Curbside Consult with Dr. Jayne 1/10/22

I started my HIMSS22 preparations in earnest today with the booking of my flights. I had looked at them a few weeks ago and then was sidetracked by a multitude of things, and based on the dramatic jump in price, I am glad I went back and got them today. I’ll be coming from an airport that isn’t a major hub, so there are some limitations, but I was surprised to see them jump over $300 in two weeks. Capitalism is alive and well, and who doesn’t love warm weather in March? As usual, I’m flying my favorite no-change-fee airline, so if HIMSS throws us a curve ball, I’ll be covered.

Mr. H pondered this weekend whether hospitals will allow their employees to attend. I would say that’s up in the air and all depends on what happens with new coronavirus variants. My local institution banned international travel at the end of December, but said people could travel domestically if they could be back at work within 24 hours. I questioned whether that was realistic based on the number of cancellations in the airline industry. Now they’ve ratcheted it up to the “don’t plan to go anywhere in the next two weeks” level. Many of my super-subspecialty friends are pretty much isolating except for going to work because there are limited numbers of them at each hospital and they can’t afford to both be sick at the same time. Hospitals are still restricting N95s, which I think is not only ridiculous, but counterproductive.

Our area hospitals are doing daily press conferences where they try to keep people calm and confident, but those on the inside wish they would do a little more to paint a picture of what’s really going on. At one hospital where a friend is an emergency department director, they’ve run out of portable oxygen tanks twice this weekend. When that happens, it’s a mad scramble to rearrange patients and get them connected to a wall unit. It also increases the time that patients have to be boarded in the emergency department because they can’t be transported to the inpatient floors if they’re on oxygen and there are no tanks.

One of them finally came out over the weekend and said they had halted all COVID testing for individuals without symptoms. That means no back-to-school or back-to-work testing and no tests prior to travel. I get it – they have to reserve the tests for patients where the result is going to make a difference in how they are managed – but it has pushed testing to the other facilities in town, which were already drowning. Most of the commercial testing vendors now have a three-day wait for testing, and turnaround times can be three or four days on top of that, which makes things challenging.

The same system had announced that it is freezing non-critical surgical procedures. The other players in town are functionally doing the same thing, but are soft-pedaling it to the public by saying that they are managing patients “on a case-by-case basis.” Everyone is nearly out of monoclonal antibodies and no one can get their hands on the new pill-based therapies, but no one is saying that publicly.

The state has dipped below 15% available intensive care beds, yet a number of people aren’t batting an eye. They’re going about their lives like they did pre-COVID, and any talk of flattening the curve to protect healthcare workers and preserve hospital capacity is met with scorn. I ran across someone today who insisted that there’s not a shortage of nurses due to sickness or being out to care for sick family or children whose schools have closed. They said it is because “all those nurses quit rather than taking that poisonous jab.” As someone who has seen the real stats (1.25% attrition rate for failure to vaccinate), I didn’t even engage in the conversation. It’s not worth it and there will be no changing of hearts or minds with that one.

Two more physician friends resigned this week, although they still have to remain in their respective hellscapes for another 90 days for contractual reasons. Hopefully, we’ll hit the peak soon and then come down the back side of it quickly so they can get some relief. Projections are that numbers will continue to be record-breaking for the next two weeks.

Both of them reached out to me for information about telehealth practice and other ways to use their degrees without caring for patients in person. They’re both great docs and I wish I could leverage their expertise on some of my teams, but unfortunately, they don’t have much non-patient-facing experience. I have plenty of other friends who want to leave their jobs but haven’t yet due to a sense of loyalty or altruism. Some have developed healthy coping strategies, but others not so much, so I’m keeping an eye on those that are in the latter cohort.

If you’ve got friends in the clinical trenches, please be aware that generally they are not OK. Although they may seem to be coping on the surface, I don’t know of anyone who isn’t struggling to some degree. Help how you can, whether it’s having a meal delivered or just leaving a bottle of wine on the porch. Physicians are finding creative ways to pitch in. A group of local subspecialists has been reaching out on physician social media groups offering to care for patients who might normally have been seen in primary care for dermatology, ear / nose / throat, and digestive issues. They’ve also offered parking lot space for drive-through testing, which would be great if people could get supplies. Some of our local primary care practices are running seven days a week due to demand, but others have had to close entirely due to lack of staff. Things are truly all over the place.

We’re only 10 days into the new year and I don’t think it’s going as anyone hoped. Regardless of where you work in the healthcare universe, keep an eye out for those who are struggling and offer a kind word or a sympathetic ear where you can. We’re all in this together and it’s going to continue to be bad for the next several weeks.

Email Dr. Jayne.

Readers Write: Five Ways to Increase the Value of Your EMR

Five Ways to Increase the Value of Your EMR
By Jason Friedman

Jason Friedman is VP of sales for EVideon of Grand Rapids, MI.

In a 2021 survey by Stoltenberg Consulting, 59% of hospital CIOs said getting the most out of their IT purchases, such as their EMR, is the biggest financial goal for next year. EMRs and EHRs have given rise to digital transformation in healthcare, and there’s no denying that adopting these tools has forever changed the way clinicians and healthcare staff do their jobs.

Yet, our industry is at a tipping point. The field of nursing is in crisis. Clinicians are burned out. There is a widening gap in health inequity. Trends in healthcare consumerism are putting increased pressure on a strained system. Never has it been so clear that it is time to think differently about the future of healthcare technology.

How can we do this? 

Deliver patient-centered care by personalizing the patient journey

The first step is to shift the focus of the EMR back to the patient by presenting information in an understandable and meaningful manner.

A digital whiteboard, when integrated with your EMR, is a centralized information hub for patients, families, and care teams, providing real-time health information that will improve care coordination as well as the overall care experience. Integration with the EMR and other installed technologies allows hospitals to personalize the patient journey with tailor messaging and targeted patient education.

In a recent research study, Brigham and Women’s Hospital (BWH) in Boston, one of the top-ranked hospitals in the US, partnered with a consortium of companies to research the impact of in-room digital whiteboards on communication and patient satisfaction in the emergency department. The study showed that 96% of participants preferred a room with a digital whiteboard as it improved communication and helped them feel more informed throughout their stay and prior to discharge.

In addition, 70% said the digital whiteboard helped them better understand what was happening during their stay. Beyond keeping patients informed, the whiteboards display patient information seamlessly, leaving little room for human error and allowing clinicians to focus on providing quality care.

Automate clinical workflows to enhance the clinician experience

We all know how overloaded and stressed nurses are, especially during this pandemic. A study published in the Journal of the American Medical Informatics Association found that higher EMR usability scores are associated with lower odds of burnout, and those usability scores have sharply declined. Specifically, researchers found that among 1,285 nurses who responded to a November 2017 survey about usability and burnout, the mean nurse-rated EMR usability score was 57.6. A 2019 study by the Mayo Clinic also supported that finding.

It’s time to make technology work for both patients and the care team. By integrating nutrition services, real-time location systems (RTLS), room controls, and other technology elements, you can automate many administrative tasks. For example, when a digital whiteboard is integrated with the EMR, nurses no longer need to manually update dry erase boards (or chase down a working marker). Advanced technology can turn the patient room into an extension of the care team, enabling clinicians to better focus on direct patient care.

Increase patient satisfaction

Patients naturally feel a sense of unease in a hospital. They’re away from home and feeling a loss of control, all while being worried about their health. Giving patients the ability to control elements in their room such as room temperature, shades, and lights, through an integration with building control systems, is a small thing that can have a big impact.

Giving control and self service back to patients can positively impact their overall rating and likelihood to recommend the hospital on their HCAHPS survey. For example, letting patients order their meals from their TV or other device – through an integration with nutrition services solutions such as Computrition, CBORD, or Morrison – puts patients in control, reminding them of the concierge service they get at home from apps like DoorDash and GrubHub.

A personalized, end-to-end experience and environment can enhance satisfaction. A television that greets patients by name as they enter the room provides easily accessible entertainment (movies and streaming TV), enables video visits with loved ones, and displays relaxation content that helps with stress and sleep can all contribute to a supportive patient environment.

In addition, announcing care team members on the TV as they enter the room, via RTLS integration, provides patients with a sense of security that the person in the room should actually be there.

Hospitals can also automate non-clinical service requests. From their room, patients can request clean linens, a visit from the chaplain, or other available hospital services.

Lastly, hospitals can keep a pulse on patient sentiment using pop-up surveys that unobtrusively collect patient feedback while they enjoy entertainment or education. Real-time insights can be automatically routed to key departments for service recovery, ensuring dissatisfiers don’t turn into HCAHPS issues.

Inform and protect patients, staff and visitors

Technology innovation can have a major impact on patient safety and workforce safety initiatives. One way to reduce harm and avoid preventable errors is using the EMR as the single source of truth to keep team members informed and aware of critical patient information.

Digital door signs that are integrated with the EMR can display critical safety information just outside the patient room. Real-time access to accurate health information can not only save staff time by eliminating the need to log into the EMR, but it also keeps them informed of any and all precautions or life-saving steps they may need to take.

Digitizing broad communications is another great way to keep patients, staff, and visitors safe. Throughout the COVID-19 pandemic, hospitals have leveraged digital signage to automatically disseminate crucial information like hand washing protocols, visitation policies, and other urgent COVID-19 related information.

