News 8/5/20

Top News

Siemens Healthineers will acquire radiation oncology technology vendor Varian Medical Systems for $16.4 billion.

Varian’s software offerings include treatment planning, treatment delivery, QA, image sharing, patient-reported outcomes, and the Aria oncology information system.

Reader Comments

From Spoofer: “Re: LinkedIn. It’s turning into Facebook now that Microsoft owns it.” I steer clear of LinkedIn except when looking up someone’s title or job history for the “People” section, but I have noticed that is becoming a home for folks (many of them salespeople) who believe themselves to be inspirational or instructional. It’s also drawing in users who litter it Facebook-like with personal musings, political commentary, and of course endless pitches for their employer or themselves.

HIStalk Announcements and Requests

Tyson Foods offered a $10 match for each $1 donated for specific Donors Choose projects, so I put my Anonymous Vendor Executive’s money to work in fully paying for these requests, most of which involve the rapid transition to remote learning. Donors Choose also sent me a note observing that this is the eighth consecutive year that HIStalk readers have supported classrooms, funding 631 projects that have impacted more than 50,000 students. I’ve already heard from several of these teachers:

• A camcorder for virtual learning and an air purifier for Coach H’s high school class in Sebastopol, MS.
• Online materials and lessons for Ms. D’s middle school class in Fort Smith, AR.
• A GoPro camera for virtual physical education and dance classes for Coach K’s elementary school class in Fort Smith, AR.
• Five Amazon Fire tablets and cases to replace the book corner activity that was cancelled because of COVID for the elementary school class of Ms. C in Nebo, KY.
• Two Chromebooks for Ms. P’s elementary school class in Forest, MS.
• Two Chromebooks for Ms. W’s elementary school class in Forest, MS.
• Classroom library supplies, organizers, clipboards, pads, pencils, cushions, earbuds, and file folders (which are no longer allowed to be shared) for the elementary school class of Ms. B in Omaha, NE, who is a second-year teacher.
• 30 headphones for Ms. S’s elementary school class in Vicksbug, MS.
• Bean bag chairs, dry erase boards, pencils, gloves, Play-Doh, balance balls,fidget toys, lanyards, pillows, charts, learning resources, and a long list of supplies for the elementary school class of Ms. R in Omaha, NE, who is a first-year teacher.
• 60 social emotional learning lesson books for Ms. S in Madisonville, KY, who is an elementary school counselor.
• An IPad, tripod, and tablet mount for the elementary school class of Ms. C in Lake, MS, who will create an online library of instructional videos for absent students or if the school closes due to COVID.
• A yearbook camera and all supplies for Mr. G’s middle school yearbook club of gifted and talented students in Madisonville, KY.
• Two IPads and a webcam to teach virtual learners at Ms. G’s elementary school class in Forest, MS.
• Supplies for at-home learners of Ms. D’s second grade class in Portland, ME.
• Math materials for Ms. P’s elementary school class in Sterling Heights, MI.
• 30 sets of headphones and 20 water bottles to allow Ms. J’s first grade school class in Chicago, IL to practice healthy behaviors.
• Digital and online learning resources for Mr. V’s high school class in Lake, MS.

Webinars

August 19 (Wednesday) 1:00 ET. “A New Approach to Normalizing Data.” Sponsor: Intelligent Medical Objects. Presenters: Rajiv Haravu, senior product manager, IMO; Denise Stoermer, product manager, IMO. Healthcare organizations manage an ever-increasing abundance of information from multiple systems, but problems with quality, accuracy, and completeness can make analysis unreliable for quality improvement and population health initiatives. The presenters will describe how IMO Precision Normalize improves clinical, quality, and financial decision-making by standardizing inconsistent diagnosis, procedure, medication, and lab data from diverse systems into common, clinically validated terminology.

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

Acquisitions, Funding, Business, and Stock

Medicare and Medicaid reimbursement services vendor Centauri Health Solutions acquires Applied Revenue Analytics, which offers business intelligence solutions.

Sales

• The US Department of State medical health units will implement Allscripts TouchWorks and FollowMyHeath, with the company serving as a subcontractor to MicroHealth. MicroHealth co-founder and CEO Frank Tucker served as a physician assistant, platoon leader, preventive medicine officer, and healthcare administrator for the US Army, CTO for Tricare, deputy CIO for the US Army Office of the Surgeon General, and an adjunct professor for several universities including the bioinformatics program of the Uniformed Services University of the Health Sciences. He has earned three master’s degrees (including in Physician Assistant Studies) and a doctorate of health science. The State Department chose the company for a $250 million project to manage the PHI of overseas government employees in 2019.

People

Brown & Toland Physicians (CA) hires Anne Barr, MBA (Counterpoint Advisors Network) as CIO.

Tom Foley (Cerner) joins AMD Global Medicine as VP of growth.

Ellkay hires Marc Probst, MBA (Intermountain Healthcare) as CIO.

Leidos promotes Liz Porter, MBA to president of its health group.

Amwell hires Serkan Kutan (Haven) as CTO.

Raymie McFarland (Glytec) joins glycemic management software vendor Monarch Medical Technologies as president and CEO.

Announcements and Implementations

Surescripts announces two new network capabilities for specialty pharmacies, a Medications Gateway that gathers information from the patient’s EHR and electronic prior authorization.

PerfectServe announces GA of Patient and Family Communication, which delivers health updates to patients and caregivers; provides a virtual room with appointment reminders and mobile check-in; supports video visits; and provides a patient inreach module for responding to on-call patient needs with direct messaging and video. Development of the system was driven by customer feedback during COVID-19.

Vyne renames its dental practice data exchange systems that were formerly sold under the NEA nameplate (claims processing, electronic claims attachments, and encrypted email) as Vyne Dental.

Imprivata publishes a digital identity framework that offers health systems advice on creating an identity and access management strategy.

Black Book surveys find that lack of interoperability has detracted from COVID-19 care and that progress has stalled, partly due to CMS’s delayed enforcement of rules. Nearly all respondents say COVID-19 clinicians don’t get complete patient records and most say manual processes fall short in submitting pandemic information to public health agencies. Another survey of 324 COVID-diagnosed patients finds none of them had their full patient record available electronically when seen by their COVID treatment provider.

Canada’s Health Sciences North goes live on Agfa enterprise imaging at 15 sites.

North Carolina’s state HIE NC, HealthConnex, goes live on real-time event notification built on Audacious Inquiry’s Encounter Notification Service.

COVID-19

CDC Director Robert Redfield, MD tells a House coronavirus committee that CDC wasn’t involved in HHS’s decision to move COVID-19 hospitalization data from the CDC’s system to HHS Protect. He says he was told only after the decision was made and did not discuss it with Vice-President Pence or HHS Secretary Azar. Redfield says it was the right decision since the driving factor was the need to track remdesivir supplies.

“CBS This Morning” runs a news item about Epic employees who are worried about the company’s return to campus. CBS News obtained an Epic employee survey in which several hundred respondents (out of Epic’s 9,000+ employees, which CBS labels a “backlash”) expressed concerns. Epic sent an employee email Monday night saying it will bring in national experts to review its plan, also noting that 24 employees have tested positive for COVID-19, with none of those cases being attributed  to Epic. Epic will require its Wisconsin employees to return to campus on September 21.

Ellen MacKenzie, PhD, dean of the Johns Hopkins Bloomberg School of Public Health, says that COVID-19 is providing a lesson to “invest in public health or else” in failing to be prepared for the next crisis, concluding, “We cannot let the legacy of a public health crisis be the devaluing of public health itself.”

President Trump says that it is unreasonable to compare the US’s COVID-19 death rate per population to that of other countries with lower numbers, saying, “You have to go by the cases … we’re first, the best … you’re not reporting it correctly … because we do more tests, we have more cases … death is way down from where it was.” He concluded, “They are dying, that’s true. And it is what it is. But that doesn’t mean we aren’t doing everything we can. It’s under control, as much as you can control it.”

New York City’s health commissioner Oxiris Barbot, MD resigns, saying Mayor Bill de Blasio has underused the department’s disease control expertise. A notable example was his reassignment of contact tracing responsibility to Health + Hospitals. She also created controversy in COVID’s early days by urging residents to visit restaurants and festivals as usual and said in a press conference that masks should be work only by those showing symptoms of infection. NYC Health + Hospitals Chief Population Officer Dave Chokshi, MD, MSc has already been chosen to replace her.

Rutgers University’s football program has 28 COVID-infected players and employees who have tested positive after several players attended an on-campus party. Meanwhile, 18 players and coaches of the Miami Marlins baseball team have tested positive and the team admits that it played a game on July 26 knowing at that time that four players had tested positive. Thirteen players and staff of the St. Louis Cardinals tested positive in the past week.

San Antonio Metro Health removes 619 COVID-19 cases from Sunday’s count after finding duplicate entries as it prepared to switch to a new contact tracing system. The agency says the data it receives from labs, hospitals, and doctors, as well as for people who have been tested in multiple locations, may contain misspellings, dates of birth, or different street abbreviations That can cause the same patient to be reported as multiple cases.

Delays in receiving COVID-19 testing results, caused by basic supply shortages and lack of a national strategy, are hampering the efforts of businesses and schools to reopen to employees and students who test negative. Delays of several days to weeks render the tests pointless.

Other

The New York Times examines whether telemedicine is here to say, raising these points:

• CMS’s coverage will end when the pandemic is no longer a declared public health emergency unless Congress passes legislation making it permanent.
• Insurers haven’t yet committed to paying for telemedicine visits comparably to in-person ones and may view telemedicine as a way to pay less.
• The cost and quality of telemedicine remains unproven for managing chronic conditions.
• Many or most patients prefer or require in-person visits.
• Insurers worry that telemedicine will increase visits without improving patient health, raising costs unnecessarily.
• Telemedicine may provide justification for doctors to bill phone calls that weren’t charged before, such as providing lab results or advising a patient to come in to the office.

A federal judge denies the plaintiff’s request to move a privacy lawsuit against UPMC to state court. UPMC is accused of sharing patient data with third parties for marketing purposes without their consent. The judge says the the lawsuit was correctly sent to federal court because UPMC was participating in HITECH.

In Argentina, an apparent server configuration error exposes the information of 115,000 people who had applied for COVID-19 quarantine exemptions. Researchers found that they could use basic information that had been exposed (ID number, gender, and phone number) to email the “circulation permit” to any email address. The exposed database was almost immediately attacked – but not disabled – by a “Meow bot” that finds and destroys exposed online data, speculated to have been created by a vigilante security expert who was annoyed by administrators who fail to secure online databases.

