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What Are Your “Working From Home” Tips?

March 11, 2020 News 11 Comments

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Many people are working from home for extended periods for the first time. If you’ve done it, what advice can you offer for those doing their jobs from home for a few weeks?

Readers Write: Walmart Health Centers Are Here — Here’s How to Respond

March 11, 2020 Readers Write Comments Off on Readers Write: Walmart Health Centers Are Here — Here’s How to Respond

Walmart Health Centers Are Here — Here’s How to Respond
By Derek Baird

Derek Baird, MBA is SVP of Avia of Chicago, IL.

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I recently wrote about Amazon’s looming threat to health systems and physician practices. I closed with a comment that Walmart poses an even greater threat. Many (actually, most) of you disagreed. Since we all have unexpected free time this week, I hope you’ll hear me out.

Walmart Health is back in the news, thanks to the opening of their second Health Center and a not-so-subtle statement from former Apple CEO John Sculley, “Walmart Health will cause a consumer revolution.” Those are bold words from a smart man (and healthcare investor). Note: John’s been wrong at least once. He drove Steve Jobs out of Apple.

Walmart has run pharmacies since the 1970s and a small number of retail clinics for many years. Last September they opened the first Walmart Health Center. It’s not your 1990s-style retail clinic crammed in a closet next to the pharmacy. The 10,000 square foot clinic sits next to a Walmart Supercenter in suburban Georgia. It provides services ranging from physical exams to dental visits to x-rays. Notably, it is staffed by physicians.

The second clinic opened in another Georgia suburb in January with a similar footprint and services. Mark Wahlberg was at the opening. Makes sense since he’s a model of men’s fitness. On the other hand, he owns a burger chain delivering saturated fat to the masses. Speaking of brand dissonance, purists like me grumble about Walmart providing healthcare services in the building next door to its lucrative tobacco counter. I doubt their shoppers share my scruples.

Not only does Walmart offer a super-convenient one-stop shopping option, the digital experience is great. It features all the stuff we admire in solutions from cooler companies like Amazon, Carbon, and 98point6: clean website UI, extended hours, online scheduling, transparent pricing, text reminders, etc.

One hundred fifty million Americans visit a Walmart every week, though most healthcare executives aren’t part of that cohort. We spend lot more time discussing Amazon and other technology offerings even though 90% of us live within 10 miles of a Walmart store. Many Walmart shoppers are commercially insured  — with $1,600 average deductibles — and are likely tempted by the sound of $40 for an office visit and $25 for a teeth cleaning. I know I am.

Out of the gate, Walmart’s model is differentiated, difficult to replicate, and a savvy marriage of physical and virtual assets. Like Amazon’s not-yet-launched offering, Walmart designed its services to address glaring flaws in traditional offerings. But unlike Amazon and other direct-to-consumer telehealth offerings, it’s not reliant on virtual care. In most markets, virtual care is still hampered by stubbornly low awareness, understanding, and adoption. It will be a lot easier for Walmart to launch virtual care than it will be for Amazon to replicate Walmart’s foot traffic. Let’s keep an eye on Whole Foods.

If you’re more likely to visit Sam’s Club than Walmart, then the Walton family has you covered, too. They launched a set of innovative healthcare packages—including family bundles—for members last year. The bundles include free generic medications, a Humana-supported provider network, and $1 virtual visits through, yes, 98point6.

Here’s the kicker. Unlike Walgreens or CVS, Walmart doesn’t appear interested in partnering with local health systems. These Health Centers are launching to make up for health system shortcomings. They will gladly displace primary care physicians sitting behind ineffective call centers, packed schedules, opaque pricing, and myChart logins.

Just like small town Main Street retailers, health systems will have to compete.

Here’s how to get started. First, aim to match Walmart on digital convenience. Your digital front door must make it just as easy to access care as it is to grab an appointment at the Health Center. Put your price list online. Offer virtual visits for those who don’t want to leave the couch. Offer virtual queuing (“save my spot”) for urgent care centers. Your goal here is to approach competitive parity. This will require an intentional, multi-year focus on convenient access and virtual care. If you don’t have your key executives focused on this effort, it’s time to pull together a task force and allocate substantial capital.

Next, leverage your incumbent advantages so you don’t have to match on price. You have brand equity, data, and locations that can be assets rather than liabilities. If you can marry your clinical expertise with personalized communications to patients, they will value that continuity and credibility.

Some good news: Walmart is not going to scale as quickly as Optum or CVS. They have two, soon to be three, locations. You have a little time to prepare. Unless you’re in Georgia.

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Morning Headlines 3/11/20

March 10, 2020 Headlines Comments Off on Morning Headlines 3/11/20

Changes and Clarifications from the Proposed Rule to the Final Rule

ONC publishes a six-page summary of changes that were made to the draft version of HHS’s interoperability rules in producing the just-released final version that took public comments into account.

HealthStream Acquires NurseGrid, #1 Rated and Top Downloaded App for Nurses

HealthStream acquires 20-employee nurse scheduling app vendor NurseGrid for $25 million in cash.

Genstar Capital Announces Recapitalization of ConnectiveRx

Genstar Capital recapitalizes ConnectiveRx, continuing as the majority investor and bringing in new funds as minority participants.

DXC Technology to Sell U.S. State and Local Health and Human Services Business to Veritas Capital for $5.0 Billion

DXC Technology will sell its technology-enabled health and human services business to Veritas Capital for $5 billion.

Comments Off on Morning Headlines 3/11/20

News 3/11/20

March 10, 2020 News 2 Comments

Top News

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ONC publishes a six-page summary of changes that were made to the draft version of HHS’s interoperability rules in producing the just-released final version that took public comments into account:

  • Vendors have 36 months to release Electronic Health Information (EHI) Export that supports exporting a single patient’s data and exporting all patient data for users who are switching health IT systems.
  • FHIR Release 4 was chosen as the standard for API certification.
  • Health IT vendors are prohibited from restricting the sharing of screenshots and videos of their screens, but are allowed to limit such use to protect their intellectual property.
  • Compliance with the information blocking provision is not required until six months after the final rule is published and timelines for assessing civil monetary penalties will be determined later.
  • EHI is defined to be the HIPAA-designated record set starting in 24 months, but until then, it is the USCDI standard.
  • It will not be considered information blocking to notify patients that the apps they’ve chosen may or may not follow best practices.
  • An actor can require patient consent or authorization before providing access to EHI, but they must make reasonable efforts to provide a consent form.
  • An actor can limit the content of its response to requests to access, exchange, or use EHI without being considered information blocking, which allows them to negotiate terms.They can also fulfill requests in an alternative manner if they have technical limitations or can’t reach terms with the requester.
  • Fees may be charged for accessing, exchanging, or using EHI.

ONC will host a series of webinars that explain the new rules starting Wednesday, March 11.

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I asked Cerner to provide a high-level summary of what the new regulations mean for developers:

  • The appropriate open and unimpeded access, exchange, and use of EHI is firmly established. Information blocking is barred as a general rule.
  • Most favored nation behaviors and use of unlevel playing fields to favor some over others for participating in health information exchange will not be tolerated by HIT vendors.
  • HIT vendors will need to establish business practices that abide by five vendor-oriented exception conditions that set guardrails for fee development; non-discriminatory business practices; evaluating requests for access, exchange and use of EHI; and for responding to such requests in a good faith manner.
  • HIT vendors will need to embrace the era of the API as a critical basis for interoperability going forward, whether for enabling access by patients / consumers, for exchange of EHI with other providers, and for other needs for interoperability.
  • Current HIT vendors of certified HIT must keep their clients current by making available updated certified HIT capabilities for interoperability and the essential data set required for exchange (Version 1 of the US Core Data for Interoperability- USCDI) within 24 months for most requirements (36 months for EHI Export).
  • HIT vendors will need to attest to HHS and their certifying body as to their compliance with conditions of certification that assure most importantly that they will not engage in information blocking, provide real world support for interoperability, and that they will support API access for all verified registered users (including developers) who seek to connect applications to said APIs to access EHI held by an HIT vendor’s certified products

Reader Comments

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From Jake: “Re: coronavirus. The clinical director for a regional hospital in Oregon, which is undergoing a COVID-19 outbreak, is peddling rumors that the flu vaccine makes you susceptible and recommending $200-$500 immune system testing through her side business. Unconscionable.” Stefanie Haines – who has a BS in clinical laboratory science and a doctorate in healthcare administration – also owns the local fitness center, which is a member of a national chiropractic group that sells various snake oils, like vaccine detox. She uses her Facebook page to push debunked conspiracy theories about vaccines, promotes the fitness center’s own services, and claims that coronavirus is a deep state conspiracy that can be prevented by using her immune system tests and nutritional supplements. You will rarely be wrong if you assume that people and companies will do the most profitable thing over the right thing.

