News 9/3/21

Top News

Baxter International will acquire Hillrom for $10.5 billion in cash plus assumption of debt that values the transaction at $12.4 billion.

The announcement emphasizes Hillrom’s recent refocus from manufacturing hospital beds to remote patient monitoring and connected care solutions.

Hillrom previously acquired cardiac monitoring company Bardy Diagnostics for $375 million, patient monitoring vendor EarlySense for $30 million, and clinical communications vendor Voalte for $180 million.

HIStalk Announcements and Requests

I was saddened to learn from Bill Bogutski that Vince Ciotti has died. Vince retired in 2019 after a 50-year health IT career, much of it spent working with Bill and other principals of the HIS Professionals consulting firm. The photo of Vince above is from a reunion of former employees of Shared Medical Systems in 2019. Vince spent considerable time over several years, starting in 2011, documenting health IT’s first decades for HIStalk readers in his engrossing HIS-tory series. I interviewed him two years ago and it’s still an entertaining read that will give you a feel for Vince’s filter-less, cynical humor. I asked him then what he wanted his epitaph to say:

If I could be remembered for anything, it would probably be my HIS-tory files, which I thank you for posting over such a long time, two and a half years. I hope some of the future CIOs read them and learn from them. I hope that’s what they remember me by, the guy that warned them about not repeating these mistakes of the past.

Webinars

September 16 (Thursday) 1 ET. “Patient Acquisition and Retention: The Future of Omnichannel Virtual Assistants.” Sponsor: Orbita. Presenters: Harris Hunt, SVP growth product, Cancer Treatment Centers of America; Patty Riskind, MBA, CEO, Orbita; Nathan Treloar, MSc, co-founder and COO, Orbita. Consumers want the same digital healthcare experience from healthcare that they get in online shopping, banking, and booking reservations, and the pandemic has ramped up the patient and provider need for frictionless access to healthcare resources and services. Health systems can improve patient acquisition and retention with the help of omnichannel virtual assistants that engage and delight. Discover how to open and enhance healthcare’s digital front door to offer care that goes beyond expectations.

September 16 (Thursday) 1 ET. “ICD-10-CM 2022 Updates and Regulatory Readiness.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, VP global clinical services, IMO; Theresa Rihanek, MHA, RHIA, mapping manager, IMO; Julie Glasgow, MD, clinical terminologist, IMO. IMO’s top coding professionals and thought leaders will discuss the coding changes in the yearly update to allow your organization to prepare for a smooth transition and avoid negative impacts to the bottom line. The presenters will review new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines, and review modifier changes.

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

Acquisitions, Funding, Business, and Stock

Healthcare Triangle files for an IPO that will raise up to $50 million.

Provation acquires Pentax Medical’s EndoPro endoscopy software. 

Accenture acquires Canada-based healthcare technology consulting firm Gevity. 

Sales

• Coalition of Asian-American IPA chooses CarePort Connect for care coordination.

People

SOC Telemed promotes Chris Gallagher, MD to CEO. He replaces John Kalix, who resigned his CEO and board positions.

Transcarent hires Snezana Mahon, PharmD (Evernorth) as COO.

Stephanie Solich (Zipari) joins VisiQuate as VP of client development.

Patient payment and engagement platform vendor Millennia names Dave Dyell as chief strategy officer and Doug Sundlof (Cloudmed) as SVP of sales.

LexisNexis Risk Solutions promotes Jeff Diamond, JD to president and GM of its healthcare business.

Announcements and Implementations

UC San Diego Health launches the Center for Health Innovation to develop, test, and commercialize technologies.

COVID-19

A University of California San Diego Health review of employee health records finds that COVID-19 vaccine effectiveness against symptomatic infection dropped from 90% in June to 66% in July, which the authors attribute to emergence of the delta variant, waning immunity suggesting the need for booster doses, and the ending of masking mandates. Adding to the argument for booster doses is that those healthcare workers who were vaccinated earlier were infected at a higher rate.

A New York attorney is suing hospitals that refuse to administer ivermectin to ventilated COVID-19 patients whose families insist.

Sponsor Updates

• Glytec will host “Time to Target: Uniting Around Patient Safety,” its inaugural conference on glycemic innovation and collaboration October 26-27.
• Everbridge wins two Silver 2021 Stevie Awards in the categories of customer service department of the year and customer service team of the year.
• The HCI Group releases a new DGTL Voices with Ed Marx podcast, “Soul-Stirring Kilimanjaro Clinic.”
• Healthcare IT Leaders publishes a new guide, “15 Tips for Patient Accounting System Project Success.”
• Ideawake releases a new video, “3 Health Systems Transforming Patient Care via Bottom-Up Innovation Programs.”
• Imprivata makes its digital identity solutions One Sign and Confirm ID available on Microsoft Azure.
• Infor publishes a new case study, “Bozeman Health raises quality of care and reduces waste with Infor.”
• InterSystems releases a new podcast, “How Can Healthy Data Save Healthcare?”
• Medicomp Systems releases a new Tell Me Where It Hurts Podcast featuring CPSI CMO William Hayes, MD.
• NextGate names Minakshi Tikoo, PhD (NYC Department of Health and Mental Hygiene) director of product management.

Blog Posts

• Balancing Healthcare Resilience with the Patient Experience (Everbridge)
• Five Actions to Help Prevent Opioid Overdose (First Databank)
• Digital Health Technology Deployed for Veteran Suicide Prevention (GetWellNetwork)
• Clinical Technology Disparities and Opportunities for Improvement (Halo Health)
• Six Tactics to Restore the Healthcare Revenue Cycle (Health Catalyst)
• The Value of ServiceNow IT Business Management (Optimum Healthcare IT)
• Telehealth Needs Your Help (Healthwise)
• T-Mobile breach exposed data of 40 million: How safe is your customers’ personal information? (Imprivata)
• What’s in a variant? Clinical documentation, epidemiology, and genomic sequencing (Intelligent Medical Objects)
• Healthcare Must Engage Patients and Clinicians as They Manage the Rest of Their Life (Medhost)
• How Meditech customers are supporting patients this Recovery Month (Meditech)
• 7 Tips for Leveling Up Your PT Practice Before 2022 (MWTherapy)

Contacts

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

EPtalk by Dr. Jayne 9/2/21

The American Medical Informatics Association is putting out a call for submissions for its 2022 Clinical Informatics Conference, scheduled for Houston in May. The CIC conference is known for being clinically focused, with lots of practical presentations about clinical informatics. Included focus areas are informatics-driven value-based healthcare; usability, efficiency, and user experience; clinical decision support and analytics; organizational challenges; emerging technology and technical infrastructure; and leadership, advocacy, and policy.

I’ve never attended, and while Houston isn’t one of my favorite cities, it might be on my list if we make it through this winter without crazy COVID and flu peaks. I can certainly appreciate any learning about organizational challenges since I seem to be having a number of them with my clients lately. Potential presenters have until November 30 to submit.

With all the stresses on healthcare organizations, mental health is at the forefront of many discussions. I was interested to read about Nike closing its corporate offices for a week to allow employees to take a break. While corporate office employees are receiving a week of paid vacation, retail employees didn’t get the same consideration. I would propose that the customer-facing retail employees probably need some bolstering of their mental health as well. If sick patients aren’t willing to mask and distance at their physician’s request, I can’t imagine being a retail employee who has to engage with people who don’t want to practice social distancing or wear masks. I’d be more impressed if they gave all employees extra time off, not just those in the corporate office.

Healthcare providers behaving badly: New York area hospital workers have been purchasing fake COVID-19 vaccination cards for $200 each. The Manhattan District Attorney’s Office announced the filing of charges against a New Jersey woman for the cards and against a New York medical worker who would enter the person’s data into the New York state immunization registry for an additional $250. The co-conspirator is alleged to have entered fraudulent immunization records on at least 10 individuals. Those purchasing the fake vaccination records were also charged, and include workers at hospitals, medical and nursing schools, nursing homes, and other critical environments. The fraudulent documents were sold through Instagram accounts and prosecutors call on social media platforms to assist in the crackdown. The idea that someone would enter fraudulent data into the state registry is so offensive – I hope the penalties are severe.

For those of us who deal with search algorithms and learning systems on a regular basis, the report that the Amazon algorithm was directing users to ivermectin, and other COVID-19 misinformation sites is also offensive. CNBC reports that not only are user reviews listing false claims, but that since the autocomplete functionality on Amazon’s search field are driven by customer activity, searches that start with “IV” are bringing up ivermectin products due to high search volumes. Amazon is supposed to be blocking those autocomplete entries to help mitigate the issue. Users searching for “ivermectin for humans” and “ivermectin covid” should also receive a warning that the FDA has not approved ivermectin to treat or prevent COVID-19.

