dexcom’s continuous glucose monitor to stop sending messages and alerts for several days.
  • T-System experiences downtime from an apparent ransomware attack.
  • Amazon Web Services unveils a healthcare transcription service for software developers.

Best Reader Comments

You don’t want the company distracted by a shiny new thing while the core competency is getting less attention. So it’s often not a question of “Oh, hey, let’s just do this other thing too.” If you were in a perfect world with an arbitrarily large number of qualified people to take on the job, then moving into these peripheral areas would be a no-brainer. In reality the value gained from the distraction needs to be more than the cost of the distraction. The technical economic term for this is opportunity cost. (TH)

We doctors should stop thinking about EHR as a “special thing.” It is just a tool to get the job done. I can ask the same questions that you asked about paper and pen documentation system and probably add a few more about accessibility across locations, storage challenges, etc. Why is no one complaining about that system of records and why was it not part of so-called “physician burnout?” The reason I believe, is that we all learnt how to use it during our training and accepted it as part of life. Rules of the game changed in the last decade and we need to get on with the program. (EHR is just a tool)

This should drive home the reality that the investor class isn’t comprised of smart people, just people who knew each other or went to the same universities and have consistently promoted and hired each other into positions of authority without any demonstrated qualifications. (HIT Girl)

If the digital companies would have seriously and thoroughly tested their products with MANY physicians and not only one SME, then maybe the EHRs of today wouldn’t have been the monstrosities that they are. (Been there)

I still can’t believe institutions like Goldman make these horrible investments. Between Outcome Health and Theranos, you’d think the investors involved would at some point ask some healthcare industry experts whether these companies were viable enough to pass the sniff tests. Readers on this site have called out the charade for both before. (Elizabeth H. H. Holmes)

The billing methodology in this country has gone totally out of control. Unfortunately, I’m in the middle of a medical situation and the last EOBs made me laugh. For a CT scan with and without contrast, the billed amount was $18K, allowable $18K, amount paid $400, patient due amount $0. How stupid is a system that allows this? If I didn’t have insurance and the provider wasn’t in the network, I’m sure they would have tried to collect the $18K. (David Pomerance)

The moral of the Outcomes Health story is that if you f*ck over @GoldmanSachs & friends for $500m you go to jail. But if you ARE @GoldmanSachs & friends and you f*ck over the US taxpayer to the tune of $62bn, we will hand over the money and allow you to keep doing it. (Matthew Holt)

While I’m (mostly) never delighted when a person loses his/her job, all David Duvall MBA, MPH needs to do is open up about 50 hospital leadership websites and then another 50 HIT vendor leadership pages and tell me where the discrimination lies. I promise you it isn’t against middle-aged white guys. (ellemennopee)


Watercooler Talk Tidbits

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The publicly traded owner of North Tampa Behavioral Health (FL) confirms that it has reassigned the facility’s 31-year-old CEO after a newspaper’s investigative report found that he had no healthcare experience and was formerly a quarterback for a pro football team’s practice squad. A company spokesperson said it’s not unusual to recruit hospital CEOs from other industries and the attributes of B. J. Coleman  include “team leadership, situational analysis, and sound decision-making.” Inspectors found that under his leadership, just four of the 96 employees who performed lab work had proper training. The kitchen’s lead cook was covering as director of dietary services even though he wasn’t qualified, so the kitchen ignored special diet requirements and sent trays containing silverware to suicidal patients.

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A Tennessee neurologist files a $25,000 defamation lawsuit against a woman who wrote a scathing Yelp review saying that he threw a tantrum when she took out her phone to record her father’s visit. She says she deleted the recording at the doctor’s request even though state law does not prohibit such recording, after which a clinic employee called her to say that phones aren’t allowed in the office. Also named in the suit is the son of the woman’s friend, who overheard her talking about it and posted a negative review on Google. Meanwhile, the negative Yelp reviews are piling up as idiots from several states who admit that they just read the online story, calling the doctor a “filthy animal” and a “nasty immigrant who is suing a real American.”

Kaiser Permanente uses text messaging to encourage 11,000 of its members to sign up for California’s CalFresh supplemental nutrition program. Kaiser didn’t have access to income data to help  choose which of its 9 million patients might benefit, so it used a census-derived “neighborhood deprivation index.”

A CMS analysis finds that the US spent more $1.2 trillion on hospitals in 2018, representing one-third of all healthcare spending. 

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NICU nurses at Brookwood Baptist Medical Center (AL) dress up newborns to celebrate their first Thanksgiving.


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Weekender 11/22/19

November 22, 2019 Weekender No Comments

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Weekly News Recap

  • The American Medical Association calls for EHRs to be fully inclusive for transgender patients and expresses its support for government funding to improve public health technology, including EHR integration.
  • Government officials in Bahamas scramble to dodge blame for signing an $18 million contract with Allscripts in 2016 that was supposed to transform healthcare, but has yet to result in any installed software.
  • HHS expands its price transparency plans by proposing that both hospitals and insurers be required to publicly post their negotiated contract prices.
  • The Spokane VA hospital hires more than 100 new employees to cover its expected productivity losses during its Cerner go-live in March.
  • Kareo sells its revenue cycle management business.
  • Stanford Hospital opens its $2.1 billion, 368-bed hospital that incorporates extensive technology.

Best Reader Comments

Epic did a big enhancement a year or two ago to replace their single “sex” field with an entirely new series of fields to capture sexual orientation, gender identity, sex assigned at birth, legal sex, preferred name, preferred pronoun, etc. It was a big change for healthcare organizations to start using the functionality, but it was the right thing to do. (Anon)

Changing the behavior of core demographic information (like name and sex) is going to be a big task. It’s not a quick and easy update, but being treated with respect (by being called by your real name) from your doctor can help an already at-risk population better engage with their healthcare providers. There are additional benefits to having this be a thing the entire industry focuses on. If your EHR can handles this gracefully but your EKG system doesn’t, then you end up with unnecessary added complexity both on the IT side and on the clinician side. The AMA of course has no teeth on this, but it emphatically is something the industry should be working towards. (TH)

I have learned and I hope some of your readers will learn that you are only as good as the last day you have completed on the job and this can happen at any moment. Tomorrow’s employment is not a promise, unless you have a contract. Layoff, RIF, firing, termination… whatever you call it, the outcome is the same. I would add that career management requires constant networking, having your resume and Linked In account up to date, trusting your intuition – meaning that if if feels or looks like it is going to hit the fan, it probably is and what are YOU doing about that. (Justa CIO)

[The informatics team needs to focus on] the lifecycle of and alert intervention to ensure that the intervention remains current and clinically relevant. This is often lacking in some systems, from my experience, as it is a significant organizational commitment to do this effectively. It require having clinical ownership of the CDS intervention, so it necessitates having clinical subject matter experts and/or a medical literature review process engaged in maintenance in an ongoing fashion. (Luis Saldana)

Seeing that the fine for not being transparent with data is $300 per day, or $109,500 per year, I suspect most organizations will just eat the cost instead of paying for the additional labor that would be required to be in compliance. Or, just look for a way to increase productivity through say, an extra 10 or so MRIs per year. (MoMoney MoProblems)

Read the Mayo Clinic article on usability. Saw that microwave ovens were better, so decided to try it in clinic. It took a while to find enough extension cords, but I managed to set up my 1200-watt Amana microwave on a rolling cart and got ready to see patients. Turns out, it was very easy! I just basically kept hitting the “Add 30 Seconds” button throughout the encounter (it’s the only button I’ve ever used on it). At the end of the encounter, I got a satisfying DING! I can’t believe how much easier it was than my EHR. Amana really gets human factors! Not like those programmers at the EHR companies, with their code and data and functionality. Good riddance, I say! (Andy Spooner)


Watercooler Talk Tidbits

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Magee Women’s Hospital (PA) escorts a man whose wife was delivering their baby off its premises, struggling with how to deal with the fact that he is also a registered sex offender. The man is prohibited from having unsupervised visits with his other two children and had alerted hospital security of his conviction before he took his wife to the hospital. The hospital security department offered to escort him to his wife’s room the next day, but he declined, fearing that he would be arrested.

