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Weekender 6/26/20

June 26, 2020 Weekender No Comments

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Weekly News Recap

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

Best Reader Comments

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

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

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

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


Watercooler Talk Tidbits

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

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

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

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

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

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

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


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Weekender 6/19/20

June 19, 2020 Weekender 1 Comment

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Weekly News Recap

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

Best Reader Comments

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

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

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

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


Watercooler Talk Tidbits

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

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

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

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


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Weekender 6/12/20

June 12, 2020 Weekender 1 Comment

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Weekly News Recap

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

Best Reader Comments

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

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

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

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

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


Watercooler Talk Tidbits

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

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

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

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

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

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

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


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Weekender 6/5/20

June 5, 2020 Weekender 2 Comments

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Weekly News Recap

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

Best Reader Comments

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

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

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


Watercooler Talk Tidbits

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

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

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

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

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

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

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


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Weekender 5/29/20

May 29, 2020 Weekender No Comments

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Weekly News Recap

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

Best Reader Comments

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

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


Watercooler Talk Tidbits

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

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

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

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

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

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

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


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Weekender 5/22/20

May 22, 2020 Weekender No Comments

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Weekly News Recap

  • Optum acquires post-acute care management company NaviHealth.
  • Amwell raises a $194 million Series C funding round.
  • Microsoft announces Cloud for Healthcare.
  • Omada acquires Physera for a rumored $30 million.
  • Cerner joins the Fortune 500.
  • Cerner begins bringing its employees back to campus.

Best Reader Comments

Optum are the healthcare Borg. Now they add Navihealth’s service and technological distinctiveness to their own. Resistance is futile. (Lazlo Hollyfeld)

If you look at all the ‘successful’ vendors, ALL of them (Epic, Cerner, Meditech, CPSI) started in HIT and built a business solely around HIT. Seems to me there is significant message there. (FLPoggio)

What I am curious about is how all those Epic-ites will react when the stay stay at home order goes away how much pressure will there be to not return to the office. And if Epic goes the route that many Silicon Valley companies seem to be (remote working can work), what happens to the billion dollar edifices in Verona? (HISJunkie)

Epic doesn’t need differentiation in their video visits to be successful and valuable for their customers. They’ve already done the leg work to get through hospital bureaucracy and get clinicians using their products. Their products are the safe choice for administration and reliable enough to have staying power with users. Unless your product is stunningly better, people are just going to wait for Epic to release your functionality. Having a technical product in an app store is living on borrowed time. Have you ever noticed how Apple takes the good iPhone apps and puts the functionality in iOS? If your product is just an app in an app store, you’re the first fish eaten whenever the sharks start getting hungry. The good thing is that Epic is slow and not hungry, but you still have to swim fast or be swallowed. (Sidelines)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Mr. M in California, who asked for codable Legos. He reported in February, “We have been having so much fun with our basic Lego set, and this expansion set will make our Coding club even better! I think students really love to build and code because it builds their confidence. They are able to experience the pride of creating something from scratch and tell their family and friends about it. We have only been able to scratch the surface with this expansion set, but the projects that are included in it will allow my students to continue in our club next year!”

New York’s requirement that recovered, hospitalized COVID-19 patients can’t be transferred back into nursing homes until they test negative is causing hospital backups, as PCR tests can show positive results – most likely from measuring dead virus – for up to several weeks after the patient recovers and is likely not infectious.

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A UK bus operator takes just two weeks to roll out an app-powered service in which hospital staff can request free transportation to and from work. The app allows workers to book a seat in advance, with the bus company then using their pick-up and drop-off information to choose the most efficient routing.

Florida spent $283 million in a no-bid deal to create temporary COVID-19 hospitals that were never used, with a politically connected bidder signing a deal to operate a 200-bed hospital for $42 million per month. That construction contractor has no hospital experience, but has developed emergency shelters and previously won a $789 million contract to build a wall on the US-Mexico border.

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Lloyd Falk, a 100-year-old World War II veteran, is cheered by employees of Henrico Doctors’ Hospital as he is discharged following a 58-day stay for COVID-19. His wife of 74 years died from COVID-19 a few weeks before.

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The UK funds a brilliantly creative trial to see if “bio-protection” dogs – which can detect some forms of cancer and malaria from smell alone – can sniff out COVID-19 as an early warning measure or for screening travelers. NHS will collect odor samples from infected patients and train six dogs being provided by the Medical Detection Dogs charity for 6-8 weeks, and then launch a three-month trial.


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Weekender 5/15/20

May 15, 2020 Weekender 1 Comment

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Weekly News Recap

  • Cerner moves its October health conference to an online format.
  • Epic is working with an unnamed group on a COVID-19 “immunity passport.”
  • AMA publishes privacy principles for companies that aren’t HIPAA covered entities, such as technology firms.
  • Quarterly reports from Livongo and Health Catalyst beat Wall Street expectations for revenue and earnings.
  • Akron Children’s Hospital creates the country’s first endowed chair in telehealth and appoints its CMIO to the role.
  • Researchers find that an app’s four-question COVID-19 questionnaire can determine with 80% accuracy if the user is infected.
  • KLAS says that more than 100 Epic customers are using its AI-powered model, making it the only inpatient EHR vendor to have a significant number of sites live on AI.

Best Reader Comments

Epic/COVID-19: If Epic has really done rigorous analysis on 100 million patients and 30 drugs, don’t they owe it to the public health experts (and to public at large) to publish that information? … Same goes for the deterioration index mentioned in the conversation. If this index has really been successful in providing early alerts to front line clinicians at over 100 health systems (and has discriminated meaningfully between COVID-19 induced crash and other underlying cause of crash) and has been a factor in reducing COVID-19 related mortality (or even in reducing hospital stay or ventilator use etc.) then that’s a huge success and breakthrough! Why not publish those results and performance of the index? Why not publish it so that other non-Epic hospitals can also use it and save lives? (Corona_Verona)

Direct Trust is doing good work, but it is mostly around how to get the next generation out and building standards for the solutions to use. Who uses, how they interpreted, and what they exchange via those standards will dictate how effective their efforts will be. Carequality is an interesting concept, but if you don’t solve the underlying interoperability failures, then you are back to the same problem. I know several EHRs are trying to get together and do formative testing between themselves, but it is slow going and has been recently hobbled. We know with certainty that certification testing is not sufficient to solve this problem Here is a challenge for you. Can you exchange your top 100 problems, allergies, medications, procedures, labs, results at 100% accuracy with the top three ambulatory, acute, and SNF solutions? Can you then create a longitudinal record for the top 10 most common conditions with and without co-morbidities — and exchange that with 100% accuracy? (Brody Brodock)

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a ubiquitously overused excuse for inaction and unwarranted “privacy” protection. And it is definitely a favorite blocking tactic of hospital administrators, especially witless ones. I have been told at my bank and grocery store that rule or policy was for preventing a potential HIPAA violation. Just for giggles, I generally ask the earnest clerk/cashier: “Who is the covered entity in question?” or “Which of the 18 protected health information identifiers are being exposed?” When they admit they don’t know what I am talking about, I explain that they obviously do not understand the HIPAA law. (Wadiego)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. M in Washington, who asked for math manipulatives for her kindergarten class. She reported in February, “My students are aware that generous and thoughtful folks have donated these manipulatives in order to enhance their math skills. I am so happy to know that my current and future students will all benefit and become better mathematicians because of your generosity. We are currently working on composing and decomposing numbers, and the number windows came in so handy. Critical thinking is happening. With the rockets, students had to basically find the numeral, the appropriate ten frame, the tally, and the array that represent the same number. Seeing how the students persevere and seeing their smile brings me so much joy.”

