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Weekender 5/7/21

May 7, 2021 Weekender No Comments

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Weekly News Recap

  • Walmart announces that it will acquire telehealth provider MeMD.
  • Cerner begins an external search to replace Chairman and CEO Brent Shafer, who will leave the company.
  • Systems at Scripps Health remain down from a ransomware attack.
  • R1 RCM will acquire VisitPay for $300 million in casb.
  • Connecticut launches a statewide HIE.
  • CareCloud agrees to pay $3.8 million to settle federal charges that it paid kickbacks to customers who recommended its EHR to prospects.
  • Ascension Technologies files paperwork indicating that it will lay off 651 IT employees in the fall as it outsources their jobs.

Best Reader Comments

Re: Epic’s growth in Canada from three hospitals in 2016 to 146. A significant portion of that will be due to the Alberta market. Alberta has Meditech implemented (understand though that the legacy picture is fragmented into an approx. three-way tie). Alberta will never upgrade to Meditech Expanse. Instead, Epic has won the entire province. Wave 3 of a 9 wave Epic implementation project was recently completed. (Brian Too)

So Brent Shafer has accomplished what during his time as CEO? Decimated all the upper level management with his cronies who now need replaced, made all the good worker bees leave by withholding raises and layoffs, lost some huge clients while not making many new sales, underperformed for the shareholders with regards to the stock price, not made any progress on meeting existing promises to clients, not made any progress on new markets. I think Brent’s Cerner legacy is that he made life moderately worse for everyone involved except his pocketbook, but at least he didn’t implode the company. (IANAL)

Similar finance-driven decisions are made not only for support, but also for the building of software at your vendor. The more mature the product, the more likely that offshoring the build might actually result in cost savings. In the startup world, it never works because the instantaneous iterative nature of early-stage software development can’t survive the communication barriers. (mburke)

So many questions are still being asked about HIMSS21. If we show up to exhibit, who will be attending the conference for us to present to? If we get a meeting room, would attendees feel comfortable meeting up in there since it’s a closed-in space with not great ventilation? If we host an event outside of conference hours, who would show up? Will the whole conference primarily be vendors? It’s really hard to justify the ROI and it doesn’t seem like it’s going to be any easier to make that decision as the conference gets closer unless we specifically ask our target audience if they will be there. (Michelle)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. S, who asked for headsets for her students as her Houston elementary school moved to online. She reported in November, “Your generous contributions have made it possible for the students and I to communicate with each other … One of my students, Tracy, told me, ‘Now, I feel like I am part of the class.’” Ms. S also passed along a letter from one of her students:

My teacher says you’re the one who got my class headphones. I just wanted you to know how thankful I am! And pretty much all my class. I don’t really know who you are but for now on, I’ll remember that you made my classroom happy. And come on, when my teacher said there was headsets, I was shocked! I already knew it wasn’t from my school. And honestly, if you didn’t give my class headsets, I’m pretty sure we would have to bring headsets to school. I just wanted you to know how thankful my class is because of you!

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Reader Eric’s generous donation to my Donors Choose project, with matching funds from my Anonymous Vendor Executive and other sources, allowed me to fully fund these teacher requests:

  • Math stations for Ms. N’s second grade class in Tyler, TX.
  • Math games for Ms. G’s elementary school class in Chicago, IL (her response is above).
  • Math picture books for Ms. F’s elementary school class in Norfolk, VA.
  • Math activity tins for Ms. S’s head start class in Provo, UT.
  • Math tools for Ms. C’s second grade class in Los Angeles, CA.
  • STEM activity tubs for Ms. M’s first grade class in New York, NY.
  • Science tools for Ms. M’s kindergarten class in Nashville, MI.
  • Lesson plans and materials for Ms. I’s sixth grade class in Arlington, TX.
  • Lesson plans and materials for Ms. N’s elementary school class in Fresno, CA.
  • Summer practice reading and math books for Ms. R’s elementary school class in Philadelphia, PA.
  • Digital learning resources for Ms. E’s first grade class in Houston, TX.
  • Interactive math whiteboards for Ms. M’s middle school class in Pharr, TX.
  • A collection of 100+ books for the book vending machine project of Ms. H in Columbus, OH.

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Crocs will give away 50,000 pairs of shoes this week in bringing back its “Free Pair for Healthcare” program during National Nurses Week.

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The Indianapolis TV station profiles 61-year-old Jeff Bick, who was looking for something meaningful to do after taking early retirement from Eli Lilly after 30 years, so he spent three years in nursing school and is now working as an RN at Riley Children’s Health. He explains, “I wasn’t ready to retire by any means. I figured I was good for another 10 or 12 years, so what could I do that would be meaningful? My wife and I both feel like we’re lifelong learners, so you keep, you know, you keep looking for challenges. You keep looking for things that make life an adventure.”

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A hospital in Senegal builds a new maternity and pediatric building, courtesy of charitable donations and pro bono architectural services, for just $2 million. One of the designers didn’t feel right about designing a hospital for doctors and patients they had never met in an area they had never visited, so they held meetings with doctors, employees, and patients to reach an ideal design for the 150-bed addition. It emphases patient and family comfort and passive cooling. The U-shaped bricks were developed by the architect and cast on site. The contractor took it upon himself to expand the idea of testing the bricks by erecting a test wall and instead built an entire building in a small village so it could be used as a school.


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Weekender 4/30/21

April 30, 2021 Weekender No Comments

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Weekly News Recap

  • Vocera acquires PatientSafe Solutions.
  • Halma acquires PeriGen.
  • Allscripts Q1 beats on earnings, misses on revenue.
  • Caresyntax raises $100 million.
  • Lyniate acquires Datica’s integration business.
  • VisuWell fires its CEO over a video showing his altercation with a male teen who wore a dress to their prom.
  • J2 Global will split into two publicly traded companies, one being its Consensus EFax business.
  • Accolade will acquire PlushCare for $450 million.

Best Reader Comments

I have experience with Dell offshored health IT staff. All I can say is that you get what you pay for. If you want to pay 1/4 for folks that really don’t understand what you are getting at and then re-do it because of said lack of comprehension, then it’s a good model. Half my job is interpretation between clinicians that have needs but don’t really “get” the system, and the techies who can’t grasp why solution XYZ won’t fit the needs of that clinician. Add a foreign culture and language in the middle, and it’s complicated. (PennyWisePoundFoolish)

Why would we let anyone else dictate anything around our patient experience? We required the tele platform to give us a webpage that we host and can then use it to serve up our own patient educational material and other messaging. Plus, we actively monitor to ensure that the patient isn’t spending any meaningful time on the “waiting room” page. Patient experience has to be valued and protected! (DA)

I don’t think consumer driven is even needed, just competition. For a starting point, the ACA exchange in New York State is as competitive as the health insurance marketplace can be. There is even a pretty legally simple model to scale it up. Take away tax subsidies for employer provided healthcare, make any healthcare benefits transferable to the exchange (like the Harris plan), then provide large income based subsidies for purchases on the exchange. Low wage employers will jump at the chance to shift the healthcare responsibility into the state. High income earners and unions won’t fight it since it is providing another option for them rather than taking something away. Employers will eventually stop offering core health insurance as a benefit and everyone will purchase their plan on the market. It isn’t the best outcome ever but it is competitive and it is achievable. (IANAL)


Watercooler Talk Tidbits

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Readers funded toe Donors Choose teacher grant request of Ms. H, who asked for math flashcards and unifix cards for her third-grade class in the Central San Joaquin Valley of California. She reported in November, “This 20 year veteran teacher became a first year teacher all over again this year through the implementation of distance learning. This has been the most challenging time in teaching that I have ever experienced. One of the biggest hurdles I’ve had has been finding creative ways to engage children in online learning. Any teacher worth their salt knows that math manipulatives are a key component to a successful math lesson with young children. The stackable counting cubes that I was purchase with your donation have been such a gift. The kids love having something familiar and fun to ‘play’ with and I love that we have been able to use the cubes to teach place value, regrouping, and now multiplication and division. I also love that it allows the kids to handle something besides their computer for a little while.”

Joe Rogan, who was accused of being reckless in telling tens of millions of his podcast listeners that young, healthy people don’t need to receive COVID-19 vaccine, clarifies that he is not qualified to offer medical advice: “I’m not a doctor. I’m a f_ing moron.” He says he’s aware that the vaccine protects other people as well as the recipient, but says “that’s a different conversation.”

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A doctor in India urges people to get vaccinated while showing the sweaty effect of wearing PPE for 15 hours of rounding. 

A nurse sues Normal Regional Hospital (OK) for firing him for posting on Facebook that a black murder suspect should be hung. The nurse says he isn’t a racist, and in fact some of his best friends are black, and that he was fired because he’s a Republican.

In Texas, the mother of a two-year-old girl who has been hospitalized for most of her life with a heart condition wages a legal battle with the hospital over stopping care it says is futile because she will never recover. The state has spent $24 million in Medicaid funds on her hospitalization.

The New Yorker describes the lonely job of medical interpreters, who work from their homes in translating conversations often involve end-of-life decisions related to COVID-19, sometimes with patient family members who live in other countries. 

