Weekender 9/24/21

Weekly News Recap

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

Best Reader Comments

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

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

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

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

Watercooler Talk Tidbits

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

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

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

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

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

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

In Case You Missed It

• News 9/24/21
• EPtalk by Dr. Jayne 9/23/21
• News 9/22/21
• Curbside Consult with Dr. Jayne 9/20/21
• Monday Morning Update 9/20/21

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Weekender 9/17/21

Weekly News Recap

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

Best Reader Comments

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

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

Watercooler Talk Tidbits

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

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

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

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

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

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

In Case You Missed It

• News 9/17/21
• EPtalk by Dr. Jayne 9/16/21
• News 9/15/21
• HIStalk Interviews Steve Cagle, CEO, Clearwater
• HIStalk Interviews Coby Skonord, CEO, Ideawake
• Curbside Consult with Dr. Jayne 9/13/21
• Monday Morning Update 9/13/21

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Weekender 9/10/21

Weekly News Recap

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

Best Reader Comments

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

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

Watercooler Talk Tidbits

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

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

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

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

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

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

In Case You Missed It

• News 9/10/21
• EPtalk by Dr. Jayne 9/9/21
• Readers Write: What’s Fueling Interest in Healthcare ERP?
• Readers Write: Embracing a Smarter Future in Healthcare
• Readers Write: How Payers Can Leverage Data Pipelines for 5-Star Results
• HIStalk Interviews Jay Colfer, CEO, Fivos Health
• News 9/8/21
• HIStalk Interviews Stephen Hau, CEO, Newfire Global Partners
• HIStalk Polls 2007-2012
• Monday Morning Update 9/6/21

Get Involved

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• Sign up for email updates
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• Contact Mr. H

Weekender 8/27/21

Weekly News Recap

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

Best Reader Comments

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

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

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

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

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

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

Watercooler Talk Tidbits

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

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

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

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

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

In Case You Missed It

• News 8/27/21
• EPtalk by Dr. Jayne 8/26/21
• Readers Write: Sharing Your Medical Info with Providers from your iPhone – What You Need to Know About Apple Health, Patient Records, and Better Visibility into Patient Data
• Readers Write: Three Common Email Security Compliance Misconceptions That Are Putting Healthcare Organizations At Risk
• Readers Write: Healthcare is Failing Overwhelmed Clinicians — Here’s How to Focus on Their Journey
• HIStalk Interviews Guillaume de Zwirek, CEO, Well Health
• News 8/25/21
• HIMSS Financial Highlights
• Curbside Consult with Dr. Jayne 8/23/21
• HIStalk Interviews Jessica Cox, RN, Director of Product Solutions, Holy Name Medical Center
• Monday Morning Update 8/23/21

Get Involved

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• Report a news item or rumor (anonymous or not)
• Sign up for email updates
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• Contact Mr. H

Weekender 8/20/21

Weekly News Recap

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

Best Reader Comments

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

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

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

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

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

Watercooler Talk Tidbits

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

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

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

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

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

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

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

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

In Case You Missed It

• News 8/20/21
• EPtalk by Dr. Jayne 8/19/21
• News 8/18/21
• Curbside Consult with Dr. Jayne 8/16/21
• Readers Write: When Hospitals Leave Patients in the Wild West, They Turn to Dr. Google
• Readers Write: Creating Resiliency Among the Newest Generation of Clinicians
• Readers Write: Why Healthcare Organizations Can’t Afford A Data Breach Caused by Human Error
• Monday Morning Update 8/16/21

Get Involved

• Sponsor
• Report a news item or rumor (anonymous or not)
• Sign up for email updates
• Connect on LinkedIn
• Contact Mr. H

Weekender 8/6/21

Weekly News Recap

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

Best Reader Comments

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

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

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

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

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

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

Watercooler Talk Tidbits

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

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

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

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

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

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

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

In Case You Missed It

• News 8/6/21
• EPtalk by Dr. Jayne 8/5/21
• HIStalk Interviews Carrie Kozlowski, COO, Upfront Healthcare
• News 8/4/21
• Curbside Consult with Dr. Jayne 8/2/21
• HIStalk Interviews Ashish Shah, CEO, Dina
• Monday Morning Update 8/2/21

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Weekender 7/30/21

Weekly News Recap

• HIMSS21 attendees will be required to wear masks following CDC’s updated guidance and state and local emergency orders.
• Two HIMSS21 exhibitors announce that they have decided not to participate based on COVID conditions in Las Vegas.
• Cerner’s Q2 revenue and earnings beat Wall Street expectations.
• Avera Health sells its 230-employee telemedicine services company to a private investment firm.
• Amwell acquires a digital mental healthcare company and an automated virtual care vendor for a combined $320 million.
• England’s System C acquires medication management vendor WellSky International and renames it CareFlow Medicines Management.
• Clinical data and genomic platform vendor Sema4 goes public via a SPAC merger at a valuation of $3 billion.

Best Reader Comments

There is such a thing as momentum and popular sentiment. This is politics playing out in the healthcare space. Imagine that the very concept of EMRs becomes tainted. It’s a Failure and it’s No Good, Anyone Can See That. Medicine would not change and modernize in ways that it desperately needs to modernize.This is what happened to the metric system in the United States. Yet, and this is very important, the metric system only failed in the US. Why? It was a political failure. You see, the problem wasn’t the metric system. The metric system is successful everywhere that isn’t the US. And I challenge you to come up with a reason that doesn’t sound like total nonsense. For example, America is Exceptional, is a nonsense reason. Yet that’s still the comfortable go-to trope of those anti-metric proponents. Meanwhile EMR technology has a LOT more value to offer than the metric system does. (Brian Too)

Regarding McLeod: What? They are ditching Cerner after only two years being active! Such a waste of time, money, etc. (Bigdog)

Ever since the HITECH Act gave HHS authority to impose ever-increasing EHR requirements, it has seemed that ONC has continually sought additional additions to those requirements, whether they make sense or not. No one disputes that these are not good ideas, but one surely can dispute how much one can expect the industry can absorb, especially when the documentation requirements and other bureaucracy continue to increase. I don’t dispute the value, just the pace of adoption and the expectations on our providers. (Bill Spooner)

Watercooler Talk Tidbits

Readers funded the Donors Choose teacher grant request of Ms. D in Texas, who asked for a set of Big Books for her first-grade class. She reported in December, “This year has been a little different some of my students are home and some are here with me in class. We use all the technology available to help bridge the distance. The first book I read to them was our ‘Polar Bear, Polar Bear, What Do You Hear?’ I was ALONE in the room and reading to the children, it was an odd feeling, but it was so nice to have a book that the students could see the book and my expressions. With regular sized books I would have to project it and then they would not be able to see my face. As a teacher of mainly low-income students, I love being able to give my students the chance to ‘have’ something that they may only see in a store. There is just something about having a large book that literally makes the students feel like they are part of the story. Thank you again for taking the time to enhance the education of a young child.”

Bringing home an Olympic gold medal in fencing is third-year University of Kentucky medical student Lee Kiefer. Her sister and 2011 NCAA fencing champion is an OB-GYN resident, their mother is a psychiatrist, and their father is a former Duke varsity fencing captain who is now a neurosurgeon.

