EPtalk by Dr. Jayne 3/5/20

March 5, 2020 Dr. Jayne 1 Comment

I’m grateful to Mr. H for posting the list of companies who have decided to cancel their attendance at HIMSS20. I think it’s useful for people to be able to plan their activities for the meeting and decide whether it will be valuable for them to attend.

Like Mr. H, I’m still planning on attending. I’m curious about the panel of medical experts that HIMSS has supposedly convened to advise them on the issue and whether they would even consider cancelling given the announcement that President Trump will be delivering a speech. HIMSS has clarified that the speech is not a HIMSS event but a White House event that happens to be occurring at the same place as HIMSS. This is a bit disingenuous since HIMSS controls the convention center for the whole week and had to agree to it.

A reader reported that the planned security protocol includes “no bags allowed in the keynote room,” which should be interesting. At least at the Daytona 500, I could bring a cooler containing up to 24 adult beverages along with a 17-inch backpack to see the President. We’re only a few days away, so we’ll have to see how things play out.

I still find it somewhat unthinkable that many healthcare organizations can’t get masks but HIMSS said they would be handing them out, although mention of masks was missing in the March 3 HIMSS Coronavirus update email.

The organizers of the Redox / AWS / PointClickCare party reached out asking registered attendees to confirm whether they would still be there or if their plans had changed. The sheer scope of potentially unused (but paid for) alcohol that won’t be appearing in glasses at HIMSS is staggering. I’d be interested to hear (anonymously, of course) about HIMSS-related contracts and when the deadlines are to lock in headcounts versus what kinds of refunds might occur for a cancellation.

From Gentle Reader: “Re: HIMSS. I’m attending on my own dime as well. If canceled, I like the idea of going anyway, to lounge poolside. My wife might object. Maybe there could be a spontaneous conference, flash-mob style, of unrefunded, self-paying attendees. I’m resigned to getting the virus eventually from my kids, if not in the clinic, so maybe I’m less concerned about going.” Ditto here. I’m exposed to everything in the clinical trenches and agree with the sentiment that it’s likely only a matter of time. See you in Orlando!

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I’m not looking forward to the upcoming spring time change. A recent Current Biology article notes an increase in the risk of fatal traffic accidents in the week following the time change Researchers looked at data on over 700,000 motor vehicle accidents from 1996 to 2017, finding a 6% increase in accidents during the week immediately following the clock change compared to the weeks before and after. My outlook calendar is still messed up, so I’m curious what it will look like after 2 a.m. hits.

Lots of chatter about the role of telehealth as it relates to COVID-19. Vendors are positioning themselves to handle increased utilization while they create the policies and tools necessary to handle potential cases. Payer and provider organizations are also beefing up their infrastructures.

In some ways, it may be easier for telehealth organizations to ramp up their capacities than brick-and-mortar practices. Telehealth vendors who are providing direct-to-consumer services don’t have to worry about the time it takes to credential providers with payers. They can also tap vast pools of physicians looking make extra money in their off hours. Many non-telehealth practices, even large ones, are reluctant to even pay for providers to be on-call or in a float pool, so it’s more likely that they’ll try to just pass increased volumes onto existing physicians rather than thinking outside the box with new models.

From the specific vendor perspective, American Well has a webinar planned for March 5 and I plan to be on it. The topic is “How to use telehealth as a key element of your infection control and prevention strategy.” InTouch Health is extending a couple of offers to help support organizations in their preparedness. They can opt for use of the technology free of monthly fees for up to six months with minimal charges for shipping, network setup, and decommissioning. Another option is a software-only offering using an organization’s existing devices. Additionally, refurbished telehealth devices can be shipped to existing customers. They were also hosting an informational webinar but it conflicted with my schedule, so I didn’t make it.

My next post should be from beautiful sunny Florida, unless something changes drastically. I’ll spend the rest of today trying to figure out my wardrobe and of course which shoes I’ll be taking, this year with a focus on comfort. Since Sunday and Monday look to be low-key with fewer meetings than planned, I hope to get some nice walks, in which will be a welcome break from the chill I’ve been in for the last several months.

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I flew yesterday with the Honor Flight Network, which was truly a remarkable experience. From the moment we stepped off the plane to be greeted by the welcoming team at the Baltimore airport to the final goodbyes from the send-off team at Reagan National, it was well organized. I didn’t see any travelers behaving differently due to coronavirus – no masks, no one (except me due to flu concerns) wiping down airplane tray tables, and plenty of people touching magazines and other goodies at the airport gift shops.

I did, however, see one traveler behaving badly in general because our group of wheelchairs slowed him down by approximately three minutes at the Reagan National checkpoint. Perhaps karma will catch up with the guy that was dropping f-bombs under his breath and giving our veterans dirty looks. To use his words, the only “ridiculous BS” that was happening at the security checkpoint was his failure to pay proper respect to a group of octogenarians and nonagenarians who risked their lives (many as volunteers) to answer their country’s call to service. To the ladies and gentlemen that I had the privilege of assisting, it was truly an honor to spend the day with you.

Email Dr. Jayne.

1 Comment

Morning Headlines 3/5/20

March 4, 2020 Headlines 4 Comments

SymphonyAI Group Acquires Healthcare Imaging AI Technology Leader TeraRecon

SymphonyAI Group, which owns Concerto Health AI, acquires advanced visualization and AI-driven technology vendor TeraRecon.

GoodRx and Data Privacy

GoodRx announces it will make several changes to its user data-sharing practices with third parties, including hiring a new privacy and security lead, giving users the ability to delete their data, and more intensely scrutinizing the data it shares with companies like Facebook and Google.

This AI Software Company Just Raised $20 Million To Help Prevent Physician Burnout

Suki will use a new $20 million investment to further scale its AI-enabled digital voice assistant for physicians.

Amazon May Extend Virtual Clinic Concept To DC-Area HQ2

Employees at Amazon’s HQ2 facility in Virginia may soon have access to the company’s virtual Amazon Care service, pending the passing of telehealth legislation by state lawmakers.

4 Comments

HIMSS20 Exhibitor Cancellations 3/4/20

March 4, 2020 News 54 Comments

HIMSS just updated its exhibit hall assignment system. There’s no easy way to see who is missing, but looking up empty booths against other announcements allows finding them in most cases. Some of those in the large booths (20×20) that won’t be there are below.

It should be noted that the cancelling exhibitors represent a tiny fraction of the 1,300 and that most of those cancelling are global technology firms rather than health IT vendors. Exhibitors are free to make their own decisions for their own reasons that go beyond the “bandwagon effect” of just doing what others do.

Those who are electing not to participate are no doubt performing their own notification to customers and scheduled booth visitors.

Accenture
Amazon
ATT
Audacious Inquiry
Butterfly Network
Change Healthcare (anchor exhibitor)
Cisco
Cognizant
Ctrl Group
Connection
DaVita
Decisio Health
DellEMC
Deloitte
EClinicalWorks (anchor exhibitor)
Elsevier
Fora Health
Google Cloud
Greenway Health
Hillrom
HL7
HP
Humana
IBM (anchor exhibitor)
Infor
InstaMed
Intel
Kyruus
Lumiata
Lyft
MDClone
Medicomp
Meditech
Microsoft
MITRE
Modernizing Medicine
NetApp
NextGen Healthcare
NTT Data
Nutanix
OpenText
PointClickCare
Pure Storage
Quil Health
Rauland
ResMed
Roche
Salesforce
SAP
SAS
Siemens Healthineers
SOC Telemed
Spacelabs
TriNetX
Validic
Veritas
Visage Imaging
Vocera
Wolters Kluwer
Workday
Zoom Video

I’ll add to the list as I manually look up the empty booths or hear details from readers.