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In Indonesia, several motorcycle taxi drivers storm a hospital that had refused to release the body of a deceased six-month-old boy to his family because of his unpaid bill, preventing the Islam requirement of a quick burial. They left with the body, but the hospital director explained afterward that the charges had already been waived, triggering the apology of one of the drivers involved in the “humanitarian mission” who now hopes to “restore the good name of the hospital” because he didn’t know the procedure and thought it was taking too long.

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A co-founder of Firefox creator Mozilla develops Brave, a privacy-first browser that blocks the recording of browser history, offers its own password manager, and blocks all ads by default in favor of offering an optional private ad platform that allows users to “tip” their favorite sites. It claims to be three to six times faster than Chrome and Firefox. I tried it on HIStalk and the load time was the same as with Chrome.

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The newest faculty member at the Uniformed Services University of the Health Sciences is two years old. Shetland, a Navy lieutenant commander and clinical instructor, is a highly trained military service and therapy dog. Shetland’s job is to accustom students to the therapy dogs they will encounter in clinics, hospitals, and in veterans with PTSD so they can choose them wisely for their patients. 


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Weekender 11/15/19

November 15, 2019 Weekender 1 Comment

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Weekly News Recap

  • HHS OCR will review the HIPAA compliance of the “Project Nightingale” data-sharing agreement between Ascension and Google.
  • NextGen Healthcare announces plans to acquire patient portal vendor Medfusion for $43 million.
  • Ontario, Canada announces a Digital First for Health strategy that will give patients more online access.
  • Results of the Apple Heart Study find that 0.5% of 400,000 enrolled users received an irregular heartbeat notification, most of whom were found to have atrial fibrillation.
  • Premier launches Contigo Health, which will connect participating employers and health systems to optimize employee care using EHR-integrated clinical decision support.
  • Kaiser Permanente Chairman and CEO Bernard Tyson dies unexpectedly at 60.
  • University of Chicago asks to have its medical center to dismissed from a class action lawsuit that was brought by a patient who says its data-sharing agreement with Google violates his HIPAA rights.

Best Reader Comments

After dozens, maybe hundreds of healthcare organizations have partnered with analytics companies to share data and develop solutions, why are we just now becoming concerned that Google has entered the ring? (SkyNet)

Cerner makes money how? From recent earnings call: “As the acknowledged data source, we plan to develop a monetizable distribution model that provides access to legacy client segments and adjacent market prospects such as biopharma, payers and actuaries, to name a few.” (Vaporware?)

I agree it is patient’s data, but that is not the business model in other industries. What about credit information? Isn’t that consumer’s data, too? But credit agencies hog it and sell it without any explicit approval from the individual to collect / distribute it. (Data Business)

What bothers me is that many hospitals willingly give the data away or sell it to entities such as Google, but when the patient asks for copies of his or her own records, they are charged. (X-Tream Geek)

The letter urges that EHR vendors not create financial burdens for physicians trying to connect to state immunization registries and called on HHS to “hold information technology vendors accountable for creating a national standardized, easily accessible, accurate, robust immunization information system.” That’s a recipe to get some terrible software shoved down physicians throats. (What)

I think Mr. Segert has a surprisingly good handle on the [Athenahealth] business here. He’s right that the ambulatory market is consolidating and that Athena has the best ambulatory-only product. If you accept those facts, it seems that Athena should mop up the rest of the smaller vendors. Athena wasn’t making much progress on that because their focus and execution wasn’t there. They were spending their effort on tiny, low volume/$, rural hospitals who would bail out halfway through implementation and go back to CPSI. That was a great way for Athena to take large piles of investor dollars and set them on fire. Also looks like he has a good grip on the sales channels, which is the hardest and most important thing when selling software to the SMB or smaller enterprise market. (GoodFirstImpression)

Layoffs are almost always painful, but it feels worse during the holidays. As a recruiter, I get to see where the layoff leads. It’s remarkable how often it turns out to be for the best. I’ve seen so many people take layoffs hard, only to look back a few months later with gratitude that it led them to something better. (Jim Gibson)

The best way that most economic development agencies have found to lift families out of generational poverty in under-developed economies is to educate girls and women. Across the board, giving women access to education leads them to start businesses that provide economic stimulus to their entire community. Giving menstrual products to teen girls has proven to do just that. Giving a girl the opportunity to get an education is the fastest method to improving her life and the lives of those who depend on her. It is the same reason that diaper banks have proven to reduce sick baby visits and increase teen mothers’ ability to attend classes and work. A child who is constantly ill due to not being able to have a clean diaper is a drain on their parent. The parent can’t improve their economic situation if they can’t go to school and work. Just because a program is focused at the individual level doesn’t meant that it won’t lift up the community. (MEDITECH Customer)


Watercooler Talk Tidbits

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Nike will release the Air Zoom Pulse, a lace-free, protectively coated shoe (“a traditional clog made athletic”) that it designed to combat fatigue in testing at OHSU’s children’s hospital. Six young “patient designers” created their own versions of the shoe, profits from which will be donated to the hospital. I like the above design from 12-year-old Sawyer Miller, whose brain tumor was treated with surgery and 30 rounds of radiation therapy. I bet I could make a HIMSS20 splash walking endless miles in these.

University of Washington students petition the university to prohibit faculty members from requiring a doctor’s note for their absences due to “unavoidable” illnesses, saying that seeing a doctor for that purpose is expensive, requires students to explain their symptoms after the fact, disadvantages low-income and DACA students, and may result in the ordering of risky tests and procedures. The students add that doctors always write the notes anyway, so there’s no impact on their behavior.

Loyola University Medical Center tells a woman who was making inquiries into her mother’s unexpected death that its autopsy camera had been stolen and the photos on it lost. Nine of the 18 cases that had been recorded on the camera hadn’t been uploaded to the electronic files as health department policy requires because the camera didn’t come with a cable and the hospital didn’t have one.

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A 26-year-old woman undergoing breast cancer treatment is surprised when her boyfriend proposes to her in front of her Sloan Kettering treatment team on her last scheduled visit, after which they were married in an event donated by a wedding planning company.

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The gift shop of Park Nicollet Methodist Hospital (MN) adds a selection of hijabs for patients and employees, saying it’s the first US hospital to do so.

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UPMC Magee-Women’s Hospital dresses up newborns for November 13’s World Kindness Day in cardigans like those worn by Mr. Rogers, who spent most of his life and career in Pittsburgh. Other local hospitals and individuals did the same, encouraged by public TV station WQED, which created Cardigan Day in honor of Fred Rogers, who filmed 895 episodes of “Mister Rogers’ Neighborhood” at the station over more than 30 years through 2000. He died of stomach cancer in 2003.


