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Monday Morning Update 8/31/20

August 30, 2020 News 6 Comments

Top News

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Konica Minolta will pay $500,000 to settle false claims act charges involving its former subsidiary Viztek, which the federal government says fraudulently obtained certification for its Exa EHR that allowed users to falsely collect Meaningful Use payments.

Also named was EHR certification company InfoGard, which “facilitated and participated” in Viztek’s false attestations by certifying the product even as its tester noted obvious manipulation.

Details of the whistleblower’s complaint, in which the government intervened without filing its own complaint, are more interesting than the $500,000 settlement might suggest:

  • PACS vendor Viztek announced rollout of its EHR-PACS integrated Exa EHR in mid-2014. It developed that product in reworking its previously acquired Opal EHR, which was ONC certified.
  • Viztek’s India-based developers underestimated the work that was required to bring Exa EHR up to 2014 edition standards.
  • The whistleblower – Exa EHR’s product manager – said Viztek founder and president Joe Cermin told her that “I don’t care if you have to lie, beg, cheat, steal, or kill” to earn certification since failure to do so would jeopardize the millions of dollars that would result from the company’s acquisition by Konica Minolta, which was underway during the certification testing.
  • Konica Minolta acquired the 120-employee, North Carolina-based Viztek in October 2015.
  • Viztek chose the remote testing option so it could manipulate the testing scenarios using a hard-coded product version that was never released. The whistleblower was told to keep multiple tabs open on her screen, one to run the test script and the other to show an already-configured result. The software failed testing at several points, at which time the company’s executives would ask for a break to allow two on-call teams in India to dummy up test results on two versions of the software, then demonstrate the result of whichever team finished first. At several points, the developers accidently displayed live patient data.
  • The developers hard-coded the EHR to pass the XML output requirements for Common MU Data Set by using programming they found on an ONC testing website. They didn’t even bother to remove the other EHR vendor’s name that was still embedded in the programming.
  • InfoGard “facilitated and participated” in the false attestations by giving Viztek multiple attempts to pass and approving frequent breaks and delays that gave developers time to falsify the programing. The InfoGard tester passed the product even though she noticed that on-screen version numbers, colors, and field layouts changed after the developers had taken breaks.
  • The UL subsidiary of Underwriters Laboratories acquired InfoGard in December 2015.

Reader Comments

From Debbie Downer: “Re: [health IT executive name omitted.] Does it seem they had to be at least somewhat evil to have made their way to the top?” We all have a good-bad behavior ratio that changes situationally, earning us a perceived “jerk score” that may be based on only superficial aspects of our character as observed at our most inopportune moments. Steve Jobs, Bill Gates, Elon Musk, and Neal Patterson kicked their dents in the universe with a psychologically obsessive focus, notoriously flaring temper, an intolerance of naysayers, psychological issues that in some cases were tied to a traumatic childhood, and a general indifference to the wellbeing of the folks who were rowing their corporate boat. But they built lasting and daringly innovative companies in their image that likely would not have happened if they were easygoing everymen. It’s probably not true that nice people finish last, but it is true that people who are successful in any field have to push themselves and others in ways that cheap-seaters would likely find despicable. Whether that leaves them happier on their deathbeds or whether society is better off as a result is an issue that is above my pay grade. Maybe my conclusion is that you can be happy only if you act as your natural self, regardless of how acceptable that may or may not be to others, and the vast majority of jerks don’t accomplish all that much.

From Woodstock Generation: “Re: US withdrawal from WHO. All of my HIM colleagues say no impact will result. We will continue to use ICD-10 diagnoses from WHO and modify them as usual to crate our ICD-10 CM. We will also will continue to create procedure codes (ICD-10 PCS) for use only in the US.”


HIStalk Announcements and Requests

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Many poll respondents say that their family connection and money situations have improved in the past year, although quite a few others don’t have much positive to report (with “optimism” taking a big hit, likely due to COVID-19).

New poll to your right or here: how much consumer and healthcare impact will the Amazon Halo wearable have?


Webinars

September 3 (Thursday) 2 ET. “How Does A Global Pandemic Reshape Health IT? A Panel Discussion.” Sponsor: Intelligent Medical Objects. Presenters: Rob Wallace, chief product officer, IMO; Andrew S. Kanter, MD, MPH, chief medical officer, IMO; Lori Kevin, VP of enterprise IT and security, IMO; Sahas Subramanian, MCA, enterprise architect, IMO. As COVID-19 continues to spread, regulation changes, code system updates, and an increased reliance on technology are making it hard to stay on top of the many ways the pandemic is altering health IT. What’s more, we’re confronting challenges that rely heavily on technological solutions – like accurate reporting tools or telehealth adaptations – and we need those solutions now. The panel of subject matter experts across the enterprise will share insights on how the global pandemic is reshaping the health IT world.

September 17 (Thursday) 1 ET. “ICD-10-CM 2021 Updates and Regulatory Readiness.“ Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, VP of global clinical services, IMO; Theresa Rihanek, MHA, RHIA, mapping manager, IMO; Julie Glasgow, MD, clinical terminologist, IMO. IMO’s top coding professionals and thought leaders will review additions, deletions, and other revisions to the 2020 ICD-10-CM code set that will be critical in coding accurately for proper reimbursement.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

Prescription shopping vendor GoodRx files for an IPO, showing first-half results of $55 million in profit on $257 million in revenue with high growth in both. The company was valued at $3 billion in a 2018 funding round.


COVID-19

US COVID-19 deaths are at 183,000, with 220,000 projected by November 1.

Public health experts question whether COVID-19 PCR tests are overly sensitive, causing people who are carrying insignificant amounts of virus to be labeled as positive and treated as contagious. The answer isn’t to stop testing, as CDC’s controversial new guidance suggests, but instead to use the newly introduced rapid tests that are less sensitive. Other options would be to confirm PCR tests a few hours later with a rapid test, or to interpret the same PCR test result using lower cycle threshold ranges. A run of samples at New York’s state lab identified 794 positive results using the common setting of 40 cycles, but detuning the sensitivity to 35 cycles reduced that number in half, which would make the results more meaningful and make contact tracing easier. The experts also question why labs report their test results as simply positive or negative instead of listing the actual measured viral load.

HHS dismisses two of its high-level PR experts following the backlash that followed erroneous statements made by FDA Commissioner Stephen Hahn, MD about the effectiveness of convalescent plasma treatment that he later declined to correct in a public forum. Hahn, President Trump, and HHS Secretary Alex Azar touted FDA’s Emergency Use Authorization of the treatment as a “very historic breakthrough” that offers a 35% reduction in deaths, a wildly incorrect misinterpretation of results from an observational study that showed that a tiny subset of patients had 35% fewer deaths when given the treatment early versus those who were given it later. Hahn tweeted that he misspoke in characterizing the findings as an “absolute reduction” instead of a “relative reduction,” but he has not elaborated further or provided more accurate information to the public. No randomized clinical trial has been done to prove that convalescent plasma treatment reduces deaths, and even taking the data at face value suggests a 5% mortality reduction at best from using the 100-year-old treatment.

FDA assigns Emergency Use Authorization to allow all hospitalized COVID-19 patients to receive remdesivir, although no research has been published to prove its benefit. FDA issued an EUA in May for using the drug in non-ventilated hospitalized patients who need oxygen. FDA Commissioner Stephen Hahn, MD said that “data show that this treatment has the potential to help even more hospitalized patients,” citing one study from May and another that found only that five days of treatment work as well as 10. Hospitals worry that broader authorization is unproven, it came in the absence of new research, and the EUA will make it harder to obtain the drug for patients whose need is better documented by evidence.

FDA Commissioner Hahn says the agency will authorize widespread use of a COVID-19 vaccine via Emergency Use Authorization before Phase III clinical trials are complete if they think the benefits outweigh the risks. He says it won’t be a political decision – companies apply for such authorization and FDA makes a determination based on the evidence they submit. The only countries that have approved vaccines before their clinical trials were completed are China and Russia.

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People who are misinterpreting CDC’s data are spreading the rumor that only 6% of reported coronavirus deaths were caused by COVID-19, confusing the fact that 6% have COVID-19 as the only ICD-10 code listed while the other 94% include COVID-19 as well as comorbidities such as obesity or diabetes, as is common in many Americans and nearly ubiquitous in older people. It was already widely published that older, sicker people are more likely to die of COVID-19, as are minorities and those who are poorer. The pandemic won’t just go away by pretending that people who die of pneumonia in conjunction with coronavirus infection didn’t really die of COVID-19 and therefore everybody else’s odds are better. But you want to blame people for letting COVID-19 kill them by daring to be older, sicker, poorer, or less white, then these are some good numbers to share with others who don’t really care about their deaths either.


Other

Ascension Michigan will lay off 223 employees of its IT network operations and service desk in October as the health system outsources their jobs. SVP/CIO Gerry Lewis said in a blog post two weeks ago that “we have begun shifting some of our technology functions to third-party partners who specialize in these services” as part of its “digital transformation.”

Cleveland Clinic President and CEO Tom Mihaljevic, MD will interview Epic CEO Judy Faulkner on Wednesday, September 2 at 6 p.m. ET as part of the speaker series “Ideas For Tomorrow.” It will be live-streamed on Facebook and YouTube Live.

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Elon Musk’s Neuralink demonstrates its skull-inserted brain-computer link in a pig, as the company continues its progress toward creating “neural shunts” that could allow paraplegics to regain use of their limbs. Musk also envisions people communicating using “conceptual telepathy” without writing or speaking. He admits that people will be wary of the technology that he calls “a Fitbit for your skull,” acknowledging that “this is increasingly sounding like a ‘Black Mirror’ episode.”