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A Cambridge, MA pub that reopened as a COVID-19 antibody testing site in partnership with the owner’s physician brother lasted four days before the city shut it down over zoning issues. According to the vice mayor, “I felt that it was a little bit odd and quite honestly concerning to see a restaurant pivot from serving food to being a phlebotomy site.”

FDA provides guidance for disinfecting refrigerated trucks that temporarily held human bodies so that they can again carry food.

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A doctor treating a COVID-19 patient at Advocate Christ Medical Center (IL) leaves the man’s sister a voicemail but fails to hang up afterward, with the doctor’s phone then continuing to capture her telling co-workers, “Look, he’s going to die. It’s just a matter of time. For the safety of everybody that’s involved, we should not do chest compressions on him.” The man died 10 days later, after which his sister expressed concerns that he didn’t receive all the care he could have.

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An Emmy-winning camera operator records parts of his two-week COVID-19 hospital stay on his phone, hoping to leave his family a record of what he feared would be his final days. He is recovering at home and says he hopes his videos will encourage people to maintain physical distancing and wear masks. His wife’s mother had died from COVID-19 two weeks before his admission in mid-March.

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A woman in labor whose husband rushed her to a Louisville hospital only to find the doors locked gives birth on the sidewalk, with a 911 dispatcher walking her husband through the delivery. He couldn’t find anything to tie off the umbilical cord, so he used one of the COVID-19 masks that his grandmother had knitted for the family. The couple’s new son is fine.


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Weekender 5/8/20

May 8, 2020 Weekender No Comments

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Weekly News Recap

  • Allscripts reports Q1 results that miss Wall Street expectations for both revenue and earnings.
  • CVS Health beats Q1 expectations and reports a 600% increase in telemedicine visits in its MinuteClinic business.
  • Change Healthcare acquires ERx Network, sells its Connected Analytics business.
  • Johns Hopkins recommendations for addressing COVID-19 include making EHRs searchable by public health officials, creating a platform for hospitals to share PPE and medical supply availability, and improving healthcare supply chain tracking and coordination.
  • Duke University’s interoperability recommendations for containing COVID-19 include collecting and reporting patient demographics with samples, defining a minimum data set, and expanding the use of the National Syndromic Surveillance Program.
  • CMS issue waivers to pay full rates for telephone-based encounters.
  • Epic launches a public website where customers can post their observational findings about COVID-19 or other health and public health issues.

Best Reader Comments

My former employer (an EHR company) had onsite primary care clinics for all employees that were also set up as somewhat of a showcase of how to “EHR” well. All the exam rooms had two armchairs facing a large monitor that the physician’s laptop was connected to. After the exam the doc would move the conversation over to those chairs to write up the note and finish the visit, making the act of writing the note more of a collaborative experience. As a patient, it felt a lot better than the doc plugging away on a laptop on their little stool while the patient sits on butcher’s paper. (EHRing well)

There’s actually a FHIR-based replacement to CCOW called FHIRCast that’s been in the development / connectathon testing stage for about two years. (Not sure if it’s in production anywhere yet.) There’s actually a track focused on testing it and playing with it during the May 13-15 connectathon too. I’m sure you’d be welcome to show up and dabble! (Lloyd McKenzie)

Re: remdesivir study. Statistical significance means less than 5% probability the result is due to chance, but you have to specify the one thing you’re measuring in advance. They didn’t do that—instead changed from mortality to recovery time. This sort of thing raises the question of how many more slices of the apple they would have taken until something passed the test. (Robert D. Lafsky, MD)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. F in Michigan, who requested Osmo learning sets for her first grade class. She reported in early February, “My students absolutely love Osmo. While they believe that they are playing, they are learning so much! My students are using Osmo Coding Awbie and Osmo Detective Agency both cooperatively and independently. They look forward to Friday afternoons, which is when we have technology time to explore and learn. Prior to the funding of this project, I only had two sets of these games. By donating to my project, my students now have the choice to work on their own or with a buddy to feed strawberries to Awbie as they code a path for him or solve the mystery in Paris. My students are so excited to explore with Osmo!”

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Intermountain Healthcare cancels its agreement to send COVID-19 capacity data to data monitoring vendor Banjo following reports that the company’s CEO was a white supremacist as a teen and served as the getaway driver in a KKK synagogue shooting. The company has received $100 million in funding to develop police surveillance tools, with the state of Utah being a big customer until it cancelled after Damien Patton’s history surfaced. He says he was a homeless high school dropout who was taken in by skinhead and white supremacy groups.

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The Ascension Seton nurse whose sign for co-workers explained why he was staying so long in the room of a COVID-19 patient provides this explanation:

I just feel like I was doing, as a nurse, what I’ve been taught. That’s what you do. I work at Seton and we have a policy that no one ever dies alone. It doesn’t matter, any circumstance. COVID makes it more difficult, but no one dies alone. Someone’s going to be there in your room with you.

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A Harvard Medical School professor says that pathogen-fueled anti-immigration sentiment isn’t new, as early US immigration laws were created out of fear of disease, especially cholera. A New York City mob, led by wealthy landowners, stormed the city’s 1,000-bed New York Marine Hospital, called Quarantine, in 1858 and burned it down, returning the next night to use battering rams to level what remained. Many of Quarantine’s patients were new immigrants who had arrived by ships on which health inspectors found at least one person who was suspected of having an infectious disease, which then forced all of the ship’s occupants into lockdown.

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Food service vendor Aramark opens makeshift grocery stores in several New Orleans hospitals so that healthcare workers don’t have to go shopping for essential and hard-to-find groceries after work.


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Weekender 5/1/20

May 1, 2020 Weekender 1 Comment

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Weekly News Recap

  • Arcadia acquires the assets of the Massachusetts EHealth Collaborative.
  • A KLAS inpatient EHR bed win-loss report for 2019 shows big gains for Epic and Meditech, big losses for Allscripts and Cerner.
  • Epic announces plans to add integrated telehealth to its product.
  • VA OIG finds that the VA had not adequately planned its now-postponed first go-live, specifically in the areas of staffing, patient access given an expected 30% drop in provider productivity for 12-24 months, and missing functionality such as e-prescribing.
  • Cerner’s Q1 beats earnings expectations, but falls short on revenue.
  • Cerner offers health systems and researchers free access to the de-identified data of COVID-19 patients for developing epidemiological studies, clinical trials, and medical treatments.
  • Facebook’s coronavirus symptom survey is sending results from 1 million users per week to Carnegie Mellon University for predicting disease spread and county-by-county impact.