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Weekender 11/8/19

November 8, 2019 Weekender No Comments

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Weekly News Recap

  • A study finds that only 10% of discharged hospital patients look at their medical information online afterward.
  • CompuGroup Medical is rumored to be a bidder for Agfa’s health IT business.
  • The VA makes patient records available on Apple Health Records.
  • A federal court orders behavioral EHR vendor ZenCharts to pay rehab EHR vendor Kipu Systems $19.5 million for stealing its trade secrets.
  • University of Rochester Medical Center will pay $3 million to settle OCR charges involving loss of two unencrypted mobile devices.
  • Google announces that it will acquire Fitbit for $2.1 billion in cash.
  • CMS delays implementation of a requirement that hospitals publicly share their negotiated contract prices.
  • Allscripts announces Q3 results that beat Wall Street expectations on adjusted earnings, but fell short on revenue.
  • Wake Forest Baptist Medical Center will bring registration and billing back in-house two years into a seven-year agreement with NThrive, which will eliminate 839 jobs in central North Carolina as a result.

Best Reader Comments

If you listen to the [Allscripts earnings] call, it is pretty clear that the Wall Street folks don’t buy it. They made Rick say twice that there wouldn’t be any increase in R&D spending due to the Northwell agreement. (TheyDidn’tBuyIt)

Most of the article [a physician’s New York Times complaint that Epic’s screen messages aren’t empathetic] could be rephrased as “I find my HIM department annoying.” (Iam)

I don’t consider myself an old fogey. but “pop-ups would float into view as small islands of empathy?” Seriously? In a NYT piece? Millenials these days, am I right? (CynicalIguess)

Epic has “unintelligible medical notes?” Nope, Epic has no such thing. I don’t think it has achieved sentience yet (thankfully). Talk to your co-workers who wrote the notes. “Urgent, intimidating, and tinged with allegation?” She’s looking for comfort and empathy from a computer system? (AC)

Everything about this op-ed by this physician is what is wrong with this country at this point. How in the world do people get through their day-to-day lives if every word that crosses their screen is “offensive” to them? It’s absurd. There are plenty of things wrong with EMRs in today’s world, but guess what — colors and “word choices” are not one of them. Not everything is about offending you, it’s simply just a word that by definition means something whether it hurts your feelings or not. Get over yourself. (EMR Snowflakes)

Would Epic benefit from having a better UI and more clinicians actively involved in software and workflow design? Absolutely. But the idea that “deficiencies” is something that Epic dreamed up and foisted upon their users? Come on, Epic configuration is heavily controlled by your own organization. You want Epic to be nicer to you? Talk to administrative and operational leadership at your organization. I’m sure they could ask IT to write an alert to pop up once a week to say “Great job!!” which everyone would then complain about being distracting and adding clicks. (AnonZ)

The authors rail against profit-seeking entities. Very slippery slope. No margin, no mission. Physicians can certainly fulfill their sense of moral mission and alignment in volunteer work, free clinics or other worthy ventures. Those skills are needed everywhere. (FreeMarkets)

Facebook design is meant to maximize engagement so that they can deliver the most ads. Do you want to maximize engagement with your EHR or do you want to make eye contact with the patient? (Lookatme)

One example that we started at a previous organization is to make sure there is a hyperlink (or text in the alert) that shows with each BPA (pop-up alert) which links to the decision-making body that approved it. Typically, it has a colleague on the committee that they know and can email directly or ask them about it. This provides accountability to the alert committee as well as the operational leaders that may have come up with the “software solution to a peopleware problem.” (David Butler)


Watercooler Talk Tidbits

Actor Will Smith creates a clever and disarmingly funny video as he undergoes his first colonoscopy. He said, “They said you can’t get to 50 million followers on IG without showing your butt.” Afterward, he finds that he had a pre-cancerous polyp removed during the procedure. He urges, “There’s a certain amount of commitment and embarrassment involved with being healthy. You just gotta do it, man.” I don’t watch many movies and thus have only seen Smith in “Independence Day,” “Men in Black,” and “The Pursuit of Happyness,” so I have to say this is my favorite of his films.

The former Hewlett-Packard Enterprise worker who shut down Oregon’s Medicaid computer system in October 2016 in retaliation for being laid off is sentenced to a year of home detention, 500 hours of community service, and four years of probation.

Fedscoop notes that HHS has two people who claim to be its chief data officer – one within the CTO’s office, and the other being the CIO, who says he is acting in that role until he can hire HHS’s “first chief data officer.”

A Pennsylvania nursing home assistant is arrested for taking photos of deceased residents and sharing them with with friends and co-workers. Stephanie Thomas says she took the pictures because her former boyfriend “liked that kind of thing,” but friends to whom she texted photos said she has an “obsession with death” and police examination of her phone turned up pictures of dead animals.

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A woman takes an after-work photo of her twin sister, a labor and delivery nurse who had worked 53 hours in four days, and posts it on Facebook with description of what the nurse deals with in a typical work day. She took the picture as her sister broke down after a day in which she helped deliver a stillborn baby. The post has earned 225,000 likes, 23,000 comments, and 133,000 shares. Her sister’s post explained what was going on:

Have you guys ever really thought about what a labor and delivery nurse sees? They see great joy in smooth deliveries and healthy moms and babies. They see panic and anxiety when a new mom is scared. They see fear when a stat C-section is called. They see peace when the mom has support from her family, because not all new moms do. They see teenagers giving birth. They see an addicted mom give birth to a baby who is withdrawing. They see child protective services come. They see funeral homes come. Did you know that they have to make arrangements for the funeral home to come pick up the baby? I didn’t either.

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A 57-year-old nurse adopts a 27-year-old man after he is ruled ineligible for a heart transplant because he has no family to care for him. He was in and out of hospitals for weeks, often discharged to a men’s shelter because he had nowhere else to go. Piedmont Newnan Hospital (GA) gave PACU nurse Lori Wood its President’s Award for going above and beyond for patients. She had known Jonathan Pinkard for just two days before suggesting that she become his legal guardian. He hopes to return to his office clerk job next month.


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Weekender 11/1/19

November 1, 2019 Weekender 3 Comments

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Weekly News Recap

  • UnitedHealth’s Optum acquires remote patient monitoring startup Vivify Health.
  • Waiting room advertising company Outcome Health pays $70 million in customer restitution to settle Department of Justice advertising fraud charges.
  • Australia’s Queensland Health confirms media reports that it ordered its IT department to perform no software upgrades, including to its problematic Cerner system, while parliament is in session to avoid embarrassment.
  • Premier acquires purchased services management technology vendor Medpricer.
  • Medecision acquires GSI Health.
  • ESolutions acquires Medidal.
  • Facebook launches a program in which user demographics will trigger preventive health information and reminders.
  • Google parent Alphabet is rumored to have made an offer to acquire Fitbit (the companies announced Friday that the acquisition is set for $2.1 billion).  
  • Cerner says in its earnings call that it will no longer offer outsourced revenue cycle management services after Adventist Health terminate its contract, which triggered a $60 million charge and an annual revenue reduction of $170 million.

