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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

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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

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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

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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

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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

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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

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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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Weekender 9/24/21

September 24, 2021 Weekender 1 Comment

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Weekly News Recap

  • Athenahealth is reportedly considering a sale of the company or an IPO at a $20 billion valuation.
  • Clearsense acquires AI-powered predictive modeling company Compellon.
  • AGS Health acquires EZDI.
  • Former Teladoc executive David Sides joins NextGen Healthcare as president and CEO.
  • Apple’s latest operating system gives IPhone users the ability to share health data with their providers via EHRs.
  • Shares in Definitive Healthcare jump 81% in their first week of trading following last Wednesday’s IPO, valuing the company at $7 billion.

Best Reader Comments

The state medical boards don’t really care about patient safety or good physician practice. What they do care about is maintaining their cash flow from physician and other professionals licensing fees … There needs to be a national licensing organization. The NBME already deals with the licensing exam and they could just as easily have everyone do the background checks and other licensing paperwork when submitting your Step 3 application. States could maintain some of their revenue by collecting a nominal standard fee ($25-35) for every state where you want a license with automatic approval with a valid federal license. Disciplinary actions would be more consistent if centralized and unscrupulous health professionals couldn’t move from state to state and fly under the radar. Telehealth would be facilitated and continuity of care would be better as well. (State Board Skeptic)

Re: Feds charge 138, including doctors, with $1.4 billion in health-care fraud involving telemedicine, Covid, opioids. This includes 42 healthcare professionals and 23 physicians! 23 PHYSICIANS! That’s why we cannot have nice things in healthcare. Those who complain about too much coding related documentation in healthcare, go and read the history of Medicare and why all those guardrails needed to be put in place over time. (Ghost of Andromeda)

When you wrote “I can only guess that the physician didn’t know how to contact the vendor”, it reminded me of hearing years ago that for many hospital/health organizations, the staff often have to channel their queries through one or two people who are the liaison to the vendor. I (sorta) get the intent here, but this makes no sense. (JT)

Epic sells to two groups within healthcare organizations: administrators and high value doctors. Epic is not going to tell the rank and file to go badger the people that cut Epic checks or the doctors who pull in a few million a year for the org. (IANAL)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. D in Arkansas, who asked for educational resources from the Teachers Pay Teachers program for her middle school class. She reports, “I cannot thank you enough for your generosity! With your donation I was able to purchase an online science curriculum that has helped me reach and engage my students this year. My students are so excited about the ‘scientist of the week’ package that I purchased, which includes information about a specific scientist that students get to explore and learn about for the whole week. This is just one of many resources that I was able to purchase that I can now use in my classroom moving forward. I was also able to purchase science stations and task cards which will help students use real world scenarios to learn science skills. Through this donation students have been able to engage in scientific thinking as well as see themselves as scientists, which has been very exciting for me to facilitate! Thank you!!!”

A North Carolina deputy is injured when a group of people who were fighting at a bingo hall resumed where they had left off in the hospital ED waiting room. The deputy was attempting to handcuff an armed participant when he was attacked by a juvenile female who charged him from behind. The deputy explains, “I hit her with my pepper spray, and I pepper-sprayed the gentleman that I’m fighting with. The gun falls out of his pocket onto the floor.” The melee started when one of those involved drove a car into the bingo hall, injuring several people.

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A federal court convicts a Michigan doctor of running a $100 million healthcare fraud scheme in which prescribed opioids for patients who agreed to falsely claim that he gave them expensive spinal injections instead. Frank Patino billed Medicare for more of the spinal injections than any US doctor from 2012 to 2017. He was also Michigan’s #1 prescriber of oxycodone in 2016 and 2017. He took kickbacks from labs to which he sent patient samples, then used the money to promote his diet, lifestyle, and wellness books and programs.

In Canada, police are seeking a man who punched a nurse in the face repeatedly for administering COVID-19 vaccine to his wife without his permission.

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New Hampshire’s health commissioner calls out the state’s highest-ranking lawmaker for spreading COVID-19 disinformation and placing federal vaccination funds on hold. Republican Rep. Ken Weyler claims without evidence that most NH COVID-related hospitalizations involve vaccinated people (when pressed, he cited his source as a talk radio show), federal government is being paid off by drug companies, the vaccine contains “something in the shot that’s going to help them control us,” and that he won’t receive the vaccine because his 25 years of flu shots – he’s 80 years old — make him immune from COVID-19. He adds that he gets his COVID-19 information from the Internet because “I don’t consider the CDC a credible source.”

