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News 8/18/21

August 17, 2021 News 11 Comments

Top News

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Streamline Health Solutions, developer of pre-bill coding audit technology, acquires RCM software and consulting firm Avelead for $20 million.

Avelead President and CEO Jawad Shaikh will remain in those roles, reporting to his Streamline counterpart Tee Green, co-founder and former head of Greenway


Reader Comments

From Borlander: “Re: HIMSS21. A vendor rep I was supposed to meet with after HIMSS just tested positive for COVID. Who could have predicted that?” I was relieved that my antigen test was negative while simultaneously wondering if other attendees are getting less-cheery news.


HIStalk Announcements and Requests

HIMSS tells me that total HIMSS21 in-person attendance was 19,000, a lot more than it seemed on the ground.


Webinars

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


Acquisitions, Funding, Business, and Stock

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ClosedLoop.ai raises $34 million in a Series B funding round, bringing its total raised to $45 million. The startup, which has developed AI-powered predictive data modeling software, won the CMS AI Health Outcomes Challenge earlier this year.

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Care coordination and social services referral company Unite Us acquires analytics vendor Carrot Health.

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The Washington Post describes what can happen when non-profit hospitals “experiment as venture capitalists” via technology investment, describing the $12 million spent by Cone Health (NC) to successfully develop diabetes management app Wellsmith. The health system shut the startup company down because its product wasn’t competitive and its success at keeping people healthy would have jeopardized the health system’s predominantly fee-for-service revenue. Former Wellsmith CEO Jeanne Teshler lists problems with having a health system as its key investor:

  • Cone was not willing to be a customer of Wellsmith because only a minority of its patients were covered by value-based care such as Medicare Advantage and ACOs and thus Cone could not bill insurers for the service.
  • Patients had to purchase home devices that weren’t covered by insurance.
  • Wellsmith released a software update that was a “dismal failure.”
  • Cone was considering an ultimately failed merger and its financial commitment to Wellsmith was uncertain.
  • Health systems that have venture funds won’t buy products that are funded by other health systems.

Sales

  • UnityPoint Health (IA) will implement Premier’s PINC AI technology, supply chain services, and service line analytics, and will join its GPO.
  • Ellis Medicine (NY) offers patients access to virtual mental healthcare using technology from AptiHealth.
  • ChristianaCare (DE) joins Premier’s supply chain service network.
  • In the UAE, Medcare Hospitals & Medical Centres will implement InterSystems TrakCare as a Service in its four hospitals and 16 medical centers. Its first hospital is already live in Sharjah.

People

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Cerner hires Lisa Collins, MBA (Accenture) as SVP of global services and Nithya Narasimhan (ADP) as SVP of client relationships in the East region.

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L. Hayley Burgess, PharmD, MBA (HCA Healthcare) joins clinical surveillance company VigiLanz as chief clinical officer.

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Robert Millette, MBA (Lee Health) joins Integrated Care Solutions as VP of delivery innovation.

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Cantata Health Solutions names Scott Anderson, MBA (Netsmart) SVP and GM of managed services and Adam Feldman (Qualifacts) SVP of sales.

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Symplr hires Kristin Russel, MBA, MPA as chief marketing officer.


Announcements and Implementations

Qardio launches QardioDirect, a remote patient monitoring and telemedicine service for patients with chronic conditions.

Ciitizen announces GA of its Cures Gateway, software designed to help HIEs comply with medical records requests initiated by patients.

Children’s National Hospital (DC) earns URAC’s first pediatric hospital telehealth accreditation.

UnitedHealth’s Optum subsidiary revamps its Optum Store to add direct-to-consumer services such as virtual care and prescriptions for people without insurance, including offerings that will compete with investor-funded storefronts such as Ro and Hims.


Government and Politics

CMS has sent warning letters to 165 hospitals that haven’t posted their negotiated prices, although it has not issued fines. A patient advocacy group’s study found that 94% of hospitals haven’t complied and are theoretically liable for a fine of $300 per day, although CMS has suggested that the penalty isn’t enough and wants to increase it to $10 per bed per day for larger hospitals.


COVID-19

CDC numbers suggest that the predicted plateau in new COVID-19 cases has likely occurred and cases are beginning to trend down, although hospitalizations and deaths lag by weeks.

Texas orders five refrigerated mortuary trailers that will be staged from San Antonio. The state has 12,000 COVID-19 patients in hospitals which also contain the most pediatric COVID-19 patients of any state at 239.

A public health study in Canada finds that while teens are more likely than babies and toddlers to carry coronavirus into their homes, it’s the younger children who are more likely to spread it to other household members, probably because those children require more hands-on attention and cannot be isolated when they exhibit symptoms.

Hillsborough County, FL reports that 5,600 students and 300 employees were in isolation or quarantine as of Monday morning after just four days of school.


Other

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Memorial Health System works to recover from a ransomware attack early Sunday morning that caused it to shut down its IT systems, divert emergency patients, and cancel surgeries and radiology exams at its facilities in Ohio and West Virginia.

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Johns Hopkins Medicine clinicians and IT staffers develop a Video Visit Technical Risk Score in Epic to determine which patients might be in need of technical support ahead of their virtual care appointments. The score, automatically calculated using EHR data, can be displayed as part of a user’s schedule view.

Weird News Andy challenges readers to come up with the most inappropriate healthcare acronyms and will judge submissions to select a winner. He kicks it off with HAPI (hospital-acquired pressure injury).


Sponsor Updates

  • Elsevier adds new features to its ClinicalKey medical resource search engine, including a new user interface, improved search functionality, and significant point-of-care content.
  • AdvancedMD publishes the 2021 edition of its “MACRAnyms” e-book.
  • The Empowered Patient Podcast features Capsule’s head of clinical informatics, John Zaleski.
  • Cerner releases a new podcast, “Supporting digital innovation in children’s healthcare.”
  • OptimizeRx partners with Demandbase to expand its direct-to-physician, account-based digital touchpoints for life sciences.
  • CHIME’s latest podcast features CHIME board member, boot camp faculty member, and healthcare leader George “Buddy” Hickman.
  • Dina will exhibit at the Rise West Medical Advantage Senior Leadership Conference August 30-September 2 in Colorado Springs.
  • EClinicalWorks releases a series of podcasts focused on “How Health Centers Nationwide are Improving Access to Care.”
  • Ellkay will exhibit at Epic UGM August 23-25 in Verona, WI.

Blog Posts


Contacts

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

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Morning Headlines 8/17/21

August 16, 2021 Headlines 1 Comment

Kareo Acquires PatientlySpeaking to Add RPA-Powered Capabilities for Billing Companies and Medical Practices

Ambulatory health IT vendor Kareo acquires PatientlySpeaking, which offers automated billing solutions to physician practices and billing companies.

The Network for Regional Healthcare Improvement and Strategic Health Information Exchange Collaborative Announce Affiliation; New Organization to be named Civitas Networks for Health

The Network for Regional Healthcare Improvement and the Strategic Health Information Exchange Collaborative will merge to form a new HIE organization called Civitas Networks for Health.

Streamline Health Expands SaaS Portfolio Through Acquisition of Avelead

Streamline Health Solutions acquires RCM software and consulting firm Avelead for $20 million.

Curbside Consult with Dr. Jayne 8/16/21

August 16, 2021 Dr. Jayne 1 Comment

Earlier this week, a friend shared a Health Affairs blog piece looking at the future of innovation at the Centers for Medicare and Medicaid Services. The blog is co-authored by Chiquita Brooks-LaSure, MPP, incoming administrator of the Centers for Medicare and Medicaid Services.

It starts by explaining the creation of the Center for Medicare and Medicaid Innovation, also known as the Innovation Center, as part of the 2010 Affordable Care Act. The primary role of the Center is to create movement towards a healthcare system in the US that revolves around value-based care, the core of which is reducing spending while delivering high quality care. The forces behind the creation of the Center tell a hard truth – that healthcare in the US is expensive and doesn’t always deliver high quality outcomes.

I enjoyed the summary of what has happened over the last several years. For some of us who live this day to day, you kind of lose the forest for the trees. I didn’t realize that there have been more than 50 alternative payment models launched. I can probably only think of a couple off the top of my head, so it would have been interesting to see a list of all of them. The authors describe having “taken stock of lessons learned” as they begin to map out value-based care plans for the next decade.

Looking at the past so we don’t continue to repeat our mistakes is already a good thing. I hope they looked beyond clinical and cost outcomes to also see what the impacts (positive or negative) have been on clinicians. It’s important to understand whether programs that achieve the stated goals promote a stable physician workforce or whether they become just another factor that drives good people to reduce their schedules or to leave medicine altogether.

They note that six models have created a statistically significant savings for Medicare and US taxpayers:

  1. ACO Investment Model
  2. Home Health Value-Based Purchasing Model
  3. Medicare Care Choices Model
  4. Maryland All-Payer Model
  5. Pioneer ACO Model
  6. Repetitive, Prior Authorization of Repetitive, Scheduled Non-Emergent Ambulance Transport Model

I had only heard of two of these and only had more than a passing familiarity with one, so am interested to learn about the rest of them.