Several of my clients have added informational banners and callouts in their patient-facing platforms and websites, letting patients and potential patients know that the group will not prescribe ivermectin off label. It’s largely an attempt to avoid angry situations in the office which have been happening with increasing frequency, as well as to lower the volume of calls that patients are making in the hopes they get them.

One physician reported to me that an angry parent called wanting to interview her as a potential pediatrician for their child, but they had already called 20 pediatricians and didn’t want to see anyone who was going to try to recommend a COVID vaccine or who wouldn’t prescribe ivermectin or hydroxychloroquine. Since my client is squarely in the camp of evidence-based medicine, her practice opted to add banners to the website and informational posts on social media so that they could hopefully avoid other calls. I guess the fact that every pediatrician the parent had talked to had the same opinion had no sway on his thinking. When I asked my client about this, she noted that the caller told her she must be in the pockets of big pharma since she was a vaccine proponent and that he would keep calling around.

I’ve known a lot of front-line pediatricians and I can tell you that not a single one seems to be in the pockets of big pharma or any other financial influencer. When you stroll through the physician parking area at the hospital, you can pretty much predict that the well-loved Honda Accords and Toyota Camrys belong to the pediatricians, family physicians, or geriatricians. Primary care physicians tend to do what they do because they genuinely care for patients and want to see people lead longer healthier lives and are willing to make a lot less money than their colleagues to do so. Many of them have worked consistently through the pandemic with less-than-ideal personal protective equipment and have taken huge financial hits, so to accuse them of being compromised by some facet of industry is laughable.

Speaking of laughable, I receive a lot of emails asking me to look at new products or check out websites in the hopes that I’ll promote them. I would highly recommend that you spell-check and grammar-check all copy that you plan to put on your website, and then have at least two people other than the author read it to find anything that the computer missed. One recent request led to multiple errors in the first paragraph of copy on the website. As a physician, once I see that, I’m done. If you don’t have the attention to detail to make sure your copy reads well, I’m not about to consider using you as my patient engagement solution because I can’t trust that you won’t send nonsense to my patients.

Big hugs to my colleagues who are trying to get their practices back up and running after being hit by the recent hurricane and storms. Many can’t even practice remotely or via telehealth due to infrastructure issues and the level of helplessness that some of them feel is agonizing after everything they’ve been through in the last year and a half. Here’s to a speedy restoration and recovery effort.

Has your organization had to cope with storm damage or other recent natural disasters? How are things going from an IT standpoint? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 9/2/21

Healthcare Triangle, Inc (HCTI) Files for up to $50M IPO

Healthcare Triangle, a cloud, security, advisory, and implementation services company, files for a $50 million IPO.

Wellbe Inc. receives Series A funding from HealthX Ventures and WISC Partners to accelerate innovation and growth

Madison, WI-based digital care management vendor Wellbe raises $2 million in a Series A funding round.

Telemetrix Completes $1M Seed Round of Funding

Remote patient monitoring startup Telemetrix secures $1 million in a seed round of financing led by South Florida Health.

98point6 CEO Robbie Cape is no longer with the company in abrupt shakeup at telemedicine startup

98point6 co-founder and CEO Robbie Cape leaves the company unexpectedly after having helped it raise $247 million.

Morning Headlines 9/1/21

DirectTrust Acquires Assets of SAFE Identity

DirectTrust acquires the assets of Safe Identity, an industry consortium and certification body for digital healthcare credentials.

Ellipsis Secures $26 M in Series A Funding to Pioneer New Clinical Standard in Mental Health Care

Ellipsis Health, which has developed AI-based voice recognition technology to detect signs of depression and anxiety, raises $26 million in a Series A funding round.

Bamboo Health – Combination of Proven Care Collaboration Leaders – Unveiled to Enable Payer-Provider Collaboration for Whole Person Care

Appriss Health rebrands to Bamboo Health following its acquisition of PatientPing.

News 9/1/21

Top News

Sources report for the second time in as many months that Baxter will acquire medical equipment company Hillrom for nearly $10 billion. Last month’s initial offer put Hillrom shares at $144 apiece, while this more recent bid inches closer to $150. The deal may be announced before the holiday weekend.

Hillrom has in the last several years ventured beyond its hospital bed roots into health IT, acquiring cardiac monitoring company Bardy Diagnostics for $375 million, patient monitoring vendor EarlySense for $30 million, and clinical communications vendor Voalte for $180 million.

I interviewed Hillrom SVP Mary Kay Ladone, a nearly 30-year Baxter veteran, in March.

Webinars

September 16 (Thursday) 1 ET. “Patient Acquisition and Retention: The Future of Omnichannel Virtual Assistants.” Sponsor: Orbita. Presenters: Harris Hunt, SVP growth product, Cancer Treatment Centers of America; Patty Riskind, MBA, CEO, Orbita; Nathan Treloar, MSc, co-founder and COO, Orbita. Consumers want the same digital healthcare experience from healthcare that they get in online shopping, banking, and booking reservations, and the pandemic has ramped up the patient and provider need for frictionless access to healthcare resources and services. Health systems can improve patient acquisition and retention with the help of omnichannel virtual assistants that engage and delight. Discover how to open and enhance healthcare’s digital front door to offer care that goes beyond expectations.

September 16 (Thursday) 1 ET. “ICD-10-CM 2022 Updates and Regulatory Readiness.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, VP global clinical services, IMO; Theresa Rihanek, MHA, RHIA, mapping manager, IMO; Julie Glasgow, MD, clinical terminologist, IMO. IMO’s top coding professionals and thought leaders will discuss the coding changes in the yearly update to allow your organization to prepare for a smooth transition and avoid negative impacts to the bottom line. The presenters will review new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines, and review modifier changes.

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

Acquisitions, Funding, Business, and Stock

Tele-genetics testing and counseling company Genome Medical raises $60 million and acquires GeneMatters, which offers genetic counseling via video visit, as well as care delivery and patient engagement software.

Summit Healthcare reports that revenue and sales have exceeded expectations for the first half of the year, with 18 health systems recently signing on for the company’s data integration and exchange, automation, and business continuity services.

The tit for tat between NextGen Healthcare’s board members continues, with the company publishing an email from the chair of its nominating committee to board member Lance Rosenzweig to further demonstrate that Rosenzweig and company founder and board member Sheldon “Shelly” Razin are in fact trying to obstruct board operations.

DirectTrust acquires the assets of Safe Identity, an industry consortium and certification body for digital healthcare credentials.

Ellipsis Health raises $26 million in a Series A funding round. The startup has developed AI-based voice recognition technology that detects signs of depression and anxiety.

Appriss Health rebrands to Bamboo Health following its acquisition of PatientPing.

Sales

• Vizient signs a two-year contract with Ascom, giving its members access to pre-negotiated pricing and terms for the Ascom nurse call and monitoring system.
• Lee Health (FL), LifeBridge Health (MD), MedStar Health (MD), MercyOne (IA), Moffitt Cancer Center (FL), and MultiCare (WA) sign on for Avia’s membership-based, digital healthcare transformation consulting services.

People

LexisNexis Risk Solutions, Healthcare CEO Josh Schoeller takes on the additional role of Elsevier Clinical Solutions president.

The VA promotes Neil Evans, MD to acting CIO.

Twistle President and COO Matt Revis also joins the Health Catalyst leadership team. Health Catalyst acquired Twistle in June.

Announcements and Implementations

Spok announces GA of its ReadyCall Text waiting room pager, alongside enhancements to its Spok Go clinical communications platform.

Government and Politics

The FBI issues an alert about Hive ransomware, which has attacked nearly 30 healthcare organizations since first detected in June. The alert may have been spurred by the mid-August attack on Memorial Health System (OH), which ended up paying the hackers to regain access to internal systems that include 800 servers and 3,000 personal devices used by physicians.

COVID-19

A pre-print analysis of 24 statewide COVID-19 vaccine incentive programs finds no significant change in vaccination rates within those states, and no significant difference in vaccination trends between states that did and did not offer incentives.

A church youth camp and concurrent (though separately located) men’s conference held by the same organization in June has been linked to 180 confirmed and probable COVID-19 cases, most of whom were unvaccinated. Those cases ultimately led to 1,000 people in four states being exposed through attendance or close contact. The host organization did not require testing or vaccination for either event.