The two Arkansas Children’s hospitals report that 24 pediatric patients are hospitalized with COVID-19, 50% more than any previous pandemic peak. Seven are in ICU and two are on ventilators. Half of the inpatients are aged 12 and over and are thus eligible to be vaccinated, but none of those hospitalized had been.

AdventHealth’s Central Florida Division cancels non-emergency surgeries and hospital-based outpatient procedures as its COVID-19 patient count swells to 1,000, exceeding that of the previous peak in January. Florida reported 18,000 new cases Thursday, the biggest one-day increase since January.

In England, a husband and wife who are both doctors whose licenses have been suspended face charges of selling puberty-blocking drugs to children via their internet-only online transgender clinic. Helen Webberley, MBChB, LLM  is working from Spain in what she calls a “global” enterprise, exploiting a loophole that allows any EU doctor’s prescriptions to be filled in the UK. The website lists 35 employees. The drugs she prescribes are being used to block puberty while the young patient considers their gender options, but the psychological and growth effects of the drugs on children are unknown.

A California cyclist who was hoping to land a spot in the Tokyo Olympics crashes on a Pennsylvania velodrome track, with his several resulting injuries resulting in a $200,000 out-of-network bill from two hospitals. Phil Gaimon was covered by two health insurance policies, but Lehigh Valley Health Network billed $152,000 for services an expert said should have cost $21,000. They billed $26,000 for a night in the ICU and $30,000 for one in the burn unit, which Gaimon said was only because the hospital had no other beds available. He lives in California, one of 33 states that prohibits surprise medical bills for insured patients, but the state’s authority applies only to in-state providers.

In Case You Missed It

• News 7/30/21
• EPtalk by Dr. Jayne 7/29/2
• Readers Write: Green Light: Why Healthcare Providers Need to Migrate to NCPDP’s Updated E-Prescribing Standard
• Readers Write: Inside the Most Challenging Data Problem in Healthcare
• HIStalk Interviews Justin Dearborn, CEO, PatientBond
• An HIT Moment With … Steve Shihadeh
• News 7/28/21
• Curbside Consult with Dr. Jayne 7/26/21
• HIStalk Interviews Vik Krishnan, GM, Intrado Digital Workflows
• Monday Morning Update 7/26/21

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Weekender 7/23/21

Weekly News Recap

• The VA tells the House Veterans Affairs Committee that it won’t bring any more sites live on Cerner for at least six months.
• A law firm files an information blocking complaint against a hospital, Meditech, and Ciox Health, claiming that it could not get a machine readable PDF of a client’s medical records.
• WebMD acquires The Wellness Network
• The New York Times says IBM Watson failed to achieve its goals of business transformation and IBM rejuvenation, noting specifically that Watson’s healthcare “moon shot” failed in multiple health systems.
• The Senate confirms as VA deputy secretary Robert Remy, JD, whose job responsibilities include overseeing its Cerner project.
• A study of 500 hospital websites finds that 471 of them have not posted their prices as federal transparency rules require.
• Clinical data and registry vendor OM1 raises $85 million.
• As HIMSS21 approaches, a COVID-19 resurgence in Las Vegas causes the Venetian, Palazzo, and Sands to again require employees to wear masks.

Best Reader Comments

If the insurance company maintains the same standard of what is medically necessary, then won’t eliminating prior authorization translate directly into increased denials? … It seems like the law ultimately makes things more convenient for providers and shifts the burden of fighting insurance companies to patients. (IANAL)

Having worked at one of the four start-ups that IBM purchased and then destroyed, it’s prime material for a case study. Bringing in IBM resources (including senior IT) that couldn’t spell healthcare and were now in charge was the beginning of the end. No ability to focus on the right problems, selling software that didn’t exist, making promises that were impossible to fulfill, etc. (tchips)

I have been an IBM “partner” in two companies, a position I would not wish on my worst enemy. “Their clients are their clients, and my clients are their clients” type of attitude. Ever since introduction 20+ years ago, I kept saying that Watson was a hammer looking for a nail. The main premise was its use in diagnostics, and I’m sorry, but well-experienced and well-read physicians can achieve similar or better conclusions than the box with the blinking lights, which at best could only suggest possible diagnoses.(Dr. Moriarity)

I think HIMSS will ultimately be at the whim of the hospitals. Should they universally re-enforce travel bans (if they haven’t already), the vendors will catch wind of it and a few of them will seize the moment as a PR opportunity to make a splashy statement about why they’re pulling out this year … Hopefully it won’t come to this and we can all enjoy the annual industry soirée safely, but I think it’s fair to say we’re beginning to see some cracks in the foundation. (LongTimeFan)

I can see imaging solutions being close to being ready [for IBM Watson-like solutions]. With a plethora of training material associated with a diagnosis, the solution could train in pretty good order. But how are you going to train it to practice oncology? (Brody Brodock)

There’s also only one vendor that can deliver basic interop out of the box with very little effort, and even richer interoperability with a some terminology mapping. Kind of sad that this project [the VA’s Cerner implementation] is doing so poorly in this area when that is allegedly why Cerner won out. (Elizabeth H. H. Holmes)

[Penalties for hospitals failing to post prices] shouldn’t be about the dollar value. If you operate in the United States, you should do your best to follow the law. What you’re seeing here is widespread malfeasance by health systems. Regulators should come down hard on them in response. (IANAL)

[IT projects reducing cost] is a goal, I think it’s somewhat dangerous to assume this in every single instance. Personally, I’ve long said that these EMR/EHR implementations often raise expectations of what can be accomplished. And those raised expectations sometimes increase rather than decrease costs. Expectations are a matter of politics. Thus, regardless of what the budget said, you may find expenditures beyond the budget. It only takes a sufficiently highly placed executive to demand that their expectations be met. (Brian Too)

Large scale project PM’ing 101 – never, ever put the software vendor in as the prime on any large contract. Especially when it involves large-scale systems integration with all kinds of third parties. At least VA is seeming to acknowledge that end goal. (John Bob) 

Watercooler Talk Tidbits

Readers funded the Donors Choose teacher grant request of Ms. D in Nebraska, who asked for COVID-related sanitation supplies and health books for her Head Start class. She reported in December, “As this fall has been full of uncertainty, we have had to shift learning styles several times, but having the items from this project in my classroom has given me a small peace of mind that the kids will be safer and healthier thanks to you. Most of all, the air purifier is such a blessing. This purifier has a setting that our classroom air is recirculated once per hour. This helps myself and all the parents to know that the germs are being filtered out. Thank you doesn’t seem like enough to say, but know your generosity has definitely not gone unnoticed.”

A ProPublica review finds that 40% of the employees of nursing homes and long-term care organizations have not been vaccinated against COVID-19, which killed huge numbers of those residents before the vaccine became available. Twenty-three facilities reported vaccination rates of under 1%.

A North Carolina doctor is named as one of the “Disinformation Dozen” who are responsible for 73% of the anti-vaccine content on Facebook. Rashid Buttar, DO posts conspiracy theory videos claiming that COVID-19 vaccines cause infertility and that wearing masks and 5G cell networks cause COVID-19. Some of the videos to which he linked generated commissions for himself. The doctor has been reprimanded twice for unprofessional conduct and cited by the FDA for illegally marketing unapproved drugs. It would be interesting to fact-check his CV, which lists impressive educational, military, and athletic accomplishments before he specialized in chelation therapy.