From Amtrakker: “Re: HISsies. Epic again? Seriously?” HIStalk readers did the nominating and voting as always, with me doing nothing except shelling out $99 for SurveyMonkey so I could tie ballots to the email addresses of HIStalk subscribers to prevent the ballot box stuffing that would be guaranteed with the typical online poll. I always hope for dark-horse winners to make my job more exciting than just copying Epic / Judy / John Halamka / KP / beers with Bush slides over year after year to announce the winners, but the majority rules.


HIStalk Announcements and Requests

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I’ll change out this week’s poll early since folks voted quickly, in which three-fourths of respondents said HIMSS did the right thing in cancelling HIMSS20.

New poll to your right or here: To what level are you avoiding crowded places and unnecessary travel due to COVID-19 concerns? I would not want to be in the cruise industry right now – I checked a couple of websites and the discounts are massive, such as an eight-day cruise on a highly rated ship for $299. Ships are still leaving ports, even Seattle, and returning to discharge petri dish passengers to go home all over the country.

I posted a list of sponsor virtual sessions that were repurposed from the lost HIMSS20. Most of them are, like their original counterparts, scheduled for this week. It’s a good time to get some desk-side education.

It is time (pun intended) to stop with “EST.” It will be “EDT” until November 1, or just “ET” if you want to wash your hands of the distinction in favor of a year-round replacement that prevents you from embarrassing yourself.


Webinars

March 25 (Wednesday) 1 ET: “Streamlining Your Surgical Workflows for Better Financial Outcomes.” Sponsor: Intelligent Medical Objects. Presenters: David Bocanegra, RN, nurse informaticist, IMO; Alex Dawson, product manager, IMO. Health systems that struggle with coordinating operating rooms and scheduling surgeries can increase their profitability with tools that allow for optimal reimbursement. This webinar will identify practices to optimize OR workflows and provider reimbursement, discuss how changes to perioperative management of procedures can support increased profitability, and explore factors that can impede perioperative workflow practices.

March 26 (Thursday) 12:30 ET. “How to Use Automation to Reduce ‘My EHR is Slow’ Complaints.” Sponsor: Goliath Technologies. A common challenge is that a clinician is ready to work, but their technology is not. EHRs can be slow, logins not working, or printers and scanners are offline. Troubleshooting these end user tickets quickly is nearly impossible, especially in complex environments that might include Citrix or VMware Horizon. This webinar will present real-world examples of how leading health systems are using purpose-built technology with embedded automation and intelligence to proactively anticipate, troubleshoot, and prevent end user performance issue across their IT infrastructure and EHRs.

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


Acquisitions, Funding, Business, and Stock

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HealthStream acquires 20-employee nurse scheduling app vendor NurseGrid for $25 million in cash. Nurses use its mobile app to manage their schedules, trade shifts, and communicate with each other, while managers use it to publish work schedules. HealthStream expects the money-losing company to contribute less than $500,000 to its revenue in 2020.

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Genstar Capital recapitalizes ConnectiveRx, continuing as the majority investor and bringing in new funds as minority participants. The company has doubled in size since Genstar’s initial investment in 2015.


People

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Philip Meer, MBA (Evariant) joins PatientKeeper as CEO.


Announcements and Implementations

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FormFast changes its name to Interlace Health.

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OptimizeRx adds COVID-19 related CDC alerts to its health network of EHR users.

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Intelligent Medical Objects partners with Perspecta and the Regenstrief Institute to integrate its Precision Patient Summary with the clinical data viewers of those organizations, which includes the VA through its use of Perspecta’s HealthConcourse.

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Salesforce announces enhancements to Health Cloud: provider management, provider search, provider relationships, an analytics solution for care management, and integration with Bridge Connector’s Destinations for integrating EHR data.

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Parkland Center for Clinical Innovation publishes “Building Connected Communities of Care: The Playbook for Streamlining Effective Coordination Between Medical and Community-Based Organizations.”

AMA will fast track development of a CPT code for coronavirus tests.


Government and Politics

Premier expressed satisfaction with the new ONC rule, but would like to see more security and privacy requirements implemented for third-party app vendors. They are also disappointed that CMS does not go further to reduce provider burdens, particularly with the new ADT Conditions of Participation requirements and their accelerated implementation timeframe.


Other

The American College of Healthcare Executives, America’s Health Insurance Plans, American Organization for Nursing Leadership, Future of Individualized Medicine, American College of Medical Genetics and Genomics, National Comprehensive Cancer Network, Congress on Healthcare Leadership, VMed, ACC, ENDO, and several other groups join HIMSS and AMIA in cancelling upcoming conferences due to COVID-19 concerns. Massachusetts has declared a state of emergency after 51 new coronavirus cases were found, with 70 of the state’s 92 cases related to a drug company’s 175-attendee conference in Boston last month.

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ICU doctors in Italy warn that government reassurances aside, conditions there have deteriorated as COVID-19 ramps up:

  • Hospitals are getting dozens of admissions for fever, breathing problems, and cough each day, all with positive swabs and all being diagnosed as bilateral interstitial pneumonia.
  • Up to 10% of cases are requiring ICU care for extended periods.
  • Hospitals that are overwhelmed at 200% of capacity have converted all ORs to ICUs and are diverting all other emergencies, including trauma and strokes (note: Italy has more physicians and hospital beds per capita than the US).
  • Hundreds of patients who have severe respiratory failure are being given nothing except a reservoir mask.
  • Patients who are over 65 or who have other medical conditions aren’t even being assessed.
  • The situation progressed from a few positive cases, then to some respiratory failures that took up ED resources, then to respiratory deterioration that filled ICUs.
  • Staff illness made it hard to cover shifts, while mortality from other causes then spiked because of lack of resources.
  • Doctors and nurses have infected their own relatives, some of whom are dying. 

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Former FDA Commissioner Scott Gottlieb, MD says it’s too late for COVID-19 containment and thus contact tracing is a waste of resources, predicting that more widespread testing will reveal existing large outbreaks. He says the next two weeks will be “very difficult” and urges shutting down movie theaters and other places where people gather indoors, requiring business to offer teleworking, and slowing transportation. He also says that while coronaviruses usually don’t circulate in the summer, nobody knows about this one. He says that March and April will be tough months, but the epidemic curve could start to go down at the end of April and the situation should improve considerably by summer. He says sporting events such as the NCAA’s Final Four may need to played in empty gyms and conferences should be cancelled: “Do you want to continue to hold conferences and have to run the risk that your entire attendee list is put into a quarantine because there was someone there who is infected?” He concludes that COVID-19 is a pandemic even though WHO is “not wanting to label it yet out of some odd sense of political correctness that I can’t fully appreciate.”

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Let’s clear those pre-HIMSS20 tweet buffers, folks (especially the HIMSS-employed ones).

It looks as though the “FHIR Festival” website has gone dark, which I assume is because HL7 and maybe HIMSS expressed minimal amusement at its use of trademarked terms. It was a parody site, which is legal to the extent that you can afford lawyers to argue your case. The good news is that it wasn’t really all that funny once you recovered from that initial small giggle from being caught off guard.


Sponsor Updates

  • Customers of professional liability insurer IronHealth can apply their risk management reimbursement dollars toward PeriGen’s PeriWatch Vigilance early warning system for labor problems.
  • Bright.md offers free coronavirus screening tool to hospitals.
  • Diameter Health adds new FHIR product capabilities to its data normalization and enhancement platform to enable payers and HIEs to share larger sets of data with other healthcare stakeholders.

Blog Posts


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Contacts

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

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Morning Headlines 3/10/20

March 9, 2020 Headlines Comments Off on Morning Headlines 3/10/20

Pager Announces $33M Financing Round

Concierge care coordination app developer Pager raises $33 million in a Series B round, bringing its total raised to $63 million.

