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Weekender 4/1/22

April 3, 2022 Weekender 3 Comments

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I will call this a “very special Weekender,” as the old TV shows used to say, as I limit this episode to a Donors Choose update. Feel free to skip this if you are looking for health IT news only.

Alex Benson, MPA is a long-time HIStalk reader, former Cerner executive, and SVP/GM of Bardavon Health Innovations since last year. He emailed to say that the company was interested in supporting the Donors Choose program. Which they did, in a generous way that needs its own post because the list of projects it funded is long.

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Overland Park, KS-based Bardavon Health Innovations is a workers’ compensation digital health partner whose “clicks and mortar” technology connects its national network of physical therapists to self-insured employers to offer injury prevention, treatment, and work readiness solutions. There’s quite a bit of Cerner DNA in the company – Cliff Illig and Zane Burke are investors and board members, Ed Enyeart is CFO, and Jeff Steiner and Alex are general managers.

The company’s donation fully funded these Donors Choose teacher grant requests that I chose:

  • Math manipulatives for Ms. F’s elementary school class in Miami, OK.
  • Headphones for Ms. G’s elementary school class in Naples, FL.
  • Science and STEM materials for Ms. W’s elementary school class in Miami, OK.
  • Math learning tools for Ms. T’s middle school class in Montgomery, AL.
  • Math learning tools for Ms. E’s elementary school class in Casa Grande, AZ.
  • Math learning centers for Ms. P’s elementary school class in Washington, DC.
  • Science sensory kits for Ms. H’s pre-kindergarten class in Washington, DC.
  • Number recognition kits for Ms. G’s pre-kindergarten class in Columbus, IN.
  • Robotics parts for the robotics teams of Mr. E’s magnet school in Van Nuys, CA.
  • Sight words puzzles for Ms. B’s special education class in Brooklyn, NY.
  • Storytelling kits for Ms. M’s elementary school class in Miramar, FL.
  • Phonics and reading material for Mr. H’s elementary school class in Orlando, FL.
  • Education centers for the kindergarten class of Ms. O in Staten Island, NY.
  • Emotional support books and supplies for Ms. J’s elementary school class in Houma, LA.
  • Math manipulatives for Ms. M’s elementary school class in Moore, OK.
  • Flexible seating for Ms. R’s elementary school class in Kansas City, KS.
  • Autism calm and focus tools for Ms. M’s autism preschool class in Glendale, AZ.
  • Behavioral specialist supplies and games for the elementary school class of Ms. M in Las Vegas, NV.
  • Dramatic play kits for language and social skills for Ms. K’s kindergarten class in Universal City, TX.
  • Classroom organization mailboxes for Ms. B’s first grade class in Erie, PA.
  • A set of 14 books for Ms. B’s elementary school class in Kansas City, MO.
  • Science invention kits for Ms. M’s high school class in Kansas City, MO.
  • 30 scientific calculators for Mr. F’s elementary school class in Kansas City, MO.
  • Headphones and dry erase markers for Ms. C’s kindergarten class in Orlando, FL.
  • STEAM bins for Ms. S’s elementary school class in Naples, FL.
  • Sensory exploration kits for Ms. T’s special needs kindergarten class in Kernersville, NC.
  • Soccer team supplies for Ms. F’s elementary school class in Yuma, AZ.
  • Reading reward book purchase gift cards for Ms. S’s elementary school class in Bronx, NY.
  • Building kits for Ms. G’s elementary school class in Sylmar, CA.
  • A shelter and water cooler for the track team of Ms. M’s high school medical science class in Bronx, NY.
  • Teaching resources for the speech therapy class of Ms. B in Detroit, MI.
  • Mental health materials for the elementary school counseling sessions of Ms. R in Los Angeles, CA.
  • Math and writing resources for the elementary school class of Ms. Z in Phoenix, AZ.
  • Literary skills tools for Ms. D’s elementary school class in Eastpointe, MI.
  • Behavior and sensitivity books for Ms. S’s elementary school class in Fresno, CA.
  • English-Spanish dictionaries for Ms. G’s middle school ESL class in Indianapolis, IN.
  • Classroom supplies for the autism elementary school class of Ms. H in Mesa, AZ.
  • Headphones for the math intervention middle school class of Ms. P in Brighton, MA.
  • Basketballs for the boys and girls teams of Ms. Q in Glendale, AZ.
  • Decorations for the alternative prom for special needs students, voted by the school’s National Honor Society as an official project, for Ms. V’s high school in Buckeye, AZ.
  • A mobile easel for the COVID-affected second grade class of Ms. M in Westminster, CA.

Many teachers responded quickly and I usually get updates (often with photos) to report how the donated items were used. Just to be clear, I receive these emails, but Bardavon Health Innovations provided the money.

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Weekender 3/11/22

March 11, 2022 Weekender No Comments

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Weekly News Recap

  • Symplr acquires GreenLight Medical.
  • Oracle shares drop after earnings miss, questions about its healthcare ambitions tied to acquiring Cerner for $28 billion.
  • EU will publish a governance framework for health data that will support cross-border health information exchange.
  • Epic announces Garden Plot, an Epic version for independent medical groups.
  • Former Livongo executives launch Homeward Health.
  • Consensus Cloud Solutions acquires Summit Healthcare.
  • Microsoft closes its $19.7 billion acquisition of Nuance.

Best Reader Comments

I don’t think [telehealth] payment parity is a good idea. Payment parity is just going to drive more money to big regional health systems. They can manage physician recruitment to address supply, they can afford to buy the technology to do the visits and they can afford to buy the marketing to find those existing high spending consumers. Pairing telehealth visits with marketing materials makes a lot of sense, which is why you see health systems talk about telehealth in the same sentence as digital front door aka the health systems website. If you make telehealth pay less than in person visits, you’ll keep it cheaper and drive the organizations doing telehealth national. (IANAL)

My guess is large independents want an EHR that is a simple, cost efficient billing machine. They don’t want to take on a lot of overhead and their providers want a UI that they can use very quickly … I’ve watched some long-time users chart in the green screen Meditech. They’re so fast. They don’t lift their hands off the keyboard and they have the exact timing of when Meditech loads the next screen. I think of them every time I’m working on some feature that I know is going to get ingrained in business users’ hands. If I can get it to no clicks, then they’ll be able to work as fast as I can load the next screen, so it better be fast. (IANAL)

Frankly I’d rather Epic do more to help independents remain independent (but with fluid chart exchange through Care Everywhere). AFAIK Consolidation in the healthcare industry has not produced measurable benefits for health outcomes or patient costs, but it has certainly helped with profits for the large systems. (Elizabeth H. H. Holmes)


Watercooler Talk Tidbits

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HIMSS22 attendees – mask-wearing is now optional per revised CDC guidance. I would add that stiff business dress is also optional, so please bring some of that ViVE beach spirit to Orlando by dressing down a little and wearing comfortable shoes in testing your long-dormant conference muscles cautiously.

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ViVE moves to Nashville’s downtown Music City Center next spring. Here’s my advice for HIMSS – if HIMSS22 attendance is as low as many predict, add the smaller, cooler, and more authentic cities back into the rotation instead of just tourist-overrun Orlando and Las Vegas (with the more interesting Chicago snuck in occasionally). A conference half the size of HIMSS at its peak has choices.

Lost in the nether regions that lie between ViVE and HIMSS is SXSW, which runs today through next Sunday in Austin. The health and medtech track is today through Tuesday. SXSW once seemed to be the up-and coming digital health conference, but I suspect it will be outflanked by ViVE, if for no other reason than health system executives don’t spend their own money to attend conferences and expensing ViVE sounds more justifiable than SXSW.

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Meanwhile, HIMSS acquired the Health 2.0 conference in 2017 and said it would continue operating under that name, but I’m thinking HIMSS sold that name (or else Indian trademark law is opportunistically loose) because a Health 2.0 Conference website suggests no HIMSS involvement, an all-India based staff, and a home office in an Alabama outlet mall that is shared by similar conferences. They’re showing a US conference April 11-13 in Las Vegas, listing no speakers and a handful of exhibitors I’ve never heard of, claiming they expect over 1,000 attendees at $2,000 a head. The last HIMSS-owned Health 2.0 conference seems to have been in late 2020 and hasn’t been heard from since.

I wrote this week about the investor-backed Chief private network for C-suite women. I heard the next day from someone who had just received a response to her five-question application to join. She was first told that the company has a backlog of thousands of membership requests and wouldn’t be able to schedule the mandatory interview for many months. She almost immediately got another email saying that her qualifications were sound and the interview would be fast-tracked to the next few days. Right after that, the company sent her an email advising her that her job title wasn’t high enough to join (she’s an executive director with no “C” or “VP” in her title) and they wouldn’t waste time interviewing her. I think she expected more polish from a membership group whose dues start at $6,000 per year.

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Two teenaged Harvard students, one of whom developed a COVID-19 tracking site two years ago, create an “Airbnb lite” type site that matches refugees from Ukraine with people in neighboring countries who are offering places to stay. They say government-run sites are too hard to use and feature little more than a text box entry form and a display of those entries.


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Weekender 2/25/22

February 25, 2022 Weekender 1 Comment

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Weekly News Recap

  • Teladoc Health’s Q4 results beat expectations, but its share price takes a wild ride.
  • Allscripts announces Q4 results that beat Wall Street expectations for revenue and earnings.
  • A study notes that while telehealth visits spiked during the pandemic, the reason seems to be lack of in-person visits rather than patient preference.
  • The DOJ sues to block UnitedHealth Group’s $13 billion acquisition of Change Healthcare, citing anti-competitive concerns related to UHG’s health insurance business.
  • Virtual chronic care management company Omada Health raises a $192 million Series E funding round.
  • WellSky announces its intentions to acquire TapCloud.
  • Health Catalyst announces its acquisition of KPI Ninja.
  • Cerner’s Q4 results beat analyst expectations for earnings, but fall slightly short on revenue.
  • Spok announces layoffs, the retirement of its cloud-based Spok Go product, and its continuing search for an acquirer.