A Colorado couple will pay $5,000 more than they expected for the birth of their son under the 1970s-era “birthday rule,” which says that when parents have separate health insurance plans, the delivery cost is covered by the policy of the parent whose birthday falls earlier in the year. That is the husband in this case, whose lower-paying insurance has forced the couple to sign up for a three-year payment plan.

Like a flight whose seats are oversold, a UK medical school offers accepted students $14,000 and a free first year of rooming if they will defer their high-demand spot for a year.

A 96-year-old woman who is believed to be the oldest working nurse in the country retires from MultiCare Tacoma General Hospital after a 70-year career. The advice of now-retired OR nurse Florence “SeeSee” Rigney to fellow nurses is “don’t ever think that you know it all.”

In Case You Missed It

• News 7/23/21
• EPtalk by Dr. Jayne 7/22/21
• HIStalk Interviews Don Woodlock, VP of Healthcare, InterSystems
• News 7/21/21
• HIStalk Interviews Tom Skelton, CEO, Surescripts
• Curbside Consult with Dr. Jayne 7/19/21
• Monday Morning Update 7/19/21

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Weekender 7/9/21

Weekly News Recap

• FDA clears AliveCor’s phone-attached EKG sensor and app to allow professionals to calculate QTc interval for diagnosis of irregular heartbeat.
• Intelerad acquires Heart Imaging Technologies.
• A second OIG review of the VA’s Cerner project warns again of unbudgeted infrastructure costs of several billion dollars.
• Sophia Genetics announces IPO plans.
• UC San Diego Health adopts the SMART Health Card.
• Three institutions form Texas Health Informatics Alliance and announce its first conference.

Best Reader Comments

Regarding AmazonCare, calling it “value-based care” is generous. Telehealth companies used to charge per-member per-month. Insurance companies started to figure out that telehealth companies weren’t doing much. Even worse is that as the insurance companies added members, the cost to the insurance company rose linearly, but the cost to the telehealth company barely changed since so few of those members actually used the telehealth service. Insurance companies also did internal measurements on the value of “urgent care” style telehealth and realized it wasn’t really substituting for primary care visits and wasn’t driving down long term costs. In urgent care style telehealth, people use it for the sniffles, while before, they would just ride it out. Increased healthcare convenience means people use more healthcare, not less. That isn’t an interesting service for insurance companies. So about five years ago, insurance companies forced telehealth companies away from per-member per-month. Many initially tried straight charging per visit and some still do, but that style of telehealth is a race to the bottom, low-margin business. Your HR department that buys your benefits is less savvy to this stuff than insurance companies, so it is easier to make money off employers directly, but selling to them one by one requires a lot of sales people. (IANAL)

I was heavily involved in the original IBM/Epic bid for the DoD. When we lost and found out what Leidos / Cerner had bid, we were mystified. Either they had low-balled, had missed some major infrastructure pieces, or had some “secret sauce” that we just hadn’t figured out. Well, I think we’re finding there was no secret sauce involved. (Bob Smith)

[Epic Care Everywhere] internal structures and mechanisms have been built. There’s a whole support structure to enable information sharing. Therefore, when two compatible Epic HIS systems aren’t sharing data, it’s entirely a customer-side issue. Maybe they aren’t mature enough to share data (after all, I’d consider external data sharing to be an “advanced”’ HIS function, and less of a priority than internal needs and priorities). Or maybe, someone at the customer has specifically decided they don’t want to share data. After all, if setting up Care Everywhere is relatively easy and is fully vendor supported, one has to start to question what the hold-up is. (Brian Too)

I find it funny that slews of provider organizations are coming out saying sepsis AI doesn’t work because they’ve all upcoded sepsis diagnoses. Seems like some great candidates for a Medicare audit. Maybe they can use the sepsis predictor to predict overpayment! (Sepsis predictor)

The Supreme Court decision in the TransUnion case this week makes it pretty clear the lawsuit against Google isn’t going anywhere. If the court doesn’t consider you to be harmed when a credit reporting agency mistakenly informs you that you’re on the terrorist watch list, they’re definitely not going to consider you harmed by having some personal info undisclosed in a log file somewhere. (Dan)

Watercooler Talk Tidbits

Readers funded the Donors Choose teacher grant request of Mr. G in Kentucky, who requested a camera for his school’s yearbook club. He reported back in December, “With school being in and out because of COVID, they have not gotten the opportunity to use it as much as they would like. However, earlier in the school year, we were lucky enough to take some action shots at a couple of our football games. This provided a great opportunity for some hands on learning with more than one student at a time. This is something that I am greatly appreciative of as a teacher! The students were able to take many great shots that will look great in our yearbook. We all thank you from the bottom of our hearts to allow us the opportunity to grow and have amazing opportunities for us to improve our school.”

I found through frustration that scanning your COVID-19 vaccination card into the HIMSS21 Clear Health Pass app works only by positioning your phone skinny side up (portrait mode) instead of the wide-side up (landscape mode) that I expected since that’s how my bank’s mobile deposits work. I finally got that to work, although the app shows my status as “pending verification” with no definition of what that means.

A Tennessee doctor whose medical license was previously suspended for possession of controlled substances will face the state board again, this time for inappropriately administering COVID-19 antibody tests to determine whether patients are actively infected. The doctor, who had started an in-home COVID-19 testing program, was accused by patients of not wearing a mask or gloves, not performing a physical exam, and falsifying medical records in documenting work he didn’t actually perform.

Riverside Regional Medical Center (VA) medical resident Eleanor Love, MD starts Richmond-based The Simple Sunflower, which asks newly married couples for their wedding flowers after the ceremony, repackages them into individual vases, and delivers them to hospitalized patients in Richmond, starting with those in palliative care. 

In Case You Missed It

• News 7/9/21
• EPtalk by Dr. Jayne 7/8/21
• HIStalk Interviews B.J. Schaknowski, CEO, Symplr
• News 7/7/21
• Monday Morning Update 7/5/21

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Weekender 7/2/21

Weekly News Recap

• The valuation of process automation vendor Olive reportedly reaches $4 billion following a new $400 million investment.
• HIMSS announces COVID-19 vaccine verification and masking policies for HIMSS21.
• The VA reaffirms its commitment to implementing Cerner while awaiting the results of an internal project review.
• Harris acquires Ingenious Med.
• Ireland’s health service estimates that the ransomware attack that has kept its systems down for six weeks and counting will cost at least $600 million for recovery.
• A private equity firm acquires and combines Verisys and Aperture Health.
• Health Catalyst announces its intention to acquire Twistle.
• Britain’s Health Secretary Matt Hancock resigns after a tabloid runs photos of him kissing a female executive who he appointed.