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The government of Japan responds to the concerns of a nurse union about the medical resources that will be consumed by the daily testing of athletes in the 2020 Summer Olympics in Tokyo, whose year-delayed start is July 23. Japan has vaccinated just 1% of its citizens and 75% of residents don’t think the Games should be held this summer. Officials will decide in June whether spectators will be allowed.


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Weekender 4/23/21

April 23, 2021 Weekender 1 Comment

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Weekly News Recap

  • Home monitoring platform vendor Current Health raises $43 million in Series B financing.
  • Consumer data aggregation vendor Seqster raises $12 million in a Series A round.
  • Hospital operators HCA and Tenet beat Wall Street estimates on quarterly revenue and profit.
  • FDA says it will use the term “MIMPS” (medical image management and processing system) instead of PACS in referring to medical imaging systems.
  • Cedars-Sinai is using facial recognition software to identify patients with a history of violence or drug fraud.
  • FCC will open applications for its $250 million COVID-19 Telehealth Program on April 29.
  • FTC warns businesses that using or selling AI algorithms that are racially based or discriminatory – intentionally or not – violates federal law.
  • FDA excludes eight software functions that previously invoked its regulation as a medical device.

Best Reader Comments

There are many ways to find out if a supplier/vendor has positive references and can deliver. Just ask for a full list of their clients contracted with during a period of time and randomly call. Don’t let the vendor just give the references as that will prove nothing. Just do some routine homework. (Bigdog3011)

I’m more optimistic about Oscar selling consumer facing software to insurers and doing some outsourced business process for insurers than I am about Oscar as an insurance company. (IANAL)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Coach K, who has been teaching PE at his Arkansas school for 25 years. He asked for a GoPro camera to make exercise videos for his 625 K-6 students whose classes are being held both in-person and online. He reports, “I simply cannot begin to express our gratitude that has resulted from your selfless giving. Oftentimes, our students come from very poor backgrounds and rarely do we have the resources like the GoPro camera to help our students learn. Because of your gift, we were able to use the camera and tools that you sent to make our virtual lessons more clearly to our students. Donors like you are the real champions of public education. You see the need and rise to the occasion time and time again. Our students were thrilled when the box arrived and they knew that we would continue to make Physical Education together because we had the necessary tools that once were lacking. Again, thank you for your kindness and generosity.”

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Massachusetts General Hospital will proceed with a delayed $1.9 billion project to build new patient towers that will net the hospital 94 new beds beyond its current 1,043.

Ohio police arrest a nephrologist who physically attacked a cardiologist in St. Elizabeth Boardman Hospital (OH) who had accused him of inappropriately discontinuing a patient’s medication. A nurse and another hospital employee had to break up the fracas.

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A federal judge orders a Spokane, WA neonatologist remain in jail on charges of several crimes he tried to arrange on the dark web. Ronald Ilg, MD tried to hire someone to kidnap his wife for a week so he could travel to Mexico with his girlfriend, offering $40,000 in bitcoin for someone to take on a “rush job” that involved giving his wife daily doses of heroin and planting used needles with her DNA so he could frame her. He offered a bonus if the kidnapper could convince her to drop her divorce proceedings, move back in with him, have sex with him at least three times in a two-week period, and promise to keep quiet about the kidnapping. The doctor had allegedly previously tried to hire someone on the dark web to break the hands of a former employee for $2,000. Meanwhile, the girlfriend who accompanied him to Mexico said the doctor forced her to sign a master-slave contract in her own blood and gave police a recording she had made of the doctor beating her. After being questioned, the doctor was found unconscious in his house next to a suicide note, but he was OK. Police obtained evidence of the money transfers from Coinbase and found his dark web name and password written on a sticky note in a search of his house, which they used to read his messages.

In Italy, a 67-year-old hospital employee is being investigated for skipping work for 15 years, having been paid $650,000 despite never having showed up to his newly assigned job. Police say the employee threatened his manager to stop her from disciplining him, and when she retired, nobody noticed his absence. Police are also investigating six managers of the hospital as part of an investigation into absenteeism and fraud in Italy’s public sector, which includes women clocking in their husbands and employees punching in before heading out for a day of shopping or napping.

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A Florida nurse inadvertently broadcasts herself giving a patient a gluteal injection while waiting on her Zoom-based grand theft case to begin.


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Weekender 4/16/21

April 16, 2021 Weekender 13 Comments

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Weekly News Recap

  • Digital health vendor K Health, insurer Anthem, and investment firm Blackstone form Hydrogen Health.
  • CHIME will integrate its Spring Forum into Vive, an annual health IT event it will co-host with the HLTH conference beginning next March.
  • Mayo Clinic launches Remote Diagnostics and Management Platform.
  • The VA reaffirms that it will not bring its second Cerner site live in Columbus, OH until it has completed a strategic review of the project and shared the results with Congress.
  • AI solutions vendor Olive acquires Empiric Health, which offers AI-powered surgical analytics software.
  • Google will conduct a user feedback study as it prepares to develop a consumer-facing health record tool similar to Apple’s Health Record app.
  • Microsoft announces that it will acquire Nuance in a deal worth nearly $20 billion.
  • HHS extends TeleTracking’s COVID-19 hospital operating data collection and reporting for a third six-month term.
  • US News & World Report highlights the legal efforts of Hoag Memorial Hospital Presbyterian to leave the 51-hospital Providence system, with a key issue being clinical standardization as enforced by configuration of Epic.

Best Reader Comments

I think this acquisition makes a lot of sense for Microsoft. The future is not on a mouse and keyboard, it’s voice control and augmented reality. There will be an exciting opportunity to integrate this with the Holo Lens which as far as I can tell is one of the more mature AR gadgets out there. When you pair Dragon + Holo Lens + Hey, Epic! and other types of integrations, you have the potential for a must-have product for certain types of providers. As others noted, this will be yet another reason for existing customers to adopt Azure and/or Azure AD. Azure AD identity integration is going to play a bigger role in healthcare consolidation than people realize. Managing healthcare user identities for external users and mergers is a PITA and Azure AD helps reduce the complexity quite a bit. Dragon can now bolt right on to that. (Elizabeth H. H. Holmes)

I would add that Cortana hasn’t been well received by the market, so picking Dragon’s voice rec is a nice cherry on top of the reasons you state. They may not plan to sell a lot of the standalone product, but adding underlying technology to their stack is appealing. The talent acquisition is also nice. (Jim)

If they are paying 14 times rev for Nuance AND they manage to get almost all the Nuance revenue into the Azure “bucket” AND revenue to Azure is more profitable than the rest of MSFT and bumps up overall market cap, can they mark this whole thing as a win by adding more to MSFTS market cap? (Matthew Holt)

Re: Hoag. A hospital in Orange County (with cash–rich patients who are willing to come up out of pocket to pay for healthcare) has more ability to consumerize healthcare and give patients every option and ultimately, deliver what the patients want. Providence has facilities that can’t do that. But does that really change the ‘standard’ of care? (ellemennopee87)

Raise your hand if you’d like to see the data use agreement for Google’s PHR (I say this while realizing I’ve turned over 90% of myself to them already). The portal is like the only thing about healthcare I enjoy. Seems like another PHR failure in the making. (Android user)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. W in Washington, who asked for a microphone, drawing tablet, ring light, and phone video stand for creating online lessons for her elementary school class. She reported last winter, “Beginning the school year remotely was difficult, but thanks to your help, my students have been performing to their very best online. My science classes have become familiar with Microsoft Teams, and have been working with Class Notebook (a version of One Note) specifically for science. This program has allowed for easy access to and organization of class notes and activities. Implementation has been so successful that I plan on going paperless for the majority of class activities for years to come. Being able to provide my students with high quality recordings, in which multiple screens can be viewed simultaneously, has been a blessing this year. The audio and visual quality of the content I can deliver has improved immensely with these items, and has helped our English language learners as well as special needs students to succeed in this new environment. I can’t wait to share these tools with students once we are able to meet in person in the classroom.”

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Montefiore Hospital (NY) implements sleep pods that allow frontline workers to relax and energize. The HOHM pods, which are reserved via a tablet app, offer a massage chair, a privacy curtain that blocks sound, and a charging station.

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Police bodycam video captures officers shooting a patient dead in the ED of Mount Carmel St. Ann’s Hospital (OH). Miles Jackson, 27, struggled with officers who felt a gun in his pants that had been missed in an incomplete pat-down. Jackson said he would comply with commands to put his hands up but was scared the officers would shoot him, after which an officer took him down with a stun gun and he was then shot by multiple officers after his gun discharged. Westerville’s police chief says he has “concerns that warrant further review.” Jackson had been taken to the ED after being found unconscious of a suspected drug overdose in a car and was being arrested in the ED on outstanding warrants.

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Police charge a 31-year-old South Florida Botox clinic nurse practitioner with anonymously calling two elderly women and convincing them to wire her $20,000 to help one of their relatives that had been injured. She was also charged with drug trafficking when the arresting officers found 170 pounds of marijuana in her apartment.

