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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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Weekender 9/6/19

September 6, 2019 Weekender 2 Comments

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Weekly News Recap

  • Cerner lays off at least 250 employees as part of a cost reduction effort intended to deliver investor-promised operating margin targets.
  • OptimizeRx acquires RMDY Health.
  • AMA releases 2020 CPT, which includes several new codes to cover digital communications with patients. 
  • The Commons Project Foundation announces plans to work with partners to develop an Android alternative to IOS-only Apple Health Records.
  • ONC chooses The Sequoia Project as Recognized Coordinating Entity for TEFCA.
  • AMA and AHA ask for changes to proposed HHS rules that would force hospitals to share medical records with their patients, expressing concern that patients won’t understand them or that they won’t be aware of the possible exposure of their information to third-party apps.
  • Walmart launches a standalone health clinic pilot that will offer primary care, dental, labs, X-ray, audiology, and mental health counseling.

Best Reader Comments

[Regarding the Vince Ciotti interview] Wow, what a great interview! Also, THANK YOU for compiling his PowerPoint presentations into one PDF document! Vince is right! “You can only learn from the past. You can’t learn from the future. It’s not here yet. The mistakes made in the past will be made in the future unless you learn from them and change them. It’s such a priceless thing.” As a young female millennial in healthcare IT, I am appreciating this wisdom and am determined to go through all 1,438 slides. Thanks for conducting a great interview! Wonderful answers Vince! (Weird_Female_Millennial_JCV)

Thinking about the situation for two seconds, many health IT discussions about burnout make no sense. Has burnout among medical assistants increased a huge amount since EHRs or EHR-heavy requirements were put in? Not really, so the source here is probably not the EHR. What’s the rate of burnout among VA staff, who have an EHR that on the clinical side is hugely unusable? It’s about 1/2 that of elsewhere. So it doesn’t seem like the EHR is a driving factor here. Why does your job suck? Probably management. If management came by with a survey asking why your job sucked, would you check the box that says “management sucks?” Only if you were a baby in the corporate world.(tEHRibble)

M&A is not an eventuality, it’s a deliberate strategy. It is so across all industries, including hospitals. How does any business grow in a zero-growth industry? M&A. Any company’s mission and responsibility lies with its shareholders. Some folks struggle with the realization that healthcare is not an altruistic endeavor, not any more at least. (El Comadante)

The reason that you don’t have to ask “Star Trek” computers three times is that the “Star Trek” computers understand meaning. This is what is missing from all the classic voice recognition systems to date. (Brian Harder)


Watercooler Talk Tidbits

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A survey by the UK’s Royal Society for Public Health finds that the most toxic feature of social media – even more so than the content posted by users — is the “like” button.

An oncologist in Australia admits that she was overly influenced by “the opioid industry” when she entered practice in the early 2000s, where drug company reps casually convinced her that the company’s opioid was safe while paying for her journal subscriptions and lunch, which was a small investment given that her resident’s father was flown by a device manufacturer to a Scottish castle to discuss coronary stents. She recommends that doctors be educated on “the insidious influence of drug companies” that vie for their attention when they have little time to critically evaluate company claims. 

Scammers are using AI-powered voice impersonation software to call company insiders and convince them to transfer money to foreign accounts or to divulge sensitive internal information.

Rennova Health, the publicly traded (but Nasdaq-delisted) lab and software company that bought and closed Jamestown Regional Medical Center (TN) after walking away with employee tax and Social Security withholding, confirms that is behind on employee paychecks at the recently acquired Jellico Community Hospital (TN) and has cancelled the employee health insurance plan while continuing to withhold their premium payments. Rennova Health’s CEO, an Irish citizen who lives in the Bahamas, sued a Tennessee state senator in July 2019 for calling him an “Irish gangster” who came to Tennessee to cheat locals after the company closed JRMC. His primary business interest appears to be a chain of toxicology labs. Several struggling rural hospitals have been acquired and eventually closed by similar lab companies that are anxious to bill at higher hospital rates, which lasts only a short while before insurers stop paying. RNVA shares are trading at $0.0001, valuing the company at basically nothing.