The authors “explicitly acknowledge health equity as a central goal for this vision.” We’ve known about the challenges for medically underserved populations and areas for many decades now and I’m eager to hear how they plan to improve care delivery in those communities. They note six key takeaways from the lessons of history:

  1. “The Innovation Center should make equity a centerpiece of every model.” This means going beyond Medicare and those organizations that have had the resources to participate and drawing in Medicaid, rural, and safety net providers.
  2. “Offering too many models is overly complex, particularly when models overlap.” Apparently, there are 28 models running concurrently, which can create conflicting incentives as well as making it difficult for participants to figure out drivers and outcomes. They will focus on offering fewer models going forward.
  3. “The Innovation Center needs to re-evaluate how it designs financial incentives in its models to ensure meaningful provider participation.” For most of the Meaningful Use period, my practice simply opted out. The burden to providers was far more than the penalty, so we took the penalty and moved forward. The authors admit that there have been challenges in testing some of the models because providers don’t join or opt out when they think they will lose money.
  4. “Providers find it challenging to accept downside risk if they do not have the tools to enable and empower changes in care delivery.” One future goal is to have manageable levels of risk for providers as well as providing supports needed to help providers take on more risk.
  5. “Challenges in setting financial benchmarks have undermined our models’ effectiveness.” They are looking at ways to modify the current risk adjustment methodology and to make sure that models aren’t leading to overpayment. I know that my colleagues will likely be excited about the former, but not so much the latter.
  6. “Innovation Center models can define success as encouraging lasting transformation and a broader array of quality investments, rather than focusing solely on each individual model’s cost and quality improvements.” They plan to scale practices that work in models by adding them to other models, to Medicare, and to Medicaid.

They go on to say that “in order to deliver on the promise of putting people at the center of their care, we need a health system that meets people where they are, keeps people healthy and independent, and coordinates care seamlessly and holistically across settings.” That statement sounded suspiciously like everything I was taught in my family medicine residency training, and I remembered how enthusiastic and idealistic I was when I graduated. Those feelings were quickly beaten out of me as I grappled with the world of prior authorizations, difficulty getting my employer to allow me to spend what I needed to hire high-quality office staff, and the crush of trying to coordinate it all while seeing 30 patients a day.

I paused for a few minutes to reflect on that before I read the rest of the blog because I wanted to see what the Innovation Center was going to propose to counter the forces that drove me out of traditional primary care.

They have identified five strategic objectives:

  1. “Drive Accountable Care.” They hope to reduce fragmentation by rewarding coordinated and team-based care the delivers high-quality outcomes. Accountable Care Organizations are a central part of this plan.
  2. ”Advance Health Equity.” Elimination of health disparities is a key goal, with one action being the active engagement of providers who have not historically participated in value-based care incentive programs. Another action is ensuring that application processes and eligibility criteria include organizations that care for disadvantaged populations. Partnership with Medicaid will be a key activity.
  3. “Support Innovation.” They propose delivering tools that help close care gaps, including addressing mental health and social determinants of health. These tools may include access to real-time data to support providers, flexibility in rules, and looking at targeted approaches to impact specific populations.
  4. “Address Affordability.” The goal is to not only lower spending for Medicare and Medicaid, but also to lower patients’ out of pocket costs. This may mean waiving cost-sharing for certain services, controlling drug prices, or reducing low-value care that is wasteful.
  5. “Partner to Achieve System Transformation.” I love me some clinical transformation, but know that the devil will be in the details for this one. CMS knows that it needs partnership with not only Medicare and Medicaid but with patients, providers, payers, and community-based organizations. The people problem is often one of the most difficult to solve, so I wish them well.

It will certainly be interesting to see what the next decade brings, especially with the ongoing challenges from a global pandemic that shows no signs of stopping, a completely burned-out clinical workforce, and tip of the spear care delivery organizations that are stressed to the max. Many healthcare organizations are not ready to take on one more thing, especially when it puts more strain on the system. I’d be interested to see if readers have any insight or thoughts to offer.

Who’s ready for the next evolution of value-based care? Leave a comment or email me.

Email Dr. Jayne.

Readers Write: When Hospitals Leave Patients in the Wild West, They Turn to Dr. Google

August 16, 2021 Readers Write 1 Comment

When Hospitals Leave Patients in the Wild West, They Turn to Dr. Google
By Mike McSherry

Mike McSherry is co-founder and CEO of Xealth of Seattle, WA.

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Good or bad, everyone has a memorable care experience. This unites us all. The division comes with how it is handled. Viewing the patient as a customer is not a new concept. So why don’t more systems anticipate our needs? Think of your experience with Google or Instagram ads. Scrolling through websites or social media, I think they may know my habits better than the doctor.

I spent 20 years in consumer technology, co-founding companies such as Boost Mobile and Swype, before joining the Providence health system as an entrepreneur in residence. I understand digital innovation in the age of immediacy. With so much information at the patient’s fingertips, it seems like a no-brainer to consult the internet. Why go to an in-person appointment when Dr. Google is just a house click away?

According to Comprehensive Psychiatry, “Googling symptoms results in an escalation of concerns and excessive worrying about symptoms.” It’s our job as healthcare purveyors to ensure the best experience possible for the patient. This experience should be comprehensive, forward-thinking, and, most importantly, conveniently available at 2:00 a.m. when a concerned father wants to know about his child’s fever.

Many times, patients are required to go for an in-person appointment for something they see as simple. Then, wait weeks or longer for that appointment. Once there, physicians have just 15 minutes to address the visit reason, and then … what? If the patient forgets something said or thinks of a question later, there are typically three choices: play phone tag with the office, wait until the next appointment, or consult Dr. Google.

Who is stepping in to fill that information void between appointments? People trust their doctors, but will search online if there is no simple way to get the answers they seek, finding who knows what in their Wild West Web search. Hospitals and health systems would benefit through offering a thorough digital experience. Not only would patients be receiving credible information, it will also give one more touch point, tightening the patient relationship while reducing office phone tag.

Garnering patient trust requires that health organizations update the user experience to accommodate immediacy and convenience. Think of your own care experience. While physically in the office, everything you are told either sounds great or could be confusingly technical. A few hours later, you question certain details or lose the paper print out. It is all too enticing to do a quick search.

Health technology can extend clinical time beyond the office and to the patient. The pandemic drove that point home, along with care options. There are several ways a doctor can be present, along with prescribing apps, health monitors, Ace bandages, diets, or anything that could improve the patient experience. This way, patients can continue receiving clinicians’ recommendations rather than an article Aunt Ada saw on Facebook — thank you, Aunt Ada.

Adding communication channels from the care team, especially digital ones, instantly raises questions from some hospitals. Who will handle the extra workload and will this hurt reimbursement? With the former, automation can handle much of this with triggers based on appointment type and diagnosis codes. Digital tools should be scalable, enhance service lines, and extend care, helping health organizations provide live-saving programs outside their four walls.

Healthcare may be the only industry where the person ordering the treatment is different from the one who uses it, who is also different from who is paying (try that at a restaurant). While no one likes to talk about it, the money for digital solutions must come from somewhere.

CMS now reimburses for several virtual tools, with commercial payers following suit. Further, open lines of communication and accurate, timely information can prevent emergency room readmissions, assisting quality scores and reimbursement.

There are also the more long-term benefits of patient satisfaction, one metric in determining reimbursement rates, and recommendations. As with other areas of our lives, we want to go where people know our names. Meeting people where they are with targeted, accurate health information furthers the patient bond and keeps the Dr. out of Google.

Readers Write: Creating Resiliency Among the Newest Generation of Clinicians

August 16, 2021 Readers Write 1 Comment

Creating Resiliency Among the Newest Generation of Clinicians
By Acey Albert, MD

Acey Albert, MD is director of clinical content for the Epocrates business of Athenahealth of Watertown, MA.

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Healthcare is facing an immediate crisis that threatens to undermine our ability to deliver care: a massive clinician shortage that grows larger with each passing day. If that isn’t enough, the COVID-19 pandemic accelerated an alarming rate of burnout, trauma, and disillusionment. In fact, according to Athenahealth’s recent Physician Sentiment Index, the fiscal responsibilities of practicing compounded by the pressure of delivering high-quality patient care contributed to feelings of frustration, with 46% of the nearly 800 physicians participating in the survey reporting feeling burned out a few times a month or more.

While there’s no magic wand that could suddenly wave away this multifaceted challenge, there are small changes we can make today to address some of the immediate drivers of this trend head-on.