Best Reader Comments

People badmouth VistA, but many MDs we worked with used it at a VA and say they prefer it to Epic or Cerner systems. I assumed Millennium couldn’t be enhanced and customized to address AL existing military-specific capabilities in Stage 1. But not having basic e-prescribing capabilities (refills) that meet safety standards in 2020 in a multi-billion dollar EHR is alarming and a show stopper IMO given VA’s target population. Likely execs on top of food chain @ Cerner and VA OK’d plan to go-live without refills without deep understanding of potential harm and disruption for millions of vets (many depend on lifetime of meds for chronic pain, injuries and illnesses) and their families. (Ann Farrell)

People like the VA system because it doesn’t have the same data capture and billing systems as those serving commercial insurers. It also doesn’t have the same central oversight of the local orgs that a big health system does. That’s one reason why vets from different areas have such different experiences and opinions of the VA. I agree though that this particular screw up was probably caused by the exec team being told to go live without any real incentive to make sure everything works. (IANAL)

Not knowing all the key ways it spreads or just how fatal it is if contracted. Because we don’t have the denominators, which are key to knowing any of the rates. Exacerbated because the only people approved for COVID testing have to have symptoms, so no total population stats are known. New data is coming in on the head counts of those with antibodies who never reported sick, which provides hope this isn’t as bad as we are led to believe and that the death rate is greatly lower across the population than modeled. And the urgency is bolstered by CDC’s original instructions on coding U07.1 as being the underlying cause for any death when present (or suspected if no testing done) with co-morbidities and end stage conditions. NY is getting excoriated because they forced nursing homes to take hospital discharges of patients with COVID, which resulted in double digit deaths in those locations, because they are filled with the at risk elderly. And it also adds to the death count numbers that probably would not have occurred. These types of factors inflate the actual COVID death rate, but even then, it is coming in quite low (most stats now are showing actual death percentage under 2% and most don’t even achieve 1% of everyone who gets it.) (Icon O. Klast)

Among the things that have changed with the emergence of COVID-19 is the number of Epic generated press releases. Have there been more this year than all of previously recorded time? (AnotherDave)

If MDs want to improve the ratio of physicians to administrators, maybe they should pressure their colleagues to open more US medical schools. (Commenter)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. O in Kentucky, who ask for hands-on practice tools for class IPads. She reported in early February, “My students have already benefited so much from this addition of resources. As we learn to use our Osmos, we are finding even more ways to use them for teaching and learning than we even knew were capable. They work amazingly with some older IPads that we had on hand. We were able to resurrect this technology and give it a new purpose. I have also been able to share them with other teachers in the school to check out and use so that all students at my school have access to this resource. Students are excited to do math, reading, writing, engineering, coding, problem solving, and so much more.”

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The Milwaukee paper describes how Epic’s 200 culinary team employees, freed up from providing up to 7,000 meals per day to employees who are mostly working off campus, are serving food pantries, long-term care facilities, frontline healthcare workers, and at-risk groups in the Madison area. The company also donated 47,000 pounds of food to food pantries and long-term care facilities between mid-March and mid-April. Epic is also offering curbside grocery pickup for its employees, which allowed a local produce company to bring its laid-off staff back to work.

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In England, an NHS anesthesiologist creates a flashcard app that allows mask-wearing clinicians to communicate with COVID-19 patients using predefined on-screen text and voice messages. Rachael Grimaldi, BM developed Cardmedic in 36 hours while on maternity leave. The free app is being used by NHS trusts and by hospitals in 50 countries and is being expanded to include 30 languages, sign language, illustrations, and downloadable PDFs.

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Doctors in Germany organize a protest called Blanke Bedenken (“naked concerns”) in which they pose nude in pictures to illustrate how lack of PPE puts their lives at risk. One doctor posed with a sign that reads, “I learned to sew wounds. Why do I now need to know how to sew masks?”

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The New York Post profiles NYU Langone Hospital Brooklyn maintenance mechanic Hans Arrieta, who maintains the hospital’s ventilation and water systems. He has self-isolated by sending his family to live with relatives.

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Kansas City Chiefs right guard and Super Bowl ring-wearer Laurent Duvernay-Tardif, MD makes Sports Illustrated’s daily cover for answering the call of Quebec’s health ministry for medical and nursing students to help give caregivers relief. He hasn’t completed a residency yet, so his assignment is to administer medications to patients in a long-term care facility. He observes, “I realize that I’m privileged. I didn’t lose my job. I don’t have three kids at home and a Zoom meeting and home school to teach. I know a bunch of my friends are going through difficult times; many are physicians who I met in medical school. I have friends who are working in emergency rooms. One does triage and tests patients for COVID-19. Those people are on the front line, and they’re giving everything to protect us.”

Children’s Memorial Hermann pediatric plastic surgeon Phuong “P. Danger” Nguyen, MD writes and performs a public service announcement featuring the song “Stay at Home.” It’s a project of Help the Doctor, an all-surgeon band.

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In England, police in a small village seek to give some “words of advice” to someone who is walking around town wearing a 17th century plague doctor outfit. Some residents were frightened, some were amused, and one was pragmatic: “If it’s not illegal and he can’t wear it now, when could he?” Plague doctors wore the black outfits for home visits during the Black Death, with the beak-like mask that was thought to filter the disease leading to the disparaging doctor term “quack.”


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Weekender 4/24/20

April 24, 2020 Weekender No Comments

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Weekly News Recap

  • Banner Health’s judge-approved $8.9 million payout for a massive data breach in 2016 includes $500 for each patient in the class and $2.9 million for plaintiffs’ attorneys.
  • The federal government announces that it will delay enforcing compliance with final interoperability rules so that healthcare stakeholders can focus on COVID-19-related operations.
  • Cognizant alerts customers that a ransomware attract is disrupting some of its services.
  • Several companies work together to create a database of de-identified, patient-level data for COVID-19 researchers.
  • The VA and DoD launch a health information exchange that allows providers from both organizations to exchange patient information with community partners.
  • Google announces GA of the Google Cloud Healthcare API.
  • CMS announces that hospitals in areas that have low coronavirus outbreak risk can start offering routine services again.
  • FDA waives limitations on using digital health for treating psychiatric disorders.
  • UW Medicine (WA) publishes its IT experience in dealing with the health system’s coronavirus response.

Best Reader Comments

Re: VA & DoD HIE capabilities. Are we going to just sit here and pretend that both agencies weren’t already bi-directionally exchanging CCDs with huge amounts of outside clinicians via the eHealth Exchange for years? Maybe the massive note formatting issues from VA-crafted documents were just a fever dream of mine. (Perplexed)

These CCF models had the peak in mid-June WITH the distancing staying in place since mid-March. Those have been discounted. They also predicted 100,000 dead in Ohio in March WITH distancing. Then 10,000 dead in April. Their models have been WILDLY off. And unfortunately the public health people have been bludgeoning the politicians with freakishly wrong modeling, which has led to scaring the public to death and closing businesses indefinitely. (Meltoots)

RE: SDH referral platforms. The SIREN network (out of UCSF) published its evaluation last year (full disclosure I was a consultant on it). What’s missing from all these platforms and reports on them is their actual impact on health outcomes. (ex-hhc)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. M in North Carolina, who asked for multicultural development materials for her at-risk, pre-school class.  She reports, “This project been a surprising resource for my young students. The children noticed right away the different families’ cultures and they love to talk with their friends about what they see. The school is in a military town and most of my students come from different ethnic backgrounds. I appreciate the posters of real families from around the world. I cannot thank you enough for supporting our classroom.”

A scrubs-wearing nurse from Canada who told border authorities that she was driving to Detroit to help Henry Ford Hospital with COVID-19 is arrested when officers open her Ford Fusion trunk and find 150 pounds of marijuana.

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A bankrupt 25-bed critical access hospital in rural Oklahoma has only eight nurses and an office manager remaining as full-time employees, hoping to trim expenses by operating just the ED to attract a buyer. A company submitted the sole bid of $200,000 at a bankruptcy auction, but has backed out of the deal as coronavirus left it worried about being unable to meet operating costs. The hospital is one of 18 facilities that have closed or entered bankruptcy after being taken over by EmpowerHMS, which is being investigated by the Department of Justice for billing out-of-state lab tests through the hospitals to take advantage of their higher payment rates.

