Former Practice Fusion Director of National Accounts Steven Mack pleads guilty to attempting to obstruct a federal investigation into the relationship between Practice Fusion and Purdue Pharma after admitting he deleted relevant computer files.
The Washington Post ran a piece this week on Zoom fatigue. It brings up some good questions about whether calls really need to have a video component and links to a paper on the topic titled “Nonverbal Overload: A Theoretical Argument for the Causes of Zoom Fatigue.”
The author, Jeremy Bailenson, PhD, is a professor and founding director of Stanford University’s Virtual Human Interaction Lab. He concludes that there are four major causes of videoconferencing fatigue:
Excessive direct eye gaze as people look at faces close up rather than at notes or other places in the room.
Constant self-evaluation from seeing ourselves in real time.
Reduced mobility for those used to walking and talking on phone calls or in person,
Bailenson recommends use of the “hide self” view and minimizing the video call screen as potential solutions. He also recommends that meeting hosts specifically ask attendees to look around their environments and move around as they would in an in-person meeting.
Another paper from Andrew Bennett, PhD, assistant professional of management at Old Dominion University, is pending publication in the Journal of Applied Psychology. It offers some specific suggestions for reducing videoconference fatigue:
Hold meetings earlier in the work period.
Enhance perceptions of group belongingness.
Mute if not speaking.
Take breaks from looking at the screen, both during and between conferences.
Establish group norms for mute, camera, acceptability of multitasking, hand raising, etc.
Interestingly, Bennett’s research found inconclusive evidence for changes in webcam usage or using the “hide self” view.
Other potential solutions to videoconference fatigue might be to do calls as audio only. Those of us who have been videoconferencing for years have already been through this and created solutions.
At some companies, the first few minutes of a call includes video so that everyone can see each other and have a time of relationship building with a little bit of chit-chat. Then cameras go off as the meeting gets underway. I like that approach personally because I take a lot of notes during meetings and people sometimes find my downward gaze to look like inattention. I’m still a pen-and-paper girl for many of my notes because I find it helps me remember content better. I also like to keep my microphone live all the time so that I don’t forget to unmute before speaking. I have a quiet work environment so this generally works, and my pen makes far less noise than my clacking keyboard would.
I personally find Zoom calls to be fatiguing only when dealing with individuals who haven’t figured out how to effectively use the system. We’re a year into this pandemic and if you don’t know where the mute button lives by now, I really feel for you. This sentiment is found in numerous comments on the Washington Post article, along with other positive impacts of remote work including decreased commuting time and expenses. I was also annoyed with a recent Zoom call that I knew was going to be audio-only when it wouldn’t let me in because I tried to access it on a computer that doesn’t have a webcam. I don’t know if that’s a setting on the host side since usually I just use my laptop, but it resulted in some last-minute scrambling.
I might be in the minority, but I find the use of Zoom backgrounds to be distracting, especially when there is a lot of bleed-through or issues with people moving around a lot and having parts of their body disappear. If you’re a fan of backgrounds, I definitely recommend investing in a green screen so you can get the best performance out of the system. Otherwise, I would recommend trying to find a calm corner to customize for when video is needed or considering something like a folding screen to provide a neutral background.
I am on far too many calls where people have children and pets running around in the background, and that’s definitely distracting. I once terminated a call when I dialed in to find my coworker sitting by her pool with her children in it. She said she didn’t want them to be in the pool without her, but thought it was OK to be on a call. I’m a firm believer that if you’re supposed to be supervising your kids in the pool, you had better be giving them your full attention. She disagreed, but I certainly didn’t need to enable her dangerous behavior.
Another angle on Zoom fatigue is to make sure that you are leveraging the leisure time benefits of videoconferencing as well as the work-related ones. I have monthly happy hours with people all across the country that wouldn’t be as much fun if we were only on the phone. It helps establish the role of videoconferencing in building relationships and not just driving one crazy. I’m about to embark on a trip with one of my video happy hour friends, and if our conversations are any indicator, it should be a doozy of an adventure. Without building a friendship on video, we might not have even thought about this since our previous interactions were mostly built on emails about cute shoes and boots.
Zoom has also allowed me to continue to take music lessons despite the pandemic. I previously studied in my instructor’s home, and since she has an elderly relative in the household, she stopped in-person lessons fairly early in the pandemic. I was happy to avoid the 90-minute round trip commute. Although Zoom isn’t perfect, the platform has made some significant enhancements to allow it to better handle events such as music lessons. The “original sound” feature has been enhanced, along with other audio settings, to allow a truer audio representation. My only issue with it is that I can’t seem to default it on, so sometimes I forget to turn it on for every lesson. As an adult beginner on this particular instrument, I was definitely less anxious about playing my first recital via Zoom than I would have been had I been in an auditorium with my 5- to 9-year-old peers.
What do you think about the idea of Zoom fatigue? Leave a comment or email me.
March 8, 2021Readers WriteComments Off on Readers Write: Remote Monitoring is Crucial for Hospital Asset Management — Here’s Why
Remote Monitoring is Crucial for Hospital Asset Management — Here’s Why By Scott Trevino
Scott Trevino, MS, MBA is SVP of product management and solutions of TriMedx of Indianapolis, IN.
As any health IT professional would know, the ability to remotely monitor hospital devices is critical in ensuring efficient operations. Unplanned downtime, spontaneous device failure, and unexpected maintenance all impact the ability to safely provide care for patients.
A recent example took place at a hospital in Indiana, when a remote monitoring device was used to detect a fault on an MR scanner. During the proactive repair process, technicians ultimately discovered that the pressure relief valve on the roof of the hospital was stuck open, a defect that could have caused countless other problems. Luckily, the remote monitoring system the hospital had in place allowed them to identify this problem before it caused a domino effect of consequences.
Preventing unplanned downtime is the most prominent argument in favor of remote monitoring. By 2025, it’s estimated that 68% of medical devices will be network connected, which only increases the need for ongoing device monitoring. Hospitals are always searching for cost-effective avenues to help improve patient care and safety, and the efficiency and scalability that remote monitoring offers is unrivaled.
Here’s a closer look at why remote monitoring is an essential component of providers’ approach to clinical asset management.
Remote monitoring is getting smarter
Even the smallest of details can make a difference in a clinical device setting. With remote monitoring, device analytics will only continue to evolve and produce predictive insights for each asset, effectively anticipating potential failures and/or optimizing service schedules.
Device failure is costly and leads to unplanned downtime, labor costs, risk to patient safety, and more. Instead of throwing potential solutions at the wall and hoping one of them sticks, utilizing predictive analytics guarantees that hospitals are putting their resources to good use. A robust remote monitoring system uses predictive analytics to produce data that is crucial in making decisions. This system will pose questions like, is a device worth the cost to continue to repair and maintain it? Or, is it time to purchase new equipment? Healthcare providers that lean on these data-driven decisions will be at a considerable advantage when it comes to optimizing acute and non-acute care facilities.
Care in non-acute settings will become commonplace
Over the past few years, healthcare has seen a large push towards non-acute settings. Transitioning care to outpatient centers helps care systems reduce costs, but reimbursements in these facilities are still lower than in a traditional hospitals, meaning that providers are going to face challenges to transition care without breaking the bank.
Where does clinical asset management fit in? Let’s look at an example. If a provider has 3,000 devices in an acute facility, typically an economy of scale is in place for teams to service on site. If the provider takes 1,500 of those devices and moves them around to various care sites, the cost to service each device at a different site will be higher since it will be less efficient and cost-draining for providers to station service teams at each location. However, this problem can be addressed through a remote monitoring system within a comprehensive clinical asset management program to keep locations up and running.
