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Katie the Intern 11/6/20

November 6, 2020 Katie the Intern 4 Comments

Hi, HIStalk readers! Katie The Intern here. I’m back and somehow made it through my first week of learning healthcare IT. How do you all keep up with this industry with such poise?

I find myself wanting to be interesting and somewhat humorous. I Googled healthcare IT humor and found a Pinterest board full of IT jokes. Once I feel like I’ve earned a few throwaway dad jokes in the IT department, I’ll share them. If you have any, I’d love to read them! 

How Journalists Use Sources

Mr. H suggested that I briefly discuss how journalists choose and use sources. From my studies and experience in journalism, the best sources are sources that are timely and factual. You’ll think, jeez, you paid for that class? But, you’d be surprised how many sources I have replaced because the information they promised to have or the timeframe in which they promised to deliver that information fell through. There is no story without sources. There is no information to be shared unless that information is substantial to reporters. We choose sources and statistics that are tangible, honest, and valuable. 

That being said, sources must also be willing to talk to journalists about what they know. I briefly studied media law, and in my opinion, protecting a source can sometimes prove more valuable than the information itself. Establishing trust with private sources, especially those whose employment teeters on that information’s publicity, is a very valuable practice.

The protection of a journalist when using an anonymous source is known as a shield law. Shield laws vary from state to state, and do not completely provide protection in all cases. Shield laws come from the first amendment and allow a journalist to claim that consumers have a right to newsworthy information despite the source it comes from. This varies in court, medical journalism, private investigations, and others. 

Shield laws apply to publications that claim to be information sources, i.e., your average newspaper, online news hubs, and most of the places you read or watch news. Blogs and private boards typically do not fall under shield laws because the information is not classified as news, but as opinion. To be completely honest, I don’t know much more about media law and where the line is drawn when information is not bound to a specific state (HIStalk readers submit information from all over). But I will do more research and update you in my next post. I’ve been reviewing sites I read in school, and this Columbia Journalism Review article is a good start. 

What I can say is, a journalist’s reputability is on the line, too, when reporting with anonymous sources. A good journalist will do their research on a source and make sure they are who they claim to be and the information they are giving is factual. A good journalist will establish themselves as trustworthy and reputable so that readers feel they can trust what they’re reading.

Now for more of what I think about sourcing information on blogs! Opinion is valuable as long as it is labeled as opinion. Rumors are valuable as long as they are labeled as rumors. Sourcing for both should follow similar guidelines. Sources should be able to confirm where they obtained their information. Sources should confirm their connection to their information. Sources should provide as much documentation as possible. It is on the journalist to confirm that these things are valuable and truthful. As long as rumors can be substantiated (such as, this could be true, but it is a rumor), then reporting on them is fair and fun. Making private or rumored information public can be quite exhilarating. HIStalk readers seem to enjoy rumors and the discussions they sponsor. 

Thoughts on Health IT News Reporting

As a journalism major, I am finding great value in reading HIStalk even though I have never read much about healthcare IT. It has opened my eyes to niche industry reporting and blogging. I did not realize the scope of the HIStalk world and the worlds that it revolves in. Niche reporting is a safe industry, but the niche does have to be big enough to be sustainable. I am learning that finding a niche and being good at hosting discussions about it is quite sustainable. Mr. HIStalk has gotten this right for almost two decades, as you all know. 

I’ve been reading other sites and comparing their reporting practices with the aggregation and types of coverage that Mr. HIStalk uses for the news he posts. In one sense, HIStalk cannot compete with regular news, simply because the audience is expecting only healthcare IT news. Any other information would seem out of place and boring. On the other hand, HIStalk outpaces other healthcare IT sources because of its unique atmosphere of readers and discussion. Blogs and news are both competitive sources, but luckily they are competitive in their own niches and universes and not so much with each other.

My future columns will consist of what I am learning, interviews with young professionals in the IT field, interviews with marketers and PR people about how and why they use HIStalk, and more research on what I have been learning. 

I am also looking for a “beat,” so to speak, that I can write about each week. My first thoughts on this focus on the growth and prevalence of using telehealth to cut down treatment times in hospitals and clinics. For example, I talked to a family friend who discussed how telehealth saves time in diagnosing a stroke in a patient, allowing life-saving medication to be administered faster. It would be both entertaining and enlightening to interview various IT employees at different levels and get their take on what telehealth has done, what it can do in the future, and how fast it will grow. Mr. H suggested looking into news and information about consumerism in telehealth, which I am also interested in writing about but would certainly need ideas for expansion of that topic. 

If you have any ideas on expanding these topics or believe they would not be as interesting as I find them to be (being new to this field, I recognize some topics that I find exhilarating are old news to the professionals), do comment or send me an email. I’d love feedback and advice!

Overall, I feel I am learning a great deal from Mr. H, HIStalk readers, and from reading about healthcare IT online. I am very appreciative of those who took the time to send me emails, advice, and tips as I learn more about this field. Thank you for reading, and I look forward to furthering my HIStalk studies with you all. 

Katie The Intern

Katie

Email me or connect with me on Twitter.

Weekender 11/6/20

November 6, 2020 Weekender Comments Off on Weekender 11/6/20

weekender 


Weekly News Recap

  • Vermont sends a National Guard cyber response team to to help University of Vermont Health Network check its computing devices for malware.
  • Healthcare integration technology vendor Bridge Connector will reportedly shut down.
  • Teladoc Health completes its acquisition of Livongo.
  • SOC Telemed begins public trading following its merger with a special purpose acquisition company.
  • The founder and former CEO of a patient-focused oncology technology company sues an investor who she says pushed her out and blocked an attractive acquisition offer.
  • Hospitals shut down and beefed up their email systems in an effort to prevent ransomware attacks.

Watercooler Talk Tidbits

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Readers funded the DonorsChoose teacher grant request of Ms. P, who asked for hands-on STEM activities for her gifted and talented grade 4-6 class in Connecticut. She reported in late April, “If you could have seen how my students faces lit up when they saw the Legos and K’Nex, excitement is an understatement. The students easily dove in to building their ideas with the new materials. We started with trying to build the tallest structure. The student jumped in to build a “skyscraper”. They found what worked to support the height of their builds and if their building could withstand a wind. Next, We moved in to their own choice creations. My fifth grade group start to build a Ferris Wheel from the K’Nex. They quickly learned the correct spacing and how to to make the structure stable enough to hold weight. They are working on making it spin from the center point. The fourth grade student were able to show their creative side in creating robots, cars, windmills and other creation from the Legos. They will be working writing stories that explain their new creations. In the future, my students will be using the Legos and K’nexs to do fraction math, test science concepts and build new inventions. My students love hands on activities. They truly enjoy being able to put their ideas in to real life practice.”

Upstate University Hospital (NY) quarantines 36 medical residents who attended an off-campus Halloween party in which a co-worker tested positive afterward. The hospital is threatening to discipline the residents for their “egregious lapse of judgment.” 

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BuzzFeed News interviews several unemployed nurses and nursing students who have turned to sex work using the OnlyFans app, which allows to collect tips from people who pay to view their nude photos and videos and to chat with them.


In Case You Missed It


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Morning Headlines 11/6/20

November 5, 2020 Headlines 7 Comments

Vermont National Guard to assist UVM Health Network

Vermont’s governor sends a National Guard cyber response team to help University of Vermont Health Network inspect each of its end-user devices for malware after a cyberattack on October 25.

Koa Health secures over €14m initial funding and spins out of Telefónica’s moonshot factory

Koa Health launches its digital mental healthcare solutions and services in the US with a $16.5 million Series A funding round.

Connected Care Pilot Program Application Window to Open on Nov. 6

The FCC will begin accepting applications on November 6 for its Connected Care Pilot Program, which will provide up to $100 million to help providers cover costs related to connectivity for telehealth programs.

News 11/6/20

November 5, 2020 News 1 Comment

Top News

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The Nashville business paper reports that healthcare integration technology vendor Bridge Connector will close its doors less than three months after completing a $25.5 million Series B funding round.

The company has obtained $45.5 million in total funding. 

Bridge Connector is reportedly laying off 160 employees, effective in 60 days. It claims to have 750 live customer sites.


HIStalk Announcements and Requests

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Brilliant and timely: I heard about “webinar dining room” vendor EatNGage from a HIMSS chapter presentation. Webinar or online meeting presenters pay booking fee plus $25 for an entree and beverage to be delivered to each attendee, after which the registrant is sent a link that displays their restaurant delivery and menu options. The company says that providing lunch reduces no-shows dramatically and more closely simulates the usual onsite sales activities. BMC, for example, found that webinar attendance jumped from 28% to 95% and attendees stayed connected throughout the event because they were eating during the presentation (that reminds me of my college roommate’s pragmatic dating methodology, which was to always invite girls for dinner because “hey, they gotta eat.”) The per-meal price includes food, delivery, tax, and tip. I suspect that in some areas the only dining choices (if any) will be dull pizza places or low-quality chains, but maybe not. The system also offers an option to provide meals only for specifically designated attendees, like the hottest prospects.

Listening: new 1970s-style acid, experimental guitar from Tom Morello, formerly of Rage Against the Machine and Audioslave. Interesting guy: he graduated from Harvard and moved to Hollywood, where he had to support himself as a stripper. He also worked in the office of US Senator Alan Cranston, but got in trouble for telling a constituent who called to complain about Mexicans moving into her neighborhood, “Ma’am, you’re a damn racist.” He also does fantastic, folky protest songs under the name The Nightwatchman, including this spectacular 2012 song “Save the Hammer for the Man” with Ben Harper. And for head-nodding and air-drumming, you can’t beat RATM, which will supposedly reunite for a world tour next year.