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Just because you can doesn’t mean you should. A 74-year-old rural Indian villager becomes the world’s oldest new mother after delivering IVF-created twin girls. Mom, who was hospitalized for her entire pregnancy, says she was inspired to give birth 30 years after the onset of menopause when a 55-year-old neighbor became pregnant. Dad is 80.


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Weekender 8/30/19

August 30, 2019 Weekender 3 Comments

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Weekly News Recap

  • Life insurance startup Ethos, which uses predictive analytics based on a customer’s EHR data rather than a medical exam to predict lifespan, raises $60 million in Series C funding round.
  • A KLAS-convened customer review of Cerner’s revenue cycle management progress finds that the user base feels the Cerner is listening, but they are frustrated with lack of progress since the initial meeting a year ago and are questioning both Cerner’s ability to execute and its sense of urgency.
  • Epic holds its UGM in Verona, WI.
  • Private equity firm Warburg Pincus acquires a majority interest in therapy EHR vendor WebPT.
  • Health Catalyst files its first quarterly earnings report following its July 25 IPO.
  • Politico reports that the VA’s initial rollout of Cerner will be delayed several months to October 2020.
  • A VA OIG report finds major backlogs of paper records scanning from outside providers at eight VA facilities, with some records going back to 2016 still piled up in storage rooms.

Best Reader Comments

State-specific regs are problematic for HIT and for clinical care in a broader sense, particularly when states have specific documentation or regulatory requirements that differ from national ones. State specific regs include those related to reportable conditions, privacy, mental health or substance use and complicate EHR design since they vary from state to state. Particularly in the electronic era, having a single standard would be much more efficient. (Federalist)

Insurance companies getting their hands on EHR data concerns me less since the ACA restricted what they can base premium prices on. (TheSnarkIsWhyImHere)

Medicare doesn’t hire doctors (like the NHS in England does, paying them salaries). Doctors submit bills to Medicare on a fee-for-service basis. Even Medicare Advantage (private insurers providing Medicare coverage for about 30-40% of the seniors) works through doctors sending bills to someone. There are projects underway to come up with other ways of paying doctors for Medicare, involving reward for achieving better overall costs and how well patients do, as measured in different ways. It still involves sending bills.The lament comes in because seeing patients and sending bills involves dozens of different payers and contracts and systems of rules and mechanics of getting paid. If there was just “one payer,” it would get simpler. (Randy Bak)

Although some like to point to foreign countries like Canada, Finland, etc. as good single-payer systems. every one of those countries has at least a two-payer system. The government system,and the private pay (or private supplemental insurance) to cover faster care or non-covered items. So I wouldn’t worry about the rev cycle folks being on the street to soon. (Frank Poggio)

I’m a fan of the Israeli healthcare system. They have several HMOs, under pretty strict government oversight. The result is a quasi-competitive system that offers a government-mandated basket of services. The cost of their healthcare isn’t outrageous, they have shown they can innovate within their economic structure (a common complaint about single-payer is stifling innovation), and the outcomes are better than the USA. I tire of the arguments against single-payer that suggest we do nothing. Clearly, we have a cost and quality problem in this country. Doing nothing is not a strategy for success. (Jim Bresee)

[With regard to health IT salespeople] I never misrepresent myself to employers or clients. That is how I can hold my head high, even when I’m in a room with one of my sales reps who decides to “do their job” despite my guidance. Because I will interject and say “technically” or “in the interest of full disclosure,” the client will light up with appreciation and the sales rep will be enraged. Those instances typically result in a successful long-term relationship with the client. As Mr.HISTalk shared, there are many good reps. But there are all way too many who are doing their job, which often times doesn’t align with being fully transparent. (Katie Goss)

[On clinical decision support systems replacing EHRs as clinician-facing technology] An EHR is a enterprise-wide. mission-critical transaction system. A CDSS is akin to a Mangement Decision Support System in commercial industry, and I know of no situation where a MDSS has totally replaced a SAP or Oracle transaction system. (Frank Poggio)