Best Reader Comments

Not sure I’d put so much faith in the public market, given Doximity’s IPO valuation of $9B+ for a business not that much different in its fundamentals than the founders’ previous effort (Epocrates) which lost 75% of its IPO value and ultimately sold for ~$250M. But America loves second chances! (Debtor)

Olive’s valuation at $4B is a signal that we’re in the midst of a bubble. They were valued at $1.5B as recently as December 2020. One could argue that the $1.5B valuation was frothy. Now they claim to be worth nearly 3 times that, a mere 6 months later. I’ve seen these companies before: Raise, dilute, raise, dilute, acquire, raise, dilute, acquire, raise. The real test will be if they IPO, what valuation does the market support. The market will be more careful, and do more diligence .., Olive seems like they are somewhere in between an enterprise software company (valuation would be 5-6 times revenue) and a consulting firm (valuation would be 1-2 times revenue). I’ve looked at lost of pure SaaS companies in my day, and Olive does not deserve a pure play SaaS valuation. Unless their revenue is way above what we estimate (even with the recent tuck-in acquisitions), this $4B valuation is an outlier – and in a bubbly way. Too bad they can’t just cash in now (but not from me). (Healthcare VC Guy)

I agree that mortality probably isn’t the best measure of EMR benefit. I also agree that having EMRs, e-prescribing, electronic transmission of lab results and vaccine receipt, and an ability to do a quick pívot to telehealth have all been very important in dealing with the pandemic. I’m less convinced that quality of care has improved in general [with EHRs] and don’t believe that documentation is improved (except for being legible). However, it’s hard to figure out because there are so many confounding factors that were introduced at about the same time … Despite the hype associated with the “learning health system”, much of the data in the EMR is incomplete or inaccurate. This will become even worse with greater propagation of errors through more and more health records with the push for interoperability … Overall EMRs have probably had more benefits than negatives but it could have been and could be so much better if the focus was actually on delivering care and less of the regulatory and payment related impediments. (Clinical N Cynical)

Watercooler Talk Tidbits

Readers funded the Donors Choose teacher grant request of Ms. B in Nebraska, who is in her second year of teaching and, as she says, “still waiting to experience a ‘normal’ year.” She asked for a library of books, organizers, clipboards, earbuds, and supplies for her fourth grade class. She reports, “Our school district is using a unique model this year where we only have half of the students in-person at one time. The other students are learning at home through pre-recorded videos made by the district. The headphones allowed my students to listen to their instructional videos in peace, without any loud interruptions. The books that were provided to my students absolutely LIT UP my kiddo’s faces! They loved being able to have books of their own, since we can’t share books through my classroom library.”

NBC News covers the medical care obstacles faced by people who are too large to fit in a CT scanner or hospital gowns. One woman can’t have a cardiac ablation procedure for fibrillation because she exceeds the surgical table’s weight limit and she can’t get an MRI for the same reason, leading her to unsuccessfully to seek testing from veterinarians whose machines are sized for horses and cows.

This is for the programmers out there. A woman’s last name of True locks her out of Apple ICloud, which mistook it for a Boolean value when she mistakenly failed to capitalize it. For disco and 1970s porn fans, her first name isn’t Andrea.

A North Carolina nursing home suspends a nurse whose TikTok videos featured her joking about mistreating patients. She says she’s a victim of “cancel culture” since “all my videos are comedy skits.” Her GoFundMe to raise $20,000 for legal fees has yielded $170.

A closed hospital that has been called “Kentucky’s second most haunted place” is listed for sale, with the former Hayswood Hospital (built in the early 1800s as a school, expanded to its current form in 1925, and opened as a hospital in 1931 that closed in 1983) featuring 80,000 square feet on nearly 3 acres. Locals say the building is not only full of ghosts and trespassers from outside the state hoping to spot them – especially in its former morgue on Halloween — but also asbestos that will cost $3 million to clean up to the point the $800,000 building can be torn down.

In Case You Missed It

• News 7/2/21
• EPtalk by Dr. Jayne 7/1/21
• HIStalk Interviews Sonny Hyare, MD, CEO, ReMedi Health Solutions
• News 6/30/21
• Curbside Consult with Dr. Jayne 6/28/21
• Monday Morning Update 6/28/21

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Weekender 6/25/21

Weekly News Recap

• Health Catalyst announces its acquisition of Twistle.
• Doximity shares surge on their first day of NYSE trading, valuing the company at $7 billion.
• Tegria acquires KenSci.
• Researchers say that Epic Sepsis Model performs poorly in identifying potential cases of sepsis.
• GE Healthcare names Pater Arduini as its next president and CEO.
• England’s NHS publishes a draft patient data strategy.
• NextGen Healthcare announces that President and CEO Rusty Frantz will leave the company.
• Amazon announces a four-week, virtual AWS Healthcare Accelerator program for startups.
• California launches a digital COVID-19 vaccination record system.
• ONC invites colleges and universities to apply for its $80 million public health IT workforce program.

Best Reader Comments

As former CIO, I am wondering if all of the billions (trillions?) spent on EMRs, etc. have really improved care / outcomes. Based on the very simple measure of life expectancy, I would say no. I am sure that billing and documentation has improved and the industry has amassed warehouses full of data for interesting studies. I know that I will be critiqued for use life expectancy as the single measure, but it is easily available and is a fundamental outcome. This should be embarrassing for a country that already had the highest cost and low life expectancy compared to other advanced economies. (Former CIO)

If you step outside the hyped world of AI/ML, a hospital system would not implement a new clinical protocol (for example, if this were a written risk-stratification model for sepsis) without it first being testing, validated, published, and even then they usually want to wait for the Professional Societies to back the protocol before widely accepting and integrating it into practice. Please explain then why hospitals are just blindly accepting these AI/ML algorithms, when there is already a standard for approving clinical decision-making tools? I suspect a large part of the issue here is that there is still not enough medical involvement / integration into the IT/IS departments at many hospitals. Their governance models still view IT and the EHR as a cost center and not a strategic asset to the organization, and think the enhancements that are being added during EHR upgrades are all functionality updates, when in fact they are slipping more and more clinical content and tools into the upgrades. (HITPM)

Coming from the overhyped world of AI/ML, I would tease apart validation of the model and validation of protocol. No model will be 100% accurate, so validating a model comes down to “sufficiently accurate” (trading off precision and recall) and some sort of explainability. In our work on sepsis models, we achieved AOC over 0.8 with the ability to see precisely which parts of the medical record led to the conclusion. We did not commercialize it, not because it was invalid, but because it needed to drive a clinical protocol that added value. And that’s the issue. First, practitioners’ intuitive sense is really good, so any model has to find marginal incremental cases that they’d miss. Second, you need to design, validate, and implement a clinical protocol for what to do when the model alarms. This has a poor ROI. (Dan G)

They [Doximity] display pharmaceutical ads to doctors. Similar to how Practice Fusion made money, but Doximity has lower risk because ad fraud is harder to bring lawsuit or regulatory action against compared to pushing oxy via EHR decision support. (IANAL)

Watercooler Talk Tidbits

Readers funded the Donors Choose teacher grant request of Ms. C in Mississippi, who asked for an IPad and accessories to allow her to create videos of her classroom instruction for students who need extra review or if COVID-19 forced her school to close. She reported in December, “Thankfully we have not had to teach virtually so far, but having an IPad makes it possible for me to record classes that students can use for review if they need extra help on a particular objective. I enjoy having a fun way to intervene with struggling students by having them play educational games on the IPad that reinforce and review skills we are learning each day. School has changed so much this year and technology has become such an important part of our school day. Thank you for making this project possible.”