Other

Southern Louisiana hospitals in the path of Hurricane Ida have reported extensive roof damage, inoperable phone systems, power failures, and the need to enact staffing emergency staffing protocols. Hospital operations teams were especially concerned about the storm’s impact coupled with a surge in COVID-19 patients. More than 2,400 COVID-19 patients were hospitalized across the state as of Sunday.

Jury selection has begun in the trial of Theranos founder Elizabeth Holmes. Set to start on September 8, the trial has been postponed several times since she was charged with multiple counts of conspiracy and fraud in 2018. This article offers a quick refresher on what led up to the legal proceedings.

A study published in Contraception looks at the growing trend in at-home IUD removal and the corresponding uptick in DIY videos on Youtube and TikTok. Top motivators for the at-home option include the expense of an in-office procedure, side effects, a desire to get pregnant, and even unwillingness on the part of some providers.

Sponsor Updates

• Ellkay has sponsored the Cerner Foundation’s Westport Bounce, which provides funding for equipment, medicine, surgeries, travel, and wellness screenings to students.
• Spok publishes a new e-book, “The ROI of the Spok Go clinical communication and collaboration platform.”
• CereCore wins ClearlyRated’s 2021 Best of Staffing client and talent awards for service excellence.
• Cerner CIO Bill Graff wins CIO of the Year in the Orbie Awards’ large enterprise category.
• CHIME’s Digital Health Leaders Podcast features Monument Health CIO and CMO Stephanie Lahr.
• Clearwater publishes a new case study, “A Clear Success: Strong Cybersecurity & HIPAA Compliance Program Positions CaringWays for Growth.”
• Clinical Architecture celebrates its 14^th anniversary.
• Dimensional Insight’s Smarter Healthcare Podcast features Mass General Brigham Chief Digital Health Officer Alistair Erskine, MD.
• Cooper University Health Care (NJ) expands its use to Nuance’s Dragon Ambient Experience to 475 physicians and APPs.
• EClinicalWorks releases a new podcast, “Improving Patient Safety by Reducing Uncoded Allergies.”

Blog Posts

• Is the Value-Based Purchasing program on its way out? What SNFs need to know. (Ability Network)
• Interpol’s Latest on COVID-19 Cyberthreats (AdvancedMD)
• Riding for a Cure: Diameter Health’s Pan-Mass Challenge Team (Diameter Health)
• The Infinity Gauntlet of Healthcare Interoperability (EClinicalWorks)
• How data standardization can improve patient outcomes (Experian Health)

Contacts

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

Morning Headlines 8/31/21

Baxter Is in Advanced Talks to Buy Hill-Rom for About $10 Billion

After similar talks fell apart last month, Baxter will reportedly acquire medical equipment company Hillrom for nearly $10 billion.

Biden-Harris Administration Invests $10.7 Million in American Rescue Plan Funds to Expand Pediatric Mental Health Care Access

HHS allocates $11 million to expand its Pediatric Mental Health Care Access program, giving pediatric teams across the country access to telemedicine-focused consultation, training, technical assistance, and care coordination services.

Genome Medical Announces Acquisition of GeneMatters and Closing of $60 Million Series C Financing

Virtual genomics provider Genome Medical raises $60 million and acquires GeneMatters, which offers genetic counseling via video visit, and care delivery and patient engagement software.

Curbside Consult with Dr. Jayne 8/30/21

During the past couple of weeks, I have spent some quality time doing decidedly low-tech things. I know I’m going to be starting a big project soon and plan to be heads-down for many months, so I’ve been trying to get as much adventure on the calendar as I can.

Camping is one of my low-tech pastimes and sometimes it’s just good to get away from the hustle and bustle, although I did enjoy having the option of firing up the hotspot and getting a little work done while I was away. I can’t say I enjoyed the ridiculous humidity or the high number of spiders that wanted to join me in my tent, but overall, it was a good couple of days away.

I also had the opportunity to take an 80-year trip back in time. The Union Pacific “Big Boy” 4014 locomotive has been touring the US, delighting tens of thousands of fans as it carves a figure eight covering Wyoming, Nebraska, Kansas, Oklahoma, Texas, Louisiana, Arkansas, Missouri, and Colorado. Having spent a good chunk of my career in healthcare IT, I’m a fan of complex systems. However, you haven’t seen a complex operation until you’ve seen what it takes to run an 80-year-old steam locomotive in the modern world. The Big Boy class of steam locomotives was the largest ever built, and they were originally used to haul freight over the Wasatch mountains. At the time, supporting infrastructure along the route would have included water tanks to keep the boiler full as well as maintenance facilities that could handle such a beast.

Needless to say, nothing like that exists in the US any more, so the train is accompanied by fuel trucks that can supply the recycled oil it runs on after being converted from coal. It also runs with multiple water cars to supply the 100 gallons it goes through each mile as well as a customized tool car that contains nearly everything it takes to keep it running. The train stops every couple of hours for maintenance and lubrication and is accompanied by a “helper” diesel engine to supply dynamic braking so that the antique doesn’t wear out its own brake shoes, since they have to be changed from below and nowhere on the tour has a roundhouse that can support a 1.2-million-pound locomotive. Stopping every couple of hours also allows people all over the US to come out and see it.

Just looking at all the piping, valves, gaskets, and hardware on the locomotive reminds me of the most complex and ancient IT systems I’ve worked with – those where any number of points of failure can bring the system to its knees and there are only a handful of people with the knowledge and skills to keep them running. During the stop I visited, I was able to see the Union Pacific “pit crew” in action getting the Big Boy ready to move out. In addition to replacing a gasket and refilling the water cars, they also performed some “percussive maintenance” on a couple of parts. and I think we can all sympathize with systems that we want to hit with a hammer at times, although the Union Pacific Steam Team gets to do it for real.

Seeing the Big Boy’s crew in action was also a great study in team dynamics. They clearly have made it to the performing stage of team development and were working in 100-degree heat with complete focus and dedication. The head of the team was spotted stabilizing a ladder for another crew member, which reminded me of some of the hospital administrators that I most enjoyed working with, those who weren’t afraid to roll up their sleeves and get to work when things got tough.

In between tasks, they were being peppered with questions from the crowd, which they always answered with a smile. Since they’re essentially rock stars of the railroading world, they were also being asked to autograph all kinds of memorabilia. Watching them interact with the children in attendance, many of whom were dressed like the crew, was priceless. One of the highlights was watching the team’s leader stand on the roof of the cab and capture video of the crowd. Seeing thousands of people come out to admire your work has to be a pretty big rush, I’d imagine.

I was also happy to learn about some of the problem solving that had to happen during the locomotive’s restoration. Much like our work in healthcare (and especially in healthcare IT) if the team didn’t have what they needed to get the job done, they had to figure out how to create it. Where they might be fabricating replacements for 80-year-old parts (as well as the tools to service them) we’re often creating solutions to problems that at times feel like they’re being randomly thrown in our direction. Since patient care is at stake, we don’t have the option of not solving them, so we have to get creative and sometimes cobble things together to get the job done. Those of us supporting legacy systems have to learn how to do things we never thought would be on our plate, and it was a good reminder that every day is a new adventure.

As dark as some of my healthcare days have been over the past year and a half, seeing the crowd at the display event gave me a lot of hope. The Big Boy brought out people of all ages, from newborns in carriers to a woman who was 99 years old, as well as different social, economic, and cultural groups. Despite a mix of masked and unmasked attendees at the outdoor event (although masks were required for those entering the actual railcars) and despite the heat and the fairly crowded conditions, I didn’t hear a single negative word about anything. People were so intent on just experiencing the wonder of the situation that everything else was secondary. When people were inadvertently jostled or bumped, apologies were given from both sides, which is seemingly rare in these days. Union Pacific kept the crowd well supplied with ice water and places to rest in the shade and provided golf carts for those who needed assistance. There was no jockeying for places to take pictures, everyone waited their turn, and it was just a pleasant time to experience a taste of the past. Best of all it was free, so kudos to Union Pacific for an outstanding public relations event that gave a lot of people great joy.

I’ll definitely go into this week with a new appreciation of the concept of hard work, as well as a boost in my mood based on my encounter with the Big Boy and all of its fans. Here’s to better times where everyone can rally around something that unites us and puts a smile on all our faces.

Have you ever heard a steam whistle that rings right through to your soul? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 8/30/21

Google confirms it’s pulling the plug on Streams, its UK clinician support app

Google shuts down its DeepMind-developed Streams app that displays patient information to UK clinicians.

Olive Launches Olive Ventures, an In-House Venture Studio

Olive launches an in-house venture studio for startups that are developing solutions for its automation platform.