Sponsor Updates

  • OptimizeRx CEO William Febbo will present at the LD 500 virtual investor conference on September 3.
  • The National Council for Prescription Drug Programs honors Surescripts Clinical Informatics Manager Larry King with its Rising Star Award.
  • TriNetX announces that Duke-NUS, a medical school in Singapore, has joined its global research network.
  • Vocera will present virtually at the Baird 2020 Global Healthcare Conference September 9, Wells Fargo Virtual Healthcare Conference September 10, and Morgan Stanley Virtual Global Healthcare Conference September 14.
  • Wolters Kluwer launches “5 Forces for the Future” series to reimagine healthcare post-COVID-19.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

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Weekender 8/28/20

August 28, 2020 Weekender 3 Comments

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Weekly News Recap

  • Amazon announces its Halo health and wellness wearable, app, and membership program, with Cerner posting its own news that it has integrated the device with Millennium.
  • Konica Minolta Healthcare Americas Inc. will pay $500,000 to settle federal false claims allegations that its former Viztek subsidiary fraudulently earned certification for its EXA EHR that allowed users to claim Meaningful Use funds.
  • The private equity owners of behavioral software vendors Qualifacts and Credible Behavioral Health announce that they will merge their respective companies.
  • CMS issues emergency regulations that require hospitals to report their COVID-19 capacity data daily to HHS to continue being paid by Medicare and Medicaid.
  • Google Cloud will invest $100 million in Amwell when the company begins public trading.
  • The VA implements patient scheduling in an Ohio facility in its first Cerner go-live.

Best Reader Comments

There are some really affordable solutions that allow patients to either pre-register online or fill out information on a tablet or other mobile device when they’re checking in. It’s more convenient for the patient and eliminates a lot of expensive data entry in the back office. You can also do things like connect to a clearinghouse to check a patient’s insurance coverage. I’m no longer surprised at how much hospitals and clinics invest in technology, but still waste time and money with manual paper processes, but it’s hard to fathom. (Greg Mennegar)

I am an Epic builder and it annoys me to no end when I pre-register and fill out all the MyChart questionnaires for an appointment at one of the “big hospitals” here in Boston only to be handed a clipboard with the same questionnaire in paper form that I am asked to fill out. I have even offered to show the front desk staff how to print out the filled out questionnaire from my chart to no avail (this has happened to me more than once and in different departments). Sometimes it is less about the lack of technology and more the lack of user training that can be the issue. (Craig Molway)

Any organization that deems it necessary to purchase higher ratings to game the system should be called out. It clearly points to an act of desperation to sell services or products that can’t stand on their own merit or reputation. This is certainly a warning sign to potential clients that an organization is willing to do all the wrong things to get a contact besides providing a high-value / quality service. (PT Franks)

I would argue that the mental / behavioral health crisis that has gained national attention to the pandemic has its roots in young people being taught that certain emotions are bad and to be avoided. If you look at metaphors, happiness is bright and full of sunshine and sadness is blue and full of clouds and rain. Who want want to admit being sad?!? To your point about the person who told you to wear a smile, it’s akin to a person asking you, “How you are?” and only wanting to hear something superficial like “good” or “not bad.” Perhaps many folks don’t have the language or skills to talk about the “bad” emotions in a meaningful way, so they choose avoidance.(Elmer Phd)

Your “compared to a year ago” poll made me smile. Exactly one year ago I was at peak misery of hot, swollen and uncomfortable, because I was nine months pregnant. I was instantly happier, healthier, and more optimistic two days later when our son was born. (What a year)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of first-year teacher Ms. N in Miami, who asked for engineering learning centers for her elementary school class. She reported in early March, “I work in a title one school with mostly students from low-income families and a low-income community. Getting gifts for the classroom makes them so excited to learn and come to school everyday regardless of what they face at home. When my students first saw the items that were donated they could not control themselves, they were so excited. They wanted to dive in right away! Some of their favorites are the turn and learn gears and the car building kit. Engineering time in my classroom is my favorite part of the day because it fosters their creativity and this time was made more special because of your donations!”

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Ralph Lauren will outfit those working as “ballpersons” during the US Open with a muted uniform, with each shirt listing the name of a Mount Sinai Health System essential employee on the back. The company says bright, colorful designs didn’t seem appropriate and thinks having the names of those who have saved lives on display will celebrate the many ways in which people can make a difference. The company will also feature profiles and stories of nine of the workers on its website.

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A team of 14 nurses, two neonatal nurse practitioners, three respiratory therapists, and a neonatologist worked through the night to care for 19 NICU babies at Lake Charles Memorial Hospital (LA) as Hurricane Laura hit with winds of up to 135 miles per hour early Thursday morning, taking out the hospital’s air conditioning and water. The team moved the babies, some of them on ventilators, to the hallway away from windows. The babies had been transferred there a few hours before when the women’s hospital was evacuated.

The CEO of Bristol Regional Medical Center (TN) resigns after accepting a cardiothoracic surgeon’s invitation to make the first incision in a patient despite having no medical training. The hospital also parted ways with the surgeon.

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A Georgia nurse who contracted COVID-19 during a two-month assignment in New York City and then couldn’t return to hospital work because she was haunted by the experience of seeing families watching their loved ones die via FaceTime starts a company that helps businesses keep their employees safe from COVID.

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The Washington Post profiles former Baton Rouge General Medical Center security guard Russell Ledet, who is now doing his third-year medical school rotation at the same hospital while completing his MD and MBA degrees. He joined the Navy out of high school and was convinced by his wife to go to college, where he doubled-majored in biology and chemistry while supporting his family with the security guard job. After finishing undergrad, he earned a PhD from NYU in molecular oncology, then started medical school at Tulane. He plans to earn triple board certification in pediatrics, general psychiatry, and child and adolescent psychiatry and then open a New Orleans mental health services clinic for marginalized communities. 


In Case You Missed It


Get Involved


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Morning Headlines 8/28/20

August 27, 2020 Headlines No Comments

Cerner ties in with new Amazon Halo to add depth to data in health records

Cerner integrates its systems with Amazon’s new Halo, a health and wellness wearable, app, and membership program.

New Jersey Electronic Health Records Company to Pay $500,000 to Resolve False Claims Act Allegations

Konica Minolta Healthcare Americas will pay $500,000 to settle allegations that its Viztek subsidiary obtained Meaningful Use certification for its EXA EHR under false pretenses, causing end users to falsely attest for MU incentives.

HHS Awards $117 Million to Support Health Center Quality Improvement

HHS will award over $117 million to 1,318 health centers across the country to help with quality improvement efforts including advancing the use of health IT.

News 8/28/20

August 27, 2020 News 4 Comments

Top News

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Amazon introduces Halo, a health and wellness wearable, app, and membership program.

Cerner simultaneously announced that it has integrated its systems with Halo, which will allow consumers to share their connected health values with their care team. Sharp HealthCare is the first to implement Halo in a healthcare setting.

The screen-free Amazon Halo measures body composition from selfies, activity duration and intensity, sleep quality and quantity, and mood as evidenced by voice tone. It will also offer health improvement ideas, such as specific exercises.

The device is swim-proof and will run seven days on a 90-minute charge if its tones are disabled.

Scientists will be interested to study the types of sensors that Amazon is using and to learn if Amazon will publish results from their use.

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Amazon Halo is available via an early access program for $65 and a $4 per month subscription after the first six months. The regular price will be $100.


Reader Comments

From Down Underwear: “Re: HIMSS. Good thing they didn’t go ahead with HIMSS20.” Researchers say the 175-attendee conference of drug company Biogen at Boston Marriott Long Wharf in February has led to at least 20,000 COVID-19 cases, based on tracking the virus’s genetic makeup over four Boston-area counties. HIMSS20 would have involved 50,000 attendees from all over the world, many of them working in patient care, so that would have been a disaster. Unrestricted travel as we have in the US makes it hard to contain and track the virus, as public health agencies are discovering in wondering how many of the hundreds of thousands of people who attended the recent Sturgis Motorcycle Rally brought coronavirus home with them.

From Hermit: “Re: Allscripts. Layoffs continue, with almost all of the Paragon development and product management team gone as jobs continue to move to India.” Unverified.

From GrBuckeye: “Re: Virginia Commonwealth University Health System. Outsourcing its revenue cycle operations to Ensemble Health Partners as of 11/1. Only patient-facing employees, such as in patient access and registration, will remain VCUHS employees, while the other 300 to 600 will become Ensemble employees. I assume that a press release will come out soon with more details.” Unverified.


Webinars

September 3 (Thursday) 2 ET. “How Does A Global Pandemic Reshape Health IT? A Panel Discussion.” Sponsor: Intelligent Medical Objects. Presenters: Rob Wallace, chief product officer, IMO; Andrew S. Kanter, MD, MPH, chief medical officer, IMO; Lori Kevin, VP of enterprise IT and security, IMO; Sahas Subramanian, MCA, enterprise architect, IMO. As COVID-19 continues to spread, regulation changes, code system updates, and an increased reliance on technology are making it hard to stay on top of the many ways the pandemic is altering health IT. What’s more, we’re confronting challenges that rely heavily on technological solutions – like accurate reporting tools or telehealth adaptations – and we need those solutions now. The panel of subject matter experts across the enterprise will share insights on how the global pandemic is reshaping the health IT world.

September 17 (Thursday) 1 ET. “ICD-10-CM 2021 Updates and Regulatory Readiness.“ Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, VP of global clinical services, IMO; Theresa Rihanek, MHA, RHIA, mapping manager, IMO; Julie Glasgow, MD, clinical terminologist, IMO. IMO’s top coding professionals and thought leaders will review additions, deletions, and other revisions to the 2020 ICD-10-CM code set that will be critical in coding accurately for proper reimbursement.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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SeamlessMD raises $3 million in a Series A funding round. The Toronto-based company’s app helps patients before, during, and after hospital stays. The company plans to expand its use of machine learning and expand into home and oncology care.