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The local paper profiles LaVonne Smith (at left above), who just retired as IT director of Tomah Health (WI) after a 40-year career, 36 of which was spent in IT after she was drafted from the admissions department in 1985 to help implement the hospital’s first computer system. The health system went live on Epic in 2017.


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Weekender 4/9/21

April 9, 2021 Weekender No Comments

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Weekly News Recap

  • KKR acquires a majority interest in behavioral health EHR/PM vendor Therapy Brands.
  • Firefly Health raises $40 million.
  • A magazine article questions the claims and effectiveness of behavioral therapy apps.
  • Massachusetts General Hospital will collaborate with drug manufacturer AstraZeneca on digital health solutions for disease management.
  • The Indian Health Service seeks help with developing a strategic plan for IT.
  • Bright Health acquires Zipnosis.
  • The federal government’s information blocking and EHR transparency rules take effect.
  • A two-system study of EHR usage finds that ambulatory physicians spend five hours on the EHR for each eight hours of scheduled clinical time.
  • Bank of America acquires AxiaMed.

Best Reader Comments

I can’t believe after all these years I am still downloading summaries from patient visits that tell me nothing I didn’t know before walking in the door. I already know my Rx med, patient medical / surgical history, VS, etc. What I WANT is a summary of what the doc and I discussed because I don’t always remember all the details and occasionally have needed to refer to it. This is NOT what was intended when this whole notion of implementing EHRs (not to mention paying docs for doing that!) was first started. (JT)

Standardize and automate. Do as much of this as you can, and no more. (Brian Too)

I don’t understand why these health insurance + digital whatever always go for the low cost market. In the Firefly Health article, they say their cost is so much lower (doubtful). But I imagine the people who would want a digital insurance care plan are not the same people who are looking for bargain basement health insurance. (IANAL)

In primary care at least, so much easier when the horse brought doc to the house where they stayed until the crisis resolved. The physician was not interrupted at all. As a country doc by training, I knew we were going down a slippery slope when consultants started saying that all patients needed to be in gowns before doc would encounter them. And now, it is all about productivity first rather than quality. (Kevin Hepler)


Watercooler Talk Tidbits

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Readers provided the New York elementary school class of Ms. F with hands-on math kits, from which she created individualized math toolboxes to accommodate COVID-19 requirements. She says, “Thank you so much for donating to my classroom and supporting us for this year and years to come. We use our materials for math on a day to day basis. It truly has helped us transition to a new type of learning. Thank you so much for all of your help. My students are so grateful as well, they are still talking about the kind person who has helped out and donated to us in a time of need. Thank you so much for everything! We appreciate you.”

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The Department of Defense profiles Army Captain Tineisha Nagle, MSN, APRN, who was deployed under a FEMA program to support ICU staff at Yuma Regional Medical Center (AZ). She graduated from the United States Naval Academy with a degree in ocean engineering and then earned bachelor’s and master’s degrees in nursing, served 12 years in the Marines including deployment to Iraq as a lieutenant, and recommissioned to the Army Reserves, where she is completing her first year as a critical care nurse.

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A Minnesota hospital nurse who was fully vaccinated for COVID-19 in January is stuck in quarantine in a Playa del Carmen, Mexico hotel room after testing positive in preparing for her trip back home from vacation. She is restricted to a small room that is guarded around the clock, but at least she bought the hotel’s $30 insurance policy that covers room and meals for 14 days for guests who test positive.

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A Michigan baby who is nearly two years old goes home for the first time, having spent her first 694 days hospitalized in the pediatric cardiothoracic ICU with a congenital heart condition that required four open heart surgeries. It’s probably best to focus on the feel-good aspect and not the size of the University of Michigan bill or who ultimately will pay it.


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Weekender 4/2/21

April 2, 2021 Weekender 1 Comment

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Weekly News Recap

  • HIMSS acquires healthcare supply chain-focused SCAN Health.
  • Cerner finalizes its $375 million acquisition of Kantar Health.
  • VA Secretary Denis McDonough expresses concern about productivity at its first live Cerner site and the possibility that the project’s cost could exceed its $16 billion budget.
  • Net Health acquires Casamba.
  • MTBC rebrands to CareCloud, taking the name of a previous acquisition.
  • The Department of Justice asks for more information about Optum’s proposed $13 billion acquisition of Change Healthcare.

Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. M in Illinois, who asked for Mini Magic Boards for online sessions of elementary school class. She reports, “This fun and engaging writing tool has been used during our remote learning lessons and during our preschoolers’ asynchronous time as well. They really love to use it, as it gives them an opportunity to practice their writing skills beyond a pencil and paper. We’ve used it to practice writing numbers, letters, their name, drawing shapes, and more. It has made a big difference during our lessons and students have shared photos of how they’ve been using it at home as well. Thank you again for helping us get this writing tool in our preschoolers’ hands and get them excited about learning remotely.“

The one consistent aspect of the US healthcare non-system is maximizing profit. A nine-state group of anesthesiologists sues UnitedHealthcare, claiming that the giant insurer used its clout to steer surgeons away from using the group’s services. United responded by saying that the private equity-owned US Anesthesia Partners, which is not in United’s network, was demanding to be paid double or triple the median rate. The practice countered by claiming that the insurer’s parent company UnitedHealth Group offers its own medical services,  has 50,000 physicians on staff, and holds partial ownership of Sound Physicians, an expanding business that offers emergency and anesthesiology services.

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Adam Litwin, MD,  who served prison time 20 years ago for impersonating a surgical resident for several months at UCLA Hospital – he forged prescriptions, although he didn’t participate in surgeries – fails to match for medical residency for the second time following his 2018 graduation from a for-profit medical school in the Caribbean. One factor in his getting caught at UCLA was that he wore a white jacket adorned with a silk-screened image of his own face, which he claims other doctors envied. Googling “Saint James School of Medicine” turns up fascinating stories from former students and a published US residency match of 6% to 20% over several years.

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A former Atrium Health paramedic who is awaiting trial for fatally poisoning his wife with eye drops he had added to her glass of water is arrested for intentionally setting fire to an in-flight medical helicopter, which was forced to make an emergency landing. Josh Hunsucker refused to give permission for his wife’s body to be autopsied and quickly cashed out her life insurance, but a blood sample that was taken for her organ donation was found to have high levels of tetrahydrozoline, the decongestant in Visine that apparently triggered his wife’s heart attack due to her previous heart problems. Authorities think he was copying a murder in which a former VA nurse killed her husband with Visine two years after he recovered from an injury sustained when she used a crossbow to shoot an arrow into his head.

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Jacksonville, FL police arrest a man who was injecting people with Chinese-labeled Botox while drinking malt liquor and champagne, posing as an oral surgeon at an advertised a “Botox and Bubbles” event at an aesthetic spa. At least his price was right – he charged $350 versus the typical $1,200 cost. Googling “Botox & bubbles” turns up thousands of similar events at aesthetic practices, although they are focused on marketing the service rather than delivering it on the spot.


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Weekender 3/26/21

March 26, 2021 Weekender 1 Comment

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Weekly News Recap

  • Amwell’s Q4 and fiscal year numbers, along with anemic projections for 2021, send shares down.
  • Bankrupt Astria Health again blames Cerner for its financial problems in bankruptcy court, saying the company overstated the integration between Millennium and its revenue cycle offerings that caused collections to plummet.
  • Providence spinout DexCare raises $20 million.
  • Data and analytics vendor Komodo Health raises a $220 million Series E funding round.
  • Appriss acquires PatientPing for a reported $500 million.
  • Aggregation and analytics vendor Evidation Health raises $153 million.
  • VA Secretary Denis McDonough orders a 12-week strategic review of its Cerner implementation following reports of problems at its first live site, Mann-Grandstaff VA Medical Center.
  • AHA asks the Department of Justice to review Change Healthcare’s $13 billion acquisition by Optum.

Best Reader Comments

[Re: Amazon’s virtual health business] Local primary care physicians / groups may be able to use this as a platform to deliver virtual health services (Amazon seller services model). If the movement towards loosening state-based licensing requirements continues to gain steam and results in long-term policy changes (Amazon might put some lobbying dollars behind it), this particular play can have a real impact in addressing clinical resource shortages, especially in rural and underserved areas. (Vikas Chowdhry)

[On Ro] They say, ‘Oh, healthcare is a $4 trillion market – it’s so massive.’ But that’s the worst thing in the entire world; it’s awful how large it is. And I think what we have the opportunity to cut it in half with technology.” So, watch out world! Ro is out to cut healthcare by $2 trillion. He further claims that: “While Ro doesn’t work with insurance currently, Reitano points out that he’s not against the concept entirely” (thank for letting us exist, exhaled UnitedHealthCare, Anthem, Aetna, Cigna and Humana) …  I wish I had the [misplaced] confidence of a well-connected, well-funded white male. (Ghost of Andromeda)

We obsess a little too much over legislating privacy around PHI versus privacy in general. (James E. Thompson, MD)


Watercooler Talk Tidbits

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Readers funded the teacher grant request of Ms. L in California, who asked for a library of 22 books for her class of 3-6 year olds with Autism Spectrum Disorder. She reports, “These books will be used for virtual story times and small group lessons via zoom. Additionally, they will possibly sent home for parents to read to their children. Eventually when school reopens in a face-to-face manner, we will finally be able to read our stories as an entire class. We thank you for your donations and passion for helping students learn to love literacy.”