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HIMSS updates its conference webpage to indicate that HIMSS21 registration will open in January. It includes a FAQ, most of which involves endless reciting of its “no refunds” policy. They are using OnPeak for hotels again, and even though they say registrations can be cancelled or changed through July 12, HIMSS20 attendee bad blood is sure to make folks think twice before sending OnPeak money again. Hotels still show available rooms on Expedia, but at higher rates – the Venetian is $365 plus an appalling $51 per night resort fee, while HIMSS and OnPeak have it for $229 with free WiFi and no resort fee required (or $25 per day if you are stuck in 1995 and can’t live without a newspaper and in-room phone calls for your fax machine). Weather should be a balmy 113 degrees or so, with the desert humidity boosted by vagrant urine and porn slapper sweat.

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HIMSS21 exhibitors, take note of these rules, sternly enumerated but most likely enforced only if booth neighbors complain:

  • All activities must take place inside the purchased booth space, with no spillover into the aisle and no noise exceeding 75 decibels. A sound level meter costs just $20 on Amazon, so I could have fun endlessly reporting violators.
  • Anyone wearing a vendor badge who enters another vendor’s booth without permission will have their badge revoked and their employer will lose all their exhibitor points.
  • Giveaway items must have the company’s logo attached.
  • Speakers must face into the booth, not into the aisles (please don’t mess with my aisle-facing magicians).
  • Exhibitors can’t use speakers or PA systems, which I don’t see working at all since nearly every in-booth presenter has to use them to be heard by dozens of people.
  • Exhibitors are “required to remain in their own booth space” at all times (so how do they get there, then?) and run around the hall wearing attention-gathering items, such as flashing lights.
  • Cameras and video equipment are not allowed on the show floor (careful, HIMSS TV and all those would-be YouTube stars filming videos that nobody will ever watch) and companies that take photos of anything other than their own booth will be docked exhibitor points. I applaud getting rid of the aisle-clogging audio and video productions, although I don’t think that will happen.
  • “Circus-like activity” is not allowed, and “clothing must be worn at all times (including tops and bottoms).” The exhibit hall might be the only place in Las Vegas that will be free of circus-like activity and half-naked performers.

Webinars

November 11 (Wednesday) 1 ET. “Beyond the Firewall: Securing Patients, Staff, and the Healthcare Internet of Things.” Sponsor: Alcatel-Lucent Enterprise. Presenter: Daniel Faurlin, head of network solutions for healthcare, Alcatel-Lucent Enterprise. The biggest cybersecurity risk for healthcare IoT isn’t the objects themselves, but rather the “network door” they can open. This network infrastructure-oriented webinar will address overcoming the challenges of architecting a network to provide security, management, and monitoring for IoT, devices, and users using ALE’s Digital Age Networking blueprint, a single service platform for hospital networks. Digital Age Networking includes an autonomous network, onboarding and managing IoT, and creating business innovation with automated workflows. Specific use cases will describe enabling COVID-19 quarantine management, contact tracing, locating equipment and people, and ensuring the security of patients and more.

November 12 (Thursday) 5 ET: “Getting Surgical Documentation Right: A Fireside Chat.” Sponsor: Intelligent Medical Objects. Presenters: Alex Dawson, product manager, IMO; Janice Kelly, MS, RN, president, AORN Syntegrity; Julie Glasgow, MD, clinical terminologist, IMO; Lou Ann Montgomery, RN, BSN, nurse informaticist, IMO; Whitney Mannion, RN, clinical terminologist, IMO. The presenters will discuss using checklists, templates, the EHR, and third-party solutions to improve documentation without overburdening clinicians. They will explore the importance of surgical documentation in perioperative patient management, the guidelines and requirements for surgical documentation and operative notes, how refining practices and tools can improve accuracy and efficiency, and the risks and implications of incomplete, inconsistent, and non-compliant documentation.

November 16 (Monday) 1 ET. “COVID-19 and Beyond: A CISO’s Perspective for Staying Ahead of Threats.” Sponsor: Everbridge. Presenter: Sonia Arista, VP and global chief information security officer, Everbridge. While hospitals worldwide work to resume elective care amid COVID-19, they’re quickly adapting and responding to a variety of emerging risks that have tested their resilience, including a surge in cybersecurity and ransomware attacks. This webinar will highlight emerging IT vulnerabilities and best practices designed to help hospitals anticipate and quickly mitigate cybersecurity risks. A former hospital CISO will share her expertise in responding to high-impact IT incidents and mitigating risks during critical events given the “new normal” that COVID-19 has created.

November 18 (Wednesday) 1 ET. “Do You Really Have a Telehealth Program, Or Just Videoconferencing?” Sponsor: Mend Family. Presenters: J. D. McFarland, solutions architect, Mend Family; Nick Neral, national account executive, Mend Family.  Healthcare’s new competitive advantage is telehealth, of which a videoconferencing platform is just a small part. This presentation will describe a comprehensive patient journey in which an organization can acquire new patients, reduce check-in time, reduce no-shows, and increase patient satisfaction, all using virtual care. Health systems did a good job in quickly standing up virtual visits in response to COVID, but telehealth and the digital front door are here to stay and now is a good time to re-evaluate tools and processes that support patient scheduling, digital forms, telehealth, and patient engagement as part of a competitive strategy.

November 18 (Wednesday) 2 ET. “Leveraging a Clinical Intelligence Engine to Solve the EHR Usability Crisis.” Sponsor: Medicomp Systems. Presenter: Jay Anders, MD, MS, chief medical officer, Medicomp; David Lareau, CEO, Medicomp. Healthcare is long overdue for a data makeover. Clinician burnout is fueled by inaccurate, inconsistent, and incomplete clinical data, but that can be improved without scrapping existing systems. The presenters will describe the use of tools that work seamlessly with EHR workflows to deliver actionable data, improve interoperability; support the clinician’s thought process; and improve usability for better decision-making and accurate coding.

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


Sales

  • Micro-hospital Cabot Emergency Hospital (AR) will implement EPowerDoc’s emergency department information system.

People

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Joann Kern, RN (State of Maine) joins Vesta Healthcare as chief product officer.


Announcements and Implementations

Meditech launches Virtual On Demand Care, which allows patients to choose “see a provider now” from the Expanse patient portal or app to launch a video chat. 

Cape Cod Healthcare goes live on Epic.

Hackensack Meridian Health goes live on Kyruus ProviderMatch for Consumers.

Black Book names Nuance as the top vendor in medical speech recognition and AI technologies.


COVID-19

The US reported nearly 103,000 new COVID-19 cases Wednesday, the first time daily new cases have hit six figures. Another 1,097 deaths were reported that day, increasing the US total to 241,000.

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Iowa reported 4,706 new cases in 24 hours with test positivity rates at 44%. Illinois had 9,935 new cases and 97 deaths.

The New York Times looks at providers who are charging “COVID fees,” claiming that they need to recoup the cost of PPE and increased sanitation. Some state attorneys general say such fees are not legal based on consumer law or insurer contracts. Dental practices are using them most often, and dental insurance leaves patients to pay everything that isn’t specifically covered, such as an extra $15-$25 for the cost of PPE used in a cleaning. One assisted living facility charged residents a one-time $900 fee for masks, cleaning supplies, and meal delivery. AMA has asked Medicare to pay $6.57 for PPE, which is much less that some providers are charging.


Other

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The founder and former CEO of oncology patient relationship management software vendor Navigating Cancer sues Merck’s innovation fund — one of the company’s investors — for pushing her out in what she says was gender discrimination that was intended to turn the company into “a boys’ club.” Gena Cook says that Navigating Cancer, which has raised $44 million, received an attractive acquisition offer from a competitor of Merck, but Merck blocked the sale. She also claims that Merck’s board rep wanted to decrease the influence of competitor-owned Flatiron Health by moving Navigating Cancer into data products and away from patient care technology.

River Hospital (NY) shuts down its email system indefinitely following increasingly frequent hospital ransomware attacks.

Vermont’s governor sends a National Guard cyber response team to help University of Vermont Health Network inspect each of its end-user devices for malware. UVM Medical Center, which has been offline since October 25 and is is open for urgent medical needs only, is asking patients to bring their own previously printed visit summaries and prescription containers to their appointments.

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A Cone Health (NC) dermatology practice was apparently taken down by malware clothing.


Sponsor Updates

  • QliqSoft posts a recording of this week’s webinar titled “Enhanced Patient Access with Chatbot Supported Scheduling.”
  • Authority Magazine features Experity SVP of Product Management Kim Commito on how its technological innovation will shake up healthcare.
  • Fortified Health Security releases a new video, “A Few Thoughts on Ryuk, Trickbot, and the Joint Cybersecurity Advisory.”
  • Elsevier partners with the Canadian Association of Pathologists to provide their members access to ExpertPath, a diagnostic decision support system for pathologists.
  • The I Don’t Care Podcast features NextGate CTO Dan Cidon and his take on interoperability challenges.

Blog Posts


Contacts

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

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EPtalk by Dr. Jayne 11/5/20

November 5, 2020 Dr. Jayne Comments Off on EPtalk by Dr. Jayne 11/5/20

Our friends at the Massachusetts Institute of Technology have created a cough detector that claims to identify COVID-positive patients even if they do not have symptoms. The system uses artificial intelligence models to identify characteristics of cough sounds that can’t be detected with the human ear. Researchers propose embedding the technology in cell phones as an early detection device. The work leverages technology that is already in process for early identification of Alzheimer’s disease. Researchers note that AI algorithms can identify various factors from a cough, including a person’s gender, language fluency, and emotions.

Researchers used thousands of recorded coughs as well as voice recordings to train the model. In the COVID analysis sample of 1,000 patients, the model was accurate for 98.5% of COVID-positive patients, including 100% of asymptomatic patients. They acknowledge that the algorithm is no substitute for proper testing, but see it as a tool that could differentiate between healthy and unhealthy coughs, alerting people to the need for testing.