Automating and digitizing manual processes reduces human error and empowers care care teams by giving them instant access to accurate, reliable, and real-time patient information when they need it most.

Manage your digital front door strategy

Rising trends in healthcare consumerism continue to push hospitals to integrate new technologies and enhance existing technologies to do more. Collecting real-time patient feedback and creating meaningful connections with your patients wherever they are, whenever they need you will help to build brand loyalty and drive utilization.

A tech-enabled experience before, during, and after the hospital stay can not only yield better health outcomes, but also influence hospital choice. Let patients complete forms prior to admission, and help them prepare for a visit and care post-discharge by sending patient care guidelines and education directly to a personal device. Delivering a care experience that is more convenient, meaningful, and effective for patients and their families will make your organization the preferred choice for today’s consumer.

EMRs can work in concert with other technologies to elevate the care experience for patients, families, and clinicians, making it seamless in ways that other industries like travel and banking have already done. Leveraging the EMR and integrating surrounding technologies also future-proofs the technology investments hospitals and health systems have already made.

It’s time to stop thinking about systems in isolation, and instead think about how systems can work together to produce a better net effect. What else is possible now and how can we leverage our current IT investments to do better?

Readers Write: If It’s Not Easy, It’s Wrong: Why Easy Is the Answer for Healthcare

If It’s Not Easy, It’s Wrong: Why Easy Is the Answer for Healthcare
By Arun Mohan, MD, MBA

Arun Mohan, MD, MBA  is president of Relatient of Franklin, TN.

Years ago, as a medical resident, I spent a lot of time in the cardiac stepdown unit. I was caring for patients who had suffered heart attacks or exacerbations of heart failure or had had various cardiac procedures. One of the patients was a 60-year-old woman I’ll call Mary who had hard-to-control heart failure. Due to a rare disease, Mary’s heart didn’t pump like it should.

After a recent hospitalization—her third in as many months—I was determined to break the cycle. I spent time reviewing everything about her case. We prescribed a diet that we thought would keep Mary healthy. We adjusted her medications, adding multiple doses of short-acting drugs to titrate for maximum effectiveness. She was eager to follow the new plan, and I thought this would be the last time I saw her in the hospital.

About a week later, Mary was readmitted, again with swollen legs, trouble breathing, and chest pain. In our desire to maximize benefit, we had created a treatment regimen so complicated that it was almost impossible to adhere to.

Optimizing personal behavior is the holy grail of healthcare. It represents the single greatest opportunity to improve health outcomes since unhealthy behaviors account for nearly 40% of all deaths in the United States. But as anyone who has tried to change behavior knows, it is hard.

In one popular model, behavior is a function of one’s motivation, ability, and a prompt. In many industries, including healthcare, we pay a lot of attention to motivation (just consider the billions that go into advertising), but don’t think enough about ability. Put another way, it’s incredibly difficult to change someone’s motivation, but it’s often possible to make something easier to do.

You don’t have to look far to see how simplicity can drive positive action. Whether it’s retail, entertainment, finance, or travel, consumers are willing to pay more for simpler experiences and are more likely to recommend a brand because it is simple. So how does this look in healthcare?

24/7 Access Boosts Consumer Response

Given changes in how we work and live, consumers are increasingly looking for 24/7 access. Just think about the last time you made a purchase decision. Was it between the hours of 9 and 5? To what extent did lack of availability make you look elsewhere?

Consumer behavior applies just as much to medical appointments. Historically, appointments have been made over the phone when the doctor’s office is open, typically 9 to 5. But when practices offer 24/7 access, consumers follow. In our own data, nearly one-third of patients go online outside normal business hours to schedule appointments.

Consumers Prefer Mobile-First Communication

Each day, the average American spends 5.4 hours on a mobile phone. Mobile-first communication is the easiest way to get a patient’s attention and will elicit the fastest response or action time. Further, patients strongly prefer their mobile devices for communication; 67% of consumers say they prefer to text with organizations about appointments and scheduling and 75% say they are frustrated when they can’t respond to a text message from a business.

You can make things easy for patients by tying an action directly into a mobile workflow. For example, we recently worked with a large dermatology group that was struggling to get patients scheduled for their annual skin checks. With numerous patients missing appointments due to COVID in 2020, many hadn’t been scheduled for their visits in 2021. Calling, emailing, and even writing letters to patients had limited effect, with response rates under 10%. But simply sending patients a text message and offering them a personalized link to click and start the scheduling process boosted conversion to more than 60%.

To Simplify the Consumer Experience, Minimize Decision-Making

We know that business can increase conversion by minimizing choices. If a person is presented with too many choices, they are actually less likely to buy. In a clever experiment, psychologists Sheena Iyengar and Mark Lepper studied the impact of the number of jams on a display table on conversion. On a regular day at a local food market, customers would find a display table with 24 kinds of jams. On another day, at the same food market, people were given only six jam choices. Guess which display table yielded more sales? While the big table generated greater interest, people were much more likely to actually buy a jar of jam at the smaller table – about 10 times more likely.

We have seen similar results in healthcare, where patients like to be given concrete choices. For example, rather than asking people to schedule a vaccination, simply giving people a choice of one or two days for appointments improves conversion. In a recent COVID vaccination campaign, some patients were asked to schedule an appointment by clicking on a link that came through a text, while others were asked to choose between three appointments, also via text. The results? Patients asked to choose one of three appointments were twice as likely to schedule.

Start Simplifying by Eliminating Duplication

These actions may sound easy, but in healthcare, we make them hard. The good news is that consumers are eager for change that simplifies. If, as healthcare leaders, we reexamine how we’re engaging patients and delivering care, we can create quick wins.

“Easy” is one of the most powerful forces at play in human behavior. Making things easy for people doesn’t have to be a monumental undertaking. Healthcare leaders can start small by identifying where patients and staff are duplicating efforts for no benefit and eliminating those redundancies. Delivering ease and simplicity will improve health outcomes and the bottom line.

HIStalk Interviews Lisa Esch, SVP, NTT Data

Lisa Esch is SVP/provider industry solutions leader of NTT Data of Tokyo, Japan.

Tell me about yourself and the company.

I’ve been with the company for a little over a year. I get to work with our clients and our customers as we tackle the challenges of healthcare and how IT supports that with services and technology. I’ve always been in healthcare. I started out as a clinician. I’m a dietitian by training and I worked for non-profit and for-profit health systems. I worked in the space around healthcare systems for many years, then in startups as well as large IT global systems integrators.

How will health systems use technology differently as they grow in size and geographic scope?

We’re seeing a lot of the innovation come out of the nimble, small companies, the ideas that can be executed and how we problem solve. There’s a balance between the large and the small, what the large can accomplish at scale versus what the small can do in driving innovation. There’s this blending of both that we need in the marketplace to drive the change that’s happening and to keep the patient at the center of what we’re trying to accomplish in this healthcare transformation, this digitization of healthcare.

Are health systems more consistently using their corporate approach and brand so that patients feel known at any of the health system’s venues?

Having the health system know them is a conversation that we are having with many of our customers. There’s this balance between “creepy know” that you get from commercial businesses that we interact with online versus knowing you so we can improve outcomes, engagement, and personalization.

You shouldn’t have to repeat things in your healthcare experience. You shouldn’t have to have nine portals. Even though you’re accessing in multiple places, it’s a single system, so personalization needs to come together. There’s a lot of fear around information and being proactive because of some of the rules and laws we have about how you communicate with patients, and the difference between marketing versus education and those types of things. But convergence is coming together with commercial industry and healthcare, and we have to figure a good way to make that happen.

What are health systems considering when developing their digital health strategy?

A lot of it involves how to humanize the digital experience. How we bring in information and data around people that isn’t traditionally healthcare that can help us drive engagement, make it more personal, make it a better experience, and make it a better outcome for the clinician as well as the patient. We are having conversations around that. We are building into our digital accelerator things that are AI driven, next best actions, personas, and different things that help with that digital experience and make it more personal.

Some organizations are more ready to have those conversations than others. Some react with, “Amazon knows more about you and Google knows more about you than you know yourself.” That’s not what we’re trying to get to, but how do we leverage the good that’s coming out of those things to bring together the clunkiness that we have in healthcare today? Imagine having a unified patient experience for someone so that an organization’s brand can stay connected to a patient as they traverse this healthcare delivery system where more is happening outside the four walls of the healthcare system than inside. There’s risk with brand and with connection. Patients have a lot of choice.

Is anyone looking far enough down the road to connect a variety of services and tools together to create an Amazon-like experience?

We are working on that strategy now. We’re putting together a marketplace where we can make it easy for organizations to have a problem to solve. We have partners that are pre-built or pre-vetted to make that process easier. We also have the capability of the technologies that can bring those things together, to make them all work together and better to get more out of them. We’re tackling this with our customers right now. 

A lot of decisions were made a couple years ago early on in the pandemic in buying technology. I need this and I need that. Now organizations are sometimes stuck with a bag of rocks. We are beefing up our healthcare consulting chops and advising organizations on, maybe we pull the plug on this. Let’s have a strategy here, and put more of a strategy around this transformation versus having the world put all this pressure on organization and people just buy things because they need something. 

Who is in the best position among healthcare players in getting the consumer’s attention as an information source or service choice?