Support distracted, fatigued minds with “peripheral brains”

Early in clinical training, there arises a certain bravado about memorizing every rare “zebra” condition in the textbooks. Students and residents are interrogated in front of their colleagues about the most obscure causes of a symptom, reinforcing this drive. At every career stage, the pressure to know it all persists. Rote memorization of obscure facts can distract clinicians from using their brains for what really matters: critical thinking, creative problem solving, and building the clinician-patient relationship.

When clinicians are mentally fatigued, access to clinical decision support tools, or peripheral brains, is more vital than ever. Medical knowledge is growing exponentially. For drug therapies alone, there is an endless flow of journal articles updating the indications, dosing, drug-drug interactions, and side effects. Keeping up with medical knowledge that doubles, by recent estimates, every 73 days is a Herculean task, even before a novel coronavirus emerged to spread devastation and confusion across the globe.

Trusted technology resources have made it possible to compile all of that practical clinical information onto a mobile device. Practicing clinicians are digital omnivores, leveraging access to their desktop and laptop computers, smartphones, tablets, and smart watches, among others. With these digital platforms at hand, clinicians are increasingly becoming managers of medical information rather than mental repositories of it.

Reduce clinical decision time through quick-access mobile solutions

If you think about a typical 15-minute office visit in a busy practice, clinicians must call on a large knowledge base in just a few brief moments: perhaps a few minutes during the patient history, another minute or two during the exam, and then — most importantly — in the last moments of the visit while making a diagnosis and developing the treatment plan. Positioning easily accessible reference data at a clinician’s fingertips means they no longer have to comb through their bookshelves or scour the internet to search for key information vital to their decision-making.

Any tool used during those moments of care needs to be quick, accurate, and intuitive. Certain user preferences can help clinicians rapidly and efficiently access the most-valued and most time-sensitive information. Time spent clicking, scrolling, and typing, or worse, figuring out some novel interface, is time not spent meaningfully interacting with patients. Through the use of familiar interaction models common in non-medical apps, such as swipe right or swipe left navigation, medical app interfaces could be leveraged to more expeditiously deliver guidance. Simple favoriting functions and other self-curation tools can also speed access and create shortcuts for busy clinicians.

Increase patient face-time with mobile technology

Throughout the COVID-19 pandemic, clinicians have increasingly been using mobile apps, both to maintain contact with their patients and as a source of trusted information that goes wherever they do. Compared with a desktop or laptop computer, mobile devices keep priorities clearer between clinicians and their patients, whether used in person or virtually.

Providers can easily integrate clinical decision support tools into the patient visit — it’s not necessary to hide them out of sight. Patients typically appreciate when clinicians demonstrate that they are using the latest technology on their behalf. Mobile medical reference apps can be used in the exam room or at the bedside, so the clinician and patient can view the screen together to look at drug interactions, pricing information, and even side effects. Time spent using these resources and apps together can enhance the clinician-patient interaction.

The future role of mobile medical apps in supporting resiliency

It’s anticipated that clinicians will continue harnessing technology like mobile medical reference apps long after this global health crisis subsides, since they can be updated more rapidly than non-cloud-based electronic health records or typical institution-based reference resources.

During the current pandemic, a super-rapid updating pace is vital to combating the even faster, ever-evolving misinformation surrounding COVID-19. Mobile medical apps offer opportunities to increase clinician knowledge and productivity in real time. Expanded use of these technologies holds potential for improving clinicians’ experience of practicing medicine, expanding their skillsets, and ultimately enhancing the quality of care delivered to their patients.

Readers Write: Why Healthcare Organizations Can’t Afford A Data Breach Caused by Human Error

August 16, 2021 Readers Write 1 Comment

Why Healthcare Organizations Can’t Afford A Data Breach Caused by Human Error
By Tim Sadler

Tim Sadler, MA, MSc, MEng is co-founder and CEO of Tessian of London, England.

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$9.42 million. That’s how much a healthcare data breach now costs, a staggering $2 million more than it was a year ago. According to IBM’s 2021 Cost of Data Breach report, data breaches in the healthcare industry are the highest across all industries today. 

While ransomware attacks have dominated the headlines in recent months, the leading cause of data breaches in the healthcare industry is actually miscellaneous errors, with the most common of these mistakes involving an email or file attachment being sent to the wrong person.

We’ve all been there. Faced with looming deadlines and overwhelming to-do lists, you think to yourself, “I’ll just quickly send that by email.” But with healthcare professionals now responsible for more data than ever before, the stakes are high. 

Employees are the gatekeepers to highly sensitive and valuable information, such as people’s personal and medical records, intellectual property, and research and development. With many clinics sharing patients’ information among colleagues or with third-party partners via email, a simple typo could result in lost data, a serious cybersecurity incident, and significant reputational damage. 

This was the case with a gender identity clinic in the UK. An employee accidentally exposed the personal details of nearly 2,000 people because they CC’d recipients instead of BCC’ing them. In addition to damaging patient trust, a mistake like this can cause major legal problems, like violating HIPAA and HITECH laws.

Many IT and security teams may not even realize the scale of the problem that human error poses to their organization. IT leaders surveyed by my company estimated that 480 misdirected emails were sent in their organizations each year. In reality, at least 800 emails are sent to the wrong person in companies with 1,000 employees each year. What’s more, one in five healthcare professionals say they’ve made a mistake that has compromised security while working remotely that no one will ever know about. 

It’s not accidents causing problems. Security leaders know that the vast majority of employees are well intentioned, but there are some people who knowingly exfiltrate data from the organization. In fact, 35% of employees working in the healthcare industry admit to downloading, saving, or sending work-related documents to personal accounts before leaving or after being dismissed from a job. Our platform indicates that at least 27,500 non-compliant, unauthorized emails are sent every year in organizations with 1,000 employees. Security leaders estimated just 720.

Visibility into the threat is sorely needed. You can’t defend against what you can’t see. 

To prevent security incidents caused by human error and avoid the eye-watering costs associated with a data breach, healthcare organizations need to start putting people at the heart of their security strategies and consider how they can best support their riskiest and most at-risk employees. 

Constantly reinforcing security awareness training is an important first step in improving people’s security behaviors. Training can’t be a one-size-fits all, tick-box exercise; it has to be contextual and relevant if it’s ever going to resonate with employees and enforce long-lasting behavioral change. 

Then create and maintain a security culture that empowers employees to make the right cybersecurity decisions. Arm people with the tools and knowledge they need,  in the moment they need it most, to avoid making risky mistakes that can compromise data security. This could mean alerting people to think twice before clicking, rewarding employees for spotting threats, and creating a safe space for people to admit when they’ve a mistake.

Businesses are digitally transforming and ways of working are changing, but one thing remains the same — people are in control of the data and systems. Their behaviors will make or break a company’s security posture. With the cost of a healthcare data breach continually rising year on year and with people being responsible for more data than ever before, IT leaders can’t no longer afford to neglect security at the human layer in their organization.

Morning Headlines 8/16/21

August 15, 2021 Headlines No Comments

Talkdesk Valuation Triples to More Than $10 Billion, Appoints First Chief Financial Officer

Customer experience software vendor Talkdesk completes a Series D funding round that values the company at $10 billion.

Labcorp Extends Leadership in Women’s Health With Acquisition of Ovia Health

Labcorp acquires Ovia Health, which offers health plans, employers, and individuals services that include women’s health coaching and apps for fertility, pregnancy, and baby development tracking.

SOC Telemed Reports Second Quarter 2021 Financial and Operating Results

Acute care telemedicine vendor SOC Telemed reports Q2 results: revenue up 84%, EPS –$0.16 versus –$0.30.

Memorial Health System Experiences Cyber Attack

Memorial Health System puts its emergency departments in Ohio on diversion and cancels surgeries and radiology exams following a cyberattack early Sunday morning.

Monday Morning Update 8/16/21

August 15, 2021 News 3 Comments

Top News

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CMS will require hospitals to attest that they have completed an annual self-assessment of their compliance with the SAFER Guides for EHR safety. The requirement starts with the EHR reporting period in CY 2022.

The nine categories of the Guides are:

  1. High-priority practices
  2. Organizational responsibilities
  3. Contingency planning
  4. System configuration
  5. System interfaces
  6. Patient identification
  7. Computerized provider order entry with decision support
  8. Test results reporting and follow-up
  9. Clinician communication

The SAFER Guides were developed by Dean Sittig, PhD; Joan Ash, PhD, MLS, MS, MBA; and Hardeep Singh, MD, MPH with the support of ONC. They first published the SAFER Guides in early 2014.


Reader Comments

From Recapper Rick: “Re: HIMSS21. Hot topics from the exhibit hall?” That’s always subjective, but I’ll try (and encourage others to chime in), remembering that low exhibitor count means underrepresentation of some topics:

  • Hot: telehealth, remote patient monitoring, cybersecurity, AI, interoperability, health equity, population health management, patient payments, digital front door, cloud, hospital data for life sciences.
  • Not: EHRs, big data, blockchain, wearables.