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Industry long-timer John Hummel died on March 20 at 67. He had served as SVP/CIO of Sutter Health, CIO of California Prison Healthcare Receivership, CTO of Dell Perot Systems, and CISO of Tahoe Forest Hospital District and Taos Health System.

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Bobby Brown, MD, a four-time World Series winner with the New York Yankees who left the game at 29 to pursue a career in cardiology and then returned as American League president for 10 years, died this week at 96. He also served in the Navy in World War II while completing his pre-med work, then was recalled for the Korean War, where he served as battalion surgeon. He was the last surviving Yankee of the 1940s. He told his future wife how to introduce him to her parents: “Tell your mother that I’m in medical school, studying to be a cardiologist. Tell your dad that I play third base for the Yankees.”

The Defense Health Agency updates its RFI for a cloud-based veterinary EHR that will replace its custom-built system that manages medical records, scheduling, billing, and inventory for 140 DoD facilities. The new system must interoperate with its Cerner EHR for humans, the Air Force’s Working Dog Management System, and the military’s animal disease surveillance and laboratory systems.

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A man who lived for 35 years since the age of 15 thinking he would die any time of a brain cancer that is usually quickly fatal discovers from old medical records that he was diagnosed incorrectly. Jeff Henigson was contacted last year by a neuropathologist who saw his story on BBC News and told him that he had seen just three cases of anaplastic astrocytomas where the patient beat the expected bleak life expectancy of 2-3 years, and two of those cases involved an incorrect diagnosis by a pathologist. Henigson dug through his old paper medical records that his mother had kept, in which two pathologists from local hospitals declared his tumor benign, but a second opinion in 1986 from an unnamed prominent institution concluded that he had a different kind of tumor that was aggressive and likely to be fatal. Based on that faulty diagnosis, he endured surgery and months of brain radiation and chemotherapy that left him with permanent hearing loss, vision problems, epilepsy, and lung problems.

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A painting by reclusive street artist Banksy that honors NHS frontline COVID-19 workers sells for $23 million, with the proceeds going to Southampton Hospitals Charity. The price, at 10 times the pre-auction estimate, is the most ever paid for a Banksy work.


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Weekender 3/19/21

March 19, 2021 Weekender No Comments

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Weekly News Recap

  • Transcarent executive chairman Glen Tullman adds the CEO role to his responsibilities.
  • Social services referral platform vendor Unite Us raises $150 million.
  • Amazon announces plans to expand its employee-only virtual care service to 50 states, then offer it to other employers.
  • Analytics vendor Clarify Health raises $115 million.
  • A study finds that two-thirds of the country’s largest hospitals are not complying with new federal pricing transparency rules.
  • Tegria acquires Cumberland.
  • Tech-enabled kidney care company Strive Health raises $140 million.
  • Grand Rounds acquires Doctor On Demand.
  • HIMSS pays $2.8 million to settle a class action lawsuit brought by HIMSS20 exhibitors over unrefunded fees.
  • HIMSS21 registration opens.

Best Reader Comments

From Amazon’s announcement, the service and sales model is basically Teladoc. I think the big question is if Amazon expects the venture to ever make money or just make financial sense for their employment expenses? I think it will be like Walmart, where they initially focused on their own employees, that didn’t work too well, so they tried to pivot to selling via in-store clinics, which didn’t work, so they gave up and outsourced it to like VillageMD or something. (IANAL)

I think we are starting to see the growth of some subscription-based service for telehealth. Just a matter of whether it will be privatized or socialized subscriptions.(Elizabeth H. H. Holmes)

Most measures required for ambulatory and pop health purposes are designed with zero consideration of the reality of clinical data and patient journeys across siloed information systems. Appropriate that the story directly follows the analysis of the failures in COVID-19 data. When the measurement system is designed without consideration of the data sources, chaos ensues. (Quality4Evah)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. D, who asked for supplies and tote bags for her elementary school class in Maine. She reports,  “On the first two days of school, students were able to color their tote bags and pencil bags. They were so excited that they had new markers to use and could not believe that they could decorate their own bags. They could not believe that they were allowed to keep the materials at home. The white board and markers was the most exciting item in the bag. The students were yelling with excitement that they had their very own white board to use at home. They use it when they are learning remotely to show me math equations and math work. It is much easier than trying to write on a laptop with a mouse! The students take a picture of their work on the white board and send it to me so I can see it. Thank you so much for your generous donations to help my students engage while learning at home.”

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The founders of bankrupt digestive tract microbiome testing company UBiome are indicted on federal healthcare and securities fraud charges. The company started by selling a “Gut Explorer” test directly to consumers for under $100, but then expanded its business to offer similar tests for medical professionals for which the company would seek up to $3,000 in insurance payments, with the intention of boosting revenue to attract investors for its Series B and Series C fundraising rounds. The company billed $300 million and collected $35 million.

A federal grand jury charges a Florida doctor, clinic owner, and clinic employees with falsifying clinical trials data by enrolling ineligible participants, falsifying medical records, and falsely stating that participants were taking the drugs being studied. Martin Valdes, MD, the study’s lead investigator, was charged with mail and wire fraud, money laundering, and making a false statement to FDA inspectors.

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Spectrum Health launches an investigation after OB/GYN residents post photos of the removed organs of surgical patients to Instagram, saying that the OR staff regularly play “guess the weight” of the removed tissue.

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Washington University in St. Louis surgery and emergency medicine professor Tiffany Osborn, MD, MSc – who works in the ED and ICU of BJC — moves back into her house after a year of living in an RV parked in her driveway to avoid infecting her family. She would work three weeks without a day off, get tested, and then spend a couple of days with her family before going back to work. She moved back after receiving the COVID-19 vaccine.


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Weekender 3/12/21

March 12, 2021 Weekender No Comments

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Weekly News Recap

  • PatientPoint acquires one-time high flyer Outcome Health.
  • Brainlab acquires Mint Medical.
  • A former Practice Fusion sales exec pleads guilty to obstructing a federal investigation into the company’s EHR change to push opioids on behalf of its drug company client.
  • Telus will acquire Babylon Health’s Canadian operation.
  • Harris acquires Bizmatics.

Best Reader Comments

[Small banks being like small providers facing large competitors] This is a good analogy from a tech angle, but bad from a business angle. Your local bank had assets that big banks were interested in. Your local practice or average small hospital does not. What will happen to them is more like what happened to independent pharmacies. When CVS came to town, the payout for your local pharmacy owner was a sign-on bonus for their new employment contract at CVS. (IANAL)

[On Newfoundland and Labrador choosing Change Healthcare Canada to develop staff scheduling software] Healthcare staff scheduling is a well-developed product category. I’m very familiar with this sector. Workbrain, Kronos, and QHR Technologies all have good solutions on offer. Also, the $28 million in incentives? Newfoundland has a bad budget deficit and no idea how to pay that off. I mean, there was semi-serious talk of just asking the federal government to come in and take over. [Brian Too]

Insurtechs, like Oscar and Clover, offered a little bit more [than provider portals] – aggregated patient histories, simplified rostering, and direct scheduling – but they weren’t light years ahead. The biggest difference between the two groups was in how much better the insurtechs were at marketing their provider portal tools … Traditional insurers didn’t attempt to defend their tech at all. They offered the kind of bland, no-frills login page you’d expect to see guarding an enterprise intranet. Investors generally believe disruption = tech superiority, so it’s not hard to see why insurtechs would take the advantage of owning that perception, especially when incumbents are leaving it unchallenged and free for the taking. (J-Hambone)

It feels like there is a lot of combined insurer-health tech-healthcare provider activity lately. My PCP is at Atrius Health, which Optum bought. And Cigna just bought MDLive, which I would guess is the third or fourth biggest telehealth company. Those are both areas that health systems thought they could grow into, but insurers are beating them out. And I’m sure that the little startup insurance companies are doing product R&D and plan to prove something works before getting bought by Optum or one of other big dogs, sort of like how in the 90s it seemed like everyone was trying a crazy software startup and Microsoft would then buy the ones that worked out. (IANAL)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. P in Florida, who asked for 10 books whose theme is “it’s OK to be different.” She reports, “Thanks to your kindness and generosity, I can choose from a multiple of well written and diverse literature. This means that my little friends can find themselves represented in the stories that I read. These students who were previously marginalized in literature are now the heroes or heroines. We learn so much from the different cultures that it created an atmosphere of acceptance for diversity. For example, we started playing music from different cultures as a form of acceptance. The Caribbean kids got to share soca with the class and next week the Latinos will choose a song for us to enjoy. My kids welcome diversity and see the beauty in everyone now.”