The organizations that create this unified personal experience are further ahead. What that unified experience is is key. When I talk about a unified experience, I’m not talking about a single EMR across an enterprise. It’s much more than that. Patients become engaged in many more ways than just that their portal, which they don’t use except when they need to pay their bills. There’s this much more enriching experience, and patients can sometimes get that more easily from outside their healthcare system in other industries. Those other industries are obviously looking at healthcare.

The term “provider” is being redefined. There’s lots of ways healthcare is being provided lately. So it’s going to require partnering with people that you haven’t thought about and doing things in new ways. We’re tackling hospital at home, health at home, and it’s really complex. It seems like it shouldn’t be that hard, but we know that it is. That’s going to require a new way of thinking about delivering healthcare, new partners, and non-traditional things to move to that space. The ones that will win are going to be driven by experience and those that will invest in that unified personal human experience. Health and wellbeing is going to be delivered outside of just healthcare systems.

Is it hard to segment the wide variety of patients that a health system would serve, such as by preferred communication channel or the desired depth of the ongoing relationship?

That ties to a healthcare persona. It really is an engagement persona — how frequently they access and what kind of communication. It still is an omni-channel strategy. Some people still want to be communicated with or educated on paper. Some people want pure digital. The omni-channel experience is key, but the persona is a big part of it. We’ve tackled a lot of what we do with, “Here’s the technology. Just plug everybody into it.” Beyond that, we have a lot of research around engagement that can be driven digitally. We probably need to look outside of healthcare a little bit more to bring those capabilities in, to drive that and have it become part of our digital strategy as we transform the healthcare system.

Will we have enough providers in the right locations to support the business models involved in offering services in new ways?

Telehealth fit a need. A lot of clinicians move to it that because, wherever they were in their careers or whatever they were doing, it worked for them. Telehealth is here to stay and we are going to have that capability. Health systems need to balance out how they will deliver it because telehealth is still going to drive a different demographic, and when you look at the lifetime value of a patient, that experience will be important as people move and age through the healthcare system.

The partners you have how telehealth is delivered needs to ensure availability, but a lot of the telehealth that was stood up was disconnected from the health system and from the records. It was disconnected for the patient. They got what they needed in that moment, but it wasn’t part of a connected healthcare journey or their healthcare experience. That’s the part that’s a little messy still, and we’re working on determining the best next going-forward strategy and how we  balance that out.

Banks deployed ATMs so they could get rid of tellers, but also addressed an unmet need of customers who ended up rarely needing to interact with a bank employee anyway. How will the rollout of technologies such as chat bots benefit patients rather than just limiting their access to clinicians?

When AI and chat reduce access, there are probably unintended consequences that aren’t so positive. It’s finding the right place to leverage that and to have it improve and enhance the experience and not be a way to block the experience. There are times where certain personas will engage with that and others won’t. That’s part of the strategy with AI —  how do you find those who will engage with that and those who will not?

An example where it worked great was putting together a SOAP note prior to a visit by having the patient chat with AI before they saw the physician. They found that patients shared more with this bot than with a human being, so they got a more robust background prior to that visit. That’s really cool technology. Sometimes AI can be a better experience than the human one, while at other times, it’s not. We  have to sort all that out as we build this strategy. There will be a place for it, and there will be a place where it’s not helpful.

Where do you see digital health and the company advancing in the next few years?

The digital health innovation that we’re going to see over the next two to three years will be similar to what we’re seeing now. The ideas, the startups being disruptive, and then elements of those things moving into mainstream. I’m also seeing the big transformations that have to happen in healthcare, the digital ecosystem and how we deliver healthcare, as that is also being transformed. We’re going to see AI and robotic process automation. We’re going to see all these small things find the right place in the bigger picture that will drive the transformation. We are excited about is helping with the roadmap, the strategy around that, and helping to find those partners and put those things together that are unique to a healthcare system.

It will be exciting to see what that transformation will going to be. We will see this transformation of, who and what is a provider? How is healthcare provided in the community? With COVID, everyone in the workplace is in healthcare. An employer is responsible for understanding and keeping their patients safe and healthy, so this definition of health and wellbeing is also being redefined and identifying who is responsible for that in our communities. This conversation is going much more broader than just healthcare providers. We’re in the middle of all of that, trying to bring that together and help communities deliver.

Digital healthcare and the digital ecosystem are patient driven. There’s a consumer aspect to it, there’s a technical aspect to it, it is driven by innovation, and it is driven by tradition. These things are coming together in a new way than we’ve seen before. It requires all of those different points of view to move forward, and that’s what I’m so excited about.

Morning Headlines 1/10/22

Qlik files for IPO six years after being taken private for $3B

Thoma Bravo-owned analytics and data services company Qlik files for an IPO, with date, number of shares, and pricing yet to be determined.

Missouri’s CRMC brings network back online, 3 weeks after cyberattack

Capital Region Medical Center (MO) brings its systems back online after a December 17 cyberattack.

Maryland health workers, lawmakers want answers as problems persist a month after cyberattack

A December 4 cyberattack on the Maryland health department’s systems continues to impede staffers, including clinicians, from accessing several systems.

Monday Morning Update 1/10/22

Top News

Medical technology vendor Stryker will acquire clinical communication and workflow platform company Vocera Communications for $3 billion.

Stryker says the acquisition will help it “significantly accelerate our digital aspirations to improve the lives of caregivers and patients.”

Stryker got its start as a manufacturer of hospital beds like its competitor Hillrom, as both companies expanded into technology. Hillrom, which acquired Vocera competitor Voalte in early 2019 for $180 million, was acquired by Baxter International last month for $10.5 billion.

Shares of Vocera, which went public on the New York Stock Exchange in early 2012, had risen 55% in the year prior to the acquisition announcement. The company has 1,900 hospitals and healthcare facilities as customers. Its Smartbadge was named to Time’s list of the “100 Best Inventions of 2020.”

HIStalk Announcements and Requests

Only a small percentage of poll respondents believe they are less effective when working from home. I would expect that some jobs that involve heads-down individual work (programming, writing, etc.) or remote contact (customer service and support) can be performed as well or better at home. I wonder, though, whether companies are being damaged in ways that aren’t yet obvious with the lack of culture-building personal contact, reduction of serendipitous hallway interactions, and having managers in charge whose forte is visually monitoring piecework production.

New poll to your right or here: What is your personal experience with COVID-19? I’m not sure it’s a relevant question since I’m pretty sure we will all have tested positive soon, but I’m curious.

Meanwhile, HIMSS still hasn’t announced any changes to its Right of Entry Protocols for HIMSS22 that may be required by Florida laws. The conference is just over 60 days away. Exhibitor count is at 603, lower than HIMSS21 although the number will likely increase as the conference draws closer. HIMSS21 had 14 booths of 2,000 or more square feet while the HIMSS22 floor plan is showing 32, so that’s a positive sign of increased exhibitor interest. The big question now, assuming that the conference won’t be cancelled because HIMSS can’t afford a skipped year, is whether COVID-drowning hospitals will allow their employees to attend a conference.

The number of friends and family members who have tested positive for COVID-19 in the past few days is getting too hard for me to track, especially since it’s not the first go-round for some of them. Mrs. H went to a tiny-town Walgreens Thursday for hairspray or something and the clerk said they had already sold out of the 4,000 antigen tests they received that same morning, even with a purchase limit of four. PCR testing lines are impossibly long and results are taking 4-5 days to come back in many cases, rendering testing somewhere close to pointless. Home testing, no-testing, and other under-reporting probably means that we’re at 3 million or more cases per day, and many of those folks who will be sick and/or isolating (and/or spreading infection because they can’t afford to miss work) are critical workers and healthcare staff. Former FDA Commissioner Scott Gottlieb, MD estimates that up to 40% of Americans may end up becoming infected with Omicron, spreading the virus widely because their mild symptoms aren’t obviously COVID-19 and tests are too hard to get to verify. Let’s hope, probably unreasonably, that the supply chain for prescription drugs and medical supplies holds up since hospital beds and physician appointments are going to be scarce for a while.

Thanks to these companies that recently supported HIStalk. Click a logo for more information.

Webinars

January 13 (Thursday) 1 ET. “Cultivating gender equity in STEM.” Sponsor: Intelligent Medical Objects. Presenters: Laura Miller, CEO, TempDev; Amanda Heidemann, MD, CMIO, CMIO Services, LLC; Deidra Jackson, VP of IFP customer success, Bright Health; Sunita Tendulkar, VP of agile portfolio management, IMO. Despites strides that are being made, women make up only 27% of the STEM workforce. This panel discussion will cover mentorship, STEM education, pay gaps, and debunking stereotypes.

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

People

Divurgent hires Joe Grinstead, MBA (Healthcare Triangle) as principal.

Industry long-timer Amy Fuller-Heffernan (Verinovum) joins Interbit Data as VP of client strategy.

Chris Apgar, president and CEO of security and privacy consulting firm Apgar & Associates, died last month at 60.

Announcements and Implementations

TriNetX announces Bring Your Own Model for applying machine learning capabilities to real-world research data.