PatientKeeper Appoints Philip Meer CEO

Former Evariant EVP Philip Meer becomes CEO of PatientKeeper.

HHS Finalizes Historic Rules to Provide Patients More Control of Their Health Data

ONC publishes its 1,244-page Cures Act Final Rule.

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Curbside Consult with Dr. Jayne 3/9/20

March 9, 2020 Dr. Jayne 1 Comment

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I’m beyond aggravated at the lack of communication from HIMSS regarding hotel cancellations and refunds.

All of the FAQ entries on the conference page say they’ll provide a notice within 14 business days. I called my hotel on Friday and tried to cancel and inquire about a refund, but was told that, “Our GM is handling it and we’ve been instructed not to speak with you.” I emailed the HIMSS refund email address with a formal request instead. (Did I mention I still haven’t received a notification that the conference was canceled?) Today, I was reading Mr. H’s Monday Morning Update and saw the link to an OnPeak refund. Although the link is no longer live, it instructed me to call the hotel directly.

After multiple calls and being rolled over to Marriott’s corporate reservation line, I was at least given a cancellation number, as well as the direct phone number for an assistant GM at the hotel. We’ll see if she returns my call. I’ve stayed at the same hotel eight years in a row and have status with Marriott, so I hope they at least make an effort. I don’t expect a full refund, but anything at all would be appreciated for those of us who pay for our trip to the show out of pocket.

Many of the folks I was scheduled to meet with at HIMSS just rolled our already-scheduled appointments into ones by phone, which made things easy. I’ve decided I’m still going to keep other pieces of my conference schedule, including starting to drink wine, whisky, or other cocktails at 4 p.m. on Tuesday and Wednesday, depending on which vendor events I was scheduled to attend. I’m going to be sure to eat seafood on Monday night in honor of Nordic Consulting’s elegant (but canceled) event at The Oceanaire Seafood Room. Tuesday’s dinner will be Italian in honor of the canceled Citrix event at Maggiano’s, and Wednesday will be contemporary Southern cuisine in honor of Red Hat’s event at Itta Bena. Thursday night I was most likely to be eating some kind of granola bar on the plane while flying home, so I don’t plan to replicate that evening.

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I’d like to invite all our readers to participate in my own virtual “Shoe-A-Palooza” and “Sock-It-To-Me” competitions. Send me your photos of the shoes and socks you planned to wear this week and I’ll pick my favorites. Be sure to let me know if you want to be added to the history books using your real name or if I should pick a kicky pseudonym to keep you anonymous.

COVID-19 has made it to my community, leading to considerable angst as patients panic and community physicians struggle to understand how we are supposed to care for patients. The biggest point of contention is the fact that we can’t even protect ourselves. Outpatient physicians who aren’t employed by big health systems have either no access to simple surgical masks or access that is intermittent at best. An informal survey of close friends reveals that 10 out of 10 of us don’t have access to gowns.

I’ve had to call the state epidemiologist several times for suspected patients. It’s an arduous process that hasn’t led to testing for any of the patients involved. Due to the shortages, we can’t care for flu patients properly by having them wear a mask when they’re diagnosed, which might be contributing to a bump in flu in our area despite numbers from the CDC that it should be waning.

I never thought I’d have to start thinking about whether to quarantine myself when I come home from work, emerging from my room only to run out the door and head to the office. I’m fortunate in not having small children or childcare issues. Many of my physician peers are struggling to figure out how they’re going to be able to see patients if more schools close. Right now it’s just a handful, but only time will tell.

It’s unclear how the recently-passed $8.3 billion in funding will impact the efforts of frontline providers. I’m monitoring news sources from across the country as well as around the world to see how our local response compares to that of others. Kudos to the Washington Post for offering free access to their articles covering the novel coronavirus. You have to subscribe to an email newsletter to get the access, but it’s good to have multiple sources of information. I’m heartened by the decision of some insurers to cover coronavirus testing, but the devil will be in the details as far as how it actually works out. Some payers are considering policies to waive co-pays for testing, but most patients won’t know how their coverage is until they get the bill.

In positive news, the CDC’s Advisory Committee on Immunization Practices voted to recommend a pre-exposure vaccine for the Ebola virus. It’s at least some comfort for the healthcare providers who work at federally designated Ebola treatment centers in the US, for those who work at Biosafety Level 4 labs, and for the genuine heroes who volunteer to respond to Ebola virus outbreaks across the globe. The single-dose vaccine has been shown to be 100% effective when used in a ring vaccination strategy, which basically means that everyone socially connected with a patient within 21 days of their illness must be vaccinated. Ebola virus outbreaks have taken a back seat to COVID-19, but the virus is still classified as a “public health emergency of international concern” in the Democratic Republic of the Congo.

The focus on vaccines is also good news for biotech firm Moderna Inc. whose experimental coronavirus vaccine is being tested on a small group of adults. The study is only a test of the safety of various doses of the vaccine and whether the subjects produce an immune response. Actual vaccines are likely to be more than a year away. Participants will receive two vaccines over the course of a month and will have to complete 11 face-to-face visits and four phone visits during a 14-month period. Those completing the entire trial will receive $1,100. I would say the real value of participation is priceless, should the vaccine progress to a full recommendation. My medical school is also working on vaccine research, so I’m eager to follow the developments.

I’ll be reporting later this week on my at-home virtual HIMSS efforts, so be sure to send those shoe and sock photos along. I’ll be glad to have something else to focus on than the reality of counting the days until I’m personally exposed to COVID-19.

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Email Dr. Jayne.

HISsies Awards 2020 Winners

March 9, 2020 News Comments Off on HISsies Awards 2020 Winners

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HIStalk Interviews Diana Nole, CEO, Wolters Kluwer Health

March 9, 2020 Interviews Comments Off on HIStalk Interviews Diana Nole, CEO, Wolters Kluwer Health

Diana Nole, MBA is CEO of Wolters Kluwer Health.

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Tell me about yourself and the company.

I’ve been at Wolters Kluwer for five years, and in and around healthcare since 2006, starting in the radiology area. Wolters Kluwer focuses on the education of medical practitioners, nurses, and pharmacists and helping them with clinical decision support tools and ongoing educational tools. The business itself is a little over $1 billion and has around 3,000 employees. We employ a lot of clinical people, which is a rarity among vendors. We couple technology and clinical expertise.

What progress has been made in turning research findings into frontline provider decision support?

We are heavily focused on that area. People search journals for a tremendous number of use cases. One of our core clinical decision support tools, UpToDate, was created from the discovery that you can’t just have somebody looking through all the journals, yet you need this information updated and you need it in the actual practice of decision-making and the clinical workflow. Even within UpToDate, we still serve up the information based on what the clinician is asking for, kind of the “Google for doctors,” but deeply curated and precise.

A customer told me they love the product, but don’t want to completely rely on the doctor knowing what to look for. More and more we are integrating the information with the EHR systems to support the patient context. We can serve up the most relevant topics for the topics for that particular patient. That’s why we introduced UpToDate Pathways. 

On the journal’s content, we continue to look for things that would be easier to absorb. We’ve applied artificial intelligence to pharmacovigilance for the life sciences industry, where we can sort the information that they’re looking for so that information that is more relevant and might need to be addressed sooner appears right at the top.

We continue to talk with customers about what they do with the information after they get it. What other systems do they need to have it integrated in? What’s the workflow? That will be more and more of our focus — deeply integrating it into the practical workflow. There’s an overwhelming amount of information for those who are practicing.

What’s involved with tailoring the information to the patient level?

You rely on interoperability with the EHR systems. We always have it resident within — you can launch it from the EHR — but more and more we’re trying to have relevant information from the patient record passed into UpToDate, which can then augment a search, but it can also tell you that clinical pathways exist for this particular context of this patient.

Let’s say they have AFib and you need to figure out the best treatment pathway, with particulars about this patient. What other kinds of things are you dealing with in terms of this patient? That helps get the evidence and the information that you want to look at down to a smaller, personalized set.

How do you see artificial intelligence affecting your business and healthcare in general?

It’s a big topic. I’m smiling because of my computer science background, where I always think technology should make something more useful. We are applying it, like many other vendors, and trying to be pragmatic. We’ve all seen these big taglines where the robot will see you versus the doctor. We don’t think that’s going to be be the immediate use of AI. We’re focusing on how to reduce variability in care. 