Servicers productivity must improve alongside device growth
Healthcare providers are not alone in their struggles to reevaluate how to manage a larger equipment footprint. Manufacturers are feeling the same pressure. No longer can servicers, such as OEMs, afford to send out a technician for every service call, especially when many arrive to find device problems that cannot be fixed. There’s little choice but for the labor force to improve productivity and reach maximum efficiency to keep up with the growing number of devices.
The best way to do this is to use remote monitoring, which allows technicians to troubleshoot a problematic device without having to physically be on site. Not only do these systems create better efficiency across the service labor force, they add to hospital systems’ ability to reduce unplanned downtime and improve patient care.
All signs point to remote monitoring as the future of the healthcare industry. Device optimization, cost pressures, and the growing number of facilities in a provider’s network have shown us that remote monitoring is no longer nice-to-have, but a need-to-have for healthcare providers who are ready to embrace a new, innovative landscape.
Comments Off on Readers Write: Remote Monitoring is Crucial for Hospital Asset Management — Here’s Why
Canadian telecommunications company Telus will acquire Babylon Health’s Canadian operations, and license virtual care technology used in the Babylon by Telus Health app since 2019.
Harris acquires Bizmatics, which offers the PrognoCIS EHR/PM.
Recent acquisitions have given Canada-based Harris, which is owned by Constellation Software, a long list of health IT brands that includes Amazing Charts, GEMMS, QuadraMed, Iatric Systems, IMDSoft, Just Associates, Picis, Obix, DigiChart, Uniphy Health, and MediSolution.
Reader Comments
From ML Ratio: “Re: tech-powered insurers. Several are going public and touting their technology. Will you be covering them?” Probably not since I think they are blowing smoke in trying to convince investors that they are sexy tech companies instead of boring old insurers whose profitability is based on stealing someone else’s insurance customers, negotiating provider contracts, and managing their medical loss ratio. You’re still an insurance company if most of your income is generated by premiums rather than a cute app or quickly launched telehealth program whose main end product is buzz. That’s especially true of recent startups whose website and pitch deck tries to make you think they are the next Facebook. Ignore the self-assigned labels and focus on their tiny market share, handful of coverage areas, and big competitors to whom they provide little threat. You don’t want to go toe-to-toe with UnitedHealth Group, Anthem, or Centene armed only with a clever idea for making Medicare Advantage primary care seem more interesting
HIStalk Announcements and Requests
Welcome to new HIStalk Platinum Sponsor Culbert Healthcare Solutions. The Woburn, MA-based company’s patient access, clinical workflow, and revenue cycle operations experience, combined with its deep IT strategy and deployment experience, uniquely qualifies it to select, implement, and optimize healthcare technologies. Its health IT consulting team includes former CIOs and vendor-focused analysts who design and deliver high-value services that advance the delivery of care, enhance the patient experience, and improve financial performance. Thanks to Culbert Healthcare Solutions for supporting HIStalk.
About 60% of poll respondents say their company’s work culture is the same or better now as it was a year ago, results I didn’t expect given a tough year of pandemic challenges, remote work, and uncertainty. I’m interested to see how both company culture and internal job opportunities are affected when some but not all employees continue working remotely as a permanent arrangement. Remote workers were out of sight, out of mind in the places I’ve worked, with those jobs (other than consulting or sales) best suited for folks who weren’t looking to gain responsibility, get promoted, or boost their resumes with challenging new assignments. Those rewards were given to the familiar faces of people who spend their days around conference room tables, in unplanned hallway conversations, and at lunch with those who have some control over their occupational destiny.
Thanks to the following companies that recently supported HIStalk. Click a logo for more information and to thank them for keeping my keyboard clacking.
Webinars
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.
Acquisitions, Funding, Business, and Stock
Real estate investment trust Omega Healthcare Investors acquires Connected Living, which provides smart devices, apps, and wearables to senior housing and care companies.
Ascension Ventures raises $285 million for its fifth strategic venture capital fund, increasing its assets under management to more than $1 billion.
The one-month performance of the Global X Telemedicine and Digital Health EFT is a loss of 18% versus the Nasdaq’s 9% loss. EDOC shares are up 15% since their July 30, 2020 listing, trailing the Nasdaq’s 19% gain in the same period.
Announcements and Implementations
Walmart heir Alice Walton, who is one of the world’s richest women at a reported net worth of $60 billion, announces that her non-profit will create a new medical school, Whole Health School of Medicine and Health Sciences, in Walmart’s home town of Bentonville, AR.
COVID-19
Nearly one-fourth of Americans have received at least their first dose of COVID-19 vaccine, including 59% of those 65-75 and 69% of those over 75.
Former FDA Commissioner Scott Gottlieb, MD predicts that meetings and widespread travel will return to the US in July through September, but that will slow again to some degree as cooler weather drives people back indoors.
Sponsor Updates
Nordic welcomes Saran Sonaisamy (Cognizant) as director of cloud transformation and cybersecurity.
PerfectServe publishes a new case study featuring the University of Tennessee Medical Center, “EMR Embedded Communication Improves Efficiency.”
Pure Storage and Equinix develop a Bare Metal as a Service storage offering that delivers a unified, connected platform for any stage of an organization’s cloud journey.
Redox releases a new podcast, “Withings’ Journey from Consumer to Remote Patient Monitoring.”
March 5, 2021WeekenderComments Off on Weekender 3/5/21
Weekly News Recap
Several health systems and home-based care companies form Moving Health Home to encourage federal payment for moving some care from hospitals to home.
Premier acquires Invoice Delivery Services.
Duke University personalized chronic care spinout ZealCare will launch later this month.
BD acquires GSL Solutions.
Universal Health Services estimates that September’s cyberattack has caused $67 million in losses.
HHS OIG officials recommend that prescriptions be required to include the condition for which the drug is being used to reduce errors, allow correct CMS payment, and help families sort patient meds.
Naval Medical Center San Diego goes live on Cerner.
Ambulatory health IT vendor MTBC will change its name to CareCloud, the EHR vendor it acquired in January 2020.
Cigna’s Evernorth health services business will acquire telehealth vendor MDLive.
Best Reader Comments
I couldn’t agree more with the second point on why vaccination self-scheduling is harder than it looks. In Florida, Publix Supermarkets is the best place to get COVID vaccinations IMHO, but their self-scheduling app stinks. And it’s for that very reason; users have to enter several screens of data before you actually get to the point of trying to find locations with appointments. And Publix has hundreds of stores here. (Jim Beall)
When big health system is the only provider in town, they don’t need to thank you for choosing them. You had no other choice. (Was a Community Hospital CIO)
Interesting to see Allscripts spend time discussing Veradigm to the investor community. We recently asked them for a briefing to better understand Veradigm’s business model, including data governance model for patient privacy. They canceled that briefing after we authored a post looking at the healthcare data-for-sale marketplace. (John)
Watercooler Talk Tidbits
Readers funded the teacher grant request of Ms. H in Arkansas, who asked for laptop accessories to support her class’s hybrid learning. She reports, “Thank you so much for your donation. The laptop riser and wireless mouse have made teaching much easier; and I honestly would not know what to do without the camera as my laptop is older and I didn’t have access to a camera until your donation. These have helped greatly with ease into this new type of teaching with blended classes of in-person and virtual students. I appreciate your help in making this year a success! These materials we are using almost daily to improve instruction and help my students.”
Baltimore County, MD’s vaccine site coordinator says his 12 years of experience as a roadie with Twisted Sister prepared him to get crowds into and out of large venues. His tips: (a) give each crew member just one job to do; (b) make it easy for attendees to follow the coned and taped areas that designate the flow of cars and people; and (c) keep attendees moving but don’t allow one station to move so quickly that people wait too long at the next one.