Research and advisory nonprofit Altarum sells its Prometheus Analytics software to Change Healthcare.

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Employer-focused, prescription-savings startup Prescryptive Health raises $26 million in a Series A funding round. Co-founders Chris Blackley and Kevin Young started the company in 2017 after long stints at Microsoft.


Sales

  • Medical University of South Carolina Children’s Health selects Proficient Health’s PH Connect referral and health data exchange software.
  • Wellstar Health System (GA) will implement telestroke and teleneurology technology from VeeMed at nine of its hospitals.
  • The Missouri Hospital Association’s Hospital Industry Data Institute will upgrade its statewide care coordination platform with predictive alerts and analytics from Collective Medical.

People

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Sean Slovenski, former head of Walmart Health, joins diagnostic testing company BioIQ as CEO.

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Best Buy names former IBM Watson Health executive Deborah DiSanzo (Harvard T.H. Chan School of Public Health) as president of Best Buy Health.

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Ambulatory surgery network operator ValueHealth hires John Gresham (Cerner) as COO.


Announcements and Implementations

Carrus Health (TX) implements Medhost’s Enterprise EHR and RCM software at its new Behavioral Hospital.

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Nova Southeastern University (FL) goes live on InteliChart’s Healthy Outcomes patient engagement software across its 20 multi-specialty health centers.

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CentraState Medical Center (NJ) implements tele-ICU services from Advanced ICU Care.

The University of Kansas Health System goes live on Epic at its locations in Great Bend.


COVID-19

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The FDA issues Emergency Use Authorization for Abbott’s rapid test for COVID-19. The company will sell the credit card-sized test, which provides results in 15 minutes using technology much like a pregnancy test, for $5. The test uses a nasal swab and must be administered by a healthcare professional who is operating under a CLIA certificate. Abbott has developed a companion app called Navica, which will display a boarding pass-style, time-limited QR code that employers, schools, and group activity organizers can scan to limit entry to those who have tested negative. Abbott anticipates manufacturing 5 million tests a month starting in October, although the White House is rumored to have brokered a deal to buy 150 million of the tests for $750 million that the federal government will distribute to high-risk schools and nursing homes, which may exhaust the supply for many months.

CMS issues emergency regulations that include requiring hospitals to report COVID-19 patient and testing data daily to HHS or face possible termination of Medicare and Medicaid payments. In addition, nursing homes will be required to test staff and offer testing to residents.

Sources say that HHS and the White House pressured CDC to quietly issue new guidance this week for people who have been exposed to COVID-19 but who are not experiencing systems. CDC now says that those people should not seek COVID-19 testing. Experts are expressing public concern that the goal should be testing more people without symptoms instead of fewer, symptom-free people can be prolific spreaders, more widespread testing is important and especially so as students return to campus, and CDC is again changing its position under apparent White House pressure. CDC Director Robert Redfield, MD, responding to criticism, has since walked back the recommendation to say that testing “may be considered” for all close contacts of people who are known or suspected to be infected. However, the changed guidance remains on CDC’s website without such clarification.

The New York Times notes that since the White House no longer allows Anthony Fauci, MD to participate in high-profile interviews and the Sunday news programs, he is instead appearing on celebrity podcasts, academic webinars, and Instagram feeds where such approval is not required. Big-audience reporters are bypassing their lack of access by listening to his niche appearances and reporting his newsworthy comments. He is scheduled to offer a session at AMIA’s virtual symposium in November.


Other

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A scenario-based survey of 523 graduating college students finds that nearly half would violate HIPAA for between $1,000 and $10 million. Between 65% and 78% of respondents would illegally share the medical records of a politician or reality show celebrity with media outlets to pay for a friend’s medical expenses.

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Non-profit technology access service Human-I-T provides 30 tablets to allow COVID-19 patients of Olive View – UCLA Medical Center who can’t have visitors to connect virtually with their loved ones.


Sponsor Updates

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  • Healthwise employees and their families volunteer in the Boise, Idaho area by sewing and donating masks, and packing lunches.
  • Goliath Technologies partners with Automai for app-performance monitoring.
  • Intelligent Medical Objects publishes a new white paper, “The 21st Century Cures Act in the age of COVID-19.”
  • Kyruus Chief Customer Officer will co-present with Jefferson Health SVP Lisa Griffin during the virtual Greystone.Net Contact Experience Conference August 28.
  • MDLive CEO and Chairman Charles Jones joins CNBC to discuss telemedicine amid the pandemic and the company’s plans to go public next year.
  • 3M Health Information Systems makes its MModal virtual assistant technology compatible with the Hey Epic! Voice Assistant in Epic Hyperspace.
  • Spok earns SOC 2 Type II compliance for Spok Go solutions, paging solutions.
  • Cedar will integrate Waystar’s pricing estimates, payment options, and eligibility verification capabilities into its patient engagement software.
  • Hayes adds revenue optimization insights to its MDaudit Enterprise revenue integrity software.
  • SailPoint updates its Predictive Identity software to include integrations with Epic and Microsoft Teams.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

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EPtalk by Dr. Jayne 8/27/20

August 27, 2020 Dr. Jayne 2 Comments

Telemedicine provider Avera ECARE creates the American Board of Telehealth, positioning it as a national body to develop best practices and standards for telehealth education. The new board plans to focus on telehealth quality and education across the scope of individuals involved in telehealth, from administrators to physicians and everywhere in between. The ABT’s advisory board includes leadership from industry players such as Amwell and the American Telemedicine Association (ATA), along with a couple of academic faculty.

Avera received a $4.3 million grant from the Leona M. and Harry B. Helmsley Charitable Trust last year, which funded a telehealth education center along with a certificate program. The new ABT program will launch online September 7 with a CORE (Clinical, Operational, Regulatory, and Ethics) Concepts in Telehealth Certificate Program. Validated guidelines will be supplied through the Harvard medical Physician Faculty Group and the curriculum will be delivered using seven online modules. I’ve been underwhelmed by previous educational opportunities from the ATA and telehealth vendors, so my curiosity sent me to check out the website. There’s a $400 fee for the program and it sounds like they will mail you a handsome certificate, since they note that there is a $150 fee for a replacement.

My wacky clinical story of the week comes courtesy of our broken healthcare system, because if it was functional, the visit would never have happened. A patient presented to a direct-to-consumer telehealth service after seeing her primary care physician, who referred her to a subspecialist, who recommended a course of treatment that the patient didn’t feel was working. She was unable to reach the subspecialist due to limited office hours, so she called telehealth for a “second opinion.” It never occurred to her to reach back out to her primary physician to further discuss it. She ended up on the phone with an emergency medicine physician who wasn’t able to assist due to both limitations of knowledge and the constraints of his scope of service. Operations people take note: technology is not the answer here (but it can help).

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Doing what I do for HIStalk is a great excuse to spend time every week checking out new companies. Sometimes a friend clues me in on an interesting thing they’ve seen, or mentions a need that gets me questioning whether a solution exists. Such was the case this week with SS&C’s Vidado platform, which was formerly under the Captricity moniker. Apparently they are a player in the insurance and financial services sector, with clients such as MetLife and Guardian. They have a track record with OCR and data extraction of insurance history and medical forms, which gives support to their entry into the world of healthcare. They processed over 300 million pages last year and obviously can play at scale.

It looks like their healthcare focus includes drug prior authorizations and specialty pharmacy orders, along with common documents such as claims forms. It sounds like they have a short-term proof of accuracy offer that allows clients to see how the solution would handle their forms before signing on the dotted line. If I was looking for a vendor in the space, that would certainly be compelling. I’ll certainly be keeping my eye on them to see how they fare in the wacky world of healthcare.

There are still plenty of paper forms out there, as I learned at the imaging center last week. They are now two years into their Epic implementation and are still handing patients a paper form to complete that looks like a downtime document – it doesn’t even have the patient’s name or demographics on it. Forms that make you fill out your address when it’s already in the registration system, EHR, and RCM system are just annoying.

One of my favorite techies has been out of work for a while and reached out today to share his acceptance of a new position. He’s been to hell and back in his job search and we caught up about some of the strange behaviors he’s seen among recruiters and hiring managers. One disheartening tale involved a recruiter who reached out twice for the same position, missing the fact that she had previously told him he wasn’t selected to move to the next step. Another involved a manager who noted that he was the first to interview for the position, but they planned to conduct interviews for the better part of a month, so he shouldn’t expect a decision any time soon. Nothing says “we don’t know what we’re looking for” like an admission that you haven’t narrowed your candidate pool.

My friend noted that multiple people asked questions like “why have you been out of work for so long” as if they were unaware of major layoffs in the healthcare IT industry or a global pandemic that has eliminated hiring in many sectors for the last six months. Not to mention that people may have been impacted by COVID personally or with the illness or loss of a family member, so it’s just not that great of a question. I’ve always found it better to focus on what the candidate is bringing to the table rather than the circumstances that led them there.

Regardless, I’m glad he found a position that seems like a good fit and that happens to be in his favorite industry. The fact that it’s work-from-home well into 2021 is a bonus, too. I know there are millions of good people looking for work right now and I wish them productive interviews with companies that have their acts together.

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Everyone falls victim to clickbait headlines. I have to admit I was pulled into this viewpoint article in Nature Reviews Urology. “Making love in the time of corona – considering relationships in lockdown” looks at impact of societal lockdowns on intimacy. Topics range from the practical to the philosophical, so if you’re looking for an interesting read, it certainly fits the bill.

What’s the worst clickbait headline you’ve ever fallen for? Leave a message or email me.

Email Dr. Jayne.

Morning Headlines 8/27/20

August 26, 2020 Headlines No Comments

SeamlessMD Raises $4 Million CAD Series A to Meet Increased Demand for Digital Patient Engagement Due to COVID-19

Toronto-based SeamlessMD will use a new round of funding to further scale its patient engagement app, designed to help patients before, during, and after hospital stays.