A former concert pianist who completed her nursing degree when her father was diagnosed with liver cancer plays the piano in Mayo Clinic’s atrium as a volunteer after her shift as a Mayo non-vascular radiology nurse. The father of Genaida Benson, RN, who is cancer-free eight years after his first visit to Mayo, is among her audience when he returns for follow-up visits.   


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Weekender 9/17/21

September 17, 2021 Weekender No Comments

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Weekly News Recap

  • Commure’s latest funding rounds reportedly value the healthcare data exchange platform vendor at $3.5 billion.
  • FTC warns digital health app developers that they must notify consumers if their health information is exposed.
  • Definitive Healthcare shares soar after the company’s IPO Wednesday.
  • DOJ says a now-closed analytics company allowed insurers to overcharge Medicare Advantage by mining EHRs to create new diagnoses months after the fact.
  • Zane Burke joins Quantum Health as CEO.
  • Symplr announces its intention to acquire Halo Health.
  • The VA reportedly issues a $1 billion RFP for remote patient monitoring.
  • Two of the three researchers who developed the SAFER Guides for EHR safety call for vendors and ONC to share responsibility.

Best Reader Comments

The thing that caught my eye from the Aaron Martin article was the quote about health tech companies compared to health systems. Talking about Apple and Amazon or whatever is how you get CEOs to pay attention to you, because CEOs eat up those business book-style quotes from Jeff Bezos. Big tech companies aren’t interested in changing healthcare, but they have so much cash that it is coming out their ears, so they’ll try whatever. Healthcare services companies with tech dressing are the ones who are really taking a run at traditional payers and providers. (IANAL)

[At Epic] it was pretty imperative that if you were supporting a go-live at a customer you did not implement at, that you were careful not to mention unimplemented features to end users since those decisions were made at a higher level than a frontline nurse, for example. That doesn’t mean we just ignored these findings – there were mechanisms to bring these requests back to implementation / technical support teams, which were then laddered up to customer leadership to assess and prioritize. (HITPM)


Watercooler Talk Tidbits

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Readers funded the Donor Choose teacher grant request of Ms. M in Alabama, who asked for STEM kits for her elementary school class. She reported in February, “It has been amazing to see students happy and excited to come to school at 6:30 a.m.! Many students who attend before-school care were not excited to be there so early. These materials have made a huge impact. They are excited and learning so much both before school and after school. When students saw the materials, they were shocked and could not believe these materials were for them. They have explored, worked together, had amazing conversations, and have become problem solvers. Second grade students are now mentoring younger students using these resources. This is an amazing benefit that I did not plan. They are investigating and using collaborative conversations and posing their own problems and working toward solutions. Thank you for your willingness to support students!”

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A Louisiana man who became impatient that a hospital wasn’t seeing him quickly enough following a car accident steals an EMS ambulance that is parked outside, drives it to another hospital to seek care where he was also not seen promptly, then is pursued by police officers in a 10-mile chase down Interstate 10. He was arrested inside the office of his primary care physician, where he had driven the ambulance and hit a parked car before going in.

A VA hospital anesthesia department employee tweets a screenshot of a 72-year-old veteran’s pre-op note to mock his government-paid penile implant surgery. The DC hospital hasn’t said that it has fired the employee, but indicated that their medical records access has been revoked.

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Conway Regional Health System (AR) requires employees who claim a religious exemption to mandatory COVID-19 vaccination to attest that they won’t use the many other products that are derived from fetal cells.

A Nevada man’s 100-day, $2 million COVID-19 hospital stay leaves him with a bill for $80,000 of insurer-denied payments because the doctors who treated him were out of network. Dignity Health says it can’t get involved in disputes between insurance companies and its contracted intensivist company.

Lewis County Health System, a small hospital in upstate New York, will stop delivering babies now that six of its 18 maternity department employees have refused mandatory COVID-19 vaccination and another seven haven’t said either way. The conservative county has one of the lowest vaccination rates in the state at 44% and 30 of the hospital’s 464 employees have already quit ahead of the September 27 vaccination deadline. The hospital says its plans could change if it can hire agency nurses or if a legal challenge against its vaccination policy is successful.