I started a new project this week with a client whose attempts at value-based care delivery were in shambles. They had someone on staff who was designated as the manager of quality initiatives. Apparently she would come to meetings and “talk big” about the work she was doing, but actually had a complete lack of understanding of the work that needed to be done in order to drive the quality needle. When the physicians’ contracted health plans would send membership rosters to the practice, she simply stuck them in a binder rather than actually doing anything with them, such as confirming whether the patients on the roster were active patients in the practice or seeing whether they were current on preventive screenings or recommended health services.

In meeting with the practice’s leadership in scoping the engagement, it was clear they didn’t understand some of the basic concepts of value-based care, including the need to understand patient attribution and to reach out to those patients for whom they had been deemed responsible. I felt like we needed to take it back to a 100-level course, so this week began with some educational sessions to explain the basics of attribution and empanelment.

They seemed so surprised to hear that a payer would use claims to attribute responsibility for care that it made me wonder whether they had been completely absent from all discussion of value-based care over the last decade. Certainly they hadn’t been reading the literature that was regularly put out by their specialty society. I’ve found that the American Academy of Family Physicians has done a great job creating materials for physicians, but unfortunately, they can’t force their members to read them.

The empanelment discussion was a good one as well, since it immediately devolved into an argument about how large their panels should be or whether it was acceptable for some providers to have larger panels than others. Fortunately, our engagement includes a subproject to look specifically at physician panel size since their wait times for appointments seem to indicate that their panels are too large. They have physicians who have cut back their hours due to health reasons, but who continue to accept new patients, and the process is creating a mismatch in supply and demand. I’m surprised no one ever recommended that they close panels, but then again by the time I wind up consulting with a practice, usually there has been a series of “things no one ever told us.”

Even though these engagements can be challenging because the client has a lot to learn and I have to figure out how to get them where they need to be without them feeling like I’m completely upending their world, they can be really enjoyable. I’m usually able to make a difference for staff as well as physicians, because staff has often been compensating for overloaded schedules and isn’t experiencing the fulfillment they could be if the practice truly embraces team-based care. The project will be a little slower going than I’d like because we’re doing everything remotely, so there’s not that burning platform of having a consultant on site. It should be a good counterbalance to the grueling months ahead in the land of urgent care.

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I had the opportunity this week to spend some quality time around a backyard fire pit with one of my favorite clinical informaticists. Even though we live in the same metropolitan area, we used to just run into each other at the annual AMIA meeting. Since there aren’t any in-person meetings this year, we made it a point to get together since the scheduling stars aligned to provide us an evening where we were both free.

He has always worked in the academic space, where I’ve been more in the health system and vendor arenas. We still face many of the same challenges, though, including clashes with upper management who don’t always see the value in physicians who work on the technology side. We’re also tasked with helping bridge the gap between organizational leadership and end users who might not understand why applications are implemented in a particular way that best supports organizational goals but might not meet specific users’ expectations.

Both of us have had a lot of job changes in the last several years, and it was good to get his perspective on how the pandemic has (or in many ways, hasn’t) transformed care delivery at his organization. Some things never change, and his practices are still doing manual appointment reminder phone calls and manual COVID screening, which seems to me a shocking waste of human capital. As a clinician, I’d much rather see those staffers redeployed as care navigators, health coaches, or in working with patients who aren’t candidates for digital reminders or screenings, or who have complex situations to navigate such as arranging rides, coordinating with family caretakers, etc.

I enjoyed filling him in on some of the interactions I have with startup companies and how they’re trying to solve various healthcare workflow issues as efficiently and economically as possible. There’s definitely some inertia at his institution, but it would be fun to do a project together some day. Until then, we’ll have to settle for commiserating by the fire, six feet apart.

What new solutions is your organization deploying to handle the next wave of COVID or to prepare for vaccination? Leave a comment or email me.

Email Dr. Jayne.

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Morning Headlines 11/5/20

November 4, 2020 Headlines Comments Off on Morning Headlines 11/5/20

Exclusive: Fast-growing Bridge Connector to shutter operations

The local business paper reports that health data integration vendor Bridge Connector, which announced a $25.5 million Series B round of financing several months ago, will shut down operations.

Mississippi State Medical Association launches MHAX: Mississippi Health Access Exchange

The Mississippi State Medical Association partners with the Konza Nationwide Network, an HIE operator, to launch the Mississippi Health Access Exchange.

Frazier Healthcare Partners Announces Acquisition of Accuity Delivery Systems

Investment firm Frazier Healthcare Partners finalizes its acquisition of revenue integrity and clinical documentation improvement company Accuity Delivery Systems.

Hospitals on high alert after phishing emails target executives

A number of hospitals in Massachusetts shut down email systems or put stronger filters in place after federal officials warn of phishing emails targeting executives.

Aptar Pharma Acquires the Assets of Cohero Health, a Digital Respiratory Health Company

AptarGroup acquires Cohero Health, a digital health company specializing in the management of respiratory diseases.

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Morning Headlines 11/4/20

November 3, 2020 Headlines Comments Off on Morning Headlines 11/4/20

Teladoc Health Completes Merger with Livongo

Teladoc Health completes its $18.5 billion acquisition of Livongo with a valuation of $28 billion.

Louisville health care company expanding operations, creating 80 new jobs

Healthcare supply chain analytics and technology vendor Handle will add 80 new jobs to expanded operations in Kentucky.

City Health Department failed to terminate former employee’s access to protected health information

The City of New Haven in Connecticut will pay $202,400 to the HHS Office of Civil Rights to settle potential HIPAA violations related to its health department’s failure to implement employee termination procedures, enabling a former staffer to download the PHI of nearly 500 patients.

Comments Off on Morning Headlines 11/4/20

News 11/4/20

November 3, 2020 News 3 Comments

Top News

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Teladoc Health completes its $18.5 billion acquisition of Livongo.

TDOC shares have dropped since the acquisition was completed, valuing the company at $28 billion.


Reader Comments

From Ossified Institution: “Re: HIMSS21. Keynote speaker ideas? HIMSS20 would have been President Trump, Chris Christie, Terry McAuliffe, and Alex Rodriguez.” Here’s who I would most like to see, looking for that combination of selfless health-related experience plus the requisite celebrity appeal to make attendees feel important:

  • Amy Abernethy, MD, PhD, FDA
  • Jose Andres, World Central Kitchen
  • Richard Carmona, MD, MPH, physician, nurse, University of Arizona medical school professor, and 17th Surgeon General of the United States
  • Paul Farmer, MD, PhD, humanitarian
  • Anthony Fauci, MD, NIAID
  • Bill Gates, Gates Foundation
  • Scott Gottlieb, MD, former FDA commissioner
  • Jen Gunter, MD, physician
  • Mona Hanna-Attisha, MD, MPH, physician
  • Siddhartha Mukherjee, MD, physician and author
  • Devi Shetty, MBBS, Narayana Health
  • Laurent Duvernay-Tardif, MD, NFL player and physician

Webinars

November 11 (Wednesday) 1 ET. “Beyond the Firewall: Securing Patients, Staff, and the Healthcare Internet of Things.” Sponsor: Alcatel-Lucent Enterprise. Presenter: Daniel Faurlin, head of network solutions for healthcare, Alcatel-Lucent Enterprise. The biggest cybersecurity risk for healthcare IoT isn’t the objects themselves, but rather the “network door” they can open. This network infrastructure-oriented webinar will address overcoming the challenges of architecting a network to provide security, management, and monitoring for IoT, devices, and users using ALE’s Digital Age Networking blueprint, a single service platform for hospital networks. Digital Age Networking includes an autonomous network, onboarding and managing IoT, and creating business innovation with automated workflows. Specific use cases will describe enabling COVID-19 quarantine management, contact tracing, locating equipment and people, and ensuring the security of patients and more.

November 12 (Thursday) 5 ET: “Getting Surgical Documentation Right: A Fireside Chat.” Sponsor: Intelligent Medical Objects. Presenters: Alex Dawson, product manager, IMO; Janice Kelly, MS, RN, president, AORN Syntegrity; Julie Glasgow, MD, clinical terminologist, IMO; Lou Ann Montgomery, RN, BSN, nurse informaticist, IMO; Whitney Mannion, RN, clinical terminologist, IMO. The presenters will discuss using checklists, templates, the EHR, and third-party solutions to improve documentation without overburdening clinicians. They will explore the importance of surgical documentation in perioperative patient management, the guidelines and requirements for surgical documentation and operative notes, how refining practices and tools can improve accuracy and efficiency, and the risks and implications of incomplete, inconsistent, and non-compliant documentation.

November 16 (Monday) 1 ET. “COVID-19 and Beyond: A CISO’s Perspective for Staying Ahead of Threats.” Sponsor: Everbridge. Presenter: Sonia Arista, VP and global chief information security officer, Everbridge. While hospitals worldwide work to resume elective care amid COVID-19, they’re quickly adapting and responding to a variety of emerging risks that have tested their resilience, including a surge in cybersecurity and ransomware attacks. This webinar will highlight emerging IT vulnerabilities and best practices designed to help hospitals anticipate and quickly mitigate cybersecurity risks. A former hospital CISO will share her expertise in responding to high-impact IT incidents and mitigating risks during critical events given the “new normal” that COVID-19 has created.

November 18 (Wednesday) 1 ET. “Do You Really Have a Telehealth Program, Or Just Videoconferencing?” Sponsor: Mend Family. Presenters: J. D. McFarland, solutions architect, Mend Family; Nick Neral, national account executive, Mend Family.  Healthcare’s new competitive advantage is telehealth, of which a videoconferencing platform is just a small part. This presentation will describe a comprehensive patient journey in which an organization can acquire new patients, reduce check-in time, reduce no-shows, and increase patient satisfaction, all using virtual care. Health systems did a good job in quickly standing up virtual visits in response to COVID, but telehealth and the digital front door are here to stay and now is a good time to re-evaluate tools and processes that support patient scheduling, digital forms, telehealth, and patient engagement as part of a competitive strategy.