Prescryptive Health Closes $26 Million Series A Financing

Employer-focused, prescription-savings app startup Prescryptive Health raises $26 million in a Series A round led by Morningside Ventures.

Altarum’s Innovative Value-based Payment Solution—PROMETHEUS Analytics®—is Acquired by Change Healthcare

Research and advisory nonprofit Altarum sells its Prometheus Analytics software to Change Healthcare.

Morning Headlines 8/26/20

August 25, 2020 Headlines No Comments

Warburg Pincus and Martis Capital Announce the Merger of Qualifacts and Credible Behavioral Health

The private equity owners of behavioral software vendors Qualifacts and Credible Behavioral Health will merge their respective companies, giving the merged organization a client base of 800 behavioral health agencies.

Lyra Health Closes $110M in Series D Funding

Lyra Health, which offers technology-powered mental health benefits for employers, raises $110 million in a Series D funding round, increasing its total to $290 million and valuing the company at $1.1 billion.

PatientPop Announces $50M in Series C Funding

Practice management software vendor PatientPop raises $50 million in a Series C funding round, increasing its total to $125 million.

Trump Administration Strengthens COVID-19 Surveillance with New Reporting and Testing Requirements for Nursing Homes, Other Providers

CMS issues new emergency regulations that include requiring hospitals to report COVID-19 data daily to HHS or face possible termination of Medicare and Medicaid payments.

News 8/26/20

August 25, 2020 News 2 Comments

Top News

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Google Cloud invests $100 million in Amwell, with timing and per-share price to be set by the company’s announced IPO.

Amwell will move parts of its business from Amazon Web Services to Google Cloud.


Reader Comments

From Chuck: “Re: Qualifacts and Credible. I heard they are announcing their merger tomorrow [Chuck was correct – he sent this on Monday and the announcement was Tuesday]. This is kind of like T-Mobile and Sprint. With Netsmart, that will make two 800-pound gorillas in the behavioral health EHR space, leaving a handful of mid-level EHRs (TenEleven, NextGen, Streamline, Echo, Foothold, Core Solutions) competing for larger opportunities.”

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From Dancing Iguana: “Re: links. We aren’t seeing web traffic coming from HIStalk like we used to. Have you changed something?” I didn’t change anything, but this inquiry led me to learn that WordPress did in an effort to eliminate a particular kind of security issue. Links that open a new browser tab intentionally hide the source website from the receiving one. That can be changed in two ways: (a) by making programming changes; or (b) setting all links to open in the same browser tab instead of a new one. Example: here’s how it works now (a new tab opens), and here’s how it would look otherwise (the existing tab displays the linked page). Let’s go to the poll: would it bug you if clicking an HIStalk link opened the new page in the same browser tab instead of a new one as in the second option above? It probably would me since I don’t like using the “back” button for navigation and then re-loading the page, but that’s the default browser behavior. Now I know why companies have asked me if my readership is down (it isn’t) – the traffic I send them doesn’t show as coming from HIStalk.


Webinars

September 3 (Thursday) 2:00 ET. “How Does A Global Pandemic Reshape Health IT? A Panel Discussion.” Sponsor: Intelligent Medical Objects. Presenters: Rob Wallace, chief product officer, IMO; Andrew S. Kanter, MD, MPH, chief medical officer, IMO; Lori Kevin, VP of enterprise IT and security, IMO; Sahas Subramanian, MCA, enterprise architect, IMO. As COVID-19 continues to spread, regulation changes, code system updates, and an increased reliance on technology are making it hard to stay on top of the many ways the pandemic is altering health IT. What’s more, we’re confronting challenges that rely heavily on technological solutions – like accurate reporting tools or telehealth adaptations – and we need those solutions now. The panel of subject matter experts across the enterprise will share insights on how the global pandemic is reshaping the health IT world.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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The private equity owners of behavioral software vendors Qualifacts and Credible Behavioral Health will merge their respective companies, giving the combined organization a client base of 800 behavioral health agencies. Warburg Pincus invested in Qualifacts a year ago at a reported valuation of $350 million.

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Lyra Health, which offers technology-powered mental health benefits for employers, raises $110 million in a Series D funding round, increasing its total to $290 million and valuing the company at $1.1 billion. Co-founder and CEO David Ebersman spent 15 years as an executive with drug maker Genentech and then joined Facebook as CFO for five years before co-founding Lyra Health.

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PatientPop raises $50 million in a Series C funding round, increasing its total to $125 million. The company offers practice management tools such as website development, online scheduling, appointment reminders, and reputation management. The co-CEOs came from ShopNation, which offers a fashion shopping engine.


Sales

  • Dignity Health Management Services will use Innovaccer’s Data Activation Platform for interoperability as well as its population health management solution. 

People

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B.well Connected Health hires Dunnie Norman (InsightRX) as chief revenue officer.

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Dan Thelen, MBA (Evergreen Healthcare Partners) joins First Health Advisory as VP of cybersecurity.

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Jay Sultan, MA (Cognizant) joins LexisNexis Risk Solutions as VP of strategy in its healthcare business.


Announcements and Implementations

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The VA launches its Cerner appointment scheduling system at the VA Central Ohio Healthcare System, with a VA-wide rollout to follow.

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Health IT startup Emme launches its first product, a $99 Bluetooth-connected smart pill case that sends women reminders to take their birth control pill via its IOS-only app. The company says that 80% of women miss at least one pill each month, causing 1 million unintended pregnancies.

Government research contractor Mitre and Nuance will work together to advance use of the MCODE cancer research and treatment data standard by using Nuance’s Dragon Medical One to capture clinician dictation that is sent to the EHR.


COVID-19

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FDA Commissioner Stephen Hahn, MD, President Trump, and HHS Secretary Alex Azar incorrectly state that the use of convalescent plasma for treating hospitalized COVID-19 patients reduces deaths by 35% in announcing FDA’s Emergency Use Authorization for the treatment. They mischaracterized the original Mayo Clinic study, which concluded that giving the plasma within three days of diagnosis was associated with a seven-day mortality rate of 8.7% versus 11.9% if transfused later, which represents a 35% relative (not absolute) improvement between the timings in a small fraction of patients but does not support any evidence of an improved survival rate overall. Hahn acknowledged his mistake in a Monday night tweet, but scientists question how he could have made such an obvious error and then allowed others to repeat it uncorrected. President Trump had accused the FDA on Twitter the day before the announcement as being run by the “deep state” and intentionally obstructing vaccine and treatment studies in hopes of harming his re-election bid, although Hahn says that that White House pressure did not impact FDA’s action. Scientists say the FDA’s EUA will have a negative effect since use of convalescent plasma has not undergone randomized controlled trials and now patients aren’t likely to sign up for those studies knowing that they have a 50% chance of receiving placebo when they can just have the plasma ordered directly under the EUA. They also worry that White House publicity will cause shortages of the plasma, which is collected from volunteer COVID-19 survivors, and that FDA might allow a vaccine to be released prematurely with similarly unconvincing science behind it.

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HHS Secretary Alex Azar told hospitals in an April 21 email that they would be required to submit their COVID-19 capacity data to HHS’s newly launched TeleTracking database to be eligible for the federal government’s $100 billion provider relief fund, a stipulation that Congress had not included in the legislation. 

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A Georgia health district explains that a sudden COVID-19 case jump was caused by activation of a new lab reporting connection to Navicent Health that sent a backlog of one hospital’s reports going back to mid-June. They organizations are working together to remove the duplicate entries.

A testing lab tells the NFL says that 77 new positive COVID-19 results that affected 11 football teams were false positives caused by contamination that occurred during test preparation.


Other

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A shareholder of SCWorx Corp. sues the company, claiming it misled investors by announcing a contract to sell $35 million worth of COVID-19 test kits each week for 23 weeks to Rethink My Healthcare. The shareholder says that customer was too small to afford the kits that it had supposedly committed to buy. SCWorx offers hospital supply chain, analytics, and interoperability solutions. According to its SEC filings, it has eight employees and is losing money to the point that its auditors question its survival. It acquired several mixed martial arts fighting championships that it still operates as subsidiaries. WORX shares are a rollercoaster, trading in the past year from $1.50 to $15, currently at $1.56, valuing the company at $15 million.

Former Sutter Health CIO John Hummel, PhD passed along the back story of former Sutter IT project manager and convicted murderer Mario Garcia, who a jury found guilty of killing a 27-year-old woman in 2005 even though her body had not been found. John says police searched the IT facilities extensively and his CISO was able to recover deleted pictures from a Sutter-owned camera in which Garcia documented scratches to his face. The photos, along with DNA evidence that proved that the victim had been in his car, convinced the jury of his guilt. John spent years searching for the woman’s body as a promise to her mother and now investigators have finally found the remains of Christie Wilson buried at Garcia’s former residence.

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Cory Chase, a network analyst at Johns Hopkins All Children’s Hospital, records “Quarantine Radio,” a half-hour music and humor show that he creates after his work-from-home day ends.


Sponsor Updates

  • CloudWave Director of Sales Engineering Mike Donahue receives the Patriot Award through the DoD’s Employer Support of the Guard and Reserve after being nominated by CloudWave Technical Consultant and US Air Force Guard member Osmandy Polanco.
  • Dimensional Insight sponsors registration for the St. Jude Walk/Run in Boston September 26.
  • Dina will exhibit at Health Catalyst’s virtual Healthcare Analytics Summit September 1-3.
  • Elsevier launches a Medical Student Hub for first-year students that offers masterclass videos, podcasts, survival tips, anatomy flashcards, and toolkits.
  • Everbridge’s contact tracing software experiences rapid global adoption across education, corporate, and government sectors.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

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Morning Headlines 8/25/20

August 24, 2020 Headlines No Comments

Google is investing $100 million in telehealth provider Amwell, which will use Google Cloud

Amwell files to go public as Google Cloud announces that it will invest $100 million in the telemedicine company and become its preferred cloud partner.