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In England, a 27-year-old former teacher from Canada who has experienced two rounds of osteosarcoma that has metastasized and is likely terminal hopes to finish a 16-week hospital rotation that will allow her complete her medical degree requirements. Krista Bose was not allowed to work in hospitals until she finished a chemotherapy round that would have made it unsafe for her to be exposed to COVID-19 patients. She explains why she is is willing to accept what could be a life-threatening risk to complete her MBBS: “No matter what I say, or what I want, or what I hope, my life is limited. This might be the last year my life … I’m willing to take that risk … If I have a limited amount of time left, but I spend that time doing what I love with the people I love and working towards my goals and working for the sake of other people and to help patients, then that’s a life worth living.”

University of Missouri pays $16 million to settle personal injury and false advertising claims over a university-developed knee repair procedure that plaintiffs claim had an 86% failure rate. One of the two developers is a veterinarian, who the lawsuits claim was allowed to perform the procedure without supervision. He holds a distinguished chair position in the university’s medical school, is chief of its orthopedics research division, and is director of operations and research of its joint center.

Police charge a Miami-area woman with practicing medicine without a license after she botched two attempts to perform a $2,000 nose job on a man who was left disfigured. The man says she also prescribed antibiotics and painkillers under a doctor’s name. She appears to be the operator of Millennium Anti-Aging and Surgery Center, a medical spa that offers plastic surgery, Botox, weight control plans, electrotherapy, and general surgery. It is conveniently located adjacent to the House of Kabob and a traffic ticket lawyer.

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Northwell Health donates items that were used to inject the US’s first dose of coronavirus vaccine — at Long Island Jewish Medical Center on December 14, 2020 — to the medical collection of the Smithsonian’s National Museum of American History. The donation includes the scrubs, ID badge, and vaccination record card of Sandra Lindsay, RN, MS, MBA, director of critical care patient care services. 


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Weekender 3/5/21

March 5, 2021 Weekender No Comments

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Weekly News Recap

  • Several health systems and home-based care companies form Moving Health Home to encourage federal payment for moving some care from hospitals to home.
  • Premier acquires Invoice Delivery Services.
  • Duke University personalized chronic care spinout ZealCare will launch later this month.
  • BD acquires GSL Solutions.
  • Universal Health Services estimates that September’s cyberattack has caused $67 million in losses.
  • HHS OIG officials recommend that prescriptions be required to include the condition for which the drug is being used to reduce errors, allow correct CMS payment, and help families sort patient meds.
  • Naval Medical Center San Diego goes live on Cerner.
  • Ambulatory health IT vendor MTBC will change its name to CareCloud, the EHR vendor it acquired in January 2020.
  • Cigna’s Evernorth health services business will acquire telehealth vendor MDLive.

Best Reader Comments

I couldn’t agree more with the second point on why vaccination self-scheduling is harder than it looks. In Florida, Publix Supermarkets is the best place to get COVID vaccinations IMHO, but their self-scheduling app stinks. And it’s for that very reason; users have to enter several screens of data before you actually get to the point of trying to find locations with appointments. And Publix has hundreds of stores here. (Jim Beall)

When big health system is the only provider in town, they don’t need to thank you for choosing them. You had no other choice. (Was a Community Hospital CIO)

Interesting to see Allscripts spend time discussing Veradigm to the investor community. We recently asked them for a briefing to better understand Veradigm’s business model, including data governance model for patient privacy. They canceled that briefing after we authored a post looking at the healthcare data-for-sale marketplace. (John)


Watercooler Talk Tidbits

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Readers funded the teacher grant request of Ms. H in Arkansas, who asked for laptop accessories to support her class’s hybrid learning. She reports, “Thank you so much for your donation. The laptop riser and wireless mouse have made teaching much easier; and I honestly would not know what to do without the camera as my laptop is older and I didn’t have access to a camera until your donation. These have helped greatly with ease into this new type of teaching with blended classes of in-person and virtual students. I appreciate your help in making this year a success! These materials we are using almost daily to improve instruction and help my students.”

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Baltimore County, MD’s vaccine site coordinator says his 12 years of experience as a roadie with Twisted Sister prepared him to get crowds into and out of large venues. His tips: (a) give each crew member just one job to do; (b) make it easy for attendees to follow the coned and taped areas that designate the flow of cars and people; and (c) keep attendees moving but don’t allow one station to move so quickly that people wait too long at the next one.

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A 75-year-old Long Island doctor is charged with murdering five patients who died of opioid overdoses. Prosecutors say George Blatti, MD worked out of a hotel parking lot, a doughnut shop, and a defunct Radio Shack, prescribing massive quantities of drugs to addicts without an exam while accepting either cash or insurance for payment.

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First-year internal medicine resident Troy Manz, MD died from being struck by a car during a Florida bicycle race last weekend. The 46-year-old Air National Guard air transport physician and captain in the 126th Medical Group served eight years in the US Marine Corps, 13 years as a US Air Force critical air transport respiratory therapist flying injured service members in Iraq and Afghanistan, and then earned his medical degree from University of Kansas School of Medicine in 2020. His commanding officer said, “He went to medical school in his 40s and that’s unheard of. it was frankly a struggle for him. But he set goals and had a vision of where his future was going to lead him.”

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Actor Hugh Jackman delivers a loaf of his homemade sourdough bread to Wyckoff Hospital (NY) ED nurse and nurse practitioner student Alina Jackson, RN, who volunteered to work a 24-hour shift during snowstorm even though she is six months pregnant.

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Ottawa Public Health’s earns accolades and millions of Twitter views for mixing up the usual serious coronavirus pronouncements with empathy, riffs, and jokes. Social media lead Kevin Parent says he uses the account to talk “with” rather than “to” readers in hopes of engaging them and having them share the information. The tweet above was seen and shared by millions of people, with newbies crowing about “you had just one job” and pondering the employment future of poor Bruce, unaware that (a) the answer to the question of whether any OPH tweet was intentional is always “yes;” and (b) there’s not an actual Bruce.

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The local paper profiles Blount Memorial Hospital (TN) environmental services worker Tom Cunningham, who cheers up employees, visitors, and patients by channeling Elvis Presley in the hallways. He has done Elvis impersonation shows at birthday parties and weddings for 20 years. He joined Blount Memorial two months ago after years at University of Tennessee Medical Center, which asked him to stop praying with patients and employees who asked him, ordering him to leave religious work to the hospital pastoral staff.


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Weekender 2/26/21

February 26, 2021 Weekender No Comments

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Weekly News Recap

  • Allscripts and Teladoc Health release quarterly results.
  • Healthcare Bluebook acquires the quality division of Quantros.
  • Innovaccer raises $105 million at an implied valuation of $1.5 billion.
  • Redox announces a $45 million Series D funding round.
  • Google Health expands the pilot of its EHR search and data presentation tool, which it has named Care Studio.
  • IBM is rumored to be looking at selling IBM Watson Health.

Best Reader Comments

When resource limited, and dealing with existing systems and a legacy of choices, “apps are dead” can sound a little blasé and soundbite-y. Now add in organizational politics, budgeting, and available skill sets. The choices get more complicated. Absent those factors though, there’s a lot to like about “apps are dead”. You get a single code base that supports all devices. Support lines tend to be simpler too. But sometimes? An old app can do a better job than the new replacement! (Brian Too)

I think the green passport idea is great. It might allow the free market to push the vaccine-hesitant to get on board when businesses and airlines start advertising special privileges for passport holders. The problem in the US, though, is that we can’t seem to get a nationwide IT system for anything unless it involves the IRS. (Bob)

We should challenge developers (I am one) to think critically. Also, bugs aren’t exclusive to coding errors. (RobLS)


Watercooler Talk Tidbits

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Two Vanderbilt University Medical Center physicians publish “From Two Doctors,” a newsletter that highlights the pandemic’s unsung heroes. Assistant Professor of Clinical Medicine Michelle Izmaylov, MD is a published author of fantasy fiction books and medical essays, while Thea Swenson, MD is a medical resident who formerly worked in health IT startup marketing and product development. Both are first-generation Americans, from Russia and Vietnam, respectively. 

A technology reporter whose broken collarbone left him with his arm in a sling for six weeks describes how accessibility technology helps people with disabilities. Topping his personal experience list is AI-based transcription for typing on all devices, which taught him that voice typing on his phone is three times faster than finger typing. He likes the dictation and voice control technology of Google Docs best. Runner-up accessibility winners are biometric authentication, password manager apps, and finger swipe typing.

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PCP versus demanding customer: In Australia, D-list reality show celebrity Yvie Jones complains in a profanity-filled Instagram post that she saw her doctor about a lump on her neck and while there, he suggested that she see a dietician. She declared that she has been “weight-shamed by my doctors for years” and said that she and many others “would rather die than be spoken so poorly to” by doctors who “never focus on what we’re there for.” She has previously posted recaps, sometimes with photos, of her other medical issues, including case of hives following a cat allergy, peri-menopause, iron deficiency, abdominal cramping, a back problem, depression, and weight loss surgery.