Casamba founder and executive chairman Ronnie Amrany buys a waterfront house on Hollywood, FL that sets the record for the highest price paid in that area at $6.9 million. Net Health acquired the therapy EHR vendor in March 2021.

Eleanor Slater Hospital (RI) COO/CFO Christopher Feisthamel takes advantage of an obscure state HR law to avoid repeat attempts to lay him off. Rhode Island’s “leave to protect” provision allows a state employee to hold up to three state jobs at the same time, and if fired from one, they can return to their previous job and “bump” whoever holds it. More than 1,600 state employees have leave-to-protect status, making it hard to fire them.

St. Vincent Hospital (MA) bans activist members of the Catholic Worker Movement from hospital property after they perform an “exorcism of the demon of corporate greed” in the lobby against hospital owner Tenet Healthcare to support striking nurses.

In India, friends of a man who was receiving COVID-19 vaccine record a video showing a distracted nurse removing a disposable syringe and injecting it without first drawing up the vaccine. Nobody noticed until one of the friends looked at the video later. The nurse has been removed from duty and the man will be brought back to receive his first dose.

In Case You Missed It

• News 6/25/21
• EPtalk by Dr. Jayne 6/24/21
• News 6/23/21
• Curbside Consult with Dr. Jayne 6/21/21
• Readers Write: Addressing the Public “Infodemic” Spurred by COVID-19
• Readers Write: Don’t Cut Corners in Hybrid Cloud Protection
• Monday Morning Update 6/21/21

Get Involved

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• Contact Mr. H

Weekender 6/18/21

Weekly News Recap

• Former Athenahealth CEO Jonathan Bush launches health developer platform vendor Zus Health with a $34 million Series A funding round.
• Google Health is reportedly downsizing.
• A Wall Street Journal report says that Apple’s plan to run a wearables-focused virtual primary care service hasn’t been successful and the company is shifting its emphasis to selling Apple Watch.
• ONC publishes the first draft of its patient address standardization specification.
• AMA says EHRs should not present drug company advertising.
• Ambulatory surgery center software vendor HST Pathways acquires patient price transparency vendor Clariti Health.
• A security services vendor COO is indicted on federal charges of launching a cyberattack against Gwinnett Medical Center (now Northside Hospital Gwinnett).

Best Reader Comments

Doesn’t look like the stock market has given up on CERN yet. Still near all time highs. (Bob)

I found the prices published by a health system I currently have a billing dispute with. Will be interesting to see what they say when I ask them why my insurance company’s payment was insufficient for the services they provided when it is 4x the minimum negotiated charge. (Price Transparency?)

While the [DoD and VA Cerner] systems may be of the same origin, they are not the same today, and so there is that specific problem of non-identical systems. Additionally, the origin data is not anywhere near identical in schema, dictionary, enumeration, etc., so that will be a broader problem. Lastly, they haven’t exactly settled the solutions at this point, so they are driving at a moving target. Failing early might not be a bad strategy, but if someone isn’t setting that expectation, then someone is going to be mighty surprised in very short order. (AnInteropGuy)

Watercooler Talk Tidbits

Readers funded the Donors Choose teacher grant request of Ms. M in Kentucky, who asked for a license to a learning platform to use in both in-person and remote classes. She reports, “”Your donation of the Nearpod Learning Platform has made a huge difference in the learning process for my English as a Second Language (ESL) students. Through this platform I have been able to modify their assignments to enable them to express their learning through drawing, matching, games, and voice recordings in addition to the tradition format of typing. The difference has been so great that my administration purchased Nearpod for the rest of our school. Now ALL students, not just ESL students are going to benefit. Thank you for helping me start this movement and show other how everyone can learn with the right tools and support.”

The charity RIP Medical Debt buys and forgives $278 million of hospital debt from Ballad Health, relieving the medical payment obligations of 82,000 low-income patients that in some cases go back decades. The charity says it works directly with hospitals that can turn bad debt into revenue without pursuing aggressive collection, address a major social determinant of health, and refine their charity care programs.

A federal court sentences a New York doctor to 57 months in prison for taking drug company bribes in return for prescribing Subsys fentanyl spray. Jeffrey Goldstein, DO took $200,000 in “speaking fees” for giving slide sessions for which attendee sign-in sheets were often forged and enjoyed an evening at a strip club in which drinks and lap dances were provided by company reps. He was the sixth-highest subscriber in the speaking program, generating $800,000 in sales in a single quarter of 2014 versus prescribing the drug just once before signing up for the speaking program. Federal agents also reported that during the speaking events, Goldstein drank heavily and used marijuana and cocaine with his staff. 

An Alabama nurse is fired and may have lost his license after he is shown in TikTok videos he posted as “@conservativecoy1776” where he says that COVID-19 isn’t dangerous and Anthony Fauci was paid to create it, claims that racism is an overreaction to what was actually a small number of slaveholders, and laughs at video of a patient who cried after receiving a high doctor bill in saying, “Hey, buddy, you better get used to saying that s***.” He made the mistake of recording some of his videos in a hospital room wearing his employee badge, which identified him and his employer, Baptist Health in Montgomery.

Emory University apologizes to a medical school applicant it rejected in 1959 with the explanation that the school was not authorized to admit “a member of the Negro race.” Marion Hood, MD says it was OK because he experienced discrimination every day and didn’t really expect Emory to admit him, but he was accepted and graduated at Loyola and then returned to Atlanta to open an OB-GYN practice that he ran for 34 years until he retired in 2008. Emory won its challenge of Georgia’s segregation laws in 1962 and admitted its first black student the next year. 

In Case You Missed It

• News 6/18/21
• EPtalk by Dr. Jayne 6/17/21
• News 6/16/21
• Curbside Consult with Dr. Jayne 6/14/21
• Monday Morning Update 6/14/21

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Weekender 6/11/21

Weekly News Recap

• Iodine Software acquires ChartWise Medical Systems.
• Cerner eliminates 500 positions.
• Amazon announces significant growth and external customer interest in its Amazon Care telehealth service.
• Ciox Health announces its intent to merge with Datavant in a deal valued at $7 billion.
• Definitive Healthcare, which acquired HIMSS Analytics in 2019, prepares to go public.
• RCM vendor Craneware enters an agreement to acquire pharmacy software vendor Sentry Data Systems.
• SAIC announces plans to acquire government health IT contractor Halfaker and Associates.
• UF Health Central Florida’s two hospitals go back to paper following a May 31 ransomware attack.