A 75-year-old Long Island doctor is charged with murdering five patients who died of opioid overdoses. Prosecutors say George Blatti, MD worked out of a hotel parking lot, a doughnut shop, and a defunct Radio Shack, prescribing massive quantities of drugs to addicts without an exam while accepting either cash or insurance for payment.
First-year internal medicine resident Troy Manz, MD died from being struck by a car during a Florida bicycle race last weekend. The 46-year-old Air National Guard air transport physician and captain in the 126th Medical Group served eight years in the US Marine Corps, 13 years as a US Air Force critical air transport respiratory therapist flying injured service members in Iraq and Afghanistan, and then earned his medical degree from University of Kansas School of Medicine in 2020. His commanding officer said, “He went to medical school in his 40s and that’s unheard of. it was frankly a struggle for him. But he set goals and had a vision of where his future was going to lead him.”
Actor Hugh Jackman delivers a loaf of his homemade sourdough bread to Wyckoff Hospital (NY) ED nurse and nurse practitioner student Alina Jackson, RN, who volunteered to work a 24-hour shift during snowstorm even though she is six months pregnant.
Ottawa Public Health’s earns accolades and millions of Twitter views for mixing up the usual serious coronavirus pronouncements with empathy, riffs, and jokes. Social media lead Kevin Parent says he uses the account to talk “with” rather than “to” readers in hopes of engaging them and having them share the information. The tweet above was seen and shared by millions of people, with newbies crowing about “you had just one job” and pondering the employment future of poor Bruce, unaware that (a) the answer to the question of whether any OPH tweet was intentional is always “yes;” and (b) there’s not an actual Bruce.
The local paper profiles Blount Memorial Hospital (TN) environmental services worker Tom Cunningham, who cheers up employees, visitors, and patients by channeling Elvis Presley in the hallways. He has done Elvis impersonation shows at birthday parties and weddings for 20 years. He joined Blount Memorial two months ago after years at University of Tennessee Medical Center, which asked him to stop praying with patients and employees who asked him, ordering him to leave religious work to the hospital pastoral staff.
Several health systems and home-based care companies form Moving Health Home, a coalition that will try to convince the federal government to permanently pay for telehealth, remote patient monitoring, virtual disease prevention and management, caregiver support, and medical record sharing as an alternative to in-hospital care.
New Duke University personalized chronic care spinout ZealCare will launch later this month, co-founded by former Duke University Health System CEO Ralph Snyderman, MD and personalized healthcare research fellow Connor Drake, PhD.
Medical and safety technology vendor Dräger will work with several healthcare organizations to develop medical device interoperability standards in a US Army-funded project that will use IEEE’s service-oriented device connectivity (SDC) standard.
Several health systems and home-based care companies – including Amazon Care, Intermountain Healthcare, Ascension, and Landmark Care – form Moving Health Home.
The coalition will try to convince the federal government to permanently pay for telehealth, remote patient monitoring, virtual disease prevention and management, caregiver support, and medical record sharing as an alternative to in-hospital care.
The group says that the pandemic has shown that clinical services can be safely and effectively provided at home. Many Americans, they say, would prefer receiving services at home instead of in hospitals.
The announcement says that home health services have been focused on delivering short-term services to primarily seniors who are recovering from an illness, injury, or hospital stay. They believe that home care should be a regular option for primary care, behavioral health, chronic disease management, and hospital-level care.
Reader Comments
From HIMSS Venues: “Re: post-COVID events. My hope is that they will combine in-person and virtual sessions, which will open up those smaller venues like San Diego, New Orleans, and Atlanta. HIMSS in San Diego was always my favorite.” San Diego was my favorite HIMSS city by far, which places it on the opposite end of the spectrum from Las Vegas. My recent mention of San Diego was with the same thought you had – conferences are likely to be smaller, so perhaps San Diego could be added back into the HIMSS rotation. My HIMSS experience in Atlanta and Dallas was big-box bland, while New Orleans was heavy on personality and great food that was more than cancelled out by infrastructure that bordered on third world at HIMSS13 (cramped airport, decrepit hotels, lack of service personnel, and boil water advisories) I’m on the bubble with Chicago because weather can be iffy and hotels are expensive, although I had fun staying in a VRBO house in Bridgeport last time. The San Diego downside to me is its limited number of business class hotels and its landlocked, often fogged-in airport that provides a white-knuckle, steep descent thrill ride with each landing. It’s hard for HIMSS to be nimble since big conferences require infinitely complicated planning and contract negotiations, so if they interrupt the Las Vegas-Orlando back-and-forth, I would expect them to push Chicago yet again to keep their own costs down. I’ll take it over Las Vegas any day.
From Spinout: “Re: partnership. What do marketing people think that word means when they use it in announcements?” They think it means free PR. I’m slowly moving to a policy of not mentioning any announcement that references a “partnership” since:
I can’t tell 90% of the time exactly what the business arrangement is under which the companies will work together, which I suspect is intentional obfuscation.
If it’s some kind of marketing or sales agreement (i.e. “we’ll both try to sell our customers each other’s stuff”), then nobody cares.
If one “partner” is writing a check to the other, then the agreement should be clearly labeled as a sale, not a partnership, which would then earn my mention.
I get a lot more interested in “collaboration” and “partnership” when they result in something that will be useful to the industry at large, which is rare. It’s mostly a concept that would only interest a salesperson.
From Unicornrows: “Re: billion-dollar valuation companies. We have a lot in healthcare.” We have a lot of companies with a billion-dollar valuation but a lot fewer that are actually worth a billion dollars, with the difference being irrational exuberance in a frothy market. I’ve heard the theories that SPACs and various forms of corporate financial shell games haven’t caused companies to be excessively valued, but I’m a fundamentals guy and most of these companies seem to be struggling to sell much of anything except their own shares. The unicorns and SPACs are floating all health IT boats at the moment, but at some point the telehealth, RPA, tech-heavy health insurance, and employee wellness music will stop due to lack of ROI and financial performance and that’s when sitting on a big position in a “story stock” becomes less fun. However, people who have more money than I could earn in 10 lifetimes are placing their bets, so follow their lead if you want but recognize that it’s a zero-sum game and many of those gung-ho traders weren’t in the market during the dot-com boom and bust that taught many of us lessons. Buy shares early and you are dealing with an insider who, by definition, knows the value of both their shares and your money and chooses the latter.
HIStalk Announcements and Requests
Welcome to new HIStalk Platinum Sponsor Lyniate. The Boston-based company partners with healthcare organizations around the globe, delivering cutting-edge solutions to address interoperability challenges. The company’s industry-leading products, Corepoint and Rhapsody, are used by thousands of customers to send hundreds of millions of messages every day. Lyniate is committed to delivering the best interoperability solutions for healthcare organizations, from specialty clinics to large networks, from payers to vendors, and everything in between to build the future of interoperability. Thanks to Lyniate for supporting HIStalk.
I found this explainer video about Lyniate on YouTube. Should you be of the barbeque persuasion as I am, study this video recap by Lyniate UK employee James Hardacre, who has embraced his inner Texas pitmaster by creating a fire-enabled (pun intended) Rhapsody engine connection to his collection of smokers to write temperatures to a database for graphing to monitor low-and-slow progress, which is fascinating to hear him describe with a British accent.
I continue to hear from readers who have stopped getting my email updates. I’ve described before how overaggressive email server settings on their end keep recipients from receiving emails that they signed up for. My suggestion is to simply sign up again, which will either fix the problem or do nothing (you won’t get duplicate emails no matter what). I use the emails only to send notices that I’ve published something new, which means just a handful of emails each week and no spam.
Webinars
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.
Acquisitions, Funding, Business, and Stock
Premier acquires Canada-based Invoice Delivery Services — which offers a system that converts paper and PDF invoices to electronic form to reduce the costs of invoicing, tracking, and payments — for $80 million. Premier will operate the business under the Remitra name.