Justice Department Settles with Large Health Care Organization to Resolve Software-Based Immigration-Related Discrimination Claims

Ascension pays $85,000 to settle charges that it violated federal immigration laws because of a software programming error that caused its employee eligibility verification software to send automated emails to all of its non-citizen employees whose documents were set to expire, requesting them (some erroneously) to submit proof of continued work authorization.

Monday Morning Update 8/30/21

Top News

Google shuts down its DeepMind-developed Streams app that displays patient information to UK clinicians.

Streams was the only DeepMind app that didn’t use AI, and plans to incorporate the technology were never acted on. It uses algorithms that were developed by the UK’s NHS.

The UK’s data protection office objected to The Royal Free Hospital providing DeepMind with patient data without their consent or knowledge during its development of Streams. Royal Free is the only NHS Trust that is still using Streams.

Google acquired AI startup DeepMind in early 2014 for a reported $500 million. Most of the company’s work involves teaching computers to play games such as Go and Pong. Its DeepMind Health business was moved within Google Health in late 2018, raising privacy objections that DeepMind had promised repeatedly that its data “will never be linked or associated with Google accounts, products, or services.”

Google says it will focus instead on Care Studio, which is being piloted at Ascension and Beth Israel Deaconess.

HIStalk Announcements and Requests

Cerner’s new CEO hire draws about a two-to-one negative among those who care.

New poll to your right or here: What background would you favor if you were hiring a CEO for your current employer? It’s an awkwardly constructed question, but my interest was piqued by IANAL’s comment last week that growing software companies usually hire CEOs whose background is strong either in sales or technology, and Cerner’s incoming CEO David Feinberg doesn’t fit that mold. I didn’t do a great job of incorporating what probably should have been a separate poll – at what point should a company’s hiring favor comparable CEO experience?

I was thinking about the prediction years ago and digital stethoscopes would replace their low-tech acoustic counterparts for a myriad of logical reasons. I get the feeling that it’s still mostly old-school instruments being used, but maybe someone has stats.

I’m taking a semi-break this week while still doing most of my usual HIStalk work, just from elsewhere and hopefully spending less time.

Webinars

September 16 (Thursday) 1 ET. “Patient Acquisition and Retention: The Future of Omnichannel Virtual Assistants.” Sponsor: Orbita. Presenters: Harris Hunt, SVP growth product, Cancer Treatment Centers of America; Patty Riskind, MBA, CEO, Orbita; Nathan Treloar, MSc, co-founder and COO, Orbita. Consumers want the same digital healthcare experience from healthcare that they get in online shopping, banking, and booking reservations, and the pandemic has ramped up the patient and provider need for frictionless access to healthcare resources and services. Health systems can improve patient acquisition and retention with the help of omnichannel virtual assistants that engage and delight. Discover how to open and enhance healthcare’s digital front door to offer care that goes beyond expectations.

September 16 (Thursday) 1 ET. “ICD-10-CM 2022 Updates and Regulatory Readiness.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, VP global clinical services, IMO; Theresa Rihanek, MHA, RHIA, mapping manager, IMO; Julie Glasgow, MD, clinical terminologist, IMO. IMO’s top coding professionals and thought leaders will discuss the coding changes in the yearly update to allow your organization to prepare for a smooth transition and avoid negative impacts to the bottom line. The presenters will review new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines, and review modifier changes.

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

Acquisitions, Funding, Business, and Stock

Olive launches an in-house venture studio for startups that are developing solutions for its automation platform.

Sales

• Wolters Kluwer, Health adds six UK customers of UpToDate and Lexicomp.
• Whatley Health Services chooses RCxRules for revenue cycle automation.

People

VitalTech hires Steven Scott (PointRight) as president and CEO.

Clearsense promotes Kimberly Dickason, RN, MBA to COO and hires Pamela Fowler, MBA (University of Washington) as chief marketing officer.

Announcements and Implementations

Mayo Clinic and Verily will collaborate to develop an evidence-based decision support solution, starting with cardiovascular and cardiometabolic conditions. The tool will be driven by Mayo-developed content and de-identified health data and will use open standards to allow integration with commercial EHRs.

Government and Politics

Ascension pays $85,000 to settle Justice Department charges that it violated federal immigration laws because of a software programming error. The error caused Ascension’s custom employee eligibility verification software to send automated emails to all of its non-citizen employees whose documents were set to expire, requesting them to submit proof of continued work authorization. Some of the recipients had presented documents that did not require re-verification, such as permanent residents and refugees. The Justice Department concludes, “Employers are reminded that while software programs may seem efficient, there is still a responsibility to ensure that programming decisions do not result in discrimination.”

COVID-19

China delays its approval of the BioNTech COVID-19 vaccine because of concerns that availability of a more modern, more effective vaccine will undermine confidence in its old-school, made-in-China products that are key to its national vaccination program.

Texas reports that nearly 14,000 people are hospitalized with confirmed coronavirus infection, occupying 21% all all hospital beds, and 300 people died of COVID-19 on Friday. The entire state has 303 ICU beds available versus the nearly 2,500 that were free pre-pandemic. A 46-year-old Houston-area Army combat veteran died of gallstone pancreatitis last week because lack of ICU beds. An ED doctor who treated him says treatment is a 30-minute procedure that is nearly always successful. The doctor says, “We are playing musical chairs with 100 people and 10 chairs. When the music stops, what happens? People from all over the world come to Houston to get medical care and, right now, Houston can’t take care of patients from the next town over.”

CDC describes how an unvaccinated teacher who kept working while experiencing congestion and fatigue and later tested positive for COVID-19 infected 12 of her 22 students after removing her mask to read to the class. The attack rate of the students seated in the front rows of the classroom was 80% versus 28% in the back rows.

Other

A Wisconsin advocacy group for raising taxes on the wealthy says that the net worth of Epic CEO Judy Faulkner rose from $2.5 billion in March 2020 to $6.7 billion in August 2021. Its data source was a web page from Forbes, which has no way of knowing the net worth of anyone beyond their publicly reported stock holdings, but that earns click bait traffic by making its made-up numbers look authoritative.

It seems obvious that the Internet’s robust supply of mean people seek health information online like everybody else, but it turns out that the headline writer misspelled “men.”

Sponsor Updates

• EClinicalWorks releases a new customer success story, “Saving Summer with Kiosk, the Patient Portal, and More at MedRite.”
• Symplr publishes a new whitepaper, “Workforce Management Strategies in Times of Uncertainty.”
• Pure Storage’s FlashArray helps to improve the performance of Korea’s COVID-19 vaccine reservation system operated by the Korea Disease Control and Prevention Agency.
• Quil Chief Customer Officer Roelf Kuitse will speak at the American Cancer Society’s Changemakers virtual series, Achieving Equity in the Telehealth Age September 21.
• The MatrixCare podcast features Surescripts Manager of Product Innovation Rachel Petersen and Surescripts Key Account Executive Jill Lytwyn.
• Visage Imaging parent company ProMedicus names Alice Williams a director.
• Azara Healthcare and Luma Health form a technology partnership for their population health data reporting and patient journey platform, respectively.
• Vocera will present at the Wells Fargo Healthcare Conference September 9, the Baird Healthcare Conference September 14, and the Morgan Stanley Healthcare Conference September 15.
• West Monroe publishes a new report, “What’s Driving the Current Wave of Healthcare M&A and Investment?”

Blog Posts

• Five reasons why chatbots fail. (And how to make yours a runaway success.) (Nuance)
• How Health Plans Can Reduce Readmissions (PatientBond)
• 3 Ways to Increase Medical Practice Revenue (PMD)
• Data Delivered: Collaborating with Pharma to Study Anticoagulant Use in COVID-19 Patients (Premier)
• Get the Support You Need: Privacy Professional Services Elevate Resource-Strapped Teams (Protenus)
• How to Realize Revenue Earlier by Offering Patients More Flexible Payment Options (Sphere)
• The guide to pagers for hospitals (Spok)
• Talkdesk integration with Zoom unifies contact center collaboration (Talkdesk)
• Why Providence is Making the Switch to Cloud-Based Data Management for EHR (Tegria)
• Unlocking the Value of Genotypic and Phenotypic Data for Translational Research (TriNetX)
• Can Postpartum Contraceptive Care be Enhanced with Technology? (Twistle)
• Revenue cycle 101: charity care screening (Waystar)
• FAQ: The 2022 Medicare Proposed Rule and Other Perplexing Payer Regulations (WebPT)
• Well Health HIMSS 2021 Recap (Well Health)

The following HIStalk sponsors have achieved top client satisfaction and user experience rankings in Black Book’s latest survey on coding, transcription, CDI, and clinical information management software and services vendors:

• Nuance – comprehensive mid-RCM coding, CDI, and compliance solutions; CDI software; medical speech recognition and AI solutions.
• Infor – clinical data interoperability solutions.
• Symplr – provider credentialing.
• Agfa Healthcare – vendor neutral archive.

