Release-of-information and clinical data workflow software vendor MRO acquires Cobius Healthcare Solutions, which offers reimbursement and compliance risk management technologies.
Digital pharma advertising and patient education company Outcome Health has merged with competitor PatientPoint to create PatientPoint Health Technologies.
Rural hospital operator Rennova Health cancels plans to sell its software and genetic testing interpretation divisions to InnovaQor, which would also include telehealth technology that Rennova had licensed from TPT Global Tech.
AI-powered cancer pathology diagnostics vendor Ibex Medical Analytics raises $38 million in a Series B funding round, increasing its total to $52 million.
Emergency medical services-focused telemedicine company DocGo will merge with Motion Acquisition Corp. to become a publicly traded company with a $1.1 billion valuation.
Former Practice Fusion Director of National Accounts Steven Mack pleads guilty to attempting to obstruct the federal investigation into the relationship between Practice Fusion and Purdue Pharma after admitting he deleted hundreds of relevant computer files from his work-issued laptop.
Practice Fusion paid a $145 million settlement in January 2020 to resolve federal allegations that it violated the False Claims Act by configuring its EHR software to influence the prescribing practices of its end users for the benefit of opioid manufacturers like Purdue.
HIStalk Announcements and Requests
Welcome to new HIStalk Platinum Sponsor GetWellNetwork. The Bethesda, MD-based company’s interactive solutions engage patients and families, empower clinicians, and deliver outcomes that matter. It has been helping to unite providers and patients as partners in the healthcare journey for 20 years. From inpatient to outpatient, its comprehensive cross-continuum platform bridges care settings to create a seamless experience for patients and their families. Recent big news for the company was its acquisition of Docent Health, which offers AI-enabled outreach technology for consumer engagement and “next best step” in their care across episodes. Thanks to GetWellNetwork for supporting HIStalk.
I took a look at the technology being touted by some of the insurance companies and for-profit primary care chains that claim that their “full tech stack” differentiates them from stodgier but infinitely larger and more profitable competitors. That seems to be especially common in companies that offer Medicare Advantage plans. Consumer-facing apps usually had some combination of these capabilities:
Appointment scheduling.
Messaging, either directly with clinicians or with a “concierge team.”
Telehealth visits.
Plan details and benefits management.
Status of claims, payments, prescriptions, and lab results.
Doctor and urgent care finder.
Cost comparisons, either drug or procedure.
Smart watch or fitness tracker connectivity for health prompts, activity goals, synchronization.
Collaborative sharing of EHR data and clinician notes (this was one specific national primary care practice).
These services alone don’t offer much competitive advantage since they are commonly offered. I expect that back-end systems contribute more to how companies market themselves, upsell to members, and create efficiency that may or may not translate into efficiency that can boost margins, so these seem a lot more important. Some of those I thought of:
Anything that can help an insurer get to the scale needed to reduce per-member costs, improve provider negotiating position, and improve actuarial forecasts. Predicting and controlling costs is the bread and butter of insurance companies, which are not, despite their self-assigned labels, technology firms.
Sales tools, especially for insurers and their broker network.
Automated onboarding systems.
Any kind of self-service capabilities that can reduce administrative costs.
Enrollment for clinical trials, selling data to drug companies.
Supporting paperless communications.
Efficiently serving employers, who are the actual customer for most US-sold health insurance.
Analytics to nudge members into behaviors that reduce short- or medium-term costs (companies aren’t likely to worry about long-term costs since members come and go and these public traded companies worry quarter to quarter).
Customer relationship management to help overcome impersonal relationships at scale and to sell additional services, either those offered by the company or co-marketed through a third party.
Chatbots to support members with administrative needs at scale.
Patient education.
Chronic condition monitoring and at-home monitoring to reduce the need for provider services.
Customer segmentation and analytics to support variable pricing.
Tools for clinicians to help ensure evidence-based practice, reduce documentation burden, increase payment efficiency.
Fraud detection.
Trying to integrate the web of third-party services that is the US healthcare system (labs, specialists, out-of-network providers, pharmacies, medical devices, home care, etc.) to provide a single experience that customers value.
My admittedly superficial conclusion is that most of the consumer-facing technology that insurers are rolling out is limited, focusing mostly on administrative tasks, upselling and cross-selling, and giving customers an alternative to long phone wait times for questions or complaints. A significant reason for this limited technology arsenal is that pure insurers have a mostly intrusive administrative role between the provider and the patient. It’s a different and much more interesting story when the insurer has vertically integrated itself to offer its own services in competing with providers who accept its insurance (as in the Kaiser Permanente model).
For me, then, companies that have a small insurance footprint (in terms of enrollees, markets served, revenue, etc.) seem to be highly at risk to big competitors who can outspend them, replicate their innovative tech tools, and just buy those companies if they get too sassy. US healthcare is almost always dominated by big companies that kept getting bigger, and late starters who hope that tech-powered disruption can upend the market (whether the insurance market or the stock market) may find that to be harder than it sounds.
Webinars
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.
Acquisitions, Funding, Business, and Stock
Canadian telecommunications company Telus will acquire Babylon Health’s Canadian operations. The deal includes a $70 million licensing fee for virtual care technology already used by Canadians in the Babylon by Telus Health app. Babylon Health is reportedly exploring IPO options via merger with an SPAC.
Patient payment vendor Cedar raises $200 million in a Series D investment round led by Tiger Global Management, giving it a $3.2 billion valuation.
Rural hospital operator Rennova Health cancels plans to sell its software and genetic testing interpretation divisions to InnovaQor, which would also include telehealth technology that Rennova had licensed from TPT Global Tech. Rennova says the companies could not agree on terms, but it will still pursue separating its software assets.
AI-powered cancer pathology diagnostics vendor Ibex Medical Analytics raises $38 million in a Series B funding round, increasing its total to $52 million.