Publicly traded hospital operator Universal Health Services says in its Q4 earnings report that its fall cyberattack cost it $67 million in labor costs and delayed billing, but it expects to get most of that back from cyberinsurance.
New Duke University personalized chronic care spinout ZealCare will launch later this month, co-founded by former Duke University Health System CEO Ralph Snyderman, MD and personalized healthcare research fellow Connor Drake, PhD. President, CEO, and investor Maureen O’Connor comes from BCBS North Carolina and breast cancer screening AI technology vendor Whiterabbit.
Medical technology vendor BD acquires 20-employee GSL Solutions, which offers RFID-powered will-call prescription cabinets and drug dispensing systems. The original developers and founders are Oregon State graduates in pharmacy and computer engineering, respectively.
Sales
In Canada, Newfoundland and Labrador choose Change Healthcare Canada to develop staff scheduling software for its hospitals and long-term care facilities, also giving the company up to $28 million in incentives for cost savings it identifies.
Axiom Healthcare Services will implement a customized version of Azalea Health’s EHR for its two behavioral health hospitals.
People
Industry long-timer Mike Raymer (AngelMD) joins clinical trials training and compliance solutions vendor Pro-ficiency as CEO.
Announcements and Implementations
Health system staffing and services vendor HCTec launches a vaccine administration support service.
A new KLAS report on EHR best practices for hospitals of under 200 beds finds that while their vendors provide technology and support, the hospitals need to get IT teams involved with frontline clinicians, set realistic expectations, invest in IT resources, deploy skilled trainers with required clinician engagement, and create a collaborative relationship with their vendor that has regular touch points. Meditech’s updated technology and more prescriptive implementation approach have elevated Expanse to the top spot in satisfaction.
Black Book’s annual survey of ambulatory practices find that specialty-driven EHRs earn the top satisfaction, although most specialists regret their hurried EHR choice and implementation that failed to consider connectivity with other providers. Nearly all specialty practices that expect to change EHRs will be looking only at cloud-based systems because of cost.
Medical and safety technology vendor Dräger will work with several healthcare organizations to develop medical device interoperability standards in a US Army-funded project that will use IEEE’s service-oriented device connectivity (SDC) standard.
Walgreens expands its Find Care digital health marketplace, which is part of the Walgreens app, with 11 new providers.
Government and Politics
A Johns Hopkins Bloomberg School of Public Health study finds that Medicare would have saved $1.7 billion in 2017 if prescribers and/or patients had not insisted on using a brand name drug for which a generic equivalent was available.
COVID-19
CDC reports 83 million COVID-19 vaccine doses administered versus 110 million distributed (76%). Hospital inpatient count continues to trend down, at 42,000 this week versus the peak of 125,000 in early January.
Italy invokes its European Union powers to block the export of 251,000 doses of AstraZeneca’s COVID-19 vaccine to Australia. EU countries are frustrated that they can’t meet their stated vaccination goals because AstraZeneca is tens of millions of doses behind its agreed-on delivery schedule. Italy’s foreign ministry flagged the shipment from AstraZeneca’s factory in Rome, noting that Australia is not considered by the EU to be a vulnerable country.
California’s switch to Blue Shield to distribute coronavirus vaccine will require consumers to use MyTurn to sign up and V-Save to report adverse events, while providers will be required to use MyCAVax for enrollment and vaccine management; MyTurn for clinic management; MyTurn, EHR, or CAIR2 to report daily doses administered; VAERS, FDA, or V-Safe to report adverse events; and VaccineFinder to report daily inventory. I learned this from the Twitter of Christopher Longhurst, MD, MS, CIO/associate chief medical officer of UC San Diego Health.
New York State continues testing IBM and Salesforce-developed Excelsior Pass for attendees of professional sports events, which allows people who have recently tested negative for COVID-19 or been vaccinated to present an on-screen or printed QR code “boarding pass” that will give them entry into the venue. The system is based on IBM Watson Works Digital Health Pass digital wallet. I haven’t seen an whether the system actually tries to import vaccination and testing records (it seems like patient identification and the wide variety of testing sites and systems would make that hard) or if it just allows users to self-report their COVID-19 status – each venue sets its own requirements.
Other
The Las Vegas Sands company sells the Venetian, Palazzo, and the Sands Expo and Convention Center for $6.25 billion as it exits the US to focus on running casinos in Asia and venturing into online gambling. The company lost $300 million in the most recent quarter because of the pandemic and its founder and CEO Sheldon Adelson died in January. The sale will close in Q4, after HIMSS21 has concluded in whatever form it eventually takes. I admit that while I like nearly nothing about Las Vegas, I prefer naturally occurring tackiness (like the off-Strip liquor stores that offer inebriates thousands of kinds of airline-sized bottles to guzzle down on the sidewalk) over upscale but even tackier gondoliers, fake sky ceilings, and celebrity-licensed generic restaurants.
A Kentucky woman sues a hospital that performed a mammogram that detected signs of cancer, but then mistakenly sent her an all-clear letter. Digital forensics experts say the radiology tech chose the wrong software drop-down option, triggering the “no cancer detected” letter, after which radiology department employees tried to hide her mistake by changing the entries. The hospital refused to turn over system audit logs until it was served with a court order, then claimed that the logs can’t track changes accurately because the hospital’s software was buggy and is no longer sold. Experts say that EHR audit logs are seldom useful for malpractice cases because they are hard to interpret and require hiring expensive experts to review them. The digital forensics expert in this case is Andy Garrett, who started Garrett Discovery in 2007 after leaving his Navy IT job. His small company offers EDiscovery, cell phone forensics, social media evidence collection, audio and video forensics, cell phone analysis, and a service in which attorneys who are questioning potential jurors are provided with their real-time social media histories and background checks.
Sponsor Updates
Everbridge announces the newest enhancements to its ManageBridge critical event management mobile app.
The HCI Group releases a new Digital Voices with Ed Marx podcast, “How I Made My First Million at Age 25!”
ChartSpan will offer its Chronic Care Management program to members of the Kentucky Hospital Association.
Health Data Movers publishes a new white paper, “How We Make it Happen: Transplant Data Conversion.”
EHR/PM vendor ISalus will integrate electronic prior authorization from CoverMyMeds .
KLAS recognizes Impact Advisors as a high performer in its latest “ERP Implementation Report.”
Infor makes new courses available for Infor CloudSuite Healthcare.
March 4, 2021Dr. JayneComments Off on EPtalk by Dr. Jayne 3/4/21
The states continue to add complexity to the vaccination process, which is unfortunate for patients, but handy for those of us who depend on billable consulting and technology support hours to pay the rent.
Florida is my new cash cow this week. It issued a form Tuesday to certify patients who have a “COVID-19 Determination of Extreme Vulnerability.” Some of my clients brought this to my attention and asked for a quick migration of this form into their EHRs so that they could complete it without patients having to bring it to the office. I have a couple of consultants frantically building them to include auto-fill fields and blobulized and digital signatures, which hopefully the public health authorities and/or vaccinators will accept.
I found it interesting that they require the physician to “certify that I have a physician-patient relationship with the patient named above,” which would seem to indicate they’re concerned about certification mills or people just buying signed notes. On the other hand, they specifically left out NPs and PAs who provide a substantial amount of primary care in the state, which is unfortunate for both providers and patients.
Additionally, these medically vulnerable patients can only be vaccinated by physicians, nurse practitioners, or pharmacists, which doesn’t make sense with medical standards of care. Not to mention, let’s use our most expensive resources to do tasks that could be done by a less-expensive resource, such as a registered nurse, licensed practice nurse, medical student, paramedic, or military medical staffer. Score one in the “poorly thought and executed” column yet again.