HIMSS launches a new certification to its stable, Certified Professional in Digital Health Transformation Strategy. The cost is $1,299 plus a renewal fee. I would question whether someone passing the exam will suddenly find themselves more employable or whether the market really needs HIMSS to sort out the lesser-competent players in it, but I always underestimate the yearning of insecure industry folks to add new letters to their walls, business cards, and LinkedIn profiles. For them, HIMSS also offers CAHIMS (associate in healthcare information and management systems) and CPHIMS (professional in healthcare information and management systems). All require healthcare IT experience, so candidates must have been boldly working without certification for employers who didn’t seem to mind.

A study finds that in-hospital mortality at the former Lutheran Medical Center (NY) declined from 2.6% to 1.9% after it was acquired by NYU Langone Health and the hospital saw improvements in central line infections, catheter-associated UTIs, and patient recommendations. Three of the five post-acquisition focus areas were related to IT – implementing Epic, using real-time analytics and dashboards, and implementing EHR-embedded clinical decision support.

Government and Politics

ONC releases final technical specifications for Project USA, which hopes to standardize the representation of patient addresses to support identity matching.

Other

A.O. Fox Hospital (NY) becomes the latest hospital to make local news for failing to pay its employees accurately because of the Kronos payroll system ransomware downtime. Most affected hospitals are paying hourly employees the same amounts as on their last system-issued paycheck in early December, meaning they aren’t being paid accurately for overtime, holiday pay, or COVID-19 coverage and instead are being promised that their money will be sent retroactively once Kronos comes back up (or, even less positively, that employees whose early December hours exceeded those afterward will need to return the overpayment).

HHS reports that 18% of available US hospital beds were being occupied by COVID-19 patients this weekend as the COVID curve resists flattening (thank goodness for our US profit-driven overbedding). Brown School of Public Health Dean Ashish Jha, MD, MPH warns that the US healthcare system is in even more trouble than is obvious, as 1 million Americans could need hospitalization for COVID-19 over the next 4-6 weeks, far exceeding aggregate hospital capacity (note also that average length of stay times a million admissions is an unfathomable number of patient days, not to mention that hospital beds don’t sit on a grid so that total supply can meet local needs). The New York Times says that hospitals are being bombarded with punishing patient loads as they operate short-staffed because of employees who have quit or who have COVID-19 themselves.

Sponsor Updates

• Availity partners with PriorAuthNow to deliver timely prior authorization services.
• The Consulting Report includes Nordic CEO Jim Costanzo on its list of “Top 50 Consulting Firm CEOs of 2021.”
• Olive appoints Credit Karma executive Nichole Mustard to its board.

Blog Posts

• Bringing Quality and Financial Viability to Long-Term Care (Netsmart)
• Marketing Your Hospital Services: How to Attract Loyal Patients (PatientBond)
• How can we make billers’ and coders’ hard jobs easier? (PatientKeeper)
• Support Nurses’ Ability to Easily Communicate with Providers and Patients (PerfectServe)
• Most Important Metrics for a Healthcare Quality Management Dashboard (Symplr)
• All Fun and Games: Gamification and Its Application to Health Care (PMD)
• Healthcare Innovation for New Year: Andy Brailo with Premier members (Premier)
• Year in Review: Top 2021 Trends in Digital Health and What They Mean for 2022 (Quil)
• How Leading NextGen Users Leverage our Revenue Cycle Engine (RCxRules)
• Infographic: The ongoing power of paging (Spok)
• Always Striving to Be Better Than We Were (Surescripts)
• For healthcare organizations, the patient experience is paramount (Talkdesk)
• Improving Patient Use of At-Home Testing and Medical Device Management (Twistle)
• RSNA 2021 / Visage’s Top Five (Visage Imaging)
• MIPS and the 2022 Final Rule: Key Takeaways (WebPT)
• Evidence-based Clinical Decision Support to Improve Care in Skilled Nursing Facilities (Zynx Health)

Contacts

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

Weekender 1/7/22

Weekly News Recap

• Stryker announces that it will acquire Vocera for $3 billion.
• Vera Whole Health signs a deal to acquire Castlight Health for $370 million.
• Nomi Health acquires Artemis Health for $200 million.
• Babylon Health acquires Higi.
• Report: IBM is again trying to sell Watson Health for $1 billion.
• Symplr will acquire Midas Health Analytics Solutions from Conduent for $340 million.
• Theranos founder Elizabeth Holmes is found guilty of four counts of investor fraud.
• Health systems report labor problems caused by underpaying employees due to the weeks-long, ransomware-related downtime of payroll system vendor Kronos.

Best Reader Comments

Thanks for noting the important role that pathologists have had in developing health information systems. I’m not a pathologist but, during my training, I had the privilege of working with Dr. George Gantner, the St. Louis City and County Medical Examiner, who was a giant of forensic pathology. It was only many years later when I got into medical informatics that I learned he was also involved with the evolution of the Systematized Nomenclature of Pathology (SNP) into SNOMED! (Path Fan)

I wonder how many end users these unmanaged [Higi] kiosks have. They seem to function as a fancy gadget for the sales team to trot out as an add on to another service. (IANAL)

What I see is that people who work from home feel they are more efficient at the expense of others who now have to fill in the gaps for them. 5 minute conversation across cubes to get something done, now requires emails being sent for a potential reply next day responding to questions with more questions. Some people are very good at that (responding to questions with questions) and very efficient. (Robo Writer)

There was a statistic from several years ago about the “cost” of interruptions for programmers, and the surveyor calculated that it costs 28 minutes of productivity for each interruption, due to mental context-switching. If we’re going to go down that spoke, I’d be curious to see how people’s answers correlate with the type of work they do. I would bet that people whose jobs are task-oriented find WFH (theirs or their colleagues) difficult while people who work in programming, research, or other types of work that require silence and long stretches of uninterrupted thought are having a much better time in an isolated environment. (HIT Girl)

Holmes: There’s a lot of talk about the “fake it until you can make it” mind set of Silicon Valley startups. Boo-hoo when VC firms and high net-worth individuals fall for a con. Her downfall was outright lying about the accuracy of critical medical tests. Time for jail when you knowingly and repeatedly put patients lives at risk. (AnotherDave)

I truly believe Epic is the best solution in the market. My only concern is that Epic is most innovative when responding to Cerner development. I’m worried a one horse race will slow down the pace of improvement. Meditech just isn’t a strong enough threat to spur Epic on to greatness. We need more competition to prevent stagnation. (Competition Please)

Watercooler Talk Tidbits

Readers funded the Donors Choose teacher grant request of STEM science teacher Ms. K in S. Ozone Park, NY, who asked for programmable robots for her elementary school class. She reports, “Having a Blue-Bot Robot in my STEM classroom makes a huge difference! Students have been learning how to code. Blue-Bot lights up and makes sounds. You can see inside of it, which the students all really love. Thank you so much for giving me the chance to expose my students to cool robots like this one and for them to have such a great time!”

Hospital employees refer to a newborn as “the Tesla baby” whose parents rushed to the hospital with their Tesla placed in autopilot mode so the father could assist his laboring wife during the 20-minute rush hour drive.

Lake Superior State University publishes its annual list of annoying and overused words and phrases whose use should be banned:

1. Wait, what?
2. No worries.
3. At the end of the day.
4. That being said.
5. Asking for a friend.
6. Circle back.
7. Deep dive.
8. New normal.
9. You’re on mute.
10. Supply chain.

My nominations for next year:

1. I did a thing.
2. Hold my beer.
3. I don’t usually post personal stuff on LinkedIn, but …
4. I am humbled to announce …
5. Hack.
6. Imma.
7. Leverage.
8. Utilize.
9. Unpack.
10. That’s it. That’s the tweet.

A state hazmat team is called in to decontaminate the ED of Falmouth Hospital (MA) when discharged patient immediately overdosed outside the hospital, was brought back to the ED for treatment, and made seven police officers and staff members with whom he was fighting dizzy from fentanyl dust.

A federal grand jury indicts the physician-owner of several rural North Carolina ENT clinics for fraudulently billing Medicare for $46 million worth of balloon sinuplasty surgeries, making her the top-paid provider of those services in the US even though her practices were not in a major metropolitan area. Anita Jackson, MD — whose LinkedIn lists degrees from Princeton, Stanford, and Harvard; played a key role in Durham County’s COVID-19 response; and was appointed to the state’s Medical Care Commission – promised patients they would owe no co-pay and also re-used the single-use devices without their knowledge, according to the charges.

The Seattle and Vancouver hockey teams donate $10,000 to 22-year-old crisis hotline intervention specialist Nadia Popovici, who urged a Vancouver equipment manager to see a doctor about a mole she saw on his neck that appeared cancerous. His doctor removed a melanoma that could have killed him within 4-5 years. The Vancouver Canucks tracked Popovici down via social media and brought her to a game to give her a $10,000 scholarship to medical school, which she will attend in the fall once she decides which of the two that have accepted her to attend.

In Case You Missed It

• News 1/7/22
• EPtalk by Dr. Jayne 1/6/22
• News 1/5/22
• Curbside Consult with Dr. Jayne 1/3/22

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Contact Mr. H

Morning Headlines 1/7/22

Stryker announces definitive agreement to acquire Vocera Communications

Stryker, a global medical technology company, will acquire digital care coordination and communications vendor Vocera in a deal worth $3 billion.

Aetion acquires synthetic data trailblazer Replica Analytics

Life sciences real-world evidence vendor Aetion acquires Replica Analytics, which generates privacy-protected copies of real world data.