I’ve often noticed how many of the sales management folks (from directors to VPs and even to a couple of CEOs) have fallen from grace (they have quotas too!) and eventually end up down the food chain again. Sales is an interesting business and the people at the top making the big decisions and big bucks are not always the best strategists. Sometimes just the best BSers! (Eyes Wide Open)


Watercooler Talk Tidbits

Healthcare long-timer and Tincture editor Kim Bellard quotes an AI expert’s recommendation to substitute “magic fairy dust” for “AI” in any article that mentions it, which helps determine how realistically the author or expert is describing unproven technology. He also quotes healthcare debunker Jen Gunter, MD, who rails against bad information as well as click-desperate news sites that either misrepresent the latest medical study (intentionally or not) or label it with a misleading headline that will be echoed endlessly on social media with no critical review.

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An Atlantic writer spends $1,300 on products from the “pretty, blonde 20-somethings” working in the luxurious storefront of Gwyneth Paltrow’s so-called “wellness” company Goop. She emitted foul body order from some wacky vitamin combos, attracted attention with a $80 “healing energy” crystal water bottle, couldn’t figure out how to use the $42 tinted face oil, and found that the Martini Emotional Detox Bath Soak resembled raw sewage when dumped into her bath water. She liked some of the expensive products, but summarizes:

For these products to be considered successful, the result wouldn’t necessarily be a stronger, more resilient, more competent me, or a more peaceful relationship with my body. It would be a person who is better-dressed, who hasn’t succumbed to the indignities of visible aging, whose hair doesn’t frizz, who never goes back for seconds at dinner … the company’s products embrace one of America’s oldest health myths: that physical beauty is proof not only of a person’s health but of her essential righteousness. If the outside is perfect, the inside must be too … Wellness companies can feel predatory, even those not making Gwyneth Paltrow richer. It’s a largely unregulated industry, and it operates in an environment of open desperation. Many women justifiably mistrust the ways conventional doctors address their concerns and treat their pain. Goop, influential in ways that would make most gurus and healers envious, has helped introduce millions of people to “experts” who argue that HIV doesn’t cause AIDS and that drinking celery juice can treat cancer.

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NICU staff at Riley Hospital for Children at IU Health North (IN) hold a graduation party for baby born at 23 weeks weighing 20 ounces. Four months later, she was discharged weighing 8 pounds, 6 ounces. I’m assuming that other hospital employees were less enthused at the same moment in trying to collect the massive bill generated as a by-product of the miracle.

The FBI arrests a Michigan doctor who it says planned to kill a condo HOA lawyer and his own attorney by injecting them with fentanyl.

Leaked emails from a regulatory affairs physician with chemical company Monsanto show that the doctor wanted to “beat the sh*t” of members of advocacy group Moms Across America for urging the company to stop selling genetically modified seeds and Roundup. The president of an environmental group says that Bayer is “reeling” after paying $63 billion for Monsanto last year, only to be hit with negative publicity as “the company that gave us DDT, Agent Orange, and PCBs.”

A veteran running late for his appointment at the St. Louis VA hospital uses its valet service to park his new car, following the valet’s instructions to just leave his car with the keys on the dash. Afterward, the valet said someone drove off with it, but the third-party valet company isn’t returning his calls to explain why it would allow someone to take the car without presenting a claim ticket. The car turned up two weeks later damaged, empty of his personal belongings, and tricked out with a new window tint job.


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Weekender 8/23/19

August 23, 2019 Weekender 1 Comment

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Weekly News Recap

  • Revenue recovery software vendor Ontario Systems is acquired by an investment firm.
  • Allscripts announces availability of Apple Health Records in its EHRs.
  • A watchdog group publishes emails detailing the involvement of the “Mar-A-Lago crowd,” including an associate of President Trump, with the VA’s contracting with Cerner.
  • EHealth Exchange announces go-live of a national, single-connection gateway service.
  • A Nature article covers the responsible use of machine learning in healthcare.
  • Several investment firms are reported to be in discussions to buy Emids Technologies.
  • Ciitizen rates hospitals on how effectively they respond to patient requests for copies of their information.
  • An OIG report finds that the VA’s overdue, over-budget scheduling project is nearly finished, just in time to be replaced by its Cerner implementation.