Sponsor Updates

• Bret Kinsella of Voicebot.ai hosts a podcast with Saykara founder and CEO Harjinder Sandh to talk about the company’s AI assistant for physicians.
• CareSignal and Innovaccer will partner to offer their remote patient monitoring and population health data technologies, respectively.
• ESolutions and Homecare Homebase collaborate to help home health agencies manage CMS Review Choice Demonstration.
• The Voicebot Podcast features Saykara founder and CEO Harjinder Sandhu.
• Surescripts earns Black Book’s #1 ranking in patient data exchange and interoperability.
• Fortified Health Security publishes its “2020 Mid-Year Horizon Report” on the state of cybersecurity in healthcare.
• QliqSoft incorporates Elsevier’s Interactive Patient Education with its Quincy chatbot and Virtual Visit software.

Blog Posts

• Preparing your stakeholders for new information blocking rules (Nordic)
• Hurricane Prep During the COVID-19 Pandemic (Optimum Healthcare IT)
• What is the Role of a Project Manager in EHR Implementation? (314e)
• Where to Find COVID-19 Reimbursement Rates & Billing Change Information (AdvancedMD)
• Better control, a single, intuitive interface and scalable to your needs (Agfa Healthcare)
• Blueleaf Banter: Trends in the Community Connect Space (Bluetree)
• Recapping Our Virtual Care Coordination Summit, “COVID-19 in Detroit” (CarePort)
• ATA Conference Opioid Panel: Three Perspectives, One Goal (CareSignal)
• Care Collaboration: The Key to SNFs Addressing COVID-19 (Collective Medical)
• Service! Nonprofit Offers Help to Industry Peers When They Need It Most (CoverMyMeds)
• Healthcare Technologies Set to Break Out as a Result of Pandemic (Dimensional Insight)
• 3 Steps to Protect Home Care Workers in a COVID-19 Era (Dina)
• Hire the Best! Tips for Finding Office Talent (EClinicalWorks)
• Manual Care Transitions Are Having a Bigger Financial Impact Than You Think (Ensocare)
• CMS Rolls Out Review Choice Demonstration (ESolutions)
• Digital Wayfinding and COVID-19 Response for Hospitals (Everbridge)
• Delivering Primary Care in an Urgent Care Clinic (Experity)

Contacts

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

Morning Headlines 8/4/20

Allscripts Cloud-Based EHR Solution to Support MicroHealth, LLC for Use Within the United States Department of State

MicroHealth will implement EHR and PHR technologies from Allscripts as part of its work to transition the US Department of State’s Health Units to a cloud-based EHR system.

DAS Health Acquires New England IT Company

Health IT and consulting firm DAS Health acquires managed IT and cybersecurity company Technology Seed for an undisclosed sum.

President Donald J. Trump Is Expanding Access to Telehealth Services and Ensuring Continued Access to Healthcare for Rural Americans

President Trump signs an executive order extending telemedicine flexibilities and provisions after the public health emergency ends.

Curbside Consult with Dr. Jayne 8/3/20

I’ve written about business continuity planning previously. It seems like every year it becomes a germane topic as we experience tropical storms, hurricanes, wildfires, and floods across the US and around the world. Throw in a global pandemic that shuts down medical offices and curtails hospital services and you’ve created a situation where continuity planning is an absolute necessity. Did I mention cyberattacks and ransomware? These are a couple of other good reasons to go through a planning exercise if you haven’t done so already.

Business continuity planning is part of the consulting work I do, so I’m no stranger to helping organizations walk through some of the circumstances their practices might encounter. As a CMIO, people expect me to be versed in the IT side of things, and many clients are concerned with the obvious things like EHR outages, power outages, etc. Clients living in coastal areas typically have a decent hurricane / storm plan, but many organizations haven’t thought about the natural disaster aspect. One summer my little corner of the world experienced floods, tornadoes, an earthquake, and locusts, so it was a bit of a sign that we all need to think about these things.

As I’ve worked with clients on this the past couple of years, we’ve spent more time discussing cyberattacks and ransomware, as numerous healthcare organizations have been hit by this. As of the last couple of weeks I have a great new case study for this with Garmin. They were hit by an attack that disabled their services for more than a week. They claim they didn’t lose any client data from their sites, but the reality is that clients lost data because they couldn’t sync their devices with the Garmin services. Understanding the anger in the client community about exercise data from wearables should make physicians think twice about how patients would feel if their actual medical information were lost or held for ransom.

When I go through a business continuity planning exercise with a client, I usually include a discussion of what it would look like if key human resources became unavailable. For example, what would happen if the CEO or COO departed the organization? Do others have signatory or contracting authority, and how would day-to-day operations run? For smaller practices, what is their plan if they lose a key biller or scheduler? Most of the time we’re focused on the operational and financial side of the house, with a brief but general discussion on the clinical side.

The clinical side of business continuity planning certainly came into focus earlier this year with COVID-19, as practices shifted to a telemedicine models and looked for new technologies to be able to safely reopen their patient care operations. I added a couple of different dimensions to my client-facing materials based on those experiences and they’ve been well received by organizations I’ve worked with. Still, I was thinking in more broad strokes about how organizations might be impacted if they can’t see patients and looking at it from a macro level.

Unfortunately, this week I had to think about it from a micro level, as my practice suddenly lost one of our full-time providers. Since I’m just a worker bee at my brick-and-mortar practice, I’ve never been privy to their business continuity planning and didn’t worry about it too much since my clinical work isn’t my main source of support. One would think that in the event of the loss of a provider, they could use the same checklists they might use when a provider quits or retires. It quickly became apparently, however, that they either didn’t have such checklists or were so overwhelmed by grief that they hadn’t worked through the process.

My involvement started when one of the nurse practitioners called me, as the most senior physician working at the time, asking what to do about the fact that the EHR was still putting my late partner’s DEA number on her prescriptions. Pharmacies in our area have an issue with NPs who write controlled substances and often ask for the supervising provider’s information as well, so we’ve added that to our prescriptions. I’m not sure if it’s custom code with our EHR vendor or a feature that they offer, but it’s how we roll. This was three days after his passing, so I can only guess that the other midlevel providers for whom he was the collaborating physician either didn’t write any controlled substances prescriptions in those days or didn’t think about what went out on the script since it hadn’t yet been addressed. In the short term, I supervised the NP for the prescription in question so the patient could be managed, but it made me wonder about the plan.

I also had the unique experience of staffing my late partner’s primary practice location, where our staffers had created a temporary memorial with flowers, photos, candles, and other tokens representing his personality. I’m not sure the organization had thought about how that would impact patients or the staff working at the location, since many patients had questions about the memorial and what had happened that our employees were unprepared to field. I was surprised by one particular patient who hounded me for details. I learned later that she had already posed the same questions to the receptionist and the nurse, but wasn’t deterred by their comments about the situation. Having to constantly respond to questions certainly weighed on the staff throughout the day.

As someone who has led other organizations, part of me wanted to go ahead and raise the question to leadership about the handling of the memorial and potential word tracks for staff, but didn’t want any inquiry to be seen as interfering with our practice’s collective grief. Knowing there are often no good answers to these issues, I opted to say nothing and let the organization figure it out. It felt like a bit of a cop out since usually I’m one to tackle problems head on, but maybe it was part of my own grief reaction. It was hard enough to get through the day with his presence all around us, and after a long day of COVID patients, I was ready to let it go.

It also served to illustrate something I’ve acutely questioned this year, the idea of “who cares for the caregivers?” Most of us are getting burned out and certainly all of us are tired, and the worst part is we know that there is no end in sight. My colleagues who have been in military operations have had the best advice for coping, but I’m concerned that this recent loss will put some of our team over the edge.

I hope sharing this story encourages organizations who may not have thought about these issues to add them to your to-do list, because it’s only a matter of time before a similar loss might impact them. If you haven’t done business continuity planning, you need to do it now. If you’ve already done it, take a moment to look at your plan to see how your organization plans to handle the loss of key staffers and consider how co-workers and the community might be impacted by such a loss. Having a plan and implementing it during stressful times certainly beats feeling like everything is swirling around you.

Email Dr. Jayne.

Readers Write: Five Strategies to Ensure Cybersecurity During COVID-19 And Beyond

Five Strategies to Ensure Cybersecurity During COVID-19 And Beyond
By Patrick Yee

Patrick Yee is chief technology officer of Ensocare of Omaha, NE.

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To quote New Zealand-born novelist and playwright Anthony McCarten, “We’re living in extraordinary times.” To which I’ll personally add, “that call for extraordinary security measures.”

In March, the Office for Civil Rights (OCR) at the US Department of Health and Human Services (HHS) issued COVID-19 HIPAA waivers to promote data sharing and telehealth, relaxing laws over the good faith use and disclosures of protected health information (PHI). The resulting explosion of COVID-19 demonstrates that providers need fast access to tools that identify, collect, track, and exchange data on the flux of infected patients.

Protecting the privacy and security of patient data is the health IT industry’s fundamental civic duty during a nationwide public health crisis. While a hospital’s core competency has never been and will never be information technology (IT), taking care of patients is.

As providers rightfully focus on saving lives, their IT teams have undergone a massive shift to working from home while tackling first-time coronavirus related challenges and juggling data security maintenance. Compounding the situation are short-staffed medical facilities where IT resources are needed the most.

Here are five strategies to help you protect and secure your organization’s patient data and network from cyber attacks.

Make sure your escalation procedures are sound.

A healthcare worker who spots a questionable issue must be free to report their concern so it can be addressed swiftly. Most every IT department has in place a reporting process, either a formal ticketing system or an on-call employee who accepts phone calls. Once the IT staffer quickly escalates the issue to the appropriate leader or medical professional, the healthcare worker can resume their day job. Whether the issues involve coronavirus or basic security breaches, e.g., an email phishing attack from an unfamiliar source, all team members, even those on the clinical side, should be empowered to bring up potential dangers to the appropriate parties.

Instruct your IT team to be extra diligent investigating unknown emails, links, and websites.

Cyberattacks targeting hospitals, practices, and healthcare organizations are on the rise dramatically, which can be at least partially be attributed to the exploitation of the coronavirus.

Unfortunately, remote workers are also being singled out. A recent McAfee report uncovered a correlation between the increased use of cloud services and collaboration tools during the COVID-19 pandemic, along with an increase in cyberattacks targeting the cloud. External attacks on cloud accounts grew 630% from January to April. Cisco WebEx, Zoom, Microsoft Teams, and Slack saw an increase of up to 600% in usage over the same period.