Best Reader Comments

Hats off to Epic and Judy for supporting their client and directly going after that patent troll. Too many companies just roll over as they don’t want to deal with the hassle, thereby leaving these patent trolls free to roam. (Trollbeater)

Neither Whole Foods nor Amazon has been greatly improved by the union. This would at least partly undermine Jain’s contention that Amazon entering the food business is some kind of model for tech in healthcare. (Brian Too)

I once had requested additional Epic certifications and had a manager tell me that the industry didn’t really look at Epic certifications. I really had to try hard not to laugh at her, but I’m sure she knew that I knew she was lying to me. Epic still makes certifications hard and expensive to get oth as revenue, and to try to support their Epic Boost boondoggle. Customers, meanwhile are okay with preventing the FTEs from getting additional certs because then they can go out the door for more money. (Fourth Hansen Brother)

[The CEO interviewing the final job candidate before they are hired] is to give all employees a personal face of the CEO. All companies, no exclusions, sometimes do stupid things. In a culture where employees do not dare to speak out to top management about this, it may linger for far too long. My idea is that if everyone has seen me personally, they will also dare to call or email me personally if there is something stupid going on that I need to know about in order to fix it. And lastly, it shows that we value all people in the company. (Torbjörn Kronander, CEO, Sectra)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Mr. E in Muskegon, MI, who asked for a digital microscope for his middle school charter academy class. He reports, “Thank you for your support of our science lab and for believing in our young scientists! Because of your support, our middle school science classroom is beginning to resemble a real science lab! Our scholars are loving the lab coats and the microscopes. They say things like, ‘When I grow up I’m going to get me one of these lab coats, with my name on it right here.’ They are learning all about lab safety and how to use science tools safely and accurately. Most importantly, their enthusiasm for learning science is growing more and more every day! THANK YOU!”

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The parents of a newborn sue MercyOne Des Moines Medical Center after a stranger enters the NICU , feeds and changes their baby, and then asks nurses “inappropriate questions” about the baby’s care.

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A Washington, DC program in which 911 medical calls are triaged by nurses has diverted 17,000 of 47,000 callers away from the ED, with 24×7 RNs reviewing their symptoms and offering to schedule a clinic appointment and arrange Uber rides both ways for non-emergent situations.

A psychiatric registered nurse practitioner faces 22 felony charges of prescribing prescriptions illegally and for billing an insurer for the time she spent having sex with a patient. And in Michigan, a prison nurse is charged with a felony for allowing inmates to touch her sexually while she provided medical services to them, which staff discovered from the number of inmates who requested her personally.

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A New York ophthalmologist sues a meat shop that wouldn’t sell him a steak because he refused to wear a mask as state law required at the time. David Kwiat, MD also wants the store’s proprietor brought up on charges of committing a hate crime and practicing medicine and law without a license. Asked by a reporter if he wears a mask while performing surgery, the doctor admitted that he does, but it gives him a headache.


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Weekender 2/11/22

February 11, 2022 Weekender No Comments

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Weekly News Recap

  • AndHealth, founded by CoverMyMeds co-founder Matt Scantland, exists stealth mode and raises $57 million in funding.
  • Germany-based Ada expands its Series B round to $120 million and plans aggressive expansion to the US.
  • Senators form a commission to consider updating HIPAA.
  • Best in KLAS named.
  • NThrive will acquire Pelitas.
  • Premier reports Q2 results.

Best Reader Comments

I have been interviewed by the CEO of a company once, and I walked away from it thinking “what do you actually *do* that this is how you spend your time?” To me it indicates poor leadership and an inability or unwillingness to build a team that can do the job independently. (HIT Girl)

I sometimes wonder if the unspoken role of the EMR is to remind and support the clinicians. What did they do, when did they do it, and why? As long as your capability includes interviewing the clinicians, maybe an incomplete EMR/EHR isn’t the worst thing. POC activities can continue. However the higher level goals we set, including Population Health surveys? Those typically mean that interviews of the onsite clinicians are too slow and introduce unwanted errors into the process. (Brian Too)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. M in Phoenix, who asked for headphones for her second grade class. She reports, “These headphones have made a huge difference for learning and our classroom environment. Students now have access to accommodations and differentiation when utilizing our online programs. As well, it helps keep our classroom environment quieter and peaceful when using our technology. We are so thankful for these! We use them every day! Thank you for supporting our classroom!”

A Florida doctor claims that he was duped by the owner of a sober living facility who is accused of insurance fraud in having the doctor order 30,000 urine tests as the facility’s medical director – the owner called them “liquid gold”– that netted the owner $31 million.

Doctors and advanced practice registered nurses in Tennessee argue over a pending state bill that would eliminate the existing requirement that doctors sign off on 20% of the charts of APRNs every 30 days. Nurses say the requirement means patients are paying for the time of a doctor they didn’t see and nurses are restricted from opening independent practices in rural areas, while the Tennessee Medical Association says nurses would rather live in cities just like doctors anyway. Tennessee is one of 26 states that require chart review.

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The state of Oklahoma is paying an unnamed doctor$15,000 for each prisoner who is executed under the state’s death penalty. The doctor doesn’t actually administer the drugs used – they start the IV and verify that the correct drugs have been prepared. The doctor also earns $1,000 per day for attending weekly training.

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Alamance Regional Hospital (NC) welcomes 25 National Guard troops who will help the hospital deal with staffing shortages.

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Epic employee volunteers create handmade Valentine’s Day cards for the 300 people who are serviced by SSM Health’s Meals on Wheels program.


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Weekender 1/28/22

January 28, 2022 Weekender No Comments

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Weekly News Recap

  • The DoD goes live on MHS Genesis in Texas, increasing its overall deployment level to 38%.
  • NextGen Healthcare’s Q3 results beat earnings expectations.
  • ADHD therapy app vendor Akili Interactive announces plans to go public via a SPAC merger at a valuation of $1 billion.
  • ViVE announces COVID attendance requirements for its March 6-9 conference in Miami Beach.
  • Change Healthcare is considering selling some of its assets to avoid competitive concerns about its acquisition by UnitedHealth Group.
  • Cerner lists golden parachute payouts of $11 million to $22 million for executives who could lose their jobs after Oracle’s acquisition.
  • IBM signs a deal to much of its Watson Health business to private equity firm Francisco Partners at a rumored price in the $1 billion range.
  • Analysis finds that two-thirds of payers have implemented provider directory APIs as required by CMS since last summer.

Best Reader Comments

Unless you already own a large share of an existing practice or have concierge connections, you [as a physician] can’t go solo anymore. Your compensation is dictated by bureaucratic rules; working harder doesn’t increase your compensation. So why work harder for the man? The professional class had the same experience a couple decades after the creation of the professional class post WWII. The solution is the same as it was then: Tune in, turn on, drop out. (IANAL)

I wish those [Cerner] golden parachutes functioned like anvils. (bob)

It’s hard to disagree with letting an individual doctor and patient determine their course of treatment. But in aggregate, that strategy has resulted in obscene amounts of duplicated, costly spending. For example, the US has insanely high prescription drug prices among developed countries. Specialty drugs for oncology are a disproportionately large part of that overspend and there has been billions of dollars spent on new oncology drugs that don’t work better than alternative treatments. Even the fact that patients see cancer drugs advertised on TV is itself insane and unique to the US. Since much of oncology treatment is billed to Medicare, ultimately the US taxpayer, and really the younger US taxpayer, pays for this enormous waste. Just a reminder to readers, 2030 is when the Medicare trust is going to be gone, and benefits will get cut or payroll taxes will go up. (IANAL)

Unfortunately, healthcare has tolerated vendors with 1990s fat client architectures, machine virtualization dependence, and other technical debt that removes any Cloud advantage, and won’t perform for AI. Rather than re-architecting the application, some are simply balling the whole mess up into a massive, expensive container that can’t spin up/down, there is still no “Cloud-scale.” Many are also seeing Artificial Intelligence as a further revenue opportunity – and their customers will be trapped into a single-threaded, horsepower-dependent model. For example, it will be interesting to see if Oracle re-platforms Cerner to increase performance and make it Cloud-agnostic, or if it is simply a one-way ticket to buying the Oracle Cloud – what’s your bet? (Jay)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of fourth-year teacher Ms. G in Chicago, who asked for math bingo games for her elementary school class. She says, “Math Bingo was a hit, to say the least! Classmates were challenging one another while laughing and enjoying their time together. The multiplication and division machine also helped me collect data, notice patterns of strengths and weaknesses, and allow me to further help students through differentiation.”

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A former photojournalist who is now a nurse at MUSC documents the care of COVID-19 patients with the permission of the hospital, the patients, and their families.

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Cleveland Clinic thanks the 20 US Air Force clinicians who are working side by side with its COVID-overwhelmed caregivers.

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Fans of the NFL’s Kansas City Chiefs, which eliminated the Buffalo Bills from the playoffs in an overtime win Sunday, donate $400,000 to Buffalo’s Oishei Children’s Hospital.