Best Reader Comments

[From the author of a report predicting that clinical decision support systems will replace EHRs as the primary physician interface] CDS are now mostly point solutions, but the CDS vendors are expanding their reach and are discovering something interesting: the more they expand, the more EHR data is required. At some point most of the data in an EHR is then in the CDS. We have not reached that point yet, but when that happens, it makes logical sense to invert the model, where an EHR gates most health It functionality and change it to a model where the EHR is actually subordinate to a more user friendly interface: likely one that looks a lot like a CDS … The essential notion is solid: EHRs are not user friendly, but CDS generally are. This is an unstable dynamic and we believe that someone will move to address the problem. Also, we did talk to practically every CDS vendor as well as every EHR vendor and healthcare delivery organization. The interesting thing is that the idea that CDS would take over did not come from the CDS community, but came from the healthcare delivery community. (Mike Jude)

[To the author of the report above] You make some sweeping assertions without any basis in fact. “EHRs are not user friendly, but CDS generally are” – what is this conclusion based on? You assert “CDS are often developed in response to specific pain points: new regulations, new dosing requirements, etc.” Are there any serious CDS systems certified for Meaningful Use AND in general adoption by doctors at the point of care? And on what fact base do you assert that EHR vendors don’t “incorporate human factors to ensure low impact human interactions?” (Supporting good decisions)

[Referencing an article on Apple Health Records] How will access to my EHR data help me “shop for high value health care services” and “avoid the need to repeatedly supply data for entry?” These discussions are without substantive support in any fashion that I can see. I hope my tax dollars did not pay for this. (FormerCIO)

The ACR AUC system is ridiculous for specialist physicians. I am a board certified orthopaedic surgeon who knows when I need an MRI or CT scan. At what point does the system trust me to make a decision about the care of my patients? After two MOC exams? After 20 years in practice? Am I an outlier with studies? No. So if ACR wants to do AUC, then have the radiologists do it, not me. I know what study I need and want to care for my patients. If you think you know better, then you take over the care of the patient when you deny the test. (meltoots)


Watercooler Talk Tidbits

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Millennials who document every potentially enviable aspect of their lives on Instagram are hiring professional photographers to shoot both natural and C-section childbirth, with full-time birth photographers elbowing doulas out of the way to charge up to $4,000 at trendy hospitals like Cedars-Sinai and UCLA. They leave business cards in exam rooms and with providers who hand them out. OBs aren’t always thrilled with the potential additional malpractice exposure of having everything recorded in photos or video and hospital policies are often inconsistent or non-existent.

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A dozen of Facebook’s low-paid content moderators – contracted from Accenture to review up to 800 pieces of disturbing user content such as child sexual abuse in a single shift – accuse Accenture of trying for force company-provided “wellbeing counselors” to disclose the details of their trauma sessions in what they say is a violation of HIPAA.

SimplyVitalHealth, which offers “blockchain-based solutions to emerging value-based healthcare programs,” returns $6 million to investors after the SEC charges it with conducting an unregistered securities offering in the form of an Initial Coin Offering.

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Google DeepMind co-founder Mustafa Suleyman takes indefinite leave from the artificial intelligence company.

University Medical Center of El Paso disputes President Trump’s claim that its surgeons left the OR to see him in during his post-shootings visit there, reassuring the public that in no case would that ever happen. The president said surgeons came out of ORs in both El Paso and Dayton in a spontaneous showing of “the love for me.” 

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A Miami plastic surgeon self-styled as “Dr. Slimthick” whose billboards offer Brazilian butt lifts financed at $30 per week is found to have falsified most of the credentials claimed on his website. The local paper checked his background in running a story about one of his patients, a 35-year-old woman who remains in critical condition a month after he performed her procedure. His cosmetic center is offering a silicone implants or liposuction for $3,500 if you’re in the market.