November 18 (Wednesday) 2 ET. “Leveraging a Clinical Intelligence Engine to Solve the EHR Usability Crisis.” Sponsor: Medicomp Systems. Presenter: Jay Anders, MD, MS, chief medical officer, Medicomp; David Lareau, CEO, Medicomp. Healthcare is long overdue for a data makeover. Clinician burnout is fueled by inaccurate, inconsistent, and incomplete clinical data, but that can be improved without scrapping existing systems. The presenters will describe the use of tools that work seamlessly with EHR workflows to deliver actionable data, improve interoperability; support the clinician’s thought process; and improve usability for better decision-making and accurate coding.

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


Acquisitions, Funding, Business, and Stock

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Meditech reports Q3 results: revenue down 5.3%, EPS $0.82 versus $2.44. Product revenue decreased 29.9% due to pandemic-related implementation delays, but service revenue increased 6.3% as more customers went live.


People

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Sentara Healthcare hires Tim Skeen (Anthem) as SVP/CIO.

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Data privacy and security company FairWarning names Lisa Counsell, RN (Soar Vision Group) VP of healthcare sales.

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Saad Chaudhry (Gartner) joins Luminis Health as CIO.


Announcements and Implementations

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Naval Hospital Camp Pendleton (CA) goes live on Cerner as part of the DoD’s MHS Genesis program.

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Cape Cod Healthcare (MA) implements Epic.

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Hackensack Meridian Health deploys provider search and scheduling software from Kyruus.

In Australia, the first five hospitals go live on NSW Health Care’s implementation of Sectra radiology imaging.

Seton Medical Center (CA) rolls out CPSI’s Evident EHR.

Novarad offers a free, AI-powered COVID-19 diagnosis tool for CT scans.


COVID-19

North and South Dakota lead the world in the daily number of new COVID-19 cases per million population at 1,457 and 1,309, respectively. Europe remains in a nearly vertical case count increase, having moved from 50,000 per day in early October to nearly 250,000 now. Experts say uncontrolled US spread will likely peak in mid-January, with daily deaths exceeding 1,000 for a sustained period.

A study finds that Quidel’s widely used quick COVID-19 test performs poorly in detecting infection in people who don’t have symptoms, detecting only 32% of the cases that were flagged by the less-timely PCR test. Quidel’s test earned FDA’s emergency use authorization for diagnosis people with symptoms, but the federal government has encouraged its use as a mass screening tool. Experts warn that no tests can accurately predict whether someone is actively infectious in being contagious to others.

Hospitals, especially rural and small facilities, are scrambling to get nursing staff as pandemic burnout is causing resignations and sending those over 50 into retirement. The answer, as always, is paying sign-on bonuses and hiring traveling nurses in competing for the limited supply of licensed personnel.


Other

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In North Carolina, the local news covers Sentara Albemarle Medical Center’s use of the “Sepsis Sniffer,” an algorithm developed by Mayo Clinic several years ago that looks for signs of impending sepsis using 4,000 patient data points found in real time within the EHR. Medical and Surgical ICU Director Daniel Mulcrone, MD says the predictive technology has been especially helpful in monitoring COVID-19 patients.


Sponsor Updates

  • Surescripts honors 10 healthcare leaders with its White Coat Award for e-prescription accuracy.
  • Arcadia’s MSSP ACO customers averaged $5.9 million in shared savings in 2019.
  • Cerner unveils the Cerner Charitable Foundation focusing on home, health, and heroes.
  • Health Catalyst will participate in the Credit Suisse Virtual Healthcare Conference November 12.

Blog Posts


Contacts

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

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Morning Headlines 11/3/20

November 2, 2020 Headlines Comments Off on Morning Headlines 11/3/20

Health-tech startup Remedy lays off 82 employees

App-based house call and telemedicine company Remedy lays off 82 employees, many of whom were hired during the summer peak of COVID-19 patients.

WELL Health Acquires DoctorCare – the Market Leader for ‘Billing as a Service’ for Canadian Doctors

Well Health Technologies forms a new business unit, the Well Billing and Backoffice Group, through its acquisition of Toronto-based DoctorCare for $13.6 million.

Federal Health IT Strategic Plan Supports Patient Access to Their Own Health Information

HHS publishes the final 2020-2025 Federal Health IT Strategic Plan, which outlines federal health IT goals and objectives with an emphasis on giving patients easy access to their digital health information.

Comments Off on Morning Headlines 11/3/20

Curbside Consult with Dr. Jayne 11/2/20

November 2, 2020 Dr. Jayne 2 Comments

I have to admit that being a blogger is a challenge sometimes. Although often the ideas for my columns come to mind easily after working in the clinical or IT trenches, some days are a struggle.

Today was one of the latter. I sat for a good hour without a solid idea in my head. I think a big piece of today’s writer’s block was the sheer stress I’m facing in the upcoming week. The clinical world has been completely out of control, with a good number of our providers down for the count with COVID or caring for close family members who have COVID.

Leadership is begging us to come in on our days off, which is a hard sell when you’ve barely been away from the clinic after your last shift. You also know that if you go in, you’’ll be crushed. So many patients who need to be seen that they are lined up before staff even arrives at the office. One of my receptionists had to park more than half a mile away, which led to a late clock-in and a fair amount of drama getting the situation remedied. Staff has to park in the lots of neighboring businesses and now has the worry of being towed to add to the stress of the day and concern about potentially becoming infected with COVID.

When you’re running with absurd patient volumes, any glitch in the technology becomes nearly catastrophic. At one of our sites, the Citrix client disappeared from multiple PCs. This led to a storm of calls to the help desk and frantic attempts to gain access to the system, all while the front desk was bringing patients in and filling the exam rooms. Trying to execute downtime procedures when you’re also trying to work with the help desk and get yourself up and running is nearly impossible. Trying to perform data entry from paper at the end of the day after you’ve seen 80 patients is just too much to ask.

Patient expectations are high and patience is low, for certain. We’re seeing over 2,000 patients a day and it’s taxing our radiology systems, with images slow to load. When you’re trying to diagnose COVID from chest x-rays because you don’t have enough rapid test kits, that’s a recipe for frustration.

The increasing hacking events directed at healthcare institutions aren’t reassuring. We’re getting daily reminders to avoid using email on work computers to reduce the risk of phishing. Employees who have been caught charging their phones via USB cables to the PCs have been disciplined. Websites have been locked down to the point where you can’t even access major pharmaceutical company information, which is always fun when you’re trying to find a package insert because you’re looking for the details needed to answer a patient’s questions.

Then there’s the thread of physical altercations. Although I haven’t had any at my worksites when I’ve been present, we did have an incident with an anti-masker patient who was ridiculing staff and other patients. He became physically agitated and had to be escorted out of the office. Businesses in our city are starting to board up in preparation for anticipated civil unrest, which is something we never planned for. Although we haven’t received a clinical bulletin on treating patients who have been exposed to pepper spray or other chemical irritants, you can bet that many of us have read up on it.

At least with my experiences in my own clinical office, I’m well prepared to meet the needs of my healthcare IT clients. Most of them are worried about the same issues, but with the hacking concerns magnified as the clients become larger in size. There are so many staff out of the office (both clinical and from a technology standpoint) that no one wants to implement any new solutions or features because they don’t want to stress already burdened caregivers or run implementation teams ragged. It sounds good to hit the pause button, until you realize that some organizations have received grant money or other awards that have strings attached, such as deadlines.

I spent a good chunk of the weekend re-engineering an implementation plan to make all the training virtual and asynchronous, including recording some of the training videos myself. Fortunately, the client has someone who can do some edits and cleanup. Although I can train with the best of them, my moviemaking skills are nearly nonexistent.

With the numbers coming off the Johns Hopkins COVID website this week, everyone is understandably worried about where the next few weeks will take us. Patients are continuing to travel and resume normal activities, and some are going overboard trying to stock up on experiences in advance of potential lockdowns. Mental health services are at a premium and those patients frequently find themselves in the urgent care setting because their primary physicians aren’t able to see them on a timeline that the patient finds acceptable.

I treat panic attacks and anxiety all the time, but there’s a special kind of anxiety that shifts to the clinician when you’re trying to help a patient cope with the fact that she has to have an outpatient hysterectomy because the hospital has put a freeze on “elective” cases that require an overnight stay. We certainly didn’t train for a world where any of what we’ve been experiencing over the last few months would be OK.

Third parties are feeding off the desperation of providers to do something other than practice medicine face to face. I was approached by a telehealth company that wanted to offer me $10 per visit and touted the ability of their platform to let me see 10-12 patients an hour. That, dear readers, is absurd. And the frightening thing is the number of physicians they’ve already signed up. I’m sure the patients don’t know that physicians are going to try to run on those volumes, or that they’re not going to get the level of care they deserve since they’re paying many multiples of that amount for the service. One colleague was offered $10 an hour to supervise a nurse practitioner. Certainly our licenses are worth more than that, but the employer thought it was more than fair. My colleague took a page from Nancy Reagan and just said no.

Then there’s the elephant in the room, which is, what will happen after Tuesday? Patients are girding for everything from “life as usual, since COVID will be gone” to full-scale civil unrest. I saw a patient last week who had been having chest heaviness that got worse as the day progressed but was better first thing in the morning. The culprit – he was wearing body armor around the house, “preparing.” You should have seen the look on my scribe’s face when I pulled that little detail out of the patient. Toilet tissue is once again flying off the shelves, although I was excited to finally score some bleach at the grocery store.