We even start way back at education. How is the person educated? It’s not in a lecture hall any more. Now we have tools that use AI and do adaptive testing, so the student can self-test their knowledge. You can’t game the system – it asks the student in many different ways how they would answer certain things. That has been proven to get a much deeper level of education and clinical judgment, to  get them ready to get out there.

Other specific use cases involve strong evidence, where you just need the information quicker. We are applying AI to areas like sepsis detection, C. diff, another hospital-acquired infection. AI that can constantly learn the pattern that indicates that a patient may be experiencing it can make the information available sooner. It can be better than a human at continually checking those things.

In my prior world of radiology, AI will be applied to some promising areas involving the images themselves that will help the radiologist. We’re seeing a good impact and tangible improvements.

How much of clinical practice can be directly supported by available evidence? Do you have to consider in product design that recommendations aren’t as black and white to the clinician as they are to the computer?

Everybody wants to help a patient get better. The patient themselves always wants to get better. But so many breakdowns exist within the system, so that even if the doctor follows the evidence guidelines, will the rest of the care team play out and will the patient follow it? It was surprising to me so see on a recent survey just how often that doesn’t happen.

Why somebody might choose to not follow the evidence is probably a deep psychological issue. In addition to having toolsets, not everything is black and white. Clinicians build their knowledge base through other assets, such as talking with their fellow clinicians. There’s also complexity, and sometimes in the most complex cases, I have to make a decision, see the result, and then take another fork in the decision-making and see what that is.

Where we focus is to your earlier point. For certain practices where there is extremely strong evidence, there shouldn’t be any reason to not follow it. That is being more and more adopted. People ask, if we move from from fee-for-service to value-based care, will that push it even further? I think maybe it does, but in general, everybody is trying to get access to the evidence in the best way possible way and to follow it, but there are definitely places where that can fall down.

What is coronavirus teaching about using technology to address a quickly changing and widespread medical situation?

People have compared and contrasted it with SARS and other things in the past. Getting constant news and updates is creating a lot of uncertainty. What should I be thinking? What should I be doing? We and other vendors are trying to help by putting the best evidence and information out there so we can get people focused on the facts at hand and how to treat it best. 

People are being prudent at the settings they put themselves in. They are saying, why put ourselves at risk for further issues by having conferences, meetings, or heavy travel? People are starting to be much wiser about that.

What is different now than in the past is this constant update of information and the lack of true facts on what situations you should avoid. They are in contrast with one another. We need to focus on the facts at hand, what people really know about the situation.

How are providers and life sciences companies using technology to work together on research?

Our Health Language product, which normalizes data, is being used in a life sciences setting for post-clinical trials, where a drug is out in treatment. They are getting data from patients who are using the drug in real time from EHR and other systems. They normalize it to potentially adjust the treatment pathway for this specific patient, and then more quickly understand through their own research whether things need to be modified.

It was impressive to me to learn how this normalization tool can be used in such a great way. In the past it, it probably fell apart a bit — how you get the data out, make sense of it, and do that across so many disparate systems. At least nowadays, everybody really is in a digital record of some type. That’s on the back end for the treatment purposes, but obviously you can see where people could get access to data and then try to work on things across systems of data. That will hopefully help solve problems like coronavirus and others more quickly.

Do you have any final thoughts?

I really am glad that I made the move into healthcare from a vendor perspective in 2006. I continue to be so impressed with the people who I get to work with and the customers I get to interface with. There are big problems out there, but I see tremendous tenacity and passion for trying to solve them.

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HHS, ONC Release Final Rule on Interoperability, Information Blocking, and Certification

March 9, 2020 News Comments Off on HHS, ONC Release Final Rule on Interoperability, Information Blocking, and Certification

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ONC publishes its 1,244-page Cures Act Final Rule.

This story will be updated as new information is made available.

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Sponsor HIMSS20 Presentations Rescheduled as Virtual

March 9, 2020 News Comments Off on Sponsor HIMSS20 Presentations Rescheduled as Virtual

This list gives visibility to HIStalk sponsors that are presenting virtual versions of the live presentations they were scheduled to offer at HIMSS20. Sponsor events scheduled through March 23 will be included.

Submit your event here. This list will be updated as I receive new submissions.

Companies that do not sponsor HIStalk can contact Lorre about becoming a sponsor or having their webinar promoted.


Arcadia


Hyland Healthcare


Meditech


National Decision Support Company (Change Healthcare)


OptimizeRx

Thursday. March 19, 3 ET: “Learning Together: Navigating the COVID-19 Pandemic.”


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    Comments Off on Sponsor HIMSS20 Presentations Rescheduled as Virtual

    Morning Headlines 3/9/20

    March 8, 2020 Headlines Comments Off on Morning Headlines 3/9/20

    It’s true: Virtual HIMSS20 is happening!

    HIMSS will develop a special virtual edition of HIMSS20 and is asking members which sessions they would like to see.

    VA leaders optimistic on July go-live date for new health record

    VA officials are confident Mann-Grandstaff VA Medical Center’s Cerner go-live will happen in July, provided several milestones are finally met including building interfaces between Cerner and VA systems, training end users, and conducting operational assessments.

    Epic changing employees’ travel plans as coronavirus concerns continue

    Epic reassesses employees travel plans as customer hospitals become care sites for COVID-19 patients.

    AMIA Statement on AMIA 2020 Informatics Summit Cancellation

    AMIA cancels its 2020 Informatics Summit that was scheduled for March 23-26 in Houston due to coronavirus concerns.

    Comments Off on Morning Headlines 3/9/20

    Monday Morning Update 3/9/20

    March 8, 2020 News 9 Comments

    Top News

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    HHS will apparently release its new interoperability rules Monday morning.

    Details will be provided to stakeholders in a 9:30 a.m. ET conference call with Secretary Alex Azar, Deputy Secretary Eric Hargan, CMS Administrator Seema Verma, and National Coordinator Don Rucker.


    Reader Comments

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    From ItsMoreThanAGig: “Re: HIMSS20. As a HIMSS staff member, I can verify how incredibly difficult this decision was today and how painstakingly careful our leadership was in fact-gathering, deliberation, etc. As our CEO said on a call today, it is ‘heartbreaking’ for all of us at HIMSS, and that truly is the case. When you work your a** off for an entire year — sacrificing evenings and weekends away from family to build out programming, communications, logistics — it’s exactly that: heartbreaking. However, we’re optimistic about the opportunities that this situation leaves us with in the form of virtual presentations. Lots to figure out in the near future. But as a HIMSS insider, I can honestly say we really do put the best interest of our members and attendees first before profit or otherwise. We all BELIEVE in the mission of HIMSS and the power we can hold in numbers.”

    From Jenga: “Re: HIMSS20. What will you miss most from the cancellation?” I will most miss being able to write about what I see and hear from the viewpoint of a normal attendee. I enjoy my normal routine of summarizing news and adding occasional pity asides or experience-based insight from the cheap seats the rest of the year, but I get just this once annual chance to roam around and describe what it’s like to be at the conference. I would always get giddy with fatigue from heading straight from the convention center to the keyboard and then staying up until midnight or 2 a.m. putting it all down on the screen sitting alone. I have fallen asleep from exhaustion at the keyboard a few times, but that’s part of the fun of living a fantasy of free-form, rules-free pseudo-journalism that can be simultaneously bizarre and informative. I may have to take a writing class or something to channel my modest creativity.

    From Implore Me: “Re: HIMSS20. What will the impact be on the organization?” Brutal, I suspect, given that the annual conference contributes about one-third of HIMSS’s total revenue per my recent analysis. HIMSS made just under $1 million in profit in its most recent tax year,  and the annual conference brought in about $15 million in profit on $30 million in revenue. The cancellation will likely spill over into its second-biggest revenue source of publishing. I don’t know what kind of insurance HIMSS carries for operating the conference, but I doubt it covers lost profits. There’s also the unknown downstream effect on HIMSS21 attendance and exhibition for two reasons: (a) the uncertainty is now obvious and those who feel wronged by the cancellation, for whatever reason, may carry their displeasure over to HIMSS21; and (b) exhibitors may decide, with a year off to think about it, that the cost of participating in the HIMSS conference may or may not be justifiable in their particular case. I don’t agree with everything that HIMSS does, particular when it strays into areas that don’t seem appropriate for a non-profit member organization, but it would be sad to see HIMSS marginalized by circumstances beyond their control. You have to have attended lame and now-dead competing conferences like MHealth and TEPR to realize how easily poor execution can turn into a death spiral. Ordinarily HIMSS would this week allowing companies to start begging for good booths at HIMSS21 with the assurance that the good ones would all be taken immediately, but I doubt that’s the case now.