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Detroit ED physician Luda Khait-Vlisides, MD, MS raises money to buy tablets to allow patients who are being placed on life support, allowing them to have what could be their final family conversations via video since visitors aren’t allowed.

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A hospital nurse in Texas posts a note in the window of a COVID-19 patient’s isolation room to explain why he was staying longer than expected.

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In Spain, a taxi driver who regularly drives people to the hospital for free is surprised there by doctors and nurses, who give him a standing ovation, an envelope with money, and the negative results of his coronavirus test.


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Weekender 4/17/20

April 17, 2020 Weekender 1 Comment

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Weekly News Recap

  • The FCC starts accepting applications for its $200 million telehealth expense reimbursement program and issues the first set of grants.
  • The American Medical Association and American Hospital Association publish a cybersecurity guide for working from home.
  • Meadville Medical Center (PA) recovers from its second malware-caused downtime of 2020.
  • Apple and Google announce plans to work together to develop Bluetooth-powered COVID-19 contract tracing on mobile phones.
  • Alphabet’s Verily defends its decision to limit access to its COVID-19 screening website to users who have created Google accounts.
  • Allscripts subsidiary CarePort Health publishes an analysis of COVID-19 using the inpatient EHR data it stores.
  • Democratic lawmakers express privacy concerns about a White House discussion of using hospital information for coronavirus surveillance, with Politico reporting that health HIT vendors Collective Medical, PatientPing, and Juvare have responded to White House inquiries.

Best Reader Comments

If you are simply extending an EMR that is already built, the short timeline [to configure a pop-up hospital] is reasonable. For ease, it’s basically a new nursing unit and you can leverage the order catalog and documentation that has already been built. You are utilizing the same make and model of devices that you use in the inpatient setting and you have the same pharmacy formularies. At its core, its a lot of copying and rerouting of printing / orders. Also keep in mind that these pop-up hospitals are not full service, so a lot of the custom build for the ancillary areas doesn’t need to be replicated. (Modern CIO)

Hospitals have always been a bit of a chimera: ERs and ICUs as public health infrastructure, sliding through surgery suites, labs, imaging and office buildings for physician practices that were more commercial, into outright profit-maximizing activities of many kinds, all under a not-for-profit umbrella in most cases. Throw in medical schools and huge research efforts and it is a mess. Pandemic has laid it bare. Our politics don’t exactly promise to sort out society’s needs here. Step out one level and it gets more perverse, as commercial health up the funding stream in the current situation are banking billions in payments for needed and unneeded care that isn’t happening. (Randy Bak)

The presence or absence of universal healthcare is not the determining factor in what is going on right now; the determining factors are the complete absence of a scientifically-informed Federal response, and an economy that relies on hourly wage labor in service industries, and minimal to no infrastructure to support us when those industries evaporate overnight. People’s ability (or inability) to pay for the treatment they receive if they become infected is a separate factor, and is significant in its own right, but is not the reason our economy just cratered. (HIT Girl)

With provider revenue dropping across the country and major expense reductions announced, it is time for our vendor community to step up and give us a break on those ongoing expenses. I’d like to see a 25-50% reduction for the duration of the crisis – a minimum three months. How about it, Partners? (Bill Spooner)

I agree that it would be nice it for the IT vendors (and others) to give the provider community a break on the provider expenses. I see most respectable, financially secure vendors working with the providers over the next few months until things normalize. However, vendors that are experiencing their own financial issues may have a hard time doing that. Bottom line, you can’t get blood from a turnip. We are going to have to all work together to move beyond this catastrophe. It is going to take much longer to recover than it did for us to get into this mess. CEOs and other top level executives from all business sectors are going to have to take a financial hit. Everyone is going to have to tighten their belt. This will be a true test of the survival of the fittest. Will be interesting to see which hospital groups, providers and provider groups, as well as IT vendors will come out on the other end of this event. (Not All In)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Mr. H in California, who requested components for his high school’s robotics team. He reported a few weeks ago, “I want to personally thank you for your generous gift of the pneumatic supplies needed for the Robotics team. The kids will use the pneumatic cylinders to manipulate game pieces for our competitions. Without these devices the robot would not be able to compete against more well-funded teams. So far, the students have started building our 2020 robot using the supplies that were graciously donated.”

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Providence St. John’s Medical Center (CA) suspends 10 nurses after they refuse to work in its coronavirus unit without N95 masks. One of the suspended nurses has since tested positive for COVID-19. An insider says the hospital ordered the nurses to work with only surgical masks and threatened to report them to the state nursing board for patient abandonment if they didn’t get to work. The hospital was giving N95 masks to doctors, who told the nurses they shouldn’t be working without them. The hospital declined to comment, citing labor laws and HIPAA, but has said it will now issue reprocessed N95 masks to all caregivers who care for COVID-19 patients. It has not reinstated the 10 nurses pending an HR investigation.

A cybersecurity firm finds 500,000 sets of login credentials for the Zoom teleconferencing service for sale on the dark web for use by Zoombombers, complete with emails, passwords, meeting URLs, and host keys.

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In Sweden, Princess Sofia completes a training program and begins working as a volunteer at Sophiahemmet Hospital, where she will disinfect equipment and work in the kitchen. 

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A pregnant COVID-19 patient who spent 11 days in a medically induced coma on a ventilator in a New York hospital awakens to meet her new son, who was delivered by emergency C-section right after she was admitted to the ICU. She was discharged Wednesday and her son Walter has tested negative for COVID-19.


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Weekender 4/10/20

April 10, 2020 Weekender No Comments

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Weekly News Recap

  • The COVID-19 global tracking website that was put together in a few hours by a first-year Johns Hopkins graduate student is drawing one billion page views per day.
  • Allscripts lays off staff and cuts costs.
  • HIMSS revises its “no exhibitor refunds”policy for HIMSS20 and offers a 25% credit that can be applied to the next two annual conferences.
  • Despite an ongoing lack of COVID-19 testing nationally, hospitals aren’t using the available capacity of independent labs because they don’t have EHR ordering and results interfaces.
  • Duke’s Margolis Center for Health Policy, along with two former FDA commissioners and former National Coordinator Farzad Mostashari, MD, proposes a national COVID-19 surveillance system.
  • AMA publishes a physician guide for implementing virtual visits.
  • FCC publishes details of its $200 million COVID-19 Telehealth Program.

Best Reader Comments

Health systems are giving themselves gold stars for upping their stats on virtual visits, which I can’t help but find to be a tad disingenuous. Using the example from the Epic post, one organization had only 200 televisits during ALL of last year and are now counting 12,000 in just one week! Wow, except I’m not really feeling the celebration here. This success happened only because health systems were finally forced into telling their patients about the option that was probably there all along (it certainly was for Epic users). (Telehealth Princess)

The reason people didn’t do telemedicine before is because it wasn’t reimbursed at the same rates, or at all, in many cases. In addition to the obvious public safety advantages of video visits right now, insurers and CMS have agreed to broadly reimburse these services. On top of that, the government is also throwing money at hospitals to purchase telemedicine technology. The comparison to Napster is interesting. Healthcare does have a similar pricing and delivery problem that the music industry had. I wonder if some facilities will go the way of Tower Records in the coming future. So far “online doctor” services that attempt to bypass traditional payment models haven’t been particularly successful. We’ll see if that changes. (Elizabeth H. H. Holmes)

It sounds like Allscripts did a graduated pay cut. Meaning if two people are in the same role and the first employee makes more than the second, the first employee took a larger pay cut. Is that true? Doesn’t that punish harder working or more experienced or more talented employees assuming those people would be the one Allscripts would have originally given raises? (IANAL)