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Weekender 1/21/22

January 21, 2022 Weekender 1 Comment

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Weekly News Recap

  • Quest Diagnostics will acquire Pack Health.
  • Big funding is announced for Lyra Health, Gale Healthcare Solutions, Big Health, Wheel, and Verana Health.
  • Babylon acquires DayToDay Health.
  • ONC and The Sequoia Project publish TEFCA.
  • CliniSys acquires Horizon, combines with Sunquest to operate under the CliniSys name.
  • VA pushes its second Cerner go-live back due to staff shortages.
  • MPulse Mobile acquires HealthCrowd.
  • CHIME launches the degree-granting CHIME University.

Best Reader Comments

At its core, Blockchain is a database. It is the slowest database ever invented due to the need to write multiple entries for every read or write transaction. Therefore it has no place in a fast paced healthcare environment. Anyone who thinks otherwise needs to spend 10 minutes with a busy physician. (Was A Community Hospital CIO)

For almost 20 years, I’ve been promoting a key factor he acknowledges. Rephrased it is “involve the patient in the decision loop through both price transparency and quality scores” so they can re-engage in their total healthcare. Our third-party payer system has kept patients, if not in the dark, at least in the shadows, and an informed patient will make better decisions. (David Wellons)

For all those reasons, the data that is used to train AI is, challenged at best, and crap at worst. You can get through the note and see what you need to see as a human today, but training up AI from that variation is nowhere near being ready. The last 10 years are rife with AI failures, but we keep thinking that without changing the underlying data and data failure causalities, we will get a different result. (J Brody Brodock)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. K, who asked for Kids First Robot Engineering Kits for her STEM class in S. Ozone Park, NY. She reports, “These cute robot engineering kits are a big hit with the little ones! My kindergarten and first-grade students jumped right in with these robot kits. They seemed to know what to do immediately. There is a book that comes with the kit to show what to do, but they were so excited to build their robots themselves, without any help. Thank you so much for making this possible! I am so happy to have new and exciting materials for my students to use and to make coding and engineering so much fun!”

Oregon has 10% of its available hospital beds occupied by patients who are ready to be discharged, but have nowhere to go because long-term care facilities are too short-staffed to accept them.

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Minnesota signs a pandemic staffing deal that will pay a private company $275 and more per hour for temporary nurses, $345 per day for living expenses, and 1.5 times the hourly rate for overtime and double for holidays, courtesy of federal taxpayers who are footing the bill. Providing the help is Galveston-based construction company SLS, which has earned billions from post-hurricane cleanup, construction of President Trump’s border wall, and the opening of several expensive COVID-19 field hospitals that saw virtually no patients while their doctors sat around making $900 per hour.

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Penn radiologist Saurabh Jha, MD, self-proclaimed as the “first Indian Radiologist-General of the USA,” has good Twitter thoughts and a fun quote from this piece:

It’s tempting to conclude that we’ve lost all f**ing perspective. But lack of perspective isn’t the whole story. The reality is that we’re thoroughly bored – a side effect of affluence. This is why we have revolutions in our heads and fight wars on our devices. We storm the Bastille without moving from our couches. Instead of calling each other Nazis, we could just as well say “whatever,” press the mute button, and roll our eyes.


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Weekender 1/14/22

January 14, 2022 Weekender No Comments

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Weekly News Recap

  • Report says that a private equity firm is close to acquiring urgent care EHR vendor Experity for $1.2 billion.
  • Ambient patient-physician voice scribing solution vendor DeepScribe raises $30 million.
  • Data exchange platform vendor Avaneer Health raises $50 million in seed funding.
  • Hospital-at-home technology and services vendor Medically Home raises $110 million.
  • DexCare raises $50 million.
  • HIMSS announces that masks will be required throughout the HIMSS22 campus.
  • PerfectServe acquires AnesthesiaGo.
  • Transcarent raises $200 million in Series C funding.
  • Clinical collaboration platform vendor TigerConnect raises $300 million in funding.
  • Aledade acquires care planning solutions vendor Iris Healthcare.
  • R1 RCM signs an agreement to acquire competitor Cloudmed for $4.1 billion.
  • Qlik files for an IPO six years after being taken private for $3 billion.
  • Stryker will acquire Vocera for $3 billion.

Best Reader Comments

Algorithm-assisted decisions will reduce that systemic bias + noise and will lead to higher quality diagnosis (and do it with better predictive capabilities for more upstream care). Of course, nobody is denying that for this to happen at scale, data quality, transparency in algorithm development process, awareness of clinical applicability etc. will all need to improve and the industry will do well to stay clear of AI/ML snake oil peddlers. Thoughtful visionaries will create and own that future – just like they always have. (Vikas Chowdhry)

Thirty years in healthcare IT implementations has taught me that hospital ABC can implement BestEverSystem and have great outcomes and usage, and hospital XYZ installs same system, but is a colossal failure. Other countries have managed [COVID-19] testing quite well, according to family that has experience with it. I’m sad to see the missteps US has taken, but I don’t think it’s intentional, just lack of experience in true public / social health environment. It’s obvious when they say “every health insurer has to provide 8 tests per person per month” that they have no idea what they are doing. Insurers should have zero to do with it, in my opinion. (ABCs)

#America – where there is a need for a service that helps patients who have the audacity to try to not die from cancer a way to declare bankruptcy. (Dales Brian)

The “line of people” and the “something” in this statement are a generalization and assumption of context. The people may not have nor want a technology-based solution that delivers the “something” without participating in a line. If a technology has been applied already and that results in a line, is the line formed because of a new demand for the “something” that would not have otherwise been available without technology? It would be better to restate as a question; Does a physical line of people waiting for something present an opportunity for technology to meet a need? (Paul Klehn)

What gives us common cause? Why do we bond as human beings? Where does the impetus to cooperate come from? As long as the answers to those questions keeps coming back to “you have to,” “your employer says so,” and “your paycheque requires it,” there is an element of compulsion involved. It also encourages a transactional environment. You are now a replaceable (and optional) cog in a machine. Good teamwork is not based upon these elements. The odd bit is that, rationally speaking, almost any corporate life involves being replaceable. You are certainly performing a bunch of activities for money. However if that is all that you are, it’s demoralizing and dehumanizing. Most people perform better if they are not slotted into transactional boxes. (Brian Too)

It’s 2022. “Hallway interaction” happens via Teams, Slack, and other random interactions that didn’t exist even five years ago. Culture is built via action and example, and always has been – not dreary in-person meetings reciting corporate values. If you can’t manage without physically being able to walk to someone’s workspace to check up on your employees, you probably weren’t an effective manager. I may be biased as an under-40 executive, but the atmosphere and culture at a work from home-optional company has been way better than the billion dollar company that preached culture every day that I left a few years back when they couldn’t adapt.(Leonard Shelby)

Slack is a very poor substitute for hallways and water coolers. Social engagement between peers outside of a work context is very hard to nurture in a remote setting … The atmosphere and culture may be better in a remote company, but correlation is not causation. In my personal experience between an billion-dollar company and a remote company, confounding factors were that the remote-first company was younger, smaller, more modern, had a much smaller and easier to change product, and had an executive tier that was more accessible to the average Joe. Being remote may have positive impacts on culture directly also, as well as on equity. It may be harder to forge an old boys club when they can’t rendezvous at the golf course. (MoreNuancedRemoter)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. T, whose Buffalo, NY first-grade class of 15 dual-language students is split into eight who are doing in-person learning and seven who are learning remotely. She reports, “This document camera has been a great tool for me to teach my students without having to share books and having students sit next to each other on this difficult time we are living with the pandemic and social distancing. Students have improved drastically because I can show not only one student, but the whole class how to solve math problems, write words, read spelling words, and practice all together by sharing the document.”

A UK doctor loses his license for using a cauterization tool to burn his initials onto livers he had transplanted.

Thirteen people, including two physicians, are arrested for their involvement in a $100 million insurance fraud scam in which 911 operators and hospital employees were bribed to provide information about car accident victims, who were then referred to doctors who ordered unnecessary treatments. The defendants took advantage of New York and New Jersey laws require auto insurance companies to pay all medical bills under their no-fault laws.


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Weekender 1/7/22

January 7, 2022 Weekender 6 Comments

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Weekly News Recap

  • Stryker announces that it will acquire Vocera for $3 billion.
  • Vera Whole Health signs a deal to acquire Castlight Health for $370 million.
  • Nomi Health acquires Artemis Health for $200 million.
  • Babylon Health acquires Higi.
  • Report: IBM is again trying to sell Watson Health for $1 billion.
  • Symplr will acquire Midas Health Analytics Solutions from Conduent for $340 million.
  • Theranos founder Elizabeth Holmes is found guilty of four counts of investor fraud.
  • Health systems report labor problems caused by underpaying employees due to the weeks-long, ransomware-related downtime of payroll system vendor Kronos.