Best Reader Comments

Deleting your Facebook account does not actually stop any tracking. All your web activity is still tracked via pixels and linked back to your deactivated FB account (example: I still would know you are a 40 year old woman with two kids over 8 who lives in a specific zip code and has certain interests from your old FB activity). I can still target ads to you through websites who publish ads through Facebook, “audience network.” (FB Marketer)

How can the responses of 6-7 customers out of thousands [in KLAS’s global VNA report] be classed as “global” insight and customer feedback? (PluckyBrit)

Why so cynical re: HLTH? I’m here now, and am finding it refreshingly relevant compared to HIMSS or Beckers. For goodness sake, the keynote presentations actually focused on current issues, and didn’t just include big name politicians, sports stars, or actors. Sure, there’s glitz, and the caricatures, etc., but for conferences, I’ve found it to have more of a “finger on the pulse of what’s coming” than any other major conference out there. (CynicAl)

Banner Health bought the University of Arizona’s medical arm and transitioned them from Epic to Cerner. It’s the reason Epic had to change their spiel to “no *voluntary* deinstalls.” (Math)

I don’t think [EHR training driving provider satisfaction and adoption] has been a big secret to those who have gone through the implementation cycle multiple times, yet it’s always the first thing in the budget to get cut. You’d think that the vendors would be more prescriptive (as opposed to “advisory”) when detailing training requirements during planning. Or maybe it’s a failure of CIOs to make the case to CMOs, CFOs and CEOs that they’re being penny wise and pound foolish. Maybe this KLAS survey will help. (Recovering CIO)


Watercooler Talk Tidbits

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ProPublica profiles 27-year-old Nerds on Call computer technician Michael Gillespie (guess which one is him in the photo above, as he receives an FBI award), who has cracked 100 forms of ransomware and provides free decryption tools that have saved hundreds of millions of dollars worth of avoided ransom payments. He receives 2,000 files per day from panicked computer users asking for help and spends his evenings on his couch surrounded by his cats, decrypting new strains and corresponding with people who are seeking his assistance. There’s a healthcare connection – he and his wife are broke because of the after-insurance costs of treating her newly discovered bladder cancer, which forced him to take a 2 a.m. paper route, surrender their car to the bank, and overcome threats of foreclosure of their $116,000 house in Normal, Illinois. Pestered by relatives who can’t understand why he helps people for free, Gillespie says, “There’s a time in every IT person’s career where they think, I’m on the wrong side. You start seeing the dollar amounts that are involved. But nah, I can’t say that I ever have. I just don’t care to go that way.”

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The offshore folk who announce a $3,000 market research report and then write it only after someone pays must know, as experts,  something we don’t – that Athenahealth, Allscripts, Epic and clinical trials platform vendor Medidata are among the sellers of pharmacy robotic dispensing systems. They say it’s a big market that is being energized because “the case of non-infectious diseases also increases.” You could take advantage of the company’s offer to “kindly feel free to grill us with queries” as it has “established the pillars of our flourishing institute on the grounds of Credibility and Reliability.”

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A despondent woman whose friend called 911 fearing for her safety is billed $30,000 by Northwestern Medicine Central DuPage Hospital for a five-night psych stay. She had bought one of the White House-touted “association health plans” (aka ACA-non-compliant junk insurance) that costs less but covers little. She knew her $210 per month plan didn’t cover mental health services, but said she didn’t expect to need them. She asked the hospital what each treatment was going to cost her, but they couldn’t answer, leaving her with a bill for double the average negotiated price (since cash-paying patients are billed higher than everybody else in our non-system). The hospital wrote the bill down to $9,000 and adds that they offered the patient help, but she didn’t return their calls or fill out their financial aid forms. She also admits that she started to buy real insurance through Healthcare.gov, but thought the information was confusing. I’m siding with the hospital on this one (although not the idea of insurer-negotiated pricing) since she blew several opportunities to make a responsible decision. But then again, much of our population seems incapable of making responsible decisions, sticking the rest of us with the bill.  

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A Texas woman live-streams her brain surgery on Facebook in hopes of encouraging others to be optimistic about their outcomes. The stream skipped the graphic parts and instead featuring her speaking to the surgery team while remaining awake as the chief of neurosurgery of  Methodist Dallas Medical Center narrated and answered viewer questions. She went home two days later.

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Police arrest a Louisiana medical practice clerk for selling fake doctor’s notes to high school students for $20, of which two students bought 14. 

The New York Times suggests that patients avoid seeing doctors whose practices are owned by hospitals, whose facility fees can tack on unexpected hundreds to thousands of dollars per visit.

This has Weird News Andy written all over it. Entrepreneur David Hachuel, MSc, MPH, who hopes to commercialize an AI-powered stool analyzer, seeks 100,000 photos of bowel movements for training the system. Experts say a poop tracking app is sort of a good idea, but worry that it will send tons of healthy people to doctors unnecessarily and that a better approach would be to actually analyze a sample only when medically indicated. I read this and ponder, has any doctor ever actually asked a patient to bring in a photo of their bowel movement, and if not, how does an app add value? And also, are we so short on good uses of IT in health that poop photo analysis will lure investors? (cue Sally Field in the 1965 “Gidget” episode titled “All the Best Diseases are Taken,” which I just found by Googling in thinking instead of an “Arrested Development” reference). I would swear that Auggi’s video (above) and its rather foul call for photos were actually clever spoofs from The Onion.


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Weekender 10/25/19

October 25, 2019 Weekender 4 Comments

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Weekly News Recap

  • Cerner’s Q3 revenue and earnings meet Wall Street expectations.
  • Amazon will use the symptom checker and triage chatbox of just-acquired Health Navigator in its virtual clinic pilot.
  • KLAS emphasizes physician EHR training to improve satisfaction.
  • Viz.ai will use a new $50 million investment to expand the availability of its AI-powered stroke detection software.
  • Recruitment and consulting firm Ettain Group acquires Leidos Health.
  • Cleveland Clinic will expand its relationship with American Well to include a new digital health company, The Clinic, that will offer patients access to Cleveland Clinic providers through American Well’s technology.
  • Cerner acquires healthcare security-focused government IT contractor AbleVets.
  • England’s NHS gives Google access to five years’ of patient data from several hospitals despite the privacy concerns of critics.
  • Google hires former National Coordinator Karen DeSalvo, MD, MPH (Dell Medical School) to the newly created position of chief health officer.

Best Reader Comments

I’m boycotting HIMSS. Not interested in attending when the keynotes get less and less relevant or even offensive. (Garrnut)

Re: 3D mammograms. I’ve also heard that more “stuff” shows up on 3D imaging, requiring more follow ups and six-month instead of one-year cycles, adding even more to the bottom line than the $50 bump in the initial fee. (Bob)

Discerning the financial health of an IT vendor in healthcare doesn’t require AI nor Machine Learning algorithms. Basic common sense is all that’s needed. The more cryptic the language, the more creative language used by executives to describe basic economics and forecasts , the more you know you’re listening to BS. It’s all in the numbers. (El Jefe)

Ancestryhealth. Interesting. People won’t willingly share a Social Ssecurity number with anyone, yet will gladly send off DNA to organizations who have no obligation to tell you exactly who / what they’re sharing with their partners. “You are not the customer, you are the product” – Pernille Tranberg. (ellemennopee)


Watercooler Talk Tidbits

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Researchers find that an Optum-developed population health management algorithm introduced racial bias in ranking healthy white patients the same as sicker black patients. They found that adjusting the algorithm to predict the number of chronic illnesses a patient will likely experience in a year – rather than the cost of treating those illnesses – reduced the racial disparity by 84%, emphasizing the importance of understanding the data that was used to train the algorithm.

The Iowa Hospital Association fires its VP of communications for his criticism of the governor’s healthcare track record on Facebook, which he he claimed was supposed to be funny as it was “kind of in a Donald Trump language, kind of an over-the-top, hyberbole thing” that went wrong when a “small but powerful” group of hospital association members objected.

Investigation of patient abuse allegations at Laguna Honda Hospital yields 130 pieces of privacy-compromising evidence from photos and videos shared by six employees who have since been fired.

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A National Academy of Medicine report finds that half of the country’s doctors and nurses are experiencing significant symptoms of burnout that increase patient risk, malpractice claims, absenteeism, and turnover at a cost of billions. They conclude that clinicians are bearing the brunt of a dysfunctional healthcare system that forces them to work long hours, mires them in bureaucratic record-keeping, keeps them worried about malpractice lawsuits, and forces them to work around a lack of resources. A co-author observes that laws are turned into regulations that are made into policies that take the most conservative path for legal protection, such as requiring clinicians to log in several times each day because of privacy concerns.  They also note that hospitals force doctors to complete long checklists full of often-irrelevant items so they can bill the maximum amount.