Some vendors moved within the hall, in some cases giving up big booths in favor of small ones. It may be that HIMSS is rearranging booths to make the empty ones less noticeable and exhibitors choosing smaller spaces for a reduced staff presence.

Readers have told me (unconfirmed) that registrants from these provider organizations won’t be allowed to attend:

Cleveland Clinic
Intermountain Healthcare
Jefferson Health
Kaiser Permanente
MedStar
Memorial Sloan Kettering
Multicare
Providence
Seattle Children’s
Tampa General
UNC Health Care

54 Comments

News 3/5/20

March 4, 2020 News 9 Comments

I don’t ordinarily post news on Wednesdays dated tomorrow, but HIMSS20 interest is high and I sense that readers are looking to stay connected. I’ll cover just a few miscellaneous items today and do a full news post on Thursday as usual.

Reader Comments

From Need to Stay Anonymous: “Re: HIMSS20. HIMSS asked our national, well-known company not to publicize or reveal that we aren’t going to HIMSS20, but rather to say that ‘we are participating at a reduced level’ if asked and without making any public statements. The concern is the optics – HIMSS can’t cancel because this is their main (almost only) revenue stream and having ONC and President Trump means the HHS people are forced to attend. The organizations I know will set up their booths, let them be empty, and attend only the panels where they are presenting and then leave.” Unverified.

From HISJunkie: “Re: HIMSS20. Could this be the beginning of the end for HIMSS? When all those companies that canceled look back in 10 months and see that not attending had little or no impact on real sales, why sign up for 2021?” Emails I’ve had with a few companies indicate that they aren’t pulling out only because they are afraid their competitors won’t and thus will gain competitive advantage. I don’t know if that competitive pressure to have a bigger booth, louder parties, and in-booth celebrities will carry over to HIMSS21 following a muted HIMSS20. Either way, I feel sorry for the HIMSS folks on the ground in Orlando who are dealing with day-to-day coronavirus updates, complaints from people who want the conference postponed or cancelled, setting up in-venue screening stations and clinics, and working through the security implications of having a sitting President kick off the conference. A HIMSS conference always requires a ton of work starting months or years in advance, but imagine this year with the added uncertainty of whether it will go on (which seems set in stone at this point) and the financial impact if it doesn’t.

From Not the Black Plague Yet!: “Re: HIMSS20. Rumors abound that payers are cancelling. If Big Tech and Big Insurance aren’t going and pressure is on Big Delivery to not go, then I think HIMSS is being disingenuous to small and mid-market vendors if their customers and prospects won’t be there. Cancelling or postponing is the right thing to do.” I don’t think HIMSS will cancel at this point barring some state or federal mandate, but they will still be left dealing with high-paying exhibitors who may not be happy with their ROI if attendance is off, exuberance is tempered by on-site health precautions, or attentions are distracted with new interoperability regs and worries about hospital employers and family back home. But I don’t think that preventing exhibitor disappointment should be the go-no go driver.

From Ponzu: “Re: HIMSS20. This is a needed call to take it virtual – it would be less cost and less time away from work for attendees, lowered carbon emissions, and of course infection related concerns would disappear.” The challenge is the bottom line of HIMSS since virtual conferences are hard to monetize. HIMSS tried virtual conferences a few years ago in a weird Second Life sort of way and they flopped. A conference without a cash register-ringing exhibit hall and in-person networking is really just a bunch of webinars that draws much less interest and money. People say they attend HIMSS for education, but even the in-person version would die out if it weren’t for parties, the exhibit hall boat show, and the chance to run around with colleagues and job-hunt at employer expense. The idea of a virtual conference is commendable, but not realistic under the HIMSS business model. And let’s not minimize that threat to HIMSS – if you like what HIMSS does in general, realize that its ability to continue doing so is highly dependent on offering a financially successful annual conference.

From USS MDRX: “Re: Allscripts. Stock hit a 10-year low today. How does the board allow this management team to remain in place when Cerner recently hit an all-time high?” MDRX shares closed down 8% Tuesday after the company reported losing $182 million on the year, flipped from black to red for the quarter, and announced significant inpatient attrition. They’re down 32% in the past year vs. the Nasdaq’s 15% gain and Cerner’s 28% increase. Ten-year performance finds that both the Nasdaq index and CERN shares gained around 250%, while MDRX was down 64%. The market cap of Allscripts is $1.2 billion.

From Chaminade: “Re: HIMSS20. Are you still going?” I’m still going. I see little health risk, although if HIStalk suddenly goes dark because I’ve become a COVID-19 fatality, then I hereby grant permission to make fun of my poor choice. My biggest worry is that everyone will be preoccupied and morose to the point that the conference won’t deliver even the modest benefits we usually see, although I will have plenty to observe and write about for those who are left home. I’m on text at 615.433.5294. I might need to find a Freddy Krueger glove or tie one hand behind my back to override my handshaking reflex.

HIStalk Announcements and Requests

I enhanced the menu system at the top of the HIStalk page with a more user-friendly floating version. This will allow me to reduce some of the sidebar items.

My unscientific, unvetted snap poll that was targeted at HIMSS20 registrants finds that 30% plan to attend the President’s opening keynote on Monday. An interesting 7% say they had already cancelled their attendance plan even before his speaking slot was announced, while 12% say they won’t attend the conference because he is speaking. I’m in the 10% category of not arriving in time to be there, especially given the resulting likely delays in local travel and convention center security.

Snap survey for health system employees: what is your employer doing in response to coronavirus concerns? IT-specific actions are especially welcome.

Lorre will be untethered from a HIMSS20 booth for the first time in years, so she is willing to drop by the booths of prospective HIStalk sponsors for a quick chat. Contact her to make arrangements. She is thrilled to be able to eat lunch and take bathroom breaks that aren’t dependent on finding visitors who are willing to cover our booth.

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

SymphonyAI Group acquires advanced visualization and AI-driven technology vendor TeraRecon. SymphonyAI’s several companies include precision oncology vendor Concerto Health AI.

Other

I received these unverified reader reports about HIMSS20 attendance:

VMware supposedly won’t attend.
Microsoft is reportedly debating internally whether to attend.
Providence and Multicare reportedly will keep registrants home.
An anonymous reader says their healthcare organization has suspended all business travel for four weeks.
Medicomp will not exhibit (that comes from Medicomp directly).
HP is reportedly not exhibiting.
MITRE is said to have cancelled attendance plans. (update: now verified via Twitter).
Cleveland Clinic reportedly won’t participate.
A reader says EClinicalWorks is notifying people who are scheduled for meetings that it won’t attend.

Interesting: the American Physical Society physics group cancelled its 10,000-attendee annual conference the day before it was set to begin in Denver this past Monday. I can’t imagine traveling there and then scrambling to find early flights back home. It’s different than HIMSS, though, in that many of its attendees are coming from outside the US, including CDC Level 3 warning countries.

HIMSS20 gets a mention in a New York Times article titled “What Happens in Vegas if No One Stays in Vegas?” Conferences drive one-third of the revenue of hotel chains that now have uncertain futures. A tech conference scheduled for next week in San Jose, CA will bar residents and recent visitors of China, South Korea, Italy, and Japan and requires attendees to bring passports that will be checked for recent travel. They will check attendee temperatures via “passive scanning,” have banned handshakes, and mandate that each attendee wash their hands before each session, apologizing in advance for the lines that will result. Analysts say Las Vegas is particularly at risk for conference-related business downturn.

I’m wondering about the “passive temperature screening” that this conference will use and wondering if HIMSS will roll it out. It has a lot of false positives and negatives from what I’ve read, but high readings just mean someone will be pulled aside for a manual temperature check. The real fun begins if your temperature is elevated there as well, when I assume you would be escorted off to an onsite clinic and maybe quarantined.