Best Reader Comments

With all of this money being poured into startups by VCs and PE and everyone promising a better widget to do X, how would patients (or consumers of health care) respond if they were to be asked this (Reagan) question – “Are you better off today than you were four years ago?” Is care more accessible? Valuable? Equitable? Cheaper? Safer? (Ghost of Andromeda)

I do worry about the monetization of the healthcare and the drive for young practitioners to get the best specialty. Some, I am sure are just drawn to that specialty, others are drawn to the compensation. The monetization goes up and down the stack, from VCs purchasing rural hospitals so they can overcharge for labs, to purchasers of EHRs so they can overcharge the clinics, to hospital administrators who have forgotten that a hospital is for patient care, not for generating an insurance bill or funding a collections company. (J Brody Brodock)

From a medical output standpoint, the most productive primary care practices probably have less than five providers. Technology provides little to no benefit. Practices get larger so that they can negotiate with insurance. The dynamics are different for single and multi speciality and hospital owned of course. We shouldn’t raise the compensation for primary care. We shouldn’t raise the compensation for anyone in medicine. We should lower barriers so that there is more competition. (IANAL)

One of the truisms I was told a long time ago by family medicine founding fathers is that primary care has always failed to compete adequately in the American way of doing things. Our commitment to patient care — our mensch-like attitudes to do good on local scales one case at a time, coupled with our lower incomes has kept primary care physicians from putting the same amount of money and time resources into changing the system as our specialist colleagues. That has only been exacerbated by the lobbying dollars of the pharmaceutical and insurance firms along with the large organized health care industry in general to take advantage of primary care physicians as malleable, low-cost solutions. Bluntly put, while we are doing our quarterly CME questions for our 2.5 points, thereby allowing our leaders to justify their latest layer of obfuscation without real change, we could have been communicating and networking with others. (Kevin Hepler)

If we are being completely honest, it’s about, how do we make the field of medicine more attractive to clinicians? And all of that adds up to going back in time. Society has already chosen, and mostly, society doesn’t care. (Brian Too)

Bold of Ascension to so immediately follow Baylor Scott & White, without even waiting to pick up some lessons learned. The latter has, at the most generous, an extremely bumpy year ahead as it tries to recover from its continuing hemorrhage of experienced Epic employees (retained and outsourced alike) and astonishing lack of due diligence (as admitted by its leadership). I suppose if more organizations outsource, analysts will be more persuadable that this is the way of the future instead of temporary insanity and attempt to stick it out. Can’t we just have nice things? (formerly BSW)

Watercooler Talk Tidbits

Readers funded the Donors Choose teacher grant request of Ms. M in Kentucky, who asked for an inspiration board for her kindergarten class. She reports, “Thank you for your generous donation to this project. Our Royal Imagination Station is so helpful for easy access and viewing from anywhere in our classroom. It is so handy to move the board throughout our classroom, so that every learner can easily see the display. My learners use it daily for creating anchor charts, practicing letter writing, phonemic awareness for letters and sounds, and reviewing previous learning materials (as a reference tool). We will enjoy this useful tool for many years to come.“

Dartmouth’s medical school apologizes and drops its threats of expulsion against 17 students who it had claimed cheated on an online exam by looking up answers. The university secretly monitored the use of its learning management system by test-takers by reviewing its activity log after the fact, but the Canvas tool was not designed for that purpose and a New York Times review found that the software’s automated background activity can mimic user interaction.

In the UK, a liver surgeon who was suspended in 2017 for using a surgical laser to burn his autograph into patient organs is allowed to practice again.

MIT Technology Review takes a look at the vaccine waitlist site Dr. B, which collected 2.5 million signups from people who hoped to be matched to leftover vaccine doses. The site, which was founded by Zocdoc founder and former CEO Cyrus Massoumi, refuses to say whether anyone actually found vaccine after signing up and how their data will be used or sold (the site is not a covered entity, so users enjoy no HIPAA protections). The site had agreements with just two vaccination sites in the entire US when it went on a PR blitz in March, but accepted signups nationally. Meanwhile, Dr. B has at least 56 employees, many of which have a background in politics, and it has acquired similar services. Massoumi unsuccessfully sued Zocdoc last year claiming that he was ousted by his conspiring co-founders in 2015. UPDATE: the company provided this response:

Dr. B was launched at the height of the COVID crisis to get vaccines into as many arms as possible and we have saved lives through this effort. While we have already sent more than 1.1 million notifications to users about available vaccines, we don’t track when shots have been received. User privacy is our top priority and Dr. B never rents or sells user data. At any time, users can also ask to stop receiving notifications and also completely purge their data from Dr. B.

The New York Post says that insurer Clover Health has become a “meme stock” whose share price swings wildly based on the whims of Reddit “WallStreetBets” traders, also noting that the company’s two co-founders – who became billionaires when Clover Health went public via a SPAC — bought three non-profit New Jersey hospitals and converted them to for-profit CarePoint, with one of them earning the distinction as the most expensive hospital in America. The hospitals, which dropped insurance contracts so they could bill ED visits at out-of-network rates, charged one teacher $9,000 to apply a bandage to her cut that required no stitches. Day-trading Redditers got interested in Clover Health shares when a short-selling analyst claimed that the company is inflating sales.

An anti-vaccine doctor and nurse who were brought to an Ohio health committee meeting as expert witnesses who oppose business or the government requiring COVID-19 vaccination argue that not only have COVID-19 shots killed 5,000 people, they also magnetize recipients. The nurse dramatically proclaimed to state legislators, “Explain to me why the key sticks to me,” sticking with her script even as the key failed repeatedly to stick to her neck. Both healthcare professionals cited as their information source “pictures all over the Internet.”

Sentara Albemarle Medical Center (NC) celebrates its longest-tenured employee, 82-year-old Willie Mae Overton, who started working at the hospital in 1961.

A military publication profiles 30-year-old Nevada Air Guard 1st Lt. Caleena Longworth, MD, whose youthful appearance and spring graduation from medical school earned her the nickname “Baby Doc.” She completed medical school in working around her COVID-19 deployment, where she was involved with testing and vaccination. 

In Case You Missed It

• News 6/11/21
• EPtalk by Dr. Jayne 6/10/21
• News 6/9/21
• Curbside Consult with Dr. Jayne 6/7/21
• HIStalk Interviews Richard Caplin, CEO, The HCI Group
• Book Review: “Big Med”
• Monday Morning Update 6/7/21

Get Involved

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• Report a news item or rumor (anonymous or not)
• Sign up for email updates
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• Contact Mr. H

Weekender 6/4/21

Weekly News Recap

• Ascension begins its mass layoff of remote IT employees with 82 workers in Indiana, whose jobs will go to offshore outsourcers.
• CareCloud acquires Santa Rosa Staffing from MedMatica Consulting Associates.
• Ensemble Health Partners acquires automated patient engagement software company Odeza.
• Scripps Health starts notifying 147,000 patients that ransomware hackers offloaded their data.
• A review finds that healthcare AI design is nearly always flawed by lack of large-scale training and external validation.
• England’s Clarity Informatics is acquired by Agilio Software.
• Epic begins bringing employees back to campus and announces an in-person UGM 2021 for vaccinated attendees.
• Doctors in England warn consumers about NHS Digital’s plan to extract the GP clinic data of 55 million people to create a de-identified research database.
• Doximity announces IPO plans.
• Virtual care company Babylon Health will reportedly go public via a SPAC merger that will value the company at $3.5 billion.