Whatever happens as a result of the elections in the US on Tuesday, my fondest hope is that people will remain calm, work through their emotions, and not lose their cool. I hope we rise to the occasion, regardless of the outcomes and the personalities involved. We all need a break.

How is your organization preparing for election day chaos? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 11/2/20

November 1, 2020 Headlines Comments Off on Morning Headlines 11/2/20

SOC Telemed Closes Business Combination and Will Begin Trading on the Nasdaq Stock Exchange

SOC Telemed completes its merger with the Healthcare Merger Corp. SPAC and will begin trading on the Nasdaq on Monday.

No End in Sight to UVM Health Network Slowdown Caused by Cyberattack

Systems at University of Vermont Health Network remain down following a cyberattack Wednesday.

Vocera Announces Third Quarter 2020 Financial Results

Vocera announces Q3 results: revenue up 6%, adjusted EPS $0.31 versus $0.23, beating Wall Street expectations for both.

Comments Off on Morning Headlines 11/2/20

Monday Morning Update 11/2/20

November 1, 2020 News 3 Comments

Top News

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SOC Telemed completes its merger with the Healthcare Merger Corp. SPAC and will begin trading on the Nasdaq on Monday.  


HIStalk Announcements and Requests

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A substantial number of poll respondents have had, as patients, experience with a scribe. JO says that most high-functioning teams have someone taking meeting notes and use of scribes should be similar, while JT observes that scribes need to learn to be almost invisible to avoid intruding on the encounter.

New poll to your right or here: Which is the most common way you’ve obtained prescription medications in the past year? Cary Breese said in our interview that chain drugstores force you to walk through shelves full of high-margin merchandise to get to the prescription counter, but that immediately triggered a question – if those drugstores are encouraging impulse sales, why do they have a drive-through window? Similarly, why do gas stations allow customers to pay at the pump without even entering the store where all the high-margin SKUs are piled high? Why does Walmart seem happy about advance ordering and store pickup on a few thousand grocery items when their store is full of other stuff you can’t impulsively buy from the curb? What does that portend for providers who may be giving up an upselling opportunity in offering virtual visits?

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Welcome to new HIStalk Platinum Sponsor Well Health. The Santa Barbara, CA-based company’s intelligent communications hub is the only two-way digital health solution that engages patients throughout their entire care experience. It enables conversations among patients and their providers through secure, multilingual messaging in the patient’s preferred communications channel: texting, email, telephone, and/or live chat. It facilitates more than 1 billion messages for 31 million patients annually with an EHR-integrated solution that is top rated by KLAS, G2, and Capterra. It reduces provider stress and errors by unifying and automating disjointed communications across healthcare organizations, increasing patient visits and loyalty. Use cases include COVID-19 patient communication, telehealth, appointment automation, care management, patient outreach, payment management, patient reviews and surveys,  and population health. Thanks to Well Health for supporting HIStalk.

I found a really good Well Health video on YouTube that shows examples of COVID-19 communication best practices. The app looks cool, especially the auto translate option for languages other than English.

Thanks to Katie the Intern for bravely writing her first HIStalk piece even though she knows basically nothing about healthcare IT yet. I’m looking to arrange some experiences for her if you want to help out (contact Katie):

  • I would like her to  interview someone who has a big-picture view of health IT, like maybe a health system CIO, CMIO, or informaticist. Self-studying enough to ask good questions will help her learn.
  • She needs to see the dynamic between vendor marketing / PR and journalism, so it would help her to talk to one of those marketing and PR veterans about what they do. This wouldn’t necessarily have to be a published interview.
  • I would like her to talk to a couple of folks who are in their 20s who are working in the industry and had to learn quickly.

Webinars

November 11 (Wednesday) 1 ET. “Beyond the Firewall: Securing Patients, Staff, and the Healthcare Internet of Things.” Sponsor: Alcatel-Lucent Enterprise. Presenter: Daniel Faurlin, head of network solutions for healthcare, Alcatel-Lucent Enterprise. The biggest cybersecurity risk for healthcare IoT isn’t the objects themselves, but rather the “network door” they can open. This network infrastructure-oriented webinar will address overcoming the challenges of architecting a network to provide security, management, and monitoring for IoT, devices, and users using ALE’s Digital Age Networking blueprint, a single service platform for hospital networks. Digital Age Networking includes an autonomous network, onboarding and managing IoT, and creating business innovation with automated workflows. Specific use cases will describe enabling COVID-19 quarantine management, contact tracing, locating equipment and people, and ensuring the security of patients and more.

November 12 (Thursday) 5 ET: “Getting Surgical Documentation Right: A Fireside Chat.” Sponsor: Intelligent Medical Objects. Presenters: Alex Dawson, product manager, IMO; Janice Kelly, MS, RN, president, AORN Syntegrity; Julie Glasgow, MD, clinical terminologist, IMO; Lou Ann Montgomery, RN, BSN, nurse informaticist, IMO; Whitney Mannion, RN, clinical terminologist, IMO. The presenters will discuss using checklists, templates, the EHR, and third-party solutions to improve documentation without overburdening clinicians. They will explore the importance of surgical documentation in perioperative patient management, the guidelines and requirements for surgical documentation and operative notes, how refining practices and tools can improve accuracy and efficiency, and the risks and implications of incomplete, inconsistent, and non-compliant documentation.

November 16 (Monday) 1 ET. “COVID-19 and Beyond: A CISO’s Perspective for Staying Ahead of Threats.” Sponsor: Everbridge. Presenter: Sonia Arista, VP and global chief information security officer, Everbridge. While hospitals worldwide work to resume elective care amid COVID-19, they’re quickly adapting and responding to a variety of emerging risks that have tested their resilience, including a surge in cybersecurity and ransomware attacks. This webinar will highlight emerging IT vulnerabilities and best practices designed to help hospitals anticipate and quickly mitigate cybersecurity risks. A former hospital CISO will share her expertise in responding to high-impact IT incidents and mitigating risks during critical events given the “new normal” that COVID-19 has created.

November 18 (Wednesday) 1 ET. “Do You Really Have a Telehealth Program, Or Just Videoconferencing?” Sponsor: Mend Family. Presenters: J. D. McFarland, solutions architect, Mend Family; Nick Neral, national account executive, Mend Family.  Healthcare’s new competitive advantage is telehealth, of which a videoconferencing platform is just a small part. This presentation will describe a comprehensive patient journey in which an organization can acquire new patients, reduce check-in time, reduce no-shows, and increase patient satisfaction, all using virtual care. Health systems did a good job in quickly standing up virtual visits in response to COVID, but telehealth and the digital front door are here to stay and now is a good time to re-evaluate tools and processes that support patient scheduling, digital forms, telehealth, and patient engagement as part of a competitive strategy.

November 18 (Wednesday) 2 ET. “Leveraging a Clinical Intelligence Engine to Solve the EHR Usability Crisis.” Sponsor: Medicomp Systems. Presenter: Jay Anders, MD, MS, chief medical officer, Medicomp; David Lareau, CEO, Medicomp. Healthcare is long overdue for a data makeover. Clinician burnout is fueled by inaccurate, inconsistent, and incomplete clinical data, but that can be improved without scrapping existing systems. The presenters will describe the use of tools that work seamlessly with EHR workflows to deliver actionable data, improve interoperability; support the clinician’s thought process; and improve usability for better decision-making and accurate coding.

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

 

Here’s the recording of last week’s Bright.md webinar titled ““How Presbyterian Healthcare Services Is Preparing for a Post-Pandemic Future Using Digital Care Tools,” featuring PHS SVP/Chief Innovation Officer Ries Robinson, MD as interviewed by Bright.md co-founder CEO Ray Costantini, MD. This is our first webinar that was presented as a video conversation and I have to say that I enjoyed it a lot.


Acquisitions, Funding, Business, and Stock

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From the Allscripts earnings call:

  • The company sold EPSi for 18.5 times trailing adjusted EBIDTA and CarePort for 21 times trailing adjusted EBITDA, which it says was above the average growth rate and margin for Allscripts but wasn’t being reflected in its valuation, so the decision was made to sell those businesses.
  • Allscripts says Veradigm is an example of it “finding adjacencies to grow.”
  • CEO Paul Black reiterated that “the market has not rewarded us for smart M&A transactions,” which included enhancing and then selling Netsmart and CarePort.

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Vocera announces Q3 results: revenue up 6%, adjusted EPS $0.31 versus $0.23, beating Wall Street expectations for both. 


Sales

  • Seattle Indian Health Board will implement order sets and care plans from Zynx Health.

Announcements and Implementations

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Arcadia launches Vista, a web-based enterprise business intelligence product for value-based care.

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KLAS finds that healthcare users of the videoconferencing platform Zoom are reasonably satisfied, mostly because they were able to implement it quickly during COVID and it connects reliably with high-quality video with minimal IT support, but Zoom falls short for video visits when integration with EHRs and medical devices are needed. A CMIO respondent suggests that the company create a product that is specific for telemedicine that the patient could launch by clicking a link sent to them by the provider.


COVID-19

England reintroduces a national lockdown as new infections and hospital admissions surpassed worst-case expectations, closing pubs, restaurants, and retail stores until December 2 as is already the case in Scotland, Wales, and Northern Ireland.

President Trump repeats his unproven accusation that hospitals and doctors falsely claim that patients die of COVID-19 to earn an extra $2,000 at a campaign rally, leading to a sharp reaction from AMA President Susan Bailey, MD, who called the President’s statement “malicious, outrageous, and completely misguided.” 

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White House Coronavirus Task Force member Scott Atlas, MD appears on the RT network to say that COVID-19 is under control and that it’s lockdowns rather than the virus that that are killing people. He then has to apologize for appearing on RT, claiming he was unaware that it’s a Kremlin-backed propaganda outlet.


Other

Systems at University of Vermont Health Network remain down following a cyberattack Wednesday.