Best Reader Comments

Thanks for noting the important role that pathologists have had in developing health information systems. I’m not a pathologist but, during my training, I had the privilege of working with Dr. George Gantner, the St. Louis City and County Medical Examiner, who was a giant of forensic pathology. It was only many years later when I got into medical informatics that I learned he was also involved with the evolution of the Systematized Nomenclature of Pathology (SNP) into SNOMED! (Path Fan)

I wonder how many end users these unmanaged [Higi] kiosks have. They seem to function as a fancy gadget for the sales team to trot out as an add on to another service. (IANAL)

What I see is that people who work from home feel they are more efficient at the expense of others who now have to fill in the gaps for them. 5 minute conversation across cubes to get something done, now requires emails being sent for a potential reply next day responding to questions with more questions. Some people are very good at that (responding to questions with questions) and very efficient. (Robo Writer)

There was a statistic from several years ago about the “cost” of interruptions for programmers, and the surveyor calculated that it costs 28 minutes of productivity for each interruption, due to mental context-switching. If we’re going to go down that spoke, I’d be curious to see how people’s answers correlate with the type of work they do. I would bet that people whose jobs are task-oriented find WFH (theirs or their colleagues) difficult while people who work in programming, research, or other types of work that require silence and long stretches of uninterrupted thought are having a much better time in an isolated environment. (HIT Girl)

Holmes: There’s a lot of talk about the “fake it until you can make it” mind set of Silicon Valley startups. Boo-hoo when VC firms and high net-worth individuals fall for a con. Her downfall was outright lying about the accuracy of critical medical tests. Time for jail when you knowingly and repeatedly put patients lives at risk. (AnotherDave)

I truly believe Epic is the best solution in the market. My only concern is that Epic is most innovative when responding to Cerner development. I’m worried a one horse race will slow down the pace of improvement. Meditech just isn’t a strong enough threat to spur Epic on to greatness. We need more competition to prevent stagnation. (Competition Please)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of STEM science teacher Ms. K in S. Ozone Park, NY, who asked for programmable robots for her elementary school class. She reports, “Having a Blue-Bot Robot in my STEM classroom makes a huge difference! Students have been learning how to code. Blue-Bot lights up and makes sounds. You can see inside of it, which the students all really love. Thank you so much for giving me the chance to expose my students to cool robots like this one and for them to have such a great time!”

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Hospital employees refer to a newborn as “the Tesla baby” whose parents rushed to the hospital with their Tesla placed in autopilot mode so the father could assist his laboring wife during the 20-minute rush hour drive.

Lake Superior State University publishes its annual list of annoying and overused words and phrases whose use should be banned:

  1. Wait, what?
  2. No worries.
  3. At the end of the day.
  4. That being said.
  5. Asking for a friend.
  6. Circle back.
  7. Deep dive.
  8. New normal.
  9. You’re on mute.
  10. Supply chain.

My nominations for next year:

  1. I did a thing.
  2. Hold my beer.
  3. I don’t usually post personal stuff on LinkedIn, but …
  4. I am humbled to announce …
  5. Hack.
  6. Imma.
  7. Leverage.
  8. Utilize.
  9. Unpack.
  10. That’s it. That’s the tweet.

A state hazmat team is called in to decontaminate the ED of Falmouth Hospital (MA) when discharged patient immediately overdosed outside the hospital, was brought back to the ED for treatment, and made seven police officers and staff members with whom he was fighting dizzy from fentanyl dust.

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A federal grand jury indicts the physician-owner of several rural North Carolina ENT clinics for fraudulently billing Medicare for $46 million worth of balloon sinuplasty surgeries, making her the top-paid provider of those services in the US even though her practices were not in a major metropolitan area. Anita Jackson, MD — whose LinkedIn lists degrees from Princeton, Stanford, and Harvard; played a key role in Durham County’s COVID-19 response; and was appointed to the state’s Medical Care Commission – promised patients they would owe no co-pay and also re-used the single-use devices without their knowledge, according to the charges.

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The Seattle and Vancouver hockey teams donate $10,000 to 22-year-old crisis hotline intervention specialist Nadia Popovici, who urged a Vancouver equipment manager to see a doctor about a mole she saw on his neck that appeared cancerous. His doctor removed a melanoma that could have killed him within 4-5 years. The Vancouver Canucks tracked Popovici down via social media and brought her to a game to give her a $10,000 scholarship to medical school, which she will attend in the fall once she decides which of the two that have accepted her to attend.


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Weekender 12/10/21

December 10, 2021 Weekender No Comments

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Weekly News Recap

  • Ambient clinical documentation vendor Robin raises $50 million.
  • Cerebral raises $300 million.
  • Report: Cotiviti is for sale.
  • Claroty uses $400 million in new funding to acquire healthcare IoT vendor Medigate.
  • Amazon’s Comprehend Medical NLP service adds SNOMED-CT support and cuts API usage prices by up to 90%.
  • The Spokane newspaper calls out problems with the VA’s Cerner implementation at Mann-Grandstaff Medical Center.
  • BDO USA acquires Culbert Healthcare Solutions.
  • Fortive will acquire specialty EHR vendor Provation for $1.425 billion.
  • Netsmart acquires Remarkable Health.

Best Reader Comments

No Surprises Act – “Seems to place a heavy burden on provider administrative staff.” Well, the existing system has placed a pretty hefty burden on patients who have gotten nasty surprise bills. Maybe this will be the incentive for insurers and administrative staff to figure it out. (Bob)

We do a lot of credentialing for providers and the payer systems do not all update from credentialing in any sort of timely manner. A provider may be credentialed but not showing as such in their EDI database. This will be an administrative challenge [under the No Surprises Act] for sure! (Practice Admin)

The real problem is, nobody is going to pay for the things that help doctors take better care of their patients, unless there is an ROI associated with it .. There are a lot of smart and creative people in healthcare IT with a lot of really good ideas who want to do the right thing, but none of us work for free and that’s what it all comes down to at the end of the day. (HIT Girl)

This quote towards the end: “What Cerner does best is capture billable events via exhaustive questions and back-and-forth as you input things.” Reminds me of a conversation I had with my doc at then Partners Healthcare after they went live with Cerner’s major competitor. My doc echoed the same sentiment in saying to me: “It’s a good system for billing I guess, but does nothing for me in helping to care for my patients.” Sad testament to our massive efforts to digitize health. It’s a slow slog. (John Moore)

“What Cerner does best is capture billable events via exhaustive questions and back-and-forth as you input things .. They’re very meaningful to a commercial organization, because that’s how they get paid, but they’re meaningless to the VA.” Well, they’re not meaningful to the actual healthcare providers in the commercial organization. So the problem, although admittedly large in the VA context, is really universal, namely trying to organize clinical information and reasoning using “billing systems with text editors tacked on.” (Robert David Lafsky)


Watercooler Talk Tidbits

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Do you know who just helped classrooms in need? Bill, that’s who – his generous donation plus matching funds included those provided by my Anonymous Vendor Executive fully paid to fulfill these Donors Choose teacher grant requests:

  • Robotic engineering kits and books for Ms. K’s STEM elementary school class in S. Ozone Park, NY.
  • A digital microscope for Mr. E’s middle school class in Muskegon, MI.
  • STEM reading and match activities for Ms. A’s middle school class in Hawthorne, CA.
  • Headphones for Ms. M’s second grade class in Phoenix, AZ.

ProPublica investigates how billionaires can write off hundreds of millions of dollars in losses from their hobbies, such as purebred horse racing, to reduce their tax bill.The article mentions healthcare billionaire Patrick Soon-Shiong, who hasn’t paid federal taxes in five consecutive years despite having earned nearly $900 million in the past eight years, although his example was more of tax sheltering than hobby losses. 

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The LA Times (owned by Patrick Soon-Shiong, with losses deducted from his taxes per the item above) obtains screen shots of Scripps Memorial Hospital using Epic to mark up supply prices by several hundred percent. Sutures that cost $20 were priced at $150 and $99 surgical blades had a price of $665. The hospital responded to the newspaper’s inquiries by confirming the accuracy of the prices, but characterizing itself as the victim of a system in which insurers decide how much of the list price they will pay. The reporter previously notes that Scripps billed a patient $80,000 for a procedure that Medicare says should cost $6,000, with the inflated price covering Scripps-imposed “technical service charges” for the room, equipment, and staff.

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The University of Texas’s Hogg Foundation for Mental Health provides a $260,000 grant to digitize and preserve the records of the the state’s first mental illness hospital, the State Lunatic Asylum, which was opened in 1861. All its buildings have been torn down except for its main building, which is a Texas Historic Landmark. A new Austin State Hospital, which will open in November 2023, will have the same number of beds (240) at a cost of $305 million. The records will be preserved for families who can review the records with the approval of the state HHS institutional review board. The hospital’s daily occupancy peaked at 3,330 in 1968 before the implementation of Medicare changed views on mental health beyond locking people up. Similar preservation work was done with the records of Virginia’s Central Lunatic Asylum for Colored Insane, which had a large percentage of black Americans as patients who were admitted for not adequately respecting whites or for being in the wrong place at the wrong time.

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The father of University of Montana senior Danny Burton played football there, while his mother graduated from the university’s pharmacy school. Burton is doing both – “Doctor Dan” plays wide receiver for the football team and will complete his pharmacy doctorate in May. 


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Weekender 12/3/21

December 3, 2021 Weekender 1 Comment

weekender 


Weekly News Recap

  • Nordic acquires S&P Consultants.
  • A private equity firm will acquire CNSI.
  • The VA revises its Cerner implementation timeline to restart the project in early 2022 and complete the rollout in 2024.
  • A new investment values Iodine Software at $1 billion.
  • HHS OCR settles with five providers who failed to give patients timely access to their medical records.
  • Greenway Health promotes President Pratap Sarker to CEO.
  • FDA forces Owlet to stop selling unapproved baby socks that monitor vital signs and sleep patterns.
  • Best Buy discloses that its October acquisition of remote patient monitoring technology vendor Current Health cost $400 million in cash.