Healthcare staff members working remotely are more vulnerable and understandably distracted supporting COVID-19 patient care, which could make them easy prey for cybercriminals. The pandemic represents a huge opportunity for bad actors to compromise your systems with things like phishing emails that include faulty links and websites, ransomware attacks, and intrusions on sensitive data. Regularly remind your remote workforce to report suspicious activities by following your organization’s security protocols.

Review your intrusion detection strategy (IDS) or continue to monitor if you already have one.

An IDS is a network security technology that was originally built for detecting vulnerability exploits against a target application or computer. Intrusion prevention systems (IPS) add the ability to block threats in addition to detecting them, and have become the dominant deployment option for IDS technologies. More broadly, think of intrusion protection as personal computer security, but in a format that can look between different servers and flag suspicious activity. You should be reviewing and updating your technology and strategy regularly to ensure that you’ve kept up with all applicable best practices.

Ensure that your remote employees have corporate VPN and two-factor authentication services.

This telework protocol should already be part of your business continuity plan. It should be reviewed and updated periodically to ensure traffic is handled securely.

Home internet networks simply are not as secure as your office network. VPN and two-factor authentication services are recommended for remote connection to support the goal of making remote work as seamless as possible. Be aware that, short of completing mission-critical projects, at-home internet outages will not necessarily cause a security issue. A larger issue is whether the remote worker has the right modem installed to handle many different in-home users.

Encourage employees to use corporate laptops with encrypted hard drives that are not shared with family members.

Keep doing all of the good things you were doing before the pandemic.

Everything in your systems security plan is still valid with some possible changes for critical business continuity that should be maintained and exercised. HIPAA compliance might be relaxed, but security protocols remain doubly important in our current health crisis.

Readers Write: CMS’s E-Notifications Condition of Participation: Three Topics to Know

CMS’s E-Notifications Condition of Participation: Three Topics to Know
By Jay Desai

Jay Desai, MBA is CEO and co-founder of PatientPing of Boston, MA.

In March 2020, the Centers for Medicare and Medicaid Services (CMS) finalized the new Interoperability and Patient Access Rule, which creates a new Condition of Participation (CoP) that requires hospitals, psychiatric hospitals, and Critical Access Hospitals to share electronic Admission, Discharge, Transfer (ADT) based event notifications (e-notifications) with other providers across the continuum of care whenever patients have inpatient or emergency department care events.

To help these organizations prepare for the e-notifications CoP, a recent hospital executive survey was conducted to gauge industry awareness about the regulation (the survey results can be found in an online e-book called “The Route to Compliance. A Simplified Pathway”). Responses from hospital CIOs and compliance executives collected through dozens of conversations, virtual focus groups, and webinars revealed three key areas that need more awareness.

#1: The Requirements

According to the survey, which was conducted in May and June of 2020, just 17% of hospital CIOs or compliance personnel are familiar with the e-notifications CoP. The goal of the new CoP is to increase information sharing across the care continuum as a way to enable better care coordination leading to improved patient outcomes. This compliance requirement will go into effect on May 1, 2021 and adds to the list of CoPs hospitals must fulfill to successfully maintain their CMS provider agreement and certification. The fact that CMS used its most consequential regulatory lever, a CoP, to create the new e-notification requirement underscores the importance the agency places on increasing provider access to needed information.

Hospitals should answer how they or their third party intermediary solution will comply with the following requirements:

• Identify and send e-notifications to post-acutes.
• Meet cross-regional provider notification needs.
• Ensure appropriate data sharing rights, security, and trust.
• Send notifications in real time.
• Manage continuous provider-patient relationship changes.
• Demonstrate compliance to meet survey requirements.
• Ensure community-based providers have excellent user experience.
• Meet compliance by the May 1, 2021 deadline.

#2: Provider-Requested Notifications

This topic is particularly important to health systems with large provider and post-acute referral networks. Hospitals must send e-notifications to community-based providers that have established care relationships with patients and that need the information for treatment, care coordination, or quality improvement activities. This includes primary care practitioners, Federally Qualified Health Centers, Accountable Care Organizations, other entities identified by the patient as primarily responsible for their care, and post-acute providers (skilled nursing facilities, home health agencies, etc.). Identifying which providers have established care relationships is critical and requires that hospitals, or their intermediary, possess two foundational capabilities:

• Ability to collect patient-identified provider information at the point of care.
• Ability to obtain care relationship information from providers through a patient roster and notification request process.

The first capability allows hospitals to determine any providers with whom the patient wants their information shared by giving patients the ability to identify providers at the point of care. The second capability allows hospitals or intermediaries to determine any additional practitioners, groups / entities, or post-acutes that need to receive notifications for treatment, care coordination, or quality improvement activities. The roster and notification request process allows providers to identify their care relationships through rosters, e.g. patient panels or census lists, and receive e-notifications based on hospital care events that match to patients on those rosters. Having both of these capabilities gives hospitals the ability to determine the required providers that need notifications thereby eliminating e-notification gaps that would lead to non-compliance.

#3: Health Information Exchanges (HIEs) as Intermediaries

Hospitals have the option to use an intermediary, such as an HIE or vendor, to fulfill the e-notification function under this CoP. In the survey cited above, 60% of respondents familiar with the rule somewhat agree with the statement, “that their local HIE will ensure 100% compliance with the CoP.” Just 17% fully agreed with that statement. Given that HIE capabilities vary widely by state and region, compliance will depend on whether the HIE can fulfill the minimum requirements specified within the final rule. Those requirements include:

• Event types and timing. Notifications must be sent at the time of patients’ inpatient admission, discharge, and transfer and at emergency department presentation and discharge.
• Notifications recipients. Established PCPs, practice groups / entities, and post-acutes irrespective of geographic location that request notifications for treatment care coordination, or quality improvement activities.Practitioners, practice groups / entities, and post-acutes irrespective of geographic location that are identified directly by patients as primarily responsible for their care.
• Notifications content. Notifications must include, at minimum, patient name, treating practitioner name, and sending institution name.

Notifications also need to be sent in accordance with patients’ privacy preferences and applicable federal and state laws and regulations. Additionally, to minimize security incidents and inaccurate notifications, a high accuracy match rate is needed to ensure notifications are sent to appropriate providers. Ultimately, hospitals are accountable to meet compliance requirements even when e-notification functions are delegated and they should therefore ensure all minimum compliance requirements are met.

Given the significance of the new e-notifications CoP, hospitals should take time to carefully assess and validate internal or third-party capabilities against the new requirements to ensure they can meet compliance by May 1, 2021. With the proper solutions in place, hospitals can share real-time patient data with other community providers to support treatment and care coordination efforts, bolster value-based care initiatives, and, most important, improve health outcomes for patients while achieving e-notifications CoP compliance.

HIStalk Interviews Jay Deady, CEO, Jvion

Jay Deady is CEO of Jvion of Suwanee, GA.

Tell me about yourself and the company.

I’ve been in health IT for 30 years, having started in 1989 with Cerner. I’ve had a series of opportunities and roles on both the clinical revenue cycle and analytics sides of the business. Mostly focused on providers, but with some exposure to payers along the way and keeping my career focused solely on health IT.

Jvion is an industry-leading prescriptive AI company. Our mission is to drive down preventable harm to patients, both clinical and cost-related harm, however we can. That has been company’s mission since Day One. The co-founders have done a great job bringing the company forward over the last eight or nine years. I was fortunate to have the opportunity to join a few months ago as CEO.

Are health systems interested in how AI and predictive analytics work under the covers, or are they just looking for solutions that can deliver the results they need?

They are definitely looking at some of the details. The reason is that over many years, certain terms in healthcare and healthcare IT tend to get somewhat abused and therefore misunderstood. It was “workflow” and “analytics” back in the day and now everybody seems to be an “AI” company. Health systems, ACOs, and payers want to understand how Jvion is different from some other company that claims to be in the space. They are clearly interested in the outcomes and benefits that current clients are achieving and they want to understand how our approach is different.

Do health systems, and particularly clinicians, struggle to trust AI that functions as a black box with hidden proprietary algorithms?

It’s a balancing act. We have proprietary technology and methods, and other companies might say the same. Under an NDA, we will go to a certain depth to explain how it is that we do what we do. Fortunately, we have a relatively large number of clients that have been using Jvion for a while, so those documented outcomes and references help in those conversations. Details about how we approach the data science and strong peer references help. We also use a model control study versus just a benchmarked pre- and post-analysis. We have a lot of rigor around documenting the outcomes we have helped clients achieve.

Will AI become another example where technology companies try to solve problems they don’t understand because they don’t know healthcare?

There is some of that. There’s another side as well. On one hand, you have AI companies that don’t understand how healthcare works. They don’t understand the triangle between a patient / member, a payer, and a provider and how you add value to each constituent by understanding their alignment. On the other hand, AI draws a lot of different correlations and can provide a lot of different solutions for a company that does healthcare, but understands that healthcare is complex and needs help with a lot of questions. It’s challenging, from a corporate perspective, to narrow the focus so that you can efficiently scale versus answering one question for one client and trying to multiply that.

How important is it when training a model to avoid amplifying existing biases and to resist the urge to overstretch the model’s capabilities?

One of Jvion’s differentiators is that we have 33 million lives with between 2,500 and 4,000 data points within our machine. We don’t take in a large volume of data for one particular client, which will be biased to their capture solely, and then run the analysis only against that. Our scale and our nine-plus years of experience allow us to leverage the underlying clusters across those 33 million to even out any regional or local biases that might come from a single data source or data from a single region.

What information from outside the EHR can help identify patients who could benefit from an intervention?

Beyond EHR data, the machine uses publicly available data from the federal government, such as community vulnerability and social determinants of health. There are various capabilities around lab data and claims data. EHR-specific data makes up less than one-third of the data that we have in the machine.

What do clients most commonly learn when they apply a broader set of analytics capabilities to data that extends beyond their Cerner and Epic systems?

There’s a lot of additional data that isn’t contained within the EHR. Cerner and Epic are clearly trying to go down the path of balancing, however they describe it, between analytics and AI. But there’s additional behavioral data — environmental data, lifestyle data, transportation data, and even weather. These have impact on the health of a population and on the health of an individual in a specific area, but they aren’t within the EHR. That is one way that we significantly differentiate our offering from the nuanced early capabilities of what Cerner and Epic are doing.

Is social determinants of health information useful other than recognizing that an individual has a problem that goes beyond the health system’s ability to fix it?

Our clients aren’t just hospitals. While source data for SDOH does in some cases come from health systems, we gather information from other sources.