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NHS England urges people to ignore the medical advice of celebrity huckster Gwyneth Paltrow, who claims that her COVID-19 infection and the resulting long COVID were successfully treated with her expensive, Goop-branded nutritional products. If faux COVID cures aren’t your thing, the college-uneducated GP will be happy to sell you – hopefully delivered in an unlabeled package – an $80 candle that smells like her vagina.


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Weekender 2/19/21

February 19, 2021 Weekender 1 Comment

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Weekly News Recap

  • Intelerad acquires Lumedx.
  • IBM considers selling IBM Watson Health.
  • Former Nuance CEO Paul Ricci joins Qualifacts as president and CEO.
  • Zocdoc receives $150 million in growth financing.
  • Innovaccer is valued at $1 billion based on a reported new investment.
  • Dexcom launches a venture capital fund.
  • Sharecare’s SPAC deal values the company at $4 billion.
  • GAO recommends that the VA stop its Cerner implementation until critical issues are resolved.

Best Reader Comments

“Apps are dead.” I’m curious what healthcare readers think about that comment. (Matt Ethington)

Syringa Hospital. Why in the world is a board involved in this level of operations? They should only be approving, or not, the CEO’s financial outlay for the acquisition. If the CEO can’t get the leadership team on the same page, the board has another, bigger problem. (Jamey)

There are probably less than 100 employees at this hospital. There just aren’t that many management staff above line managers. The board is probably composed of community leaders who may have some experience in the area either in IT or just organization in general. It isn’t easy running 15 bed rural hospitals on shoestring budgets. (IANAL)

The developer’s opinion and the comment represent the age-old battle between developer’s who view the system as “working as designed” and the users who are just trying to make an appointment. In this case, I’m betting the specification did not mention that users should not be able to make multiple appointments for the same dose. The developers either missed the difference between the two doses or just let anyone make as many appointments as possible. Clearly the system was not working as required. I loved the comment it allowed our technical folks who don’t normally interface with customers the opportunity to do that … what a rewarding experience. (AllHatNoCattle)

Agree that if the clinician isn’t checking the transcription, then that is on them. With the number of scribes and “speech processors” out there, I have yet to find one that is much above 95% per word accuracy — the more complicated the word, the lower the accuracy. With a word count of 171, which eight were recorded incorrectly in this missive? (AnInteropGuy)

For the “lung cancer” versus “tongue cancer” mistake, I’d think that something suggesting the correct diagnosis could have helped. “Note indicates lung cancer, lung cancer not documented as patient diagnosis.” No idea how difficult that would be to not trigger on false positives, but it could help fill out a patient’s problem list and medical history. (AI what?)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. D in Kentucky, who asked for online instruction resources for home using during “COVID days.” She reports, “My class is very grateful to receive this generous gift. I have become a full-time virtual teacher with more than 50 students. These supplies have helped lessen the cost of that I would have had to purchase for my students.”

I read most news on my tablet and find myself avoiding the Washington Post even though I subscribe to it because I despise the app’s layout, navigation options, and inability to view reader comments. Not to mention that there’s no way to forward an article to my email so I can remember to mention it in HIStalk. I found a better way — place the browser link on the IPad’s home screen and skip the app. The navigation is better, “send to” works, comments display, and it feels a lot more like something worth paying for.

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The New York Times covers the thousands of medical school graduates who aren’t chosen for the limited number of US medical residency slots, leaving them with an average of $200,000 in student loans and no ability to work as a doctor. The US has at least 10,000 such graduates, many of them Americans who went to medical schools in the Caribbean or other countries whose chances of landing a residency are about 50%. Medical schools have increased their enrollment, but residency positions — which are funded by CMS – remain capped. Experts say the offshore medical schools that recruit American students sometimes overstate the history of their graduates being matched and thus eventually employed.

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Hospitals in Texas are collecting buckets of rainwater and using portable toilets as storm-related water shortages affect even the largest facilities. Patients are being double-roomed and boarded in hallways, dialysis patients are showing up in hospital EDs because dialysis centers are closed, patients who are ready for discharge can’t leave, and hospital employees are sleeping over because they can’t get home. Hospitals are also seeing patients with carbon monoxide poisoning due to improper use of generators and heaters. About 100 hospitals in southeast Texas declared an internal disaster in hoping to avoid receiving new patients by ambulance. Meanwhile, the CFO of a natural gas company owned by billionaire Dallas Cowboys owner Jerry Jones giddily tells investors with Enron-level greed and indifference to the misery of others that the weather “is like hitting the jackpot” as the company is selling natural gas “at super premium prices.”

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New York-born Indian-American actress, film maker, and former physician Lakshmi Devy, MD serves as the writer, director, and lead actor in “When the Music Changes,” which address rape and assault. She previously made “Daro Mat” (which translates to “Don’t Be Afraid,”) a short film that is available on YouTube.

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Missouri Baptist Medical Center COVID-19 ICU nurse, family nurse practitioner, and first-time mother Mandi Tuhro, RN, MSN describes the challenges of watching patients die, trying to find time to pump breast milk, feeding her son overnight, and dealing with the fact that at 30 years old, “there’s not a single facet of my life right now that I’m not needed, and that is a heavy feeling.”

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Clark County, Indiana health officer and Colts fan Eric Yazel, MD writes a letter to the team’s general manager every year to offer his service as quarterback. He’s perhaps not the perfect candidate, as he admits to the GM: “A less visionary GM might be given pause by my age (44),  mediocre BMI, and relative lack of any athletic experience.” The GM called him back this year just to be nice, but Yazel ignored the call because it came from a Houston area code and “I thought it was the Texans calling. I will listen to some other options, but I am not going inter-division.”


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Weekender 2/12/21

February 12, 2021 Weekender 3 Comments

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Weekly News Recap

  • Fourteen large health systems form Truveta to provide anonymized patient data for research.
  • Value-based care coordination and payments vendor Signify Health prices its IPO at a valuation of $5.3 billion.
  • Cerner meets Q4 earnings expectations, beats on revenue.
  • CPSI misses Wall Street’s expectations for both revenue and earnings.
  • HHS OCR enters its 15th settlement involving providers that failed to provide patients with timely copies of their medical records.
  • Nuance acquires Saykara.
  • A security researcher finds problems with 30 popular health apps and their APIs.
  • Duke spinout Clinetic, which monitors EHR activity to identify patients for clinical trials and next care steps, raises $6.4 million in equity.

Best Reader Comments

It seems like Cerner is going for the data play for their growth. That’s what Allscripts told Wall Street for the past five years and they never were able to execute on it. The solution in that space is not really a technology as much as it is a social process. Maybe they can pull it off. On a different note, CPSI seems to be more in the outsourced to Overseas billing business than in the EHR business these days. (IANAL)

This seems to me to be part of an ongoing problem space that really shouldn’t be part of a free market society. We have seen many examples of VCs buying facilities and clinics then turning them into profit centers. Be that through purchase of rural hospitals and using the lab systems to “outsource” labs at many multiples of the normal cost, or hospitals aggressively pursuing clinical debt up to and including leans on homes and garnishment. The stories are numerous and from credible sources (KHN, NPR, DOJ). Frankly, we shouldn’t allow venture capitalists into our health systems — their mission is to turn a profit and they use the opaqueness of the HC system to do that. A $46,000 rabies shot that normally costs $3,000? (AnInteropGuy)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. P in Pennsylvania, who asked for three sets of books covering math, space, and the environment for her elementary school class. She reports, “These books have made a big difference in our classroom. Since I am teaching virtually, I have recorded myself reading the books to the children. This way they can go back and listen whenever they wish. There are definite favorites. I don’t blame the children, I have my picks too. When we return back to in-person classes, these books will have a special home. They will have there own special shelves for easy access for the children. I can see them being read for years to come.”

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A patient in Canada who is undergoing treatment for throat cancer panics when new CT scan results that he saw on MyChart referred twice to his lung cancer. He couldn’t reach his oncologist, but the hospital connected him with the radiologist, who apologized that the transcription system had misheard his dictated “tongue” and instead documented “lung.” The patient says of his stressful reaction, “It confirmed my impression that the healthcare system has yet to establish an effective way for caregivers and patients to communicate except through in-person, video, or telephonic visits. I’ve not been successful in getting questions answered using the Cancer Centre’s Patient Support Line. And so far, MyChart has mostly wasted my time or misled me … I’m struck that when I read my CT report, I saw immediately that the reference to ‘lung’ was anomalous. If a layperson can see an anomaly, could we train an AI to catch one? Don’t dismiss the thought. I certainly don’t want a robot that autocorrects CT reports. But I do want one that can register surprise when something unexpected happens.”

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NASA will offer 1,000 employees, including astronauts, a Fitbit Charge 4 device and Fitbit’s Ready for Work app to help them decide whether they are experiencing COVID-19 symptoms and should stay home from work during the critical pre-flight period. The app tracks resting heart rate, heart rate variability, and respiratory rate and allows users to self-report symptoms, temperature, and possible COVID-19 exposure.