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Weekender 9/10/21

September 10, 2021 Weekender 1 Comment

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Weekly News Recap

  • Intelerad acquires Insignia.
  • Sanford Health (SD) will use a $350 million donation to develop a virtual care center.
  • Period and ovulation tracking app vendor Flo raises $50 million, valuing the company at $800 million.
  • TransUnion is reportedly seeking a buyer for its TransUnion Healthcare business for up to $2 billion.
  • Invitae announces that it will acquire Ciitizen for $325 million.
  • A review finds that 34 of 36 systems that use AI for breast cancer screening are less accurate than a single radiologist.
  • The VA renews its CliniComp contract for another five years.
  • Four of six traveling nurses at a California hospital quit on their first day when faced with using Meditech, which the hospital is replacing with Epic.
  • Baxter announces that it will acquire Hillrom for $12.4 billion.
  • Accenture acquires Gevity.
  • Healthcare Triangle announces plans for an IPO that will raise up to $50 million.

Best Reader Comments

I would assume someone from Amazon would have some story about how they significantly made Providence cheaper and faster, but maybe hiring people from out of industry to shake things up is just as ineffective as outside companies shaking up healthcare. (Cynical Consumer)

Although I haven’t worked for public, for-profit companies, I’ve also had that universal experience where you start the first day, don’t know the organization, barely know a soul, and where a good argument can be made for several months that you don’t deserve to be there. That made for some really ugly first years. The executive class likes to have us convinced that they are smarter and more deserving than the rest of us. Many of them are fairly intelligent. I simply reject that someone coming from outside can just drop in and be more effective than someone who knows the company, how it operates, and what might really be going well or poorly. (CEO Supply Chain Issues)


Watercooler Talk Tidbits

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I missed this from a few weeks back. Miami-based MSP Recovery, which recovers inappropriate Medicare payments for which Medicare does not have primary payment responsibility, will go public via a SPAC that will value the company at a mind-boggling $33 billion. Founder and CEO John Ruiz stands to make $23 billion in the deal, which will be the second-largest in SPAC history. MSP uses analytics to buy portfolios of claims (click the image above to enlarge), and if it succeeds in collecting a payment, the insurer that overpaid gets half, lawyers get 40%, and MSP keeps the rest. Ruiz’s own law firm represents MSP, so it takes half of the 40% legal cut as well. MSP’s pitch deck shows a $37 million loss this year that it says will balloon to more than $5 billion in profit by 2026.

VA OIG finds that a Massachusetts VA hospital’s failure to follow proper procedures allowed a veteran to lie dead in a stairwell 20 yards from his room for a month before being found. The stairwell wasn’t searched because even though it is on VA grounds, it is operated and maintained by a homeless services group. OIG also notes that the veteran was a resident rather than a patient, so “missing patient” rules weren’t followed.

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Jackson Health System (FL) places a NICU nurse on leave after she posts photos and seemingly derogatory comments of a baby whose birth defect exposed its intestines.

In Spain, a chance DNA test reveals that hospital employees accidentally switched two newborns after their birth 19 years ago. A 19-year-old is suing the regional health department after a child support complaint resulted in DNA tests that indicated she had been raised by the other girl’s parents.

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A North Carolina doctor fresh off a seven-day ICU shift caring for COVID-19 patients stands by his Facebook bluntness toward unvaccinated people, saying, “There are some complete idiots who when shown death in the face will just cling to their crazy belief that it’s a conspiracy or they’re trying to use the vaccine to do mind control or whatever, or just some jackass theories … even some of the ones who are dying, are like, I still don’t believe this is a thing. How can you not believe this is a thing when you’re dying?”

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New Zealand Prime Minister Jacinda Ardern, when asked by a reporter about a COVID-19 inpatient who was caught having sex in the hospital, gamely responds, “I would say generally, regardless of the COVID status, that kind of thing shouldn’t generally be part of visiting hours.”