B3 Group Acquired by Octo

Federal IT contractor Octo acquires B3 Group, which offers low code/no-code software development and holds a $686 million contract to develop the VA’s Digital Transformation Center.

News 1/7/22

Top News

Vera Whole Health, which offers healthcare navigation, care coordination and coaching to its members, will acquire navigation technology vendor Castlight Health for $370 million in cash, representing a 25% premium to Castlight’s share price.

Castlight customer Anthem will make an investment in the combined company.

Vera Whole Health’s president and CEO is Ryan Schmid, MBA, who founded the company in 2007 while operating a non-profit fitness center.

CSLT went public in March 2014 with a first-day trading pop of 149% as shares closed at $38.85. They were at $1.63 prior to the acquisition announcement.

Reader Comments

From Optum Employee 1160: “Re: Optum-owned remote patient monitoring vendor VivifyHealth. CEO, chairman, and founder Eric Rock is out, replaced by Optum Technology CMIO Alejandro Reti, MD, MBA. The CTO and COO have also left.” Unverified. I’ve reached out to the company.

HIStalk Announcements and Requests

I mention below the deaths of two health IT pioneers who were also pathologists, reminding me of the outsized contributions of experts in laboratory medicine, pharmacy, and radiology in the history of clinical IT. Those folks who worked in the relative solitude of hospital basements far from patients, especially pathologists, were involved in more patient-benefitting technology projects than anyone, often running rogue operations involving under-desk servers to avoid being shut down by old-school, command-and-control MIS/DP departments who focused on the care and feeding of billing mainframes. It is interesting that companies like Cerner and Meditech got their start with laboratory information systems, while Epic didn’t roll out Beaker until late in the game (presumably to avoid the heavily-regulated environment of labs, Elizabeth Holmes notwithstanding).

I took advantage of holiday slack time to upgrade my laptop to Windows 11, with no problems or noteworthy improvements to report.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Employer healthcare payment vendor Nomi Health acquires employer benefits analytics platform vendor Artemis Health for $200 million. Both companies are headquartered in the Salt Lake City area.

Digital health technology vendor Babylon acquires health kiosk vendor Higi. Higi has raised $91 million, most recently in a May 2020 Series B round that was led by Babylon. London-based Babylon went public on the Nasdaq via a SPAC merger in November 2021. Share have since dropped 42%, valuing the company at $2.6 billion.

Life sciences real-world evidence vendor Aetion acquires Replica Analytics, which generates privacy-protected copies of real world data. Price was not disclosed, but Replica has raised just $1 million and reports just a handful of employees. CEO Khaled El Emam, PhD is a scientist Children’s Hospital of Eastern Ontario Research Institute and director of its laboratory that studies the identifiability of health information and how to measure it.

Axios reports that IBM is once again trying to find a buyer for IBM Watson Health at a rumored price of more than $1 billion.

Federal IT contractor Octo acquires B3 Group, which offers low code/no-code software development and holds a $686 million contract to develop the VA’s Digital Transformation Center.

Sales

• Seattle Children’s will implement AdaptX’s EHR-powered Mission Control Center for care management.

People

Healthcare information distribution and business continuity vendor Interbit Data hires industry long-timer Steve McDonald, MBA (Impact Advisors) as president.

Oncology systems vendor Flatiron Health hires Stephanie Reisinger (Allscripts Veradigm) as SVP/GM of real-world evidence.

Ronald Weinstein, MD, a hospital pathologist who developed the concept of telepathology in the 1980s and led the Arizona Telemedicine Program at the University of Arizona in Tucson for 25 years, dies at 83.

Industry pioneer Sidney Goldblatt, MD died Monday at 87 in Johnstown, PA. The hospital pathologist and entrepreneur founded Sunquest Information Systems in Tucson, AZ in 1979, took it public, and sold the company to Misys in 2001. He then founded precision medicine company Goldblatt Systems, genomics testing firm MolecularDx, and forensic science center ForensicDx.

Announcements and Implementations

PointClickCare and Sound Physicians will offer a long-term and post-acute care virtual health solution.

Alternate site infusion vendor Option Care Health will provide connectivity via the CommonWell Health Alliance in partnership with WellSky.

A surgeon’s letter to the editor of the BMJ notes that while Theranos news stories are focusing on Elizabeth Holmes being found guilty of investor fraud, some of the company ‘s hundreds of employees must have known that its technology was issuing erroneous patient lab results, and those complicit folks have likely found related jobs elsewhere.

A report reviews the telehealth regulations of individual states, evaluating best practices such as:

• Not requiring an initial in-person visit.
• Recognizing all remote care and monitoring modalities.
• Allowing providers to serve patients in other states.
• Allowing licensed, non-physician providers to provide services via telehealth.
• Allowing nurse practitioners to practice without physician supervision.
• Not imposing mandates that all services be covered since outcomes vary by service type.
• Not requiring telehealth services to be paid at the same rate as in-person visits.
• Supporting licensure compacts that allow providers to provide services in multiple states without high cost and laborious application requirements.
• Not allowing health systems to charge facility fees for telehealth.

Massachusetts Health Quality Partners President and CEO Barbra Rabson, MPH observes that surveys show that patients are a lot happier with their telehealth visits than their providers. Patients save the sometimes full-day effort that is required to show up for a 10-minute provider visit, but providers are less enthused because it’s a different experience from their training, they were thrown into telehealth with no transition in the pandemic’s early days, and telehealth quality varies based on organizational practices. An MHQP group recommends creating mode-appropriate triaging guidelines, measuring and comparing physician satisfaction across modalities, asking providers about their technical support needs, promoting community and workplace sites for patients to have telehealth visits, and studying barriers to patient use.

Former White House health advisors say in a JAMA Viewpoint article that the “zero COVID” vaccine-centric strategy is not valid and a new US strategy is needed to move from crisis to control in exiting “a perpetual state of emergency” to recognition that the virus is likely to remain endemic. They recommend recognizing that COVID-19 is one of several respiratory viruses whose risk should be aggregated (instead of ignoring older ones like flu and RSV) with a focus on hospitalizations and deaths. They also call out the need to develop a real-time, digital public health infrastructure that links respiratory viral infections to hospitalization, deaths, outcomes, and immunizations from local, state, and national public health units, health systems, laboratories, and universities. In this and two other JAMA articles, the six former White House health advisors also call on universal access to low-cost testing, N95 masks, and oral COVID treatments; next-generation vaccines that address variants or are delivered nasally or via skin patch; and continued research to develop of a universal coronavirus vaccine. They also express support for an electronic vaccine certification platform. One of the physicians says that the White House has not invested enough in tests, treatments, and public health protections, concluding that, “No one wants to face up to the reality. You can pay for it with prevention, as we’ve outlined, or you can pay for it on the back end, which is the American way.”

Government and Politics

The White House Office of Science and Technology Policy issues an RFI that seeks information about how digital health technologies are being used, or could be used, to transform community health, individual wellness, and health equity. The request is part of OSTP’s Community Connected Health initiative.

Privacy and Security

Ciox Health notifies 32 health systems that an unauthorized person accessed the email account of one of its employees last summer and may have downloaded emails and attachments that contained limited patient information. The company says the attack appears to have been intended to collect email addresses to launch phishing attacks unrelated to Ciox.

Patient portal vendor QRS is accused in a class action lawsuit of failing to adequately secure its systems in an August cyberattack that involved 320,000 patients. One lawsuit participant says he believes that his information was sold on the dark web since his bank account and credit card were hit with unauthorized charges and he was targeted by robocall scams.

Other

Cerner co-founder Cliff Illig is interviewed by former Cerner President Donald Trigg in a new episode of the latter’s podcast that covers health IT entrepreneurship (it was recorded before the Oracle acquisition announcement, so perhaps a follow-up is indicated). All three Cerner founders grew up in families of kitchen-table businesspeople and saw in the early 1970s how computers were starting to be used by businesses, then started selling custom built problem-solving software in a half-dozen industries, with healthcare being on the list of industries they knew nothing about until a medical lab engaged them. Illig says Cerner sought venture capital because they needed credibility, not money, then were reasonably pushed by the VCs into going public as a liquidity event. He says that entrepreneurs shouldn’t be scared of complexity, which is common in healthcare, because you can figure it out by breaking it down into pieces. He says Neal Patterson was the most biased toward action of any of Cerner’s leaders and had an intolerance for things taking too long, spending too much time on analysis, and studying market surveys to decide what to do. The Cerner founders said that rather than studying every possible course of action, they just picked one by “shooting real bullets” and learned from the results.

The labor union of Ontario-based London Health Sciences Centre will file a grievance against Sodexo on Friday if the contractor can’t resolve payroll problems that have been caused by the Kronos ransomware attack. The union says more than 50 of its employees haven’t received their full paycheck for a month. In a related item, the Montana Nurses Association accuses Missoula’s for-profit Community Medical Center of illegally underpaying its nurses an average of $1,000 for work hours that they recorded manually during the Kronos downtime. Kronos has not been able to provide a resolution date for the the December 11 ransomware attack on its private cloud solutions.