    From Chevy De Novo: “Re: HIMSS20. There’s a COVID-19 health concern, but just 11 US deaths out of 352 million people, and we do nothing about flu that kills 15-30K. The sky is falling even though Florida has just two cases and Orlando brings in more than 100K people per day to the theme parks alone. The ramifications of cancelling are far and wide. Startups were counting on HIMSS to jumpstart their business, and many won’t be in business by year’s end having spent half or more of their marketing budgets on this non-show. Non-refundable airfares, hotels, booth shipping and setup, ad revenue from journals who now have no HIMSS coverage to leverage ad sales against, and the list goes on. HIMSS didn’t have a choice because if it didn’t cancel, people would say they put profits first. Now they will catch flack anyway, especially since they are not refunding registration fees are instead applying credits to HIMSS21. I would not have wanted to make the call, but I would have said let the show go on, and if you choose to cancel your booth space, don’t ask us for money back. Now HIMSS is majorly screwed and may even face lawsuits, which could have long-term ramifications for the organization. It’s going to get ugly.”

    From Back Home: “Re: HIMSS20. This hotel cancellation link appears to still be alive.” The OnPeak HIMSS20 refund request form is still online, but I don’t know if submissions are being monitored.

    From YooHoo: “Re: HIMSS. It is reminding people about ‘not using their brand.’ Apparently they aren’t keen on ‘Virtual HIMSS’ and speakers and exhibitors trying to salvage the investment they made in HIMSS20.” HIMSS is right to ask people to avoid using its trademarked name in their unsanctioned activities, no matter how well intended (‘Virtual SXSW’ would be equally poorly received by the group whose name is being used by others). Luckily nobody needs to apply the HIMSS name to market their virtual activities. UPDATE: HIMSS has announced that it will resurrect its previous “Virtual HIMSS” efforts from years ago in offering some HIMSS20 sessions online.

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    From Ja Rule: “Re: FHIR Festival. Good joke!” Someone with a few dollars and a good sense of humor launches a website for “FHIR Festival, The HIMSS20 Alternative,” in which Ja Rule will take President Trump’s speaking slot and Elizabeth Holmes will be in the house. I would have added some caustic wit about selfie-obsessed influencers since we have those, too, and I suspect that some of those are being paid as they were for the Fyre Festival. HIMSS was probably wise to not take Fyre Festival’s “Let’s just do it and be legends, man” approach.

    From Epic Trench Warrior: “Re: Epic banning customers from using automation software. Epic supports customers doing RPA work with several vendors, such as Olive. But Epic has seen some real disasters, such as 40,000 patient records corrupted by a vendor’s script that damaged med lists and took thousands of hours of Epic and customer time to clean it up. They have also had vendors use brute force techniques that create exceptionally high system loads. Epic requires the third party and customer to sign off acknowledging  the risks, obligations, and safeguards. They also ask the third parties not to patent a combination of on-screen steps that simply mimic what an Epic user would do and then sue Epic or a customer if someone else develops a similar script. And of course Epic does not steal their scripts.”


    HIStalk Announcements and Requests

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    The most recently used patient engagement technologies are almost everything except online or app-based education, telehealth, and care team collaboration (ignore the displayed percentages because the polling tool counts votes rather than individuals with multiple-answer responses).

    New poll to your right or here: For those who had planned to attend HIMSS20: was cancelling it the right call?

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    Thursday was the busiest single day in HIStalk history by far, with 32,907 page views in 25,631 unique visits. I’m honored that people came to me when looking for HIMSS20 news, although I’m not exactly proud of achieving a success metric due to an unfortunate incident.

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    I published great responses to my exhibitor survey about the HIMSS20 cancellation. Lost in the shuffle of the cancellation was my earlier health system survey about coronavirus precautions – I’m still interested in what’s happening out there.

    I enjoyed the later sunset on Sunday but was still feeling robbed of the extra hour when it occurred to me – not attending HIMSS20 will give me an entire week back.


    Webinars

    March 26 (Thursday) 12:30 ET. “How to Use Automation to Reduce ‘My EHR is Slow’ Complaints.” Sponsor: Goliath Technologies. A common challenge is that a clinician is ready to work, but their technology is not. EHRs can be slow, logins not working, or printers and scanners are offline. Troubleshooting these end user tickets quickly is nearly impossible, especially in complex environments that might include Citrix or VMware Horizon. This webinar will present real-world examples of how leading health systems are using purpose-built technology with embedded automation and intelligence to proactively anticipate, troubleshoot, and prevent end user performance issue across their IT infrastructure and EHRs.

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


    Sales

    • Jefferson Community Health and Life chooses Cerner Millennium via CommunityWorks. The 17-bed critical access hospital is apparently paper-based today.

    Announcements and Implementations

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    HIMSS will develop a special virtual edition of HIMSS20 and is asking members which sessions they would like to see.

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    A new KLAS report on AI in imaging finds that use has accelerated, with nearly half piloting or using imaging AI, others saying they are close to deployment, and deeper adoption expected as radiologists and cardiologists begin to see the value. IBM Watson Health is most often mentioned as being well positioned, with Aidoc and Nuance gaining the most mindshare. Providers place great weight on the references of colleagues when making purchasing decisions.


    Government and Politics

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    Cerner Chairman and CEO Brent Shafer expresses the company’s support for HHS’s interoperability rules. He says,

    The passage of these rules has become needlessly controversial, opposition stemming largely by businesses that have financial interests at stake. This is especially frustrating as most healthcare providers, polled by Reaction Data, predict favorable impact from the rules’ release. Now is the time to support the government’s role as an enabler of private sector innovation and competition in its efforts to ensure patients’ rights to access their information … We strongly oppose any business practice that willfully prevents the flow of information. We believe empowering consumers is the right thing to do. We welcome the innovation that will be unleashed by open and interoperable healthcare data. As technology advances, there are new opportunities for digital products to support providers and individuals in managing their health and wellbeing. We encourage the immediate release of the ONC and CMS interoperability rules because healthcare is too important to stay the same. And we believe that in a seamless and connected world, everyone thrives.


    Other

    A reader says two Orlando organizations that might be able to use donated conference items are Boys & Girls Club of Central Florida and Orlando Day Nursery. Repurpose that booth swag, y’all.

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    AMIA cancels its 2020 Informatics Summit that was scheduled for March 23-26 in Houston due to coronavirus concerns. AMIA is considering offering panels and presentations virtually on the original dates. Its Clinical Informatics Conference May 19-21 in Seattle is still on for now. 

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    An American Hospital Association-commissioned  presentation to hospitals warns that COVID-19 could create a disease burden 10 times that of flu in the US, with 96 million cases, 4.8 million hospital admissions, 1.9 million ICU admissions, and 480,000 deaths (the timeline was not provided). Stats I’ve seen suggest an unfathomably rapid ramp-up, to the worst-case point that we’ll run out of hospital and ICU beds in the next few weeks. Meanwhile, CDC advises people over 60 and those with underlying health problems to avoid crowds, including traveling by air, attending movies and concerts, and going to church. The novelty of reporting the number of US cases, the number of states that have reported deaths or declared public health emergencies, and countries that are sealing off borders thinking they can create an infectious disease moat should be wearing off almost immediately as the new status quo. Let’s hear more about what experts are learning as they study more cases and how hospitals are preparing for the ample challenges they face.

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    The Far Side was right: we need this.

    Weird News Andy apologies for titling this story “Domo Arigato Mr. Roboto” since it’s a Japanese name referring to China, but at least he welcomes our robot overlords. China deploys robots to combat COVID-19, using them to disinfect, take temperatures, and to perform dangerous cleaning and food preparation jobs.


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    Contacts

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

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    HIMSS20 Cancellation Impact for Exhibitors

    March 6, 2020 News 2 Comments

    My survey question: What impact will the conference’s cancellation have on your organization, in terms of expense, strategy, marketing, etc.?