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Weekender 8/27/21

August 27, 2021 Weekender No Comments

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Weekly News Recap

  • Allscripts sells 2bPrecise.
  • ManpowerGroup will acquire Ettain Group, which had previously acquired Leidos Health.
  • Ginger will merge with Headspace at a combined valuation of $3 billion.
  • Connect America will acquire 100Plus.
  • Two NextGen Healthcare board members, including its founder, attempt to install new board members in claiming that board chair Jeffrey Margolis is impeding shareholder value.
  • Former VA CIO Roger Baker warns that its homegrown Vista system will need to remain operational for several years as Cerner is installed and will require funding.
  • Google Health’s teams and projects are decentralized as its health division is shut down.
  • Inovalon announces that it will be acquired by a private equity firm for $7.3 billion.
  • Cerner SEC filings indicate that the compensation package given to incoming president and CEO David Feinberg totals $35 million in his first 15 months, although much of that is in the form of restricted shares that won’t vest immediately.

Best Reader Comments

On social media over the past couple of days, I have seen C-suite execs of some of the most prestigious health systems in the country gloat over this or that recognition / award that they got from Epic. I have never seen executives at that level in any industry feeling rewarded by vendor recognition. That speaks to the genius of Epic / Judy / Carl. They have managed to create an amazing aura (or kool-aid or reality distortion field) around Epic to make this possible. This goes way beyond “we let our customers speak for us”. This is in another realm altogether. (Ghost of Andromeda)

[Allscripts] has zero debt and close to $1.5B in annual revenue. And two decades of clinical data. They should go private like Epic or sell for $4B. (NOM)

NextGen mostly has exited the affiliated market that Epic dominates. NextGen focused on large office practices, specialties, and multi-specialty practices while keeping or picking up affiliated practices whose hospitals don’t use Epic. That positioning seems smart since that’s the market where the deal size is large and the cost of getting and supporting the deal is low. They also acquire cheap add-ons to upsell to their existing customers and outsource all of their dev work. It actually seems like a reasonable strategy to me if you are looking for ROI in the current competitive ambulatory market. (IANAL)

If you poll Americans, they generally and somewhat surprisingly don’t resent large compensation packages for CEOs. What is a point which provokes ire and resentment across the entire political spectrum is the kind of compensation package that Feinberg gets. He’ll get rewarded handsomely regardless of what happens during his tenure at Cerner. It is the equivalent of fully rewarding a shipping captain in the 19th century before the vessel even left port. The captain gets paid even if he crashes the ship on to the rocks and all of the cargo & shipmates sink to the bottom of the sea. (Lazlo Hollyfeld)

As someone who likes to get as much out of a buck as possible, remember who pays for these exorbitant CEO salaries – you and I. Cerner is paid by hospitals, many supported by Medicare and Medicaid. Hospitals have to pay Cerner. It trickles down through our premiums. I find it disgusting, but the game of life is to acquire as much as one can, so he’s leading the game. Hopefully he’s a philanthropic soul, and much goes back to the other 99%. As colleagues wander wide-eyed through Epic, in awe of their campus, I’m secretly ill by all the dollars spent that should have actually gone to people’s health. Am I the only one who feels this way? (FrugalFrannie)

CEOs of growing software companies have qualities that help them do two things: sell and get their people to execute. Good CEOs normally either have a strong sales background or a strong technology background. These traits provide value to customers. CEOs of healthcare systems and division level executives at Google spend most of their time being politicians. They do PR type stuff for “innovation,” say different things to different stakeholders without appearing two-faced, make sure the unethical behavior stays behind the scenes, collect fat checks, etc. These traits do not provide value to customers. Also arguably the problem with Cerner is the board, not the CEO. (IANAL)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. E in Mississippi, who asked for an IPad and tripod kit to help her deliver online learning. She reported in December, “I truly appreciate the support you showed to my students and our school. The technology has provided my students with the opportunities to continue to learn even as we have moved to a hybrid schedule with rotating days of students at school and at home. My students have truly enjoyed being able to access enriching programs on the iPad when they are at school and it provides the opportunity for me to continue to reach them when they are at home. Thank you again for your donation. May God bless you for generosity.”

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Construction costs of the Denver VA hospital top $2 billion, making it one of the most expensive health facilities in the world. The hospital opened a decade behind schedule and $1 billion over budget, but work that was initially stripped out of the budget has been done after opening and fixing mistakes added another $20 million. The original budget was $600 million and increasing estimates forced the US Army Corps of Engineers to take over the project in 2016.