Another quirk in the quirky US healthcare non-system: a man whose injury from being hit by another driver requires major surgery learns the hard way that an auto policy’s personal injury protection is the primary medical payer in auto accidents. The hospital and surgeon billed $700,000 (Medicare would have paid $29,500) and his auto insurance’s PIP coverage was limited to $250,000. Not only that, auto insurers often have no network or negotiated discounts, so patients end up being out-of-network and are subject to paying full list price. He owes $89,000 despite having bought the maximum PIP coverage and carrying health insurance.

A defibrillator delivered by drone helps save the life of a 71-year-old man in Sweden who went into cardiac arrest while shoveling snow in his driveway. A physician who was driving to the hospital saw the collapsed man, started CPR, and called Sweden’s equivalent of 911, which dispatched an Everdrone-delivered defibrillator that the doctor used to resuscitate him. The drones can also be used to deliver naloxone, EpiPens, and other medical devices.

Sponsor Updates

• Cerner associates donate 646 toys to local charities during its virtual toy drive.
• A recent Meditech podcast features First Databank Director of Product Management Anna Dover, “How Genomics will Revolutionize Healthcare in the Next Decade.”
• Konza has earned the Validated Data Stream designation in the NCQA’s new Data Aggregator Validation program.
• Meditech publishes a new case study, “KDMC gives back 100+ hours to nurses with Meditech Expanse Patient Care.”
• PM360 recognizes OptimizeRx’s evidence-based physician engagement solution as one of the most innovate life sciences products of 2021.

The following HIStalk sponsors have achieved top rankings in Black Book Market Research’s latest cybersecurity survey:

• Security advisors & consultants: Clearwater
• Compliance & risk management solution: Clearwater
• Outsourcing & security network managed services: Fortified Health Security
• Secure communications platforms: physician practices: PerfectServe
• Secure communications platforms: hospitals & health systems: Spok

Blog Posts

• A Historic Year for Enterprise Resilience (Everbridge)
• Healthcare Trends in 2021: Moving from Headlines into Practice (Get Well)
• Stories of a Post-Modern Healthcare CIO (feat. Ed Marx) (HCI Group)
• Reflecting on the Past, Anticipating the Future (HCTec)
• Here’s How Personalization Increases Patient Engagement (Healthwise)
• 4 Health IT Employment Trends for 2022 (Health IT Leaders)
• How athenahealth Users Leverage the Revenue Cycle Engine for Increased Efficiency (RCx Rules)
• Electronic Health Information (EHI) Made Simple (Impact Advisors)
• Save the dates: 2022’s standardized code system updates (Intelligent Medical Objects)
• Thought Leaders: Simplicity, Flexibility to Shape the Future of Patient Access (Kyruus)
• 9 Healthcare Predictions for 2022 (LexisNexis)
• Optimum Healthcare IT Top 5 Posts of 2021 (Optimum Healthcare IT)
• How to Use the CMS H&P Exception to Improve Surgical Pre-Assessment Caseload by +60% (Lumeon)
• 3 Dangerous Medication Errors Missed by Legacy CDS Tools (MedAware)
• Memos from the Medhost CISO: Stop Zero-Day Attacks with a Team Effort (Medhost)
• 7 healthcare IT leaders to follow in 2022 (Meditech)
• 6 New Technology Trends in Physical Therapy in 2022 (MWTherapy)
• Open System Imaging empowers next-generation radiology reporting with PowerScribe One (Nuance)

Contacts

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

EPtalk by Dr. Jayne 1/6/22

I spent a couple of hours tonight on the phone with a colleague who is burned out and thinking about leaving medicine. She was asking my advice, not only as someone who has worked in a variety of different care-delivery paradigms, but also as someone who might be able to help mitigate some of the hassles she’s currently encountering.

She’s part of a large Direct Primary Care practice, which manages patients more like customers as opposed to patients. Unfortunately for the physician, that comes with the expectation of 24×7 access. Apparently the organization is using something from Salesforce as a substitute for a patient portal, and when messages come in, they are in a silo, requiring the physician to also log into the EHR, load the patient, then double-document in both places. Adding to her frustration is a recent change to the Salesforce side where she can only manage messages from a laptop, which makes it hard to be 24×7 accessible if you ever want to step away from your desk or have a life.

We had a good chat about alternatives to in-person care including telehealth, which I think she’s considering. We discussed some of the pitfalls of the different telehealth companies and the challenges of being an independent contractor versus being employed, as well as the dramatically different processes that the national telehealth providers use to onboard new physicians. As someone who has historically been efficient with the EHR, I think she’ll struggle with their homegrown EHR-lite solutions, but she needs a change if she’s going to maintain her humanity.

We talked a lot about the concept of moral injury and how hard it is to deliver good care when you’re constantly operating under crisis standards of care, you don’t have adequate staff, and you’re being pushed to see more patients per hour than your comfort level allows. I’m glad she reached out and is contemplating a change. Too often, physicians wait until they’re past the point of no return or until a significant negative event forces their hands. Hopefully, telehealth will give her some breathing room while she steps away from in-person care and allows herself to recharge.

Despite my disappointment at being denied a media credential for the Consumer Electronics Show, different examples of cool technology are falling into my lap through other outlets. The first thing I ran across today was the clear-sided toaster, which not only allows you to monitor the progress of your toast, but has one-touch defrost, reheat, and bagel functions as well as seven browning levels. I haven’t shopped for any kitchen electronics in forever, but if my $9 college toaster ever gives up the ghost, one with clear sides might just be on the short list.

Withings reached out regarding its new BodyScan device, which is undergoing clinical and regulatory validation. Described as “the first at-home connected health station,” it promises to deliver weight, segmental body composition, and six-lead electrocardiogram data as well as a calculation of vascular age and an assessment of nerve activity. I’ve been happy with my Withings blood pressure cuff and have a couple of friends with Withings scales. The BodyScan certainly looks interesting, and at a $300 price point, will be attractive to people who have become accustomed to spending $800-$1600 on a smartphone.

I also ran across this smart watch sensor that helps with opioid relapse. The team at University of Massachusetts Amherst, along with colleagues at Syracuse University and SUNY Upstate Medical University, received a $1.1 million grant from the National Science Foundation’s Smart and Connected Health program to continue work on the project. The sensor feeds data to a machine learning platform to help identify if physical signs such as respiratory rate, electrocardiogram findings, etc. are at levels that indicate opioid cravings. Once a craving is identified, the device alerts the wearer to consider mindfulness techniques to try to address the situation. Ultimately, they hope to customize those interventions based on individual patient characteristics. Researchers believe they can identify with 80% accuracy when a user has taken an opioid. They hope it may evolve to help ensure proper use of prescribed opioids to prevent opioid use disorder. This is an area where we need as much assistance from technology as we can get, so I’m excited to see how it progresses.

Kohler knows I’m a sucker for the dream of a high-tech, aromatherapy-rich bath, and sent me information about its new PerfectFill technology that uses voice commands to control the temperature, filling, and draining of a bath. No more sticking your finger under the faucet while you fiddle with the knobs or worrying about scalding a little one. A former urgent care colleague who left the urgent care trenches to go to school to become a plumber let me know that the bath I swooned over last year requires special installation considerations and that he used it as an example for a class project. I know who I’m calling when I win the lottery.

I also did a bit of technology mourning this week, as I learned that all former BlackBerry phone services stopped working this week due to lack of support. BlackBerry was a tech darling in the days prior to the iPhone and at one point seemed like the number one business accessory. The last BlackBerry OS was released in 2013, but people have been limping the devices along as phones or messaging devices. I have to admit I still have a BlackBerry Torch, with its keyboard hidden beneath a sliding touch screen. It’s possibly one of my favorite phones, and fun to show off when I participate in STEM-based education programs where we talk about the history of personal electronics and communication. Most of the youth I work with can’t imagine life without a smartphone, let alone life without the internet, so it’s fun to talk with them about the pre-internet days when we used dial-up connections to bounce messages around the country.

What’s your favorite piece of extinct technology, be it healthcare or something else? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 1/6/22

Castlight Health and Vera Whole Health to Combine to Pioneer and Scale Value-Based Care in Commercial Market

Primary care company Vera Whole Health will acquire health data and benefits navigation technology company Castlight Health in a deal valued at $370 million.

Babylon Acquires Higi to Extend its Digital-First Healthcare Platform to Millions of People in the U.S.

Global digital health company Babylon acquires health kiosk vendor Higi.

Kiddo Announces $16M in Growth Investment to Address the Growing Need for Remote Patient Monitoring and Care Coordination for At-Risk Children

Pediatrics-focused remote patient monitoring vendor Kiddo raises $16 million in a Series A funding round led by Vive Collective.

Scoop: IBM tries to sell Watson Health again

After potential sale efforts floundered in early 2021, IBM is once again fielding offers for its Watson Health business.

Morning Headlines 1/5/22

Symplr to Acquire Midas Health Analytics Solutions from Conduent

Symplr will acquire Midas Health Analytics Solutions from Conduent for $340 million in cash.

Waymark closes $45M Series A to improve healthcare access and outcomes among Medicaid beneficiaries

Waymark, which supports Medicaid primary care providers with technology-enabled community care teams, raises $45 million in a Series A funding round.

Growth Continues for Carenet Health with Acquisition of Access-to-Care Innovator, OpenMed

Consumer engagement and telehealth solutions vendor Carenet Health acquires healthcare collaboration platform vendor OpenMed.

News 1/5/22

Top News

After seven days of deliberation, a jury finds Theranos founder Elizabeth Holmes guilty of four out of 11 counts in her criminal fraud trial.