Contacts

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

Weekender 8/27/21

Weekly News Recap

• Allscripts sells 2bPrecise.
• ManpowerGroup will acquire Ettain Group, which had previously acquired Leidos Health.
• Ginger will merge with Headspace at a combined valuation of $3 billion.
• Connect America will acquire 100Plus.
• Two NextGen Healthcare board members, including its founder, attempt to install new board members in claiming that board chair Jeffrey Margolis is impeding shareholder value.
• Former VA CIO Roger Baker warns that its homegrown Vista system will need to remain operational for several years as Cerner is installed and will require funding.
• Google Health’s teams and projects are decentralized as its health division is shut down.
• Inovalon announces that it will be acquired by a private equity firm for $7.3 billion.
• Cerner SEC filings indicate that the compensation package given to incoming president and CEO David Feinberg totals $35 million in his first 15 months, although much of that is in the form of restricted shares that won’t vest immediately.

Best Reader Comments

On social media over the past couple of days, I have seen C-suite execs of some of the most prestigious health systems in the country gloat over this or that recognition / award that they got from Epic. I have never seen executives at that level in any industry feeling rewarded by vendor recognition. That speaks to the genius of Epic / Judy / Carl. They have managed to create an amazing aura (or kool-aid or reality distortion field) around Epic to make this possible. This goes way beyond “we let our customers speak for us”. This is in another realm altogether. (Ghost of Andromeda)

[Allscripts] has zero debt and close to $1.5B in annual revenue. And two decades of clinical data. They should go private like Epic or sell for $4B. (NOM)

NextGen mostly has exited the affiliated market that Epic dominates. NextGen focused on large office practices, specialties, and multi-specialty practices while keeping or picking up affiliated practices whose hospitals don’t use Epic. That positioning seems smart since that’s the market where the deal size is large and the cost of getting and supporting the deal is low. They also acquire cheap add-ons to upsell to their existing customers and outsource all of their dev work. It actually seems like a reasonable strategy to me if you are looking for ROI in the current competitive ambulatory market. (IANAL)

If you poll Americans, they generally and somewhat surprisingly don’t resent large compensation packages for CEOs. What is a point which provokes ire and resentment across the entire political spectrum is the kind of compensation package that Feinberg gets. He’ll get rewarded handsomely regardless of what happens during his tenure at Cerner. It is the equivalent of fully rewarding a shipping captain in the 19th century before the vessel even left port. The captain gets paid even if he crashes the ship on to the rocks and all of the cargo & shipmates sink to the bottom of the sea. (Lazlo Hollyfeld)

As someone who likes to get as much out of a buck as possible, remember who pays for these exorbitant CEO salaries – you and I. Cerner is paid by hospitals, many supported by Medicare and Medicaid. Hospitals have to pay Cerner. It trickles down through our premiums. I find it disgusting, but the game of life is to acquire as much as one can, so he’s leading the game. Hopefully he’s a philanthropic soul, and much goes back to the other 99%. As colleagues wander wide-eyed through Epic, in awe of their campus, I’m secretly ill by all the dollars spent that should have actually gone to people’s health. Am I the only one who feels this way? (FrugalFrannie)

CEOs of growing software companies have qualities that help them do two things: sell and get their people to execute. Good CEOs normally either have a strong sales background or a strong technology background. These traits provide value to customers. CEOs of healthcare systems and division level executives at Google spend most of their time being politicians. They do PR type stuff for “innovation,” say different things to different stakeholders without appearing two-faced, make sure the unethical behavior stays behind the scenes, collect fat checks, etc. These traits do not provide value to customers. Also arguably the problem with Cerner is the board, not the CEO. (IANAL)

Watercooler Talk Tidbits

Readers funded the Donors Choose teacher grant request of Ms. E in Mississippi, who asked for an IPad and tripod kit to help her deliver online learning. She reported in December, “I truly appreciate the support you showed to my students and our school. The technology has provided my students with the opportunities to continue to learn even as we have moved to a hybrid schedule with rotating days of students at school and at home. My students have truly enjoyed being able to access enriching programs on the iPad when they are at school and it provides the opportunity for me to continue to reach them when they are at home. Thank you again for your donation. May God bless you for generosity.”

Construction costs of the Denver VA hospital top $2 billion, making it one of the most expensive health facilities in the world. The hospital opened a decade behind schedule and $1 billion over budget, but work that was initially stripped out of the budget has been done after opening and fixing mistakes added another $20 million. The original budget was $600 million and increasing estimates forced the US Army Corps of Engineers to take over the project in 2016.

The governor of Nebraska directs officials to recruit unvaccinated nurses, hoping to alleviate a shortage by hiring from hospitals that require employees to be vaccinated for COVID-19.

A Paducah, KY hospital arranges visits by Nelson the therapy dog to boost caregiver morale.

A New Zealand children’s hospital asks college students in the dorm across the street to close their curtains after patients and families observed them engaging in “certain naked activities.”

In Case You Missed It

• News 8/27/21
• EPtalk by Dr. Jayne 8/26/21
• Readers Write: Sharing Your Medical Info with Providers from your iPhone – What You Need to Know About Apple Health, Patient Records, and Better Visibility into Patient Data
• Readers Write: Three Common Email Security Compliance Misconceptions That Are Putting Healthcare Organizations At Risk
• Readers Write: Healthcare is Failing Overwhelmed Clinicians — Here’s How to Focus on Their Journey
• HIStalk Interviews Guillaume de Zwirek, CEO, Well Health
• News 8/25/21
• HIMSS Financial Highlights
• Curbside Consult with Dr. Jayne 8/23/21
• HIStalk Interviews Jessica Cox, RN, Director of Product Solutions, Holy Name Medical Center
• Monday Morning Update 8/23/21

Get Involved

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

Morning Headlines 8/27/21

ManpowerGroup to Buy Ettain Group for $925M

ManpowerGroup will acquire IT staffing and services provider Ettain Group, which acquired Leidos Health several years ago, for $925 million in cash.

Recuro Health Announces Its $15 Million Series A Round Led by Arch Venture Partners: Funds Additional Acquisitions Expanding Digital Health Solutions Capabilities, Increased Marketing, Company Growth

Digital health startup Recuro Health, founded earlier this year by several former Teladoc executives, raises $15 million in a Series A funding round.

Mayo Clinic, Verily to Build Advanced Clinical Decision Support to Enhance Care

Mayo Clinic (MN) and Verily will co-develop a clinical decision support tool over the next two years, initially focusing on certain cardiovascular and cardiometabolic conditions.

News 8/27/21

Top News

Allscripts sells its precision medicine software subsidiary 2bPrecise to laboratory diagnostics software company AccessDX. Terms were not disclosed.

The sale comes nearly a year after Allscripts sold CarePort Health to WellSky for $1.35 billion.

Readers pointed out at the time that 2bPrecise and Veradigm might be next in line to sell.

Reader Comments

From Legerdemain: “Re: job question. I get great reviews, but they say there’s no budget for a decent raise and promises of promotions never pan out. Is it time to look elsewhere?” Of course. In fact, it’s always time to be looking elsewhere, especially if your potential new job is one that can be performed remotely so you don’t have to uproot yourself and your family. Employers have no incentive to voluntarily offer higher pay to employees who otherwise seem content to stick around without it. Somehow the money magically appears only when you threaten to quit and they realize how hard or expensive it will be to replace you. But I’ll add this — don’t let your employer buy you back once you’ve received another job offer. Why would you want to keep working for a company that treats you fairly only when there’s a gun to their head and that will likely remember your perceived disloyalty unfavorably in future HR decisions?

Webinars

September 16 (Thursday) 1 ET. “Patient Acquisition and Retention: The Future of Omnichannel Virtual Assistants.” Sponsor: Orbita. Presenters: Harris Hunt, SVP growth product, Cancer Treatment Centers of America; Patty Riskind, MBA, CEO, Orbita; Nathan Treloar, MSc, co-founder and COO, Orbita. Consumers want the same digital healthcare experience from healthcare that they get in online shopping, banking, and booking reservations, and the pandemic has ramped up the patient and provider need for frictionless access to healthcare resources and services. Health systems can improve patient acquisition and retention with the help of omnichannel virtual assistants that engage and delight. Discover how to open and enhance healthcare’s digital front door to offer care that goes beyond expectations.