I continue to see a lot of poorly planned initiatives among organizations. One created a shingles vaccine campaign that brought patients in for immunization, only to launch their COVID-19 vaccine campaign shortly thereafter, which created confusion as patients were turned away due to having had a vaccine in the previous 14 days.
I’m still seeing aggressive intake forms and pre-screening processes that exclude patients from in-person visits for findings that may or may not be COVID-related, such as fever. I guarantee that the six year-old who is attending in-person school and had exposure to a child with strep throat and who now has a fever and sore throat is much more likely to have strep then COVID-19, but algorithms are still pushing those patients to virtual care, which either results in antibiotics over the phone (less than ideal) or an additional in-person trip for testing or evaluation.
As someone who has passed the 1,000-patient mark for COVID-19 exposures, this is starting to feel similar to what we went through with HIV. We need to just start assuming that everyone might be carrying it and make sure healthcare providers have appropriate universal protections (including adequate and regularly replaced N-95 masks) and proceed accordingly. People much smarter than me are all similarly concluding that we’re going to head into a phase where this virus is endemic and we’re going to deal with it for a long time, so we need to start retooling our processes for the long haul. This includes IT systems that haven’t been updated. I still see electronic intake forms with questions about travel to China and we’re long past that being relevant.
Lots of attention this week to a pre-print research study that suggests that wearing glasses might reduce COVID transmission, a phenomenon jokingly referred to as “nerd immunity.” Although we know that protective eyewear can be a barrier to viral particles entering the eyes, the backlash on this one was swift, with multiple people pointing out that pre-print studies can be problematic. Fact-checkers concluded that there is no definitive evidence that wearing simple eyeglasses make someone less susceptible to COVID-19 and that the study cited was low powered (304 patients with disease) and noted that the study has not gone through the peer review process. There are additional design problems in that the researcher only included patients with mild disease and excluded those with moderate or severe illness. If we’ve learned one thing during this pandemic, it’s that watching science unfold in real time can be messy and confusing to those not involved in the process.
HIMSS recently put out a call for nominations for its Changemaker in Health Awards. Nominators were asked to put forth “inspiring senior health executives who rigorously challenge the status quo in their journey to build a brighter health future.” As part of the nomination process, one had to submit an essay on why their candidate was deserving of the Changemaker designation, as well as providing the candidate’s CV and other supporting materials. On March 2, my nominee received a notification that he had not been selected as a finalist, but no communication was made to the nominator. He was encouraged to visit the Changemaker page to see the finalists and vote, but it took HIMSS a full day to get it live despite it being March 2 and the website encouraging people to come back on March 2 to vote.
The page finally went live sometime on March 3. It looks like a fairly solid bunch of people, but none of them are big-league rabble rousers or changemakers in my opinion. Most have led steady careers as CIOs or equivalent, and work for large hospitals or health systems. There was little representation from entrepreneurial or cutting-edge technology interests. In order to help the public vote, the site lists the individual’s title and a link to their LinkedIn page, but doesn’t include any of the color or meaty information that some of us included in our nominating essays, which is disappointing.
I wish good luck to those who are in the running, although selection is a mixed bag because the winners have to engage in various HIMSS events and panels as a condition of recognition. My candidate suggested that perhaps HIMSS “wasn’t looking for the real troublemakers” and suggested we have our own “Rebels in Healthcare” list and party at HIMSS. In the absence of a HIStalk kegger (and don’t get me wrong, that would be perfect for the half-baked HIMSS that we might be all walking into this August), it’s sounding like a fairly decent idea. If you have a rebel you’d like to nominate for inclusion, or just want to nominate yourself, leave a comment or email me.
Care Medical, which powers the Amazon Care virtual and house-call clinic offered to Amazon employees in Seattle, has filed paperwork to operate in 17 additional states.
The House Select Subcommittee on the Coronavirus Crisis launches an investigation into One Medical’s COVID-19 vaccination practices after NPR uncovers that it provided vaccines to ineligible patients, including some with ties to company leadership.
Healthcare API developer Health Gorilla raises $15 million in a Series B round of funding it plans to use for market expansion and product development.
HHS OIG Principal Deputy Inspector General Christi Grimm, MPA and HHS OIG Chief Medical Officer Julie Taitsman, MD, JD say that prescriptions should be required to include the condition for which the drug is being prescribed.
Hill-Rom cancels its plan to acquire ambulatory ECG monitoring vendor Bardy Diagnostics for $375 million, citing potentially unexpected reductions in Medicare reimbursements for patient-monitoring devices.
HHS OIG Principal Deputy Inspector General Christi Grimm, MPA and HHS OIG Chief Medical Officer Julie Taitsman, MD, JD say that prescriptions should be required to include the condition for which the drug is being prescribed.
They say in a Stat opinion piece that including the reason the drug is being prescribed would help Medicare detect off-label use that is not payable, such as prescribing hydroxychloroquine for COVID-19.
The authors believe that including the diagnosis would also help people organize the meds of their family members and would make it easier for pharmacists to identify safety issues. They note that privacy concerns are minimal since pharmacists are bound by HIPAA.
Cures Act standards already require EHRs to be able to send and receive the reason for the prescription.
HHS OIG previously made the same recommend in 2011, when it was endorsed by the American Pharmacists Association.
Reader Comments
From Carry On: “Re: my new CIO job. Thanks for mentioning it. I have been an avid HIStalk reader for many years and it is required reading for my team.” I’m always surprised when someone says that they read what I write, given that I just fill an empty screen with whatever interests me without considering the invisible presence of bystanders. An industry legend seemed puzzled years ago when I expressed skepticism about how many CIOs read HIStalk (since I have no way of knowing), after which that person said every CIO they know reads it. Regardless, I’m happy to have anyone who keeps coming back.
Webinars
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.
Acquisitions, Funding, Business, and Stock
Mayo Clinic-backed maternal and fetal remote patient monitoring company Marani Health raises $3.7 million.
Blueprint Health Merger will raise $200 million through its IPO, according to SEC filings. Led by former Thomson Reuters CEO Richard Harrington and former Virgin Pulse CEO Rajiv Kumar, MD the blank-check company plans to pursue digital healthcare deals.
Health IT vendor MTBC renames itself CareCloud, the EHR vendor it acquired last year for $36 million.
DeliverHealth Solutions completes its acquisition of Nuance’s transcription services business and EScription technology, first announced last November. Nuance holds a minority share in the Madison, WI-based company.
Hill-Rom cancels its plan to acquire ambulatory ECG monitoring vendor Bardy Diagnostics for $375 million, citing potentially unexpected reductions in Medicare reimbursements for patient-monitoring devices. Bardy has filed a lawsuit in an effort to force the acquisition.
Truvian Sciences raises a $105 million Series C round of financing. The company, which counts former Livongo Chairman Glen Tullman among its investors, is developing an automated, bench-top device that can perform multiple blood tests. Truvian President and CEO Jeff Hawkins has stressed that the company’s goals are far less “extravagant” than those of its pseudo-predecessor, Theranos.
Reperio Health raises $6 million in seed funding to advance the rollout of its kits for employer-provided, at-home wellness screenings. The co-founders came from contact lens prescription service Sightbox, which Johnson & Johnson acquired in mid-2017 and then shut down two years later.
Sales
Apervita embeds Diameter Health’s data optimization and interoperability capabilities within its care collaboration software.
The government of Scotland chooses Genesis Automation for hospital inventory tracking.
People
Philips hires Shez Partovi, MD (Amazon Web Services) as chief innovation and strategy officer and a member of the company’s executive committee. He held executive informatics roles at Dignity Health from 2011-2018 and helped launch the biomedical informatics program at Arizona State University. He replaces Jeroen Tas, who is leaving the company to spend more time coaching digital businesses.
Divurgent hires Adam Tallinger (Impact Advisors) as VP of provider services.