She had raised nearly $1 billion during the life of her blood testing startup, earning the company a valuation of $9 billion before it closed in 2018 after civil and criminal inquiries.

Jurors decided that those investments were raised using false claims about the technology’s effectiveness, including doctored reports, exaggerated capabilities, and concealment of the use of third-party devices and faked demonstrations. She was found not guilty on charges of defrauding patients.

Holmes, who will be sentenced at a later date, faces up to 20 years in prison.

Reader Comments

From Orlando: “Re: HIMSS. HIMSS and its Accelerate solution group — created by Hal Wolf and McKinsey — started layoffs this week.” Unverified, because the HIMSS press contact quit and I don’t see her replacement listed on the HIMSS site. I signed on to Accelerate and my reaction was the same as months ago — all I see is HIMSS hawking its vendor-paid webinars, a bunch of lame promotional stories with the obligatory stock photos from Healthcare IT News, and Accelerate people trying unsuccessfully to get users to interact. The default group lists 6,700 members, but searching for users named “Smith” and “Jones” turned up just 10 names each. None of the people Accelerate recommended that I follow have completed their profiles or posted anything to the site. LinkedIn shows 27 employees and 348 followers, with the HIMSS VP in charge appearing to be Barry Edelman (who lists “himms.org” on his lightly used Twitter profile). I will say from experience that readership and interaction happens quickly or not at all. Accelerate aspires to be the “digital platform that drives 365 healthcare transformation,” but like a lot of health IT websites, its “curated content” from its first five months of existence doesn’t strike me as being even slightly useful. I invite Accelerate users to correct me in explaining the value that rewards their participation.

HIStalk Announcements and Requests

Poll respondents say they will beef up their COVID-19 precautions by avoiding unnecessary gatherings, upgrading cloth masks, and getting a booster shot. Most will follow the nearly universal trend of ignoring the one technical solution of contact tracing apps, whose minimal acceptance and low value demonstrate what happens when big tech companies barge into healthcare convinced that cool apps are disruptive.

New poll to your right or here: How does your work-from-home job effectiveness compare to working in the office?

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Jacob Reider, MD announces in a blog post that Circulo acquired his company, social determinants of health-focused Huddle Health, last October. Olive CEO Sean Lane launched Medicaid-focused managed care company Circulo nearly a year ago alongside a $50 million funding round. Reider, a former deputy national coordinator for health IT, has taken on the role of general manager of health solutions at Circulo Health.

Symplr will acquire Midas Health Analytics Solutions from Conduent for $340 million in cash. The deal marks the twelfth acquisition for Symplr, a healthcare governance, risk, and compliance technology vendor.

Waymark, which supports Medicaid primary care providers with technology-enabled community care teams, raises $45 million in a Series A funding round. The co-founders are MD-PhDs who care for Medicaid patients.

Healthcare market intelligence vendor Trella Health acquires PlayMaker Health, which offers a post-acute CRM and EMR referral management system.

Consumer engagement and telehealth solutions vendor Carenet Health acquires healthcare collaboration platform vendor OpenMed.

Share price of the Global X Telemedicine and Digital Health Fund was flat in December, up 7% since their first day of trading in July 2020.

Sales

• Priority Health, the country’s third-largest provider-sponsored health plan, will use Epic’s Payer Platform.

People

Harris promotes Mihir Shah, MBA to EVP of its Clinical Computer Systems business, developer of the OBIX Perinatal Data System.

Bamboo Health promotes Rob Cohen, MCIT, MBA to CEO.

Marcus Gordon, MBA (Lumeris) joins Sharecare as SVP of growth marketing.

Jvion hires Curt Thornton (Medicom Health) as chief growth officer; Jim Stansell (TeleHealth Solution) as CTO; and Leah Ray (Zelis) as chief customer officer.

Kimberly Lynch, MPH (Aledade) joins Stellar Health as COO.

Marcus Osborne, MBA, SVP of Walmart Health & Wellness, announces on LinkedIn that he has left the company. Walmart removed Osborne from running its clinics reassigned in September 21, the same day it removed the SVP/COO over Health & Wellness.

Kieran Murphy, MSc, president and CEO of GE Healthcare, leaves the company as previously announced after 4 1/2 years in that role. He will be replaced by Peter Arduini, formerly president and CEO of Integra LifeSciences.

Announcements and Implementations

The Bermuda Hospitals Board will go live on Cerner Millennium across its two hospitals and urgent care center later this year.

Mary Washington Hospital (VA) will launch an e-ICU using remote patient monitoring technology from Hicuity Health later this month.

CES, the Consumer Electronic Show, will end a day early due to COVID-19 concerns. Several major exhibitors have cancelled their participation in the Las Vegas show, which will now run for three days.

At CES, Withings announces the Body Scan Connected Health Station, which measures weight, body composition, heart rate, and vascular age. It also includes a six-lead ECG function and nerve assessment. The $300 scale, which is awaiting FDA clearance, will be sold with a health monitoring service that includes coaching, clinical services, and health goals planning.

Amazon’s at-home COVID-19 PCR test earns FDA’s Emergency Use Authorization. Users register their $40 kits online, drop off their nasal swab sample at a UPS location with prepaid label attached, then have their results posted on the website within 24 hours of receipt. Amazon says it built its own CAP-accredited, CLIA-certified lab for its own employees in April 2020 and is now extending its services to Amazon customers.

Privacy and Security

Broward Health (FL) reports that the medical and personal information of 1.4 million patients was exposed in an October breach in which someone penetrated its network via the office of an unnamed third-party medical provider.

MU Health Care says it will implement a new time-keeping system after some employees report not being paid in full as a result of the Kronos ransomware attack last month. Hospital representatives say pay discrepancies will be resolved this week. Meanwhile, some UF Health (FL) employees say they are looking for new jobs after the Kronos problem left them underpaid for actual hours worked since the health system can’t track overtime with the system down.

Other

Fast Company says “the telehealth bubble has burst” as pandemic lockdowns have ended, proving wrong the technology experts who declared that most healthcare services will be delivered online. Soaring telehealth company share prices have crashed hard — Teladoc Health shares have tanked 70% in less than a year, Amwell is down 86%, and Hims has shed 75%. Telehealth companies are trying to figure out how to pivot, with behavioral health being the only service that has earned a permanent spot. Key issues are payments by CMS and insurers; the possible incorporation of telehealth into other areas such as retail clinics; and the possible future of individual tools and services being rolled up into an Amazon-like patient experience.

A NEJM perspective piece says that the US public health system is a patchwork of policies and technologies that the pandemic has exposed as being expensive while delivering poor population health outcomes. Notes:

• The federal government has 21 major agencies that are involved with pandemic preparedness.
• State health departments are sometimes independent but more commonly parts of other organizations, and top state health officials are governor-appointed.
• Local health departments often perform fewer than half of the services HHS has deemed core to public health, with many of them offering nothing in tobacco prevention, opioid addiction, chronic disease management, and injury surveillance.
• Much state and local public health work is conducted on paper, with limited ability to obtain, analyze, and share information. Just 3% of local health departments say their IT systems are interoperable.
• Health officials who support evidence-based public health measures are often harassed and threatened and 32 states have passed new laws that limit the authority of public health departments during emergencies.

Sponsor Updates

• Availity employees volunteer at the Jacksonville Humane Society.
• Bluestream Health adds PCare’s patient engagement software to its virtual care platform.
• Change Healthcare AVP Edward Hafner has received WEDI’s 2021 Andrew H. Melczer Leadership in Volunteerism Award.
• Pivot Point Consulting has been honored for the eighth consecutive year as a winner in The Best and Brightest Companies to Work for in the Nation program, as well as the new 2021 regional program.
• Cerner Director of Interoperability Strategy Hans Buitendijk joins the GAO’s National Health IT Advisory Committee.
• Healthcare Triangle reports developing tech solutions to help the post-COVID healthcare industry use big data to deliver better care.
• OptimizeRx CEO Will Febbo will moderate a panel on virtual care at the LifeSci Partners Corporate Access Event January 6.
• AGS Health’s learning and development team has won an award from TISS Leap Vault CLO in the Best Induction Program category for new hires in healthcare.
• Arcadia publishes a new study, “Reduced Incidence of Long-COVID Symptoms Related to Administration of COVID-19 Vaccines Both Before COVID-19 Diagnosis and Up to 12 Weeks After.”
• CHIME releases a new podcast, “A Conversation with John Kravitz, 2020/21 CHIME Board Chair – The Year in Review.”
• Emerge has improved revenue and quality for a multi-specialty group using natural-language processing.
• Glytec’s EGlycemic Management System has achieved HITRUST CSF certification for information security.

Blog Posts

• 2021 Year in Review – Looking Toward 2022 (Azara Healthcare)
• Coordinating Behavioral Healthcare for a Healthier America (Bamboo Health)
• Behind the IT Support Desk: Why It Matters for Your Patients (CereCore)
• A dramatic change in CCM reimbursement rates kicked into effect January 1st (ChartSpan)
• The Future of HEDIS is Digital: How Plans Can Prepare (Collective Medical)
• Supporting Patients to Help Them Get and Stay on Specialty Therapies (CoverMyMeds)
• Meeting Staffing Needs: Looking Beyond COVID-19 (EClinicalWorks)
• Four Major Takeaways from the ATA EDGE2021 Conference (EVisit)
• Preparing for Omicron: streamlining care with digital scheduling tools (Experian Health)

Contacts

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

Morning Headlines 1/4/22

Jury finds Theranos founder Elizabeth Holmes guilty on multiple charges in criminal fraud trial

Theranos founder Elizabeth Holmes has been found guilty on four of 11 charges in her criminal fraud trial.