Best Reader Comments

Thank you for honoring our dear Dr. Virginia K. Saba. She was a colleague, educator, mentor, and friend to many. Her influence is international. Her work will carry on through the multitude of nurses and others she has mentored. Dr. Saba promoted her Clinical Care Classification to the very end. Her legacy also will continue with two named awards that she endowed administered by Sigma and AMIA. (Susan K. Newbold)

Re: The WSJ Article: I think one of the takeaways from that article is that operations, both clinical and business, needs to take ownership of their role in decision-making, priorities, strategy, etc. In a lot of organizations (including my own), I don’t see this happening well. Many departments are fine with throwing things over the wall as an “IS problem” instead of an organizational problem. That puts IS (or IT) in a bad spot and enforces the image of IS being a barrier. (Ralphie)

Fast Forward 10 years: new WSJ.com Headline – “Decentralized IT Departments are Dead – Centralized IT Could Solve Fragmentation and Interoperability Issues.” (HITPM)

I think getting into healthcare regulatory reporting software would make a ton of sense for InterSsystems. InterSystems has an existing relationship with almost every health system running Epic. InterSystems has an integration product, and the majority of the work in integration projects are related to understanding the organizations data and understanding the organizations process. If you do regulatory software, you also have to do the work to understand data and processes in order to compare that to what the government expects. (IANAL)

If you implemented distributed IT at my employers, the result would be an unsatisfactory mess. Some few departments would be organized and effective. The majority would be rather distracted and neglectful  (IT is neither their interest nor their core competency). A few would do the absolute minimum, which might mean they do nothing at all. Most companies wind up with a central IT department. I don’t think that’s an accident. Truly distributed businesses are a rarity; trying to shoe-horn in IT as distributed, when everything else is centralized? It’s a culture clash and a recipe for big problems. It’s one thing to identify a problem, WSJ. It’s quite another to recommend a solution which will be helpful. (Brian Too)

About that WSJ article. I take EXTREME exception to the author’s assertion about the type of people that work in healthcare IT. I can tell you most, if not all that I have worked with do so because of the greater good and being part of something that matters. (Justa CIO)

Having acknowledged those failures, the wheels didn’t come off [on Athenahealth] until Elliott got rid of Bush, through questionable means, and forced an acquisition. It’s extremely charitable to call Elliot’s involvement merely “applying discipline.” Hundreds of employees were laid off, which Bush and his management team initially refused to do. Benefits were scaled back. Products were cancelled. Market segments were eliminated. Investment in R&D was significantly reduced. Efficiencies and discipline that leads to greater shareholder value could have been achieved without going to those extremes. I’m of the opinion that shareholder interests are important, but they should be balanced by customer and employee interests. Elliot only realized those gains by prioritizing shareholder interests (and primarily their own, at that) over those of customers and employees  (who don’t have a voice in the boardroom, of course). So who won in the end? Certainly not customers. (Ex-Athena)

Elliott did quite a bit better than 3x on its investment [in Athenahealth]. The original deal was funded with about $4.8B of debt and $1B of equity from the hedge fund sponsors. Add in the acquisition cost of Centricity (call it $500M of equity, $500M of debt) and the equity investors are all-in with $1.5B of equity and $5.3B of debt. They sold off some assets for a total of ~$600M in cash, so net equity in play is $900M. They turned that equity into $11.7B (assuming no interim debt pay down), which is a 13x return. 13x feels ridiculous, but if you’d invested that same levered-up $6.8B in the Nasdaq (QQQ) on the same timeline (Elliott began buying ATHN in spring 2017), you could sell today for $18.1B. Absurd as this whole deal sounds, it has actually underperformed the market. This story is more about tech multiple expansion/bubble broadly than it is about improving management or running the business. (Debtor)


Watercooler Talk Tidbits

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Generous “Giving Tuesday” donations from Vicki and Mark (Mark’s was made in honor of the IT professionals of Atlantic Health System), with matching money from several sources along with my Anonymous Vendor Executive, allowed me to fully fund these teacher projects, nearly all of which involve historically underfunded schools:

  • A drawing tablet for Mr. M’s middle school science class in Hemet, CA.
  • A programmable robot for Ms. K’s STEM computer science class in S. Ozone Park, NY.
  • Science books and resources for Ms. H’s middle school class in Hattiesburg, MS.
  • Computer science and robotics materials for Ms. H’s middle school class in Kissimmee, FL.
  • STEM kits for Ms. H’s first grade class in Escondido, CA.
  • A makerspace for Ms. G’s elementary school library in Paterson, NJ.
  • An all-in-one printer, fax, and scanner for school nurse Ms. U in Trenton, NJ.
  • AV presentation technology for Ms. M’s middle school class in New Castle, DE.
  • Learning station supplies for Ms. W’s middle school science class in San Marcos, TX.
  • Programmable robotics kits for Mr. N’s middle school class in San Antonio, TX.
  • Privacy boards and math flash cards for Ms. S’s elementary school class in Kittanning, PA.
  • Hands-on STEM materials for Ms. Z’s elementary school class in New Windsor, NY.
  • Headphones for Ms. H’s middle school class in Manassas, VA.
  • Inclusive STEM books for Ms. K’s middle school class in Las Vegas, NV.
  • Weighted hula hoops for the structured autism class of Ms. D in Laguna Niguel, CA.
  • Magnetic letters for Ms. G’s first grade  class in Philadelphia, PA.
  • Kites and balls for outdoor science learning for Ms. C’s elementary school class in Ryan, OK.
  • Online resources for the International Baccalaureate high school class of Ms. K in McAllen, TX.
  • Instructional resources for Ms. S’s high school class on Los Angeles, CA

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Ms. P checked in with an update on the projector and remote control presenter readers provided to her Baltimore elementary school via Donors Choose donations: “Thank you! The technology has really helped transform family events, classroom experiences, staff professional developments, and more. The projector has allowed me to project presentations that converted our learning. Students were able to see across the classroom the texts we were discussing, videos to supplement the work, and dance it out to ‘brain breaks.’ The projector was also utilized for family and student events. For example, students who had perfect attendance got to watch a movie with snacks and another time, we utilized the projector to share a presentation that discussed health to families. It was great! Instead of being hovered around a tiny computer screen or only having paper copies of the materials, we were able to create a view large enough for all to see! The most exciting part about receiving the items was seeing the students react! They were so grateful that people they never met and some they knew chose to donate to support them. They were appreciative that people cared about their education and making it fun. So thank you again for thinking of my kiddos!”

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Physicians are complaining that physician assistants – who say that their jobs haven’t required hands-on physician oversight for decades – are pushing to change their titles to “physician associates.” The AMA says the new name would confuse patients and is intended to position PA’s for independent practice. Another group pushing for a name change is the former American Association of Nurse Anesthetists (they changed the last word to “anesthesiology” last year), who said “anesthetist” was confusing to the public and hard to pronounce, but they note that the new title still labels them as nurses rather than physicians even though “we’re doing the lion’s share of anesthetics in this country.” Both name changes were chosen carefully to preserve the all-important existing abbreviations.

A South Carolina rehab center’s director of nursing is indicted on federal charges of creating phony COVID-19 vaccination cards, then lying to FBI and HHS. Her lawyer says she only made a couple of fake vaccination cards to “help” an anti-vaxxer family member.

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In Australia, a cosmetic surgeon who has 13 million TikTok followers is ordered to temporarily stop practicing medicine pending an investigation into issues with hygiene, safety, and surgical mistakes. Daniel Aronov, MBBS was also ordered to take down his social media accounts, which included photos of near-nude female patients and explicit lyrics. Australia allows anyone with a basic medical degree and no specific training – such as Dr. Aronov, who is a GP – to call themselves cosmetic surgeons.

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In Italy, a dentist is charged with fraud after a healthcare worker notices that the veinless arm that he bared for his COVID-19 shot was in fact artificial. The man, who was trying to obtain the country’s Green Pass that requires vaccination for most public activities, asked the worker to ignore his failed attempt and said, “Would you have imagined that I’d have such a physique?” The local newspaper speculates that he bought a male chest suit from Amazon since someone commented on that listing in Italian, “If I go with this, will they notice? Maybe beneath the silicone I’ll even put on some extra clothes to avoid the needle reaching my real arm.”


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Weekender 11/19/21

November 19, 2021 Weekender 2 Comments

weekender 


Weekly News Recap

  • Athenahealth’s private equity owners are reportedly in final discussions to sell the company for up to $20 billion.
  • Healthcare payment options platform vendor PayZen raises $15 million.
  • HIMSS estimates that modernizing public health IT systems will cost $30 billion.
  • The US Coast Guard completes its Cerner implementation.
  • Healthcare API company Ribbon Health raises $43.5 million.
  • QGenda acquires Schedule360.
  • Lightbeam Health Solutions acquires CareSignal.
  • Medidata Solutions co-founder Glen de Vries dies in a plane crash.

Best Reader Comments

[Amazon Care] sounds like how employees get care from their local doctor’s office through employer-provided insurance? Except with another megacorp inserted into the mix to soak up some healthcare dollars. I guess the home visits are unique but that will last only as long as the option doesn’t have any real utilization. (IANAL)

Just to be clear, Teladoc paid almost no cash for Livongo — about $11 cash a share which was then valued at $150. The rest was in stock. Still a great sale by Glen Tullman but there’s doubtless an alternative universe where the two companies are going after each other, with one paying up to build out a chronic care management operation and the other building a telehealth service. (Matthew Holt)

Medicine shouldn’t be a lousy job, but from what you write, it clearly is in many cases. I would think that telemedicine will become very common particularly in true health systems where providers across the whole system are using the same EHR – telemedicine, urgent care, ER, PCPs, specialists, and everyone else. I get my care from a such a system and it is comforting to know that however I need to get care for a particular thing, my up-to-date and comprehensive records will be available as long as I’m getting care in system. (West Coast Vendor Mgmt)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. D in Arkansas, who asked for supplies, furniture, and math kits for her special education high school class. She reports, “I can’t tell you how much your donations have impacted my class. Being in special education, I deal with a low budget and many needs. So many of them have excess energy and now they are able to fidget around on their new stools without disturbing others. This has given them the opportunity to focus on the assignment rather than being constantly distracted by being redirected for making noise. The analog clock has been used by every class as we work in calculating the time and the time difference in word problems. The foam bag is a favorite of every student! They can relax, read and enjoy a break from the typical chairs and tables. Our students learn best with hands-on activities and the construction paper has given us the ability to build and create scenes from books, work geometry, and bring numerous projects to life in science. We are forever grateful for your kind generosity and will pay you back with our success in the future as productive members of society.”