Sales
USA Health (AL) selects Twistle’s COVID-19 vaccine management technology, including automated patient outreach and adverse effect reporting.
Wellstar Health System (GA) will offer its employees digital health and wellness resources from Sharecare, and will work with the Atlanta-based company to develop similar tools for patients.
Hartford HealthCare (CT) will implement Cedar’s patient billing software.
The Christ Hospital Health Network (OH) selects Omnicell’s automated Central Pharmacy Dispensing Service.
Mountain Health Network (WV) will work with Infor, The Chartis Group, and Avaap to implement Infor’s CloudSuite ERP technology.
People
Kevin Johnson, MD, MS (Vanderbilt University Medical Center) joins University of Pennsylvania as professor, VP of applied informatics at University of Pennsylvania Health System, director of a new informatics center, and senior scientist in science communication.
Southwestern Health Resources hires Donghui Wu, PhD, MBA (Texas Health Resources) as VP of data science and analytics officer.
Investor and advisor Scott Vertrees joins Heal as CEO, replacing co-founder Nick Desai, who remains a shareholder.
H1 names Julie Stern (HealthReveal) CISO and VP of engineering.
Alcatel-Lucent Enterprise promotes Lisa Simpson to head of North American sales.
Provider analytics vendor Trilliant Health hires Sanjula Jain, PhD (The Health Management Academy) as SVP of market strategy / chief research officer.
Announcements and Implementations
Fifteen VA health systems and medical centers in 11 states join Medicom’s health information network.
Change Healthcare announces GA of Data Science as a Service, which assists customers in using de-identified claims and social determinants of health data for analytics projects.
Philips will add OpenDoctor’s radiology patient self-scheduling technology to its new Patient Management Solution of its Radiology Workflow Suite. The system will also offer contactless registration, automated communication, and intake questionnaires.
Meditech launches a genomics solution for its Expanse EHR, which includes the ability to collect and store patient genetic information, connect to reference labs, and enable personalized treatment. Its embedded pharmacogenomic alerts are provided by First Databank.
PVerify launches a real-time and batch Medicare Beneficiary Identifier lookup solution that can be accessed via API, Excel file batch processing, or individual patient lookup on the company’s portal.
COVID-19
CDC says it’s OK for people who have been fully vaccinated against COVID-19 to gather indoors without masks and distancing, as long as the group is made up of either all people who have been fully vaccinated or those from the same household who are not at increased risk. Masks and distancing are still recommended while in public, while visiting with unvaccinated people who are at increased risk, or when assembling in groups that involve multiple households. Domestic and international travel are still not recommended, advice that CDC defends by citing a lack of information about the impact of variants.
A study finds that the relationship between obesity and negative COVID-19 outcomes is nearly linear, as increased BMI is associated with higher rates of hospitalization and death. Severely obese patients were 33% more likely to be hospitalized and 61% more likely to die of COVID-19 than non-obese people.
A study that was performed using University of California EHR data finds that 27% of people who tested positive for COVID-19 experienced symptoms that lasted 60 or more days afterward, including shortness of breath, chest pain, cough, or abdominal pain. Many of those people did not originally experience any symptoms when they tested positive, and the severity of any initial symptoms didn’t always line up with eventual post-COVID problems. Patients in all age groups had long COVID effects, including 11 of the 34 children in the study. The study was limited in that (a) it was not able to review people who were asymptomatic but didn’t get tested; and (b) the static 60-day snapshot would have missed an unknown of people who don’t develop problems until after two months.
Other
A long-time hospital IT technologist friend of HIStalk and supporter of my Donors Choose projects sent a CIO job opening my way for Denver Health. You can read all about its clinical and community services (the latter are extensive), and on the IT side, Denver Health is in the 91st percentile of Epic’s gold stars program and recently migrated its self-hosted data centers to colocation centers (the new CIO will lead development of a full-blown cloud strategy). US News & World Report ranks Denver and nearby Colorado cities as four of the best five places to live in the US (Boulder, Denver, Colorado Springs, and Fort Collins). What better candidate can you get, my reader asks, than someone who routinely reads HIStalk? I appreciated that thought so much that I decided to mention the job opening here, which I usually wouldn’t do.
University of Washington researchers develop an Alexa skill that can detect heart rhythm problems in people who sit within two feet of a smart speaker during a telehealth visit. They are also looking at whether the same technology could detect sleep apnea in the home.
Sponsor Updates
Clinical Architecture staff volunteer at the Gleaners Food Bank of Indiana.
Capsule receives the 2021 New Product Innovation Award in the North American remote ventilator surveillance industry.
Humber River Hospital in Canada deploys Ascom’s transformative tech ecosystem for improved patient safety.
CarePort announces that more than 130 hospitals and health systems selected CarePort Care Management in 2020.
CereCore publishes an overview of Meditech reporting and regulatory submission.
The Cerner Charitable Foundation approves medical grants for 66 children.
SOC Telemed earns full URAC accreditation in telemedicine.
Frost & Sullivan features Change Healthcare in its Executive Brief, “Empowering Healthcare with a Cloud-based Enterprise Imaging Strategy.”
ChartSpan will market its services to members of the Kentucky Hospital Association.
Clinical Computer Systems, developer of the Obix Perinatal Data System, releases a new Clinical Concepts in Obstetrics podcast, “Cardiac Disease in Pregnancy.”
Divurgent releases a new episode of The Vurge podcast, “Using AI to Identify and Correct Issues with Claims.”
Waystar adds text statements to its line of payment tools, and announces that nearly 300 healthcare facilities now use its Price Transparency solution.
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.
Great seeing Dave Furhmann get a shout-out! Since he helped grow Epic Care Everywhere from its early days, I'd bet…