    Looking to the positive innovation that can come from this crisis. We all have our HIMSS routine and must get creative this year to turn this negative into the next generation. Whether it be virtual solutions, care management platforms, or new ways to connect and learn from each other, now is the time. New ways of working are essential. HIMSS in its current form may be the old model. Excited to design the future.


    Will definitely reduce investment for any other conferences for remainder of 2020. It was laughable that HIMSS sent an email to us this week asking if we wanted to meet to discuss exhibiting at Health2.0 in the fall. Unlikely, on the heels of us wasting >33% of our promotion budget on HIMSS20. This is much harder on small to medium companies like ours. Which is why big companies could drop out, but not small.

    I will be very interested to see how this plays out contractually — refunds, HIMSS points, etc. It would be nice if HIMSS found a way to reward those of us who remained committed up to cancellation — perhaps those who pulled out lose 50% of their HIMSS points, or something.


    Rescheduling high value meetings is the first priority. Prior to HIMSS officially cancelling, about half of our meetings had cancelled on their own (and we were on the cusp of just pulling out all together) so that process had already begun, but logistically it will not be without challenges.

    Figuring out what / how we will be reimbursed. Besides HIMSS sponsor / booth costs and the associated hotel costs, there’s also misc vendor costs that we contract for separately (build, hardware, set up etc.). I’m guess we’re SOL on those, but the hardest part is just not knowing what HIMSS will do as we await their “14 business days” to figure it out.

    Generally deciding if we’re going to sponsor HIMSS going forward. For one, I’m very concerned about their long-term financial viability following this unfortunate series of events, and two, could this be the year vendor marketing execs decide enough is enough with the exorbitant exhibitor costs and take that $$$ for something else?


    Frankly, we are trying to figure that out. We weren’t told yet what refunds are available for hotel rooms for example. We had an expensive event scheduled and aren’t sure yet how they will work with us on cancellation at the venue. Airfares are the worst –change fees at best. It’s a real financial loss.


    Simply put, it’s devastating. In stark reality, some individuals at my company will lose their jobs. HIMSS represents a significant portion of our overall strategy, so the direct impact to sales and budget isn’t recoverable this year. I am likely to be one of those individuals.

    Months of planning and work has been lost, with only limited elements able to be reconfigured for digital or virtual consumption within the small window of time HIMSS attendees’ attention will turn to #virtualHIMSS20, not to mention the lack of budget available to spend on the digital promotion required to capture that attention. Similarly, HIMSS is where we conduct a signification portion of partner networking at scale, which has been completely wiped out.

    It is completely unclear if any sunk costs will be refunded and the likelihood of other upcoming healthcare conferences — such as ACHE Congress and Beckers — being cancelled means additional devastation for our company’s budget and ability to make sales this year. Because the cancellation came so very late, the vast majority of our expense cannot be recovered in any way and it’s unlikely new revenues will be generated in time to keep our 2020 strategy from collapsing.

    While trying to keep perspective and recognizing first that we must do no harm in healthcare, today was especially hard and the situation is now bleak.


    We’re rallying to host as many of our scheduled events as online options during the original event days. We want to make good use of the time and expense paid to prepare, regardless of sponsorship fees that are in flux.


    BizDev outreach becomes MUCH more costly for small / medium businesses if we have to travel prospect by prospect.


    It was tough to find out we aren’t able to share with and learn from so many others face-to-face in Orlando this year. That being said, we fully appreciate the willingness of HIMSS and its supporting sponsors and vendors to put public safety first, and ultimately, do the right thing.

    One of the many traits I love about healthcare is that it fosters a never-ending conversation through seemingly infinite channels. Speaking for our company, we’re more excited than ever to actively participate in those conversations around improving the patient journey across all touch points for hospitals and health systems—whether that’s in the exhibit hall, through digital programs, or in the media. And when we do connect, we’ll have the “HIMSS20 that never was” as common ground.


    Clearly 90% of the expense of HIMSS will be non-refundable and it will deliver 0% of its already-questionable value.

    As a software vendor, IMO, the ROE on HIMSS is always questionable. We’ve been exhibiting at HIMSS for 20 years and ultimately decided that we could find value in the show two ways: 1) visiting with existing customers; and 2) guiding well-known, already-engaged prospects just a bit further towards a decision. The neophyte exhibitors show up with their order pads ready to go, thinking they will find new, qualified prospects and actually close business. With a typical 6-to-72 month sales cycle for healthcare software, at best new vendors will find a few folks kicking tires and they can fill the very top part of the sales funnel with the quality of leads likely not much better than an electronic form on their website saying, “Contact us to learn more about our solution.” Why else attend every year?

    As a very long-term vendor with Round 1 booth selection priority, the HIMSS policy of “points reset” if you skip a year is the death knell for future years. Meaning, skip HIMSS once and you lose all of your seniority. Moving to the back of the line for booth location would make the entire show ROE much worse. Being on the main aisle next to the big boys dramatically helps in trying to find a few unknown prospects. As you often say, HIMSS is a boat show paid for by exhibitors and enjoyed by attendees as a chance to network. With the HIMSS organization so deeply dependent on the show for revenue, I expect there will be some very difficult business decisions for them in the near future.


    We have mixed feelings about the cancellation of HIMSS20. On one hand, we’re disappointed that we won’t see our good friends, clients, colleagues, and competitors as we all gather to make the state of healthcare even better. We’re also disappointed that we won’t be able to showcase our latest innovations that we were excited to share and have spent lots of time and money getting ready to showcase. On the other hand, we’re grateful that HIMMS has taken this bold step to keep everyone safer.


    The financial impact is high in terms of investment — both financial and the investment of time of our resources — all of which to date is not recoverable. We will wait the 14 days to see what HIMSS will do in terms of booth electrical, rigging, hanging sign, utilities as well as registrations and booth space. I suspect they will defer it all to next year, which is a great solution for them and cuts down on the administrative overhead, but for those already deciding not to go next year, this is not optimal.


    It’s a double whammy. Lack of lead generation + costs we can’t recover.

    We had spent the last 3-4 days “figuring out how to make lemonade” in terms of a smaller audience. Because we do a lot of business with other vendors, we had an opportunity to focus on those vendors (probably similar in size to us) that did attend.

    Costs for sure we won’t recover: 1) Marketing contractor expense for the year-long HIMSS 2020 planning activities. 2) Cost of new banners / signage this year. Really glad we didn’t go with those expensive light boxes! 3) Shipping costs for booth furnishings. 4) Hotel / flights? We had access to a separate condo and were told that WILL be refundable. So that is some positive news.

    That being said, I think it was the right call. I just wish they’d made the call sooner when honestly many of us felt this was going to be the eventual outcome. Those few days of delay cost us several thousand dollars on top of all the other unrecoverable expenses. Hoping that booth fees are rolled over to next year. If we can’t get booth fees credited or rolled over, we will very likely not do a booth next year at all.


    We are ultimately happy with the decision to cancel. It was an inevitable public health risk, so we feel relieved for the Orlando community, attendees, fellow exhibitors, and our own team members.

    The big loss from not having HIMSS is the industry impact. The conference typically sets the major trends for the year for health IT. It’s also our big opportunity to see diverse provider organizations face to face to hear their pain points and be inspired for innovation to address them. We need to take the momentum going into HIMSS20 planning and put that toward how we can directly impact this massive public health crisis.


    We did not invest a lot this year, so not much sunk cost loss. We were going to present in a partner booth and am thinking about taking advantage of the open calendar to do a webinars instead. I expect we will have a similar sized audience with ability to share, record, promote, etc. So for us, small vendor, little impact.


    HIMSS is the ONLY organization that demands full pre-payment of each exhibitor’s entire hotel reservation. We do not yet know what HIMSS and the hotels will do with these funds for folks who have not yet arrived. Installation staff (MarCom, tech) who are already on site are being told that, even though they have used two room nights– the industry-standard room night deposit– by checking out early, they will forfeit the complete prepaid amount. For a some of our staff, that is five to eight room nights wasted, at $175 per night plus tax. We are being told there is no option to reschedule use of those room nights.

    No other conference group, not RSNA, not ACC, etc. instructs the housing bureau to instate such a money-banking policy. The money for entire hotel stays, not standard two nights, has been in HIMSS hands for months, behaving like a financial institution rather than a health industry association. This is simply an unnecessary hardship to foist on the exhibitors who fund these meetings, and an unseemly way for HIMSS to earn some interest.