There will be titanic shifts across the whole economy that will reverberate for the rest of the year or even longer. Lots of docs are laid off already — the surgicenters are closed and many may not reopen.The disruption has only started. For many younger medical professionals who have never experienced a shrinking economy, the experience it will come as a shock that “MD” or “RN” does not means monotonically increasing wealth and well being. For anyone who remembers the 1990s, it is just a reminder of what we already knew. (Richard Irvin Cook)

In our county, a single for-profit health system owns the hospital and all urgent cares in the county. Last week, my wife had all of the symptoms of COVID-19 and she began to decline. I took her to the ED, and the note said that she was suspected of having COVID-19. The interesting part is they didn’t test her for COVID — their protocol was not to test anybody unless a positive test would change the treatment course. Instead of a single test, the did a CXR, metabolic panel, and a Chem 7. The Medicare reimbursement rate for a CDC COVID test is around $35.91, while my wife’s visit rang up $4,000. From a revenue perspective, it seems far more lucrative to not test for COVID-19. (Jim Bresee)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. S in New York, who asked for a VersaTiles math practice set. She said a few weeks ago, “The impact that these math VersaTiles have had on my children is immeasurable. It has allowed me to target weaknesses in individual students and help them understand the concept to mastery. The children are so focused on the task and so interested in the activities that the success rate has been through the roof. This has allowed those children who struggle, to move on to the next concept as they have now built that foundation. They have proven to be equally engaging and successful for those students who need to be challenged to do more. We will be forever blessed with your love and support.”

In Mexico, a man in a grocery store throws hot coffee on a nurse who was wearing scrubs as he shouts, “You’re going to infect us all.” Another nurse had an egg thrown at her as she waited for a ride, while residents of one small town threatened to burn their local hospital down if it treats any COVID-19 patients.

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A South Carolina ED nurse isolates herself by sleeping in a RV in her back yard that was provided by RVs 4 MDs, which helps healthcare workers find a place to stay during the pandemic.

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A hospital in Thailand fits newborns with face shields to protect them from coughing or sneezing that could contain coronavirus.

Pharma bro and Turing Pharmaceuticals profiteer Martin Shkreli offers to apply his drug development expertise to search for COVID-19 treatments in return for a three-month furlough from his seven-year securities fraud sentence.

Intensivist Julie John, MD makes a goodbye video for her children after coming down with severe COVID-19 symptoms at home and declining to call 911 because she didn’t want the presence of paramedics or the possibly being intubated to frighten her young children. She is recovering in quarantine, but even after 14 days the infection still leaves the 38-year-old doctor her feeling like she’s a 90-year-old woman with emphysema.


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Weekender 4/3/20

April 3, 2020 Weekender 1 Comment

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Weekly News Recap

  • HHS and CMS issue a long list of waivers and rules that relax limitations on telehealth billing, off-premise hospital services, PA/NP/CRNA supervision, COVID-19 testing, and sharing of patient information by business associates.
  • Microsoft warns hospitals about VPN vulnerabilities that may attract ransomware hackers.
  • FCC allocates $200 million to help providers buy telehealth equipment and services.
  • CereCore lays off employees as its parent, HCA Healthcare, implements COVID-related expense cuts.
  • The Department of Defense pauses its MHS Genesis Cerner implementation to focus on COVID-19.
  • HHS asks hospitals to share COVID-19 testing data and to send bed capacity and supply inventory information to CDC via emailed worksheets.
  • Apple develops a COVID-19 screening website and app in partnership with the federal government.

Best Reader Comments

10+ years after the HITECH act, countless billions of dollars being invested into EHRs, and endless hype about information exchanges, the government solution right now is to have everyone send VPOTUS a spreadsheet. (Low-Tech Act)

The dysfunction and regulatory ridiculousness of our health care system is laid out in perfect form when you look at all of the items CMS must DEREGULATE in an health care emergency — with the only interpretation being that more are completely unnecessary burdens on the physicians and other health professionals working day in and day out to treat patients. Absolute absurdity all around. (Regulatory Overreach)

If even a small portion of these comments [from HIMSS20 exhibitors] are true and come to fruition – and I agree overall – HIMSS will be greatly diminished. I wonder how many people HIMSS have laid off? And whether leaders are taking a haircut? Or will they cut and run? Sorta sucks that many of us – myself sort of included, but here I am – hesitate to share our true feelings for fear of being blacklisted, lose points, have the powers that be think poorly on our comments, etc. HLTH Forum in October WILL BE the canary in the coal mine for healthcare events in 2020. (ShimCode)

I think the way to be prepared for a once-every-100-year event is not by maintaining a large, expensive, and underutilized permanent bed capacity, but having detailed plans and the necessary supplies/materials to expand temporarily in an emergency. In spite of clear history and warnings from epidemiologists, we don’t seem to have done a very good job preparing for this eventuality at the organization, state, or national level. I’m not saying the challenges aren’t herculean, just that they should not have come as a surprise. (Surprised surprised)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teach grant request of Ms. H in Maryland, who asked for STEAM lab equipment for her class. She reported a few weeks ago, “The additions to our classroom were a surprise to our students. I waited until it was time to go home to display them. The looks on their faces were PRICELESS! I told them to write their questions on paper and being them to me the next day. I allowed students in groups of four to demonstrate how to use each activity in front of the rest of their peers. Each one of these have become a regular part of our day. For example, during our past Fun Friday Lab, I constructed an obstacle course for students to build and navigate the robot through. There were three rules to this Lab. 1) you must work with a partner, 2) you cannot use your hands or feet at any time while operating the Robot, and 3) When assisting with navigation, you must use directional words (left, right, forward, backward etc.). As you can see in the pictures, this is their favorite activity. This week we are adding the robot with the Twister mat to practice coding algorithms.”

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The National Bobblehead Hall of Fame and Museum is accepting $25 pre-orders for a version featuring the federal government’s Anthony Fauci, MD, with $5 of each sale being donated to the American Hospital Association.

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The $3.5 million Philadelphia home of private equity tycoon Joel Freedman, owner of shuttered Hahnemann Hospital, is vandalized after the city’s mayor accused him of demanding an excessive price to reopen the facility to increase COVID-19 patient capacity. Freedman bought the money-losing, safety net hospital for $170 million in early 2018, then closed it and filed bankruptcy for the hospital business while splitting off the land to develop condos.

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Montefiore Medical Center (NY) insists that the New York Yankees ponchos it included in bags of personal protective equipment for clinical staff were gifts, disputing the statements of employees who said they were told to wear them as PPE.

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FDNY thanks employees of hard-hit Elmhurst Hospital during shift change. BBC News profiled “the young doctors being asked to play God” at the hospital, which called nine codes in a single 12-hour shift on Wednesday, of which none of the COVID-19 patients survived.

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Meanwhile, zealots are using #filmyourhospital to offer video proof that the lack of ambulances and foot traffic outside hospitals means that coronavirus is a media hoax, a psychological operation, an excuse to implement martial law, or the first step toward imposition of digital currency to create “one world order.” Some of the filmers chased hospital and ambulance employees down the street to demand an explanation for the scam.

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A good Samaritan in Detroit uses $900 of his savings to offer free gas for nurses at Detroit Medical Center.