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A Texas woman faces 20 years in prison after being accused after subjecting her healthy son to 323 hospital and clinic visits and 13 major surgeries in the first eight years of his life in a case of Munchausen syndrome by proxy. She had also started several online fundraisers for the boy, claiming that he was dying from a genetic disorder and later from cancer. She had placed him on a lung transplant list and enrolled him in hospice care, caught only when employees of a Dallas hospital called child protective services. 

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Wolfson Children’s Hospital (FL) posts a video of 15-year-old Yanira Guzaman, who was able to stand for the first time and dance with her father at her quinceañera thanks to spina bifida treatments and a new power chair.


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Weekender 8/9/19

August 9, 2019 Weekender 1 Comment

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Weekly News Recap

  • Allscripts announces mixed Q2 results, which include a $145 million charge toward settling any liability that results from the Department of Justice’s Meaningful Use investigation against its acquired Practice Fusion.
  • CVS beats Wall Street’s quarterly expectations and announces plans to expand its HealthHubs concept and to implement “next best action” programs for chronic care management.
  • England’s NHS announces plans to form an $300 million artificial intelligence lab.
  • Truman Medical Center pays ransomware hackers to regain access to its systems.
  • Duke Clinical Research Institute and Cerner announce a pilot project to study patient data from non-Duke sites as the initial step in forming Cerner’s Learning Health Network.
  • The DefCon cybersecurity conference creates a mocked-up hospital full of medical devices for hackers to play with.
  • A new funding round values London-based AI health services vendor Babylon Health at over $2 billion.
  • Guidehouse will acquire Navigant for $1.1 billion.
  • Beaumont Health responds to reports of IT-heavy layoffs and the recent departure of its CIO and CMIO.

Best Reader Comments

Are you getting your license in other states for telemedicine purposes?? It always interests me how you have to have to be credentialed in the state of the patient even though you are providing the service from a different state, right?. Then I think of weird examples, like if you are on the phone with a patient who is riding in a car and they drive across state lines. One second you are having a legal conversation with a person and the next second you might be breaking the law! (Creds)

Even the most tech-awarded CHIME and HIMSS hospital systems are relying on their insurance to protect the corporation (not patients’ privacy) from hackers, Shamefully, most hospital CIOs have maintained very small budgets for cyber protection solutions and put basic security on auto pilot. [Ransomware victim] Truman Medical Center is “Most Wired” since 2010, Stage 7 HIMSS Analytics since 2013, a 2015 Davies Enterprise winner, and a Cerner model show site in its home town. (Are CIOS Ignoring or Ignorant?)

We need a law that says that they can’t play around with “re-identifiable data.” At this point we’re all aware that de-identified really means “not immediately identified”, or “you have to put in some work to make identifiable again.” De-identified should become un-identifiable. Of course in order to do that, you’ll probably be destroying whatever value they’re getting out of it. But they shouldn’t get to call it de-identified, it’s still PHI/PII unless mathematically provable that you can’t use that data to get to the identity of the people. (AC)

Why is Eric Topol not brave enough to say it? If you are in hospital administration, the group that collectively lobbies for you is called the AHA. If you are a small business owner – physician, the group that collectively lobbies for you is the AMA. If you are an employee of either of those two, the group that collectively lobbies for you is called a union. Ask a nurse to explain it to you. (SelfInflictedWound)

Meditech’s sales revenue is declining again. The company’s progress seems to be one step forward, two steps back. Saying the company is profitable and the balance sheet looks good, as was heard at the shareholder’s meeting, is another way of saying they are surviving. Meditech has yet to explain to its shareholders why it suffered such a large contraction during the period of greatest expansion the market has ever experienced, placing it a very distant third behind Cerner and Epic. (Running on MT)

I’ve talked to 5+ doctors about the thought process that they use to diagnose patients. I would characterize it as being a “satisficing” approach and I don’t think that computers are going to help make it better. I’m curious, though, about the percentage of diagnoses people think are incorrect. It really depends on how you define a misdiagnosis. 10% seems reasonable. (IANAL)

What’s [tackling problems with more impact than misdiagnosis] worth in real dollars that real physicians or medical organizations are going to spend? Unless I can convince enough physicians to pay for that service, what good does that do? I have to pay for my rent and groceries, too. We can have as many clever ideas for improving outcomes and patient health as we like, but we can’t do it for free. (HIT Girl)


Watercooler Talk Tidbits

A doctor from University of Calgary’s medical school mines Alberta’s EHR to find 60 ED visits that contain the word “scooter” to determine the extend of e-scooter injuries, although he admits that word usage might compromise accuracy. He urges those using the scooters to wear a helmet, which few riders of the newly introduced rental e-scooters do. The city requires helmets for bicyclists but not scooter-riders and allows only scooters to be ridden on sidewalks. 