    Working to recreate the types of important feedback and research that we were going to conduct from a product perspective. A lot of this is solvable, but don’t have a great way to recreate the experience of someone walking up and having the type of unstructured interactions that HIMSS affords.


    We used to be one of the top 20 exhibitors in terms of space (cost). We stopped exhibiting a few years ago and scaled back our attendees to less than 10. We have found the conference too big, too broad, and unproductive in generating real leads. This year for us, the impact of a cancelled HIMSS is likely some lost travel expenses.


    Weekender 3/6/20

    March 6, 2020 Weekender 1 Comment

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    Weekly News Recap

    • HIMSS cancels HIMSS20 at the recommendation of its medical advisory panel.
    • SymphonyAI Group acquires TeraRecon.
    • RevSpring acquires Loyale Healthcare
    • Allscripts misses Wall Street revenue and earnings estimates for Q4.
    • HIMSS announces that President Trump will become the first sitting president to address a HIMSS annual conference.
    • GoodRx apologizes and makes changes in response to a Consumer Reports investigation that found the prescription discount app shares patient information with 20 online companies.

    Best Reader Comments

    I’m conflicted by all of this. HIMSS did make the right decision. I had decided independently last night that I wasn’t going to attend. It was the optics of it all. Healthcare workers at a convention where were we home would have advised our patients to be more prudent. That said, I miss catching up with friends. This is our annual meet-and-greet. But I couldn’t justify a week in the sun to see friends, particularly after nearly every single one of the vendors I had appointments with had cancelled earlier in the day or this week. (Samantha Brown)

    My latest realization was that, while I might be able to avoid getting coronavirus, the possibility (probability) of getting swept up in a blanket quarantine (there still aren’t enough test kits) would be hugely disruptive to my life and those of my colleagues who would have to cover for me. (Randy Bak)

    I posted a tweet stream last night urging HIMSS to repurpose HIMSS20 along with other recommendations. This is a tough call. But after spending a couple of days poring over evolving data and reports, for me it comes down to this: we can’t stop the outbreak, but we can flatten the curve. Having tens of thousands of healthcare workers and healthcare focused companies who are not fully trained to interact safely aggregate in an alcohol-fueled networking gathering and then disperse globally is, mildly stated, unwise. Transforming the week into a smaller event targeted on building epidemic-focused tools and services could turn this into a vital component of the global strategy to address the need. (Ross Martin)

    I’m assuming HIMSS themselves has event insurance, which may help them on costs, but wouldn’t help on revenues. (Nick Kagal)

    A huge problem I can see with my company’s wellness program is that it relies on medical information being self reported by the user. I’m a low-level-grunt and have zero interest in wellness, but they give a $1,000 incentive; So I signed up and told the app all the “correct answers” [BMI of 23, zero alcohol, zero tobacco, zero caffeine, 110/60 blood pressure, sleep eight hours every night, etc.] Every day I go through the motions, telling the app what it wants to hear. I’m probably one of the most “engaged” with the program, but as with everything in the wellness industry, it’s not real. It’s just a scam to extract money out of my employer. (Jose)


    Watercooler Talk Tidbits

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    Readers funded the Donors Choose teacher grant request of Ms. M in West Virginia, who asked for GoPro and MacBook accessories to support her special education students. She reports, “Thank you so very much for your most generous donation. My fifth grade students absolutely loved seeing our new equipment come in after our winter break. It made coming back to school a little more enjoyable for them. They especially loved all the accessories for their GoPro. This will allow them to make videos using a variety of different perspectives. They will create movies that will allow for easy transition for the upcoming fifth graders next year. They will be able to showcase the exciting events that happen at our middle school. Again, my students and I greatly appreciate your donation. You truly warmed our hearts!”

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    I decided to spend a bit of my Anonymous Vendor Executive’s money on Donors Choose teacher book requests since those donations are being matched dollar for dollar this week. I’m donating in honor of the lost HIMSS20 – for the HIMSS people who worked valiantly to make it happen only to see it cancelled, those presenters who spent a lot of time and energy preparing talks that won’t be delivered, and the companies who bet big on getting ROI from a now-cancelled event. I funded these projects:

    • A classroom library for the first grade class of Ms. D in Alton, TX.
    • A set of 12 books for Ms. B’s kindergarten class in Columbia, SC.
    • A set of 14 books for Ms. R’s kindergarten class in Fayetteville, NC.
    • A set of 20 history books for Ms. S’s third grade class in Kittanning, PA.
    • Novels for Ms. J’s middle school class in Bridgeport, CT.
    • Eight books on in inclusion and diversity for Ms. P’s elementary school class in Orlando, FL.
    • Civil rights books for Ms. W’s elementary school class in Greenville, SC.
    • Classroom library books for Ms. H’s elementary school class in Rantoul, IL.
    • Books for Ms. K’s elementary school class in Chicago, IL.
    • Books for the Autism Spectrum Disorder kindergarten class of Ms. L in Bakersfield, CA.
    • A set of 20 books for Ms. M’s elementary school class in Gallup, NM.

    Ms. H responded almost immediately to say, “I am literally speechless right now! I am so happy my students are getting more books! They love to read, and will be thrilled! Thank you for your big heart and for helping my classroom! I can’t wait to tell them! Thank you SO much for everything! Reading IS rich!” Ms. S said, “WOW! Thank you so much for funding our project! I just told my kiddos & they CHEERED! They are so into these books, and I just LOVE how excited they get!””

    Ms. P was eloquent in her thanks for inclusion and diversity books:

    In today’s polarizing society, more emphasis needs to be paid to appreciating the differences in each of us. It’s these differences that makes us fundamentally human, and we should celebrate and not criticize this beautiful uniqueness. Thank you for giving me books that will teach my kids to value the beauty that lies within us all.

    A nurse union’s coronavirus survey of 6,500 members finds that 70% say their hospital employer doesn’t have enough personal protective equipment to support any surge in patients, while just 44% say their employer has provided information about identifying and responding to potential cases.

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    A cosmetic surgeon gets three years of probation for ordering his staff to not call 911 for five hours after his 18-year-old breast augmentation patient stopped breathing while under anesthesia, leaving her in a vegetative state.

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    The Orlando paper covers the effect of two cancelled conferences, including HIMSS20, that would have brought 60,000 people to Central Florida. Orange County’s mayor says the area is low risk, vacationers are still coming to theme parks, and only 0.3% of the area’s 75 million annual visitors come from Level 3 countries. The HIMSS20 cancellation involves 94,500 hotel room nights and $113 million in economic impact. Cheerleading and volleyball competitions will draw 50,000 people to the convention center this weekend.

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    Audacious Inquiry worked with Orlando restaurant Cuba Libre to donate the food that was intended for its Wednesday networking reception to Second Harvest Food Bank of Central Florida.

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    A hospital nurse in Wuhan, China posts a photo of herself holding a sign that says, “Hope that my country will assign me a boyfriend when the Covid crisis is over.” Medical workers there are writing words of encouragement on their protective suits to motivate each other.

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    Also in Wuhan, a 20-something doctor asks an 87-year-old patient who had been hospitalized for a month if he wants to see the sun set.


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    Morning Headlines 3/6/20

    March 5, 2020 Headlines 1 Comment

    HIMSS Announces Cancellation of the 2020 Global Health Conference & Exhibition

    HIMSS cancels HIMSS20 at the recommendation of its medical advisory panel.

    Apple is rejecting coronavirus apps that aren’t from health organizations, app makers say

    Apple is rejecting coronavirus-related apps that aren’t from hospitals or governments.

    Vecna Technologies Awarded Cerner Integration Contract

    Cerner awards Vecna Technologies a contract to integrate its patient self-service platform with the VA’s Cerner EHR.

    News 3/6/20

    March 5, 2020 News 7 Comments

    Top News

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    HIMSS cancels HIMSS20 at the recommendation of its medical advisory panel. The panel advised HIMSS that frequently updated coronavirus reports from WHO and CDC were making it hard to predict the risk to attendees, plus many of those attendees are frontline healthcare workers who would be taken away from their jobs to attend.

    CHIME events scheduled for next week are also cancelled.

    HIMSS20 will not be rescheduled due to the logistics involved. HIMSS will provide updates on any reimbursement of registration and hotel expenses. Exhibitors will be contracted with further information about their exhibit contracts.