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Weekender 3/27/20

March 27, 2020 Weekender No Comments

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Weekly News Recap

  • UC San Diego Health publishes a description of Epic enhancements it created to address COVID-19, including tools for screening, ordering, secure messaging, and support for video visits.
  • Scripps Research launches a wearables study that hopes to identify viral illnesses more quickly.
  • Several organizations form the COVID-19 Healthcare Coalition, a data-driven effort to address coronavirus challenges.
  • CMS offers exceptions and extensions for MIPS and MSSP.
  • HIMSS announces that it will not offer refunds or credits to exhibitors and sponsors of the cancelled HIMSS20.
  • The HCI Group begins hiring up to 600 people to staff its COVID-19 telephone triage service for hospitals.
  • Thoma Bravo calls off discussions related to selling Imprivata for up to $2 billion, citing market volatility.
  • UK Prime Minister Boris Johnson meets with technology and healthcare startups to ask them for help in addressing coronavirus.

Best Reader Comments

New York hospital bed shortage? For over 40 years, the State of NY and many other states have beaten hospitals up via a payment system that pushed / punished them to close beds. (FLPoggio)

It’s always been understood that HIMSS was a vehicle for vendors to interact with prospects and clients. But they have aligned their focus on leveraging all HIMSS community members to realize the greatest revenue they can, and by way of their recent investments, they have continued to focus on media, conferences, and other marketing ventures, combined with their lucrative lobbying business. I believe that it is time for “reset” for HIMSS and even CHIME, which I was also a member of and also I’ve allowed my membership to lapse. The vendors provide the greatest percentage of revenue to HIMSS and they need to demand more. I believe this year provides vendors to determine if they are getting value out of HIMSS and I suggest they collaborate or work in a unified manner to make HIMSS serve them better. HIMSS needs you more than you need them. (HIMSS Insider)

I’m on a copious number of healthcare groups on Linkedin and it’s almost sickening how everyone is trying to get brand recognition from the crisis. Some have real things to offer, like a free year’s licensing to virtual visit module, but most seemed to be forced to use the crisis as a way of saying “we get it” and/or “we get it, and btw, think of us when you buy.” I understand. If I were a software exec at a virtual VP meeting, I would feel pressure to tell the marketing folks to come up with a C19 message and get it out there. Not so fast, though – everyone else is doing the same and you will look like a C19 make-money pile-on. (Dave S.)

One message I’d really like to get out is that a lot of us in healthcare, even administrative, do not have time for 30-60 minute webinars. So many people are working from home right now and have all the time in the world, so they aren’t realizing that many of us actually have LESS free time because we’re trying to navigate healthcare rules which are changing at least once daily. Please please please use your time to put together fact sheets with important information we can use, and make them as brief and to the point as possible. (A-M)


Watercooler Talk Tidbits

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Readers funded the Donors Choose project of Ms. B in Arizona, who asked for programmable robots for her gifted middle school class. She reports, “My students are being helped by the Ozobot coding robots because they have to use collaboration in tandem with critical thinking skills. The most exciting thing about the product is that they can code the robot to go on any path they can imagine. There is a lot of trial and error but it provides the students the opportunity to fail forward. The cool thing about this technology is it is accessible to all of my students, especially my girls. No one was intimidated by the idea of coding, instead they opened up the boxes and got down to work!”

Phelps Health (MO) asks Missouri University of Science and Technology to help address an expected shortage of caregiver masks and face shields. The few students remaining on campus set up a 3D printer farm that can run 24 hours per day. Students on the design team who worked since fall on now-cancelled design competition entries say they are energized to be performing positive, meaningful work.

Another shortage in New York: foster dogs, as applications from stay-at-home workers surge 10-fold. Rescue organizations are happy for the fostering help, but worry that joblessness will increase the number of pets that are surrendered.

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The FBI kills a Missouri extremist in a shoot-out that followed a sting operation in which the man hoped to buy a vehicle packed with explosives and use it to bomb a local hospital for treating patients with COVID-19, which he believed to be a Jewish plot.

A Kentucky hospital lays off 300 employees, 25% of its workforce, due to declines in non-COVID-19 business.

Airbnb hosts are evicting traveling healthcare workers in fearing they will bring the coronavirus into their homes. One Las Vegas landlord demanded that her ED nurse tenant vacate the premises within 24 hours as a “choice I’m making to protect myself,” then threatened to seize all of her belongings if she refused to leave. Healthcare workers in India, England, and Japan have reported being harassed and threatened, while hospitals in Australia warn nurses not to wear their scrubs in public after some were spat on or refused entry into stores.

A hospital nurse quits due to lack of personal protective equipment, warning that other frontline workers may resign after watching friends being put on ventilators or dying and then realizing they could be exposing their own families. Meanwhile, a Tennessee doctor says the state health department suggested using diapers and swimming goggles if PPE isn’t available.

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A California ICU doctor who treats COVID-19 patients moves into a tent in his garage to prevent exposing his family to coronavirus, urging everybody to stay home as he “voluntarily became homeless to protect my family.” 

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Time to dust off those orthopedist jokes. Hospital police officers arrest UConn Health orthopedic surgeon Cory Edgar, MD, PhD after he intentionally coughed on two other employers and was observed disregarding space and safety concerns. I note with wonderment that he holds both a bachelor’s and a master’s in molecular and cell biology.

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Bicycle companies rush to offer a replacement bicycle to an ICU doctor in England whose $2,000 Ribble bicycle was stolen from a locked area while he was treating COVID-19 patients. Dan Harvey says he will donate the bike to charity after the crisis ends and will put bike companies in touch with other staff members who don’t have transportation.

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An unidentified man thanks staff at Morristown Medical Center (NJ) for his wife’s treatment by holding a sign up to the ED’s back window. Nurses took a photo, but don’t know the identity of the man or his wife.


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Weekender 3/20/20

March 20, 2020 Weekender No Comments

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Weekly News Recap

  • Hospitals ask the federal government for a $100 billion bailout to offset their costs of diagnosing and treating COVID-19.
  • COVID-19 predictions and recommended federal government actions dominated the news.
  • HHS announces that it will allow physicians to practice across state lines, although individual states must waive their own requirements.
  • HHS OCR relaxes its requirements on the use of consumer video technologies such as Skype and FaceTime for offering telehealth services.
  • Telemedicine companies struggle with a high volume of demand that strains their infrastructure and provider availability.
  • WebMD acquires StayWell.
  • Epic cancels its XGM conference.
  • Cerner asks all employees who are able to work from home to do so.

Best Reader Comments

We are a hospital with numerous clinics making about $350 million per year in gross revenue with an average profit margin of 1.3% over the last 10 years. Our best estimate is that we will lose $10 million per month that this continues. That doesn’t even take into account our cash reserves that keep us afloat, which are being decimated in the market. We absolutely will see hospitals go bankrupt and/or be acquired this year without a bailout. (Bobby Bailout)

[COVID-19 testing data]. Epic has released functionality (COVID-19 Pulse Dashboard) that will aggregate de-identified data across their organizations. Considering they boast that their organizations cover half the US population, I would think they should be able to get some good aggregated data soon. Hopefully they do a good job of collecting the right metrics and cooperating with research institutions to help bring out some of this data. I hope Cerner is also looking to or already is doing something similar considering they also have a large share of US population. (AC)

I will think twice before ever booking our hotel rooms through OnPeak again. If we would have booked through the hotel directly, we would have been able to cancel with no fees. If you book with OnPeak/HIMSS, you lose your shirt. For what? A small room discount? Live and learn. (Jennifer)

On the practice side, most places have a little door barricade set up. People get a symptom check in the barricade one by one before they get in the waiting room area. People are told to call for instructions before approaching the clinic. On the hospital side, most of the clinical folks I’ve talked to have been told not to talk about internal details with the public. (What)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. P in California, who asked for robotics programming blocks for her kindergarten class. She reports, “The Cubelet blocks were exactly what I needed to connect computer science principles to solving real world problems. Our first experiment with the Cubelets was a simple challenge, to connect the blocks so their robot would move around the table and then stop. The kids were so excited to work together, every member of the group was trying different combinations and excitedly chiming in suggestions. I listened to these five year olds problem solve and collaborate and thought, ‘Wow. These are exactly the 21st Century skills that they need to be practicing.’ Thank you so much for giving us these high interest, durable robot blocks. You’ve made my class very happy, and given me a tool I will be using frequently in the future.”