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The leader of the World Health Organization team that spent two weeks in China studying that country’s COVID-19 response makes interesting points:

He says containment is still possible for countries that act quickly, but that requires speed, money, imagination, and political courage. He says COVID-19 isn’t a global pandemic, but rather a series of outbreaks that are occurring globally.
So far, it doesn’t appear that we’re seeing just the tip of the iceberg, although that could change with more widespread testing. Reported cases in China are trending down fast and hospitals have empty beds.
The fatality rate seems to be 1-2% (recent reports suggest a higher rate).
Kids get flu, but don’t seem to get COVID-19 or serve as carriers. An untested theory is that children gain immunity from being exposed to four milder coronaviruses. Still, he says you have to close schools if disease clusters pop up, and that’s a big problem because half the local work force has to stay home with them.
Most of the infection clusters occur in families, not hospitals, restaurants, prisons, or other public sources.
China almost immediately moved 50% of its medical care services online to allow people to stay home.
Fever clinics geared up for rapid screening, with CT lung scans being run at up to 12 per hour versus the US rate of one or two per hour. Swab test time was reduced to four hours so people could be quickly isolated.
China changed its best hospitals to address only COVID-19, moving other patients out to routine care hospitals.
He says, “China is really good at keeping people alive,” noting the quality of hospitals and the extent of equipment they have.
The lack of universal healthcare in the US will “wreak havoc” because people will not have the money to seek treatment or to take time off from work and will remain carriers. Testing is free in China and the government covers all costs beyond insurance.
Technology is important in China’s response because they are tracking all 70,000 cases, they have moved schooling online, people who track contacts use online forms instead of paper, and rural areas of the country have rolled out 5G.
He concludes when asked if such measures would work in the US instead of China, “There has to be a shift in mindset to rapid response thinking. Are you just going to throw up your hands? There’s a real moral hazard in that, a judgment call on what you think of your vulnerable populations. Ask yourself: Can you do the easy stuff? Can you isolate 100 patients? Can you trace 1,000 contacts? If you don’t, this will roar through a community.”

I missed that Atrium Health made an official announcement recently about its move to Epic. Its Navicent Health locations in Georgia will go live in 2021 and other locations through 2023.

Meanwhile, for something completely different, HIMSS defines “digital health” (much-needed Oxford commas mine):

Digital health connects and empowers people and populations to manage health and wellness, augmented by accessible and supportive provider teams working within flexible, integrated, interoperable, and digitally-enabled care environments that strategically leverage digital tools, technologies, and services to transform care delivery.

Contacts

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

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9 Comments

Morning Headlines 3/4/20

March 3, 2020 Headlines Comments Off

RevSpring Announces the Acquisition of Loyale Healthcare

Patient engagement and payment solutions vendor RevSpring acquires Loyale Healthcare, which offers patient financial engagement technology.

HCI Group hires industry veteran to new executive position

The HCI Group names Ed Marx (Cleveland Clinic) chief digital officer.

Holy Name Health and Medicomp Systems to Premiere Internally Developed EHR System at HIMSS20

Holy Name Medical Center (NJ) develops Harmony EHR to replace the multiple EHRs used in its ED, ambulatory, and inpatient settings.

Comments Off

News 3/4/20

March 3, 2020 News 6 Comments

Reader Comments

From CoronaHIMSS20: “Re: Confirmed that Intermountain Healthcare is pulling all their staff back. Our contact there said to expect the same of other provider organizations, both from a practical view plus the optics involved. Siemens has also told its employees that they have pulled out of HIMSS and that all activities must be performed remotely if possible.” A reader told me that Partners HealthCare is also keeping its folks home. Lumiata has also cancelled as an exhibitor. We won’t really know the extent of the no-shows until we get to Orlando because most organizations won’t bother making an announcement. There’s no registration refund, just a rollover to HIMSS21 registration fees, so even HIMSS won’t know how many no-shows to expect if people don’t bother until later. It will certainly be a different environment than in years past. The burning question: will MedData have scones?

From Humana Insider: “Re: HIMSS20. Humana just banned any non-essential travel within the US for the entire month of March. That includes conferences such as HIMSS, so I’m assuming their 20×20 booth will be impacted.”

From Critical Juncture: “Re: HIMSS20. My doctor advised me not to attend due to a chronic health condition that raises my COVID-19 risk. All of my requests to cancel my HIMSS-booked hotel have been rejected even though they say they are making accommodations (no pun intended).”

From Game Afoot: “Re: HIMSS20 exhibitor cancellations. You should squat in the vacant Cisco booth, planting your Smokin’ Doc standee dead center and see if anyone notices or cares.” I received zero ROI from exhibiting, so I’m not sure I would bother even if some cancelling company donated their space. Perhaps an impromptu HIStalkapalooza-lite could be held there in silent concert mode, where we all wear headsets and dance frantically to a soundtrack that puzzled observers can’t hear. I could charge for the headsets, “curate” the tracks as the hipsters say, and donate the proceeds to Donors Choose.

From Elucidator: “Re: President Trump at HIMSS20. Politics aside, should they have invited him?” Every conference would love to have a sitting President show up to validate its existence and the importance of its attendees, and I’m sure HIMSS has extended the same invitation every year regardless of who occupies the Oval Office. I’m hoping (but not betting) that political ugliness will be absent from both sides of the podium since the keynote is supposed to inspire rather than leave attendees arguing with each other. Trivia: HIMSS will now have had two of three impeached US presidents as their keynote speaker, a record that will stand unless someone holograms Andrew Johnson. Here’s my plea – for whoever introduces the President (Hal Wolf, probably), please just get him up there without the usual beaming, glad-handing, and nervous delight at being in the rarefied air of a celebrity who just wants you to shut up and let him speak. I hate it every year when someone from HIMSS takes obviously excessive pleasure in rattling off an overly long and fawning introduction, hand-shaking (or perhaps elbow-tapping this year) with an ear-to-ear fanboy grin, and then inserting themselves into a post-talk analysis or lame fireside chat.

From Derek Smalls: “Re: HIMSS20. Almost all related attendee expenses are non-refundable, including registration fees that just roll over to HIMSS21. Not everyone wants to head to Las Vegas next year, and vendors will go nuts if they cancel HIMSS20 since some of them invest 50% or more of their marketing budget on just this one show. Meanwhile, Orlando theme parks remain open and draw 100,000 visitors per day, European Congress of Radiology is making no change to its March 11-15 meeting in Vienna, and we’ve had two people out of 328 million die in the US from not very many confirmed cases.” It was just announced that ECR 2020, which draws 20,000+ attendees, has been postponed until July 15-19. For HIMSS, the common answer is “stay home if you aren’t comfortable with the risk,” but I wonder how that plays when your employer is an exhibitor and you’re scheduled to work the booth? I also question the “frequent handwashing” recommendation given the large percentage of “healthcare” guys I see in the convention center’s men’s restroom who bolt for the door afterward without a sink stop, including some whose pre-departure position was sitting.

From Bonhomme: “Re: HIMSS20. If a guest in the hotel I’m staying in becomes symptomatic, could they quarantine the whole hotel? What if an attendee is found to have COVID-19 – could they quarantine the whole convention center as in the Diamond Princess?” Beats me, although Florida’s governor just declared a public health emergency after two state residents tested presumptively positive for COVID-19. Let’s hope we’re better at treatment than surveillance because we’ve certainly fumbled that. Meanwhile, I’m thinking about all the employees of Orlando hotels, restaurants, the airport, and the convention center itself who not only have crossed paths will people from everywhere in the past couple of weeks, but who also in many cases can’t afford to miss work.