Best Reader Comments

The Meditech database literally cannot contain French language data as there is no support for the various accented characters. Thus you also have the issue of, the portal may be in French, but the data will all be English. The net result? No matter how technically good this portal effort was, it’s a kluge solution. Citizens using it will see an awkward mix of English and French content. (Brian Too)

I am always amused when someone assumes that they can take software that was built specifically in one language, for that language, and somehow migrate it to other languages. Software localization and translation are non trivial things, with considerations for everything from how dates are represented to how the thousand marks are “ticked.” “All your bases are belong to us” anyone? I even had a group tell me that they were going to sell to the Japanese market because that market used English. The idea died quickly with the purchase of a Japanese keyboard and switching to Romanji that ‘looked like English’ but was UTF16 character based. (AnInteropGuy)

Has any clinician had a positive experience with Doximity? It seems like they make their money off recruiter spam and fake clicks on their ads. (IANAL)

Watercooler Talk Tidbits

Readers funded the Donors Choose teacher grant request of Ms. B in Louisiana, who asked for a USB headset for her class of first graders, half of whom will be in the classroom and the others on virtual connections. She reports, “The headset has provided me the opportunity to keep the two types of learners separate. My coworkers complain that the background noise is an issue for the learners at school and at home. My virtual students can unmute and ask me questions without my in person students getting distracted. More importantly, the virtual students, who already have the distraction of being at home, do not have to hear the constant commotion of the classroom. For me personally, I had such anxiety to start this year; the year of the unknown and how to make all this work. The headset is not only comfortable, but has made teaching much easier.”

VA OIG says an Arkansas VA hospital should have done more to oversee a pathologist whose alcoholism has been blamed for at least 600 major diagnostic errors, including some that were related to cancer. The facility did not act on complaints that he was working while intoxicated, even after he failed a blood alcohol test. He received a 20-year prison sentence.

The British Indian Nurses Association, which was formed last year to support nurses from India who take jobs with NHS, offers virtual COVID-19 care training for nurses who are still in India.

A nurse in England who publicly claims that NHS is a “death squad” that is murdering vulnerable patients with COVID-19 vaccine, that no vaccine has ever been proven safe or effective, and that COVID-19 is caused by 5G telephone signals loses her nursing license for spreading disinformation. Former NHS nurse Kate Shemirani, who appeared publicly and on videos while wearing scrubs and a stethoscope and touting her nurse background, now calls herself an “aesthetic nurse practitioner.” She previously said that the people who accuse her being wrong or lying are mostly”overweight, envious nurses” who are jealous of her appearance.

Northwell Health Nurse Choir receives accolades for its performance on “America’s Got Talent.”

In Case You Missed It

• News 6/4/21
• EPtalk by Dr. Jayne 6/3/21
• News 6/2/21

Get Involved

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• Sign up for email updates
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Weekender 5/28/21

Weekly News Recap

• Ireland’s health system says it may be weeks before it goes back online following a May 14 ransomware attack.
• McKesson will combine RelayHealth and two of its other businesses under the CoverMyMeds organization and name.
• VA OIG says the VA’s $16 billion Cerner implementation budget failed to include up to $2.6 billion in required infrastructure upgrades.
• Google will develop algorithms for HCA Healthcare using HCA’s patient data.
• Iodine Software acquires Artifact Health.
• Weight loss app vendor Noom raises $540 million in new funding at a $3.7 billion valuation.
• Bassett Healthcare will outsource analytics, IT, and RCM to Optum, which will take on 500 Bassett employees.
• Zocdoc fixes a software problem that exposed patient data.
• FBI says that at least 16 US healthcare and first responder networks were attacked by Conti ransomware in the past year.

Best Reader Comments

PE has absolutely brought a net negative in terms of societal value – they have sucked dollars out and devastated so many major areas of our society and economy – newspapers, retailers, housing stock, emergency rooms, ambulances and now of course, hospitals. And VCs are not too far behind. But as the guy says in the documentary – hey, don’t blame them for taking advantage of the way rules of the game are set up. Of course, no one says the quiet part aloud – that these guys are also actively funding politicians who block any changes to rules of the game. (Ghost of Andromeda)

Buried in an Epic EHRN.org study published today, Epic now has data on over 100 million people in Cosmos. (EHRN Watcher)

Looks like a net shift of ~30,000 beds from Epic to Cerner in the United States. I think it raises a couple of questions – although # of hospitals are still roughly similar does this put a dent in the narrative that Epic and Cerner are the two biggest fish in the sea? Seems like Epic is starting to pull away on this one. Perhaps the DoD and VA contracts may have been a bit of a poison pill for Cerner. (EHRMusing)

I don’t think it is reasonable to expect health insurance or health insurance tech startups to be profitable before they are at national scale. There are high costs to enter that market. To my mind, there are two Medicare Advantage strategies that potentially could work. First is that mega health systems are well positioned to offer MA plans but don’t have the organizational competence to do it. Bright is sort of going for that. Second is for the insurer to successfully insert themselves between the patient and the interaction with the high cost healthcare system, then guide the patient to lower cost alternatives. If there aren’t lower cost alternatives available in the market, the insurers should provide them. This is a little bit of Devoted Health’s strategy and a bit of UHC’s strategy. (IANAL)

Does Cerner currently have an employee exodus? That seems to be a concern at the hospital organization I work with. Lots of turnover in IT. Can’t imagine it wouldn’t also apply to vendors, especially if one is struggling. How is Cerner doing? And Meditech? And Epic? Or what about Allscripts? I’m definitely concerned for our own turnover, but am much more scared.if our vendor is also losing people we work with. (Neil’s Parking Lot)

For all those who are vaccinated, what’s the concern by August whether there are people on the [HIMSS21] floor that are not? I have an idea. “Let’s assume attendees are stupid and will all require vaccinations. Then we will tell them if they present a topic, they need a face shield to protect vaccinated people from vaccinated people. Oh, and we can’t have the vaccinated people too close, so we’ll spread out their booths. Then, cocktail hours in booths, oh no, we can’t have that. Push them outside in the August Las Vegas temps and they can drink warm wine and beer to go along with to go bags. They can shout at each other six feet away. Plenty of business will get done there. Oh and we won’t tell them that we cannot require the support staff, Venetian employees, and anyone else that will be on prem to be vaccinated.” Never mind what everyone does on their own time in casinos, bars, restaurants and god knows where in Vegas. But, we are protecting them and others.” LAUGHABLE – who’s falling for this stuff? (Mike_T)

Watercooler Talk Tidbits

Readers funded the Donors Choose teacher grant request of Ms. M in California, who asked for a headset and webcam for teaching her transitional kindergarten students virtually, She reports, “Thank you for helping this old teacher ( I didn’t think I was old until we started Distance Learning) get hip with new technology! Having a extra webcam that I can use as a document reader really helps my instruction daily. I can Zoom with students on one screen and share the work with the camera. This is especially important with our littlest learners when we are learning how to write our letters. Students learn so much through teacher modeling, I can model how to color in the lines, write from top to bottom and read from left to write. So much learning fun. Thank you!”

Doctors in India threaten to sue a politically connected, billionaire yoga guru who told followers that “allopathy [medicine] is a stupid and bankrupt science,” claimed that medicinal treatment has killed more people in India than oxygen shortages and COVID-19, and questioned why doctors get sick if medicine is so efficient. He also recorded a video mocking people who were desperately searching for oxygen cylinders for their relatives who were dying of COVID-19, urging them to “just breathe the free oxygen.” His company sells a COVID-19 cure that is made up of three herbs, falsely claims that the product has been cleared for use by WHO, and when threatened with charges for misleading claims, instead convinced the BJP government to distribute 100,000 of his kits as an immune booster. 