HIStalk Announcements and Requests

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Take these results with a grain of salt since some non-providers missed the “healthcare providers” part of the poll and responded about their non-provider workplace. That’s perfectly fine – basically across the industry, it’s a fairly even split of requiring vaccination proof.

New poll to your right or here: How did HIMSS21 change your perception of HIMSS?

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I checked out some of the HIMSS21 videos on the HIMSS Accelerate platform. They are posted as unlisted YouTube videos and stream embedded from there, although the Alex Rodriguez keynote doesn’t work since it has been blocked by Warner Music Group. I don’t know if A-Rod has anything to do with WMG, so maybe it has something to do with background music or something.

I still haven’t seen a HIMSS21 attendee count, although they said that 18,000 people had registered for both the in-person and online versions. Since HIMSS didn’t provide a count of onsite, paid attendees, I’ll throw out my guess of 8,000 given the expanse of empty space in the exhibit hall and hallways. Let me know if you have better information.

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One final HIMSS21 to-do item – complete my quick 10-question survey about your experience with either the in-person or virtual version. I’ll summarize the responses shortly. Thanks.

My vaccinated, COVID-infected relative is feeling a good bit better although with brain fog, but she learned from emails from others in her camping trip group that at least 60 of them have been infected, which makes it a superspreader event. The other relative who was infected last week from an unknown source now has three of four family members testing positive and symptomatic, for which they initiated a telehealth visit (filled out an online form, paid $90, got a telephone call back two days later) with the controversial America’s Frontline Doctors, who prescribed a Z-Pack and hydroxychloroquine.

HIMSS21 returnees, consider following Dr. Jayne’s suggestion to isolate until the fourth day after you left the conference, then take a COVID-19 test on that day for the all-clear. Walmart sells the BinaxNow self-test at $20 for two, and given present circumstances, it’s unlikely that the second one will expire unused.

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I set a reminder to see if anyone had analyzed HIMSS conference tweet counts as a proxy for general conference interest and participation. Ottawa-based medical writer Pat Rich did.

I’m disappointed that nobody Photoshopped the “Chris Christie on the closed beach” meme onto his HIMSS21 keynote stage photo.


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Welcome to new HIStalk Platinum Sponsor Ideawake. The Milwaukee-based company enables employers to unleash the entrepreneurial spirit of their workforce. Its industry-leading idea management software makes it easy to capture, evaluate, and implement targeted ideas from frontline employees. Support a culture of innovation by using its one-stop platform for facilitating innovation challenges, shark tanks, hackathons, and improvement symposiums from initial sourcing of ideas to measuring ROI. Customers such as Advocate Aurora, UnityPoint, OSF Healthcare, and Sanford Health use Ideawake to cost-effectively discover more solutions, prioritize the best ones faster, and transform more of them into impact. Engage hundreds to tens of thousands of employees to solve your biggest problems and break down entrenched silos and geographic barriers while fostering a global, company-wide culture of innovation. Thanks to Ideawake for supporting HIStalk.

Here’s an Ideawake intro video.


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Reader Tom Foley, chief growth officer of GenieMD, emailed to say that the company was busy during HIMSS21, still going strong with demos and meetings at 4:00 Thursday as the exhibit hall closed. I was intrigued and asked why his company did so well when others didn’t seem as thrilled. I appreciate his ideas:

  • GenieMD offers an integrated telehealth and remote patient monitoring solution, which is a growth area since providers are finding out that their EHRs aren’t robust in those areas and video-only platforms aren’t a long-term solution.
  • The majority of booth visitors were senior decision makers.
  • The company expected reduced conference attendance, so decided just four weeks out to upgrade from a Caesars Forum kiosk to a 10×10 space in the main hall.
  • They bought a full-page ad in the conference magazine.
  • They issued four press releases the week before and during the conference and posted those on LinkedIn and Twitter.
  • GenieMD has chosen an 20×20 booth for HIMSS22, expecting to have more information to share then.

Webinars

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


Acquisitions, Funding, Business, and Stock

Acute care telemedicine vendor SOC Telemed reports Q2 results: revenue up 84%, EPS –$0.16 versus –$0.30. Shares dropped 34% on Friday following the announcement, valuing the company at $414 million. TLMD shares are down 69% since early November 2020, when the company went public via a SPAC merger.

Customer experience software vendor Talkdesk completes a Series D funding round that values the company at $10 billion.

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Clinical workflow solutions provider Medstreaming and its acquired M2S clinical data registries company rename the combined entity to Fivos Health. Industry long-timer Jay Colfer is CEO.

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Labcorp acquires Ovia Health, which offers health plans, employers, and individuals services that include women’s health coaching and apps for fertility, pregnancy, and baby development tracking. The company whose annual revenue is $20 million, previously received an investment from Labcorp’s venture fund.


Sales

  • Oklahoma Heart Hospital chooses Health Catalyst’s Data Operating System and DOS Marts.
  • Stratum Med will offer its practices CareSignal’s Deviceless Remote Patient Monitoring.

People

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Jeannell Thomas (UnitedHealth Group) joins Protenus as VP of implementations and customer solutions.

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Industry long-timer Brian Gildea (Spok) joins NThrive as VP of new client acquisition.

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Divurgent hires Scott Freeman, MHA (Leidos) as VP of client service.


Announcements and Implementations

Intelligent Medical Objects launches IMO Core CSmart app, which allows Cerner users to more easily capture ICD-10 specificity and secondary codes, improve capture of HCCs, and organize problem lists in clinical categories.

Imprivata rolls out a new digital identity maturity assessment tool.

Everbridge announces new versions of its CareConverge and HipaaBridge secure clinical collaboration solutions.

Adventist Health joins Cerner Learning Health Network.


Government and Politics

UnitedHealthcare will pay $15.7 million to settle federal and state charges that it overcharged or denied coverage for patients with mental health and substance abuse issues using a software algorithm to trigger extra reviews.


COVID-19

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The federal government’s HHS Protect system shows that hospitals in Florida and Georgia are using more than 20% of their inpatient beds for COVID-19 patients.

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State officials in Mississippi warn that its hospital system is facing imminent failure and ask for federal government help with more than 1,500 COVID-19 patients hospitalized, 400 in the ICU, and University of Mississippi Medical Center turning a floor of its parking garage into a field hospital. Oregon is sending National Guard members to hospitals that are overwhelmed with COVID-19 patients.

COVID-19 test positivity rate exceeded 50% in Oklahoma and Mississippi last week. Their percentage of fully vaccinated residents is 41.7% and 35.9%, respectively.

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Even more concerning is the percentage of ICU beds that are housing COVID-19 patients.

NIH Director Francis Collins said on a Sunday news program that he expects the daily case count to exceed 200,000 within two weeks – it’s at 140,000 now — because 90 million people still aren’t vaccinated, concluding that “we’re in a world of hurt.”

Eric Topol, MD says in an op-ed piece that CDC is making a mistake by ending its monitoring of post-vaccination COVID-19 infections that don’t involve hospitalization or death. He says we are “flying blind” since we don’t know how many breakthrough infections are occurring, the threshold cycle of positive PCR tests would provide an understanding of viral load, and we can’t perform genetic sequencing to see if the virus is continuing to mutate. Data collection would also help public health officials identify who is at risk for breakthrough infections, analyze vaccine effectiveness, and figure out the types of patients who need booster shots.

In another call for increased CDC data analysis, former FDA Commissioner Scott Gottlieb, MD says it should gather data on children who are hospitalized with COVID-19 to determine whether the big ramp-up in the South is the “top of a huge iceberg of dire infection” or a sign that the virus has become more pathogenic in children.

Politico’s “Inside America’s COVID-Reporting Breakdown” says that state surveillance systems aren’t capable of giving public health officials real-time data to determine where outbreaks are occurring. Labs are short on staff to process tests quickly, many results are reported manually, and the systems that are used by state health departments are not interoperable with each other. Newly opened labs that weren’t prepared to report results electronically forced health department volunteers to pull results off fax machines and re-enter them into spreadsheets. Data de-duplication to make sure each result was entered only once was hampered by misspelled names.

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CDC issues a recommendation that people whose immune systems are compromised get a booster dose of vaccine. Those conditions are listed in the slide above from CDC’s vaccine advisory committee. CDC is also now recommending that pregnant and breastfeeding women receive the vaccine.

The Atlantic science writer Ed Yong writes a new version of his influence March 2020 piece titled “How the Pandemic will End.” He makes these points in the newly published “How the Pandemic Now Ends”:

  • The goal is once again to buy time to keep hospitals and schools open and to get more people vaccinated.
  • Unvaccinated people are often clustered geographically and that allows the variant to spread. Vaccinated people can transmit the delta variant to an unknown degree.
  • Societies cannot use vaccines as their only defense, and unvaccinated pockets can still shut down schools, overwhelm hospitals, and create more changes for worse variants to emerge. Available tools include better ventilation, rapid tests, and social support such as paid sick leave, eviction moratoriums, and free isolation sites.
  • Universal vaccination mandates probably won’t fly, but vaccination should be required for employees of hospitals, long-term care facilities, and prisons, where vulnerable people don’t have a choice about being exposed. They may also be likely for university students, government employees, and the military.
  • The delta variant has made it unlikely that COVID-19 can be eliminated. The pandemic will eventually turn into an endemic like the common cold.