    HIMSS does not plan to make the scheduled sessions available virtually. It is working with the White House to make the contents of President Trump’s scheduled speech available.

    HIMSS21 will be held in Las Vegas March 1-5, 2021.


    Reader Comments

    From HIMSSHappy: “Re: HIMSS20. Anyone know where I can get several thousand backpacks cheap?” Hopefully whoever was providing them can find schools in Orlando or in their home city to donate them. That’s a lot of backpacks. I’m getting reports that companies are donating their HIMSS20 items to Orlando area schools, homeless shelters, or other organizations, which is a great way to repurpose hand sanitizer, wipes, and other useful items. I will publicize the contacts for organizations interested in accepting these donations if someone knows. I would also like to shine a favorable light on companies that make these donations, so let me know.

    From Denote This: “Re: HIMSS20. Imagine the economic effect on Orlando.” It will be significant, especially for those people who are in the service industry and are paid – probably not very well, possibly on contract – to staff the convention center, hotels, restaurants, bars, and meeting venues that were booked up with HIMSS20 business that now won’t need them. It’s not just HIMSS20, though, or not even just conferences in general. COVID-19 could be a bigger killer to businesses than to people with supply chain interruptions, reduced travel, lost work time, people staying home to care for kids whose school is cancelled, etc. Not to mention the inevitable stacks of provider bills that will be generated by any resulting healthcare encounter. 

    From Bellboy: “Re: HIMSS hotels. We’re already seeing fallout on getting refunds with finger-pointing between OnPeak and the hotel. I called OnPeak, they told me to call Hilton Orlando, they sent me back to OnPeak. It’s a complete mess, possibly newsworthy, and I’m sure thousands of others are experiencing the same.” I’ll invite readers to share their experience or suggestions.

    From EHR Guy: “Re: hospital in Dubai. Decided to replace Meditech with Cerner. This is ironic since this customer had Meditech for years and only made this move when 2019 was the best year for Meditech in years with more than 30 hospital wins while Cerner lost 9,000 beds.”


    HIStalk Announcements and Requests

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    Wednesday was the busiest day in HIStalk history by far, with my server refusing new connections at some points due to overload. The final count was 24,385 page views in 19,697 unique visits. Thursday’s total might beat it – I’ll let you know.

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    I assumed that I would eat the pre-paid expense for my Orlando Airbnb condo next week from cancelling on short notice, but I checked the site on the off chance that I might get a little something back. I was surprised to be immediately credited $821 of my $915, which was everything except the service charge (in other words, Airbnb kept its full share, but the host got nothing). Hopefully those who booked hotels through HIMSS or otherwise will fare equally well. I might have taken an Orlando vacation if I was paying for the condo anyway, posting write-ups and photos from the convention center and Pointe Orlando of the “what might have been” category. It would be kind of bittersweet to be there, actually.

    I’m really happy I decided to end HIStalkapalooza a few years back. Tight contracts for the facility and band would have left me destitute next week, sitting alone in the House of Blues enjoying a one-person buffet, drowning my sorrows at the open bar, and listening to Party on the Moon imploring me to get up and dance.

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    We’re in uncharted waters in skipping a HIMSS conference, so I’m interesting in hearing from companies that were exhibiting – what effect will the cancellation have on your organization in terms of expense, strategy, marketing, plans for HIMSS21, etc.? Some vendors spend the majority of their marketing money and effort on the HIMSS conference and I’m wondering what they do now. At least the big announcements that always hit on the first conference day will get more attention.

    Meanwhile, if you’re an HIStalk sponsor and are taking your HIMSS20 presentations virtual, let me know and I’ll put together a schedule or something. We’re also ready as always to take on new sponsors or webinar presenters given that the HIMSS20 won’t be providing the expected exposure. 


    Webinars

    March 26 (Thursday) 12:30 ET. “How to Use Automation to Reduce ‘My EHR is Slow’ Complaints.” Sponsor: Goliath Technologies. A common challenge is that a clinician is ready to work, but their technology is not. EHRs can be slow, logins not working, or printers and scanners are offline. Troubleshooting these end user tickets quickly is nearly impossible, especially in complex environments that might include Citrix or VMware Horizon. This webinar will present real-world examples of how leading health systems are using purpose-built technology with embedded automation and intelligence to proactively anticipate, troubleshoot, and prevent end user performance issue across their IT infrastructure and EHRs.

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


    Acquisitions, Funding, Business, and Stock

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    The bio of MDLive CEO Rich Berner has been removed from the company’s executive page, apparently confirming his unannounced departure as reported here last week. The bio of board chair Charles S Jones now has the CEO title added.

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    American Well will announce Tuesday that it is changing its name to Amwell, which is what most people call it anyway. 

    Ro, formerly known as Roman — which started off selling Viagra and Rogaine by mail — a service in which it will provide 500 common generic meds for $5 per month, including shipping. That doesn’t seem sustainable, at least until it makes a big splash that results in someone overpaying to acquire the company, but meanwhile it’s a direct shot at PillPack, Walmart, and others.

    Allscripts announces Veradigm AccelRx, a software solution for specialty medication management.


    Sales

    • Cerner awards Vecna Technologies a contract to integrate its patient self-service platform with the VA’s Cerner EHR. Vecna offers self-registration and scheduling, express check-in, tablet registration, and workflow administration.

    People

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    Urgent care EHR/PM vendor Experity hires Kernie Brashier (Payspan) as CTO.

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    Travis Bond (CareSync) joins muscle pain app vendor Fern Health as CEO.

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    Jon Scholl, president of the health group of Leidos, will leave the company to perform church service and mission work.


    Announcements and Implementations

    Wolters Kluwer will integrate its data quality solutions with SAS Health’s analytics platform to drive the use of real-world evidence for life sciences.

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    PerfectServe releases a new version of its cloud-based Nurse Mobility solution that includes a VoIP dialer for voice communication, creating a single inbox for all calls, secure messages, and integrated alerts.


    Other

    Mount Carmel Health System (OH) will pay a $400,000 fine to the state board of pharmacy for allowing overrides to its medication dispensing cabinets that resulted in 25 patient deaths from narcotics that were ordered by one of the hospital’s intensivists. The doctor is awaiting trial on 25 counts of murder, two pharmacists were fined for verifying his fatal doses of fentanyl without question, and 25 nurses face disciplinary action.

    The Economist says that COVID-19 is boosting China’s use of telemedicine, with some platforms reporting a tenfold increase due to full hospitals, fear of infection, and government encouragement. Some telemedicine vendors are winning over the public by offering free online consultations.


    Sponsor Updates

    • Healthcare Growth Partners publishes its “Health IT February 2020 Insights.”
    • Frost & Sullivan honors Greenway Health with its North American Ambulatory Revenue Cycle Management Customer Value Leadership Award.
    • Healthcare Growth Partners advises AlertMD in its acquisition by Evercommerce.
    • Lightbeam Health Solutions releases a new edition of its “Pop Health Podcast.”
    • Redox releases its latest podcast featuring Regina Holliday and the Walking Gallery.
    • Surescripts issues a statement regarding COVID-19.

    Blog Posts


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    Contacts

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

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    HIMSS Cancels HIMSS20

    March 5, 2020 News 6 Comments

    HIMSS announces that it has cancelled the HIMSS20 conference, following recent coronavirus reports from WHO and CDC.

    HIMSS President and CEO Hal Wolf said in a statement, “We recognize all the hard work that so many have put into preparing for their presentations and panels that accompany every HIMSS conference. Based on evaluation of evolving circumstances and coordination with an external advisory panel of medical professionals to support evidence-based decision making, it is clear that it would be an unacceptable risk to bring so many thousands of people together in Orlando next week.”

    The advisory panel said that risk could not be assessed due to frequent coronavirus updates. It also expressed concerns about taking healthcare workers away from their jobs.

    This is the first time the annual conference has been cancelled in its 58-year history.

    All CHIME-related events scheduled for the week are also cancelled.

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    A cancellation FAQ says:

    • The White House was not involved in the decision. HIMSS will work with the Office of the President to share the content of President Trump’s speech.
    • The conference will not be rescheduled.
    • HIMSS is working with hotels to address reimbursement. Airline travel will not be reimbursed.
    • Updates on registration refunds will be issued within 14 working days.
    • Exhibitors will be contacted with further information about booth contracts.
    • HIMSS has no plans to make sessions available virtually.

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