We break our market down into three segments. We have health systems on the provider side. We have population health entities on the provider side, where on their own or in conjunction with maybe a payer joint venture. There are ACOs or other initiatives where some level of risk is being taken around the defined population, whether that is the hospital’s employee base if they are really large or expanded into a provider-sponsored health plan. We have more than hospitals as clients and sources of SDOH.

What opportunities have arisen from helping customers address COVID-19?

It certainly was an unexpected impact for the industry, the nation, and for Jvion. I started as a new CEO three days after Georgia locked down, and multiple months into my career at Jvion, I think I’ve met 18 of my colleagues in person. I just went on my first in-person client visit in Georgia two days ago, wearing masks and socially distancing. Otherwise, it has been a virtual engagement, and that has had a big impact on general business operations.

At the solution level, the hospital provider segment has been impacted the most. Their economics have been fairly devastated. They were a 2-3% margin business, generally not for profit. They lost 30-60% of their high-margin business for a period of time. Our average health system client will probably be off 20, 30, or 40% of the financial operating numbers they had expected for the calendar year, and that is massively impactful from the operations side. From the caregiver side, the daily onslaught of delivering care in this COVID world versus a multi-service line clinical care delivery system is very different.

We initiated a COVID map that we pushed out for free. We worked with Microsoft on it. It’s available online. We’ve had 4 to 5 million hits and uses of it, everybody from the Pentagon and the White House Task Force to the CDC and others. We mapped down to the actual block area to show the vulnerability of a particular community, which is more beneficial – particularly for health systems – than looking at government data that’s at a county level. We expose that for our clients as well as anybody that would care to use it. We’ve been happy with the massive use.

For our clients, we took a look at their current patient lists, applying both the COVID map and other data we created and something we do for our normal solutions. We don’t just create a list of folks who might be susceptible to a negative quality event coming up and predict that. We do that, but we also put that in rank order based on the ability to intervene with a suggested intervention that could make a positive trajectory change and improve the potential outcome based on what the current trajectory is. A number of our clients are using that to outreach to those in their capture who might be the most susceptible and vulnerable from a COVID perspective to make sure patients are getting assistance.

We created a triage select solution, which we refer to as a vector. It works both for COVID and for any type of potential respiratory-impacting areas or diseases, such as basic flu, where you may need to make triaging decisions around the right time and appropriateness to ventilate. How do you prioritize that as the patients are presenting? That helps our clients deal with the onslaught of folks coming in.

I’m really proud of the team here at Jvion and appreciative of the feedback that we got from our clients in critical, overwhelming times. We were able to take that input, understand their needs, and bring our resources, assets, and capabilities to assist.

Do you have any final thoughts?

The US health system environment has faced challenges in my 30-year career and in the past, but they were more financially market oriented, where hospitals had reduced access to the bond market during the financial crisis, for example. But I’ve never seen anything that was so impactful to the actual operations of the health system itself. We will move through this at Jvion. 

We are also looking at our prescriptive AI, which historically has been solely clinical in nature, to understand the challenges of our health system clients. In those parts of the country that are post-COVID or in a lesser COVID world, how do they start getting a return to care? One client’s research found that 68% of community patients are reluctant to seek care because of fear of going to a medical facility related to COVID.

That deferment of care is having a major impact on the providers and the services that they can provide to patients. They will have higher acuity and more severe illness and disease state based on the deferment of that care. If they’re a commercially insured patient or member, payers have an influx of money today based on all the deferment of care, but there’s a tsunami coming of that care having to be delivered, and it will be more expensive later than right now.

It’s an interesting alignment period, with patients getting the care they need sooner than later, providers needing those types of patients back into their health system, and payers wanting them to get the care now versus deferring it and it being more expensive later. We’re focused at Jvion on how we can help drive that alignment across those three constituents whose interests are aligned with a single incentive.

Morning Headlines 8/3/20

Lemonaid Health Raises Oversubscribed $33 Million Series B to Expand Telehealth Offering

Telemedicine and prescription drug vendor Lemonaid Health raises $33 million in a Series B funding round, increasing its total to $55 million.

Samaritan computer systems still down as investigation into malware continues

Systems of Samaritan Medical Center (ME) remain down from a July 25 malware attack.

Siemens Healthineers Expands Into Cancer Care With $16.4 Billion Deal for Varian

Siemens Healthineers will acquire radiation oncology treatment and software developer Varian Medical Systems for $16.4 billion.

Exclusive: Prescription drug marketplace GoodRx files for IPO – sources

Reuters reports that Web-based prescription savings company GoodRx is preparing to file for an IPO.

Monday Morning Update 8/3/20

Top News

From the Allscripts earnings call, following the posting Q2 results that sent shares up 19% on Friday:

• The $365 million sales price of EPSi to Strata Decision Technology represents 7.5 times trailing 12-month revenue at 18.5 times adjusted EBITDA.
• The company sold no new Sunrise systems, although some existing customers extended their agreements.
• Allscripts will migrate the 450-clinician US Department of State medical units to a cloud-based version of TouchWorks and FollowMyHealth.
• CarePort is managing 40% of post-acute transitions in the US, with 18 million referrals per year.
• Allscripts says that while lower patient volumes and the DoJ settlement caused Q2 revenue to drop year over year, those headwinds will have smaller impact going forward.
• The company says that while it isn’t actively considering selling other parts of “the portfolio,” its data analysis and care coordination systems do more business outside the Allscripts EHR customer base and could stand on their own.
• Pressed by an analyst who observed that the company boosted its quarterly margin by cutting R&D to a level lower than that of competitors such as Epic, Allscripts says it moved work to its offshore employees and downsized its project management offices.

Reader Comments

From Anita Bath: “Re: HIMSS21. Odd that they still haven’t tweeted out that the date has changed.” I didn’t see any mentions on their so-called news site or HIMSS.org (except they’ve added it to the “Events” page) and no actual announcement was made on the conference website, which contains a mix of HIMSS20 and HIMSS21 references. Urgency is minimal since we’re a year away, but let’s hope communication and transparency improves compared to how the cancellation was mishandled. My primary PR advice would be to explain the often-repeated claim that the HIMSS contract prohibits it from offering refunds to attendees and exhibitors – why would HIMSS sign that, and with whom? (my interpretation is that the contract doesn’t require it to provide refunds, which is a vastly different issue). I’m not getting my $895 registration fee back regardless, so given that sunk cost and the fact that I would rather visit Baghdad than Las Vegas in the similar August weather, I will evaluate all over again whether it’s worth it. HIMSS has a big job in trying to drum up the bandwagon effect that makes HIMSS21 seem like a can’t-miss event, which is challenging because we will have already missed it for 30 months and ROI was questionable even before the unexpected contemplation period. And of course there’s the possibility that our coronavirus mess will still be keeping people home even a year from now, especially those from the entire rest of the world that has handled it better, and Las Vegas visitors will probably find COVID to be an exception to the “what happens in Vegas stays in Vegas” mantra for bad behavior. The HIMSS21 floor plan shows 1,249 booths booked by about 350 vendors so far, including the usual big footprints of Cerner, Epic, Allscripts, EClinicalWorks, InterSystems, and Change Healthcare.

From Nick Rails: “Re: HIMSS. They have a long dry spell until August 2021, when the next bolus of revenue comes in.” I’m pretty sure exhibitor and attendee count will be down a lot, and some of those who show up will be applying credits for money they gave HIMSS years before. I expect all member organizations (especially the majority that, unlike HIMSS, gave full refunds for their cancelled conferences) to downsize while simultaneously strong-arming vendors to spend more money to offset those losses. That could create a downward spiral wherein the provider members (the “ladies” in the “ladies drink free” model of attracting those who are willing to pay for access) get so tired of being hit on that they stop coming.

From Long Memory: “Re: Strata. I seem to remember Allscripts suing them at one point over EPSi, which Strata is now acquiring.” Allscripts sued Strata Decision Technology in June 2016, claiming that the company hired former Allscripts Chief Marketing and Strategy Officer Dan Michelson as CEO in 2012 and then used confidential Allscripts information to displace Allscripts-owned EPSi from KLAS’s #1 spot with Strata’s StrataJazz. I don’t know how that lawsuit turned out, but Strata will now own EPSi. Those with long industry memories will recall that Eclipsys acquired EPSi in early 2008 for $53 million in cash.

From Florida Unmasked: “Re: Baptist Health Jacksonville. Over 1,100 beds, signed with Epic last week. Didn’t see it here, so maybe it’s off-the-recordish.” Verified – they signed last week. Epic will displace Cerner.

HIStalk Announcements and Requests

Most poll respondents aren’t worried about career time bombs that are ticking away somewhere online, although it’s interesting that more folks worry about public information than social media posts. Probably because they can control the latter but not the former, which makes Google stalking unchallenging.

New poll to your right or here: Which factor will have the greatest impact on HIMSS21 attendance?

Pondering: why do company executives who boast that they have “right-sized” their business never take the blame for wrong-sizing it in the first place?

Webinars

August 19 (Wednesday) 1:00 ET. “A New Approach to Normalizing Data.” Sponsor: Intelligent Medical Objects. Presenters: Rajiv Haravu, senior product manager, IMO; Denise Stoermer, product manager, IMO. Healthcare organizations manage an ever-increasing abundance of information from multiple systems, but problems with quality, accuracy, and completeness can make analysis unreliable for quality improvement and population health initiatives. The presenters will describe how IMO Precision Normalize improves clinical, quality, and financial decision-making by standardizing inconsistent diagnosis, procedure, medication, and lab data from diverse systems into common, clinically validated terminology.

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

Acquisitions, Funding, Business, and Stock

Meditech reports Q2 results: revenue down 3.4%, EPS $0.88 versus $0.44. Product revenue declined 22%, but net income increased to $33 million.

Exchange-traded funds provider Global X ETFs launches the Global X Telemedicine and Digital Health ETF (EDOC) that will invest in telemedicine, analytics, connected health, and administrative digitization. The top percent holdings among its 40 investments are Ping An Healthcare, M3, Alibaba Health, Nuance, Teladoc Health, Veeva, Tandem Diabetes Care, Dexcom, Agilent Technologies, and Insulet. Also in its portfolio are Livongo, Cerner, Premier, R1 RCM, and Allscripts. I may start tracking the fund’s performance versus market indices, especially if I can set up some kind of portfolio tracker to monitor the share performance of the individual holdings.

Vocera announces Q2 results: revenue up 6%, adjusted EPS $0.10 versus $0.07.