Sponsor Updates

  • Avtex publishes a Digital Front Door Toolkit.
  • OptimizeRx SVP & Principal of Agency Channels Angelo Campano joins The Curtis & Coulter Podcast to discuss “The ‘Tele’ Movement & Evolution of Point-of-Care.”
  • Nordic publishes a new whitepaper, “The new healthcare ecosystem: Preparing for decentralized care.”
  • TCS Healthcare Technologies will use Healthwise Care Management Solution in its care management platform.
  • Protenus co-founder and CEO Nick Culbertson joins the ReCon Labs Podcast.
  • University Medical Center Utrecht in the Netherlands signs a 10-year contract for digital pathology with Sectra.
  • Spirion appoints Billy VanCannon head of product management.
  • Well Health salutes five customers who made the US News Best Hospitals 2021-22 Honor Roll.
  • Frost & Sullivan honors Lumeon with the 2021 North American Customer Value Leadership Award.
  • Nordic Consulting partners with Fortified Health Security to offer its customers cybersecurity solutions.
  • Surescripts publishes a new data brief, “COVID-19 Heightens the Need to Improve Interoperability, Provide Price Transparency & Relieve Provider Burnout.”
  • Halo Health releases a new infographic, “Clinical Collaboration Platforms and EHRs – An Essential Partnership.”
  • Healthcare Growth Partners has advised Radix Health in its sale to Relatient.
  • Infor announces significant success and momentum for its cloud-based interoperability solutions.
  • Meditech releases a new infographic, “How NMC Health leverages data with BCA dashboards.”

Blog Posts


Contacts

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

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Dr. Jayne Goes to HIMSS Digital – Thursday

August 13, 2021 Dr. Jayne No Comments

Thursday is functionally the last day of HIMSS for many attendees, as they’re worn out from cocktail parties and walking the exhibit hall. By this point, I would typically be packing my suitcase and dropping it at the bell desk so I could pick it up on the way to the airport for my late evening flight. Historically I do an Exhibit Hall Crawl with one of my long-time HIMSS friends, as we see who is left standing at the end of the week and who has headed out early. This time I’ve been receiving photos of the mostly empty exhibit hall from people on the ground.

I decided to attend the “Encouraging Science of Happiness” keynote featuring Rainn Wilson, since it was one of the few in-person sessions that was to be live-streamed. Logging into HIMSS digital, there was no information on the session, but I remembered hearing it was going to be streamed through the Accelerate platform. After way too many clicks, I was able to access the session, which was to start at 8:30 a.m. Ten minutes into it, I was still watching people wander in and find seats, with no update from HIMSS about any delays other than a single instance where a voice said something about “Changemakers, take your seats, the program is about to start.” It’s not like they had a crush of people they had to fit into the room.

Things finally got going at 8:42, but instead of showing video of speaker Reid Oakes, we were treated to a static image, and then the slide deck moved onto the HIMSS Stage 7 award recipients. They finally cut to a speaker view, but then the same thing happened when the keynote speakers came out – we got the slide deck, but we never got to see the actual speakers again until nearly the end. I guess HIMSS couldn’t figure out how to do a split screen?

Still, it was a good presentation, and talked about some of the challenges of current times – specifically the challenge of loneliness (which several nations including Japan and the UK have appointed governmental ministers to address) which according to the speakers has the same negative health effects of smoking a pack of cigarettes each day. Despite being one of the most connected generations, 18- to 24-year-olds (even pre-COVID) report higher levels of loneliness than senior citizens. One of the main points of the speech was the idea that intentionally choosing joy is an act of rebellion – going against the status quo. There was a part where the audience wrote notes to people who had positively influenced them and some of them read their notes aloud. It would have been nice to see those interactions rather than just a static slide.

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Great Tweet from Jan Oldenburg @janoldenburg yesterday, pondering how we will identify the potential impact of COVID-19 spread from HIMSS21. Everyone will be going back to their homes and their day-to-day lives, not necessarily knowing where or when they might have come into contact with someone who was positive. This makes determining if and when to test somewhat problematic, since CDC recommends that even if you’re vaccinated, as all HIMSS21 attendees are, that you test on day 3-5 if you’re exposed. Since HIMSS keeps touting its Accelerate platform and the meeting app, having a COVID-19 tool as part of it would have been cool – even my alma mater has one for its on-campus students.

Although I can’t provide medical advice since I don’t want to run afoul of any laws, I can tell you what my own plan was going to be for post-HIMSS symptom surveillance: stay mostly in one part of the house, avoid the rest of my household, and have a test four days after coming off the plane. If negative, it’s highly likely that the virus has been dodged.

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From everyone who has corresponded with me, it sounded like the in-person conference still had value even though there were some 100% unstaffed booths today. People generally liked being able to conduct their business without having to navigate crowds and without having to rush from meeting to meeting, since some of the meetings had canceled. Vendor-side reps felt the conversations were high value and less rushed. We’ll have to see what things look like a few short months from now, when we (hopefully) gather in Orlando. Time to hit the end-of-summer sale rack for what will become my sassy spring sandals.

Will you be attending HIMSS22? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 8/13/21

August 12, 2021 Headlines 1 Comment

PracticeSuite Announces Entrance into Consumer Health Information Market with Acquisition of HelloHealth

Ambulatory health IT vendor PracticeSuite acquires competitor Hello Health for an undisclosed sum.

Another big company hit by a ransomware attack

Accenture, which sells cybersecurity services, is hit by a ransomware attack in which hackers have threatened to publicly release company data.

US Indian Health Service to replace health information system

The Indian Health Service issues an RFI to vendors interested in being considered for its 10-year Health IT Modernization program contract.

From HIMSS 8/12/21

August 12, 2021 News 20 Comments

The conference was pretty dead today. Even Epic’s booth had basically nobody in it except a few employees. Some booths were already cleared out as practicality outweighed the HIMSS policy that requires booth tear-down only after the hall closes at 4:00. Everybody’s mind was on getting safely home.

Supplies of conference totes are ample if anyone needs one or 25.

Siemens Healthineers had a huge booth that was almost empty today, although I seem to recall that it had some decent traffic earlier in the week.

Thanks to Ultimate Kronos Group (UKG) for a hot doughnut that I accessorized with lava-hot pistachio sauce and tutti-frutti. NOTE: a reader found that the doughnuts were provided by InterSystems, which I should have suspected since I remember its Wall of Doughnuts at HIMSS19.

I liked this tee shirt from Vivify Health, which offers remote patient monitoring tools.

I stood in the hot, bright sun for a few minutes waiting for this rotating video display to hit the CoverMyMeds banner again after I saw it flash by. You can see the splashing of the fountain between the Wynn and Palazzo at the lower right.

I asked HIMSS for in-person attendance at HIMSS21, which they are supposed to be sending me, hopefully with an explanation of how the count was derived (registered or actually showed up to get a badge, exhibitors versus non-exhibitors, etc.) I only care about in-person, paid  attendance excluding exhibitor passes.

A-Rod has probably faced more DEA agents than the number of audience members he’ll see in his 1:15 p.m. Friday session called “Mindset of a Champion,” with that mindset apparently being that it’s OK to cheat by using performance-enhancing drugs and then lie about it as long as the personal payoff is significant. If anyone actually sticks around to hear what he has to say, please take a photo of the audience since anything other than a tiny turnout would be shocking given the time slot. I understand that he’s a celebrity entrepreneur and all, which seems easier when you start out with a few hundred million dollars, but I don’t see the healthcare connection. I’m sure HIMSS paid dearly to get Patrick Dempsey, Rainn Wilson, and A-Rod to add star power along with minimal relevance.

Someone who wasn’t at HIMSS21 tweeted that they had heard that a bunch of exhibitor staff were unmasked. I saw nothing of the sort — with maybe one or two exceptions that may well have been short term, everybody I saw was responsible. That wasn’t necessarily true outside the HIMSS velvet ropes, although even there compliance was pretty good. I got invaded a second time by someone unmasked crashing into the  hotel elevator as the door was closing (perhaps the disdain for others extends from not mask-wearing to refusing to politely wait for the next elevator), to the annoyance of the other passengers who were all masked up but trapped.

I pressed even harder against the back wall of the elevator since I had just heard from a relative who got COVID-19 during a group camping trip this week, one of at least 10 people there who have tested positive after spending time in a nearby bar. All of them had been vaccinated. The symptoms are apparently miserable, and while the odds of hospitalization or death are low for those who are vaccinated and thus have a “mild” case, the chance of experiencing long COVID symptoms is maybe 20%. Another set of relatives, a family of four who had decided that vaccination was unnecessary, just messaged that two of them have been diagnosed with COVID-19 (one of them is a child) and a third is now showing symptoms. At this point, you’re either going to get vaccinated or you’re going to get COVID, and regrets from the former are minimal while those of the latter are sometimes expressed in writing while dying on a ventilator.