From DontCoughOnMe: “Re: Amazon Web Services. Pulled out of HIMSS20 citing COVID-19, but wondering if it was related to the Trump announcement, Bezos, DoD, etc.” I think Amazon implemented a company-wide travel ban before the President Trump announcement.

From Dr. Karma: “Re: [executive name omitted.] Fired from [company name omitted] for sexually harassing a small group sales rep. Here’s the email sent to the company.” It doesn’t feel fair for me to name the individual and company over a personnel issue, especially when the email didn’t specifically say why the person was fired. Still, he was indeed let go, an presumably for good reason.

HIStalk Announcements and Requests

I created a PDF version of my HIMSS20 guide that lists what my sponsors are doing, giving away, and presenting. Download it, print it, whatever works for you.

I planned my HIMSS conference travel this year around an “arrive late and leave early” goal, so I won’t be attending Monday’s events, including the President’s speech. Maybe someone can record it for me. Good luck if you are traveling to Orlando Monday afternoon like me since airports and local roads are going to be disrupted by the President’s visit.

HIStalk drew over 16,000 page views in 13,000 unique visits on Tuesday, the second-highest total in 16 years. The Department of Defense selection announcement on July 30, 2015 generated a few more page views, but with fewer visits, so you could argue that Tuesday was the busiest day ever.

Snap poll for HIMSS20 registrants: will you attend President Trump’s keynote on Monday? I’ve disabled poll comments since I’m not interesting in fomenting disharmony, just curious about how attendees will respond to a newly added session on an odd conference day.

I’m worried about how the opening keynote by the President will set the mood of HIMSS20 when attendees are already in a down mood over COVID-19 fears, new HHS regulations, and a scaled-back conference. Opening keynotes have always been collegial, self-congratulatory, and boring in having some vendor suit babbling on to a restless crowd that is checking their watches, ready to sprint to the exhibit hall opening in a feeling of unity and purpose. It won’t be the same if we start with oppressive security precautions, protests, attendees screaming in each other’s faces, angry heckling, and watching people get removed to the cheers of others. Not to mention that the open bar is next up and there’s nothing like alcohol to stir up the political blood sport. You just know that someone’s MAGA hat will trigger an incident that will end up as cellphone video news.

The list of announced HIMSS exhibitor cancellations that I’ve heard:

Amazon Web Services
Cisco
HL7
Humana
Intel
Lumiata
Salesforce
Siemens Healthineers
TriNetX

Webinars

March 4 (Wednesday) 1 ET: “Tools for Success: How to Increase Clinician Satisfaction with HIT Solutions.” Sponsor: Intelligent Medical Objects. Presenter: Andrew Kanter, MD, MPH, FACMI, FAMIA, chief medical officer, IMO. Dr. Kanter will explore how striving to achieve the Quadruple Aim (by focusing on the provider experience) can improve clinician satisfaction and population health needs while also reducing per capita healthcare costs. Attendees will learn how to set providers up for success with new technology, the potential unforeseen consequences of purchasing without the clinician in mind, and the factors that are critically important to clinicians who are using new health information systems.

March 4 (Wednesday) 1 ET: “Healthcare Digital Marketing: Jump-Start Patient Discovery and Conversion.” Sponsor: Orbita. Presenters: Victoria Petrock, MBA, MLIS, principal analyst, EMarketer; Kristi Ebong, MBA, MPH, SVP of corporate strategy, Orbita. Does your digital front door capture consumers who search for health-related information one billion times each day? Do you have actionable steps to convert them into patients? Do you understand voice and chat virtual assistants? The presenters will explore the consumer challenges involved with finding, navigating, and receiving care, discuss why healthcare marketers need to embrace conversational voice and chatbot technologies, and describe how new technologies such as conversational micro-robots can improve engagement.

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

Acquisitions, Funding, Business, and Stock

Patient engagement and payment solutions vendor RevSpring acquires Loyale Healthcare, which offers patient financial engagement technology.

Sales

Saudi Arabia’s King Faisal Specialist Hospital & Research Center chooses TransformativeMed to improve EHR workflow and care quality. The hospital will work with the company to develop apps for thrombolytics, oncology, congestive heart failure, and other conditions and will assist other hospitals in implementing the system.
Continuing education and patient engagement solution vendor MedBridge will expand its integration to EHRs using Redox’s health integration platform.

People

Ed Marx (Cleveland Clinic) joins The HCI Group as chief digital officer.

OptimizeRx promotes Todd Inman to CTO.

The SSI Group hires Diana Allen, PhD (Culbert Healthcare Solutions) as president and CEO, replacing Jimmy Lyons.

Announcements and Implementations

Holy Name Medical Center (NJ) develops Harmony EHR — powered by Medicomp’s Quippe Clinical Data Engine — to replace the multiple EHRs used in its ED, ambulatory, and inpatient settings. Harmony EHR, which will be made commercially available later, will be demonstrated at Medicomp’s Booth # 3559 at HIMSS20.

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Nuance and the American Medical Association will run a pilot test to see if their combined technologies – Nuance’s DAX ambient clinical intelligence and AMA’s IHMI clinical knowledge graph – can reduce burnout-causing documentation burden.

First Databank rolls out an Alexa service that allows consumers to ask questions about commonly prescribed medications, including side effects and drug interactions, in both English and Spanish. I tried it this morning and it was pretty cool – I asked, “Alexa, what is amoxicillin used for” and it gave a nice summary, leading off with “According to First Databank …” I then asked, “Alexa, who is First Databank” and it gave a consumer-oriented summary.

Privacy and Security

Walgreens says a bug in its mobile app allowed users to see the personal information of other users, such as name, prescription information, and shipping addresses over a week-long period in January 2020.

Other

The government of China requires citizens to use a smartphone app that decides whether they should be quarantined for COVID-19, but a New York Times analysis found that it also sends the user’s location and ID to local police for tracking. The Alipay Health Code app uses unspecified big data to assign a user QR code that is green (unrestricted movement), yellow (seven-day quarantine), or red (14-day quarantine). More than 50 million people signed up in Zhejiang Province alone, with one million of them getting yellow or red codes. Employers and housing units are denying entrance to holders of red codes and nobody has explained what it takes to make the red code go away.

In similar news that could make a great episode of “Black Mirror,” South Korea is deploying apps that use government data to show details of nearby confirmed COVID-19 patients, including date the infection was confirmed, the patient’s demographic data, and their location history. One of the apps issues a smartphone alert if the user gets within 100 yards of a location that has been visited by a COVID-19 patient.

HL7 withdraws from HIMSS20 due to COVID-19 concerns. First-time exhibitor TriNetX also announced that it won’t attend, as have Salesforce, Intel, Cisco, Amazon, and Siemens Healthineers.

Apple will pay $500 million to settle a class action lawsuit that accused the company of intentionally slowing down older IPhones to compel users to buy new ones.

Families in Australia who receive a government childcare subsidy struggle to cover daycare costs after an error in the country’s Centrelink social security payments system cuts off payments to families of children it incorrectly thinks have not been vaccinated, which is a condition of the program.

The COO of Cape Fear Valley Health makes an interesting comment at a gala of one of its hospitals, as reported by the local paper for some reason: “There are just awesome people here, and very resilient folks here, and you have been through a lot of things through natural disasters. And if you work in the hospital, you know that one of those is Epic, our new electronic medical record. That was tough as well.”

Sponsor Updates

Four strategically aligned healthcare technology venture capital funds invest in CareSignal, previously Epharmix, two of them being customer-partners.
Nuance will partner with the American Medical Association to combine and test their respective technologies in an effort to reduce documentation burden.
King’s Daughters Medical Center (MS) reduces ED length of stay by one hour with Meditech Expanse.
Datica features Greenway Health CMO Geeta Nayyar, MD in its latest “4×4 Health” podcast.