Hospitals in Israel are dealing with incidents of mass violence such as parking lot gunfights, mobs attempting to force their way into EDs that are treating crime victims, and a funeral that turned into a shootout in which participants then stormed a hospital.

CDC predicts that when total ICU bed capacity reaches 75% in the US, 12,000 excess deaths can be expected in the following two weeks, while exceeding 100% of ICU capacity could be associated with 80,000 excess deaths.

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Apple profiles Northwell Health’s use of T6, an IPad trauma care app that was previously used only by the military. The app’s name refers to the six hours in which a traumatic injury requires medical intervention to achieve the best outcome. Northwell Health trauma surgeon Omar Bholat, MD, MS – who is also an Army reserves command surgeon who has deployed on six combat tours – says, “T6 is going to help streamline the flow of data from the point of injury to the ICU and everywhere in between. That’s going to be huge for trauma medicine, whether that’s civilian or military.”


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Weekender 11/5/21

November 5, 2021 Weekender 1 Comment

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Weekly News Recap

  • Allscripts and Change Healthcare report quarterly results that beat earnings expectations but fall short on revenue.
  • EverCommerce announces that it will acquire DrChrono.
  • Worklfow automation vendor Notable raises $100 million in a Series B funding round.
  • CMS will increase the minimum penalty for hospitals that don’t comply with pricing transparency requirements to $10 per bed, per day starting on January 1, 2022.
  • 23andMe says it hasn’t decided how to integrate its recent acquisition of telehealth provider Lemonaid Health, but expects to incorporate genetic risk factors into its primary care prescribing.
  • A VA survey of employees at its initial Cerner implementation site find widespread worsening of morale, burnout, and lack of confidence in performing their jobs using Cerner, leading to the VA’s pledge to add executive oversight to the project.
  • Kareo and PatientPop merge to form Tebra.
  • Cerner and NextGen report quarterly results that beat expectations for revenue and earnings.
  • Cerner CEO David Feinberg addresses EHR usability and a tightening of less-profitable company products and partnerships in its quarterly earnings call.

Best Reader Comments

ECW is done, no group of size will consider them given their history with the ONC and DOJ. Ambulatory is a three headed race: NextGen, Allscripts, and Athena. And if you don’t want to outsource your billing and/or you want complete control over your data then Athena is out and it’s a two-headed race: Allscripts and NextGen. Yes, smaller market has a lot more competitors. Yes, when part of a hospital those deals automatically go to Epic / Cerner / Meditech / Allscripts. NextGen and Allscripts sitting pretty with cash, decades of data, and way less comp then three years ago. (Allscripts OUTSIDER)

Not sure why the Jonathan Bush post created that much “wake” this week (pardon the boat terminology). HIMSS isn’t any different from any large industry conference gathering including RSNA. Both are still dwarfed by the Consumer Electronics Show, too. HLTH is very well funded, run by experienced conference organizers, and benefited from a market right now (digital health) that is dealing with record inflows of funding. It isn’t some guerilla or boot-strapped effort run by industry outsiders. Probably rivals J.P. Morgan Healthcare Conference in SF right now for industry buzz and appeal to healthcare insiders. Just adding dental benefits to Medicare though would have a much more substantial and immediate impact than anything that comes out of the HLTH conference the next few years. (Lazlo Hollyfeld)

Telehealth is most likely to benefit patients by allowing patients to sidestep their local large medical groups and health systems. That really gets the hairs up on the medical establishment. The telehealth convenience aspects you discussed are very similar to how retail clinics shook out in the 2010s; consumer perceive retail clinics and telehealth to be strictly lower quality but the lower cost and convenience sometimes win out, especially within certain populations / conditions. There is only room for a couple players in this space who will have to have comparatively large scale and potentially with operations subsidized by another line of business. I don’t think any of the pandemic era entrants will survive long enough to challenge the existing participants.
I think what the money people are really interested in now is whether they can shake another business model innovation out of this tree. One model could be your insurance company employs your primary care provider who is readily available remotely. You trust this provider and they direct you to lower waste, lower cost, higher quality care. (IANAL)

Upcoding will always be a problem in the current payment model. Whatever is in the contract between the healthcare facility and the insurer will always trump short lived media attention. Whether it be state-owned hospitals sicking collections agents on their patients, massive hospital groups gobbling up competitors and driving prices up, or ruthlessly upcoding to extract as much revenue from the patient encounter as possible, the system financially rewards all of these behaviors. The hospitals give some discounts to patients exposed in the media, then quietly go about continuing mostly the same practices. (Elizabeth H. H. Holmes)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. S in New York, who asked for supplies to allow her first grade class to write letters and journal to offset all the time in front of Zoom and staying at home without siblings. She reports, “Thank you for the boost in letter writing! The children have been talking about their feelings, how they can be a good friend (while in COVID and at home), and have been excited by these extra materials that they have received. As you can see by their letters, they have been writing about how they can be kind, brave, responsible, honest, just to name a few. They are learning about making good choices and how to be great brothers, sisters, nieces, nephews, friends, and children. I have been teaching remotely to students via Zoom and I have to share with you how rewarding it is. They have been reading, writing, and wearing their capes to show their superpower! All of these activities are helping with expressing themselves. The families are so appreciative of all that we do and that YOU do! Thank you for your generosity and for enriching the lives of my children.”

A 65-year-old Utah man faces charges of posing as a doctor in selling medications and surgical procedures out of the basement of his house, which he limited to people who are in the US illegally. He diagnosed an undercover agent with multiple sclerosis, then offered to cure the condition for thousands of dollars in cash.

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A New York Times article describes how tribe-operated Alaska Native Medical Center (AK) offers patients native fare items such as moose, herring roe, and seal, all donated and prepared as an exception to USDA guidelines since commercial sale is not allowed. Natives weren’t raised on chicken noodle soup and sandwiches, so the hospital added dishes made with traditional ingredient as a connection to the patients it serves. Food Services Manager Cynthia Davis says, “I do not believe that people go into a hospital for a gastronomic experience. I believe that they’re in a hospital because they’re sick or in pain, and they need care. They want comfort foods, foods that someone made for them when they were younger,  someone who loved them and made it with love. And that is our role.”


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Weekender 10/29/21

October 29, 2021 Weekender No Comments

weekender 


Weekly News Recap

  • Northwell Health and Aegis Ventures create what they say will become a multi-billion dollar program for investing in seed-stage AI-driven healthcare companies.
  • Pharmacy fulfillment, diagnostics, and telemedicine company Truepill raises $142 million in funding at a valuation of $1.6 billion.
  • RCM platform vendor NThrive and its financial backer Clearlake Capital Group will acquire TransUnion Healthcare for $1.7 billion in cash.
  • Cerner launches Enviza, an operating unit that combines expertise from Cerner and its acquired real world data vendor Kantar Health.
  • Amazon launches Alexa Smart Properties for healthcare facilities.
  • Britain’s finance ministry will allocate $2.9 billion for technology improvements across the NHS.
  • Consumer DNA testing company 23andMe will acquire telemedicine and online pharmacy vendor Lemonaid for $400 million.
  • Medicare primary care provider Oak Street Health acquires RubiconMD, which offers PCPs electronic patient consults with specialists.
  • Shares in London-based digital health tools vendor Babylon Health closed their first day of trading Friday up 18% following its SPAC merger.

Best Reader Comments

I enjoyed HLTH, split time in sessions and networking with exhibitors. Safety protocol was solid. Also, got a haircut, why not? Came up with a “crazy enough it just might work” idea while in the chair. PS: barbers have a *lot* of inside info. (Dysf(n))

Since the subject you’ve raised is security, well security is surely an area requiring flexibility. Thus what do you implement? AES? ECC? What should the key length be? Do we need to worry about quantum decryption attacks? Did the NSA really weaken this or that algorithm, and if so, by how much? Who do you trust and why? Honestly, security can be one giant argument that never ends.(Brian Too)

I would guess half of people 18-35 have moved in the last couple years. Younger people have less time off work. They are on a high-deductible plan and primary care practices can’t tell them what they’ll have to pay (retail can). Wait times to get a visit are a couple months in many parts of the country, more if you are trying to establish a new relationship (which in turn will run the bill up over half a grand.) Younger people don’t have a chronic condition, so the immediate value of going in for a visit a few months from now is mostly based around screening. Overall, the costs and barriers to accessing the “country doctor” relationship are higher for younger people while the value and ability to pay is lower. It isn’t a youth “culture” thing; it’s just money. The incremental solution is the same as it has always been, absent major federal legislation. Dramatically increase the supply of people who can be PCPs. It’s well within state legislatures abilities and it is well within the physician industry’s power. In 40 years, all the living voters will have only ever had a transactional relationship with doctors, but the retired providers will have sold their practice to private equity, so the political backlash will be somebody else’s problem. (IANAL)

How many virtual primary care startups can the market support? (IANAL)

To quote Cady Heron from the timeless classic Mean Girls, “The limit does not exist” (at least not yet, but at some point these companies will have to make money). (Dales Brian)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. Y in California, who asked for an IPad to use as a document camera. She reports, “I am at a loss for words. I recently had to teach from home due to pandemic circumstances and I was not able to teach much math (specially) because I did not have a document camera to show my work and solve problems. The document camera I have at work is very blurry so even if I am in my classroom it is difficult for my students to see my notes. However, now with the document camera we are able to learn every day regardless of my setting and students are able to see my notes clearly. Thank you!”