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The governor of Nebraska directs officials to recruit unvaccinated nurses, hoping to alleviate a shortage by hiring from hospitals that require employees to be vaccinated for COVID-19.

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A Paducah, KY hospital arranges visits by Nelson the therapy dog to boost caregiver morale.

A New Zealand children’s hospital asks college students in the dorm across the street to close their curtains after patients and families observed them engaging in “certain naked activities.”


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Weekender 8/20/21

August 20, 2021 Weekender 2 Comments

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Weekly News Recap

  • Cerner announces that Google Health VP David Feinberg, MD, MBA will be its next president and CEO.
  • Verily announces that it will acquire SignalPath.
  • CDC announces creation of the Center for Forecasting and Outbreak Analytics.
  • Inovalon announces that it will be taken private by an equity group at a valuation of $7.3 billion.
  • Commure acquires PatientKeeper.
  • QGenda acquires CredentialGenie.
  • Unite Us acquires Carrot Health.
  • Streamline Health Solutions acquires Avelead.
  • A report says a health system shut down a diabetes management app in which it had invested $12 million because its success would have threatened the hospital’s fee-for-service revenue.
  • Optum offers virtual care and prescriptions direct to consumers, offerings that will compete with investor-funded storefronts like Ro and Hims.
  • Labcorp acquires Ovia Health.
  • CMS announces that hospitals will be required to self-attest their compliance with the SAFER Guides for EHR safety starting next year.

Best Reader Comments

As a customer of Cerner, this appointment [of David Feinberg as president and CEO] is massively disappointing. (Justa CIO)

As for Feinberg, he made this move for the compensation. Shafer was at Cerner for a little under three years and made more than $30M in total compensation. He got the company right-sized for the financial folks. Feinberg is 59 and this is his chance to create dynastic wealth for his family. I’d bet his compensation will be even more lucrative than Shafer’s because Cerner will be sold during Feinberg’s tenure which should drive the stock option he gets higher as well as the executive parachute he’ll get as a part of any M&A. Work 3-5 years and bank $30-$50M. (Lazlo Hollyfeld)

Today Google Health head left and Apple scaled back its app. A few months back Amazon’s joint venture imploded. The only reason we are discussing such failures is because certain reporters hype tech’s every step in healthcare. (Chinmay A. Singh)

I think Feinberg has decided that getting anything done at Google is impossible and that if he gets out now he can combine the Geisinger & Google pixie dust / reality distortion field, and parlay that into a public company CEO job. Who knows, Cerner may hit an upswing, and if not, I don’t think anyone is expecting too much. (Matthew Holt)

A bit strange that Kareo sold its managed billing service a year ago and now acquired a startup that promises to … manage its customers’ billing? (IANAL)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. S in Texas, who asked for math materials for her bilingual pre-K classroom. She reported in December, “Our class is made up of in-person as well as remote learners, but we have gone through one class quarantine and three full class remote learning weeks. Every single time we are learning from home, all our students have been able to use their materials for counting, making sets, creating patterns, and sorting colors and sizes. Thank you for making sure every student in my class has access to hands on materials.”

A Chicago pharmacist who worked for a COVID-19 vaccine distributor is arrested for selling 125 authentic CDC vaccination cards for $10 each on EBay. He has been charged with 12 counts of theft of government property and faces 10 years in prison for each count.

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Sandro Platzgummer, a 24-year-old student of a medical school in Austria who never played college football and is trying to earn a running back spot with the New York Giants, breaks out an explosive 48-yard run from his own one-yard line against the Jets.

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An obese patient who has been hospitalized at Wentworth-Douglass Hospital (NH) since May hopes to lose enough weight to be discharged in September. The hospital is suing to try to get him to free up his bed, where he was admitted despite needing no acute care because EMS wouldn’t allow him to try to get back to his second-floor apartment and he refuses to live elsewhere. He wants to stay until he loses enough weight to undergo bariatric surgery. Jack Bocchino hasn’t walked for four years and still weighs 450 pounds after losing 114 pounds. He will not accept the hospital’s offer to find him a first-floor apartment or one with an elevator.

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Texas bans in-state nurses and travel nurses who were recently assigned to a state hospital from taking in-state jobs with federally funded COVID-19 disaster management programs. Texas is hoping to fill 6,500 positions with out-of-state or retired in-state nurses. In a related item, Arizona reports nursing shortages as in-state nurses take travel jobs paying four times their hospital salary plus housing and food.