Northern Inyo Healthcare District (CA) will implement Cerner Millenium through the CommunityWorks program.
Sharp HealthCare is using Experian Health’s Patient Schedule to allow patients to self-schedule COVID-19 vaccinations.
Highmark Health and Verily will develop digital solutions for chronic care management in a six-year collaboration that includes Verily-owned wellness app vendor Onduo, whose CEO is former National Coordinator Vindell Washington, MD, MS.
Diameter Health develops a HL7 C-CDA Online Search Tool for the Consolidated Clinical Document Architecture and its Companion Guide.
Community Hospital (CO) goes live on Meditech Expanse.
Gatorade introduces its first wearable, a “sweat patch” and IOS-only app that measures sweat loss during exercise to recommend the volume of sports drink to consume as a replacement (guess which one?) Single-use patches costs $12.50 each, which would seem to limit the potential customer base.
Period tracking app vendor Clue earns FDA clearance for its “digital birth control,” which statistically models a woman’s self-reported period onset to predict days where they are more likely to become pregnant. The company claims that the app is 92% effective with typical use, although it recently removed a similar feature from its period tracking app because it was found to be unreliable for avoiding pregnancy. The company’s user access agreement had better be airtight to prevent disastrous payouts from the inevitable lawsuits that claim unwanted pregnancy in demanding the net present value of the resulting lifetime cost.
Senior living community operator Asbury Communities renames its Frederick, MD-based IT outsourcing and consulting group to ThriveWell Tech.
Government and Politics
CMS hires Liz Fowler (Commonwealth Fund) to lead its Center for Medicare and Medicaid Innovation.
Naval Medical Center San Diego goes live on Cerner in the fourth wave of the DoD’s MHS Genesis rollouts.
COVID-19
President Biden says that the US will have enough doses of COVID-19 vaccine to give every adult American their shots by the end of May, cutting two months off the previously announced timeline.
Merck will help competitor Johnson & Johnson manufacture the latter’s COVID-19 vaccine in a deal brokered by the White House to ramp up supplies. Merck, which manufactures and sells several other vaccines, halted Phase 1 clinical trials of its own COVID-19 vaccine on January 25 when the product failed to elicit adequate antibody response.
Novavax expects FDA to issue Emergency Use Authorization for its COVID-19 vaccine as early as May. Novavax, which has a contract to supply 100 million doses to the US, was forced to delay the start of its Phase 3 trials twice due to manufacturing holdups, possibly giving it a too-late start in the race and raising the potential that patients will go off-study to get a known vaccine rather than a possible placebo.
Microsoft admits that problems with its COVID-19 vaccine appointment scheduling system have caused frustration for several states and their residents, with errors, web page crashes, and inability to complete appointments. The timing is not great given that the company’s recent rollout of Microsoft Cloud for Healthcare.
Researchers find that high employee turnover at nursing homes may have contributed to their large number of COVID-19 deaths, as their infection control practices may not have been adequate. The average nursing home experienced a 128% one-year turnover rate, while some exceeded 300%. Owners of nursing homes, many of them for-profit companies and private equity firms, say Medicaid doesn’t pay them enough to ensure adequate staffing, while observers note that any increase in federal payments should be earmarked to make sure they don’t end up in the pockets of those owners.
Colleges that spent big money on symptom-based COVID-19 screening technologies such as temperature scanners, self-reporting app passports, location tracking, and heart rate monitors have seen few results because the technologies can’t detect pre-symptomatic carriers, they are often inaccurate, and they aren’t always used consistently. Most of the schools, some of them eminent medical research centers, aren’t studying the effectiveness and outcomes of their use of the technologies.
The founder and CEO of Zocdoc explains why vaccination self-scheduling is harder than it looks:
Walled garden practice management systems weren’t designed to connect to patient-facing scheduling systems.
Sign-up screens collect too much information upfront before showing any available appointments, and if none are available, the user is required to start over to try again.
Too little time was available to develop scalable, integrated systems.
Other
Nursing informatics students: AMIA is offering a travel stipend for poster presenters at this fall’s annual symposium in San Diego, with submissions due March 10. That’s bringing back my fond memories of HIMSS in San Diego, where I enjoyed the opening reception on the patio overlooking the bay, Old Town for Mexican food, and Balboa Park for walking in the sun. They still haven’t expanded the civic center, so San Diego will remain a HIMSS orphan along with New Orleans, Atlanta, and Dallas (I’m excluding Chicago since HIMSS is like a jilted lover who wants desperately to patch things up despite its two-for-two whiffs).
Madison Magazine profiles Carebot Health, launched by Healthfinch co-founder Jonathan Baran and former Healthfinch sales director Tyler Marklein last March. The startup is focused on helping providers use its automated software to manage COVID-19 vaccinations. Health Catalyst acquired Healthfinch in July for $40 million.
In a reverse telemedicine (or perhaps a telejudicial) session, California’s medical board investigates a plastic surgeon after he reports to his Zoom traffic court hearing while wearing scrubs in front of a patient who was on the operating table. A Superior Court commissioner ends the proceeds — eloquently, I would say — in explaining, “Unless I’m mistaken, I’m seeing a defendant that’s in the middle of an operating room appearing to be actively engaged in providing services to a patient … I do not feel comfortable for the welfare of a patient if you’re in the process of operating.”
Sponsor Updates
Meditech announces that 61 hospitals went live on Expanse in 2020.
Cerner Chief Human Resources Officer Tracy Platt joins the Kansas City Chamber of Commerce board.
Deloitte will offer CareSignal’s Deviceless Remote Patient Monitoring to its healthcare clients.
ChartSpan announces its partnership with I2I Population Health.
The local news covers the new $240 million CoverMyMeds headquarters, set to open sometime this summer.
Staffing Industry Analysts includes Ettain Group CEO Trent Beekman on its “Staffing 100” list.
Wolters Kluwer Health introduces Lippincott Clinical Context, a suite of digital learning tools intended to help medical schools as they incorporate digital and remote instruction into their curriculum.
Fourteen healthcare organizations come together to form Connecting for Better Health, a California-based coalition in support of state efforts to create a unified HIE.
UK-based virtual care company Babylon Health names Steve Davis (Expedia) CTO, Stacy Saal (Amazon) COO, and Paul-Henri Ferrand (Brex) chief business officer.
March 1, 2021Dr. JayneComments Off on Curbside Consult with Dr. Jayne 3/1/21
My calendar made me smile today with an appointment reminder that had 2020 been a normal year, I would be in Las Vegas attending HIMSS21 and drinking martinis with all of my healthcare IT friends. Alas, it was not meant to be. Instead, I’m ever-present in my home office digesting a constant stream of email, press releases, and journal articles.
The theme of the week seems to be telehealth, with different companies in the news. MDLive, which was thought to be setting up for an IPO, was instead acquired by Cigna’s Evernorth subsidiary. At the same time, Mercy and Humana teamed up to expand access to telehealth services for Humana Medicare Advantage members. The latter agreement is particularly interesting because it specifically called out a value-based care component of the relationship. Once the US healthcare system begins to fully process the burden of COVID-related care, I suspect there will be a greater drive towards value-based care.
Due to the fragmented testing strategies across the country, many patients are receiving high-cost testing at urgent care centers that require a physician visit to justify the testing. A better strategy would have been to enable public health-based testing, where patients could have been tested under standing orders from local public health authorities, reducing the overall burden on the system. The nation has been walking a tightrope, balancing the need to ensure access to testing with the potential for out-of-control testing costs.