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Doctors eventually find that a Michigan woman who had choked on the first bite of a grilled hot dog and then experienced repeated problems afterward with breathing, talking, and swallowing had a wire embedded in her throat, which turned out to be a bristle from a grill brush. Doctors removed it and she’s fine. She urges people to use plastic grill cleaning brushes, explaining that her husband later passed a magnet over the grill and picked up 30-40 more bristles.

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A  man who was sentenced 20 years ago to jail and six months of psychiatric counseling for impersonating a doctor over a six-month period at UCLA Medical Center graduates from a Caribbean medical school at 47, admitting that it’s tough to get licensed and accepted into a US residency when his past includes forging prescriptions. His education probably isn’t helping his quest – a current student of the for-profit Saint James Medical School says the school has a minimum GPA of 2.0, an MCAT-optional admissions process, an attrition rate of 86%, an 8% first-pass NBME pass rate, and a low residency match rate. 

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Physician assistant Johnny Presley buys the recently closed Cumberland River Hospital (TN), pledging to open his fourth outpatient clinic there within four weeks and then possibly eventually adding a standalone ED. He paid $200,000 for the hospital, which had been bought for $6 million by a local hospital in 2012 that closed it after ongoing financial losses. He explains, “I might not be hardly as smart as some people or have as much money as some people, but I’ll outwork anybody. I just apply a lot of commonsense approaches. It’s a one-man show … I spent my life working in rural hospitals and rural communities and it’s a needed service in these areas. Unfortunately, it’s like time left those places, and it’s very sad. Growing up and working in them, seeing them all start to close is very sad.”

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The for-profit hospital operator that bought two Wheeling, WV-area hospitals two years ago announces plans to close them both. One started as a city hospital in 1890, while the other opened its doors in 1906.

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A jailed, 77-year-old pain management doctor in Detroit who is accused by the federal government of bilking insurers out of $500 million in a scheme involving opioid prescribing and spinal injections offers to turn his lakefront estate into a privately guarded prison if authorities will release him. Raj Bothra, MD’s most prolific prescriber, Eric Backos, MD – who “specializes” in “pain management, medication management, opioid detoxification, EMG/NCS testing to identify specific location of nerve injury, Botox therapy, and acupuncture” – prescribed 5.9 million pills from 2013 to 2018, with 86% of them being opioids and with at least two patients dying of overdoses following their visit.


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Reader Comments

  • Junkie needs an intervention: Partners makes extensive use of MyChart Online Appointments for patients. BTW, not a huge research project had you w...
  • Umm: The real story is there is no story. No department quit, no group quit, no abnormal amount of staff quit....
  • HISJunkie: Partners spends $1.2 billion on an Epic install and does not get online patient appt scheduling? What's wrong with th...
  • What: What's the real story?...
  • BS: This "entire department quit" thing is untrue....
  • AynRandWasDumb: Sounds like rumor mongering. If that were true and if that actually had an impact, I'd expect we'd have seen more news a...
  • What: That's a good explanation. Maybe not a good example. The rumor around Madison bars is that Hosting management is so ...
  • ellemennopee: @bisexualreader: The largest provider of poverty relief in the LGBTQ community is....who? Yes, it's an opinion pie...
  • bisexualreader: I hope you'll reconsider your support of the Salvation Army due to their long history of homophobia (https://en.wikipedi...
  • ellemennopee: I don't personally know Stephanie Reel but after reading through to the end of her Thanksgiving note, I wish I did. We ...

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