VA rolls out new patient-appointment tool, as part of electronic health record modernization transformation

The VA Central Ohio Healthcare System goes live on a centralized scheduling solution as part of its agency-wide transition to Cerner technology.

Hartford HealthCare pushes ahead in pandemic to bring workers to office building on prominent corner in downtown Hartford

Hartford HealthCare (CT) will move forward with plans to open a patient care access center in downtown Hartford that will include a telemedicine-equipped urgent care center.

Curbside Consult with Dr. Jayne 8/24/20

August 24, 2020 Dr. Jayne 2 Comments

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There’s a lot of talk in the healthcare industry about “wellness.” Everyone is trying to cash in on it, and it seems like there are as many different definitions of wellness as there are companies trying to figure out how to make it part of their portfolio.

As a physician who strives to practice evidence-based medicine, I find many of the elements that are rolled up under the wellness umbrella to be questionable.

I ran across an insurance company last week that is encouraging its members to have “wellness labs” performed. This sounds like a good idea until you look at the contents of the lab panels, which include multiple tests that aren’t recognized as screening tests and aren’t recommended unless patients are experiencing symptoms. We all know that when tests are ordered that aren’t needed, we not only increase the healthcare cost burden, but also place patients at risk, as additional tests may have to be performed to further evaluate the results of a test that shouldn’t have been performed in the first place. I find it shocking that payers would want to spend money on unproven evaluations. I don’t fully understand what they hope to accomplish.

When various groups try to define wellness, they include anywhere from five to eight dimensions of wellness, including emotional, environmental, financial, intellectual, occupational, physical, social, and spiritual aspects. All of these certainly impact the ability of individuals to achieve their ideal state of health, but it’s difficult to quantify the complex interactions and how modifying one dimension might lead to changes in the others.

Many of the companies that are trying to get into the wellness space seem to be playing on people’s insecurities as a means of generating profits rather than being truly interested in the science as we understand it. Gwyneth Paltrow and her Goop brand has made millions of dollars selling wellness products ranging from nutritional supplements to sex toys. Wellness is the place to be, but that doesn’t change the fact that I tend to think twice about organizations that make it a central focus.

This really hit me the other day as I drove by a shop that had a “find wellness here” banner to promote their sales of CBD oil. Even though there is a small body of evidence looking at it, many of the shops promoting it aren’t selling medical-grade product and are certainly hyping it well beyond what the evidence shows.

Especially with confusion around the proven effectiveness of various products, patients have an extremely difficult time determining which wellness interventions they should most vigorously pursue. Does a mammogram or a pap test carry the same weight from a wellness perspective as trying to eat healthier to reduce cardiovascular risk? How do those interventions compare to improving emotional and spiritual health? Should EHR vendors be branching out to gather more data about the dimensions of wellness in addition to gathering all the usual discrete data about recommended screening tests? Or should we recognize that the jury is still out on many of the aspects of wellness and stick with trying to manage the conditions and interventions for which we have the best data?

I have a potential client who would like me to help them build a dedicated wellness practice. I’m struggling with the idea. I know how to help them accomplish what they’re trying to do and can help them with both the operational and technical pieces. They plan to staff the practice with their usual physicians, who will take turns seeing the wellness patients. If they find something that requires more in-depth follow up, they will refer the patients back to the traditional practice.

The client doesn’t seem to care whether the physicians have much buy-in to the concepts of wellness, or whether they are prepared to address all the different dimensions of wellness. In talking with them about their goals, it feels like they’re just trying to catch a ride on a popular concept while making some money along the way. One partner specifically mentioned wanting to keep patients away from telehealth practices that offer wellness services.

On one hand, it would be easy to just take the engagement and get the work done. However, part of me will still have doubts about the validity of the plan since it seems more about the money than offering a comprehensive portfolio of services that would help support their patients in the pursuit of better health.

This situation underscores the issues with healthcare in the US today. We have a mismatch of incentives that leads providers to look for ways to bolster the bottom line at the expense of initiatives that are designed to shift to a value-based approach. Organizations cite the idea of “no margin, no mission” as a way to justify some of the choices they make. Given the financial beating that many practices have taken this year, you can’t blame them.

The decision might be out of my hands, as I’m not sure they’re going to be willing to spend the amount of money that will be needed to build the whole wellness concept from start to finish, including marketing, staffing, and changes to their EHR and other technical systems. I bid on several projects like this each year, where people think they are going to be able to do major projects on the cheap, and then seem shocked when someone fully spells it out for them. I can’t imagine that any of the larger consulting companies can do it more economically unless they’ve dramatically slashed their rates due to slowdowns from the pandemic.

Plus, the practice need to be ready to handle the losses they will incur over the next year or so until they know whether it’s going to turn out the way they hope. Given the uncertainty of the pandemic and the upcoming flu season, I’m surprised they are willing to even consider taking the plunge.

What do you think of the idea of wellness? Do you think it’s a good time to take the plunge on new service lines? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Interviews Jose Barreau, MD, CEO, Halo Health

August 24, 2020 Interviews No Comments

Jose Barreau, MD is chairman and CEO of Halo Health of Cincinnati, OH.

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Tell me about yourself and the company.

I’m a physician and oncologist. I practiced until 2015. I was involved in creating a cancer institute and what I called multidisciplinary care, where a patient can come in and see all of their oncology doctors — surgical, medical, and radiation – at the same time. That got me interested in communication and collaboration and how that is important to a health system.

Halo Health offers a clinical collaboration platform. It is a cloud-based application that goes across health systems and has every clinician on it — doctors, nurses, and medical staff. It allows them to message each other, call each other, and receive alerts. It supports real-time clinical communication on one application across the system. We focus on real-time, high-priority, urgent and emergent information and communications.

How would you describe the clinical collaboration platform market and how Halo Health differs from its competitors?

We are focused on role-based communications, which is different in healthcare than in other businesses. About 40 to 50% of healthcare communication with a role you know – such as “cardiologist on call” or “charge nurse on the 14th floor” – rather than a named individual. Our platform allows for accurate manual and schedule-based, role-based communication, which differentiates us from anyone else.

How has the care team definition changed with COVID-19 and the rise of telehealth?

We started off as a secure texting application. We realized pretty quickly that secure texting is OK, but it is poorly adopted. People only text the people they know are working at that moment, so the platform is adopted only in pockets. Identifying roles and communicating call message and alert roles opens up the other 50% of the health system in a single platform.

With COVID, we really needed to set up teams, identify contacts, and get people moved through the system quickly. For example, “COVID charge nurse” is a role that multiple people fill based on the time of day, and a role-based platform can support that.

How has the mix of message types changed between real-time voice and asynchronous text?

I learned two things in studying communication and collaboration. Doctors and nurses want to do things faster, but they also want to be interrupted less. A doctor or nurse is interrupted from a patient encounter every time their phone rings since they are usually in front of a patient. That’s a problem when just calling them or messaging them with routine information. You want to give them a chance to respond when they can, and asynchronous communication is effective for situations where you don’t need to answer right away, but instead can wait a few minutes to wrap up your conversation with the patient. Nurses and doctors want patients to feel like they are the most important thing in the world to them at that time.

Do clients expect their messaging systems to be integrated with other systems?

They do. The big question is, what do you integrate? We are trying to clearly define that to protect the platform. We don’t want all the information that’s out there. If you want something from the EHR, we want you to go to the EHR. We also want to keep integration real time, so we integrate with the nurse call system, the PBX, physiological monitoring, and those types of things.

We have to do discovery about what that organization thinks is important. Even the level of integration with the EHR depends on what the organization wants.

Do you have to protect clinicians from being barraged with messages that non-clinicians send just because it’s convenient for them to do so?

I battled a long time with that when I was practicing medicine and directing the cancer institute. Some physicians are comfortable with being contacted when needed, but others don’t want anyone contacting them. We do a lot with healthcare leadership, such as chief medical officers. I personally feel that physicians should be open to communication from everyone, but everyone should know what is appropriate to communicate at what time, and that’s our philosophy.

I don’t think doctors and nurses should be on separate platforms, although some people believe that. I think that’s a huge mistake. One communication platform for everyone is appropriate, as long as the platform can provide certain protections and users have been educated on what is real time and reminded that they are interrupting a doctor or a nurse.

I find it funny that people talk about interrupting doctors, but nurses get interrupted all the time and nobody is saying much about that. Nurses are barraged with alerts and all this type of stuff. It’s OK to interrupt nurses eight times when they’re with a patient, but it’s not OK to interrupt a doctor. I would argue that nurses often spend more time with patients and develop stronger relationships with them.

It needs to be looked at holistically across the organization in terms of each role, but each doctor, nurse, or other clinician should be easily accessible. That’s our philosophy.

Email is notorious for allowing people to add others to a conversation without turning any of the discussion into actual assignments. Are messaging workflow components available to assign actions and log them as either completed or reassigned?

Everything in a clinical collaboration platform like ours is auditable and traceable. It’s usually individual-to-individual or individual-to-role. Everyone has an ID, and there’s an individual behind that role. Everything that is sent, delivered, and read is tracked. If you send a message to five people on the code team, all of them have the responsibility to read the message and respond to the code. The sender can see who has read it and who hasn’t.

You can put controls in place for resending and escalating, but if the message was directed to you or the role you’re filling, you are responsible. That’s why the role-based platform component is important, and having accuracy on the other side so that someone receives the alert or message.

What capabilities of secure communications systems have changed with the availability of cloud-based systems?

We are 100% Amazon technology. We evaluated a lot of technologies in 2015 and felt Amazon gave us the most scalability, reliability, and security. We signed a business associate agreement with them and developed a good partnership.