Telemedicine and prescription drug vendor Lemonaid Health raises $33 million in a Series B funding round, increasing its total to $55 million.

People

Bruce Brandes, MBA (Avia) joins Livongo as SVP of directed virtual care.

Announcements and Implementations

Researchers who reviewed TriNetX’s research database found that cancer screenings fell 90% in the first four months of 2020 compared to 2019.

COVID-19

A new CDC projection shows 20,000 more US COVID deaths in the next three weeks, raising the total to 173,000.

Data scientist Youyang Gu, MEng, whose online pandemic tracker has been among the most accurate, believes that the US has passed its peak of cases and expects daily deaths to top out this week. He warns, however, that many states ignore CDC’s reporting guidelines for “probable deaths,” which could skew his model. He expects to see 230,000 US deaths by November 1. Deaths are increasing most in Florida, Texas, and Mississippi, while cases are increasing most in Missouri and Oklahoma.

A YMCA sleepaway camp in north Georgia sees a COVID-19 outbreak in its first few days of operation, with 76% of campers and staff whose test results were reviewed by CDC showing positive. The camp took several precautions, including requiring campers to show proof of negative test results, but did not mandate mask-wearing, housed campers 15 to a cabin, and led groups in singing and cheering.

NPR calls out more problems with HHS’s COVID-19 hospitalization data switchover from CDC’s reliable system to a new $10 million one built by contractor TeleTracking. Hospital-submitted information appears to go live immediately before being QA’ed, sometimes with obvious errors, and HHS has backtracked on its original promise of updates multiple times per day to committing to only a weekly refresh. Hospital capacity information on HHS Protect Public Data Hub was last updated July 23 as I look just now 10 days later. Among several state-level anomalies, NPR found that CDC’s old system showed that 24% of Arizona’s inpatient hospital beds were occupied by COVID-19 patients, but the new system shows 42% occupancy even with 82 fewer patients, and Colorado’s state dashboard lists 341 hospitalized patients on July 30 versus HHS’s 491. 

Major League Baseball faces the possibility that its just-started season may end quickly as a second team cancels games after players and staff test positive for COVID-19. Meanwhile, 27-year-old Red Sox pitcher Eduardo Rodriguez, who returned after a “mild” case of COVID, is out for the season due to COVID-caused myocarditis in a reminder that “recovering” from COVID doesn’t necessarily mean a return to previous health. 

Recreational boat-owning Americans are sneaking across the border to Canada and turning off their transponders like drug dealers, as locals decry having people from the “biggest Petri dish in the world” going ashore into their otherwise protected communities with no masks or distancing. Eighty percent of Canadians want the border to remain closed to Americans, who are seen as widely ignoring rules of personal responsibility.

Other

Systems of Samaritan Medical Center (ME) remain down from a July 25 malware attack.

Sponsor Updates

• Redox releases a new podcast, “EConsults and Coping with the Year 2020 with Gil Addo of RubiconMD.”
• Customers give Spirion their highest ratings in Gartner’s latest report on enterprise data loss prevention solutions.
• Netsmart lists 16 hospice and palliative care organizations that recently signed for its EHR.

Blog Posts

• My internship at Nuance in the wake of COVID-19: uncertainty and satisfaction (Nuance)
• Texting Consumers is Smart Business Strategy (OptimizeRx)
• How Virtual Waiting Rooms Protect Patients, Staff, and Productivity (PerfectServe)
• MIPS 2020 – What’s New? (PMD)
• Uncover the Hidden Pharmacy Supply Expenses (Premier)
• Pure Accelerates Hospital’s Recovery from Ransomware Attack (Pure Storage)
• Challenges of Remote Patient Monitoring Technology: When and How to Use SMS Texts and Phone Calls for Patients (CareSignal)
• Maximizing Outcomes in the Post-Acute Care Space (Relatient)
• How the Stress Test That is 2020 Taught Me to Lead with Intention (SailPoint)
• Why scalability is crucial to reducing your sensitive data exposure (Spirion)
• U.S. News announces the 2020-21 best hospitals, all rely on Spok (Spok)
• Telehealth technology: from scramble to strategy (StayWell)
• Marketers, Clinicians, and Care Managers in the Patient 360° Ecosystem (SymphonyRM)
• System Administration Appreciation Day – Celebrating Heroes Supporting Heroes (Vocera)
• Using Google Maps and Business Messages to Attract More New PT Patients (WebPT)

Contacts

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

Weekender 7/31/20

Weekly News Recap

• HIMSS pushes out its 2021 conference from March to August in Las Vegas.
• Allscripts will sell its EPSi business to Strata Decision Technology for $365 million.
• New investment in WellSky values the company at $3 billion.
• Irregularities are found in HHS’s $10 million contract with TeleTracking for a COVID-19 hospitalization tracking database.
• The COVID Tracking Project says that COVID-19 hospitalization data is now unreliable, partly because of HHS’s abrupt switch to a new system and accompanying data element changes.
• Private equity investments in Edifecs value the company at $1.8 billion.
• A surgery journal retracts an article in which the authors created fake social media accounts to search for photos or comments by surgery residents that they deemed unprofessional.

Best Reader Comments

I couldn’t care less about what my PCP or NP is doing with their family and friends in their off time. What’s considered “professional” and “unprofessional” is a social construct and is consistently changing over time based on patriarchal or even outdated viewpoints. To this day people still consider minority hairstyles as “unprofessional.” I’m glad they retracted this ridiculous journal article. (Brooke)

Very frustrated and disappointed with HIMSS. I am a small single attender and have attempted to reach them for a refund, as a refund would be of financial help. They won’t answer a phone nor reply to email. As Mr. Wonderful would say, “You are dead to me.” (Bigdog)

Watercooler Talk Tidbits

Readers funded the Donors Choose teacher grant request of Ms. K in California, who asked for headphones for her middle school special education class. She reported in February, “Your generosity towards my students have made a huge impact on their learning. Being a special education teacher, I teach students with a wide range of abilities. In order to differentiate instruction and meet their individual needs, I use various forms of technology in the classroom. In my language arts class, I rely on computers for their reading intervention program and audio books. The online intervention program is individualized to work on deficits each child still has. The headphones allows my middle school students to work on phonics and reading comprehension skills at their own level and pace. These headphones are exactly what my students need to progress as successful learners.”

Organizers of the influential CES technology conference, which draws 175,000 attendees to Las Vegas each year, announce that the January 2021 event will be virtual only.

The Arizona Diamondback fill the empty seats for its home opener with teddy bears representing Phoenix Children’s Hospital.

Former pro football player Myron Rolle says it’s not yet safe for the NFL to resume play. His credentials exceed just being a retired 33-year-old player – he holds an MD degree from Florida State University College of Medicine, earned a master’s degree in medical anthropology as a Rhodes scholar, and is a neurosurgery resident at Mass General.

ED physician Candice Myhre, MD plays the winning hand in the #MedBikini protest by posting a photo of herself saving a boating accident victim while wearing a pink bikini.

In Case You Missed It

• News 7/31/20
• EPtalk by Dr. Jayne 7/30/20
• News 7/29/20
• Curbside Consult with Dr. Jayne 7/27/20
• Monday Morning Update 7/27/20

Get Involved

• Sponsor
• Report a news item or rumor (anonymous or not)
• Sign up for email updates
• Connect on LinkedIn
• Contact Mr. H

Morning Headlines 7/31/20

Allscripts Announces Second Quarter 2020 Results

Allscripts reports Q2 results: revenue down 8.6%, adjusted EPS $0.18 versus $0.17,  beating Wall Street expectations for both.

NextGen Healthcare, Inc. Reports Fiscal 2021 First Quarter Results

NextGen reports a slight drop in Q1 revenue to $130.9 million, and EPS of $0.21 versus $0.16.

Strata Decision Technology to Acquire EPSi From Allscripts

Allscripts will sell its EPSi business unit to Roper Technologies-owned Strata Decision Technology for $365 million.

Teladoc (TDOC) Reports Q2 Loss, Tops Revenue Estimates

Teladoc Health reports Q2 results: revenue up 80%, EPS -$0.34 versus –$0.41, beating revenue expectations but falling short on earnings.

News 7/31/20

Top News

HIMSS reschedules its HIMSS21 conference to August 9-13 in Las Vegas. It was originally planned for March 1-5.

HIMSS22 reportedly remains on schedule in Orlando for March 2022, just seven months later.

Reader Comments

From Pearl Drops: “Re: HIMSS21. In August? In Las Vegas? Really?” My reaction:

• Assuming the event actually happens a year from now, it will have been 30 months since the last live HIMSS conference. Relevance is a crapshoot given the ill will created by the HIMSS20 refund policies, the pandemic’s financial impact on exhibitors and attendees, and the many months everybody will have had to decide whether they should just show up lemming-like as usual or instead look harder at ROI. People have learned to live without restaurants, sports, and concerts in their absence with potentially permanent impact, so a full-fledged return to conference life is far from assured. 
• The email says HIMSS22 will remain on track for March in Orlando, which would mean doing it all over again just seven months later, so the fatigue factor could be significant.
• The revenue hit to HIMSS is surely monumental just from timing alone, not even considering a likely big drop-off in exhibitor and registrant revenue.
• The timing of HIMSS20 could not have been worse for HIMSS since it coincided with the early start of a long pandemic, thus impacting at minimum both HIMSS20 and HIMSS21. RSNA20 moved to a virtual event in losing one live conference, but its 2021 conference will take place as planned unless 2021 is a full-year scratch, in which case HIMSS will be in even more trouble.
• I visited my least-favorite city of Las Vegas in late June a few years back to scout HIStalkapalooza venues, and it was nuclear hot even then. I swear my flip-flops started melting while walking to the pool, which was steamier than any hot tub should be. Miserable outdoor heat is good for exhibitors and casinos, however.

From Concision: “Re: health IT articles. Have you noticed how long they take to get to the point and start off reciting the obvious?” I have. Writers are either short on skill or long on vanity when they can’t lead off with compelling information and instead meander around before making some questionably valuable point. I turned down a lot of Readers Write articles because of my #2 test (after #1, “don’t pitch your company”) – if three randomly chosen sentences don’t contain anything insightful or fresh, or if the opening sentences stiffly recap universally known facts, then you’re wasting the time of readers.