September 16 (Thursday) 1 ET. “ICD-10-CM 2022 Updates and Regulatory Readiness.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, VP global clinical services, IMO; Theresa Rihanek, MHA, RHIA, mapping manager, IMO; Julie Glasgow, MD, clinical terminologist, IMO. IMO’s top coding professionals and thought leaders will discuss the coding changes in the yearly update to allow your organization to prepare for a smooth transition and avoid negative impacts to the bottom line. The presenters will review new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines, and review modifier changes.

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

Acquisitions, Funding, Business, and Stock

ManpowerGroup will acquire IT staffing and services provider Ettain Group for $925 million in cash. Ettain Group acquired Leidos Health, the commercial EHR consulting business of Leidos, in October 2019. Leidos Health was formed when Leidos acquired Vitalize Consulting Solutions and MaxIT Healthcare.

Mental health app company Ginger will merge with meditation app startup Headspace. The newly combined company will be known as Headspace Health, a division originally created by Headspace in 2018 to develop FDA-approved, prescription-strength meditation apps. Ginger CEO Russell Glass will take on the same role with the new company, while Headspace CEO CeCe Morken will retain that title and become president of the new business. Ginger raised $100 million in a Series E round earlier this year. The combined companies have a reported valuation of $3 billion.

Antidote Health, a virtual primary and urgent care company serving patients in five states, will use $12 million in seed funding to establish a health maintenance organization for its customers.

Not directly health IT related, but they cover the industry: Robert Albritton, the 52-year-old founder and owner of Politico, will sell the 14-year-old digital publishing group for more than $1 billion to a Germany-based media conglomerate.

Dollar General says in its earnings call that its healthcare push will take several years and involve services that aren’t readily available to its rural customers, such as eye care, telemedicine, and prescription drug delivery. The company has already partnered with GeniusRx, Higi, and telehealth provider Babylon.

NextGen Healthcare’s board says in a surprisingly blunt public statement that two of its members – one of them company’s founder, Shelly Razin – are “obstructing the Board’s effort to drive Board refreshment” with their proxy campaign to add their own slate of board members. The board says that members Razin and Lance Rosenzweig don’t want their candidates interviewed. The other board members also accused Razin of previously presiding as board chair over “a deteriorating business” and pushed a capital allocation plan that would have prioritized paying $400 million in dividends that would have mostly benefited him personally, with the company turning itself around only after he stepped down as president and CEO in 2000 as board chair in 2015.

Sales

• Axis Community Health and Tiburcio Vasquez Health Center choose CareSignal’s Deviceless Remote Patient Monitoring.

People

Holon Solutions promotes Scott Tatro to chief customer officer.

Albany Medical Center (NY) has hired Suryakant Kale as its first CTO and VP of information services, technology, and infrastructure.

Nikolas Green (Amazon) joins Mercury Healthcare (formerly Healthgrades) as chief data officer.

ResMed promotes CTO Bobby Ghoshal to president of its SaaS business.

Announcements and Implementations

The Rural OB Access & Maternal Services network deploys Twistle’s text-based patient engagement technology to its network of providers in New Mexico.

Upstate Medical University in New York will use $2 million in funding from the FCC to upgrade its telehealth services, including improved integration with its Epic system. Nearly 70% of Upstate’s clinics have offered telemedicine services since the pandemic began; the health system has sometimes averaged 6,000 virtual visits a week.

UT Health East Texas offers patients telemedicine services and remote physical therapy and rehabilitation treatment from TheraNow.

COVID-19

COVID-19 hospitalizations have hit 100,000 for the first time since January, when vaccines weren’t widely available, and ICU patient count has exceeded 25,000 for the first time in the pandemic. Pediatric hospitalizations topped 2,000 for the first time in a year. Florida has 17,000 COVID-19 hospital inpatients, while Texas has 14,000. CDC reports 154,000 new cases and 1,138 new COVID-19 deaths on Wednesday.

COVID-19 cases in Meade County, SD, home to the Sturgis motorcycle rally, have risen 1,500% in the past two weeks. South Dakota has the largest percentage case increase of all states. Neighboring states had a big jump in documented infections after last year’s scaled-back event.

A music and surf festival in England with 50,000 attendees has been linked to nearly 5,000 COVID-19 cases, most of them in people aged 16 to 21. The festival required attendees to prove their COVID-19 vaccination status using the NHS Covid app and for festival campers to take a second test during the event and log the result.

Montana’s schools struggle to comply with a recently passed state law that prohibits treating vaccinated and unvaccinated people differently, which means that schools can’t follow CDC guidelines to quarantine only unvaccinated employees and students after COVID-19 exposure. Some schools say they will ignore the law when they reopen this week or next, some say they will make quarantine optional, and others will force vaccinated students to quarantine unnecessarily. Montana is also the only state that prohibits public and private employers from requiring employees to be vaccinated, which it says is discrimination and a violation of human rights.

Four states with low vaccination rates and high COVID case counts – Florida, Texas, Mississippi, and Alabama – are using half of the shipped supplies of the Regeneron antibody treatment that is given early in COVID infection to reduce the chance of hospitalization. Federal taxpayers are paying $1,250 per dose, plus an administration fee of several hundred dollars for Medicare patients, versus the $20 that vaccine would have cost. The governors of Texas and Florida are touting the treatment and opening government-run centers to administer it. One Florida hospital has administered the antibody treatment to 2,000 patients, at least 90% of them unvaccinated. According to the hospital’s chief nursing officer, “What’s amazing to me is that a vaccine we’ve been working on for 10 years, they are deathly afraid of. But this highly experimental cocktail? They’re willing to run in there the minute that they’re sick to get this infused into their bodies.”

An important review finds that airborne transmission of aerosolized respiratory viruses over longer distances and for longer time, including coronavirus, may be the dominant method of infection instead of droplets that fall quickly to the ground. Some mitigation measures overlap for both types of particles, such as distancing and masks, but the findings place extra emphasis on ventilation, mask type and fit, air filtration, and UV disinfection. For healthcare workers, medical masks and eye protection were designed for droplets and not aerosols and N95 types are best. The authors recommend using carbon dioxide sensors to monitor and optimize ventilation and the use of HEPA and HVAC aerosol filtration.

Other

University of South Australia researchers design an AI-powered facial digital camera system that can remotely monitor the vital signs of a NICU baby with ECG-level accuracy.

Sponsor Updates

• Experity launches the next generation of its Experity EMR/PM software for urgent care.
• EClinicalWorks releases a new customer success video, “Using Healow Check-In at Utah Orthopedic Spine & Injury Center.”
• Everbridge has won the 2021 Service to the Citizen: Champions of Change Award for the deployment of its Return to Work and vaccine distribution software solutions over the last year.
• First Databank publishes a new study, “Characterization of Pharmacogenetic Information in Food and Drug Administration Drug Labeling and the Table of Pharmocogenetic Associations.”
• Bluestream publishes a digital developer checklist titled “Key Features to Look For in Virtual Care APIs.”
• The Healthcare de Jure Podcast features Halo Health CEO Jose Barreau, MD.
• Healthcare Growth Partners advises Symplr in its acquisition of SpinFusion.
• The American Red Cross of Greater Atlanta names LexisNexis the 2021 Corporate Blood Sponsor of the Year.

Blog Posts

• Delivering on the Promise of Health Equity in Inequitable Times (GetWellNetwork)
• The Clinical Collaboration Investment – Can You Afford Not To? (Halo Health)
• Accelerate Charge Capture Improvement with Health Catalyst VitalIntegrity (Health Catalyst)
• Taming the data tsunami: 5 clinical terminology tactics for success (Wolters Kluwer Health)
• COVID-19 Testing Support (Optimum Healthcare IT)
• In the Age of Chronic Conditions, Patient Education is Crucial (Healthwise)
• This ESPN-Televised Basketball Tournament Used Vaccine Verification to Keep Players and Staff Safe (Healthcare IT Leaders)
• What’s in a variant? Clinical documentation, epidemiology, and genomic sequencing (Intelligent Medical Objects)
• New Study Shows How Clinical AI Can Improve End-of-Life Care for Cancer Patients (Jvion)
• Which apps are best for patients and providers to share medical data? Digital health formularies may help them decide (Lyniate)
• Improve Care by Improving Clinic and Hospital Communication While Preventing Revenue Leakage (Medhost)
• Through the pandemic and beyond, more hospitals are choosing MaaS (Meditech)
• 6 Tips on Implementing a Team Approach to Patient Care (MWTherapy)

Contacts

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

EPtalk by Dr. Jayne 8/26/21

The big news of the week was the official FDA approval of the Pfizer COVID-19 vaccine, which in turn triggered a rush of corporations to mandate employee vaccinations. Those companies that want to offer alternatives will require regular testing in lieu of a vaccine. Others, such as Delta Airlines, will charge unvaccinated people a premium on their health insurance and will block them from receiving pay-protection funds if they become infected with COVID-19.