A couple of folks asked about the after-hours party risk from attending HIMSS. I did not attend anything outside the conference areas and ate only at uncrowded restaurants whose tables were widely spaced, but I walked by the bar-restaurants in the Palazzo and Venetian (like Sugarcane and Chica) and they were wall-to-wall crammed with HIMSS attendees who were displaying the behavior that makes bars a hotbed of viral spread — leaned-in and loud conversations (lots of vocal cord spray), no masks, no spacing, and extended periods of close contact. That wouldn’t be too bad if it were just conference-goers of known vaccination status, but at least one of the packed venues was not closed to the public at the time. HIMSS can’t control conditions outside its boundaries, but I assume that some of those folks are going back to work at hospitals — many of them overwhelmed with COVID-19 patients — and I hope they will either get tested or isolate before going anywhere near patients or caregivers.

Something to consider for HIMSS22 or other conferences that limit attendance to vaccinated people. Require exhibitors sign a form that they won’t have after-hours events unless they are held in venues that are closed off to the general public (in Orlando, unlike Las Vegas, I believe that HIMSS controls the entire hotels). Arrange some kind of dining options that don’t require exiting the vaccination bubble — discounted room service, outside food delivery with conference rooms for group eating to scratch the socializing itch, or ballroom-type food service accessible only by badge — and include bar service. Leave the bubble if you want, but you aren’t required to given provided options. Feeding attendees in the exhibit hall like an extended happy hour would be a win-win with exhibitors. Basically to keep live conferences from becoming superspreader events and thus risking cancellation, you have to control more than just the meeting rooms and give your attendees easy ways to avoid people who are unmasked and possibly unvaccinated. And perhaps give them an easy way to take a COVID test before  they return to work. News item: RSNA just announced that it will require vaccination and masks.

A couple of companies ask Lorre to stop by to say hello and she wants me to give a shout-out specifically to Nordic, who welcomed her like a queen when she dropped by wearing her now-vintage HIStalk tee shirt. Nordic has been a longtime supporter and several of its executives rushed over to chat and make her feel welcome.

I got an overview of Telemedicine 911, which allow telemedicine providers whose patient experiences an emergency during their session (like a heart attack or stroke) to get in direct connection with the patient’s 911 emergency services dispatcher and send details or patient background. The nurse practitioner who was working in the booth said she once had a patient say they intended to harm themselves during a telehealth visit, she asked the patient if it was OK if she sent some help, and she got in direct contact with the 911 team in the patient’s local area so they could respond.

The folks at PORTL got in touch after I mentioned that their hologram technology was interesting, but nobody would explain it in the booth of its partner Avaya. They offered a private showing that I declined, but here’s a video of how University of Central Florida’s medical school is using it to allow students to diagnose 3D patients. The technology has been used for the Emmys red carpet and for musical performances.

I’ll be back to normal posting this weekend, where I’ll ask for feedback about both versions of HIMSS21. HIMSS22 is just seven months away.

Dr. Jayne Goes to HIMSS Digital – Wednesday

August 12, 2021 Dr. Jayne 1 Comment

I rolled out of bed for an early morning client call, which I would have had to do had I been in person in Las Vegas, but it was at 7 a.m. rather than 5 a.m. so I was grateful. Rather than a $33 room service coffee such as the one Mr. H mentioned yesterday, I opted for a Diet Coke with my morning bagel.

Once clients were done for the day, I got ready to tune in to HIMSS, only to have the neighbor’s lawn care service join the party. I’m used to it by this point and was ready with a headset, but it just illustrates the contrast between HIMSS in-person and HIMSS Digital.

I had a little bit of frustration with the programming this morning as I logged into what was supposed to be a keynote session. Instead of getting a typical intro for a keynote speech, we started out with 10 minutes of banter between the hosts. They were again pushing the Leaderboard Challenge and the participation prizes, this time sweetening it with not only a Starbucks gift card, a HIMSS membership, and a paid registration for HIMSS22, but an Alex Rodriguez autographed baseball. The host was giddy with excitement when talking about it. Personally, I’d rather have a Farzad Mostashari autographed bow tie, but that’s just me.

When the keynote speaker, Arianna Huffington, finally arrived, the presentation was more like an interview than a keynote. I guess I’ve become too accustomed to actual keynote speeches where the speaker is up on a stage, or if virtual is delivering prepared remarks, rather than having what feels like an impromptu conversation. The discussion went on for about 20 minutes and covered some good points, then it was back to the hosts and the “HIMSS Community Wall.” Host Chris tried to amp up the audience with an enthusiastic “Hey healthcare changemakers, temperature check time!” and honestly I didn’t even know what to say to that.

The next segment was “Global Burnout: Can Digital Transformation Be the Cause and the Cure?” The speakers had some good points about burnout in general among clinicians, and it warmed my heart when the speaker from Stanford talked about how important it is to have clinical informatics physicians involved in major technology projects. Overall, the consensus was that all of us are suffering with some degree of burnout and I certainly agree. One panelist talked about how when her institution implemented an EHR, she swapped her 20% clinical work for 20% teaching because the work required to learn the EHR wasn’t worth it. Another panelist who is a subspecialist discussed being re-tasked to the emergency department during COVID and how glad she is to be back doing colonoscopies.

They talked about how delivering telehealth causes a different kind of exhaustion than in-person care – where people are not getting up from their desks, not taking restroom breaks, not eating or drinking, and having to provide technical support for patients when the physicians themselves weren’t equipped to do so. She noted that for the people who think telehealth is easier, thinking about it in that way is a mistake.

They also discussed what their institutions were doing to prevent burnout. One panelist noted that her organization has a team that calls patients pre-visit and does the technical check-ins to remove that burden from providers. Her organization also pushed a program called “Home for Dinner” which encouraged workflows to allow providers to finish their office days quicker and get home to their families. They used EHR data and personal observations to create individual learning plans to help providers. Inbox optimization and creation of refill protocols were also part of the initiative. Of those who completed the program, 85% of physicians recommended that their peers participate, so now they have a waiting list. I wish more organizations would take this approach, but of course training is just another budget line item that often gets overlooked yet leads to provider dissatisfaction.

The final part of the session was about preparing future clinicians for the digital workforce. The moderator’s feed was having issues with the video not lining up with the audio, which was distracting. There was good conversation about the need for 1:1 mentoring for clinicians who want to work in tech, identifying skills gaps and trying to develop existing workers. Other comments included the need to set up designated training programs to ensure clinicians are ready to embrace digital health.

Vendor notes: Podium sent an invite at 9 a.m. for their event at Topgolf tonight. It came to an email address that isn’t registered for HIMSS so I’m not sure how I got on the list or why the invites went out so late, but good try!

Presenter tips from the HIMSS Digital trenches:

  • If you’re using a ring light, do a brief video of yourself and make sure your ring light is not reflecting in the lenses of your spectacles. You’ll thank me later when you don’t release a timeless recording of yourself with weird circles over your eyes and your audience will thank you for not providing that as a distraction.
  • Test your audio and do a brief recording of yourself and see how you sound. Not all devices have good microphones and sometimes people using Bluetooth headsets experience feedback or weird static sounds compared to using a wired microphone. Understanding microphone gain is important to make sure you’re not too quiet and that you don’t have to yell to have your volume at the same level as other presenters.

Today’s reader shoe pic is great – I love the tassels. I got a kick out of Microsoft Word suggestion that they were sandals, however. Perhaps the folks at Microsoft need a shoe advisor? I’m available.

From HIMSS 8/11/21

August 11, 2021 News 3 Comments

It’s Day 2 of HIMSS21. It was even quieter and less crowded than yesterday. I bet some vendor folks have already headed home and I’m sure luggage will be carefully hidden within booth confines tomorrow for afternoon dashes to the airport.

Meanwhile, here’s what is happening with COVID-19 in Florida, the home (maybe) of HIMSS22 seven months from now. UPDATE: a reader correctly noted that CDC initially posted inflated case count data for Monday in failing to adjust for Florida’s Monday through Friday only reporting, but this hospitalization data was correct since it was a snapshot. Florida’s hospitals have more than 15,000 COVID-19 patients in beds, representing 28% of their overall capacity, and 3,100 COVID-19 patients are in their ICUs. Florida also has the highest rate of children hospitalized with COVID-19 in the US, with 8.1 per 100,000 residents versus the national average of 2.2.