From Vaporware?: “Re: DoD. Fascinating update from Cerner earnings call, and a reminder that the CommonWell Vaporware Alliance was formed in March 2013 to address the DoD’s expressed desire for an interoperable EHR.” Cerner mentioned in the earnings call that DoD and the VA launched a joint HIE in April and will connect to CommonWell later this year.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Everbridge. The Burlington, MA-based company is the global leader for integrated critical event management (CEM) solutions that automate and accelerate organizations’ operational response to critical events to help keep people safe and businesses running faster. More than 1,200 hospitals rely on the Everbridge CEM Platform to deliver resilience on an unprecedented scale. With COVID-19, Everbridge is helping hospitals to safely resume care and establish a new normal with a robust risk mitigation and emergency response platform that offers automated contact tracing and wellness checks, safe and secure telehealth, critical events management platform, incident management response for cybersecurity risks, and digital wayfinding with blue-dot turn-by-turn navigation. Thanks to Everbridge for supporting HIStalk.

Webinars

August 19 (Wednesday) 1:00 ET. “A New Approach to Normalizing Data.” Sponsor: Intelligent Medical Objects. Presenters: Rajiv Haravu, senior product manager, IMO; Denise Stoermer, product manager, IMO. Healthcare organizations manage an ever-increasing abundance of information from multiple systems, but problems with quality, accuracy, and completeness can make analysis unreliable for quality improvement and population health initiatives. The presenters will describe how IMO Precision Normalize improves clinical, quality, and financial decision-making by standardizing inconsistent diagnosis, procedure, medication, and lab data from diverse systems into common, clinically validated terminology.

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

Acquisitions, Funding, Business, and Stock

Allscripts reports Q2 results: revenue down 8.6%, adjusted EPS $0.18 versus $0.17,  beating Wall Street expectations for both.

Allscripts will sell its EPSi business unit to Roper Technologies-owned Strata Decision Technology for $365 million.

Cerner reports Q2 results: revenue down 7%, EPS $0.44 versus $0.39, beating consensus earnings expectations but falling short on revenue. From the earnings call:

• The company says its revenue came in lower than expected because the pandemic impacted sales or timing of some low-margin offerings, such as technology resale and billed travel.
• Q3 revenue expectations have been reduced because of divested businesses and a larger-than-expected pandemic impact, but the company expects earnings to grow due to cost reduction.
• The company says it won’t cut R&D spending.
• Cerner says that while virtual go-lives work for simple implementations, the future model will be a hybrid, with fewer people on site who are supported centrally, which also reduces billable travel for the client. The company notes that employees are 25% more productive working remotely because avoiding two half-days of travel during the work week means they have five days billable per week instead of four.
• Cerner is looking beyond its Amwell virtual visit partnership to virtual hospitals and ICUs that would involve its CareAware platform.
• An analyst asked about a $35 million acquisition that he saw on the cash flow statement, which Cerner says was for a cybersecurity company that it can’t talk about otherwise.
• Cerner is interested in acquisitions related to research data and analytics.
• The grating phrase “new operating model” thankfully wasn’t uttered even once.

Teladoc Health reports Q2 results: revenue up 80%, EPS -$0.34 versus –$0.41, beating revenue expectations but falling short on earnings. Expenses increased 63%, mostly in marketing, sales, technology, and acquisition costs, and the company projects a loss per share of $1.36 and $1.45 for the year.

Private equity firms TA Associates and Francisco Partners invest in healthcare clearinghouse operator Edifecs at a valuation of up to $1.8 billion.

Private equity firm Leonard Green & Partners acquires a stake in WellSky from TPG Capital that values the company at over $3 billion.

Ciox Health acquires NLP vendor Medal to enhance its real-world data business for drug companies and researchers with information extracted from unstructured EHR data. 

NantHealth acquires OpenNMS, which offers an open source network management system.

In-hospital specialty care telemedicine provider SOC Telemed merges with Healthcare Merger Corp. in a complicated transaction that will create a Nasdaq-listed company that values SOC at $720 million.

Sales

• Australian Capital Territory government chooses Epic for implementation across Canberra’s public hospitals and community health centers in a 10-year, $80 million contract.
• Summit Healthcare announces several new clients for its Summit All Access for web-based and mobile information sharing, including ADT notification, community data sharing, and downtime data access.
• Franciscan Health chooses Accruent’s Connectiv software, based on ServiceNow, to manage its facilities and biomedical assets and devices.

People

David Tucker. MHA, MBA (Huntzinger Management Group) joins 314e as VP of sales and client services.

Announcements and Implementations

WebPT adds 1,700 clinics to its rehab therapy platform in the first half of 2020 as the company rolled out a virtual visit system, a digital patient intake feature to minimize waiting room contact, and increased use of its patient relationship management solution. 

Diameter Health releases its turnkey FHIR Patient Access solution that allows payers to comply with CMS requirements that they give members access to their data using FHIR standards.

Goliath Technologies creates a managed service offering for remotely monitoring the availability of applications running under Citrix and VMware Horizon, which allows clients to make sure users aren’t having problems accessing business applications from home or other offsite locations.

InterSystems lists how its TrakCare health information system has been globally deployed in response to COVID-19, including rollout of a screening module that was installed on site in Beijing early in the pandemic, connecting labs and temporary hospitals in Madrid, creating interfaces between new COVID-19 testing machines to its lab system in 48 hours, and implementing TrakCare Lab Enterprise for the 118 COVID-19 labs of the UAE’s Pure Health in two weeks.

Premier enhances its crisis forecasting and planning technology to predict a given hospital’s COVID-19 patient census in near real time.

DirectTrust releases the draft of its Trusted Instant Messaging+ standard for testing.

Aiva offers customers of its in-room patient communication system – which is powered by voice assistants such as Amazon Alexa and Google Assistant — with caregiver-to-caregiver technology from Hillrom’s Voalte.

Cerner will add Nuance’s virtual assistant technology to Millennium, allowing users to navigate by voice for chart search, order entry, and scheduling. 

Intelligent Medical Objects launches IMO Precision Normalize, which standardizes diagnosis, procedure, medication, and lab data from diverse systems into common, clinically validated terminology.

Government and Politics

An NPR investigation into HHS’s awarding of a $10 million contract to health IT vendor TeleTracking for a COVID-19 hospitalization data collection system finds several irregularities:

• HHS first said the contract was sole source, but now says it was competitively bid among six companies that it declines to name using criteria that it declines to list.
• The process HHS used to award the bid is normally used for innovative research, not the development of government databases.
• TeleTracking’s CEO is a long-time Republican donor who is loosely connected to a company that financed billions of dollars worth of Trump Organization projects.
• The contract ends in September and TeleTracking says it hopes for an extension, which could cost millions. The current contract is 20 times larger than all of TeleTracking’s previous federal contracts combined.

COVID-19

The US now leads the world in number of COVID-19 deaths per day, averaging over 1,000 and most recently hitting nearly 1,500 as total US deaths crossed the 150,000 mark. The US has less than 5% of the world’s population, but nearly 25% of its COVID-19 deaths.

An HIStalk reader reports that their large Texas hospital has been forced yet again to change COVID-19 testing platforms due to a nationwide supply shortage, leaving clinicians and the IT folks scrambling. Delayed results force clinicians to assume that the patient is positive, which requires them to needlessly use PPE that is also in short supply.

The COVID Tracking Project says COVID-19 hospitalization data is now unreliable, partially due to HHS’s no-notice switch to a new reporting system:

• Some states can’t report their data at all, some hospitals have stopped submitting data, and hospitalizations don’t always line up with local case counts.
• HHS and state-reported hospitalization information is sometimes dramatically different, with HHS oddly reporting higher numbers much of the time.
• HHS collects information of all COVID-19 hospitalizations, including suspected cases, but some states report only those cases in which COVID-19 is the primary diagnosis.
• States that collect information from state hospital associations may not be reporting numbers from the VA or other federal hospitals.
• Each state decides on its own which information to make public on dashboards and reports, which then feeds national dashboards such as that of the COVID Tracking Project.
• Case, testing, and death data remain accurate because the information was not affected by HHS’s change.

University of Colorado School of Medicine describes in a JAMIA article how it applied informatics interventions to meet UCHealth’s COVID-19 challenges, drawing on the relationships its doctors and nurses have with frontline staff and their experience in leading change. The team:

• Used an electronic teaching tool to ramp up EHR training for nurses who were being prepared for inpatient roles.
• Developed an electronic training guide for volunteer clinicians that included embedded videos and linked resources that covered, EHR, rounding, and common patient conditions.
• Created new Epic-based pathways using AgileMD that included proning, clinical trials, convalescent plasma, antivirals, anticoagulation, intubation checklist, septic shock, and hyperinflammatory response treatment.
• Added “indication for use” to discourage unapproved use of hydroxychloroquine and azithromycin.
• Created a Virtual Health Command Center to train clinicians on its Epic-integrated Vidyo virtual visit system in two weeks.
• Coordinated with the patient experience team to present training webinars on conducting video visits, including non-verbal communication and reflective listening.
• Partnered with Masimo to deploy a wearable device for discharged patients to monitor respiratory rate, heart rate, and pulse oximetry.
• Redeployed tablets to COVID-19 units to minimize staff exposure, to provide remote translator service, to help the palliative care team convene videoconferences with patients and families, to present group therapy for psychology and rehab, and to capture audio and video from non-networked monitors so that nurses can listen for alarms from the nursing station (pictured above).
• Created a Microsoft Teams collaboration site for regional intensivists, which then led to creating a public website for community providers.
• Developed logic for three levels of COVID-19 chart alerts based on patient check-in information.
• Developed note templates to store patient advance directive status in a central location.
• Helped nurses who were not able to work in the hospitals to use Epic Secure Chat to follow patients and then update their families, who were not allowed to visit.
• Created a scoring tool to ration therapy if needed.
• Studied EHR data for information that could be predictive of hospitalization rates. 

Yale New Haven Hospital describes how it customized Epic’s antimicrobial stewardship module for COVID-19, developing patient lists, assessment tools, and a handoff process, all to support reviewing a large number of patients quickly and to optimize their management.

Former FDA Commissioner Scott Gottlieb, MD raises an interesting economic point.

Wolters Kluwer Health uses clinical search activity in its UpToDate reference, along with online and mobility data, to predict COVID-19 outbreaks in specific areas.

Seventeen University of Florida Health anesthesiology residents and one fellow contract COVID-19 after attending a party that was attended by 20-30 residents. The health system refused to acknowledge either the outbreak or the party in inappropriately citing HIPAA.

Former Republican candidate for President Herman Cain dies at 74 of COVID-19, for which he tested positive nine days after attending President Trump’s June 20 Tulsa rally without wearing a mask even though he was a Stage 4 colon cancer survivor.