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The Washington Post reports that President Trump will nominate MD Anderson radiation oncologist and chief medical executive Stephen Hahn, MD as FDA commissioner.

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New York Jets guard Kelechi Osemele, apparently worried that his employer doubts his claims of a shoulder injury because they’re fining him for not showing up for practice, posts his doctor’s surgery recommendation to his Instagram.


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Weekender 10/18/19

October 18, 2019 Weekender 6 Comments

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Weekly News Recap

  • Microsoft and Nuance announce plans to work together to use ambient sensing and conversational AI to help doctors document encounters.
  • Google hires former National Coordinator Karen DeSalvo, MD, MPH to the newly created position of chief health officer.
  • Change Healthcare is reportedly looking for a private equity buyer for its Connected Analytics unit, which includes the Ansos staff scheduling system, at a potential price in the $300 million range.
  • The VA pilots making telemedicine services available at local VFW posts.
  • Northwell Health extends its Allscripts Sunrise agreement through 2027.
  • A KLAS report finds that customers of acquired health IT vendors are equally split among being less satisfied and more satisfied, with just 20% saying nothing changed.
  • Centra (VA) resumes billing and collections following a three-month hiatus that it says was caused by Cerner software problems.

Best Reader Comments

This is inspiring and has so much more potential for healthcare. So many new reimbursements focus on patient engagement (CCM, RPM, PCM, BHI, CoCM). Like Dr. Bhavan and her team at Parkland demonstrated, patient involvement / engagement creates better outcomes. We focus so aggressively on the delivery of healthcare, but who has studied the receipt? Think of this for a second: we’re at a place in healthcare where actively and persistently involving the patient is viewed as disruptive and innovative. Dr. Bhavan’s model included education and team work – to make it easy for the patient – and they certainly did their part yielding massive reduction in re-admission and higher satisfaction. (Matt Ethington)

For those of us who participate in this [Epic] market as HUMAN resources (FTE or contractor), it is a strange situation to learn that after working hard to be offered a role /,contract, your customer / employer will have to submit you to Epic for ‘approval’ before they agree to grant you access to both (a) the resources at Epic’s UserWeb and (b) potentially access to Epic at the client site (even if you’ve been hired). It’s a sobering moment to jump from one employer to another or in and out of the contractor-FTE world to learn that you are not actually in charge of the outcomes of your own decisions and that you never agreed to the terms that are being imposed on your life and livelihood. (Code Jockey)

The restrictions that Epic places on his customers, employees, and third parties on hiring is so frustrating. While I understand they want to protect their IP and reduce poaching, it creates such a toxic attitude among their employees and frustrations to employees who have life changes that require them to move away from Epic. Rather than being able to utilize your skills in the free market, they use a big stick to hold people hostage. They extend those restrictions on their own customers, keeping them from hiring really qualified people that could help make them successful and avoid really expensive consulting costs. It also make hiring Ex-Epic people in the Madison job market incredibly risky because many are just trying to burn their one-year non-compete rather than looking for a longer term role. (Epically Annoyed)

I’ve worked on two Cerner implementations and two Epic implementations. The Cerner implementations had, in my opinion, sleazy salesmen who showed up to take the director out to lunch, drinks, strip clubs, or whatever it took to get the sale and expand the services. The Epic implementations, I never saw any of that going on, not that some client sites didn’t want to be wined and dined and tried to get the Epic AC/AMs to do that. I think you are correct in stating that because Epic is not a public company, Judy does not have the Wall Street pressure, but I also think there is just a generally more clean approach from Epic overall. (X-Tream Geek)

While that [in-hospital employee] telemedicine booth is kind of odd, I think a lot of people still underestimate how much employees don’t want their employer to have permanent access to their full health record, regardless of what kind of end user confidentiality might sit between other colleagues and their data. I know a lot of people who would gladly talk to a booth over anyone that’s also employed by their employer. Though I would bet there’s some type of interoperability that exists between their existing records and this vendor. (Sam Lawrence)

Insurance exists because people overall are risk averse, but from your comments, that’s not you. You sound pretty confident of the outcome, so you prefer to gamble. It’s interesting that if you take the gamble and lose, it’s not actually you paying for it. If you’re uninsured or under insured today (because you don’t feel like you need it), and then a catastrophic event happens, your fellow taxpayers will be conducting a wealth transfer to you. Would you plan on refusing it because it’s unfair to them? You’re also gambling that by the time you need the healthcare system, all the Boomers will be gone and the rational Gen X, Gen Y, and Gen Z folks will vote in an affordable and responsible system. This is a huge gamble, and by George I’d love if it ended up going your way. However, the idea that once the Boomers are gone the way will be clear for sweeping reform is a massive oversimplification of US healthcare politics. (TH)

The youngest Baby Boomers are 54, so they have another 25+ years of living to do before they hit the median life expectancy, by which time us Gen Xers will be in our 60s and the Millennials will be experiencing back spasms, trick knees, and menopause, so we’ll all be oldheads together. GenZ is going to come along and wipe us all out, which is fine – they are the ones really inheriting the mess, so if they want to transform society “Logan’s Run” style, I can’t say I blame them. (HIT Girl)


Watercooler Talk Tidbits

A hospital doctor in England fails to convince a review board that the reason he squeezed a nurse’s bottom was euphoria that was caused by a drug interaction between his allergy pill and Pet Remedy, a calming spray he was using on his dog during a thunderstorm.

The Ohio Board of Pharmacy cites three former pharmacists at the now-closed Mount Carmel West Medical Center (OH) for failing to intervene when high doses of opioids were ordered by ICU doctor William Husel, DO, who faces 25 counts of murder involving inpatient overdose deaths. The board noted that the pharmacists sometimes did not verify drug withdrawals from automated dispensing cabinets until after the drugs had already been administered.

Experts say hospitals are creating an “epidemic of immobility” in which hospital patients are forced to stay in bed, contributing to muscle weakness that can cause life-threatening falls afterward. One study found that one-third of patients aged 70 and older left the hospital more disabled than when they were admitted. Patients are often forced to remain in bed, but may do so voluntarily due to pain or weakness, IV lines that make it hard to walk, a lack of employees to help them, and the reluctance to walk down hospital hallways in flimsy gowns.

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Identical twins who work as nurses at Piedmont Athens Regional Medical Center (GA) work together for the first time in helping deliver another set of twins. That’s Epic photobombing behind them.

Peyton Manning stars in a fun video spot for the children’s hospital bearing his name at Ascension St. Vincent in Indianapolis, to which Manning has donated a reported $50 million since 2007. He played quarterback for the Indianapolis Colts for 14 seasons through 2011.  


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Weekender 10/11/19

October 11, 2019 Weekender No Comments

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Weekly News Recap

  • Mednax will sell its MedData business to private equity firm Frasier Healthcare Partners for between $250 million and $300 million.
  • DCH Health System (AL) agrees to pay Russian hackers after an October 1 ransomware attack forced it to divert patients and revert to paper processes.
  • Membership-based primary care company One Medical hires several banks to help it prepare for an IPO.
  • Patient engagement vendor Relatient acquires patient self-scheduling and waitlist software developer Everseat.
  • Cerner reveals details about “Project Apollo,” new cloud-based technology that will leverage the company’s previously announced partnership with AWS.
  • Researchers determine that 25% of healthcare spending – between $760 billion and $935 billion per year – is wasteful.