A new book called “Women in White Coats” looks at the “she-doctor” panic of 1869, when students of Woman’s Medical College of Pennsylvania attended a medical lecture at Philadalphia’s Pennsylvania Hospital. They were forced to enter via the back stairs; subject to curses, thrown objects, and tobacco-spitting by the 300 male medical students in attendance; and were stoned by the male students as they left while someone played the taunting military discharge song “The Rogues March.” The county medical society had previously barred women from attending public teaching clinics or joining medical societies.

The husbands of two IT employees of Children’s Healthcare of Atlanta go into renal failure within days of each other, requiring a transplant from someone other than their wives due to blood type mismatch. The employee were sharing their stories with each other when they realized that they were each a match for the other’s husband, so they donated kidneys that were successfully transplanted.

In Case You Missed It

• News 5/28/21
• EPtalk by Dr. Jayne 5/27/21
• News 5/26/21
• Curbside Consult with Dr. Jayne 5/24/21
• Readers Write: How the New ONC Cures Act Will Transform Patient Access to Healthcare Data
• Readers Write: Alert: Three Keys to Navigating the Traffic Ahead on the Road to Healthcare Access
• Monday Morning Update 5/24/21

Get Involved

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• Report a news item or rumor (anonymous or not)
• Sign up for email updates
• Connect on LinkedIn
• Contact Mr. H

Weekender 5/14/21

Weekly News Recap

• Patient payments platform vendor Cedar announces that it will acquire competitor OODA Health for $425 million.
• ONC will spend $80 million of American Rescue Plan funds to train public health professionals to modernize the public health data infrastructure.
• “Hospital at home” and decentralized clinical trials platform vendor Huma raises $130 million.
• Mayo Clinic and Kaiser Permanente make a rumored $100 million investment in Medically Home.
• Regulators in England block Imprivata’s planned acquisition of digital identity vendor Isosec.
• Amwell’s Q1 results send shares down sharply as investors fear a growth slowdown.
• CPSI acquires TruCode.
• Aetion, which offers a real-world evidence platform for drug companies and payers, raises $110 million.
• “Hospital-at-home” company Huma raises $130 million.
• Walmart Health acquires telehealth provider MeMD.
• Health Catalyst’s Q1 results beat expectations.

Best Reader Comments

So what should Cerner do, though? They have some market issues because the largest potential or current customers have attached medical groups and those medical groups drive customers to Epic. The customers that don’t fit that description are substantially more price sensitive. With their current product and a replacement market, they need to have significantly lower costs to win deals. Their strategy now seems to be slowly cut costs and lose customers until they are a government contracting company. They should have kept going on the RCM, support, data sales, analytics on the theory that the EHR is sold closer to at cost and they make it up on services. Make a couple acquisitions (Athena) and they could have a strong alternative to play against Epic’s weaknesses. That would have required looking further ahead than the next couple quarters. (IANAL)

That’s been our experience as well at Parkland and broadly with Dallas County, TX public health department. Specifically related to COVID-19, we were strategically able to utilize ML derived insights to improve many aspects of COVID-19 related workflows including patient triage, testing site optimization, identification of COVID-19 hot spots, and vaccination prioritization and understanding of herd immunity to just name a few. And we continue to build on it to help with other public health issues such as access & equity, other communicable diseases etc. AI/ML is a useful tool and is constantly getting better and when aligned with strategic goals and with the right moral compass can be really useful. (Vikas Chowdhry)

Watercooler Talk Tidbits

Readers funded the Donors Choose teacher grant request of Ms. J in North Carolina, who asked for a library of books for her middle school agricultural education students. She reports, “My students have learned so much about Theodore Roosevelt, Milton Hershey, and Temple Grandin this semester. It has tied in with our current curriculum related to natural resources (Roosevelt), food science (Hershey), and animal science (Grandin). Students were able to listen and watch recordings of me reading the book (to assist students with reading challenges) in order to gain more understanding about the individuals and the industries they impacted. We were able to have meaningful discussions about each book. This was an eye-opening experience for some of these students.”

I don’t actively solicit Donors Choose donations since you can donate to them directly without my involvement, but if you want to donate and have matching funds applied from my Anonymous Vendor Executive, do this:

• Purchase a gift card in the amount you’d like to donate.
• Send the gift card by the email option to mr_histalk@histalk.com (that’s my DonorsChoose account).
• I’ll be notified of your donation and you can print your own receipt for tax purposes.

Former Collective Medical executive Kat McDavitt, along with the Sharp Index, has started Mothers in Medicine, a fund that provides frontline healthcare workers who are struggling to pay for childcare with grants of $1,000 per child. She welcomes donations, volunteer help, and stories from clinician mothers.

A former Indiana sinus surgeon who hid out in the Italian Alps for three years to dodge healthcare fraud charges but was eventually arrested and sentenced to seven years in federal prison turns up in Florida after his release after five years, where he is trading in cryptocurrency and selling yoga classes so customers can get “hot chicks” and “look great naked.” His license was permanently revoked in 2005 and 300 of his patients shared in a $55 million medical malpractice settlement. He vanished from a yacht in the Greek Islands in 2004, abandoning his family and leaving them $6 million in debt to hide out in a tent in the mountains, where he was later turned in by his Italian girlfriend after he was featured on “America’s Most Wanted.” His practice had been profitable – he commuted from Chicago to the working class suburbs of Indiana via chauffer-driven limousine, sent a different chauffeur back to Chicago at lunchtime to bring him his favorite sushi, lived in a five-story townhouse worth $3 million, and owned the 80-foot yacht from which he intentionally vanished.

Employees of Swedish Medical Center (CO) throw a prom for 18-year-old Miracle Manzanares, who missed her own event while being hospitalized for 10 weeks with serious burns. She will be discharged soon.

In Case You Missed It

• News 5/14/21
• EPtalk by Dr. Jayne 5/13/21
• Readers Write: AI is Essential to Stopping Further COVID-19 Spread and Limiting Future Pandemics — Here’s Why
• Readers Write: Providers’ Post-Pandemic Assessments of Telemedicine
• Readers Write: Sharing Diverse Patient Data to Support Clinical Trials: Can We Afford Not To?
• HIStalk Interviews Stephen Gorman, CEO, RCxRules
• News 5/12/21
• Curbside Consult with Dr. Jayne 5/10/21
• Readers Write: Taking the Friction Out of Digital Health Adoption
• Readers Write: Provider Scheduling Matters
• HIStalk Interviews Carina Edwards, CEO, Quil Health
• Monday Morning Update 5/10/21

Get Involved

• Sponsor
• Report a news item or rumor (anonymous or not)
• Sign up for email updates
• Connect on LinkedIn
• Contact Mr. H

Weekender 5/7/21

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

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!

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.

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

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.”

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.

In Case You Missed It

• News 5/7/21
• EPtalk by Dr. Jayne 5/6/21
• HIStalk Interviews Charles Tuchinda, MD, President, Zynx Health
• News 5/5/21
• Curbside Consult with Dr. Jayne 5/3/21
• HIStalk Interviews David Baiada, CEO, Bayada
• Monday Morning Update 5/3/21

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