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A 37-year-old Boston NICU nurse leaves her job at a hospital that ordered her to stop posting racy photos on pay sites such as OnlyFans. Her co-workers bought a subscription, then sent screenshots to her boss, who demanded that she close her online accounts. She says she doesn’t need nurse money anyway since she’s making $200,000 per month from OnlyFans. She’s also a Navy veteran, gets help with her online work from her husband, and has the support of their children, aged 12, 17, and 18.

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This press person’s email subject misspelling at least got my attention.

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TikTok videos of a former New Jersey gang member turned hospital phlebotomist singing for ICU patients go viral. Enrique Rodriguez started in housekeeping at Robert Wood Johnson University Hospital in 2012 and taught himself to play guitar and piano by practicing with patients. 


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Weekender 8/6/21

August 6, 2021 Weekender 1 Comment

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Weekly News Recap

  • Healthgrades sells its doctor marketplace and renames the remaining enterprise software business to Mercury Healthcare.
  • Relatient raises $100 million and announces plans to merge with Radix Health.
  • HIMSS21 remains on track for its Monday start, although minus some exhibitors that have cancelled their attendance plans.
  • Allscripts announces Q2 results that beat Wall Street revenue and earnings expectations.
  • Change Healthcare’s Q1 results beat revenue estimates, but fall short on earnings.
  • Evolent Health will acquire Vital Decisions.
  • Clarify Health acquires Apervita’s value optimization business.
  • Renown Health gives a look at its new Transfer and Operations Center.
  • Cerner’s Q2 results exceed Wall Street’s revenue and earnings expectations.
  • Epic requires its Verona employees to be vaccinated against COVID-19 by October 1, with 97% of them already meeting that requirement.
  • WellSky will acquire Healthify.

Best Reader Comments

No doubt HIMSS will stay mum about cancelations, ultimately they’re just a trade organization maintaining their position against the likes of HLTH and whatever shiny new entity shows up to try and steal the healthcare IT crown. I’m more disappointed by the exhibitors like Salesforce, Philips, and Accenture, which clearly eliminated almost all of their LinkedIn posts promoting their booth and presentations but have yet to make a statement about their presence. (LongTimeFan)

OMG, [cyberattack vulnerabilities of] pneumatic tube systems! We got rid of the last of ours in the 1999-2000 era. They were already a relic by then and ours broke down or jammed constantly. Of course, I am reliably informed that the Internet is a Series of Tubes, so maybe the pneumatic tube systems just evolved into a higher plane of existence. (Brian Too)

Since it’s positioned as a “Transfer and Operations” hub, I’m not sure that they’re claiming it will improve clinical outcomes. Seems more like the goal is increased efficiency and probably reduce redundancy across different facilities. I think the patient outcomes in other countries is more likely to be tied to better access to primary and preventative care, rather than logistics technology or lack thereof. (KatieB)

I remember having a discussion [about privacy of minors] with a public health-type person, many years ago. The topic was youth, STDs, sexual health, and how the rights of the parents intersected with the rights of the youth. My concerns were information related and not service delivery. My assumption going in was, Age of Majority was everything. Well, was I given a jolt! It turned out that the topic was complex and effectively, the youth was granted various adult-type rights and protections in stages. Yet I also remember, I was not introduced to any specific policy or plan, enumerating exactly how that happened. Which left me scratching my head a little, to be honest. It sounded more like, a clinical judgment call was being made. Perhaps they were gauging how mentally and emotionally mature the youth was? (Brian Too)

I am working on a project surrounding Adolescent and Young Adult care transitions this summer! One major barrier for my project specifically is the organization’s interpretation of a minor’s ability to consent to the Terms and Conditions of the patient portal as an individual. This bars patients under the age of 18 from creating and managing their own patient portal account, so there is no ability to teach patients how to manage their own healthcare via a digital platform. This interpretation is compounded by limitations in the patient portal with hiding and showing information dynamically based on the clinical area, such as labs related to sexual or reproductive health or notes from child and family abuse visits. Re: discussing “Healthcare Adulting 101” at age 17, my research has found that introducing the concept as early as age 12 leads to best results, with discussions happening over time until the patient leaves the practice. (JustAnIntern)