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The organizer of a live autopsy event cancels its Halloween day stop in Seattle after authorities question the ethics of selling tickets for the public to watch autopsies performed on donated cadavers. Death Science charged $500 for its Portland show, which was held in a Marriott hotel conference room. The body came from Las Vegas-based for-profit company Med Ed Labs, which gives families the cremated remains of their loved ones, avoiding funeral costs in return for allowing company to sell the corpses for many thousands of dollars (Death Science would only say that it paid more than $10,000 for the body it used). Reporters who viewed the Portland event along with several dozen attendees noticed that a medical bracelet that listed the man’s name was still attached to the body. Downtown Courtyard Marriott cancelled the Seattle event after finding out that Death Science had misrepresented the gathering as a medical equipment training class.

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Boca Raton Regional Hospital Foundation refuses to comment on why its fundraiser for immunocompromised women is being held indoors with masks and vaccination optional. The headliner is former Dallas Cowboy Emmitt Smith, who tweeted photos last week showing him signing autographs unmasked at an event. An anonymous insider reports, “It’s typical Boca. When given the chance to have a glitzy event or keep people alive, the glitzy event will win every time. There is just no reason that a foundation with so much money, connected to a hospital, is hosting an in-person event right now.” The foundation, which holds $300 million in assets, earned unwanted publicity earlier this year for allegedly fast-tracking the vaccination of big donors.

A former Texas nurse is sentenced to death for killing four ICU patients who were recovering from heart surgery by injecting air into their arteries. Prosecutors played a recording of jailhouse phone conversations in which William Davis told his wife that the deaths were accidental and his only intention was extend the ICU stays of the patients so he could accrue overtime.


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Weekender 10/22/21

October 22, 2021 Weekender No Comments

weekender 


Weekly News Recap

  • Vanderbilt University Medical Center reports that patient-to-clinician messages doubled when it started posting lab results immediately to its patient portal as required by the Cures Act.
  • Virtual care company Babylon begins trading on the NYSE via a SPAC merger that values the company at $4 billion.
  • Microsoft enhances Cloud for Healthcare and Teams with expanded virtual visit capabilities.
  • General Catalyst and Jefferson Health form an innovation partnership in which the health system will use technologies from the venture capital firm’s Health Assurance Network of companies.
  • The merged Grand Rounds Health and Doctor on Demand rebrand as Included Health.
  • Transcarent announces that it will offer Walmart’s pharmacy services to its self-insured employer customers.

Best Reader Comments

Appreciate the shift in language from “follow the science” to “evidenced-based.” The latter may be less intimidating and widen the door for more shared decision making as the patient and provider collect and review the “evidence” together. (Quynh Tran)

Love it when someone relatively new to the industry has all the answers and calls out the “crooks in the room” who don’t have all the answers – or does have them but they don’t want to share them?! (Steve Ex Twitter)

Am I the only one who thinks that the ratio of “Innovation Conferences” to “actual implemented, at scale innovation” is probably the highest in our industry compared to other sectors? Somehow, other industries keep making my life better through innovation without needing to have some many innovation conferences :). What gives? (Ghost of Andromeda)

Can we talk about how pretty much all of the interoperability standards for healthcare are not secured? HL7 is not an inherently secure protocol. DICOM is not an inherently secure protocol. I don’t think X12 are inherently secure protocols either. The protocols don’t support any native encryption and have little to no authorization/authentication mechanisms. So our healthcare InfoSec friends basically have two overlapping options: 1) encapsulate these messages in a protocol that is secure; 2) Use network microsegmentation to limit which endpoints on your network are allowed to talk to your databases. The problem with #1 is that while it’s doable in theory, and there is even an RFC for doing this with X12, I haven’t seen any commercial products or solutions that implement it. (Elizabeth H. H. Holmes)

Correct that HL7 v2, DICOM, X12 etc. do not have security in the protocols themselves – they are routinely secured by microsegmentation as detailed. I’m not persuaded that it’s more mistake prone than the alternatives – and it’s at least easier to test (but does need testing). FHIR is different – it’s built on the the web stack in order to get web level security. But as the report shows, that requires actual commitment to security to get right. But #2: a commit to metasploit… sounds like a good idea for someone to do. (Grahame Grieve)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. K from Arizona, who asked for hands-on math learning tools for her special education class of fourth and fifth graders. She reports, “The materials have arrived, and my students have loved using them during virtual teaching and learning! Thank you for supporting education and helping students develop a love of math! These math materials are awesome at inspiring students to keep learning and to be able to visualize important math concepts.”

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TV show “The View” demotes its health and safety manager Nurse Wendy after two fully vaccinated hosts tested positive – apparently falsely –-for COVID-19 minutes before Vice-President Kamala Harris was scheduled to go on in late September. The hosts tested negative several times after the incident despite their original positive PCR test. Host Sunny Hostin was angered because her surgeon husband had to be pulled out of the OR because of her false positive and the incident required her medical information to be revealed without her authorization. The show had previously honored Wendy Livingston, RN with an extensive on-air tribute as a healthcare hero.

A Seattle man is indicted for impersonating a nurse for 10 years by stealing the identity of a former college classmate. He had been discovered and fired several times but kept finding new nurse jobs, most recently as a care home’s director of nursing.

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A hospital ED nurse wheels a stretcher to the helicopter ambulance only to see that the occupant is her boyfriend – who is also an ED nurse at the same hospital – who dropped to his knee to ask her to marry him. She said yes.


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Weekender 10/15/21

October 15, 2021 Weekender 3 Comments

weekender 


Weekly News Recap

  • Intelerad acquires Ambra.
  • Healthcare Triangle shares drop after IPO.
  • GetWellNetwork renames itself to Get Well.
  • A security researcher documents widespread security vulnerabilities in FHIR APIs.
  • Best Buy announces its planned acquisition of Current Health.
  • Cerner President and CEO David Feinberg, MD, MBA kicks off the virtual Cerner Health Conference with a call to “eliminate the noise in healthcare.”
  • SSM Health outsources services, including digital transformation and RCM, to Optum and will send 2,000 employees to the company.
  • The VA contracts for a year-long cost review of its Cerner implementation.

Best Reader Comments

The NPfIT attempted to build a system rather than buy one. My pet theory is that this is part of why the NHS failed with NPfIT. Having an existing system to implement automatically puts all sorts of conceptual stakes in the ground. You not only get the What will this system do, you also get the How and the Why laid out for you. Ultimately, this is why purchasing third-party software eclipsed homegrown systems. Well, that and the ability to spread the development costs around. (Brian Too)

I believe this announcement [of the VA’s 12-month Cerner implementation cost review] still requires far more of an explanation than was given. I think an explanation can be given that protects the identities and dignity of VA employees, but also makes it clear that changes are underway. This organization still serves a gigantic public need for a very valued constituency. Our veterans really do deserve a lifetime of strong support from the VA. I want to recognize that there is a lot of good work the VA does in fulfilling that mission. This project sounds like a corner where the VA may not be living its values. (Accountabilibuddy)

UHC is amassing a huge presence in healthcare (data, contracted patient lives, POC resources, etc), where they can use their position to control cost and access, much in the same way people fear digital companies like Google having access to large amounts of healthcare data. Your CIO audience should be concerned about the motives of these vendors, short and long term. They are in it to make money, many times at the expense of patients. (Susanna Stevens)

I don’t want to diminish [Seve] Job’s legacy in tech, because it is truly massive. That said, I think his early death is a good parable for Apple (and others) attempts to break into healthcare technology. Steve Jobs died because he thought he was smarter than oncologists who had studied cancer for years, and appeared to think he was smarter than the healthcare delivery system as a whole. Had Jobs pursued traditional treatment as soon as his cancer was detected, he would very likely be alive. He should be a very real warning to every startup and VC that thinks they are smarter than the people who have actually been doing it for their whole career. (Elizabeth H. H. Holmes)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. R in Oklahoma, who asked for a tripod stand and microphone for conducting virtual classes. She reports, “I am beyond blessed to have people like you continue to believe in the importance in education even during difficult times. Teaching online is difficult as it is, but knowing I have wonderful people like you who are willing to go the extra mile warms my heart and gives me the energy to keep doing the best I can for my students. Thank you once again and may God bless you for your contribution to this wonderful project.”

In England, an NHS nurse is fired for refusing psychiatric help after losing her lawsuit against a hospital that she claimed was secretly hypnotizing her, which she says caused headaches, breathing difficulty, uncontrollable flatulence, and unspecified attacks on her private parts.

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Harborview Medical Center (WA) nurse Guy Maddison, RN launches a podcast that interviews hospital workers about the challenges of caring for COVID patients. Maddison is also the bass player for Seattle cult grunge band Mudhoney.

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England’s Leeds Teaching Hospitals responds good naturedly to a sign’s spelling error that was called out on Twitter.