The House of Representatives requires members to wear masks following the COVID-19 diagnosis of Rep. Louie Gohmert (R-TX), who previously refused to wear a mask for protection against the “Wuhan virus” and then speculated after testing positive that, “I can’t help but think that if I hadn’t been wearing a mask so much in the last 10 days or so, I really wonder if I would’ve gotten it.”

Amazon Prime Air drone engineers design NIH-approved face shields that Amazon will sell at cost to frontline workers, saving them at least one-third over other reusable face shields at $2.65 each. The company is also offering an open sourced design package for 3D printing and injection molding.

A Vanity Fair investigative report finds that a White House panel led by Jared Kushner developed a national COVID-19 testing strategy and ordered 3.5 million China-produced tests for $52 million from a company connected to the ruling family of the United Arab Emirates, but the tests were contaminated and unusable. The group’s national testing strategy was never announced and testing responsibility was eventually moved to individual states, to the group’s surprise. It called for federal distribution of test kits, oversight of contact tracing, lifting contract restrictions on where doctors and hospitals send tests so that any laboratory could perform testing, reporting all test results to a national repository as well as state and local health departments, and rapidly scaling up antibody testing to support returning employees to work. It also proposed establishing a “national Sentinel Surveillance System” with real-time identification of hot spots. The plan lost favor with President Trump, who insiders say was worried that more widespread testing would increase case counts that would harm his re-election chances. He favored optimistic coronoavirus models from Deborah Birx, MD that were eventually proven to be wildly wrong. The report also found that one member of Kushner’s team argued that a national plan would squander the political opportunity to blame Democratic governors of states that were being hit hardest early in the pandemic.

Other

Nacogdoches Memorial Hospital (TX) and Cerner agree on partial payment to settle the $20 million the hospital owes for an implementation it delayed repeatedly and finally cancelled.

Sponsor Updates

• Diameter Health launches FHIR Patient Access to help payers comply with federal regulatory requirements to provide members with access to their health data using FHIR standards.
• TriNetX will conduct a medical record review of 200 hospitalized COVID-19 patients to create a dataset that can be used to support drug treatment and vaccine research.
• InterSystems introduces a new credentialing program for its products and technologies.
• Fortune profiles the way in which Jvion re-focused its CORE technology to develop a COVID-19 community vulnerability map.

Blog Posts

• MIPS 2020 – What’s New? (PMD)
• Top 10 Ways COVID-19 is Changing US Healthcare Systems (Get-to-Market Health)
• Healthcare’s New Help Desk: A Modern Approach (HCTec)
• HAS 20 Virtual: Featuring a World-Class Lineup of Keynote Speakers (Health Catalyst)
• American Telemedicine Association: Improving Patient Outcomes and Cost Savings at Esse Health by Leveraging Deviceless Remote Monitoring Technology (CareSignal)
• Taking Prescription Renewal Workflows from Good to Great (Healthfinch)
• Consumers Want Convenience and Telehealth from Health Payers (Imat Solutions)
• Continued Cloud Conversions Give ERP the Attention it Deserves (Impact Advisors)
• Maintaining a Culture of Wellness in a Virtual Work Environment (Imprivata)
• Why Interoperability is Crucial to Medtech’s Survival (InterSystems)
• Insights from Banner Health: How to Transform Your Digital Front Door (Kyruus)
• How Hospitals can Thrive in the Midst of Constant Change (LiveProcess)
• Financial Agility is Essential to Healthcare’s Post-COVID-19 New Normal (Loyale Healthcare)
• How to Create a Business Plan for Your Physical Therapy Private Practice (MWTherapy)
• Senior Living Leaders Innovate to Combat COVID-19 (Netsmart)
• Top 10 Telehealth Benefits and Challenges Concerning Hospitals (Access)
• Are quality metrics becoming MacGuffins of healthcare? (Nordic)
• American Telemedicine Association: Improving Patient Outcomes and Cost Savings at Esse Health by Leveraging Deviceless Remote Monitoring Technology (CareSignal)

Contacts

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

EPtalk by Dr. Jayne 7/30/20

It’s been a wacky week in the informatics trenches, as I had a run of non-clinical days in preparation for working three in a row this weekend. I used the time to attempt to catch up on email and voice mail. Although I’m still woefully behind, it’s a little more under control.

One of the voice mails that was left for me was priceless. “Hi, this is Kate from X Company. We’re one of your company’s approved vendors for staff augmentation services and wanted to talk to you about your upcoming projects and any staffing needs you might have.” Since I’m the person that would approve any vendors and had never even heard of this company, I just chuckled and hit delete. I wonder if this is the way they do business all the time, and if people actually fall for it.

I also had a chance to catch up with some of my colleagues across the country and get a feel for how they’re coping with either an extended first wave, or the beginnings of a second wave, of COVID cases. It seems the theme of the last couple of weeks has become “patients behaving badly,” with increased conflicts at the front desk from patients who refuse to wear masks. Especially entering a medical office, I think having a healthcare institution require a mask is no different from “no shoes, no shirt, no service” anywhere else (although I always wondered why they didn’t require pants, but that’s another discussion).

One colleague’s practice had to bonus their receptionists because they were threatening to quit due to the stress of having people come in and yell at them. Another physician friend told a story about coming around the corner in the office and having a patient raging in the hallway about being refused a rapid test, because his son is a major league sports player and the dad needs a documented negative to be able to interact with him. The kicker – dad was standing in the hallway with no mask on in a healthcare facility that has a 20% positive return rate on tests. You can’t make this stuff up.

In other news you can’t make up, rumor has it that HIMSS is moving the HIMSS21 conference from spring to August next year, but still in Las Vegas. A friend mentioned it after seeing it in Modern Healthcare, but HIMSS didn’t bother to put an announcement on its website or send anything out to members, including our local chapter president. Seems like their communication is really improving since the debacle of this spring.

That would make it almost a year and a half between HIMSS meetings, which is plenty of time for vendors to come up with new and creative offerings. Still, it remains to be seen how many companies will actually exhibit, given how much money was lost on HIMSS20 and the potentially limited pool of attendees if international travel is still snarled and domestic institutions aren’t eager to allow their employees to head to a 40,000 person Petri dish. I spoke with my favorite traveling technology consultant the other day and his employer has him grounded, even though he’s amenable to travel and clients are requesting him on site.

Perhaps by August 2021 we’ll see a healthcare implementation of smart glasses again. Remember the exciting times of Google Glass and when wearables were just coming on the market? We need some cool offerings to get us excited again. Vuzix has an industrial application that includes Bluetooth connectivity and voice recognition, which might be attractive in healthcare. Apparently, several healthcare institutions in the US are already piloting the device and it’s also being used internationally. Battery life is supposedly 16 hours, which is pretty impressive. It uses the same chip as Google Glass, but seems more rugged and can be disinfected with alcohol-based products so it meets the COVID challenge. If they’re looking for a sassy urgent care doc to give it a try, I might know someone. It might also find interesting applications in education, since it looks like many school districts across the nation will be embracing distance learning this fall.

I attended the Health Impact Summer Forum and really enjoyed the keynote speech with Wendy Dean MD, who is a psychiatrist and co-founder of the non-profit group The Moral Injury of Healthcare. I’ve written a couple of times about moral injury and it’s gotten even worse with COVID. Organizations are still rationing personal protective equipment and we’re still operating under crisis standards of care, seven months into this pandemic. Clinical workers are risking their lives daily, often for patients who don’t care and who may be hostile to them. One local practice refused a physician’s request to put up signs asking patients to keep their masks on in the exam room while waiting because it would be perceived as “unwelcoming.” This is nonsense, plain and simple, and Dr. Dean validated the negative impacts of decisions like this.

She commented that calling healthcare workers “heroes” makes the public think we can do anything, when in reality our “superpower” is our humanness. She commented on the business challenges that are impacting clinical care as well. The pandemic certainly highlighted the broken pieces of our healthcare system in the US and identified opportunities for improvement. She notes that there is no clearly drawn road map that gets us where we want to go and proposes that we start orienteering with our moral compass as our guide and excellent patient care as our true north.

As someone who knows her way around a map and compass but who has been lost in the healthcare trenches for years, that definitely resonated with me. I really enjoyed Dr. Dean’s commentary on the issue and just having my feelings validated gave me hope. There’s another Forum in the fall and I’ve already signed up.

Is your employer taking any steps to combat moral injury as the pandemic rages on? How are your support structures? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 7/30/20

Humana invests $100 million in telehealth start-up Heal

App-based house call and virtual primary care company Heal announces a $100 million investment from Humana, which will offer the company’s services to its members.

Cerner Earnings Beat, Revenue Misses In Q2

Cerner announces Q2 earnings per share of $0.63 on revenue of $1.33 billion, down slightly from analyst expectations of $1.36 billion.

Using population health analysis to improve patient care brings Sema4 a $1.1 billion valuation

Mt. Sinai Health spin-off Sema4 raises $121 million, earning the precision medicine and analytics company a $1.1 billion valuation.

SOC Telemed to Merge with Healthcare Merger Corp.

Special purpose acquisition company Healthcare Merger combines with SOC Telemed under the acute-care telemedicine company’s brand, which will be listed on the Nasdaq at an initial valuation of $720 million.

Morning Headlines 7/29/20

Withings raises $60 million to bridge the gap between consumer tech and healthcare providers

Withings will use a $60 million Series B funding round to building out its Med Pro division, which offers remote patient monitoring devices to programs run by providers, payers, and employers.

TA, Francisco Partners join hands in $1.4bn-plus deal for Edifecs

Francisco Partners and TA Associates invest in health IT company Edifecs, giving them a combined 51% interest in the company.

Ciox Health Acquires Biomedical Natural Language Processing Pioneer, Medal, Inc.

Health records retrieval company Ciox Health acquires Medal, which specializes in using AI to process unstructured data from medical records.

DOE, HHS, VA Announce COVID-19 Insights Partnership

HHS and the VA will use the Department of Energy’s high-performance computing and AI resources to analyze health data and conduct COVID-19 research.

News 7/29/20

Top News

Withings raises $60 million in a Series B funding round led by Gilde Healthcare. The investment will go towards building out its Med Pro division, which offers remote patient monitoring devices to programs run by providers, payers, and employers.

The company pivoted largely from consumer wearables to medical-grade products when several of its original founders and investors re-acquired it from Nokia in 2018.