I see this in my urgent care practice, which is one of the organizations requiring a provider visit prior to testing. Patients are seen and examined, then the most appropriate test is determined, ordered, and obtained. Over the last few weeks, we’ve seen a shift in testing behavior. Previously, the majority of our tests were done on symptomatic or exposed patients, with rare testing for travel. Now we’re seeing a boom in pre-travel testing, and doing that kind of testing in an urgent care setting is a significant waste of resources. We are also seeing people just coming in to be tested weekly because they can, and because they don’t have any financial skin in the game. They’re going about their lives unmasked and practicing unsafe behaviors and the rest of us are picking up the tab.
Out of necessity, we don’t want to create barriers to testing, and as a physician, I totally get that. Recent executive orders and subsequent guidance from federal agencies make it clear that patients must be tested with no cost sharing or utilization management oversight. As someone watching the costs mount, especially in states that didn’t bother to prioritize low-cost testing options, it’s anxiety-provoking.
Fast-forward then to a new world where payers are going to be looking to make up for all of those expenditures. Premiums are certainly going to rise, and they’re going to crack down on payments for other services. I predict that use of low-cost telehealth services will be pushed to the forefront. That’s good for patients who are technology-savvy and value the convenience. It’s not so good for patients who don’t have access to technology or aren’t skilled with it, or for whom an in-person visit would be better. Telehealth may become an additional layer of triage that helps control which patients receive more expensive in-person services, and this is most certain to happen if payment parity for telehealth services does not continue.
Practicing in a telehealth environment doesn’t come naturally to physicians, and few schools taught telehealth skills prior to the pandemic. I enjoyed reading a recent article in the American Family Physician journal which explained how to do high-quality management of musculoskeletal issues through a telehealth encounter. That’s the kind of practical retraining that many physicians are going to need if they’re going to be expected to practice in that world. They shouldn’t be expected to just figure it out on their own, as most have had to do.
But if they are going to be held to the same value-based care metrics and standards that they are held to in the brick-and-mortar world, they’re also going to need adequate telehealth infrastructure to deliver it. This means being able to coordinate visits with ancillary providers such as registered dieticians or certified diabetic educators and being able to leverage high-quality remote patient monitoring services. Although these are great concepts, we’re not remotely close to delivering that level of care to most of the US.
I’ll be watching the recent telehealth acquisitions, agreements, and expansions closely to see who is hitting the mark and who starts drifting off course. Many organizations will be forced to migrate from make-do virtual visit platforms to robust telehealth solutions that integrate with the EHR. Physician groups will have to determine how they figure telehealth into evolving physician compensation strategies. Much like groups might pay physicians less when they stop taking overnight call, will they pay physicians less if they elect not to come into the office? Will they create different kinds of practice-share arrangements for teams of virtual and in-person physicians to partner together? Will telehealth be part of a continuum of care, or will it continue to be a bit siloed?
I’ll also be watching lab and other ancillary businesses. Will the big lab vendors start performing COVID testing in person, so that a patient could receive a telehealth-driven order for testing and go to a lab patient service center to have it collected, just like they might go for a blood draw or a urine culture? Or will local public health agencies step up to fill that void, especially since those states that had mass testing centers are starting to close them down? Will we see COVID testing booths on street corners like you might see in other countries? The devil will be in the details as far as how we try to contain costs and deliver the medical services that provide the most value to our patients without breaking the bank.
Looking in your crystal ball, what do you think are the next steps for telehealth in the US and around the world? Will we see massive shifts in utilization? Leave a comment or email me.
Cigna’s Evernorth health services business will acquire telehealth vendor MDLive, the company announced Friday. Terms were not disclosed.
MDLive had raised $200 million and was reportedly valued at $1 billion early last fall, when it was considering an IPO.
Reader Comments
From Umbrella Beverage: “Re: Twilio. Was down Friday, affecting the ability of multi-factor authentication vendors (Entrust, Duo, Imprivata) to send out second-factor push or SMS notifications to phones, thus the ability of those users to access any services. Have the Russians figured out that Twilio is the center of the SMS universe?” Twilio’s incident log shows Friday downtime with “cross-platform API erors involving multiple products” that was resolved at just after noon Eastern on Friday. I’ll take this as an opportunity to provide some background on Twilio. The company offers APIs for sending and receiving phone calls and text messages, such as those for two-factor authentication, and Epic uses Twilio Programmable Video for its native telehealth offering. Twilio is huge, with 4,500 employees, over $1 billion in annual revenue, and a $61 billion market cap. TWLO shares are like riding a rocket, up 240% in the past year versus the Dow’s 20% rise. Had you invested $10,000 on April 20, 2020 when the company’s deal with Epic was announced, you would be holding well over $36,000 in shares today. The co-founder and CEO is a multi-billionaire, of course.
HIStalk Announcements and Requests
One might quibble with the clinical and business operations of hospitals, but don’t doubt their ability to market themselves, although their owned medical practices don’t register to poll respondents any higher than independent ones (probably because they don’t always make their ownership obvious).
New poll to your right or here: How does your employer’s company culture compare today to a year ago? Define “company culture” however you like, but in general, think of the company’s social fabric – what it encourages or discourages, how it relates to employees and customers, how well its goals align with those of employees, and how its beliefs and leadership practices are likely to make it successful for the long term. Vote, then click the “comments” link to explain whether you saw changes during the pandemic.
March 1 isn’t spring, but with the changes in weather and COVID-19 trajectory, it feels that way, especially now that baseball spring training games have started. It was one year ago Friday that HIMSS20 was cancelled, an early warning that 2020 was going to be eventful in all the wrong ways. Parts of the country that were almost cold enough to store Pfizer’s COVID-19 vaccine on the back porch last week have swung to daytime highs that are nearly 100 degrees warmer. I get the feeling that the US economy is about to rebound vigorously, although national debt, lingering and structural unemployment, political divisiveness, and income inequality are sobering long-term issues that could have major geopolitical ramifications.
I started subscribing in 2017 to a little-known app called Texture, which was like the Netflix of magazines. Apple bought the company a few months later, subscriptions automatically lapsed while Apple retooled their acquisition, and I lost interest and didn’t sign up under the newly christened Apple News+. I discovered this weekend that Mrs. HIStalk had subscribed on her own, mostly to read The Atlantic, and I Googled to find that her $9.95 per month subscription can be shared by up to six family members under Apple’s Family Sharing (which also includes Apple’s music, TV, games, and ICloud storage subscriptions – am I the only person who didn’t know about this?) I’m back in, and minor quibbles aside about lost features (easy back-issue searching, such as for Consumer Reports), it’s better now. Included are a bunch of expensive national newspapers, like the Los Angeles Times and San Francisco Chronicle; the Wall Street Journal (!!); Business Insider; PCMag; National Geographic; Consumer Reports; and 300 magazines with a nice mix of travel, food, sports, and vacuous celebrity updates. Like Texture before it, you can follow specific publications or topics, but it also brings up articles it thinks you’ll like based on your perusal habits, giving you an endlessly scrolling page of reading material that beats the heck out of killing time on Facebook looking at feta pasta recipes and faked prank videos.
Webinars
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.
Acquisitions, Funding, Business, and Stock
Health Catalyst reports Q4 results: revenue up 22%, EPS –$0.16 versus -$0.21, beating estimates for both. HCAT shares are up 69% in the past 12 months versus the Nasdaq’s 54% gain, valuing the company at $2.1 billion.
Paul Black chose the perhaps unfortunate term of “infectious enthusiasm” to describe the company’s success in 2020.
The company will continue to encourage on-premise clients to move to its Azure-powered hosting services.
The Veradigm EHR and linked claims data-selling business was discussed at some length, with the company noting that while most of its data comes from the ambulatory EHRs of customers, that’s the most important to drug companies since that’s where most prescribing happens.
CEO Paul Black reiterated that it sold EPSi and CarePort Health in Q4 because those businesses “were not receiving the appropriate valuation under Allscripts ownership.”