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Weekender 10/8/21

October 8, 2021 Weekender No Comments

weekender 


Weekly News Recap

  • Virgin Pulse announces that it will acquire Welltok.
  • Healthcare Triangle revises its $40 million IPO plans down to $21 million.
  • Carbon Health acquires remote patient monitoring tools vendor Alertive Healthcare.
  • Evolent Health acquires Vital Decisions.
  • Cerner launches RevElate, which will be its single go-forward patient accounting system.
  • Three large health systems launch Graphite Health, a non-profit that will help member organizations with digital health solutions.
  • Quality measurement and clinical intelligence platform vendor Apervita shuts down.
  • David Feinberg, MD, MBA takes the helm as president and CEO of Cerner.
  • Cerner, reversing its previous position, will require US employees to be vaccinated by December 8.

Best Reader Comments

If all that Jobs + Woz had done had been the Apple I & II, they would have been important. Add in the Mac and they became industry leaders. Now add to that the iPhone, iPod, Apple Music, iPad, and more. Jobs also had those interesting side projects of NeXT and Pixar. Thank goodness that Jobs didn’t fade away during Apple’s low point in the 1990s. (Brian Too)

Many people, especially those with serious mental illnesses, have very brittle illness, just like a brittle diabetic. No one would think of terminating a brittle diabetic from care just because their glucose levels are under control by one or more glucose measurements. So why are we even discussing the “benefits” of “measurement based care” in making quicker transitions and terminations of care for those with psychiatric disorders for whom we know that a stable consistent therapeutic alliance is just as important (if not more so) than in other clinical contexts. Perhaps, in addition to the other barriers to using patient reported outcomes in mental health treatment, clinicians are being understandably cautious in trying to protect their patients from even greater harm and outright discrimination and victimization by insurers and others. (Concerned clinician)

I don’t know anything about Apervita, but it seems like an extremely consulting heavy business, one that wants to be product-like. In my idea of consulting’s business model, lots of senior rock star consultants are the exact opposite of what you need for product-based consulting. Implementing quality measures seems very similar to the most common type of consulting business: implementing new accounting practices and performing accounting audits. The big accounting firms know that this work does not require rock stars. It requires a few senior people to sell to the C suite and verify juniors’ work, and it needs an army of juniors to do piles of grunt work for a manageable cost, which in turn necessitates a hiring pipeline so you always have a fresh crop of juniors to replace the attrition of juniors aging into seniors, being poached, or otherwise leaving. The most successful companies in the accounting consulting market are the ones who are the best at hiring and managing lots of juniors. (IANAL)

I tend to refer to HR, legal, and marketing as the “pink ghetto.” It’s unfortunate, really. It’s difficult to be CEO when you haven’t been responsible for P&L. (Pamela)

Will having someone with informatics experience directing the Joint Commission make it more or less likely that they will continue to (1) Demand more EHR documentation that doesn’t help patients but burns out clinical staff; (2) Require use of “evidence based” scales for which the evidence of actual benefit is weak (e.g. C-SSRS); (3) Terrorize organizations with the threat of impending visits while they are just trying to stay ahead of a raging pandemic. Yes, I understand that the Joint Commission is just doing what CMS tells them to audit, but it’s also clear that they have a neat little racket going, frightening organizations into paying for their consulting services in the hope of not getting dinged in the next visit. Has anyone actually examined the evidence that the CMS conditions of participation and the other Joint Commission requirements are actually worthwhile? Perhaps health care organizations should band together and just say no to JCAHO.  (Joint question)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. C in North Carolina, who asked for headphones and teacher motivational stamp for her combined kindergarten and first grade class. She reports, “Thank you so much for your generosity to our classroom. Our school has IPads that our students use for independent reading and lessons. With kindergarten and first grade students, they are able to have the iPad read aloud to them. Unfortunately it becomes very disruptive for the students to focus on their lesson when the student next to them is listening to a lesson. The headphones allow the students to focus on their own lesson. Focusing on their own lessons and reading will allow them to be more successful in the classroom.”

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A Virginia woman’s tweet earns puzzlement and scorn for the US health system from Twitter users in other countries who understandably misinterpret the hospital’s charge description for CPT 96127,  a short mental screening questionnaire whose full description is “brief emotional / behavioral assessment.” Those Twitter users are directionally correct in their brief emotion at how our health system differs so wildly from theirs and the rest of the civilized world – a company has turned CPT 96127 into a business by selling quiz software that doctors can use to generate up to four of the charge items per patient visit.

Federal agents arrest 18 former professional basketball players who are charged with defrauding the NBA out of $4 million by submitting fake medical claims for reimbursement. They were caught because of mistakes they made in creating the claims, such as one player claiming that he had dental work in Beverly Hills during a week he was playing in Taiwan. Others may have recalled their college days when they copied each other’s claims, with multiple players declaring that they had the same dental procedures performed on the same six teeth on the same days. 

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A St. Louis children’s hospital doctor follows through on her promise to a nine-year-old with aplastic anemia that if a bone marrow transplant caused the girl’s hair to fall out, she would shave her own head. She even let the patient do the honors.


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Weekender 10/1/21

October 1, 2021 Weekender 2 Comments

weekender 


Weekly News Recap

  • Microsoft invests in Truveta, the health system-owned data-selling company.
  • Walgreens is rumored to be considering the acquisition of Evolent Health.
  • A GAO report says three big donors of President Trump violated federal law by exerting improper influence on VA decisions, including their recommendation that the VA sell patient data.
  • Walmart announces that it will implement Epic across all of its health and wellness business lines.
  • ONC finds that third-party health apps have been slow to adopt the HL7 FHIR standard as mandated by the Cures Act.
  • Clinical research network vendor Elligo Health Research raises $135 million in a Series E funding round, with existing investor Cerner participating.

Best Reader Comments

I have long noticed when you run updates on promotions that the women featured are most often in HR, marketing, maybe legal, or some lesser important department. Rarely are they sales, CEO, or finance. Sorry, but there is still a very rampant Bro Culture out there. Don’t believe me? Ask your female staff! (JT)

I have asked Truveta if they will allow me to be removed from de-identified data sets and I have asked two participating healthcare organizations if they would remove me from their data submissions to Truveta. Only one organization responded, and they did not address the question. (Concerned_Patient)

A $20 billion valuation for Athena seems strange when you look at comparable companies. If I had to pick some companies that are in the same business as Athena, I would pick Allscripts, NextGen and R1 RCM. Adding up the valuations of those companies is maybe $8 or $9 billion. It’s hard to gauge Athena’s growth since they went private and everybody seems to have stopped publishing stats on outpatient EMR vendors. I get the sense their business improved, but more because the company started to be run more efficiently, not that they are blowing the other vendors out of the water on market share. (IANAL)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. S in California, who asked for headphones to support distance learning for her elementary school class. She reported in December, “Your generous donation has made an impact on my students’ lives. Due to distance learning, focusing has become a major challenge, as not all students have equal access to a calm, quiet, and safe learning environment. Access to headphones has made the task of focusing much easier. My students are incredibly thankful to you.”

A woman sues Springhill Medical Center (AL), claiming that ransomware-caused downtime prevented doctors and nurses from noticing test results that would have told them that her unborn baby’s umbilical cord was wrapped around its neck. The baby was born in July 2017 with brain damage and died in April 2020. She says the hospital should have disclosed its IT problems so she could have gone elsewhere for delivery. The hospital has made 678 objections for 88 document requests from the woman’s attorneys, arguing that its records are protected by Alabama medical liability laws. The woman’s lawyers say the records are needed to prove the hospital’s assertion that the downtime didn’t affect patient care.

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Cox Medical Center (MO) will issue panic buttons to 400 nurses and other employers after assaults by patients tripled to 123 in 2020, causing 78 injuries. The article didn’t mention the product, but I think it is Midmark’s real-time locating system Clearview badge.

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Hedge fund billionaire Leon Cooperman and his wife donate $100 million to Saint Barnabas Medical Center (NJ), for which the 597-bed hospital which will rename itself Cooperman Barnabas Medical Center. Cooperman hopes their donation will “improve the human condition.” The couple donated $25 million to the hospital in 2017 to create a 241,000 square foot expansion that was named after them.

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Federal agents seize 600,000 counterfeit 3M N95 masks from a Detroit storage facility for which an unnamed hospital had paid $3.5 million to a China-based company that has been distributing counterfeit masks all over the US.

An investigative report finds that financially struggling Griffin Health (CT) has earned $51 million in COVID-19 testing fees as part of its $138 million contract with the state as the primary contractor for nursing home testing. The proceeds provided 25% of the hospital’s total revenue for 2019 as it was paid $55 per test, double the amount of five other hospitals that signed similar contracts. The hospital says it paid $80 million of the money to a laboratory because it didn’t have capacity to process the samples.

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Sharp HealthCare ophthalmologist and informaticist Tommy Korn, MD writes on LinkedIn that he is using the macro capabilities of his IPhone 13 Pro Max to document patient care in the EHR, to show patients what he is seeing, and to support telehealth consultations. 

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Staff at Las Palmas Medical Center (TX) celebrate the return of orthopedic surgeon and active-duty Army surgeon Richard Purcell, MD, who spent three months in Afghanistan treating victims of the Kabul airport bombings.

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In rural Australia, the local transportation department denies a doctor’s request to have his NIssan GT-R sports car registered as an ambulance. Michael Livingston, MBBS hoped to install emergency lights and sirens on his car for responding to emergencies that can be 30 or more minutes away, saying that his speedy response makes other drives think he is challenging them to a race. He holds an emergency pass that allows him to exceed the speed limit when responding to a confirmed emergency. The Western Australia Department of Transport expressed concerns that the car lacks bars in the front to protect the occupant from kangaroo or livestock collisions, noting that, “A dead or severely injured doctor is of no benefit to the current emergency, your community, or any future patients.”  


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