Sponsor Updates

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  • Santa Rosa Consulting team members raise over $2,000 for breast cancer research during a virtual walkathon.
  • Change Healthcare will participate in a virtual fireside chat during the Credit Suisse Healthcare Conference November 11.
  • Health Catalyst announces a partnership with the Middle East Healthcare Company to service six Saudi German Hospitals in Saudi Arabia.
  • OpenText announces that Enfuse On Air 2020, a security conference focused on the prevention, detection, and investigation of threats, will be held virtually November 10-December 1.
  • PMD releases a new video, “This is PMD – Life After Bootcamp.”
  • Premier awards Call to Freedom, a nonprofit focused on navigating a healthy path for victims of human trafficking, its annual Premier Cares Award and $100,000.
  • Pure Storage enhances its Pure Partner Program to provide partners with increased incentives, marketing, support, and training solutions.
  • Spirion launches a Global Alliance Partner Program to provide a structured program for collaborative partner engagement and solution development.
  • T-System, a CorroHealth company, launches the App Showcase.
  • Medidata, TriNetX, and Datavant partner to enable seamless integration of real-world data in clinical development.

Blog Posts


Contacts

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

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Katie the Intern 10/30/20

October 30, 2020 Katie the Intern 2 Comments

Hi, HIStalk readers! My name is Katie and I am excited to be interning under Mr. H. He suggested my first entry be an introductory column about myself, my studies, and my interests in healthcare IT. 

To start, I’m a recent graduate with two part-time jobs and two side “gigs,” including this internship. I work a lot and my schedule is busy, but whose isn’t these days? I work in media communications, PR, and write for a local paper. Outside of work, I write and record music, read a lot, ride horses, and write. That just about sums me up. 

I graduated in May from a prestigious journalism school with a BA in journalism and media. I say “prestigious” because that is how it was described to me when I applied to the school, and it is one of the top-rated journalism schools in the United States. I call myself a “Covid Grad” as I lost the last three months of my collegiate career to the current pandemic. Obviously, this is not half the loss that many have faced during this time, but I do mourn the experiences and the connections I might have made had my time not been cut short.

I’ve often joked that graduating during a pandemic should be listed on my resume. Losing your last three months of college, obtaining a degree, not having graduation, moving back in with your family, and stepping into a globally crumbling economy should be listed as an acquired skill set. Anyone out there hiring? 

My studies focused on multimedia news. I have experience with photography, print, broadcast journalism, animation, interviewing, multimedia design, and writing. I am proud of the school I come from and very proud to have my degree.

I had hoped to work in breaking news reporting for a local paper. I still hope to one day do this, but as the industry changes to concise and fast-paced delivery, I know I have to expand my portfolio. I enjoy writing breaking news, interviewing, taking photos, producing videos, and getting information out in a timely manner. I believe that getting concise, factual, and interesting news and stories to the community is extremely important. 

I recently spoke with a reporter for a local paper that I have wanted to write for for some time. He is a sports reporter and is now only covering Covid news. This was an eye-opener for me about the state of the news industry and the state of the world. I remember teachers assuring myself and other students, “There will always be a need for news.” I believed them and I still do, but I am quickly learning that a need for news does not promise a need for true, journalistic storytelling. So here I am jumping into an industry I know very little about! 

To be fully transparent, I know next to nothing about healthcare IT. I even had to Google what IT meant and how that related to healthcare news and what Mr. H does. I have had an interest in healthcare since early college because I have a family member who is affected by healthcare legislation. My interest stems from a curiosity as to how healthcare impacts my sick family member and her caretakers. Information technology was not among those interests, but when Mr. H described to me the possibility of learning more about the field, I decided to give it a try. So thank you for your willingness to let me learn about your industry and what makes it tick. 

I hope to learn many skills during this internship, both from Mr. H and from this audience. I expect to learn how Mr. H aggregates sources and communicates with readers about those sources. I expect to further my journalistic skills such as concise writing, compelling interviewing, interesting and important storytelling, and more. I want to learn how sources report on what healthcare IT is doing and how media concentrate efforts in publishing that information as quickly and accurately as possible. I feel I will learn a lot from interviewing professionals in the healthcare IT field and from interviewing HIStalk readers.

I desire to learn as much as possible about healthcare IT itself. Information technology is a concise name for a robust industry. I hope to learn what IT is, what it involves, and how it impacts healthcare. I want to understand who develops healthcare IT and what pushes those developments forward. I want to learn how healthcare legislation is impacted by the IT industry. I want to learn how professionals in the field predict what IT will do next. I want to understand how the stock market is impacted by healthcare IT. The jargon in health care, information technology, and in Mr. H’s posts will also install a learning curve for me. I’ve been researching and learning acronyms that Mr. H and readers use. If I can get over that hump, I think I’ll be good to go. 

I believe that the more I learn about this field and what Mr. H does, the more I will want to expand that newfound knowledge. I fully expect the list of what I hope to learn to grow. I will be writing a weekly column about what I learn and researching healthcare information technology as much as I can. I will also be doing interviews with readers and sponsors. I would love to hear from healthcare IT marketing and PR workers who could describe to me what they do.

For now, I am excited (and thankful) to be able to step into your industry and to learn what it does. I am appreciative of your patience and willingness to teach me and to interact with me, and I look forward to diving into this internship more and more.

Thank you for reading. I do hope I’m even half as entertaining as Mr. H.

Best,
Katie the Intern

Katie

Email me or connect with me on Twitter!

Weekender 10/30/20

October 30, 2020 Weekender Comments Off on Weekender 10/30/20

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Weekly News Recap

  • HHS/ONC extend the dates for Cures Act compliance.
  • Several US hospitals report cyberattacks as the federal government warns that Russian hackers are targeting 400 of them for ransomware, with payment demands of $10 million and more.
  • Allscripts and Cerner report quarterly results, with both beating earnings expectations but falling short on revenue.
  • HHS releases a final rule that requires insurers to report their negotiated provider rates and patient out-of-pocket costs for 500 shoppable services.
  • Blank check company Health Assurance Acquisition Corp., formed by departing executives and backers of Livongo, prepares for an IPO of up to $500 million.
  • The VA goes live on Cerner at its first site.

Best Reader Comments

Cerner put on a pretty good Cerner Health Conference given the limits of a virtual platform. The puppy and kitty cams were a nice touch. Exhibits were pretty boring — not sure how to replicate the real-time repartee even with vendors whose services you don’t need. The Cerner solutions center was a better experience and the ability to have a scheduled 15 min Zoom session with a solutions expert was much better than clustering around and fighting your way to the front to ask a 30 sec question at the in person event. Some of the most interesting workshops had a cap on attendance and they didn’t seem to record those sessions for later viewing which was unfortunate. Overall, they’ve done the best job that I’ve seen of a virtual conference. (CernerSuperUser)

Regarding the lab interface being down and no one noticing: I think every internal business user should have the expectation that their internal IT department will monitor functioning of business critical interfaces and similar processes like file transfers and ingestion. If you had outsourced operation of your IT to a vendor, you’d certainly cover things like that in a Service Level Agreement and you’d make plenty of noise if the vendor didn’t meet the SLA. If I was a lab internal customer, I’d ask the IT department 1) Is the interface between the EHR and the lab system monitored by tools for both up/down status and throughput? What are the performance thresholds for throughput that are considered acceptable? 2) Who is in IT is responsible for receiving the alerts from the monitoring tools? 3) What is your requirement for how quickly your people respond to an alert indicating a serious system or interface down condition? 15 minutes? 4) What do you consider prime hours for the lab-EHR interface? 7 x 24 including holidays, or something less than that? (Vendor Mgmt Guy)

Concerning hospitals and HIEs not allowing individual providers access to information in their systems … would this not constitute a form of information blocking? (Bill Marshall)

The training that Dr. Jayne describes would be to the level that I would be comfortable with the scribe process. That level of training is not what I see in the field today. Third party vendors who hire med school applicants, pay them $8-10 and hour, while charging $30-50 with a ‘training’ package of working with another scribe for a couple weeks — quickly weaned to a couple clinicians. Virtual scribing is even more problematic in my mind — communication is tough enough when you can see the patient and clinician — think about all the connection issues between the phone, the computer, the security of access, etc. Plus, in a clinical environment you can control who is in the ‘room’ with you. However, how do you do that when the scribe is sitting at their kitchen table while the family is making breakfast? And remember, these kids aren’t making enough to have an office they can secure themselves in. (AnInteropGuy)

In the early days (i.e March) patients had similar Dx codes to Sepsis – as that appeared to what was happening as well Covid Dx codes. I would hope that by now we’d know the difference of dying WITH Covid verses OF Covid. My guess someone from the Commercial Carriers would be able to chime in on this. Either way, I suspect some claims are stretched, but the vast majority are coded correctly. Also… if you are looking for conformational bias…. you can find it. (Silence Dogwood)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. P in Minneapolis, who asked for math tools for her class of Pre K-2 students. She reported in March, “Thank you so much for the hands on tools we received! Students have enjoyed learning how to use them. They have been really helpful to all students because they are hands on tools. Research shows the best way to learn is by doing something and repetition. You’ve made that possible. Students can create graphs, solve algebraic problems with the balance and use the hundreds place value mats combined with our blocks to build numbers. The mini clocks have been a hit! We are appreciative of your donation.”

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Flint, MI pediatrician Mona Hanna-Attisha, MD, MPH donates her American Public Health Association 2020 Fries Prize of $60,000 to fund a pediatric public health fellowship. She found from analyzing Epic patient records that Flint’s water supply had high levels of lead due to a water supply change, triggering state and federal emergencies. 

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Teens as young as 16 are working as volunteers in Czech Republic hospitals that have had 15,000 workers, including 3,000 doctors, sidelined by COVID in the country of 10 million. Czech Republic’s infection in rate is among the highest of major countries, six times higher than that of the US.