Best Reader Comments

Re: Putting off health care for financial reasons. According to GoFundMe’s CEO, one third of all campaigns are for medical expenses. Folks are literally begging strangers for money to help them pay their medical bills. (Kermit)

My “great expectation” would be that every time someone makes an entry into my medical record, that I would get a notification say that “X just entered something into your medical record. If this is appropriate, do nothing. If this is an error, please call us”. I feel this way because I was a victim of an identity mix-up with inappropriate merging of my record with someone else’s. Patient awareness like what happens with my credit care/bank might go a long way to reducing errors – and maybe it might make patients feel more responsible for their records at the same time. (Joe Schneider)

Sucks about athena but it is a hard market at a hard time. It looks like everybody will be stuck with CPSI until Allscripts buys them out and puts Evident out to pasture. (2Bad)

re: NextGen acquiring Topaz. The ‘agnostic’ market that NextGen has attempted to build (Eagle Dream Analytics, Entrada Mobile etc) continues to struggle with execution, two to three years in for analytics and mobile. If they could fix that problem, NextGen could be a different company. I don’t know if Topaz is another agnostic unicorn attempt but if the company doesn’t figure out how to execute, it will still be the same old NextGen regardless of the shade of lipstick on the pig. (ellemennopee)


Watercooler Talk Tidbits

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Ghanian teenager Mustapha Haqq develops a predictive analytics model that uses AI to diagnose breast cancer. Because of poor Internet access in his area, Haqq walked several miles to an Internet café, where he taught himself to code and develop the model using resources from UC Irvine. “Internet access is expensive,” he says, “but thanks to the generous support of my parents – who made some sacrifices to give me a chance to complete a few online courses – I built sufficient coding skills to start developing solutions to some of the problems affecting our community.” Haqq has gone on to launch several coding clubs for students of all ages.

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CNN profiles Olawale Sulaiman, MD a professor of neurosurgery and spinal surgery at Ochsner (LA) and founder of RNZ Global, which provides spinal surgeries and medical training in the US and his homeland of Nigeria. Sulaiman has taken a 25% pay cut to spend time – up to 12 days every month – caring for patients in Nigeria at little to no cost. “I believe that happiness doesn’t come from what you get, rather, it comes from what you give,” he said. “There is always room to give; you don’t need to be a millionaire to give.”

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National Library of Medicine researchers call for “no-selfie zones” after determining that 259 people died attempting to take death-defying pictures of themselves between 2011 and 2017.

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Restaurant franchise company Chanticleer Holdings decides to spin off its dining assets, which include the Hooters chain, so that it can merge with cancer drug maker Sonnet BioTherapeutics. @VentureValkyrie has started a tweet thread to crowdsource names for the newly combined company.


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Weekender 10/4/19

October 4, 2019 Weekender 2 Comments

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Weekly News Recap

  • Northwell Health (NY) will work with Allscripts to develop a cloud-based EHR incorporating voice recognition and artificial intelligence.
  • Walmart will pilot several programs across the country to connect its employees to healthcare services that it hopes will offer quality care at more affordable prices.
  • Private equity firm Francisco Partners will acquire laboratory information systems vendor Orchard Software.
  • Beginning next year, the VA will automatically share health data with community providers using the Veterans Health Information Exchange.
  • Siemens Healthineers subsidiary Siemens Medical USA will acquire ECG Management Consultants from Gryphon Investors.
  • FDA issues an alert about Urgent/11, a cybersecurity vulnerability found in IPnet third-party software that attackers may exploit to take over medical devices and hospital networks.
  • After laying off half its staff this summer and filing for Chapter 11 earlier this month, UBiome will cease operations and liquidate assets.
  • Canada’s New Brunswick Medical Society will close Velante, the for-profit company it created in 2012 as the sole EHR provider for the province’s doctors.

Best Reader Comments

Re: Walmart connecting employees to health services around the country. I like the concept. I would love to be able to go to the best of the best for treatment of a very serious illness if my insurance allowed. The travel, the hotel, etc., to be arranged and paid for through my insurance. I would welcome that. If I had serious heart problems, I would want to go to the Cleveland Clinic; if I had a rare form of cancer, I would want to go to MD Anderson; if I had kidney disease, I would want to go to Johns Hopkins. Will the next generation of Healthcare define Centers of Excellence around the country for various diseases and allow the insured to pick? I gotta say, it is a concept that I am slowly warming up to as I watch what Walmart and Amazon are up to. (X-Tream Geek)

I think naughty lists based on reports generated from the EHR are the way to go. It’s also easy to automate with the IT team. First time you mess up, automated email at the end of the week with quick note about what not to do. Second time, note+policy with manager cc’ed. Third time someone calls you. Fourth time … (Santa)

RE: Your comment: “I can’t recall an EHR vendor in recent memory putting boots on the ground at a single client site to design, develop, and implement a product before releasing it to the market. ” GE Healthcare attempted to do the same thing (well…kinda) with Intermountain Healthcare 2007-2013. GE invested approx $500M and the final product wound up being a meager ‘white board’. The project essentially killed the careers of numerous execs as well as what was left of IDX/GE. (leftcoaster)

Re: HealthTech “Influencers” — I agree on all shared above, and I know Mr.HISTalk has well documented his concerns over the years (as well as created a brilliant suggested scoring system), so I won’t elaborate on the lunacy of such lists. EXCEPT to comment that the most glaring concern are those named whose role is marketing on behalf of an organization/group/client. Marketing Brand experts should be invisible, not found on these lists. Especially considering the fact that they likely have a very warm fuzzy relationship with a publisher as they are the go between for the client. That does not make them an “influencer”. Their sole job is making money off of media placements and brand recognition, NOT to revolutionize technology for improved health delivery or outcomes like some on the list. I find it VERY poor form for the publisher to do a favor to recognize the man who brands himself and actually believed he is changing healthcare. Worst part….said man inspires countless others like himself, and is creating a small army of brand promoters. I kind of feel like John Legend in the R.Kelly documentary…..no one else in music would speak up. Often times when I do, I receive countless IMs from people telling me they agree with me, but refusing to go on record. Folks….can we change this, or is this social media world such that we just have to roll with it? (BehindtheScenes)


Watercooler Talk Tidbits

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In Florida, AdventHealth and Philips commit to becoming anchor partners of Metro Development Group’s third Connected City. The mixed-use development will offer residents concierge telemedicine services, a wellness park, and on-site Advent services including a standalone ER.

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Healthcare fraudster Jesse Lopez will spend more time behind bars after attempting from jail to hire a hit-man to kill her husband, a witness in her court case. Lopez was previously found guilty of posing as a nurse and performing unlicensed medical procedures at the Drop It Like It’s Hot Weight Loss Clinic and Jesse’s Gym in Florida.

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Saratoga Hospital (NY) will move some of its non-clinical operations to an anchor space in nearby Wilton Mall in order to free up space on its campus for more patient care. Information systems employees will be among the first to transition to the former Sears space.

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Micron Technology has developed a toilet that uses artificial intelligence to analyze a user’s waste to diagnose potential health issues. CEO Sanjay Mehrotra urges skeptics to “[I]magine smart toilets in the future that will be analyzing human waste in real-time every day. You don’t need to be going to visit a physician every six months. If any sign of disease starts showing up, you’ll be able to catch it much faster because of urine analysis and stool analysis.”

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Kaiser Health News profiles the secretive world of Instagram dolls, a community of women who have taken to the social media platform to share their cosmetic surgery journeys. 