The Amazon platform gives our product scalability. We can have a huge organization on the West Coast, a huge organization on the East Coast, and another in the Midwest, and all of them can add users and mobile transactions without affecting response times or delivery times. We can add organizations on the fly and constantly release products and features as software as a service. Health systems, physicians, and nurses should be on the latest, greatest technology in the most current version at all times and cloud technology allows us to do that.

How do you see the company’s future?

We have built all the channels, the alerting, the calling, and the messaging. We have a tremendous amount of data going through our system. A lot of it was never captured before, stuff on pagers or on personal phones. We’re focused on data analytics to create insights around communication patterns and communication workflows to define their impact on patient outcomes.

We want to get the right information to the right person, make it accurate, improve patient throughput, reduce staff burnout, and increase clinician satisfaction. The future is in creating those insights and continuously optimizing workflows to improve patient care. We add features and functionality solely to improve patient care. Then we need to have data to show the chief medical officer, the CFO, and people who are playing for the platform how it adds value to patient care in their health system and how it creates return on investment.

Do you have any final thoughts?

The lack of communication and collaboration is one of the biggest, if not the biggest, causes of patient harm right now. Solving this problem will save more lives than a new medication. It has been fragmented in the past. We should all get behind unifying it and shedding a spotlight on the importance of communication and collaboration to keep making progress.

Morning Headlines 8/24/20

August 23, 2020 Headlines No Comments

Outset Medical on deck for IPO

Outset Medical, which offers a portable, cloud-connected home dialysis machine that can integrate with EHRs, files for a $100 million IPO.

Appeals court further erodes huge 2016 jury award for Epic Systems

A US appeals court reduces the $280 million in punitive damages that Tata Consultancy Services had been ordered to pay Epic in a 2014 trade secrets lawsuit, saying that $140 million is a reasonable figure.

Exo Raises $40M Series B Extension To Bring Ultrasound Device To Market

Handheld ultrasound device manufacturer Exo raises $20 million in a Series B round, increasing its total to $100 million.

Monday Morning Update 8/24/20

August 23, 2020 News 2 Comments

Top News

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Outset Medical, which offers a portable, cloud-connected home dialysis machine that can integrate with EHRs, files for a $100 million IPO.

The only connection required for the touchscreen-operated, sensor-managed portable machine is a wall outlet and tap water that it uses to create its own dialysate.

The company has raised $450 million, most recently $125 million in a Series E funding round earlier this year.


Reader Comments

From Puzzled PR: “Re: partnership press release. Why didn’t you mention our announcement?” I ignore any announcement that I can’t figure out within 15 seconds, including this infuriatingly imprecise one that has puffed some sort of “partnership” to the point I can’t tell who (if anyone) actually bought something. I doubt it was newsworthy anyway, but I honestly couldn’t tell. Too many PR cooks spoil the announcement broth in rendering simple statements such as “what does this company do” into intentional inflated gibberish in shooting for high-falutin’ prose and instead hitting their own foot. I typically don’t mention partnership announcements (because who cares?) and I also pass on “news” items that affect only existing clients who surely be contacted individually anyway. The folks whose committees ruin clear communication by over-polishing it always seem shocked that the rest of the world doesn’t take notice, either because they couldn’t figure it out or it was of minimal value even before being butchered.


HIStalk Announcements and Requests

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A possibly surprising 60% of provider employees who registered for HIMSS20 say they won’t attend HIMSS21 even if COVID-19 isn’t a factor by then. Most respondents, based on what they know today, have already made plans one way or another, with few of them saying they don’t know yet.

New poll to your right or here, repeating one I did in the pre-COVID days of last summer that seems like years ago: what’s better about your life now compared to a year ago?


Webinars

September 3 (Thursday) 2:00 ET. “How Does A Global Pandemic Reshape Health IT? A Panel Discussion.” Sponsor: Intelligent Medical Objects. Presenters: Rob Wallace, chief product officer, IMO; Andrew S. Kanter, MD, MPH, chief medical officer, IMO; Lori Kevin, VP of enterprise IT and security, IMO; Sahas Subramanian, MCA, enterprise architect, IMO. As COVID-19 continues to spread, regulation changes, code system updates, and an increased reliance on technology are making it hard to stay on top of the many ways the pandemic is altering health IT. What’s more, we’re confronting challenges that rely heavily on technological solutions – like accurate reporting tools or telehealth adaptations – and we need those solutions now. The panel of subject matter experts across the enterprise will share insights on how the global pandemic is reshaping the health IT world.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Handheld ultrasound device manufacturer Exo raises $20 million in a Series B round, increasing its total to $100 million. The company will launch the device and its workflow software over the next few months in the US.

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Hyland acquires Germany-based robotic process automation software vendor Another Monday.

A US appeals court reduces the $280 million in punitive damages that Tata Consultancy Services had been ordered to pay Epic in a 2014 trade secrets lawsuit, saying that $140 million is a reasonable figure. Tata continues to fight the lawsuit, arguing that it did not misuse the information that its consultants were accused of copying from Epic’s UserWeb while claiming to be Kaiser Permanente employees. The original jury award was $940 million, which was lowered to $420 million to comply with Wisconsin state caps on punitive damages. Epic accused Tata of stealing its intellectual property to improve its competing product Med Mantra. Tata employee Philippe Guionnet, who managed the company’s contracts with Kaiser, was the whistleblower who conveyed his suspicions to Epic.


People

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Vinnie Whibbs (TogetherMD) joins TVR Communications as VP of enterprise solutions.


COVID-19

Updated models predict 227,000 to 300,000 US COVID-19 deaths by November and December. The current US death count is at 176,000.

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Former FDA Commissioner Scott Gottlieb, MD warns that a new HHS policy that removes FDA’s authority to oversee lab-developed tests will lead to direct-to-consumer tests that operate without FDA oversight and will leave FDA with no authority to take enforcement action against bad tests. FDA had traditionally not actively regulated such tests anyway, but now will be unable to work with test makers to improve quality in the absence of a process that was working.

FDA will reportedly authorize the use of convalescent plasma from recovered patients for treating COVID-19 under pressure from the White House on the eve of the Republican National Convention’s kickoff, although its Emergency Use Authorization will make it harder to conduct randomized clinical trials, which have never been performed on the procedure.

California’s infectious disease monitoring system recently went down for 20 days, hampering the efforts of local health departments to manage their pandemic response. The state’s backlog of 300,000 lab tests contained 15,000 that were positive for COVID-19, eliminating the possibility for individuals to isolate themselves and for public health officials to perform contact tracing. An outage in the state’s CalREDIE database prevented delivery of electronic lab reports to counties. Mendocino County performed its tracking by telephone and fax machine as usual, leading to its decision to shut down bars in even though the state’s backlogged electronica data showed the county as doing fine.

An August 7 wedding reception at a Maine inn with 65 attendees – 15 more than state law allows – has resulted in 53 known COVID-19 cases that were discovered by contact tracers. A woman who did not attend the reception died after becoming infected by someone who did.

In Ireland, two high-ranking federal government officials resign and others are under pressure after getting caught attending an 80-attendee golf tournament and dinner that was illegal given the country’s 50-person limit. The newly resigned / fired minister of agriculture, who had held the position for just six weeks, had warned citizens three days before that house parties were spreading the virus and that “COVID loves to party.”


Other

A Catholic hospital in Toronto opens up its Internet content filtering system to allow doctors to access the websites of abortion clinics for patient referrals.

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Scientists in China say that their AI algorithm can predict coronary artery disease by looking at a person’s photo for signs of thinning or gray hair, wrinkles, and ear lobe creases.


Sponsor Updates

  • The RedSail Technologies QCompass podcast features OmniSys Chief Innovation Officer David Pope, PharmD.
  • SymphonyRM’s HealthOS: Health AI Powered Patient Engagement is now available on the Salesforce AppExchange.
  • Waystar will open an office in Utah, creating up to 70 jobs over the next seven years.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

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Weekender 8/21/20

August 21, 2020 Weekender No Comments

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Weekly News Recap

  • HHS denies a Wall Street Journal report that says COVID-19 hospital data reporting will revert back to CDC’s control using a new system.
  • Bankrupt smart pill developer Proteus Digital Health sells its assets to Japan-based pharmaceutical company Otsuka for $15 million.
  • Clinical communications vendor Vocera acquires EASE Applications, which offers messaging tools to connect family members and a patient’s care team.
  • Health IT vendor TeleTracking refuses to answer the Senate Health Committee’s questions about its $10.2 million contract to develop a HHS COVID-19 hospitalization reporting database.
  • HHS CIO Jose Arrieta resigns unexpectedly after 16 months on the job

Best Reader Comments

Spoke with an MD yesterday, they’re doing pot over the phone now. Great job, telehealth, you really saved the world this time. Meanwhile, back at the facility, kidney patients are bearing a COVID burden on top of the mortality rate associated with dialysis. Point: mobile works, big brick things with windows that don’t open don’t. Disclaimer: I’m talking about patient healthcare, not funding a better grasp on a sinking anchor. (richie)

I would rather some dumb startup provide access to marijuana cards, Rogaine, birth control, contact lenses, etc. than have to wait in line behind those people in the doctor’s office. Those are mostly just doctor employment programs anyway, which they don’t need. (IANAL)

Here’s how your insurance company thinks about [telemedicine]. You know that nurse line that they run where you can call in and ask questions? What if the people on that line could write prescriptions, order and interpret labs, etc.? What percentage of doctor’s office visits could they cover? Rough guess would be 1/3 of your typical PCP visits. How much less could the total cost be for that office visit? Maybe it is 60 percent of the in-person cost, more in high rent areas or areas with limited physician supply. When an insurance company is required to spend 80 percent of revenue on claims and they optimistically have a margin of 5 percent, it is a no brainer for them to try as hard as possible to make their telehealth solution work for their consumers. I agree it doesn’t make sense for traditional fee-for-service health systems to be using telehealth. Instead, it is something that cuts the traditional health system out of the relationship because they are too expensive or their service is too bad. Which makes the idea of health systems buying telehealth services sound strange to analysts. Why would health systems want to fund their competitors unless they have no hope of putting the telehealth cat back in the bag? (Bogon)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. P in Texas, who asked for programmable Ladybugs for her kindergarten class. She reported in February, “These little robots are the STAR of our classroom right now. I wish that I could send you a video of the children using the ladybug robot and coding remote. The shrieks and laughter were amazing. When I sent the videos and photos to the parents, they were thrilled, as well. I can tell how meaningful it is to these parents that their children learn more and accomplish more than they were able to at their age. It is really sweet. The first time I showed the children how to use it, they thought it was pretty cool. The first time each child got to program in a code and watch the ladybug travel over the mat, THEY WENT WILD!!! It was the perfect example of how seeing something happen can be a learning experience, but actually doing something is the best way to learn. Thank you for providing this opportunity for my littles.”