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The mother of a 14-year-old who receives brain cancer treatment from the National Institutes of Health emails staff to see if Dr. Anthony Fauci could drop by for a selfie. Fauci said no because of social distancing, but offered to FaceTime with Benjamin Ciment, who asked him if he was relaxing (no, but hanging there, Fauci said), laughingly confirmed that NIH has a painting of him on the wall that Benjamin had seen, and asked Benjamin if his hair was dyed. Benjamin said the hair color is due to his chemotherapy treatments, to which Fauci said, “Is it really? That’s one of the positive things of the medicine —  it looks kind of cool.”


In Case You Missed It


Get Involved


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Comments Off on Weekender 10/30/20

Morning Headlines 10/30/20

October 29, 2020 Headlines Comments Off on Morning Headlines 10/30/20

HHS Extends Compliance Dates for Information Blocking and Health IT Certification Requirements in 21st Century Cures Act Final Rule

HHS and ONC extend compliance dates for the Cures Act information blocking provisions to April 5, 2021, while 2015 Edition health IT certification criteria updates and standard API functionality deadlines are moved out to December 31, 2022.

Allscripts Announces Third Quarter 2020 Results

Allscripts reports Q3 results: revenue down 9.6%, adjusted EPS $0.20 versus $0.17, beating earnings expectations but falling short on revenue.

KēlaHealth Raises $12.9M in Combined Seed and Series A Financing Round to Deliver AI-Powered, Clinician-Centered Solutions That Improve Surgical Care

Surgery analytics vendor KelaHealth raises $12.9 million in combined seed and Series A financing.

Cyberattack causes ‘significant’ UVM Health Network technology outage

The University of Vermont Health Network begins recovering from a cyberattack that has impacted its seven hospitals, most notably University of Vermont Medical Center.

Comments Off on Morning Headlines 10/30/20

News 10/30/20

October 29, 2020 News 2 Comments

Top News

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HHS and ONC extend compliance dates for the Cures Act information blocking provisions to April 5, 2021, while 2015 Edition health IT certification criteria updates and standard API functionality deadlines are moved out to December 31, 2022.


HIStalk Announcements and Requests

My least-favorite term lately is “patient leakage,” which elicits two unsavory visuals: (a) bodily fluids dribbling uncontrollably from health system customers, and (b) millionaire health system executives dragging patients by the scruffs of their necks back to the facilities that they hoped to avoid.


Webinars

November 11 (Wednesday) 1 ET. “Beyond the Firewall: Securing Patients, Staff, and the Healthcare Internet of Things.” Sponsor: Alcatel-Lucent Enterprise. Presenter: Daniel Faurlin, head of network solutions for healthcare, Alcatel-Lucent Enterprise. The biggest cybersecurity risk for healthcare IoT isn’t the objects themselves, but rather the network door they can open. This webinar will address meeting the challenges of security, management, and monitoring using ALE’s Digital Age Networking, a single service platform for the network infrastructure that includes an autonomous network, onboarding and managing IoT, and creating business innovation with automated workflows. Specific use cases will be described, including COVID-19 quarantine management, locating equipment and people, and ensuring the security of patients.

November 12 (Thursday) 5 ET: “Getting Surgical Documentation Right: A Fireside Chat.” Sponsor: Intelligent Medical Objects. Presenters: Alex Dawson, product manager, IMO; Janice Kelly, MS, RN, president, AORN Syntegrity; Julie Glasgow, MD, clinical terminologist, IMO; Lou Ann Montgomery, RN, BSN, nurse informaticist, IMO; Whitney Mannion, RN, clinical terminologist, IMO. The presenters will discuss using checklists, templates, the EHR, and third-party solutions to improve documentation without overburdening clinicians. They will explore the importance of surgical documentation in perioperative patient management, the guidelines and requirements for surgical documentation and operative notes, how refining practices and tools can improve accuracy and efficiency, and the risks and implications of incomplete, inconsistent, and non-compliant documentation.

November 16 (Monday) 1 ET. “COVID-19 and Beyond: A CISO’s Perspective for Staying Ahead of Threats.” Sponsor: Everbridge. Presenter: Sonia Arista, VP and global chief information security officer, Everbridge. While hospitals worldwide work to resume elective care amid COVID-19, they’re quickly adapting and responding to a variety of emerging risks that have tested their resilience, including a surge in cybersecurity and ransomware attacks. This webinar will highlight emerging IT vulnerabilities and best practices designed to help hospitals anticipate and quickly mitigate cybersecurity risks. A former hospital CISO will share her expertise in responding to high-impact IT incidents and mitigating risks during critical events given the “new normal” that COVID-19 has created.

November 18 (Wednesday) 1 ET. “Do You Really Have a Telehealth Program, Or Just Videoconferencing?” Sponsor: Mend Family. Presenters: J. D. McFarland, solutions architect, Mend Family; Nick Neral, national account executive, Mend Family.  Healthcare’s new competitive advantage is telehealth, of which a videoconferencing platform is just a small part. This presentation will describe a comprehensive patient journey in which an organization can acquire new patients, reduce check-in time, reduce no-shows, and increase patient satisfaction, all using virtual care. Health systems did a good job in quickly standing up virtual visits in response to COVID, but telehealth and the digital front door are here to stay and now is a good time to re-evaluate tools and processes that support patient scheduling, digital forms, telehealth, and patient engagement as part of a competitive strategy.

November 18 (Wednesday) 2 ET. “Leveraging a Clinical Intelligence Engine to Solve the EHR Usability Crisis.” Sponsor: Medicomp Systems. Presenter: Jay Anders, MD, MS, chief medical officer, Medicomp; David Lareau, CEO, Medicomp. Healthcare is long overdue for a data makeover. Clinician burnout is fueled by inaccurate, inconsistent, and incomplete clinical data, but that can be improved without scrapping existing systems. The presenters will describe the use of tools that work seamlessly with EHR workflows to deliver actionable data, improve interoperability; support the clinician’s thought process; and improve usability for better decision-making and accurate coding.

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


Acquisitions, Funding, Business, and Stock

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Allscripts reports Q3 results: revenue down 9.6%, adjusted EPS $0.20 versus $0.17, beating earnings expectations but falling short on revenue.

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Cerner reports Q3 results: revenue down 4%, adjusted EPS $0.72 versus $0.62, beating Wall Street expectations for earnings but falling short on revenue. From the earnings call:

  • EVP/CFO Marc Naughton will leave the company in 2021 after 29 years.
  • An analyst noted that two recent high-level hires came from Leidos, suggesting an interest in getting more federal business, which Cerner hinted is the case. It was mentioned later in the call that Cerner is looking at “adjacencies” to its DoD and VA business, such as Indian Health Service, and “looking at ways that we can use data proactively with different branches of the government.”
  • President Don Trigg says the next focus in its relationship with Amazon Web Services will be CareAware, also noting that Amazon’s PillPack pharmacy will play into pharmacy trends.
  • Cerner had 22,000 people register for this month’s virtual Cerner Health Conference, with an advantage of the virtual format being able to see which sessions attendees choose and compare that to company focus and investment. Cerner mentioned interest in real-time workforce management, hospital operations, and consumer focus.
  • Data opportunities include release-of-information for life insurance, legal, and workmen’s comp; the Learning Health Network; and clinical trials identification and enrollment for non-academic medical centers.
  • Cerner will consider making acquisitions, but will also focus on repurchasing shares and paying dividends.

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Surgery analytics vendor KelaHealth raises $12.9 million in combined seed and Series A financing. The company says its software improves surgical quality while preventing complications. It was formed by a group of Duke-affiliated surgeon-scientists, including founder and CEO Bora Chang, MD.

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Fitness and sleep monitoring membership company Whoop raises $100 million in a Series E funding round that values the company at $1.2 billion. The $30 per month membership includes a simple monitoring strap (heart rate, sleep, and respiratory rate) and access to its analytics and community.


Sales

  • Digital therapeutics vendor Voluntis will use the interoperability platform of Redox to offer providers actionable, EHR-integrated insights on how patients experience treatment at home.
  • Greater Baltimore Medical Center (MD) will deploy app-based way-finding, appointment reminders, Epic MyChart integration, and mobile bill pay from Phunware.
  • Alliance Health (NC) will implement ZeOmega’s CareIntel for population health management.

People

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Marshall Health (WV) promotes Shannon Browning, RPh, MD to the newly created position of CMIO.

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Greenway Health hires Michael Blackman, MD, MBA (Allscripts) as chief medical officer.

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Long-time friend of HIStalk David B. Dillehunt is retiring as VP/CIO from FirstHealth of the Carolinas in Pinehurst, NC at the end of the year. He sent me a nice note about HIStalk that would be vain of me to post (but I appreciate it anyway), and he also mentioned that FirstHealth will do its own VP/CIO search without using a recruiter, so interested folks can apply on its website. An email search finds that Dave and I first exchanged messages in early 2006, so we go back a ways.


Announcements and Implementations

Optum’s annual health executive AI survey finds that 59% of them expect to see a payback period on investments in under three years and 95% think that hiring AI-experienced employees is a priority. The top three use cases identified are wearables monitoring, accelerating research, and assigning billing codes.

Ellkay launches its Women in HIT recognition interview series program, noting that while all of its own departments have more women than men, tech companies in general have just 25% women. Nominations are accepted online.

Epic says in an increasingly common press release that 190 health systems will go live this fall.

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Tampa General Hospital says its use of GE’s command center has eliminated $40 million worth of inefficiencies, including decreasing length of stay and ED diversion that equate to 30 additional beds.