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This is American culture and its healthcare system in a nutshell. Tessica Brown uses Gorilla Glue spray adhesive as a replacement for hair spray in a pinch, then spends 22 hours in the ED trying to get it removed. The daycare owner was finally freed of her adhesive hair net by a plastic surgeon, but meanwhile earned dozens of millions of TikTok video views, raised $22,000 in a GoFundMe to cover her medical bills for “this unfortunate ordeal,” and is reportedly planning to sue Gorilla Glue for misleading her (she denies reports that she’s suing). Not to be outdone, a fellow Louisiana resident – who previously earned his 15 minutes of fame on Dr. Oz for participating in the “ice cream challenge” of licking the contents of a carton of ice cream and putting it back on the store’s freezer shelf for someone else to buy — attempts to prove that Brown was exaggerating by gluing a Solo cup to his lip, then videoing himself triumphantly licking it off. That didn’t work as planned and he, too, ended up in the ED, where doctors peeled the cup off.

A UK hospital asks midwives to change their childbirth-related terms to be more inclusive – “mother” will be replaced by “birthing parent;” “her” will be retired in favor of “them;” “maternal” will become “maternal and parental;” and the new term for “father” will be “co-parent.”

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A Texas nurse whose car was pinned between two semi trucks in the early morning 100-car I-35W accident that killed six people crawls out through her trunk to free herself, hops the highway barrier to hitch a ride with a co-worker going the opposite direction, and goes to work.

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Cerner Charitable Foundation Program Manager Allison Chael worked her other job as a Kansas City Chiefs cheerleader last weekend. Each team had to choose eight members of its cheerleading squad — the Chiefs have 33 cheerleaders on the roster – and they were not allowed on the playing field for this year’s game.

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Cheering on the other side of the Super Bowl field was Tampa General Hospital ICU nurse and Buccaneers cheerleader Anastasia Lusnia, RN.


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Weekender 2/5/21

February 5, 2021 Weekender No Comments

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Weekly News Recap

  • Netsmart acquires GPM.
  • Nordic acquires Bails & Associates.
  • HIMSS confirms that HIMSS21 remains on track pending further COVID-19 developments, but with a virtual component added.
  • Zyter acquires Casenet.
  • KLAS announces Best in KLAS winners.
  • Sharecare acquires Doc.ai.

Best Reader Comments

A “dead” language (a proprietary one at that!) put food on my table and a roof over my head for 31 years until I was laid off in 2014. Alhough that effectively ended my coding career, I was able to apply all of the software life cycle best practices to become a Product Analyst in which I design the look, feel, and flow, and have a team of ‘modern’ developers do the magic. (Marshall)

I couldn’t agree more with Dr.Van Vert, but as a patient, I often feel woefully ill equipped to create an informed advance care plan. Besides revive or DNR, yes or no to breathing machine / feeding tube? There may be other decisions to be made, such as pacemaker, surgery, antibiotics for repeated UTI. What about relatives who disagree and fight my wishes? What about if my AD is not avail at time of crisis? IMHO, there is still much work to be done to educate patients and family members so that the conversations, once normalized, can be meaningful. (Kathy Kastner)

Ultimately though, this cannot simply be about end-of-life. You need to open the doors to patient priorities and issues throughout the entire healthcare system. We’ve got one big initiative called person-centered care. When you ask the patient upfront what they expect from the care episode, this sends that message. (Brian Too)

So, if I get this right, you were shown an internal error message as an end user (patient). One that should have gone to the user who selected the document in the first place or someone who could actually do something about the error. To say this is a poor user experience is putting it mildly. (AnInteropGuy)

I work for a CRM vendor and so I have that lens on as I read your story. What I see is that the actual test went just fine, it was your entire experience around the clinical event that caused you frustration. Imagine if through a series of coordinated text, emails, calls, chats you were guided exactly where to go, and were given the results in the appropriate context? Yes, there were some physical plant issues (CRM can’t help with dust bunnies), but aside from that, it was all communication. As one health system leader said recently, “the contact center is the new waiting room,” If your health system had a Digital Front Door, you would have had a better experience. (Brendan Ward)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. T from Texas, who asked for a ring light so her students can see her better while she is teaching virtually from home. She reports, “My wonderful students and I would like to thank you for your generous contribution. Teaching virtually has been a great challenge. With the light ring, my students have been able to see me much better on camera.I really, truly appreciate everything that you have done for us.”

A science futurist website questions whether the DNA information of 18 million people that is stored by Ancestry.com is safe in the hands of its private equity owner, Blackstone, which has pledged to find new ways to “package and sell data” as a revenue stream. A finance professor says, “[Blackstone] owns healthcare companies. They own insurance companies. They own retail companies. So they can identify spending behavior, health care expenses, actual health outcomes for individuals.” The article also questions how genetic information will be protected when 23andMe goes public via a SPAC that is owned by Virgin’s Richard Branson.

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In the UK, a COVID-19 conspiracy theorist is banned from hospitals – except for emergencies and scheduled appointments – after filming empty hospital hallways to prove that the British government is lying about the pandemic.

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A man who made money on last week’s wild ride of GameStop stock spends his profits on gifts for patients at Children’s Hospital of Richmond, where his son receives treatment for neurofibromatosis. John Theobald explains, “If a kid that’s stuck at the Children’s Hospital wants unicorn curtains, I’m going to get them unicorn curtains, as opposed to a slush fund.” Another investor, a 20-year-old student who made $30,000 in profit, donated Nintendo Switch games and consoles to his local children’s hospital.

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Mother Jones finds that online nurse groups, including that of the ANA, are filled with COVID-19 vaccine disinformation. Nurses who post that they have been vaccinated are being attacked, threatened, and accused of harming their unborn children. 

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A 10-year-old boy and his mom’s friend head out after Monday’s snowstorm to clear the snow off cars of employees at Westerly Hospital (RI) so they could get home to their families faster.

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In Canada, International Space Station astronaut and primary care physician David Saint-Jacques, PhD, MD returns to the medical front lines to work on the COVID-positive unit of McGill University Health Centre, where he completed his residency. He says, “In the space between the people who have no symptoms and the people who die from them, there are people who will get through it, but who get very sick, who really go through hell, on oxygen, pumped full of drugs, in the hospital, with an impact on their families. Now is not the time to let our guard down, even though we’ve all had enough.”


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Weekender 1/29/21

January 29, 2021 Weekender 2 Comments

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Weekly News Recap

  • Athenahealth pays $18.25 million to settle federal False Claims Act allegations related to paying kickbacks to increase sales from 2014-2020.
  • GetWellNetwork acquires Docent Health.
  • Sharecare acquires Doc.ai.
  • ECRI lists its top 10 health technology challenges for 2021.
  • Symplr acquires Phynd.

Best Reader Comments

My take is that more public pricing will mostly affect hospitals that are undifferentiated and not capital efficient. So your-well branded academic system will still attract those with the ability to pay, your ruthlessly cost conscious commercial chain will actually benefit from the public knowing how much cheaper they are, and your community / rural hospital with decent volume already mostly gets the customer who has no other options. It ain’t fun for inefficient hospitals to close, but it also ain’t fun to be price gouged for medical care. (IANAL)

If you have to be short of something, you want to be short of vaccine. We can get more vaccine. I’m confident of that now. Now the converse: You are short of physicians. How long does it take to train a physician? How much money does it take to train a nurse or pharmacist? What are the hurdles you need to jump to open a new PH Office? It’s all difficult, costly, and there are years-long lead times. According to the Milken Institute, there were 133 experimental therapies as of April 2020. There were 49 in clinical trials. Holy cow! We will be up to our eyeballs in vaccines and treatments very soon. I’m guessing by summer 2021. And all those physicians, nurses, pharmacists, and public health offices will be waiting. They will scale up the vaccine rollout like crazy. (Brian Too


Watercooler Talk Tidbits

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A Mississippi man complains to the local TV station that a hospital wouldn’t let him in because he refused to wear a mask. He says he can’t breathe through a mask, wears a bandanna instead, and says he has a doctor’s note explaining his situation, but the hospital says he refused to wear any face covering even after they called his doctor, who said he should have no problem wearing a mask.

Stormont Vail Hospital (KS) defends giving its fundraising board members COVID-19 vaccine by saying that “our team members include our boards.”

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Former Athenahealth CEO Jonathan Bush buys the Maine oceanfront home of former environmental lawyer and two-time candidate for governor Eliot Cutler in the most expensive home sale in the state in 2020 at $7.55 million. The 15,455 square foot home features a 5.5 acre oceanfront lot with 650 feet of shore frontage, gymnasium with sauna and steam rooms, heated pool, tennis court, a 4,000-bottle secured wine vault, and a four-bedroom guest house. It was originally listed at $11 million.

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Employees of St. Mark’s Hospital (UT) launch a GoFundMe campaign to buy a car for ED environmental services worker and employee of the month Michael Piper, who showed up for his night shift on a freezing New Year’s Day when buses weren’t running after riding his bicycle 37 miles to work.