Webinars

August 19 (Wednesday) 1:00 ET. “A New Approach to Normalizing Data.” Sponsor: Intelligent Medical Objects. Presenters: Rajiv Haravu, senior product manager, IMO; Denise Stoermer, product manager, IMO. Healthcare organizations manage an ever-increasing abundance of information from multiple systems, but problems with quality, accuracy, and completeness can make analysis unreliable for quality improvement and population health initiatives. The presenters will describe how IMO Precision Normalize improves clinical, quality, and financial decision-making by standardizing inconsistent diagnosis, procedure, medication, and lab data from diverse systems into common, clinically validated terminology.

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

Acquisitions, Funding, Business, and Stock

Transformative raises $1.7 million to further develop and gain FDA clearance for software that can predict cardiac arrest in pediatric patients. The company plans to eventually launch similar capabilities for other life-threatening conditions.

Connecticut Children’s Medical Center and consulting firm Guidehouse will launch an RCM software and services company for pediatric healthcare facilities.

Sales

• Allegheny Health Network (PA) selects prescription-savings software from Medicom Health.
• Sana Behavioral Hospitals (AZ) will implement Medsphere’s CareVue EHR and RCM Cloud technologies.
• Cooper University Health Care (NJ) selects Nuance’s Dragon Ambient EXperience, which includes app-based virtual assistant and clinical documentation capabilities.

People

Tim Conroy (Refocus Data) will join Cary Medical Center (ME) as CIO.

Optimum Healthcare IT names Brenda Ashley, RN (Impact Advisors) VP of its Last Mile Training program.

Don Pettini (Change Healthcare) joins Trio Health as CTO.

Announcements and Implementations

The University of California, Irvine Medical Center equips its new 16-bed unit with EHR-integrated digital whiteboards and interactive bedside technology from Sonifi Health.

In Chicago, the Midwest Institute for Minimally Invasive Therapies implements Saykara’s voice-enabled, mobile AI assistant for physician charting.

Summit Healthcare announces GA of All Access software to help providers better comply with CMS Conditions of Participation and access data during downtimes.

COVID-19

Texas health officials who approved the $295 million purchase of contact-tracing software from MTX Group say they are now running into technical difficulties that prevent its widespread use. Workers hired to help with the Texas Health Trace program have reportedly been left with little to do, citing confusing instructions and, presumably, poor training.

The New York Times paywalls what is presumably a profile of disgraced vascular surgeon Sapan Desai, MD, PhD one of three collaborators that put together an influential COVID-19 treatment study published and then retracted by The Lancet and New England Journal of Medicine after fault was found with underlying data provided by Desai’s now-shuttered company Surgisphere.

Clinicians at Yale New Haven Hospital in Connecticut share how they repurposed their Epic system’s antimicrobial stewardship module to care for a surge in COVID-19 patients.

XPrize launches a six-month Rapid Covid Testing competition that will award $5 million to teams that develop faster, cheaper, and easier to use COVID-19 testing methods.

Other

HIMSS is considering a new date for HIMSS21, currently scheduled to take place March 1-5 in Las Vegas. The society has promised more concrete details by the end of the week. Should the conference be pushed out to August, we’ll get to enjoy average daily temperatures of around 104°. UPDATE: a reader forwarded an email HIMSS reportedly sent to exhibitors confirming a new HIMSS21 date of August 9-13. I’ve asked HIMSS to confirm.

Sponsor Updates

• The Chartis Group promotes Mike D’Olio to director.
• Cumberland Consulting Group achieves HITRUST CSF certification to further mitigate risk in third-party privacy, security, and compliance.
• Dina wins the 2020 Transition of Care Challenge put on by Tulane Health System and the New Orleans Business Alliance.
• OptimizeRx makes its digital health information, including prescription savings and treatment information, available through Change Healthcare’s Intelligent Healthcare Network.
• Hillrom integrates its Voalte clinical communication platform with Aiva’s voice assistant technology.
• Health Catalyst makes available financial impact recovery applications to help providers manage elective backlogs and evaluate performance.

Blog Posts

• What Happens During an EHR Digital Learning Class? (314e)
• 6 Tech Tips to Quench the Burnout (AdvancedMD)
• Healthcare PowerChat podcast with Jason Knox on Enterprise Imaging (Agfa Healthcare)
• Denial Management: CarePort’s comprehensive solution (CarePort)
• Why Investing in EHR Solutions Featuring Speech Recognition is Beneficial for Providers (ChartLogic)
• How COVID-19 Has Impacted Substance Use Disorder Treatment (Collective Medical)
• Delayed Care Could Have Long-Term Impact on Patient Health (CoverMyMeds)
• Empathy in Healthcare: Why It’s Needed Now More Than Ever (Dimensional Insight)
• Pushing Boundaries, Reaching New Horizons (EClinicalWorks)
• After public health emergency extension, ESolutions supports home health providers in states resuming Review Choice Demonstration (ESolutions)
• Overview of Nordic’s Provider Experience Solution (Nordic)

Contacts

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

Morning Headlines 7/28/20

Ro, a 3-year-old online health provider, just raised a new round that values it at $1.5 billion

Health, wellness, prescription delivery, and telemedicine company Ro raises $200 million.

Transformative Raises $1.7M Seed Round After Developing Technology That Predicts Sudden Cardiac Arrest

Transformative raises $1.7 million to further develop and gain FDA clearance for software that can predict cardiac arrest in pediatric patients.

Connecticut Children’s Medical Center and Guidehouse Form New Company to Deliver Revenue Cycle Management Improvements to the Pediatric Healthcare Industry

Connecticut Children’s Medical Center and consulting firm Guidehouse launch an RCM software and services company for pediatric healthcare facilities.

Curbside Consult with Dr. Jayne 7/27/20

I’m not sure if I ever thought I’d reach this point, but today marks my 1,000^th post for HIStalk. I should have hit it earlier in the year, but without daily posts from HIMSS it took a little longer than anticipated. I’ve been struggling with what to write about, since I felt like it should be something with gravitas for a momentous occasion. I don’t think any of us thought we’d be in the middle of a global pandemic this year, and that our industry would be going through all kinds of changes as the world’s healthcare system is pushed to the breaking point. After floating in the neighbor’s pool for a couple of hours, which is marvelous for achieving clarity, I decided to do a little tour down memory lane.

My first post appeared on January 8, 2011, when we were deep in the world of Meaningful Use. Browsing through my first few months of writing, I came across a quote that certainly applies to 2020. “The life of a CMIO is never dull; there’s always a fire to be put out somewhere, and usually an angry physician behind the scenes holding a lit match.” Over the last nine and a half years, the physicians have become less angry about IT projects, but now they’re burned out and frustrated from the challenges of treating a brand-new and deadly virus in less than ideal circumstances. I don’t envy members of technology teams that have to try to deploy new solutions in this challenging new environment.

The next year brought such adventures as the transition to the HIPAA 5010 transaction standard and the beginning of Medicare allowing its claims database to be used for provider report cards. August 2012 brought the passing of astronaut Neil Armstrong, and I had a few things to say about his passing that still ring true today:

His death was marked in a way that matched the way he lived – quietly and with little fanfare. By commanding the Apollo 11 mission and being the first person to walk on the moon he had earned the right to be celebrated. The amazing part of his story however is what happened after July 20, 1969. He didn’t dance in the end zone or become tabloid fodder. He went back to work and back to his roots. I’m touched by a quote from an article marking his passing. In an interview in February 2000 he said:

I am, and ever will be, a white socks, pocket protector, nerdy engineer. And I take a substantial amount of pride in the accomplishments of my profession.

We should all take a substantial amount of pride in the accomplishments of his profession. Not to take anything away from the astronauts, but I’m talking about the engineers. NASA’s steely eyed missile men sent people to the moon using chalk boards and slide rules. They didn’t have anywhere near the technology that most of us carry in our pockets today, but they changed the world.

Those of us working in health care IT today are up to our eyeballs in technology. It feels like things are moving so fast we will never catch up. As hospital leaders we are challenged to deploy the latest “thing” regardless of quality or outcomes. I have many friends in the medical software industry ranging from developers to CEOs. The aggregate of their skills and creativity could propel us into a new era of patient care. Instead we seem mired between the twin terrors of governmental compliance and simply improving yesterday’s products. I want to see the software equivalent of the space race where vendors are competing for the best designers and engineers and working to deliver a superior product.

Rather than the challenge of getting a man to the moon and returning him safely, the goal should be to deliver patients safely through the health care experience while we collect all the telemetry data needed to make the next trip with even better safety and quality. Another challenge – it’s easy to forget that as broken as our health care delivery system is, it is still better than what is available in some parts of the world. Let’s figure out how to make those leaps for all mankind.

It really got me thinking about whether we’ve really made the great leaps we could have been making over the last eight years. Although there are some nimble companies innovating, from the physician end-user perspective, it feels like we’re still dealing with marginal improvements on older products. The exam room of the future has not yet come to pass for the more than a handful of physicians, and although we can ask Alexa for the weather forecast, we certainly can’t ask her to predict when we’ll actually see the results of the COVID swab we just ordered. We’ve had a substantial missed opportunity as far as improving the lives of our end users, who have largely slipped into the mode of learned helplessness.

Thumbing through posts from around Thanksgiving in that year, I had a moment of sadness as I read “Dr. Jayne’s Holiday Recipe Guide.” I think it’s safe to say that the days of the office potluck are over for the foreseeable future. I treasure those times spent with my team as well as the delicacies shared – whether it was Bianca Biller with her “Hot Bacon Dip” or Paul the Intern with his “Crave Case” of White Castle hamburgers, there was always a variety of interesting things to eat and a lot of laughter.

Don’t get me wrong, things can still be fun and relationships can be built in the virtual world, they’re just different. In a world built around virtual meetings, I certainly wouldn’t have been able to clink glasses with both Jonathan Bush and Judy Faulkner within 10 minutes of each other (thank you, HIStalkapalooza 2013). There’s something about the bonding that happens when you stroll the HIMSS exhibit hall with a friend (especially one wearing a beauty queen sash that he won the night before), whether you’re trying to do serious work or just making fun of the insanity that is our industry. There’s also something about trying to get your shoulder back into its socket after dancing with Matthew Holt, but that’s another story for another day. Perhaps one day we’ll be able to do those things in-person again, and when we do, I’ll have the sassy shoes I purchased for HIMSS20 at the ready.

To my readers, thank you for being part of my world for the last 1,000 posts. I hope that each of you is able to stay safe, healthy, and sane during the great dumpster fire that is 2020. Whether you’re on the clinical front lines or in a supporting role, I appreciate your contributions to the care of patients around the world. The practice of medicine would be substantively different without everyone in the healthcare IT family. And so, I raise my virtual martini glass to each of you – here’s to the next 1,000 posts, and to better times ahead.

Email Dr. Jayne.