DispatchHealth Acquires Dynamic Mobile Imaging Becoming One of the Nation’s Largest Mobile Imaging Providers

On-demand house call company DispatchHealth acquires mobile medical imaging vendor Dynamic Mobile Imaging for an undisclosed sum.

Huron Closes Acquisition of Perception Health

Global consulting firm Huron will incorporate newly-acquired predictive analytics vendor Perception Health into its healthcare operations segment.

Kiira Health raises $4M to transform healthcare for young women.

Virtual women’s health clinic Kiira Health raises $4 million in seed funding.

Curbside Consult with Dr. Jayne 1/3/22

Most of my regular readers know I’m a fan of pastry therapy, but I decided to start the year out with something a little different. My food-related knot-tying skills are apparently far less developed than those used for everyday applications (or even wilderness survival), but the taste made up for the lack of aesthetics. The warm oven made the kitchen a little more habitable with the cold snap we’re experiencing, and what better way to reflect on a new year than sitting around watching dough rise?

The last two years have made most of my friends and colleagues reflective, and I’m no different. After slogging through the worst year and a half of clinical practice I’ve ever had, I decided to hang up my stethoscope for a while. Although I’m still practicing telehealth, it’s been a transition, and I’ve spent a lot of time explaining to friends and relatives what exactly it is that I do. Unless they’ve had a telehealth visit themselves, they usually don’t quite understand how we can provide care without the ritual laying on of hands that occurs in the doctor’s office.

I’ve done some medical volunteering to keep my skills sharp, as well as some in-town locum tenens work. I’ve learned more about epidemiology and infectious diseases than I ever thought I would know, as I work to advise local schools and youth-serving organizations on how to navigate the ever-changing new normal. I’ve piloted new paradigms in specialty board certification for two different disciplines; experienced the good, the bad, and the ugly of remote continuing education; and have finally transitioned to reading all but one medical journal electronically.

I watched my consulting business ride the rollercoaster of the pandemic, alternating between not having enough work and being crushed by requests my team can’t fulfill. I picked up three clients, watched one get acquired, saw one flounder, and supported a couple more as they continue to onboard new clients and expand their offerings. I’ve become adept at canceling travel more than I book and finally let my Alaska Airlines credits that I couldn’t use in April 2020 lapse into oblivion. Victoria BC, I would have loved to have seen you, and to have embraced the floatplane adventure we had planned, but it just wasn’t meant to be.

After some medical misadventures, I started to embrace the idea of a bucket list – doing things while I’m young and healthy rather than waiting for the other shoe to drop. I’ve also vowed to take advantage of unique opportunities when they present themselves instead of overthinking them.

I spent a week in the Florida Keys, snorkeled through jellyfish, went nearly 60 miles per hour on a zip line, and did things in a climbing harness that I didn’t think I’d ever do. I’ve now officially soaked in a chandelier-lit hot tub in the French Quarter after a long day of work and shoe shopping, and am glad to have found some new travel companions for when things are a little closer to the “normal” we all remember. I had a multi-week adventure following an 80-year-old steam engine and enabled some quality teenaged school-skipping along the way. My only open bucket list item is exchanging my motorcycle permit for an actual license so I can do a road trip with my dad, but we’ll have to wait for the wind chill to disappear before I work on that one.

I’m looking forward to 2022, because frankly it can’t get any worse than what some of us have been through the last two years. Lives interrupted, loved ones lost, fires, floods, tornadoes, dreams denied, and life generally feeling upside-down are things we’ve all had to deal with as we figure out how to keep putting one foot in front of the other. I’ve met some amazing new colleagues who I’ll continue working with in the new year, and hopefully we’ll be able to deliver some cool new things that will help patients and providers alike. I’m excited to be entering my twelfth year writing for HIStalk and can’t wait to get back to the exhibit hall madness that is HIMSS and catch up in person with my healthcare IT besties.

What are you looking forward to in 2022? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 12/31/21

Rhode Island attorney general reviewing RIPTA’s response to cyberattack

Rhode Island Public Transit Authority reports that thousands of medical records that were exposed in a breach were of people with no connection to RIPTA, which it blames on an insurer that sent someone else’s files.

Cybersecurity incident on Dec. 17

The president of Capital Region Medical Center (MO) warns of long ED wait times and overloaded phone lines as it recovers from a December 17 cybersecurity incident.

How telemedicine ruined a physician’s career

An anonymous physician who has done independent telehealth contracting work for 10 years says than the actions of an unnamed telehealth vendor have forced him to think about leaving medicine.

News 12/31/21

Top News

Rhode Island’s attorney general is investigating a breach of the state’s Public Transport Authority after thousands of people who have never worked for RIPTA were told that their health information had been compromised in the incident.

RIPTA says a previous insurer had sent it files that contained the information of people who had no connection to RIPTA. It did not name the insurer or explain why the information was not deleted.

RIPTA’s HHS breach filing says that 5,000 people were affected, but the letters it sent said that the information of 17,000 people was involved.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

People

Juli Stover (Envision Healthcare) joins EVisit as chief strategy officer.

Industry long-timer Miriam Paramore retires as president and chief strategy officer of OptimizeRx.

Hannah Luetke-Stahlman, MPA (Cerner) joins WellSky as VP of its personal care solutions business.

Dan Ferris, MBA (Hillrom) joins Iris Telehealth as chief marketing officer.

Announcements and Implementations

HealthStream CEO Robert A. Frist, Jr. donates $2.25 million worth of his personally held company shares that will be distributed to 1,000 employees who don’t receive executive-level equity grants.

Privacy and Security

The president of Capital Region Medical Center (MO) warns of long ED wait times and overloaded phone lines as the health system recovers from a December 17 cybersecurity incident.

A surgeon in Spain is sentenced to a year in jail for illegally accessing the medical records of his housekeeper of 23 years to verify that she was sick enough to justify missing work.

Other

Computerworld interviews Mark Eimer, SVP, associate CIO, and CTO of 17-hospital Hackensack Meridian Health (NJ), about his department’s IT accomplishments in 2021:

• Rolled out 3,000 Chromebooks to employees who were being shifted to remote work, increasing its Chromebook count to 5,000 with Citrix Workspace providing access to Epic.
• Replaced Office 365 with Google Workspace for 40,000 employees who now use Docs, Meet, Chat, and Spaces. He observes that Office 365 applications don’t work well together, while Google offers a seamless experience in providing 80% of Office’s functionality. He also notes that Microsoft’s pricing was “exorbitant” in an environment where hospital payments are being reduced.
• Moved ahead with a goal “to move off as many Microsoft platforms as we can” because  Windows is always targeted by ransomware attacks.
• The health system is expanding its use of Google Cloud and is talking with Google executives about developing Workspace apps that support healthcare-specific workflows.

A NEJM Catalyst commentary piece says that telemedicine’s value can be maximized through sustaining innovation (improving what is already being done) and disruptive innovation (providing simpler solutions for simpler needs or for patients whose needs are not being met). It says that both in-person and virtual physician visits give patients “more than what they need and less of what they want,” with an example being people who use virtual solutions for hair loss, obesity, and contraception who haven’t seen a doctor for years. The authors tout the potential value of remote patient monitoring and coaching for chronic conditions. The graphic above shows the complexity of patient needs (and eventual profitability of the solution) at the top of the pyramid that is occupied by Firefly Health, which has expanded its virtual primary care platform by starting a health plan (the company’s executive chair is former Athenahealth CEO Jonathan Bush).

An anonymous physician describes how their telehealth work ruined their career:

• Their work as an independent telehealth contractor turned into an “antibiotic dispensary service.” Physicians had to keep patients happy at all costs since they were being graded on customer service scores.
• They were placed on a performance plan for using templated notes, with the alternative being that the telehealth company would report them to the National Practitioner Data Bank.
• The terms of the performance plan limited them to 10 consults per day for one month, after which the company told them they failed the plan because they  didn’t work 30 consecutive days. The company reported the physician to the NPDB.
• NPDB allows any health entity to report a physician. The reported physician cannot challenge the claim.
• The physician says their professional reputation was damaged, they lost income, and they are having a hard time finding work, leading them to question whether they should leave medicine.

Physicians at Durham, NC-based private, for-profit Private Diagnostic Clinic — whose doctors work at Duke University and its health system – sue Duke for requiring 400 of PDC’s 1,850 physicians to take jobs instead with the recently formed Duke Faculty Practice to be able to continue their research. The lawsuit claims that Duke’s previous attempts to acquire PDC fell through because of its estimated value of $1 billion, so Duke is trying to take it over for free.

A virtual meeting of the Beverly, MA board of health is taken over by masking opponents who used the meeting software to hand off speaking to those with similar beliefs, including one who urged someone to burn down the house of Boston Mayor Michelle Wu. A participant declared that a proposed mask mandate would violate her HIPAA rights.

Contacts

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