As a physician, I appreciate the Delta Airlines strategy since it’s trying to tie cause and effect. The reality is that unvaccinated people who contract COVID-19 have a much higher risk of hospitalization and higher odds of costing their employers money and hitting people in the pocketbook might be much more effective for some than current vaccination strategies.

Once a drug has formal FDA approval, that opens to door for clinicians to consider so-called off-label prescribing, where they recommend use of the drug outside of the official approval. Off-label prescribing is common with a number of medications. For example, while we were having a shortage of antibiotic ear drops last year, physicians substituted the same drug in an eye drop formulation, which is widely considered to be safe and effective.

The official FDA approval for the Pfizer vaccine was only for patients aged 16 and older. Those 12 to 15 are still covered under an Emergency Use Authorization. Still, in the early hours following approval, several sources in my area made a play to administer vaccine doses to 10- and 11-year-olds. A quick clarification from the FDA as well as the American Academy of Pediatrics made it clear that this shouldn’t be happening, and that prescribers need to wait for additional approvals in younger age groups. Part of the delay in younger patients involves evaluating the dosing, but given the relative size of some larger 11-year-olds compared to smaller 12- and 13-year-olds, the risk of harm in those few children who received “unauthorized” doses is likely to be small.

Regarding the potential for upcoming booster shots, a couple of my neighbors were discussing the idea of trying to jump the gun on a third dose. One of them heard that a local pharmacy was throwing away doses that were expiring, so went and presented herself like she was there to receive her first dose. My other neighbor was incredulous that someone would be able to do that, “because don’t they have a national database of who has received what kind of vaccine?” She was shocked to learn that immunization registries are a patchwork across the states, and that they’re often not bidirectional or fully interoperable with hospitals and health systems, let alone other states.

I had a similar conversation with a neighborhood mom after the local school district requested copies of vaccination cards for students so that they would have them on hand in the event of an exposure. She didn’t understand why the schools “just can’t get them from the pediatricians’ offices.” Lots of members of the general public assume healthcare technology is a lot farther along than it is. I look forward to the day we can really exchange data like we need to in order to better enable quality care.

Many of those organizations requiring vaccination are healthcare delivery organizations, who have a vested interest in not only keeping their workers healthy, but in helping reduce transmission between staff and patients. A recent Kaiser Family Foundation brief concluded that over the last two months, COVID-19 hospitalizations of unvaccinated patients has cost the health system $2.3 billion. For hospitals running on razor thin margins, there is likely to be a certain amount of uncompensated care that will never be recouped. Other costs will be absorbed by taxpayer-funded programs (Medicare, Medicaid) or passed on to workers or businesses. In other words, we’re all going to be paying for this debacle for a long time.

For those of us on the vendor side of the healthcare IT industry, this means hospitals will continue to be strapped for cash for the foreseeable future, reducing available funds for technology projects including upgrades and new solutions. In addition to funding challenges, hospitals and health systems are also focused on trying to recruit and retain staff while keeping overloaded clinical divisions working. They’re certainly not going to be as eager to hear from technology vendors as they might have been a couple of years ago unless they’ve identified something particular that needs resolution and can’t wait. I’ve watched many companies turnover their entire sales teams over the last year due to low sales, but it seems inevitable that organizations will be pinching pennies for months to come.

The Medical Group Management Association has announced that its October Medical Practice Excellence: Leaders Conference in San Diego will require full COVID-19 vaccination for all attendees, suppliers, speakers, and exhibitors. Attendees will have to interact with plenty of other personnel – hotel staff, transportation workers, and those at dining establishments as well as members of the public who aren’t attending the conference, so the conference won’t be able to create a complete bubble. As for masks, MGMA says “masks are strongly recommended for attendees.” but it appears the organization is holding off on announcing a mask mandate pending changing conditions.

The Healthcare Financial Management Association’s Annual Conference slated for Minneapolis in November will also be vaccination-required for those attending onsite. Unlike HIMSS, registrants are able to cancel penalty-free or they can switch to the digital version of the conference if they do not want to comply with the vaccination mandate. In addition to attendees, vaccination is required for speakers, exhibitors, volunteers, staff, and backstage crew.

In speaking with some of my vendor contacts, everyone is already in the thick of their HIMSS22 planning. It will be interesting to see what the winter conference season looks like, starting with the Consumer Electronics Show kicking off in January. I’m planning to attend digitally this year as I did last time and looking forward to seeing innovative new technologies as well as things that are just quirky.

What are you most looking forward to in 2022? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 8/26/21

Ginger and Headspace Will Merge to Meet Escalating Global Demand for Mental Health Support

Digital mental health and wellbeing companies Ginger and Headspace will merge to form Headspace Health, with Ginger CEO Russell Glass taking on the same role with the combined company.

AccessDX Holdings Acquires 2bPrecise

Allscripts sells its precision medicine software subsidiary 2bPrecise to laboratory diagnostics company AccessDX.

Antidote Health raises $12 million to set up the first virtual HMO in the United States

Antidote Health, a virtual primary and urgent care company serving patients in five states, will use $12 million in seed funding to establish a health maintenance organization for its customers.

We just closed our $2.5m seed round. Here’s what that means.

Rezilient Health raises $2.5 million to launch its hybrid clinic concept for employees in St. Louis.

Readers Write: Sharing Your Medical Info with Providers from your iPhone – What You Need to Know About Apple Health, Patient Records, and Better Visibility into Patient Data

Sharing Your Medical Info with Providers from your iPhone – What You Need to Know About Apple Health, Patient Records, and Better Visibility into Patient Data
By Daniel Kivatinos

Daniel Kivatinos, MS is co-founder and COO of DrChrono of Sunnyvale, CA.

Apple’s announcement of their new iOS15 feature demonstrates a major step forward in giving patients better control of their own health data in a more seamless, straightforward way. Coming this fall, this update will allow patients to share health app data with providers.

For background, here’s how it will work. When choosing to share health information from their iPhone, the patient’s care team will be able to view the information within the medical record patient chart from the electronic health record (EHR) software. Patients can share a range of information, including physical activity, heart rate, cycle tracking, sleep, irregular rhythm notifications, and falls, as well as certain health record categories like labs and immunizations.

As we move into a new world of digital health, we are tracking more data than ever, and an ever-present question is whether or not physicians will be able to aggregate and use all of this information. With new features like Apple’s, medical care teams have easy access to a more holistic view of their patients’ health information. For example, providers will not only be able to see a patient’s lab results, but their workouts, food tracking, genomics, and more should they opt to share that information.

The overload of data is an understandable concern, and some healthcare professionals wonder whether or not this onslaught of information will only overwhelm practitioners. But the issue isn’t about the amount of data we have around a patient. Rather, it is about having access to the precise information that is best needed for the medical care team, patient, and family members.

While more data is better when it comes to giving precise care, what technology companies must do is work toward ways to better present, manage, and interpret the data in ways that help providers at the point of care. There is only so much time with a patient during a visit, and the data that is reviewed needs to be relevant and clear to understand. As a point of comparison, regardless of what you may think about the Robinhood investment app, they have succeeded at presenting data in a quick, simple way for investors.

Over time in the healthcare industry, insights gleaned from machine learning will be increasingly accurate for care teams. If the technology is leveraged correctly, the most important data trends that need to be shared won’t be lost in the shuffle, and machine learning assistants will eventually become more useful and relevant for providers.

After all, it is better to have 40 years of data on a patient bubble up or emerge with contextual information when needed than not. For example, a 12-year-old patient gets stung by a bee and the provider notes in their chart that the child is allergic to bee stings. Later in life, the patient may not recall this event, but this data should still be available to the care team and patient in their electronic medical chart. With the right user interface, this data will be useful, rather than a nuisance, to a busy provider.

Thankfully, machine learning continues to improve. Think of it as a co-pilot with the provider driving the patient experience and ultimately determining what to do, but with machine learning also helping in giving indications and insights about a specific patient and their needs. The patient’s numerous health factors are always evolving, but understanding more clearly a patient’s overall wellness, genomics, and labs are all critical to giving a precise prescription.

Patients on Medicaid and Medicare with multiple comorbidities would benefit the most from sharing their daily data with a physician, and patients have more access to better devices at a cheaper cost every year. As Moore’s law states, the number of transistors in a dense integrated circuit doubles about every two years. What this means is that as the cost to buy an iPhone is going down, you are getting more for your money. Through hard work across engineering, technology is getting better and better to the point where patients will be able to get more data over time at a cheaper cost. This not only applies to phones, but wearables and all consumer health tech products.