Blog Posts

How Eva, the eClinicalWorks Virtual Assistant, is transforming the office visit (EClinicalWorks)
Targeting the Leading Threats to Health (EClinicalWorks)
Why Extensive Testing is Non-Negotiable for EHR Interface Implementations (314e)
Managing a Successful General Practice Office (AdvancedMD)
Why Remote Work is More Important Today than Ever (Avaya)
Four Cybersecurity Trends for 2020 (Burwood Group)
3 prerequisites to health IT innovation (Nordic)
Defining and Tracking Quality with Your SNF Partners (CarePort Health)
Health IT Spend: Takeaways for Health System Leadership (CereCore)
EHRs: A Source of Burnout & Optimization Strategies (Collective Medical)
Improving Provider Workflows for Specialty Medications Through Technology (CoverMyMeds)
Top Advantages of Big Data in the Healthcare Industry (Dimensional Insight)

Contacts

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

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6 Comments

Morning Headlines 3/3/20

March 2, 2020 Headlines 1 Comment

HIMSS Confirms President Trump for HIMSS20 Kickoff

HIMSS announces that President Trump will become the first sitting US president to deliver an address at its annual conference.

AxialHealthcare Announces $15 Million in Series C Funding to Support Expansion into SUD Treatment and Recovery Sector

Substance use disorder analytics vendor AxialHealthcare raises $15 million and announces new personalized medicine services.

National Institutes of Health Had Information Technology Control Weaknesses Surrounding Its Electronic Health Record System

An OIG audit of NIH’s CRIS EHR finds insufficient security policies and practices have left it exposed to a variety of security risks.

Allscripts announces fourth quarter 2019 results and outlook for 2020

Allscripts reports Q4 results: misses on revenue by 1.5%; EPS – $0.17 vs. $0.20.

Walgreens Mobile App Leaks Prescription Data

Walgreens discovers a bug in its mobile app that may have given users access to the personal information, including prescription details, of other users.

1 Comment

HIMSS Confirms President Trump for HIMSS20 Kickoff

March 2, 2020 News 23 Comments

HIMSS announced Monday afternoon that President Trump will become the first sitting US president to deliver an address at its annual conference.

The President will speak at 4 p.m. on Monday, March 9 in the Valencia Ballroom of the Orange County Convention Center.

That Monday is the pre-conference day. The President’s speech will begin before the pre-conference education sessions have concluded and will precede the opening reception at 5:30 p.m.

President Trump will likely talk about interoperability in conjunction with an HHS announcement about its new interoperability rules. He is also sure to talk about COVID-19.

The President’s Orlando campaign rally last year disrupted flights at Orlando International Airport and created rush-hour traffic problems on major roads. HIMSS20 attendees who are flying in on Monday will probably experience delays, while Secret Service security procedures could impact Orange County Convention Center for much of the day.

Planning for a presidential visit takes weeks, Orlando’s police chief said before last year’s rally, so it’s likely that the President has planned to speak all along but wasn’t announced until now by HIMSS.

23 Comments

HIMSS Says HIMSS20 Remains On Track and President Trump May Speak

March 2, 2020 News 12 Comments

A HIMSS update on HIMSS20 and COVID-19 says that an expert panel of medical professionals will provide recommendations for its conference planning. Those experts will “further advise our evidence-based decision-making and to ensure the safety of the healthcare community currently planning to assemble in Florida for HIMSS20.”

Meanwhile, HIMSS announced that President Trump has been invited to speak at the conference, with further details following later today. A White House reporter says the President is planning to attend and time slot of Monday, March 9 at 4:00 p.m. has been rumored. That’s the pre-conference day, with the only scheduled all-attendee event being the opening reception at 5:30.

Health IT regulations have been published immediately before or during previous HIMSS conferences, leading to speculation that announcements will be made that week about the proposed interoperability rules of HHS/ONC.

12 Comments

Curbside Consult with Dr. Jayne 3/2/20

March 2, 2020 Dr. Jayne Comments Off

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We’re definitely in the pre-HIMSS doldrums, with very little going on and even less news about it. Anyone who has a major announcement is going to hold it for the big show, even though odds are it will get lost in all the noise. Or the silence, if HIMSS chooses to cancel the event.

Most of the non-IT news out there in the healthcare realm is about the novel coronavirus and its transition to community spread within the US. Lots of chatter about how organizations are gearing up to identify and track it, but there are still serious challenges as far as how healthcare organizations are actually going to manage the patients especially given shortages of masks, gowns, and other critical supplies.

We finally had some surgical masks appear in our workplace this weekend, although it’s not clear if the supply will hold out or if the office will be replenished if we run out again. Most of the time we’re using them to help reduce the risk of flu transmission.

I was glad to see the most recent CDC numbers show a sharp decrease in positive flu tests. However, I think some of that downturn might be driven by people who aren’t coming in to be tested because they know just about everyone they’ve come in contact with has flu, so they’re just assuming a diagnosis and staying home. Several local schools have closed for deep cleaning as well, so at least they will be well practiced when coronavirus arrives. Our practice is as busy as ever with multiple providers covering extra shifts to make up for those who are out with flu.

Mr. H mentioned in his Monday Morning Update that Cisco is canceling, and there are plenty of rumors about other companies that are bailing out but haven’t announced it yet. HIMSS has been uncharacteristically slow in sending out invites (or “sorry, you’re not invited” notices) for many of their breakfast and lunch events, which is annoying both to the attendees who tried to register for them as well as the vendors who are paying for them. I’ve heard of many companies that had previously decided to downsize their exhibit hall presence and were planning on sending fewer employees than past years, so it would be less of a loss if they decide to cancel.

For those of us who aren’t being subsidized by a vendor or employer and who attend out of pocket, it’s not a small financial hit. Even if it is canceled, I have half a mind to go anyway and just enjoy being somewhere warm with a pool. On the other hand, I could stay home and catch up on all the things I haven’t been able to do since flu season has been so exhausting. I have some Maintenance of Certification questions I need to do for my boards and I would no longer have an excuse to dodge them. There’s also taxes to file and a shower to re-caulk, so the possibilities are endless for fun and excitement.

In the event that HIMSS goes forward, and a good chunk of exhibitors decide to show, I always get the question about what I’ll be looking for or what I want to see at the event. Here’s a short list of things I’m interested in:

Ambient intelligence, smart exam rooms, and the like. How close are they to being able to make this work for in-the-trenches primary care practices? Are the solutions able to handle the scenarios where anything could walk through the door, and most of the time patients present with multiple and complex problems? Are they able to integrate with multiple EHR platforms or just the big ones? There are thousands of physicians across the US who are in need of such solutions but who don’t have Epic or Cerner.
Telehealth. What do consumer-facing organizations have planned for the next five years? Will hospitals and health systems continue to try to do internal programs, or will they partner with some of the national players? Will the institutionally-focused vendors merge or partner with the consumer-facing ones? Will they be able to thrive financially, or will they continue to run on thin margins?
Patient engagement. Are vendors really able to drive the needle for deliver patient outcomes, or is it all flash? Do the apps have staying power for patients or are they like fitness trackers and other solutions that patients use for a few weeks or a few months and then abandon?
Helping the “little guys” succeed. What solutions are out there to help small practices or organizations that aren’t in the 800-pound gorilla range? What’s out there for people that don’t have half a billion dollars in the bank ready to spend on IT solutions?
And finally, one of the least provider-facing but very important topics. What’s new in terminology, taxonomies, and all the “guts” that make the systems run while trying to facilitate interoperability and data exchange? I’ve heard that there may be some cool things on the horizon that could be transformative from the informatics perspective. I do love the logic and organization of a well put-together system, and if there are tools that can make that better, I say bring them on.