I heard several thought leaders claim today that their pet topic (virtual visits, cybersecurity, whatever) “has to change,” which always leads me to question why they think it “has” to change versus their desire that it change for reasons reasons self-serving or otherwise. These are the only healthcare change factors that I’m aware of, in order of least to most potency:

  • It’s the right thing to do.
  • Patients would like to see things done differently.
  • Patients will seek competitive alternatives if the change isn’t made.
  • Changing will increase profit.
  • The change is required by law.

Change Healthcare has one of the busier booths in the hall.

Avaya’s hologram thing was cool, but the reps were too busy looking at each other and their phones to tell me its purpose even after I stood around expectantly for a couple of minutes with nobody else around.

Here’s a footwear combo that I think Dr. Jayne will like.

Smart marketing — you have probably seen and remember this guy in the “please scan me” suit adorned with QR codes. It’s for data company MDACA. It reminds me of the old days when provocatively clad pairs of ladies would roam the hall wearing “follow me” shirts hoping that eyes-bulging attendees (mostly male, presumably) would follow them like lemmings. Companies would justifiably be called out instantly if they tried that kind of stunt today. This is a more clever and subtle variation and the guy was very nice when I chatted with him.

I like this “tiny house within a booth” concept for meeting space, TeleTracking in this case. Leg room is apparently challenging, at least beyond the first leg.

This vendor got a huge booth, but then again, they are also putting on the conference. HIMSS has a lot of space to tout their own offerings in their exhibit hall.

All but one of the booth folks I talked to said that while traffic is way down, they are having good conversations. The other exhibitor — who is CEO of a smallish company — said the lack of people was awful, he felt ripped off by HIMSS, and anyone saying otherwise was just trying to put a positive spin on a bad situation. I’ll survey readers after it’s all over for their thoughts and to see what conclusions they take into HIMSS22.

The good news for smaller exhibitors is that they aren’t lost in the shuffle of massive booths, armies of big-company employees, and highly publicized announcements. This version of the HIMSS conference felt more like an even playing field where even small-booth vendors could earn some attention.

It occurred to me that the HIMSS Bookstore isn’t here, so maybe it’s no longer a thing. I can’t say I ever bought any books there and some of its tomes were self-stroking vanity works, but I sometimes stopped in.

I had a brief chat with Sandeep Jain, MD, founder and CEO of ListenMD. The company offers a distraction-free doctor messaging app that allows both message sender and recipient to set deliverability preferences. It also allows the medical practice to set recipients and times for receiving messages from patients.

I acted on a company tweet to check out Nationwide Medical Licensing, which offers a turnkey service to license physicians and other professionals in multiple states, which is keeping them busy due to telemedicine. They also work for companies that need to get their doctors licensed in additional states, taking care of the forms and documentation and returning a simple file containing everything that is required. They also do physician credentialing. I am fascinated that CEO Alexis McGuire worked for the Brevard Zoo (UPDATE: fixed, I originally wrote Broward) in Florida until late 2018 while also working her way up from receptionist at NML.

J.J. Richa, CEO of Quality Care Metrics, gave me a quick booth overview of its Deep Empathy patient questionnaire solution. Patients answer psychology-based questions (not so obvious as “do you have suicidal thoughts”) that assess pain levels and psychological issues and report back to the clinician, including telehealth providers.

I chatted briefly with the folks from Clearstep, which offers automated a healthcare screening and routing triaging type solution that is used by CVS Health, BayCare, and HCA Healthcare. It also delivers population health insights on the back end and has been used for COVID-19 screening.

I took a look at Hyro‘s conversational solutions Adaptive Communications Platform, which it says is more effective than intent-based chatbots and IVR systems. It has impressive nameplate customers such as Weill Cornell (where it was developed), SCL Health, and Novant Health.


From Cornwall: “Re: HIMSS coverage I have been in the industry for about 10 years and have read HIStalk, on the days it is published, all of that time. HIStalk is by far the best HIT source that I read. I appreciate the amount of effort that you put into this as well as how steadfast you are about your anonymity given the quality of the work. Have a great HIMSS.” Thank you. I went anonymous after almost getting fired from my hospital job for being too honest about our vendors even though I was scrupulous about not using any information I obtained from my IT leadership job. In addition, I have no interested in turning into a narcissistic talking head or trading tepid fame for for cash, so being anonymous means there’s no temptation for journalistic impropriety. I even attend HIMSS anonymously, changing up names, using a low-level job titles like “intern” and claiming made-up employers so that I get no special treatment, which sometimes means I get ignored completely.

Accenture, which sells cybersecurity services, is hit by a ransomware attack. The hackers say they will publish company data publicly if they don’t pay up.

1upHealth offers to test the patient access APIs of health plans at no charge to see if they meets CMS requirements to connect with third-party developers.

Verizon’s BlueJeans Telehealth virtual health app will allow users of IOS devices to share their IOS-only Apple Health record with telehealth providers after the upcoming IOS 15 upgrade is installed. I’ve never heard of BlueJeans Telehealth and I loathe IOS-only patient apps (talk about running roughshod over health equity), but good for them I guess. UPDATE: Verizon reached out to say the Apple Health integration is actually already available with IOS 14 and that they recognize the limitations of an IOS-only solution and are working on more integration. Verizon was scheduled to exhibit at HIMSS21 with more information but decided to opt out. I appreciate that update. BlueJeans, I learned by Googling, was a year-ago collaboration tool acquisition by Verizon for $500 million and the telehealth offering was announced four months ago.

Morning Headlines 8/12/21

August 11, 2021 Headlines No Comments

Elektra Health funnels new $3.75M round into helping women navigate menopause

Elektra Health raises $3.75 million in seed funding to further develop its telemedicine and support service for menopausal women.

CVS Health launches first nationwide virtual primary care solution

CVS Health launches its Aetna Virtual Primary Care program for self-funded employers in partnership with Teladoc Health.

Sharecare enters home health market with acquisition of CareLinx, augments comprehensive platform with network of over 450,000 tech-enabled caregivers

Digital health and wellness company Sharecare acquires CareLinx, a tech-enabled, home-based care business, for $65 million.

Medstreaming and M2S Announce New Brand Fivos Health

Clinical workflow company Medstreaming and its M2S subsidiary, which specializes in clinical data registries and data services, merge their solutions under the Fivos Health brand.

Clearlake, Insight Sell Appriss Unit For $1.8 Billion

Clearlake Capital and Insight Partners sell Appriss Insights to Equifax for $1.8 billion, retaining parent company Appriss and its Appriss Health business unit.

Dr. Jayne Goes to HIMSS Digital – Tuesday

August 10, 2021 Dr. Jayne No Comments

No line at the coffee bar (a.k.a. my kitchen counter) again this morning, and my bagel was included as “complimentary” given the list of things I picked up on my Costco run last week. I could order delivery for every meal this week and still come out ahead compared to what I’d pay in Las Vegas, so I’m not complaining.

I had some frustrations with the HIMSS Digital platform today. First, when you add a session to your calendar in the platform, there’s not an option to add it to your Outlook or other calendar. Instead, you have to open the session, then click the “Add to calendar” button. At least for Outlook, rather than opening an appointment with my native Outlook client, it tried to send me into Office 365. Not sure why they can’t make their tech work like every other calendar interaction that consumers encounter, but after all it is HIMSS.

I also had the usual HIMSS frustrations around there being no sessions I cared about at a particular time but then having a couple that I was interested in that occurred on top of each other. That would likely be the same in-person, except for Digital you can opt to stream the recording a couple of hours later. One of the conflicting sessions revolved around the cultural aspects of digital healthcare transformation and the other was about capturing structured and unstructured telehealth data to determine whether telehealth is truly delivering return on investment. I ultimately opted for the cross-cultural session and was rewarded with a pop-up thunderstorm with lots of lightning and an unstable internet connection, so it was kind of a wash. I’ll have to try to pick up those two recordings tomorrow.

We’re all used to big press releases at HIMSS but the only thing I saw today was the announcement that CVS Health has launched its Aetna Virtual Primary Care program in partnership with Teladoc Health. The offering is available for self-funded employers and includes both remote and in-person care. It includes coordinated care between a designated virtual care physician and a consistent team of specialists, which differs from some of the other virtual primary care offerings out there that don’t include the specialist piece. Other features include unlimited communications with a virtual nurse care team including support for navigation to in-person services and a zero-dollar copay for primary care services. We’ll have to see what the uptake looks like over the coming months. According to my friends at Statista, 67% of US workers are covered by self-funded plans, so it’s quite a market.

I can’t be there for the exhibit hall happy hour, but made sure to have a cocktail in hand for my afternoon sessions which were largely on-demand. I did receive my first reader shoe pic today, and I think this attendee is fully embracing casual mode. Two of my usual HIMSS BFFs and Exhibit Hall Crawl pals sent me some pictures of after-hours social activities, so at least I can live vicariously. I miss you all, and especially all of your fabulous shoes.

What’s your take on HIMSS21 in-person or digital? Or are you glad you’re not part of it at all and just going on about your day? Leave a comment or email me.