We are also witnessing a renaissance taking place in healthcare data exchange through FHIR and other modern APIs. This is a game changer in the industry and one to keep an eye on. I am excited to see what Apple and other digital health companies do in the future, as Apple’s latest iOS feature is a massive milestone and a bright future for healthcare.

Readers Write: Three Common Email Security Compliance Misconceptions That Are Putting Healthcare Organizations At Risk

Three Common Email Security Compliance Misconceptions That Are Putting Healthcare Organizations At Risk
By Hoala Greevy

Hoala Greevy is founder and CEO of Paubox of San Francisco, CA.

HIPAA violations are rapidly increasing. In 2020 alone, there were 188 PHI related data breaches via email, a 17% increase from 2019. As healthcare organizations look to stay competitive in the rapidly evolving digital landscape, they continuously search for more efficient and secure communication methods between employees and patients. HIPAA’s top priority is to protect a patient’s protected health information (PHI), requiring covered entities to take reasonable steps to accomplish this.

With the proper encryption and well-trained staff, email is an effective method to communicate with patients about their health. However, misconceptions about the difficulties or feasibility of HIPAA-compliant email often keep healthcare organizations using outdated communication tools like fax machines and the postal service to share PHI with patients. Providers shouldn’t let common misconceptions about email deter them from using it.

Misconception #1: You can’t send an email and maintain HIPAA compliance. HIPAA does not prohibit the transmission of PHI via email. In fact, according to the HIPAA Security Rule, healthcare providers may adopt new technologies, including email, as long as they:

• Ensure the confidentiality, integrity and availability of PHI.
• Identify and protect against reasonably anticipated threats.
• Ensure employee compliance with HIPAA.

Email is perfectly acceptable as long as it is encrypted in transit and at rest. Under HIPAA, encryption is an “addressable” way to secure email rather than being required. However, since there is no other effective method to secure email besides encryption, it is de facto a requirement.

Misconception #2: HIPAA compliant email has to be difficult to use. Most email security solutions require employees to take several steps to encrypt a message, such as putting a special keyword in a subject line to trigger encryption. Recipients might also need to jump through hoops to read a message, such as creating an account to log into a patient portal.

These extra steps leave plenty of room for human error. An employee might not remember to encrypt an email containing PHI, or they might simply put a typo in the subject line keyword. A recipient can easily forget their password, requiring them to reset it the next time they have a message waiting from their doctor.

However, there are alternative methods that don’t require any extra steps from a patient or a provider. The safest way to ensure staff uses email in a HIPAA compliant matter is to partner with a HITRUST CSF certified email security provider that encrypts all outbound email by default and sends messages directly to patients’ inboxes. That way, staff doesn’t need to decide which emails to encrypt and recipients don’t need to worry about logging into a portal to read their messages.

By eliminating extra steps, healthcare organizations can easily and safely use email while remaining HIPAA compliant, thus allowing providers to focus on patients rather than encrypting messages.

Misconception #3: Extra steps increase email security. People often think that the harder something is to do, the more secure it must be. However, email solutions that include extra layers of complexity to send and read a message provide people with a false sense of security.

Patient portals, for example, give the appearance of more privacy as they require a separate login and password. However, portals also involve an email component to access messages. Although they might appear to be harder to break into, portals are only as secure as the email address they are associated with. Ultimately the number of steps in a process doesn’t dictate the security it provides.

Misconceptions like these have limited email’s adoption throughout the healthcare industry, but it need not be so. With a clear understanding of how to secure messages and maintain compliance, organizations can partner with a HIPAA compliant email provider that is both easier to use and more secure than other solutions that rely on security theater to lull their customers into a false sense of security.

Readers Write: Healthcare is Failing Overwhelmed Clinicians — Here’s How to Focus on Their Journey

Healthcare is Failing Overwhelmed Clinicians — Here’s How to Focus on Their Journey
By Michelle Davey

Michelle Davey is co-founder and CEO of Wheel of Austin, TX.

Over the last few years, the health tech industry has invested billions into improving the patient experience. Direct-to-consumer healthcare companies raised $1.2 billion in Q1 2021 alone. Now patients can get prescriptions delivered to their door and avoid the pharmacy line. They can skip the waiting room and chat with a doctor from their couch. They can even get their blood drawn without leaving their home.

But it’s been surprising to see the industry pay so little attention to clinicians, especially with the critical role they play in the patient journey. They are setting expectations, determining treatment plans, and listening to patients’ concerns. Yet for some reason, we continue to set clinicians up to fail.

Think about how you feel on your worst day at work. Tired, stressed, and overwhelmed, right? That’s how clinicians feel every day with their patients. Nearly half of clinicians reported alarming rates of burnout before the pandemic. Over the last year, 80% of people said their doctor or nurse seemed burned out during a healthcare visit. Even more concerning, one in three said they believe their quality of care may have been affected by clinician burnout.

That’s why the digital health industry should look at “D2C” through a new lens: direct-to-clinician. It doesn’t matter how much time and investment we spend on improving the patient journey. When clinicians are burned out and overwhelmed, patients won’t feel satisfied. But if clinicians feel supported and set up for success, patients will be motivated to take charge of their health.

Here are three ways to put a D2C(linician) strategy in place:

Prioritize the Clinician As Your End User

When developing a clinician-facing product, get clinician feedback early and often. That includes surveys, interviews, demos, and beta launches, just like any company would do with consumers before launching a product. Feedback is a gift and bringing clinicians along the journey is worth the investment. Clinicians want, need, and deserve user-friendly tech, processes, and workflows.

Also, look for opportunities to hear the clinical voice outside of product development. In our company all-hands meetings, we share clinician feedback about what we’re doing well and where we can improve. This tight feedback loop helps us stay honest and it keeps us focused on clinicians and what they need to do their job well.

Invest in Ongoing Education and Coaching

Remember that clinicians are highly trained and educated. They love to learn and they’re eager to upskill throughout their career. That includes traditional opportunities like continuing medical education (CME), which offers the latest research and best practices in developing areas of their field. But they also want to stay on the cutting edge of technology and care models. Especially in light of the pandemic and the transition towards virtual-first care.

Clinicians now have 50 to 175 times the number of virtual visits compared to before the pandemic. Medical schools have largely failed to provide comprehensive training on virtual care. But it’s also the digital health industry’s responsibility to make it as easy as possible for clinicians to understand how to treat patients remotely.

Before clinicians start seeing patients with Wheel, for example, we provide them with “webside manner” training. This includes:

• Testing their webcam, microphone, and speakers before a patient visit.
• Looking into the camera throughout the visit to make eye contact with the patient.
• Nodding their head during the visit to demonstrate active listening.
• Dressing professionally to set a good impression.
• Picking a neutral background to avoid distraction.

For those who have spent the pandemic on back-to-back Zoom meetings, some of this guidance may feel obvious. But clinicians are used to being in the same room as their patients. We need to help them feel comfortable and confident behind the screen.

Cultivate a New Work Culture

Doctors and nurses are well known for putting up with long shifts and demanding schedules, but they’re fed up, burned out, and overwhelmed. The toll and trauma of the pandemic has led three in 10 clinicians to think about quitting their jobs altogether. Digital health companies not only have an opportunity to create a new work culture for clinicians, they have an obligation. It’s incredibly challenging and expensive to recruit and retain clinicians. If the workforce continues to shrink because we aren’t providing them with the support they deserve, our innovative devices and services will go dark.

One of the ways we focus on retention is by getting to know clinicians as people, just like we do with our engineers and product managers. Our team regularly conducts surveys and interviews to better understand their motivations, their career aspirations, and how the pandemic has affected both their work and personal life. For example, we found the majority of clinicians in our network are the primary income earners for their family. As with many of us, the pandemic had placed them under extra stress to provide for their families. These findings prompted our team to offer free therapy services so they could get support during a tumultuous time without needing to worry about the cost.

The digital health industry should continue to focus on improving the patient experience, but we need to consider all the factors that impact the patient experience. Getting clinician feedback early and often, investing in ongoing coaching and education, and finding opportunities to better understand their career aspirations and motivations should be table stakes for every digital health company. This is our opportunity to address one of the biggest failures of our healthcare system — providing clinicians with the support they need to provide great care to patients.

Investing in a D2C(linician) model now will pay off in the long term, keeping our caregivers engaged, patients healthy, and investors impressed. Now that’s a winning strategy.