We should know soon whether HIMSS is a go or no-go and people can start adjusting their plans accordingly. If you’ve already decided you’re not going to attend, how do you plan to spend your time? Will you play catch-up on projects or are you so busy that staying home will just keep you from falling behind? Leave a comment or email me.

Email Dr. Jayne.

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HIStalk Interviews David Fast, President, Agfa HealthCare North America

March 2, 2020 Interviews Comments Off

David Fast is regional president, North America and VP/CFO/COO of Agfa HealthCare of Morsel, Belgium.

Tell me about yourself and the company.

I joined Agfa HealthCare 11 years ago as the North American CFO. After a couple of years, my role was expanded to cover the CFO role for our Latin American business. I spent a couple of years supporting them, then refined it back to North America and added the COO title to the North American operations. For a few years, I was doing CFO/COO for Agfa HealthCare IT in North America. Just over 12 months ago, I assumed the role of president of the North American region.

How much of the company’s focus involves imaging?

Our customer base is still very much radiology imaging, but customers have been asking us to expand our expertise to help manage all imaging across the enterprise. There are actually over 70 service lines in a typical health network that produce medically required images. Managing all that imaging data is a huge and costly undertaking for CIOs and their IT departments. Our new enterprise imaging platform is designed to reduce complexity throughout all image producing service lines or “ologies” if you will. Our goal is to provide the complete patient imaging record in a health system’s EHR, whether the images come from radiology, cardiology, point of care imaging such as ultrasound, surgery, or wherever medical imaging contributes to the care plan.

Consensus seems to be that artificial intelligence will support rather than replace the clinicians who interpret images. Will the workflow component be the key element?

I would say so. We prefer to use the term augmented intelligence, as our focus is to assist clinicians in making informed decisions, not to replace them.

And, you are absolutely correct: Workflow will be key since the technology will only be useful if it becomes part of the clinician’s routine. We have people focused on augmented intelligence, most recently in the mammography area, where our customers have found that the technology can assist and aid the clinicians in making better decisions earlier on in analysis of these images, which can be complex to read. We think it will augment rather than replace the kind of care they can give.

What level of integration exists between imaging and imaging workflows and the EHR?

The whole industry is evolving for sure and this has been a key focus area for Agfa. We find our enterprise imaging solution must be connected to the EHR in each subspecialty are in order to maximize the benefit for the clinician and ultimately the patient. Our technical teams routinely work with the major EHR vendors on integrations that either we or healthcare providers ask for.

How will patients carrying their own images on CDs from one provider to another be replaced with more sophisticated imaging interoperability?

We have a solution today called Engage Suite that addresses just that issue. It is quite typical, unfortunately, for a patient to get a CD from a small imaging clinic and then have to run across town or across state to bring that image to another viewing physician in order to receive timely care.

Engage Suite is an interface with our enterprise imaging platform that facilities connections to various venues, such as remote clinics or big hospital groups. They can exchange images, view, archive, and move them around electronically. There’s no more need for CD burning and running the CD across town. We see the ubiquitous sharing of medical images as a differentiator.

Do use cases exist for using imaging and related information in population health?

I would say so. For the most part, we still see imaging in a traditional sense of being imaged by professional technicians in order to advise a diagnosis. But more and more you’re seeing that both physicians and patients, as with people in general, are using their cell phones to take pictures and send them in. That will broaden the horizon of how we address patient care. It’s at the early stage but will evolve. We call these medical selfies and they can contribute to an increase in patient engagement and satisfaction in their care.

What do radiologists see as their most pressing challenges and their greatest opportunity?

There’s a lot of consolidation going on in the industry. From that perspective, institutions are looking for the ability to have systems that can not only be enterprise-wide from a facility perspective, but that are also scalable and sustainable when it comes to their acquisitions. From the radiologist’s s perspective, they want to be able to retrieve images quickly from wherever they came from and have the best view of that image on their screens as quickly as possible.

We have a good solution in terms of our universal viewers and the whole workflow piece that you mentioned earlier. That is critical when it comes to the radiologist being more efficient. Getting more done more quickly and more accurately is the name of the game in healthcare today.

Are radiologists prone to burnout from the time and accuracy pressures? How do the technologies they use impact their stress levels?

It’s dependent on the individual, but the focus of radiologists is productivity. They define their success in being able to read images quickly, but also effectively, so that they’re giving patients the best care possible. But at the same time, it’s disheartening for them when their systems create delays.

The key for our environment is that we make them more efficient, not less efficient. That means having a system that is responsive and very quick, with viewing and reporting capability. They are constantly demanding systems that will make them more effective and more efficient and our job is to help them do that.

What will be the most impactful changes in the next five to 10 years?

We had the vision of this enterprise-wide solution a few years back. We were primarily a radiology PACS company, so we were primarily supporting the radiology department. We had a cardiology solution as well, but now that we have this enterprise-wide solution, we’re just scratching the surface. It’s mind-blowing to think of how much we could get done in adding other service lines and anything related to imaging that happens in a healthcare system and what that would do for patient care.

Radiology and cardiology are probably still the biggest imaging departments that are touched in one system. But as we go forward over the next two or three years, forget about five to 10 years, the whole platform of enterprise-wide imaging solutions is going to take off dramatically. You’re going to see a very different world not too long from now, less than five years away.

Do you have any final thoughts?

We have a fantastic opportunity and a good future in front of us to truly contribute to reducing total cost of ownership of imaging systems and reducing complexity in health IT. Our solution and the technology that we have developed is getting to maturity. We are doing a lot of terrific work in our labs and development centers on value-adds to that platform. I see a huge potential, particularly here in North America, the area that I oversee. Agfa HealthCare is a Belgian company, but we have very much turned our focus on the North American market, and with that will come additional investment that will drive the results and our market share here in North America.

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Morning Headlines 3/2/20

March 1, 2020 Headlines Comments Off

Cisco at HIMSS 2020

Cisco withdraws from HIMSS20 due to COVID-19 concerns.

Wellpepper acquired by Caravan Health in sign of growing market for digital patient treatment plans

ACO development company Caravan Health acquires Wellpepper, which offers technology to create digital patient treatment plans.

Health Catalyst Reports Fourth Quarter and Year End 2019 Results

Health Catalyst reports Q4 results: Revenue up 21%, EPS –$0.39 vs. –$16.33, beating Wall Street expectations for both and sending HCAT shares up 9.5% on Friday.

Thousands locked out of Pentagon and VA benefits websites

The Defense Department acknowledges that a problem with a common login system has prevented military members, retirees, veterans, and their families from logging in to the Tricare Online Patient Portal and to its MHS Genesis Cerner system for several days.

Coronavirus Reveals Limits of AI Health Tools

Vendors of AI-powered symptom checkers and chatbot struggle to update their algorithms with COVID-19 information.

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Monday Morning Update 3/2/20

March 1, 2020 News 16 Comments

Top News

Cisco withdraws from HIMSS20 due to COVID-19 concerns.

HIMSS filed its most recent coronavirus update Thursday, reporting a registrant cancellation rate of 0.6%. This may be misleading, however, since the organization offers refunds only to registrants from specific countries, meaning that most people who have changed their minds about attending would not necessarily bother to notify HIMSS.

Any potential cancellation of HIMSS20 would probably need to be announced in Monday’s update to allow time to notify registrants. HIMSS has not given any indication that it plans to cancel the conference.

Several companies that are scheduled to exhibit have recently cancelled their own user and sales meetings. HIMSS20 exhibitor Workday, for example, cancelled its sales kickoff meeting that was scheduled for March 2-4 in Orlando. Readers have said that Intel, Salesforce, and Amazon won’t participate, although those companies have not made any announcements.