Carnival offers the federal government use of some of its cruise ships as temporary healthcare facilities for non-coronavirus patients in major coastal cities, potentially freeing up hospital beds for treating COVID-19.

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China exonerates a Wuhan doctor it had reprimanded for warning about the coronavirus outbreak in an almost unheard-of admission by the Communist Party that it made a mistake. The party apologized to the family of Dr. Li Wenliang, who died of COVID-19. The government’s treatment of the doctor stirred uncommon public anger, with complaints that it was hiding outbreaks, punishing journalists, and valuing its own image over public safety. Several citizen journalists and critics were arrested and some disappeared after sharing information online about the outbreak. Insiders also claim that Wuhan’s claim of zero new cases is untrue because the local government suspended testing and discharged quarantined, symptomatic patients early to make President Xi Jinping look good during his scheduled visit there.

Italy presses 10,000 final-year medical school students into COVID-19 service, waiving the final exams normally required to put them on the front lines nine months early.

A California private practice doctor offers appointment-only drive-up coronavirus testing outside his office, with cash prices starting at $200. He has performed 40 tests, received eight results, and identified one positive patient. Mask shortages have forced him to buy from Craigslist scalpers.

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Ten conferences that have been cancelled at the Orlando’s Orange County Convention Center have hit the area with a $363 million economic impact. HIMSS is mentioned as working by mid-February to arrange on-site medical services to convince exhibitors not to pull out. The local paper intercepted emails from HIMSS in which it expressed dissatisfaction with the Visit Orlando convention bureau, which it said was not supporting the conference by agreeing to distributing attendee health information at local hotels. The photo above was taken on Wednesday, March 4, the day before HIMSS20 was cancelled.

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Fox’s “The Resident” TV drama, which is filmed in Atlanta, donates masks, gowns, and other supplies to Grady Hospital. “Grey’s Anatomy” and “Station 19” have donated masks and gloves to a Los Angeles fire station.


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Weekender 3/13/20

March 13, 2020 Weekender 2 Comments

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Weekly News Recap

  • COVID-19 dominates the national and healthcare news.
  • Use of telemedicine ramps up to meet COVID-19 screening and management needs.
  • HealthjStream acquires nurse scheduling app vendor NurseGrid, which offers the #1 most downloaded app for nurses.
  • FormFast changes its name to Interlace Health.
  • Final versions of the federal government’s interoperability and patient access rules are published.
  • HIMSS announces plans to offer some HIMSS20 sessions virtually.
  • Organizers cancel most of their upcoming conferences due to coronavirus concerns, including AMIA.

Best Reader Comments

Heading from a lot of friends inside of Epic that things are getting rough. No guidance from HR or the COVID team on what people are to do if schools close, no telework option given to any staff in the Verona office, some divisions (Implementation) have been given the guidance to attend all meetings via WebEx but that they still must physically come to campus. Little to no transparency from the leadership team, and they appear to be one of the only major tech company not implementing remote work. (Ex-Epic)

Epic’s travel policy is not right. They may think that they are helping us, but these people who go from one hospital to another may act as pollinators for COVID-19. We have already determined to cut all non-employees visiting our clinics and hospitals. (CMIO @ Med Centre)

Will 2021 finally be the year of the PHR now that these ONC rules came out? B.Well’s gimmick is to make the employer pay for it, though they can only swindle employers out of looking at the apps adoption rate for so long. IMO there isn’t enough value in a PHR to run a business. You either have to keep your costs extremely low or make money some other way. To me, two models come to mind. The Linux model, in which some devs do it as a passion project for awhile until it gets big enough that some institutional players start chipping in, maybe with some consulting opportunities with big health system or payer orgs. Or the Facebook model, in which you make it free for the consumer and sell their data. (What)

The big thing that’s missing for me personally is any accountability for breaches of apps or app vendors. My reading of the summary is that app vendors will not be HIPAA covered entities even if they are accessing and storing PHI. ONC is basically waving their hands saying consumers and app vendors can figure this out for themselves with a Terms of Service agreement. Key language from the summary: “In effect, this places more of an obligation on the party requesting the EHI and the individual to attempt to satisfy the precondition by providing a consent or authorization.” (Elizabeth H. H. Holmes)

I find there are two main reasons companies attend [the HIMSS annual conference]. Large mega vendors and even the larger names use it as a current customer meet and greet, and a chance to take them to dinner / schmooze (which they should be doing the other 51 weeks of the year anyway). The other are startups looking for investors or partners. Most don’t return the next year. Due to HIMSS rules on booth location based on seniority (I don’t disagree, just noting), these newbies are relegated to the basement level in building 2, or on the back wall of row 2400, where no one seems to go. Every time I’m asked about conference attendance as a key marketing tool, I tell the company my views. Even during a couple of job interviews I went against what I thought they wanted to hear, but was surprised they agreed with me. I’m not saying having a booth at conferences is a total bust, but isn’t a major tool in revenue growth for the majority of attending companies. Yes, I’m sure I’ll get some pushback from a few here where their effort pays off, but I’m betting it is a small slice of all vendors. (Contrary Ann)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. A in New York City, who asked for sensory play tiles for her class of autism and multiple disability students. She reports:

It is my honor and privilege to be working as a New York City public school teacher. It is in thanks to donors such as yourselves, who have enabled me to do my job even better. I am filled with such joy that you choose to help my students. It means so much to me to bring them an engaging educational experience that has meaning for them. My students inspire me every day, which I have seen inspires wonderful donors such as yourself.

I have already started using the sensory tiles and it is starting to make a difference for my students. Students who are in sensory overload are able to use them to self-soothe and get back to our lesson. We also use them for our lessons to show how colors mix and how force causes the colors in the tiles to move. They are so wonderful on so many different levels. These will allow my students to have an engaging experience exploring Science and STEM and keep control of their senses. Thank you for your kindness!

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Brilliantly making lemonade from the unfortunate HIMSS20 lemon is Medic.Life, which missed the chance to demo its upcoming “smart toilet” but touts its ability to detect virus markers in urine samples for early detection.  

Facebook, Ebay, and Amazon try to throttle back advertisements from price-gouging sellers of face masks and hand sanitizer.

The Los Angeles Times writes about doctors whose medically related poetry is published in medical journals, whose editors say they turn down a lot of badly written poems, but seek out those whose vivid imagery invokes an emotional reaction. A retired internist wrote this one:

Tell Me

Tell me the night silence
on the locked Alzheimer’s ward is broken
by a yell from room 206,

that an old man with flattened
nose and crumpled ears,
whose family moved away to Arizona,

whose doctor never comes
to visit, is standing
in the middle of that room, naked,

his freckled face a clenched fist,
urine and feces running
down his legs.