Question on the Epic requirement – is anyone seeing hospitals require vaccination for third party vendors? If so, is it self-reported or are they requiring documentation? (HITGUY24)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. C in Illinois, who asked for books for her classroom library. She reported in December, “I would love to thank you again for your generosity! The students were so excited to receive brand new books to take home during remote learning. Our school is a Title 1 school, which means a high percentage of students (93.9%) are from economically disadvantaged families  — students in families receiving public aid, living in substitute care, or eligible to receive free or reduced-price lunches. Many lack access to books at home and few have a library card. My classroom library is typically a place that my students really enjoy; however, the pandemic has forced us into remote learning. Due to your generous donation I was able to send books home for the students to use! One of my students, Anthony has already read several of the books that were provided. He was so excited that there were multiple books from the same series so he could continue to read book after book. This project has helped to enrich my student’s experiences with the printed word. They are so excited that we can read books together on Zoom meetings and discuss what we have read. Believe it or not they are sick of technology and love the opportunity to have real books to read.”

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BBC covers “Munchausen by Internet,” where would-be influencers fake illnesses and one-up each other’s list of diagnoses, post their medical records and surgery photos, or share Apple Watch readings. A Reddit group does armchair investigations of their posts to look for inconsistencies, although that has sometimes devolved into posting home addresses and other personal information. The conclusion is that nobody can assume anything about a person’s health by looking at their social media.

COVID-overwhelmed employees of Arkansas hospitals are walking off the job in the middle of their shifts. Only 37% of the state’s residents are fully vaccinated and cases and hospitalizations are climbing steeply.

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Kaiser Health News looks at Detroit’s privatization of public health going back to the early 1900s. The city’s health department went from 700 employees in 2008 to five in 2012 as white flight, auto industry turmoil, and the recession eventually led Detroit to file bankruptcy in 2013. A state-funded non-profit ran health programs with little local accountability. The city’s former executive health director says, “There’s not that much money in making sure that babies have what they need to thrive. There’s not that much money in making sure that restaurants are up to code. If there was, private industry would hop to do it.” A private developer is turning the public health department’s former home, the Herman Kiefer complex (above), into space for auto and medical technology businesses as the city rebuilds the department – whose budget is paid for by federal and state taxpayers — while struggling to address COVID-19. The city’s COVID-19 vaccination is at 34%, its COVID death rate is double the national average, and pandemic response has stalled lead poisoning programs and less than half of the city’s children have been vaccinated against measles and mumps.

A San Diego TV station asks several hospitals that were called out by a patient advocacy group for not posting their prices as required by CMS why they failed to do so, with these answers:

  • Dignity Memorial Hospital – we are working to comply over the next several months, but meanwhile enhanced our online tool to estimate out-of-pocket costs for specific insurance plans.
  • Kaiser Permanente – we provided the shoppable services list, but as an integrated delivery system, our hospitals have only one rate, which is with our own health plan.
  • UCSD Health – we developed a patient-specific price estimator, but most of our contracts don’t involve set prices and instead use a percentage of gross charges or a not-to-exceed number, neither of which are supported by the CMS-required format.
  • Sharp HealthCare — we developed a patient-specific price estimator and consumers would be confused by commercially negotiated rates because costs vary by plan and coverage.

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Mattel honors healthcare workers by creating a #ThankYouHeroes set of six Barbie dolls that are sold at Target. Mattel will donate $5 from each sale to the First Responders Children’s Foundation. The US workers depicted are Las Vegas internist Audrey Cruz, MD and New York City ED nurse Amy O’Sullivan, RN.


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Reader Comments

  • Admin Consultant: re: ASMR videos. I have been intrigued by this new genre. I recently started following an Instagram account @MenWithTheP...
  • Brian Too: Point of order here. You have to say "distributed ledger", because that sprinkles magical marketing pixie dust on it! ...
  • TH: "eliminates the need for point-to-point connectivity by creating an environment of 'connect once to many.'" "other pa...
  • Esquse Me: Right there with you. I was thinking, "Oh! A HISTalk piece that might actually tell me it's usefulness." Nope. Every s...
  • Kelly Bacorn: I’ve personally been fairly impressed with Epic-based tools such as CareEverywhere and Healthy Planet for information ...

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