Email Dr. Jayne.

From HIMSS 8/10/21

August 10, 2021 News 6 Comments

HIMSS21 looked quite a bit different than usual – far fewer exhibitors and attendees, big expanses of open space in the exhibit hall that featured widened hallways and the unused booth space of cancelled exhibitors, lack of blockbuster announcements and newly issued federal rules, and fewer C-level level provider and vendor executives who stayed home and let their underlings attend. I’m going to take the contrarian point of view and say that I might have enjoyed it more than usual, for these reasons:

  • It was calm and quiet everywhere, but not necessarily in a “this place is dead” kind of way.
  • Seating was ample, boosted by the no-show vendors whose spaces were turned into makeshift lounges with plenty of tables and chairs.
  • Food lines were minimal and places to sit and eat overpriced convention center food were plentiful.
  • It felt more like a scientific conference in the absence of jugglers, costumed and/or scantily clad booth reps, non-clinicians wearing white coats and scrubs, and over-the-top giveaways and food service in the hall.
  • The many booth folks I asked said the conversations they had were of high quality and made it worth exhibiting since product and service demand was pent up from the long pandemic holding period.
  • HIMSS did its usually great job organizing it all, even given the sting of the cancelled HIMSS20, the distraction of the digital track, and the always-present possibility that the in-person HIMSS21 could have been cancelled at the last minute.

I always gripe that the HIMSS conference has grown to be too big, too unfocused, and too much of a celebratory blowout that earns its high attendance only because of FOMO and vendor worries about being one-upped by competitors. For me, HIMSS21 was more to my liking. We’ll see how HIMSS22 lays out, although Florida’s world-leading COVID-19 case count and hospitalizations is raising questions about whether a spring conference is likely to happen. At least HIMSS won’t have to worry about rolled-over registrations from HIMSS21.

I felt perfectly COVID safe in the conference areas, but I worry about what attendees might be bringing home other than booth swag when I saw the hotel bars and restaurants packed 10-deep with unmasked people, mostly attendees, talking closely and loudly. We all know that bars are among the highest areas of COVID spread and some of those venues didn’t appear to be closed to the public. I steered clear and hope those attendees don’t work around patients or at least plan to isolate.

I had forgotten since HIMSS19 just how much young sales guys curse when conversing with each other in private conversations near others.

The cost of Palazzo room service coffee – $20 plus 18% plus $9 (around $33). The line at the hotel’s Starbucks at 6 a.m. – about 50 people, most likely Easterners who crashed early Monday night after gaining three hours and then woke up early seeking a caffeine jumpstart.

I almost welcomed once again seeing the conference phenomenon of people walking slowly down the middle of busy conference hallways while screwing around with their phones, unaware of how many rear-end crashes they are narrowly avoiding.

Is it overly ironic when people at an in-person conference demand that virtual medical visits be paid for because they are efficient and convenient, but watching educational sessions virtually instead of spending patient money to congregate in Las Vegas apparently is not acceptable? Especially when every part of the hall is already jammed with amateur and professional videographers, talking heads, and podcasters who are recording content that few will ever bother to consume?

I cringe every time someone call this city “Vegas.” Three syllables isn’t all that many.

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One of few areas in which HIMSS planned poorly was having educational and exhibit sessions in the Caesars Forum (note: the missing apostrophe is correct), which is easily accessed through a 50-yard outdoor walkway bridge from the end of Aisle 22 of the exhibit hall (it is not anywhere near Caesars Palace, either). The problem is that HIMSS scheduled early morning sessions in that building, and that bridge was therefore not accessible until the exhibit hall opened at 9:30 a.m., leaving the shuttle bus or walking as the only alternatives. Otherwise, that brand new facility was super nice, and I enjoyed visiting the exhibit hall and specialty pavilions there even though I entered it every time temporarily blinded by the hot, bright sun.

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Some exhibitors were understandably not quite ready when the hall opened at 9:30, as employee were still unpacking boxes and bringing monitors to life.

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Seating was plentiful throughout the exhibit hall thanks to reduce vendor count, some from last-minute decisions. I like that those vendors, or perhaps HIMSS itself, paid Freeman a fortune to have their areas populated with benches or tables and chairs.

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The much-reviled Hall G exhibit area downstairs, which was like a poorly planned basement rumpus room, has been closed, thankfully, although not before I paid $5,000 several years ago to have a tiny, seldom-visited booth down there. Exhibitors revolted one year against low traffic, forcing HIMSS to install new signage, announce overhead its pleas for people to go down there, and comped lunch for those folks who took in the subterranean spectacle. The area is blocked off from the main hall now and the only HIMSS attendee access was via the downstairs entrance, where you could see its only tenant, the COVID-19 testing center.

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The big exhibit hall booth winner was Ellkay, for these reasons: (a) its booth was across the aisle from Epic’s; (b) it drew people like crazy from the moment the hall opened until it closed, outdrawing even its neighbor Epic; and (c) it was a big space that was well designed and staffed by helpful employees. Someone from the company told me Ellkay has grown from 60 employees to 650 over a short period. Their booth was packed every time I walked by, from hall opening at 9:30 on.

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Some vendors suffered from poor location. I hope HIMSS offered a big discount for this space.

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Canon Medical had a mini-museum of disruptive technology, including this display related to music. The rep told me that Canon invented autofocus.

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The Zipnosis folks were sporting cool orange shoes, which they said were Allbirds.

Man & Machine was showing washable medical grade and sealed keyboards and mice. Founder, CEO, and self-proclaimed “The Big Cheese” Clifton Broumand, MSE is apparently quite a character.

I got a quick look at the patient engagement platform of Twistle by Health Catalyst, which had some nice folks working their booth.

I was surprised at the customer logo gallery of virtual care platform vendor EVisit, which includes Texas Health Resources, Trinity Health, and Banner Health. It declares that unlike telehealth technology competitors, “it does not and never will include a competing provider network.”

Bravada Health’s Ayva offers an interesting surgical journey system that offers videos, checklists, and reminders to give patients the best outcome, all without installing an app.

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And the winner of Best Customer Name-Dropping is …

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This isn’t a brilliant marketing idea but a true story, the rep said. Which makes it a brilliant marketing idea.

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Epic’s booth was predictably decorated with big, weird pieces, but I didn’t see Judy or Carl there, probably because UGM is coming up shortly.

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Cylera was printing custom tee shirts, of which Lorre got me this one.

NCQA had a great happy hour today, with food that exceeded typical convention center expectations (although by exhibit hall policy it certainly must have come from said convention center).


Raintree Systems founder and CEO Richard Welty died last month at 57, the company announced.

Adobe announces Adobe Experience Cloud for Healthcare. It’s hard to tell what it does from the company’s excessively lofty description, but it sounds like online marketing, audience insights, and digital enrollment.

Automation vendor Olive acquires revenue cycle management vendor Healthcare IP.

A SymphonyRM consumer survey finds that physicians dropped off their communications with patients during the pandemic and that infrequent communication was the top reason patients lost confidence in their doctor during that time. About 20% of respondents say they will look for a new doctor because of how they handled COVID-19. Fewer than half received COVID-19 information from their doctors and only one-third received communication about the vaccine.

Healthcare professional network operator Doximity announces Q1 results: revenue up 100%, adjusted EPS $0.11 versus $0.00, sending shares up in after-hours trading. The company’s market cap is $9.4 billion. Its IPO was in late June.

Salesforce announces new Health Cloud features that include remote patient exception monitoring, intelligent appointment management, and medication management. I wasn’t sure if they really pulled out of HIMSS21, but swinging by their listed booth to check out the new features yielded only a large expanse of bare carpet.

Philips adds Health Suite features – Patient Flow Capacity Suite and Acute Care Telehealth.

Zoom launches a beta release of a no-app mobile browser version of Zoom for Healthcare, available only for patients who use IOS.

I’m looking for interesting stuff to see Wednesday now that I’ve done a superficial surf of the HIMSS21 landscape, so send suggestions my way. Lorre will be in the hall Wednesday and Thursday if any current or prospective sponsors want to chat. She doesn’t really have anything to do since we aren’t exhibiting or doing HIStalkapalooza, thank goodness.


Morning Headlines 8/11/21

August 10, 2021 Headlines No Comments

AI For Population Health And Medical Imaging Gets A Boost With $230 Million Acquisitions

Nanox, an Israeli medical imaging systems vendor, acquires Zebra Medical Vision for $200 million, and USARAD and its Medical Diagnostics Web business for $30 million.

Olive enters the clearinghouse business and eliminates traditional transaction fees to align incentives with customers

Olive acquires RCM vendor Healthcare IP, adding clearinghouse and claims management to its healthcare automation services.

Doximity shares jump after digital health company says revenue doubled in first report since IPO

Doximity saw its shares jump by as much as 10% after the networking and telehealth company released its first earnings report, touting Q1 revenue of $72.7 million versus an anticipated $63.6 million.

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