Then tell me that the fat one, twelve
years on the job,
working her second shift because

someone’s car won’t start,
comes with a pan
of warm water, a sponge and a towel;

how, back in bed, he
cries, You know—
I’m in the ring tomorrow with Killer
;

how a tiny smile begins, how
her hand reaches out
to flick down his wild flame of hair.

Now tell me again
why you don’t believe in angels.


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Weekender 3/6/20

March 6, 2020 Weekender 1 Comment

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Weekly News Recap

  • HIMSS cancels HIMSS20 at the recommendation of its medical advisory panel.
  • SymphonyAI Group acquires TeraRecon.
  • RevSpring acquires Loyale Healthcare
  • Allscripts misses Wall Street revenue and earnings estimates for Q4.
  • HIMSS announces that President Trump will become the first sitting president to address a HIMSS annual conference.
  • GoodRx apologizes and makes changes in response to a Consumer Reports investigation that found the prescription discount app shares patient information with 20 online companies.

Best Reader Comments

I’m conflicted by all of this. HIMSS did make the right decision. I had decided independently last night that I wasn’t going to attend. It was the optics of it all. Healthcare workers at a convention where were we home would have advised our patients to be more prudent. That said, I miss catching up with friends. This is our annual meet-and-greet. But I couldn’t justify a week in the sun to see friends, particularly after nearly every single one of the vendors I had appointments with had cancelled earlier in the day or this week. (Samantha Brown)

My latest realization was that, while I might be able to avoid getting coronavirus, the possibility (probability) of getting swept up in a blanket quarantine (there still aren’t enough test kits) would be hugely disruptive to my life and those of my colleagues who would have to cover for me. (Randy Bak)

I posted a tweet stream last night urging HIMSS to repurpose HIMSS20 along with other recommendations. This is a tough call. But after spending a couple of days poring over evolving data and reports, for me it comes down to this: we can’t stop the outbreak, but we can flatten the curve. Having tens of thousands of healthcare workers and healthcare focused companies who are not fully trained to interact safely aggregate in an alcohol-fueled networking gathering and then disperse globally is, mildly stated, unwise. Transforming the week into a smaller event targeted on building epidemic-focused tools and services could turn this into a vital component of the global strategy to address the need. (Ross Martin)

I’m assuming HIMSS themselves has event insurance, which may help them on costs, but wouldn’t help on revenues. (Nick Kagal)

A huge problem I can see with my company’s wellness program is that it relies on medical information being self reported by the user. I’m a low-level-grunt and have zero interest in wellness, but they give a $1,000 incentive; So I signed up and told the app all the “correct answers” [BMI of 23, zero alcohol, zero tobacco, zero caffeine, 110/60 blood pressure, sleep eight hours every night, etc.] Every day I go through the motions, telling the app what it wants to hear. I’m probably one of the most “engaged” with the program, but as with everything in the wellness industry, it’s not real. It’s just a scam to extract money out of my employer. (Jose)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. M in West Virginia, who asked for GoPro and MacBook accessories to support her special education students. She reports, “Thank you so very much for your most generous donation. My fifth grade students absolutely loved seeing our new equipment come in after our winter break. It made coming back to school a little more enjoyable for them. They especially loved all the accessories for their GoPro. This will allow them to make videos using a variety of different perspectives. They will create movies that will allow for easy transition for the upcoming fifth graders next year. They will be able to showcase the exciting events that happen at our middle school. Again, my students and I greatly appreciate your donation. You truly warmed our hearts!”

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I decided to spend a bit of my Anonymous Vendor Executive’s money on Donors Choose teacher book requests since those donations are being matched dollar for dollar this week. I’m donating in honor of the lost HIMSS20 – for the HIMSS people who worked valiantly to make it happen only to see it cancelled, those presenters who spent a lot of time and energy preparing talks that won’t be delivered, and the companies who bet big on getting ROI from a now-cancelled event. I funded these projects:

  • A classroom library for the first grade class of Ms. D in Alton, TX.
  • A set of 12 books for Ms. B’s kindergarten class in Columbia, SC.
  • A set of 14 books for Ms. R’s kindergarten class in Fayetteville, NC.
  • A set of 20 history books for Ms. S’s third grade class in Kittanning, PA.
  • Novels for Ms. J’s middle school class in Bridgeport, CT.
  • Eight books on in inclusion and diversity for Ms. P’s elementary school class in Orlando, FL.
  • Civil rights books for Ms. W’s elementary school class in Greenville, SC.
  • Classroom library books for Ms. H’s elementary school class in Rantoul, IL.
  • Books for Ms. K’s elementary school class in Chicago, IL.
  • Books for the Autism Spectrum Disorder kindergarten class of Ms. L in Bakersfield, CA.
  • A set of 20 books for Ms. M’s elementary school class in Gallup, NM.

Ms. H responded almost immediately to say, “I am literally speechless right now! I am so happy my students are getting more books! They love to read, and will be thrilled! Thank you for your big heart and for helping my classroom! I can’t wait to tell them! Thank you SO much for everything! Reading IS rich!” Ms. S said, “WOW! Thank you so much for funding our project! I just told my kiddos & they CHEERED! They are so into these books, and I just LOVE how excited they get!””

Ms. P was eloquent in her thanks for inclusion and diversity books:

In today’s polarizing society, more emphasis needs to be paid to appreciating the differences in each of us. It’s these differences that makes us fundamentally human, and we should celebrate and not criticize this beautiful uniqueness. Thank you for giving me books that will teach my kids to value the beauty that lies within us all.

A nurse union’s coronavirus survey of 6,500 members finds that 70% say their hospital employer doesn’t have enough personal protective equipment to support any surge in patients, while just 44% say their employer has provided information about identifying and responding to potential cases.

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A cosmetic surgeon gets three years of probation for ordering his staff to not call 911 for five hours after his 18-year-old breast augmentation patient stopped breathing while under anesthesia, leaving her in a vegetative state.

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The Orlando paper covers the effect of two cancelled conferences, including HIMSS20, that would have brought 60,000 people to Central Florida. Orange County’s mayor says the area is low risk, vacationers are still coming to theme parks, and only 0.3% of the area’s 75 million annual visitors come from Level 3 countries. The HIMSS20 cancellation involves 94,500 hotel room nights and $113 million in economic impact. Cheerleading and volleyball competitions will draw 50,000 people to the convention center this weekend.

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Audacious Inquiry worked with Orlando restaurant Cuba Libre to donate the food that was intended for its Wednesday networking reception to Second Harvest Food Bank of Central Florida.

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A hospital nurse in Wuhan, China posts a photo of herself holding a sign that says, “Hope that my country will assign me a boyfriend when the Covid crisis is over.” Medical workers there are writing words of encouragement on their protective suits to motivate each other.

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Also in Wuhan, a 20-something doctor asks an 87-year-old patient who had been hospitalized for a month if he wants to see the sun set.


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Reader Comments

  • Pay to play: Can we all agree that HCI and Santa Rosa paying a firm to inflate their KLAS numbers is just taking it one step further ...
  • Elizabeth H. H. Holmes: If protests were a significant vector to spread COVID, I would expect Minnesota to be much worse than where they are....
  • Eric: With the current pandemic healthcare need to adapt tele health, remote patient monitoring is very critical and digital h...
  • Art_Vandelay: Is it just me or are others tired of receiving HIMSS Digital Health Indicator and Digital Health Advancement ads? They h...
  • Dan: https://www.nber.org/papers/w27408 This found that the protests caused a net reduction in the transmission of COVID, ...

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