Most respondents to this week’s snap poll – which is not vetted — say they haven’t changed their HIMSS20 plans, although 15% of respondents indicate that they are US residents who won’t attend as planned after all.

Readers who are epidemiologists or public health experts and are registered to attend HIMSS20 – will you still attend, and if so, will you take any non-obvious precautions? I’m also interest in hearing from employees of companies who have decided not to send employees to Orlando.

Reader Comments

From Wizened Sage: “Re: MDLive. Changes at the top – chief medical officer, CEO, CFO.” Rich Berner is still listed as CEO on the exec page, but a reader said his resignation was mentioned on a medical directors’ call. CFO/COO Dan Monahan left in November after 10 months and Chief Medical Officer Lyle Berkowitz, MD moved on last month after a couple of years. Comparing the executive web page from April 2019 to the current version shows that seven of the 13 are no longer listed.

From Doc X: “Re: HIMSS exhibitor press release upload portal. My upload failed and I noticed that it accepts only .doc files, which were superseded in Word in 2003 by .docx. So a state of the art health IT conference is using 23-year-old information exchange infrastructure?” I’m actually surprised that the third-party service HIMSS uses accepts Word documents at all instead of requiring PDFs, where formatting is consistent and the threat of malware micros is zero. PR people sometimes email me announcements as Word documents, which even if I wasn’t worried about malware, would go right to my trash folder anyway because it means they are greenhorns. I’m not blaming HIMSS since the technology still works as long as the submitter is willing to do a “save as.” I also think there may have been a time when non-Microsoft word processors such as Open Office and maybe even Apple Pages could export only as .doc files, so this might actually be a commendable interoperability provision.

From Being There: “Re: ZDoggMD’s claim that patients can’t share their Epic data with providers that use a different EHR. I can say as a user of an Epic-enabled mobile app through my PCP that this is categorically untrue. The Share Everywhere option on the mobile app gives any provider one-time, limited access to meds, allergies, health issues, and immunizations. They can even write a clinical note to my care team.” ZDogg also ignores Carequality EHR-to-EHR data sharing, which in also being connected to CommonWell allows sharing information with just about any EHR whose vendor wants to support doing so. I wonder if the EHR that ZDogg designed for his failed Turntable Health had interoperability capability since he’s so passionate about it.

From Midship: ”Re: HIMSS20. What is the financial impact to registrants if it is cancelled?” HIMSS policy is that you don’t get a registration fee refund – it rolls over to HIMSS21. Hotel reservations booked through HIMSS are non-refundable, so you’re out those costs along with flights unless you bought comprehensive travel insurance, which may or may not cover you anyway unless you got the expensive “cancel for any reason” coverage or purchased before COVID-19 became a known event that is therefore excluded. Employers pay the tab for most attendees, so the paperwork required will vary, but you’ll have all week to complete it.

HIStalk Announcements and Requests

Poll respondents say the best way by far to get people into your HIMSS booth is to deploy friendly, alert reps (hint: reps who stare longingly into the eyes of their phones are neither).

New poll to your right or here, following up on the KLAS survey: Which of the following patient engagement technologies have you personally used in the past year? I probably should have excluded dentists since they are far better users of consumer-facing technology than their medical counterparts.

I’m looking for a few good companies that are interested in signing up for HIStalk webinar services and sponsorships. Startups get a first-year discount because Lorre decided that would be nice for the little guys. We always get more interest right before and after the HIMSS conference as companies are paying more attention to the comparative effectiveness of reaching an audience of actual decision-makers. Contact Lorre.

Geek gadget alert: I read that resetting your router occasionally will ensure good Internet speed. Mine isn’t in a handy location, so I thought about plugging it into a mechanical timer like you do for Christmas tree lights and having it power off early in the morning and then on again a minute later. I then ran across these smart plugs, which allow you to control the plug over WiFi with a slick app, with Alexa or Google Home, and even IFTTT. I think it even has as one of its programmable elements sunset time, so that you might turn on a lamp at sunset and then turn it off at 11 p.m. A four-pack costs just $25, they were a snap to set up in just a few seconds, and they are working perfectly so far. The only caveat is that they work only on 2.4 GHz WiFi networks.

Listening: The Equatics, high school kids from Hampton, VA who recorded a single funk-soul album in 1972. I heard them on Hulu’s “High Fidelity,” which I’m enjoying a lot (Zoe Kravitz is excellent, at least while I’m waiting for Tony nominee Da’Vine Joy Randolph to steal every scene in which she appears.) The soundtrack is all deep cuts and oddities from obscure LPs like this one and the playlist is on Spotify.

Webinars

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

Acquisitions, Funding, Business, and Stock

Health Catalyst reports Q4 results: revenue up 21%, EPS –$0.39 vs. –$16.33, beating Wall Street expectations for both and sending HCAT shares up 9.5% on Friday.

Sales

Ontario Mental Health Partnership will upgrade its Meditech system to Expanse.
MatrixCare will integrate NVoq’s speech recognition solution to its home health and hospital EMRs.

Government and Politics

The Defense Department acknowledges – after initial denials – that a problem with a common login system has prevented military members, retirees, veterans, and their families from logging in to the Tricare Online Patient Portal and to its MHS Genesis Cerner system for several days. The ID platform DS Logon is working from inside the DoD’s network, but not from outside computers.

Privacy and Security

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A Consumer Reports investigation finds that prescription discount coupon vendor GoodRx sends patient information to 20 online companies that include Google, Facebook, and a marketing firms. Most surprising is that consumers and doctors interviewed by the magazine somehow think that HIPAA protects medical information everywhere, missing the major point that it binds only covered entities and their business associates, not discount websites. GoodRx reacted to the unwanted publicity with an apology, the hiring of a data privacy VP, reduction in the information it shares with Facebook and Google, and new user options for opting out and deleting their data as required by California’s privacy laws. The company says it will make sure the third parties to which it sends patient data follow HIPAA standards, which I’m not quite sure I understand.

CNN resurfaces the two-year-old story in which a Facebook bug was found by health IT expert Fred Trotter as having exposed the membership lists of its closed, private groups – as was found with a breast cancer gene support group – to developers and marketers. Facebook changed its closed group settings, but denies that the existence of a privacy loophole even though it admitted that developers had access to membership lists, saying that users shouldn’t use its Groups product if they are worried about privacy. The Federal Trade Commission has not yet responded to the December 2018 complaint filed by Trotter and healthcare attorney David Harlow.

HHS will review the St. Louis Fire Department’s participation in the TV show “Live Rescue” following HIPAA-related privacy concerns about its depiction of accident victims in near-live broadcasts. The fire department accepted legally responsibility for any HIPAA violation in its deal with the TV show’s producers, an agreement that pays the city nothing for its participation.

Other

Vendors of AI-powered symptom checkers and chatbot struggle to update their algorithms with COVID-19 information.

A small Reaction Data survey of health system clinicians and C-suite leaders finds that most respondents expect HHS’s proposed interoperability rules to have a positive impact. Epic users are more favorable to the ruling than those of any other EHR vendor. The rule’s biggest health system supporters are clinicians and executives, and while IT leaders were less enthusiastic, they don’t feel all that strongly about it either way. Respondents were pretty much equally split as to whether patients should control their own information versus hospitals and clinics doing it for them.

Healthcare in America: a man and his three-year-old daughter who underwent mandatory US government quarantine after returning from Wuhan, China find a pile of hospital, radiologist, and ambulance bills waiting when they finally got home. The government didn’t have a plan for who pays for being forced into quarantine in a non-government facility, and since the man has no health insurance since his China-based employer doesn’t offer US coverage and he’s lived in that country for years, he’s looking at a $4,000 expense so far. The biggest chunk of the bill, $2,600, was from a short ambulance ride provided by American Medical Response, which was sold to private equity operator KKR in 2017 for $2.4 billion in cash. He was coughing and his daughter was blinking excessively in a TV interview, which he would like to have checked out if he can qualify for Medicaid.