Government and Politics

HHS releases its final Transparency in Coverage rule that requires health insurers to disclose their negotiated rates and patient out-of-pocket costs for 500 shoppable services for plan years that begin on or after January 1, 2023. They will also be required to show historical payments from and payments to out-of-network providers as well as negotiated prices for prescription drugs.

Aetna pays $1 million to settle three HIPAA breaches in 2017, one related to an online document display and the other two involving mailing envelope disclosures.


COVID-19

White House advisor Jared Kushner said in a recorded interview in April that President Trump was “getting the country back from doctors” in developing a strategy to push states to reopen for his political benefit, after which the White House would then blame state governors for any resulting coronavirus spread.

Politico reports that HHS spokesperson Michael Caputo, who is on medical leave, privately pitched its $300 million, pre-election  “defeat despair” coronavirus ad campaign as “Helping the President will Help the Country.” HHS declines to say whether the ad campaign will ever run, is accused by House Oversight leaders of not providing documents they requested, and said that HHS Secretary Alex Azar was not aware of Caputo’s direct involvement. The $300 million cost was taken from CDC’s budget.

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Atlanta magazine examines the botched rollout of Georgia’s coronavirus dashboard that left public health officials, local governments, businesses, and residents uncertain about how to comply with the governor’s push to reopen or to evaluate his wisdom in doing so. He assigned the dashboard’s development to to the state’s budget office instead of its public health department, where it was then outsourced to private contractor SAS. The state’s epidemiologists took the black eye for its lack of reliability and confusing presentation. National public health experts say it is unusual to let a third party contractor publish unvetted data to a state health department’s website. A much-Tweeted gaffe was a chart that appeared at first glance to show a steady decrease in case counts, but the X-axis case counts were sorted from greatest to least instead of by date.

Chicago’s NPR station looks at the lack of a central agency to coordinate COVID-19 patient transfers, with one small hospital that mostly treats low-income people of color being told by several hospitals that they had no available ICU beds despite having reported them empty to a state database. Some hospitals told the smaller one directly that they wouldn’t take a transfer if the patient had certain public-funded health insurance. The hospital was also rejected by the 3,000-bed field hospital that was built inside McCormick Place, which was mostly empty. The station notes that no state agency or public health official can force a hospital to accept a transfer and they have no incentive to cooperate with each other.

Science says that October was good for remdesivir manufacturer Gilead Sciences, which got an early look at WHO’s Solidarity trial results – which showed that remdesivir doesn’t decrease mortality or recovery time – before it signed a billion-dollar EU distribution deal and earned FDA’s approval even though FDA did not have its information reviewed as usual by its panel of outside experts. Gilead says it won’t renegotiate its $2,400 price following the Solidarity study’s disappointing findings about efficacy. Gilead got a look at the Solidarity study results on September 23, which FDA didn’t see until October 10 prior to its full approval on October 22. Gilead has sold $873 million worth of remdisivir (Veklury) so far this year.


Other

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The FBI warns that Russian ransomware hackers are targeting US health systems and have taken down four of them so far. A cybersecurity expert says that hackers are demanding more than $10 million per target and discussing plans to infect 400 hospitals and clinics. Another analyst reports that 59 US providers have been impacted so far in 2020, disrupting care in 510 facilities. St. Lawrence Health System (NY) went on diversion and back to paper documentation in three hospitals Tuesday following a ransomware attack, while University of Vermont Health Network reported a system-wide outage Thursday. Sky Lakes Medical Center (OR) also reported a ransomware attack Tuesday and remains down. The Cybersecurity & Infrastructure Security Agency has issued an advisory describing how Trickbot-deployed Ryuk ransomware works and offers the usual broad mitigation suggestions, most of them not easily implemented quickly (although applying US updates, reviewing RDP ports, auditing user accounts with administrative privileges, backing up systems and storing the copies offline, and auto-updating antivirus software should be done regularly anyway).

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I’m intrigued by posed skeleton displays in yards for Halloween. This Zoom call one best represents 2020, although I also like the cleverly topical ones in which an evil skeleton flings lurid coronavirus balls at others who are desperately fleeing while wearing masks.


Sponsor Updates

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  • Healthwise volunteers help the Idaho Food Bank deliver food to seniors.
  • Experity makes its Virtual User Experience sessions available online.
  • Saykara President and Chief Medical Officer Graham Hughes, MD authors a Medical Economics article titled “Can AI Rescue Physicians from their EHR Woes?”
  • Fortified Health Security publishes a new white paper, “Using Zoom for Telehealth Visits: How to Maintain an Acceptable Risk Profile.”
  • Aspioneer includes Goliath Technologies CEO and chairman Thomas Charlton on its list of revolutionary CEOs of 2020.
  • Healthcare Triangle publishes a new case study, “Standardization Across Surgical Areas for ASC to HOPD Conversion at Great Falls Clinic Hospital.”
  • IDG Connect profiles Imprivata CTO Wes Wright.
  • FeaturedCustomers ranks LiveProcess as a Rising Star in its “Fall 2020 Customer Success Report.”
  • Meditech recognizes the role of virtual care during Canadian Patient Safety Week.
  • NextGate publishes a new case study, “UHIN Leverages Leading Patient Identification Platform to Drive Quality and Coordination of Care, Support COVID-19 Response.”

Blog Posts


Contacts

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

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EPtalk by Dr. Jayne 10/29/20

October 29, 2020 Dr. Jayne 5 Comments

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Hospitals and health systems are going on the offensive against COVID. One example is this two-page ad in the Tulsa World that illustrates hospitalizations within Saint Francis Health System.

Hospitals in my metropolitan area are approaching maximum capacity, having taken numerous transfers from rural hospitals that quickly became overwhelmed as cases surged. Our flagship tertiary care hospital has put limits on elective operative cases, not only to preserve bed capacity, but also to try to mitigate the load on care delivery staff who are anticipating a rocky winter.

One of my ICU nurse colleagues has been working with COVID patients since the beginning, spending several months in a vacant college dorm to reduce the risk that she would take the virus home to her high-risk household. In the ultimate show of compassion, another nurse from a “regular” unit offered to trade places for a few weeks so that my friend could have a break. It’s people like these that drew many of us to healthcare, those who truly set the example of service. But it’s a sad commentary on where we are right now and the concerns around what is to come. We had two more resignations at my practice this week and I fear more are to come.

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ONC released a data brief this week looking at the state of interoperability among major US cities. The report looked at variation in interoperability within 15 cities, which are represented by combined statistical areas. They looked specifically at four key areas of interoperability – to find, send, receive, and integrate electronic health information with sources outside their health system. Data on HIE participation was also included.

Not surprisingly, small / independent hospitals performed the worst, with system-owned hospitals reporting higher rates of engagement across all domains. I practice in one of the areas that was surveyed and can attest to our paltry performance. The hospitals refuse to share information with independent facilities, and most of the time, my best source of information at the point of care involves the patient handing their phone to me so I can flip through their MyChart account.

The state HIE isn’t much help either since they won’t let individual physicians participate. Physicians only get access if they’re part of an organization that is sharing data. There are plenty of us that are independent, locum tenens, or contract physicians who care for patients outside the walls of a hospital or across multiple rural facilities, and it would be useful to have access to the data when those patients cross our threshold. That’s how the state’s prescription drug monitoring program works – it’s funded by tax dollars and each provider has their own login. Not sure why the HIE needs to be different.

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My office recently suffered the devastating loss of a staff member, who passed away at the practice during the work day. It’s been an incredibly difficult time for everyone. The office has been closed and we just re-opened Wednesday. Based on the experience, I have a new item to add to our contingency plans for such a situation. If you have shared PC workstations, I highly recommend having someone log in to the PC that was last in use by the staffer in question and make sure that their login screen isn’t going to pop up for the next person to see. It never occurred to me that it might be an issue until I walked past a staff member who was staring catatonically at a login screen with her departed co-worker’s name, waiting for her password. The whole situation has been traumatic. This was another hurt that the team didn’t need on our first day without her.

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Especially in a pandemic, there’s a lot of focus on the clinical workers at hospitals, along with those who perform essential functions such as food service, housekeeping, and facilities engineering. You don’t hear much about the unsung IT heroes, although they’re just as critical where taking care of patients is concerned.

One of my physician friends reached out to me recently about what she perceived as an IT disaster and I had to agree with her assessment. The hospital has had some significant delays in the return of pathology results over the last few months, due to layoffs and backlogged specimens. She’s been waiting for several sets of patient results to return and checking the system daily because she knows it’s a big deal for her patients. The lab director had told her to be patient, but I understand her reluctance to do so when she was waiting for information that could change her patients’ lives.

Late Sunday evening, she received a large volume of pathology results to review, some of which had been finalized and released by the lab more than five days previously. Apparently one of the interfaces had gone down and the results had been available but just sat there queueing until someone finally noticed an issue and pushed them through after restarting the interface. Her hospital recently outsourced quite a few of its IT functions and she couldn’t help but wonder if the changeover had anything to do with the failure, so called for my thoughts. My impression is that of a multi-level failure, first with the interface itself, then with the monitoring systems, then with a lack of notification to the responsible providers explaining the situation.

She had several dozen sets of results to address, but in a system her size, there may have been hundreds if not thousands of patients who were impacted. I know she felt terrible about the delays and was trying to figure out how to find time in a busy Monday office schedule to call notify all the patients. The reality is that on the other side of each one of those pathology results sits a woman who has likely been worrying about the outcome of her biopsy and that failure of the system added additional burden that she probably didn’t need right now.

It’s important for those of us in the healthcare informatics world to realize how critical our work truly is, and for the leadership that manages our departments to make sure we have the resources to do the work properly. My heart goes out to all the patients who had their results delayed and especially to those who received news that likely changed their lives.

Has your hospital cut resources for infrastructure reporting and monitoring? How does it notify patients and clinicians of similar situations? Leave a comment or email me.

Email Dr. Jayne.

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