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Google launches a six-month certificate program that will prepare students for high-paying technical jobs, such as data analyst, project manager, UX designer, and IT support specialist. The company says that college is too expensive for many Americans and a diploma shouldn’t be required for economic security. Google will treat the career certificates equivalent to a four-year degree in its own hiring, will fund 100,000 scholarships to the program, and will offer apprenticeships and job search services. 

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An Alaska doctor is indicted for $9 million in Medicaid fraud for requiring his addiction patients to undergo a urine test that he sent to a lab he owns in Tennessee, for which he billed $3,000 to $8,000 each. A cash-paying patient filed a complaint with the state’s medical board. The doctor is posting rambling videos to YouTube proclaiming his innocence in referring to himself in the third person. Bonus footage minimizes COVID-19 and the “mind control” involved in mandating mask wearing, says his tests are expensive but nothing compared to what Medicare pays for a COVID-19 admission that “in most cases, is not even as bad as a cold,” and his persecution under the Obama administration for donating money to Republicans.

Missouri’s medical board revokes the license of a 70-year-old doctor who amputated a patient’s toe on the porch of his office, a machine shed that does not have running water. He says, “Everything was absolutely perfectly sterile, out in the bright sunshine and fresh air.” His practice’s website is full of bizarre conspiracy theories, along with his offer of video counseling ($50 per 15 minutes) for marital difficulties and unruly children, also offering student tutoring at the same rate. Googling turns up previous charges for narcotics distribution.


In Case You Missed It


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Morning Headlines 8/21/20

August 20, 2020 Headlines No Comments

Troubled Covid-19 Data System Returning to CDC

HHS denies a Wall Street Journal report that says COVID-19 hospitalization data reporting, which was moved to an HHS system with little warning and with criticism from some members of Congress, will return to CDC’s control under a new system.

Trump plots broad health data overhaul after troubled rollout of Covid-19 database

The federal government has launched Modernizing Public Health Reporting and Surveillance, a multi-year initiative to improve data quality at state and local health departments.

Experity Announces Acquisition of Calibrater Health

Urgent and primary care software vendor Experity acquires patient relationship management company Calibrater Health.

Patient engagement startup raises $15 million from Google’s Gradient Ventures

Physician practice-focused patient engagement vendor Klara raises $15 million in a Series A round, bringing its total raised to $32 million.

News 8/21/20

August 20, 2020 News 2 Comments

Top News

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The Wall Street Journal reports that COVID-19 hospitalization data reporting, which was moved to an HHS system with little warning and with criticism from some members of Congress, will return to CDC’s control under a new system.

HHS denies the report, saying that no plan is on the table to have CDC take over again.

The WSJ article quotes a recent statement from Deborah Birx, MD that it interprets as signalling a move to a new CDC system. It did not read that way to me.

In a possibly related item, Politico reports that the federal government has launched Modernizing Public Health Reporting and Surveillance, a multi-year initiative to improve data quality at state and local health departments. Ideas being discussed include automating hospital and lab reporting, moving to electronic case reporting, replacing data systems, and digitizing mobile coronavirus testing sites. Experts worry that the program will conflict with existing efforts and question whether technologists at the White House’s US Digital Service have the knowledge to solve a problem that has vexed public health officials for years.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Healthcare Triangle. The Pleasonton, CA-based company brings together healthcare cloud and security vendor 8K Miles and health IT advisory and implementation services consultancy Cornerstone Advisors. It offers services such as IT strategy and planning, cloud technology, Epic and Meditech consulting, EHR managed services, backup and disaster recovery, data management and analytics, performance data, value-based care insights, supply chain management, and staffing optimization. The company’s customers include provider, payer, and life sciences organizations, with five of the world’s biggest pharma companies using its healthcare data pipeline management, analytics, and aggregation services. I interviewed Chairman and CEO Suresh Venkatachari a couple of months ago. Thanks to Healthcare Triangle for supporting HIStalk.

I cruised YouTube for Health Triangle videos and found this “Week in Review” series that I think is brilliant, especially given that I have no interest in the usual lame podcasts and videos from industry amateurs. The host is Health Triangle Director of Business Development and industry long-timer Damian David, who delivers a smooth, relaxing news recap and interview that he follows with a remarkably good song performance. Other episodes feature fine covers of “With or Without You,” “Sweet Melissa,” “The Wind Cries Mary,” and “Ring of Fire.”

Listening: new from Bully, which sounds like a new grunge album from Courtney Love and/or Hole. Bully isn’t really a band any more – singer-songwriter Alicia Bognanno did a Courtney in in sending her musical mates packing while keeping their collective moniker. She’s also like Love in being bipolar and thus prone to sprinkling her recordings with therapeutic yelling and growling that makes you happy she’s not mad at you. Bognanno is amused by those who compare her music to grunge, explaining that being born in 1990 means she didn’t exactly grow up listening to Nirvana.


Webinars

September 3 (Thursday) 2:00 ET. “How Does A Global Pandemic Reshape Health IT? A Panel Discussion.” Sponsor: Intelligent Medical Objects. Presenters: Rob Wallace, chief product officer, IMO; Andrew S. Kanter, MD, MPH, chief medical officer, IMO; Lori Kevin, VP of enterprise IT and security, IMO; Sahas Subramanian, MCA, enterprise architect, IMO. As COVID-19 continues to spread, regulation changes, code system updates, and an increased reliance on technology are making it hard to stay on top of the many ways the pandemic is altering health IT. What’s more, we’re confronting challenges that rely heavily on technological solutions – like accurate reporting tools or telehealth adaptations – and we need those solutions now. The panel of subject matter experts across the enterprise will share insights on how the global pandemic is reshaping the health IT world.

Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Clinical communications vendor Vocera acquires EASE Applications, which has developed messaging tools to help family members communicate with a patient’s care team during hospital stays. EASE co-founder Patrick de la Roza, now an SVP/GM at Vocera, started the company while working as a system administrator at AdventHealth Nicholson Center in Orlando.

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Bankrupt smart pill developer Proteus Digital Health sells its assets to Japan-based pharmaceutical company Otsuka for $15 million. Otsuka had been an investor and partner of Proteus, which pre-bust was valued at $1.5 billion, apparently by folks with unreasonably optimistic expectations. Going down in flames with Proteus is the nearly $500 million poured into it by investors who rode the rocket up and then down through a Series H funding round.

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Change Healthcare enhances its Enterprise Imaging Network with the acquisition of Nucleus.io, a cloud-based medical imaging company.

Emids acquires payer-focused IT consulting company FlexTech, its second acquisition since purchasing Encore Health Resources in 2017.

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Urgent and primary care software vendor Experity acquires patient relationship management company Calibrater Health.

Year-old, China-based health platform operator JD Health raises $830 million in a Series B funding round. The company – which raised $1 billion in November 2019 Series A round that valued it at $7 billion – offers pharmacy delivery, telehealth services, genetic testing, and hospital systems. It processes 100,000 diagnostic inquiries each day and is working on an online family doctor service that will serve up to 50 million families. New investor Hillhouse Capital was founded in 2005 by a Yale graduate with $20 million in seed capital from Yale’s endowment fund and was named after a New Haven street. The investment firm, which focuses on businesses in Asia, runs a joint venture with Mayo Clinic to boost that provider’s influence in China.


Sales

  • Genesis Health System (IA) will use Bright.md’s SmartExam software to power its expanded telemedicine service.
  • Florida-based hospice Haven selects Netsmart’s MyUnity EHR.

People

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Impact Advisors promotes Susan Stewart to VP and Amy Reid to VP of recruiting.

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Senior home care support and technology vendor Seniorlink hires Amy McConnell (NantHealth) as chief compliance officer.

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Steve Eckert (Avaap) joins Cook Children’s Health Care System (TX) as CTO.


Announcements and Implementations

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Baptist Health South Florida President and CEO Brian Keeley says the health system will spend upwards of $100 million on a digital transformation over the next several years that will include adding new scheduling and registration capabilities to its Cerner system; investing in analytics; upgrading its website with more patient engagement tools; and bolstering its Amwell-powered Care on Demand telemedicine app. The search for a chief digital officer is underway.

In Australia, SA Health implements interoperability software and services from InterSystems to interface its Notifiable Infectious Disease Surveillance system with new workflow technology as it prepares for future waves of COVID-19.

Carilion Clinic (VA) implements Wolters Kluwer’s AI-powered Sentri7 clinical surveillance software to more quickly identify patients at risk for C. diff infections.

Higi adds OptimizeRx’s prescription savings and patient educational materials to its Smart Health Stations that are installed in pharmacies and retailers.

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Capsule Technologies announces GA of a cloud version of its Ventilated Patient Surveillance workstation that runs on Microsoft Azure. 