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In Virginia, Joel Smithers, MD is sentenced to 40 years for prescribing over a half million doses of opioids – at least one prescription per patient – since opening his practice in 2015.

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Weird News Andy asks, “Perhaps they should start a new one and put up the names of those responsible?” St. Mary’s Regional Medical Center (ME) officials apologize for a “Wall of Shame” kept by employees that mockingly showcased pictures and details of patients with disabilities. Kept on the inside of a cabinet door, the collage was discovered and reported on in 2016 by an employee who told administrators about it. Citing a toxic work environment, she later quit after colleagues retaliated against her by looking up her medical records and discriminating against her because of her own disability. St. Mary’s has been quick to assure the media that no identifying patient details were kept on the wall.


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Weekender 9/27/19

September 27, 2019 Weekender No Comments

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Weekly News Recap

  • FDA releases draft guidance explaining how it will determine if a clinical decision support software product should be regulated as a medical device.
  • Emids is acquired by a private equity firm.
  • Prescription discount service GoodRx adds virtual visits.
  • Amazon launches a virtual medical clinic for its Seattle-area employees.
  • China’s Ping An Good Doctor reaches 300 million registered users of its online healthcare platform.
  • CHIME, AMIA, and other groups ask Congress to address specific information blocking issues and to extend the timeline for enforcement.
  • University of Kentucky HealthCare diverts patients over several days after a registration system update causes a system crash.
  • Campbell County Health (WY) diverts patients following a ransomware attack.

Best Reader Comments

If your organization is resistant to change (like most acute orgs) and not receptive of feedback (like most places with bad politics), you should probably keep your mouth shut. If you can’t, you should quietly leave. If you want to be a hero, volunteer after work or donate some money to a good cause. In general, sacrificing yourself on the molehills of office politics is a bad way to achieve moral goals. (DifferentIndustry)

One thing that always startled me as a someone who entered healthcare from a different field is how low quality healthcare management is. In private practice, you often have MDs trying to be managers. A general manager at McDonald’s has more well- developed management skills than these people. Sometimes they eventually realize that they don’t have what it takes and cede the role to a clinic manager or the practice is small enough that everyone learns how to work around them. The acute side is where you get real pathological relationships due to the scale, low pay for middle managers, and lack of competitive pressure. Every office has politics, but if people are incentivized to backstab, they will backstab. (Diseased)

Re: downloading health data. One more manifestation of the consistent phenomenon (see: open notes, patient portals) that patients are less fascinated by their heath data than we imagine. Most find this information to be either unpleasant, confusing, inaccurate, or some combination of these. A small core of patients find access to be essential, but it is a very small fraction. Assuming that all patients want to see their info makes us think we are failing. But maybe we need a different denominator.(Andy Spooner)

If I may, I’d like to add my two cents about why patients don’t download their data. I, for one, do download my data, especially the visit summary. But it is usually a waste of time and paper/ink because the substance of the discussion I had with my provider(s) is rarely reflected in the note. It’s more of a CYA note so pretty useless to me if I want to go back and try to see what the doc said in past visits. I even had a couple of physicians who dictated their notes AFTER I downloaded the note so the only thing entered in the visit note was PMH, Meds, VS, etc. Very disappointing. (Eyes Wide Open)


Watercooler Talk Tidbits

In England, twins who were mistakenly assigned the same NHS number at birth 37 years ago still have problems booking services, getting the right meds, and following up on appointments whose reminders are sent to the other sibling. NHS says it can’t talk about individual cases, but the problem is most likely to happen when patients share a last name, data of birth, and address.

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A woman receives 500 letters at her home address from UnitedHealthcare that are addressed to “State of Maine DHHS.”

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ProPublica congratulates itself on its story about non-profit Methodist Le Bonheur Healthcare’s aggressive pursuit of unpaid hospital bills in which it sued 6,500 patients, many of them living in poverty. The hospital was shamed by the report into offering more generous financial assistance, eliminating court-ordered interest on medical debt, and eliminating attorney fees. The feel-good story ignores the obvious – patients who didn’t pay their bills now don’t have to (unlike many patients before them), the hospital will surely find other ways to squeeze money out of patients once the headlines fade, and the problem of super-high hospital bills remains. The pea has simply been moved under a less-noticeable shell. Interesting facts from the health system’s tax forms:

  • It paid its current CEO $1.6 million and its “senior advisor” and former CEO $1.3 million in its most recent tax year.
  • The CIO was paid $469,000, the CTO made $337,000, and the chief health information officer earned $370,000.
  • Cerner was among its five highest-paid vendors, with $13.3 million in maintenance costs for the year.

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The stored stem cells of 56 cancer patients at Children’s Hospital Los Angeles are lost when the hospital’s freezer fails. CHLA apologized for the failure and for sending the notification letters addressed to the children instead of their parents. On a positive note, they bought a new freezer.

A Staten Island doctor is arrested for trading opioid prescriptions for sex, with 20 of his patients filling prescriptions for 100,000 oxycodone tablets.

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Former San Diego Chargers team doctor David Chao, MD  — an orthopedist whose history includes DUIs, a DEA investigation, 20 malpractice lawsuits, and a revoked medical licensed that was stayed in a settlement – launches a subscription football injury service called the Injury Index for gamblers under his moniker “Pro Football Doc.”

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A New Zealand woman credits her throat cancer recovery to a retired New Jersey pediatrician and cancer survivor who gave her a second opinion on Facebook. Sajjad Iqbal, MD wrote a 2017 book titled “Swimming Upstream: My Struggle and Triumph Over Cancer and the Medical Establishment: New Hope in Cancer Treatment.”


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Weekender 9/20/19

September 20, 2019 Weekender 1 Comment

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Weekly News Recap

  • Australia’s Queensland Health struggles with its new EHR and ERP systems.
  • Alphabet restructures its DeepMind health business to report to Google Health.
  • Warburg Pincus acquires behavioral health and human services EHR company Qualifacts for over $300 million.
  • Jonathan Bush (Athenahealth) joins video and office visit provider Firefly Health as executive chair.
  • Leidos sells its Leidos Health EHR implementation and consulting business to private equity firm A&M Capital.
  • Specialty practice EHR, PM, PACS, and AI chat bot vendor OrbCare is reportedly nearing insolvency just six months after announcing a $2 million seed round.
  • Livongo’s shares drop below their July 25 initial offering price after its first quarterly report shows widening losses.

Best Reader Comments

I don’t think people in general really care that much about their information getting out there or the government having it. People hand all their data over to Facebook, there is no organized movement around data leaks, and there has been very weak opposition to the Patriot Act or the Snowden leaks. The reason that we don’t have a national patient identifier is largely a result of it being bad for special interests. In the US political process, if you have a large sum of money you can always drum up “grassroots” efforts to stall legislation or pay politicians in power to pretend to hold a view. (People)

The term “copy / paste” is used excessively in a way that obscures problems with current EMR use. Plagiarizing someone else’s free-text information should be seen as very bad. Regurgitating your own previous note with minimal or no changes is merely bad and more responsible to the note bloat issue cited. But talking about the “past medical history” that autopopulates most EMR notes as if it were somehow reliable and true is naive. At minimum it’s often either incomplete or redundant and, worse, internally contradictory. Worse yet, free text narrative history notes from specialists often contradict medical history imported elsewhere into the selfsame note. Are there any examples where this sort of thing had legal ramifications? (Robert D. Lafsky)

The real irony is that in 1965, the AMA was vehemently opposed to Medicare. They claimed it would ruin the doc-patient relationship and make docs wards of the state. They were right — it has ruined the relationship, and given their income levels today, most of which comes from taxes, they are wards. Poor things. They must be gleeful just thinking about Bernie’s Medicare for all. (Frank Poggio)


Watercooler Talk Tidbits

A sexual harassment lawsuit brought by a since-deceased ED doctor against her hospital employer continues, with her husband claiming that the stress of her boss’s rejected sexual overtures followed by his work-related retaliation led her to die of gallbladder cancer in 2017 at 53.