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Weekender 1/22/21

January 22, 2021 Weekender 2 Comments

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Weekly News Recap

  • Micky Tripathi is named National Coordinator.
  • The co-founder of The COVID Tracking Project says that the recently implemented HHS Protect COVID hospital status database is working well and urges the Biden administration to continue its use.
  • Philips announces plans to acquire medical device integration vendor Capsule Technologies for $635 million in cash.
  • ONC says it will invest $20 million in vaccine-related interoperability projects.
  • An appeals court vacates MD Anderson’s $4.3 million civil money penalty for losing three unencrypted mobile devices that contained the PHI of 35,000 patients, challenging HHS’s ongoing interpretation of HIPAA requirements and its method of setting penalty amounts.
  • Cerner replaces its chief client and services officer and chief legal officer and hires a CFO.

Best Reader Comments

I’ve been arguing with my health law friends that HHS and the conservative compliance lawyer mindset were wrong viewing HIPAA violations a some form of strict liability. I feel vindicated for now since I think the Fifth Circuit got this correct. 1. The technical requirements are met by simply not being negligent. You have implemented encryption? you make reasonable efforts to encrypt the data? Good enough. Perfection isn’t required. Doing more isn’t required. 2. Disclosure is an affirmative action, not merely just loss. It’s active. It’s participative. This construction fits nicely inside the framework. It also addresses the risk of loss to nation-state actors or those who are intent on stealing data. That’s not a punishable “disclosure” that’s a theft. 3. And I realize that HHS updated its penalty guidance, but this makes it very clear: outside some intentional acts, the penalties aren’t business-ending penalties. Yay for reasonableness of courts. (HIPAA Relieved)

The concept that that would not be considered a breach is mind boggling. I fully support the capriciousness but it shouldn’t be allowed to be pushed down to the staff level. In 2017 we all knew that we had to dictate it from an IT organization. (Jeremy)

Cerner Chairman and CEO Brent Shafer may wish to check out his own uCern “ideas” space to get a sense of how his peeps are doing on “strengthening relationships, delivering on promises, innovating faster, and executing on strategies.” There are loads of ideas that are no-brainers and/or have had significant support for many (5+) years, yet are not yet implemented or have been rejected as not on the road map. Other ideas point out serious safety risks, but are said to be working as designed (WAD), although they would be better termed WAHD (working as horribly designed). (CernerClient)


Watercooler Talk Tidbits

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You as an HIStalk reader provided Ms. S’s elementary school class in Mississippi with 30 sets of individual, high-quality headphones in responding to her Donors Choose teacher grant request. She explains why she needed them: “Each year, I’ve bought headphones for my students completely out of pocket. The headphones which I get are usually a cheaper brand, which don’t tend to last long. I am so thankful for your support on this project! My students absolutely loved opening up the box and finding the beautiful headphones inside! Thank you for believing in us, and thank you for supporting our cause.”

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California’s UCI Health will spend more than $1 billion to build 144-bed UCI Medical Center Irvine-Newport. That is $7 million per bed.

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The state of Colorado dismantles a temporary COVID-19 hospital that was built in April 2020 inside Denver’s Colorado Convention Center, which the state leased for $60,000 per day for a year. None of its 2,000 beds were ever occupied.

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A St. Louis TV station profiles 65-year-old pulmonologist Steven Brown, MD, who monitors 100 ICU patients per night – most of them on ventilators with COVID – from his living room as a physician with Mercy’s Virtual Care Center. He says it is hard to watch patients die remotely, in one case seeing four patients expire in a single hour.

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A husband and wife who had been married for 70 years die together and within minutes of each other of COVID-19 in Riverside Methodist Hospital (OH), three days before their appointment to receive COVID-19 vaccine on would have been the husband’s 90th birthday. The family said in their obituary, “We are devastated to lose them both at the same time. But, we are blessed that they walked together, hand in hand, through the Gates of Heaven into Eternity, never having to face ‘Until Death Do Us Part.’”

A 29-year-old nurse who inspired her hospital co-workers by singing “Amazing Grace” after a 12-hour shift caring for COVID-19 patients – captured by a colleague in a video that went viral – sings it again in scrubs at the Lincoln Memorial Reflecting Pool to President-elect Biden and a national TV audience in the National COVID-19 Memorial. Lorie Marie Key, RN works for St. Mary Mercy Livonia Hospital (MI).

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Acclaimed rapper-songwriter Lazarus encourages his fans to get COVID-19 vaccine, a recommendation that carries extra credibility because his other job is as Kamran Rashid Khan, DO, a Las Vegas family medicine physician.


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Weekender 1/15/21

January 15, 2021 Weekender No Comments

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Weekly News Recap

  • Health and technology leaders, including Epic and Cerner, announce their participation in the Vaccination Credential Initiative, which hopes to provide patients with digital proof of their COVID-19 vaccination.
  • QGenda acquires Shift Admin.
  • Walgreens announces plans to develop an extensive customer engagement, care integration, and health marketplace platform.
  • Flo settles FTC charges that it shared the ovulation data of 100 million users with Facebook, Google, and other companies while telling them it was keeping that information private.
  • AdventHealth says its replacement of Cerner, Athenahealth, and Homecare Homebase will cost $660 million.
  • Federal prosecutors say that Theranos destroyed its laboratory information system database that it had hoped to use to prove fraud and use of unreliable tests.
  • ONC releases United States Core Data for Interoperability Draft Version 2 for public comment.
  • Central Logic acquires Acuity Link.
  • Tech-enabled Medicare Advantage insurer Clover Health begins trading on the Nasdaq in a reverse merger with a SPAC that values the company at $7 billion.

Best Reader Comments

It’s kind of absurd that you’re talking about robotic process automation as an innovation. Using computers to automate navigation and administration of our bloated regulatory structures is not innovation. It doesn’t help patients or improve care in any way. It only helps organizations improve their bottom line. The best innovation we could unleash would be to adopt a single payer healthcare system. Innovation should be focused on improving care, not doing paperwork. (Elizabeth H. H. Holmes)

In my opinion, workflow design (and of course system design) questions are often difficult conceptual problems, and they take a good deal of focused thought to come up with a sensible answer. Confounding the problem is the fact that a good design, once clearly laid out, is deceptively easy to follow and understand, leading to the mistaken idea that it was equally easy to come up with. Thus people don’t generally have an adequate appreciation for the task of design. Thus they sometimes aren’t prepared to devote the time and focus actually required. As my high-school English teacher used to tell us: “Anyone can take a simple problem and make it complicated. It takes a genius to take a complicated problem and make it… anyone? anyone?” (Clustered)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. K in Illinois, who asked for several books for her elementary school class. She reports, “These books have been such a wonderful addition to our classroom library. They are so popular that I cannot keep them on the shelves and students eagerly wait for their classmates to finish the next book in the series. While it previously felt like a struggle to get some of my students to read, now, nearly every student in my class is found reading whenever they get a chance. When students finish their work before others, they take out their book and read. When students need to take a short break from instruction, they take out their book and read. When students go home at the end of the day, they take out their book and read. These books have made such a positive change to our classroom, and it would not have happened without your help.”

Microsoft patents a “Black Mirror”-like process of turning data about a person – even a dead one – into a chatbot that includes a 3D rendering, a voice, and the trained ability to converse like that person.

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The family of a nursing home patient who was allowed to install a security camera in his room to monitor his care captures him dying after his oxygen cannula dislodges. The footage shows the 80-year-old patient, who was infected with COVID-19, gasping for air just after 4 a.m. after not being checked for nearly four hours and with a nurse call button that was draped over the bed railing where he couldn’t reach it. His daughter noticed his situation, but her calls to the facility were not answered and nobody came to its door when she frantically showed up in person.

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Two Chicago-area broadcasters launch a podcast that covers the history of Edgewater Hospital, which was built as a high-end facility in 1929 for patients like Frank Sinatra, was the birthplace of Hillary Clinton and serial killer John Wayne Gacy, and then was closed in 2001 after its management company and some of its doctors were caught running a massive fraud scheme. The hospital became a popular destination for urban explorers who found the interior to be intact from the moment the doors were closed until it was mostly torn down in 2017.

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A new nurse in North Carolina has photos taken with her 98-year-old great-grandmother, who graduated from nursing school in 1942.

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The director of performance improvement at Ascension St. John Medical Center runs 46 miles from another Ascension hospital in a 10-hour tribute to “nurses and the marathon they run every day.” Wyatt Hockmeyer gave out 85 medals to healthcare workers in the two hospitals on behalf of Medals4Mettle, which awards medals that have been donated by endurance athletes to those who are fighting serious illness.


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Reader Comments

  • Vikas Chowdhry: Will AI (I prefer the term Machine Learning - ML) magically fix all the incentives that have been created in the US heal...
  • Brian Too: I dunno. Seeking an answer in AI for America's healthcare woes seems a little desperate. LIke, adding one magic new in...
  • meltoots: You forgot that politics will have to be programmed in your AI. On both sides of the aisle, misinformation, doing things...
  • IANAL: So what should Cerner do though? They have some market issues because the largest potential or current customers have at...
  • Ghost of Andromeda: That's exactly the opportunity here! Cerner is struggling and could really use someone who knows how to execute with dis...

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