COVID-19

Researchers find from cell phone data that 7% of workers at a given nursing home also work in at least one other facility, calculating that eliminating such shared staffing would reduce COVID-19 infections by 44%.

The federal government forced companies to manufacture billions of dollars worth of ventilators under the Defense Production Act, but most of them are gathering dust in the national stockpile as COVID-19 treatment protocols de-emphasized their use after a high percentage of intubated patients died and their role in infecting caregivers was questioned. Less then one-fourth of hospitalized COVID-19 patients are placed on ventilators, a big drop from the pandemic’s early days. The federal government says it will either sell or give away dozens of thousands of the devices to other countries.

Pooled COVID-19 testing, which worked well in other countries to reduce the use of short-supply reagents, can’t be used in the US because our infection rates are so high. Partial samples from several patients are combined, the batch is tested for coronavirus, and a positive result triggers re-testing of the retained samples from the batch. Efficiency is good until positivity rates hit 5-10%, at which time the re-testing that is required takes more labor and reagent than testing the individual samples. Experts also question whether the pooled tests miss people with low levels of virus and worry about the extra work that is required for lab techs since robotic processors are overwhelmed.

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I received a forwarded internal email from Baylor College of Medicine that looked at the Houston metro area’s wildly fluctuating COVID-19 testing numbers, which recently tripled. That turned out to have been caused by a state system upgrade on August 1 that increased doubled reporting capacity, which triggered a big surge as the backlog was being cleared. The email notes that public health has poorly integrated systems and still are sent manual results, including faxes, that someone has to enter.


Other

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University of Colorado Health CMIO CT Lin, MD shares numbers on video versus in-person visits since the beginning of the year. In-person visits (purple) dropped off sharply in early March and were outnumbered in a handful of weeks by the virtual visits (cyan), but in-person visits have mostly recovered after the state ended its stay-at-home policy and virtual visits have gone back down. Total visit counts seem about the same now as in January and February, but virtual visits went from essentially zero to about 15% of the total. Extrapolation is always dangerous — especially looking at the seemingly unstoppable telehealth upturn in March — but one might speculate that even though some patients have been forced to discover the convenience and lower infection exposure of virtual visits, they still prefer seeing clinicians in person and having related services provided at the same time. It may also be that either (a) they would rather have an in-person visit, but might have a virtual one forced upon them for one reason or another; or (b) clinicians either get paid more predictably or can offer more services when sitting in the room with the patient. Visits from outside UCHealth’s network also aren’t accounted for, so third-party virtual visits and urgent care might be impacting the numbers. Lastly, it may be that a higher than normal number of virtual visits were due to deferred higher-acuity or chronic disease management services. I would be interested in seeing a drill-down of both visit types by nature of the visit, demographics of the patient, new versus existing patient, categorization of visits by diagnosis and services rendered, and the recency of previous visits.

I missed this earlier as an interesting wearables story. Texas Tech fires its woman’s basketball coach one day after a USA Today investigative report calls out its “culture of abuse” that included forcing players to wear heart rate monitors during games and punishing those whose pulse dropped below 90% of capacity for more than two minutes.


Sponsor Updates

  • Medicomp Systems releases an updated version of its Quippe Nursing care planning and clinical documentation software.
  • Goliath Technologies publishes a new case study, “Terralogic, IT Service Provider, Avoids ‘Citrix is Slow’ Escalations.”
  • Phynd’s Schedule Advisor, which allows patients to see a provider’s open scheduling slots, is now available in Epic’s App Orchard.
  • The HCI Group launches a Referral Incentive Program Department.
  • PatientPing and Lyniate will develop a hospital connector solution for integrating ADT notifications using integration engines from Corepoint and then Rhapsody.  
  • Kyruus adds online scheduling for virtual visits to its ProviderMatch for Consumers software for health systems.
  • KDL Lab in Russia implements InterSystems TrakCare Lab Enterprise.
  • Pure Storage publishes a new case study, “McArthur Lab Adds Capacity and Performance with FlashBlade.”
  • Capsule announces GA of a cloud-deployed and -managed version of its Ventilated Patient Surveillance workstation, part of its Medical Device Information platform.
  • Nuance’s virtual assistant technology for Hey Epic! in Hyperspace is now available through its Dragon Medical One cloud-based clinical documentation solution.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

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EPtalk by Dr. Jayne 8/20/20

August 20, 2020 Dr. Jayne 3 Comments

There’s been so many notices from CMS in my inbox lately that I missed a biggie, and that was the recent release of the 2021 Medicare Physician Fee Schedule. CMS is planning to shuffle some of the telehealth codes, eliminating 70 or so codes from the 80-ish that were created to cover services during the pandemic. They are adding more than a dozen new codes, though, and some advocates are hopeful that the public comment period will lead them to add even more. They’re going to have an uphill battle since CMS isn’t convinced that the services are beneficial outside the context of a public health emergency. The organization will be looking for data to make a decision, and in reality, none of us know how long the declared emergency will last. Flu season will soon be upon us – I’ve already had patients trying to get vaccinated – and only time will tell.

The Physician Fee Schedule noticed was tucked in between about 10 emails about new resources and strategies and collaboration spaces for eCQM projects. In my previous life with a large health system, the clinical quality measures fell under my purview. I’m fairly certain that dealing with all the calculations and making sure our EHR was handling them properly killed more than a couple of my brain cells. I have tremendous respect for the IT and clinical teams that live in that world all the time, and just wish there could be an easier way to go about gathering the data needed to drive value-based care.

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The American Academy of Family Physicians launched their new redesigned website today. Although it’s much cleaner than the old one, virtually no information is available from the home screen without going through menus. The entire first page is sucked up by a big graphical tile and the concept repeats down the screen, offering little value. They also changed the login scheme from one using the member number to one using an email address, forcing every single user to change their password.

A blurb they sent out about the update mentions the addition of new “mega-menus” for users to find their content, and I’m definitely not impressed. The menus are so long you have to scroll through them, and they completely cover the rest of the screen even though a good chunk of the menu popup is blank. Seems like perhaps it’s supposed to be optimized to some other form factor than the PC I was using it on. The menus are so big though I can’t imagine them on a phone screen. It took me four clicks to access content I used to find with one, so I give the update a grade of C at best.

A better website was the one for the COVID-19 Prevention Network, which I visited to volunteer for a potential vaccine trial. Based on the questions, I’m not sure what their ideal candidate looks like, but if they are seeking people who are constantly exposed to unmasked sick people, I might know a couple.

My clinical employer sent out a notice from a local medical testing place that is also doing vaccine trials, but I’d much rather participate in one that is part of a university study versus the commercial lab that was offering cash to participants. Not to mention that I have no desire to be part of a safety trial, but would be happy to be a guinea pig for one that determines whether the vaccine is effective in the real world.

I’ve read several articles in the last couple of weeks about so-called toxic positivity and its negative impact on people as they try to cope through the pandemic. Although experts agree that having a positive mindset can help with coping, when overdone, it can make it seem like the only way to deal with a negative situation is to put a happy face on it.

I’m a huge fan of Fred Rogers. As an adult reading about his life, one of the things I came to appreciate about him is that he told children that it was OK to feel mad, or sad, or bad. One of his goals was to help his viewers learn to process those emotions in a productive way. One study from 2018 looked at “The psychological health benefits of accepting negative emotions and thoughts” and found that those who don’t manage difficult emotions don’t do as well as individuals who manage them effectively.

I used to have someone in my life who told was constantly telling me to smile, which I loathed. Trust me, there is nothing to smile about when you’ve been on call in the critical care unit for over 24 hours, have had to pronounce patients dead overnight, or have had to do any of a number of difficult things that healthcare professionals do all the time. Years later, I understand that the real reason I hated the comment was that it was an attempt (conscious or not) to minimize or invalidate my experiences or to try to mold them into something that the other person was more comfortable with. As we learn more about the trauma that healthcare providers experience and other concepts such as moral injury, it becomes even more important to give ourselves permission to be less than OK.

Getting through this pandemic and whatever other economic and societal crises go along with it will be a long, hard slog across the globe. I saw a figure the other day that some 20% of first line healthcare workers had contemplated suicide in the last 90 days, which should be setting off alarm bells. As someone who has been personally touched by physician suicide this year, I encourage everyone to try to find moments to check on your co-workers and to care for each other.

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This week provided another crazy day at the urgent care, where I was completely understaffed and “over-patiented.” We have some newer-ish staffers who are still a little freaked out about COVID, unlike the rest of us who are just used to it by now. Mask, double mask, face shield, let’s go. We were trading stories about whether we’re still doing the whole “strip in the garage and run to the shower” track and field event when we get home from work. 

The paramedic I was working with had me literally laughing out loud. His wife won’t let him in the house until he strips in the garage, sprays a cloud of Lysol, and walks through it to the shower. He refers to it as “the fog of war,” which was just the right degree of hilarious coming from a guy who served his country in both Iraq and Afghanistan and who could probably kill me three different ways with chewing gum and a popsicle stick. Somehow the camaraderie made up for the 68 patients I saw by myself, and I’m actually looking forward to my next shift.

What’s the funniest thing you’ve heard in the time of COVID? Leave a comment or email me.

Email Dr. Jayne.

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Reader Comments

  • AnInteropGuy: I would hope that we have better medicine and science than we did 67 years ago. Our understanding of virus mechanisms ar...
  • Angela C. Witt: Most of the suggestions you have to improve order management in the EHR are features available in current vendor product...
  • masterblaster: I was intrigued by your statement of "Because they so tightly control access to the vendor’s documentation, I have no ...
  • IANAL: In spite of AMA lobbying, regulatory changes in the early 2000s allowed pharmacists to give flu shots. Costs fell, acces...
  • Brian Too: My theory is that telehealth is a bigger benefit for the patient than it is for the clinician (though there are clinical...

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