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Several biohackers who believed the health claims of “hydrogen-infused water” company Trusii say they were scammed into taking out high-interest loans of up to $12,000 to buy its home water fountain, with the company promising to send them monthly checks if they posted glowing social media reviews of its health benefits. Trusii’s owners say they’re the victims of mob mentality, it’s their competitors organizing the bad PR, and that they actually overpaid users, some of whom didn’t meet its testimonial requirements. The CEO was arrested in February for alleged scams related to his previous used car business.

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University of Michigan will build a $920 million, 264-room patient tower that it says is “an investment in Michigan Medicine’s mission of advancing health to serve Michigan and the world.” Existing semi-private rooms will be converted into private rooms, adding a net bed count of 154 (at a cost of $6 million per bed).

NPR notes that government-employed doctors in Venezuela earn less than $2 per month, forcing them to live on free food provided by local merchants and bus money offered by patients. At least half of the country’s medical employees have left the country or changed jobs, not just because of wages, but because Venezuela’s economic woes under an authoritarian government have left it without medical supplies, drugs, and hospital air conditioning as annual inflation rates have risen to 10,000,000%. Doctors report being fired or threatened for complaining about patient endangerment due to situations such as having to use their cellphone lights to perform surgery.

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A 23-year-old Iowa State football fan whose on-camera ESPN College GameDay sign asked viewers to Venmo him beer money receives $1,600 in donations, leading him to decide to buy one case of Busch Light and send the rest of the money to University of Iowa’s Stead Family Children’s Hospital. Anheuser-Busch – owned by Belgium-based InBev – promoted his cause and offered matching funds. The donation total now exceeds $350,000.


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Weekender 9/13/19

September 13, 2019 Weekender No Comments

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Weekly News Recap

  • Surescripts cuts off prescription data access to Amazon’s PillPack mail order pharmacy.
  • The premier of Queensland, Australia promises to investigate a 14-hospital downtime of several hours that was caused by a Cerner upgrade.
  • Apple announces that it will partner with several high-profile healthcare institutions to conduct studies related to hearing, women’s health, and heart health using its new Research app.
  • Mayo Clinic signs a 10-year partnership with Google in which Google Cloud will provide Mayo with data hosting, cloud computing, analytics, and machine learning and AI.
  • Bayfront Health St. Petersburg (FL) pays $85,000 to settle HHS OCR’s first case under the Right of Access requirement to give patients complete copies of their medical record within 30 days.
  • Hackers breach DDS Safe, a cloud-based records retention and backup solution that is sold to dental practices, and use it to install ransomware on the computers of hundreds of dental practices.

Best Reader Comments

Private equity can jump in the line of who all are screwing the consumer –bloated organizations, vendors charging five times what it would cost out of healthcare, solutions bought not needed, physicians making a fortune off their patients’ problems, and hospital execs stuffing pockets while driving up costs. Next up: pediatric offices charging based on parent fear level. (Overcharged)

I use PillPack and one of the things that appealed to me was that it took five minutes to sign up and they had my insurance information and prescription information without my needing to supply it. If this had been manual, I would have never signed up. (To be or not to be)

Is a really high deductible and co-pay actually “coverage” or just the illusion of coverage? (Brian Dale)

I’m honestly thrilled that a hospital / health system got nailed for obstructing access to patient records. It’s overdue. As a hospital, I owe it to my patients to assure that they can get to their records in a timely manner. I don’t always know why they need it, and it isn’t my problem. It is their information. They should have a right to it. (MEDITECH Customer)

In effect, Epic aptitude testing tries to determine if you are a smart person. The assumption is, if you are a smart person, you can be a good IT analyst. Good grief! Only your job history proves that and I already have that. (Brian Too)

Epic doesn’t tell you how you do on the exams, but you can assume you did well if you’re offered the job. Carl Dvorak, in a new hire class, told us that the aptitude and personality tests were better predictors of how well Epic employees would perform than their college major, job history, college, etc. (Publius)

Worked in a border city in a prior life — we had hospitals in both states. One state required a physician signature on every individual script, the other allowed batch signing. EMR workflow was a nightmare, as was physician adoption for the physicians that worked in both hospitals. (Was A Community CIO)

Burnout is a real condition, but for most of organized and academic medicine, it has provided a handy new topic to generate more content for sale and consultation fees. (Kevin M. Hepler)

If the AMA was fighting for us, they would be loudly demanding truly radical restructuring of US health care rather than tweaking the existing one with apps, conferences, wimpy comments on CMS rule-making, etc. The solution to our problem isn’t going to come from the AMA until they recognize that they helped to create the problem. (Joe Schneider)

That’s the nature of implementation in general. People who have previously done the exact same thing as you need command a premium salary. Most of the work isn’t really that complicated and is just grunt work. Therefore vendors provide the grunts and let the high-powered implementation people go become consultants that the customer can pay high salaries if that’s what the customer wants to do with their money. (Grunt)

I like where you are going with a basic skepticism of feedback you receive from folks who have not yet bought your product. In the startup world, a little book called “The Mom Test” has become the standard for the “customer discovery” process, in which you learn that people desperately want to tell you what they think you want to hear – and it’s usually not helpful. (Michael Burke)


Watercooler Talk Tidbits

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The Seattle newspaper recites yet another example of The Joint Commission giving a hospital a glowing review while state inspectors were nearly simultaneously threatening to shut it down for safety problems, highlighting the Commission’s self-proclaimed role as being the non-punitive advisor to hospitals that want to improve.

Google adds naloxone-finding tools and addiction recovery meeting locations to Maps.

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An 86-year-old Georgia doctor who operates a weight loss clinic is arrested for illegal drug distribution and money laundering, charged with taking cash from former NFL linebacker Sedrick Hodge for providing him with prescription medications to sell on the street.

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San Diego physician Murray Alsip, DO discovers that he can continue practicing medicine even after a heart transplant left him unable to see patients in an office by signing on as a telemedicine doctor with MDLive. Alsip previously met with the former girlfriend of 20-year-old man whose heart he received so she could hear it beating in his chest.


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Reader Comments

  • New Entrant: While I'm feeling like when I occasionally try to converse with my dog, I can't help myself - do you have any thoughts o...
  • butt hurt are we?: Admit it, this has been the biggest slap in the face to Epic, an epic slap to the face. They failed miserably here, poin...
  • Sidelines: As a non-Epic affiliated observer, there is a remarkable difference in maturity level displayed by the people at or ex E...
  • All the leaches: 17 Epic consultants/leeches don’t approve of this messages. LMAO...
  • Also Ex-Epic: I got my start in healthcare at Epic. The guiding principle for my team and for the teams I managed was always, "The nee...
  • Ex-Epic: Disclaimer: on the internet, nobody knows that you're a dog. Given that I once worked at Epic on Care Everywhere, I c...
  • Vaporware?: Why go through all that effort to sell vaporware when you can sell pharma something they badly want? “As the acknow...
  • Goodluck: The advertising business model does not work in healthcare. Most developed countries have some sort of ban on medical ad...
  • Stinky: Did nobody ever really wonder why it was free?...
  • Goodluck: I think we can all agree that health providers should provide your complete medical record in a consumable format at no ...

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