Black says he does not see the just-formed Truveta organization, which includes big Allscripts client Northwell, as affecting its Veradigm business.
President and CFO Rick Poulton says that the company’s “extensive data rights” from its ambulatory EHR customers give Veradigm an advantage over competitors who are chasing that “in vogue” business model.
Allscripts expects the fragmented US EHR market to consolidate and the company expects to be a net winner in system replacement, while “outside the US is still a lot of greenfield.”
Black said, in response to an analyst’s question, that client feedback on Sunrise 20.0 has been “universally positive,” but declined to specifically answer another question about the number of Sunrise clients.
Humana will offer its Medicare Advantage customers who are patients of Mercy access to the health system’s Mercy Virtual telehealth service. Also included in the agreement is a value-based care component, where Humana will pay Mercy based on outcomes instead of fee-for-service.
TriNetX appoints four new members to its board following October’s acquisition of a majority stake in October 2020, including former Pfizer Chairman and CEO Ian Read as chair.
COVID-19
FDA issues its Emergency Use Authorization to the COVID-19 vaccine of Johnson & Johnson’s Janssen subsidiary, a single-shot product that requires simple refrigeration instead of the two-shot, freezer-stored vaccines from Pfizer and Moderna. The boost in vaccine supply to 20 million doses per week, along with the new vaccine’s simple storage requirements, could add up to 25% to US vaccination capacity almost immediately. Mostly missed by the press – the first two vaccines were tested before coronavirus variants surfaced, so their efficacy against them is unknown, but the J&J vaccine were tested later and was proven to be effective against those variants (suggesting that the other two vaccines probably are also effective).
CDC reports that 73 million doses of COVID-19 vaccine have been administered out of 96 million distributed (76%), with 19% of the adult US population having received at least one dose. The pace could soon reach 3 million doses per day.
A KFF poll finds that the percentage of Americans who plan to wait and see before being vaccinated has dropped from 39% in December to 22% now. The 15% who say they won’t get it under any circumstances remains unchanged. Groups with the highest resistance to being vaccinated are Republicans and rural residents, while 25% of non-healthcare essential workers and 14% of healthcare workers fall into the “wait and see” category.
The state of California declines to renew its coronavirus mobile testing contract with Alphabet-owned Verily, which the federal and state government touted last year as a high tech approach to help Americans find COVID-19 testing. The state says the program, which cost $63 million and was operated entirely by subcontractors, didn’t serve poor areas of the state. Optum/UHG-owned OptumServe is now operating state vaccine clinics, but one county had already cancelled its contract with OptumServe, saying that its testing clinics were poorly run, performed only a few dozen tests in each 12-hour session, spent a lot of money sending negative tests results by FedEx next-day delivery instead of electronically, and were staffed by employees who were “coughing violently” and not wearing PPE.
Other
A two-year study finds that Medicare’s PAMA decision support requirement for ordering expensive advanced imaging exams – as implemented with Change Healthcare / National Decision Support Company CareSelect – improved ordering appropriateness. The authors note the limitations of their study – inappropriate use could have been reduced by other simultaneous changes, users can game CDS by choosing an invalid ordering reason, and the lack of pre-CDS implementation data – but their next step will be to have experts determine order appropriateness by reviewing EHR and imaging data.
A few Epic employees told the Madison paper that the company has told employees to stop holding discussion groups related to diversity, equity, and inclusion on company time and has eliminated a training session on identifying white privilege. The article notes that Epic, with $2.9 billion in annual revenue and 10,000 employees, is unusual for not having a chief diversity officer or other executive to manage equity and inclusion and instead created a a diversity council made up of five employees who still work in their full-time jobs.
A Florida pediatrician who was arrested on child pornography charges asks the court to let him conduct telehealth visits. He initially told investigators that he thought he was downloading photos of older girls, but finally agreed with a detective’s observation that a pediatrician should be able to recognize pre-pubescent children.
Sponsor Updates
Meditech launches a Telemetry Appropriateness Toolkit in its Expanse EHR.
PatientPing publishes a new case study, “How Kintegra Health is improving transitions of care and succeeding in value-based care programs through real-time ADT notifications.”
PeriGen’s innovative perinatal technology supports the US Surgeon General’s call to action to improve maternal health.
The Ethisphere Institute recognizes Premier as “One of the World’s Most Ethical Companies” for the 14th year in a row.
Pure Storage announces fourth quarter and full year fiscal 2021 financial results.
Sectra publishes a new e-book, “The radiologist’s handbook for future excellence 2021: Key technologies to amplify success.”
Krames publishes a new infographic, “Easy telehealth tips to drive positive patient experience.”
Vocera releases a new podcast, “The Burden and Joy of Caregiving During the Pandemic.”
February 26, 2021WeekenderComments Off on Weekender 2/26/21
Weekly News Recap
Allscripts and Teladoc Health release quarterly results.
Healthcare Bluebook acquires the quality division of Quantros.
Innovaccer raises $105 million at an implied valuation of $1.5 billion.
Redox announces a $45 million Series D funding round.
Google Health expands the pilot of its EHR search and data presentation tool, which it has named Care Studio.
IBM is rumored to be looking at selling IBM Watson Health.
Best Reader Comments
When resource limited, and dealing with existing systems and a legacy of choices, “apps are dead” can sound a little blasé and soundbite-y. Now add in organizational politics, budgeting, and available skill sets. The choices get more complicated. Absent those factors though, there’s a lot to like about “apps are dead”. You get a single code base that supports all devices. Support lines tend to be simpler too. But sometimes? An old app can do a better job than the new replacement! (Brian Too)
I think the green passport idea is great. It might allow the free market to push the vaccine-hesitant to get on board when businesses and airlines start advertising special privileges for passport holders. The problem in the US, though, is that we can’t seem to get a nationwide IT system for anything unless it involves the IRS. (Bob)
We should challenge developers (I am one) to think critically. Also, bugs aren’t exclusive to coding errors. (RobLS)
Watercooler Talk Tidbits
Two Vanderbilt University Medical Center physicians publish “From Two Doctors,” a newsletter that highlights the pandemic’s unsung heroes. Assistant Professor of Clinical Medicine Michelle Izmaylov, MD is a published author of fantasy fiction books and medical essays, while Thea Swenson, MD is a medical resident who formerly worked in health IT startup marketing and product development. Both are first-generation Americans, from Russia and Vietnam, respectively.
A technology reporter whose broken collarbone left him with his arm in a sling for six weeks describes how accessibility technology helps people with disabilities. Topping his personal experience list is AI-based transcription for typing on all devices, which taught him that voice typing on his phone is three times faster than finger typing. He likes the dictation and voice control technology of Google Docs best. Runner-up accessibility winners are biometric authentication, password manager apps, and finger swipe typing.
PCP versus demanding customer: In Australia, D-list reality show celebrity Yvie Jones complains in a profanity-filled Instagram post that she saw her doctor about a lump on her neck and while there, he suggested that she see a dietician. She declared that she has been “weight-shamed by my doctors for years” and said that she and many others “would rather die than be spoken so poorly to” by doctors who “never focus on what we’re there for.” She has previously posted recaps, sometimes with photos, of her other medical issues, including case of hives following a cat allergy, peri-menopause, iron deficiency, abdominal cramping, a back problem, depression, and weight loss surgery.
NHS England urges people to ignore the medical advice of celebrity huckster Gwyneth Paltrow, who claims that her COVID-19 infection and the resulting long COVID were successfully treated with her expensive, Goop-branded nutritional products. If faux COVID cures aren’t your thing, the college-uneducated GP will be happy to sell you – hopefully delivered in an unlabeled package – an $80 candle that smells like her vagina.
The Hot Ones is brilliant. There have been many great interviews, the host does his homework. Also worth looking for…