I had a double gotcha on this story in the Venice, FL paper. The first was that I thought it was about telehealth – it’s actually about architects for a new hospital trying out the design on employees using virtual reality. My second thought is that those cataract sunglasses that are ubiquitous among Florida’s senior citizens have gotten awfully large.

Paging Weird News Andy: Maryland police arrest a man who stabbed a woman with a syringe full of semen in a grocery store. Tom Stemen (!) told the woman when she confronted him, “It felt like a bee string, didn’t it?”

Sponsor Updates

Meditech adds a Hypertension Management Toolkit to its Expanse EHR.
Health Catalyst announces that former UPMC CFO Rob DeMichiei will join its board as a strategic advisor.
Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the AWHONN Missouri Section Conference March 5 in Chesterfield.
The Greenville Chamber honors OmniSys founder Jerry Ransom with its 2019 Worthy Citizen award.
Experian Health will exhibit at Quorom Solutions Expo March 4 in Litchfield Park, AZ.
Phynd adds six new health system clients in Q4.
Impact Advisors is named a Workday Alliance Services Partner.
Redox releases a new podcast, “Using transportation to improve healthcare access and outcomes with Ankit Mathur of Roundtrip.”
Relatient will exhibit at Nextech Edge March 5-7 in Orlando.
Surescripts will exhibit at the 2020 PBMI National Conference March 2-4 in Orlando.
Rare disease patient data platform Raremark partners with TriNetX to bring more clinical trials to its community.
SAS Health integrates Wolters Kluwer Health Language portfolio of data-quality solutions with its analytics software.

Blog Posts

How Every Value-Based Care Organization Can Optimize Their Referral Process: Part 1 (Lightbeam Health Solutions)
Optimize Emergency Coalition Response with Real-Time Situational Awareness (LiveProcess)
EHR Systems. The Cure Has Become Worse Than the Disease. (Loyale Healthcare)
How Ontario’s hospital partnerships are leading Canada’s public healthcare system transformation (Meditech)
Three Must-Haves for a Successful Healthcare Data Strategy (Health Catalyst)
Should Your Physical Therapy Practice Still Have a Blog? (MWTherapy)
Virtual Care: A New Frontier for Post-Acute Providers (Netsmart)
More than buzzwords: how consumer data is opening up the healthcare industry (Experian Health)
Don’t miss these 4 things at HIMSS20 (Spok)
5 Tech Trends Poised to Reduce Healthcare Costs & Improve Collections in 2020 (PatientBond)
4 Keys to Optimize the Patient Payment Process (Patientco)
Quincy’s HIMSS20 Survival Guide (QliqSoft)
Mistaken Identity: Ransomware, Facial Recognition, and Liz Wharton (SailPoint Technologies)
Measuring the ROI of Test Automation: A Starting Point Model (Santa Rosa Consulting)
Understanding the importance of wellness champion networks (StayWell)
Using Services to Unlock the Potential of Your Incredible Staff (Summit Healthcare)
Price Transparency: It’s in the Best Interest of Patients and Providers (Surescripts)
More than a Form: 4 Tips for a Better PT Patient Intake Process (WebPT)

Contacts

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

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16 Comments

Weekender 2/28/20

February 28, 2020 Weekender 1 Comment

weekender

Weekly News Recap

HIMSS announces that HIMSS20 will continue as scheduled with added on-site precautions to address coronavirus-related concerns.
Medical chat service K Health raises $48 million in a Series C funding round.
MIT Technology Review announces its 10 most promising breakthrough technologies, which include hyper-personalized medicine and AI-discovered molecules.
The VA says it hopes to go live with Cerner at its first site in July 2020, months after the originally announced date.
AMA releases a patient records access guide for medical practices.
HHS and ONC publish a report on reducing the provider burden of health IT.

Best Reader Comments

Shame on the state health system hiring Vendor A without a thorough background check of their employees and shame on Vendor A for hiring 1099 contractors who work for other companies that are bidding for the Epic work. I’m not an attorney; therefore, I don’t know if this is illegal vis-a-vis taxpayer’s or anyone’s money. However, it sure smacks of unethical practices. Independent HIT advisory consultants should have NO ties to any HIT companies, period. (Woodstock Generation)

Being in an enclosed space with 40,000 of your closest friends and their dirty germs with uncertain handwashing habits takes its toll. If they moved it to April I think we’d all be better off anyway, maybe something to think about for next year. (HIT Girl)

The entire clinical informatics community depends on places like Vanderbilt to advance the field. To see how they have restructured and refocused after their Epic implementation is exciting. We all benefit when an institution embraces their system and sets aside resources for clinical informatics research on it. (Andy Spooner)

Vendors should always compensate healthcare providers for their data with equivalent value in some form or another, including product discounts, in order to remain legally compliant. (Grant)

Watercooler Talk Tidbits

Readers funded the Donors Choose teacher grant request of Mr. L in New Mexico, who asked for programmable robots for his sixth grade class. He says, “From your generosity, students collaborated in learning coding software, developed an understanding that making mistakes can be fun, and that by sharing laptops and robots, everyone could participate. Students had to figure out and practice several math concepts such as angles, degrees and decimals. On Saturday, January 18, 2020, students participated in a Play Shop or Robotics Workshop on the Northern New Mexico College campus. At this Play Shop, a daughter managed to teach her father coding, and a son demonstrated how to navigate a robot through a maze to his father. This resource provided a positive moment for fathers to participate in the learning process. Moments like these will always be cherished by the family. And what about hanging out with your best friends in the classroom and on a college campus? As you can imagine, there were smiles and clapping when a student opened the package containing the robot. Everybody wanted to be the first to touch and code the robot. The next steps will be to continue to share the robot, learn much more of the coding during the day and after school, participate at a RoboRave Rally on the Northern New Mexico College in March, and to participate in the RoboRave Regional Competition.”

People are following homemade YouTube and Facebook instructional videos to perform at-home fecal transplants, which include instructions on how to find a donor and the proper use of kitchen appliances for mixing (you might want to pass on their dinner invitations).

An ophthalmologist sues a former employee for $2 million for posting a negative Yelp review that accused the doctor of making patients return for unneeded extra visits to inflate bills. The employee, who left after two months on the job, had signed an employee confidentiality agreement (thus the breach of contract part of the lawsuit) and refused to take her review down.

Digital health: police arrest a Gulf Coast Hospital (FL) employee after an elderly patient wakes up to find him licking her toes. The man, who was a sitter in the patient’s room, said he dropped his phone under her bed and accidentally touched her while retrieving it. Meanwhile, a woman sues the Florida hospital where she had received emergency mental health treatment, claiming that a male employee groped her and then asker her how much money and drugs she would need to have sex with him.

HIMSS coronavirus recommendations or not, this is way too weird for me to even consider at HIMSS20. I would prefer the Namaste gesture, Japanese-style bowing, or that up-and-back-once head nod acknowledgment thing, if indeed any physical gesture is really needed to greet a colleague or exhibitor when you’re already looking at each other and saying hello.

Speaking of HIMSS20, Orlando weather is all over the place, with highs around 70 on some days and then 90 degrees expected mid-week. Last year’s weather on March 9 was overcast with a high of 77 and low of 64. You won’t need a coat unless you’re going home somewhere cold.

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Morning Headlines 2/28/20

February 27, 2020 Headlines Comments Off

HIMSS Update on the Coronavirus

HIMSS will proceed as scheduled March 9-13, though it will be a handshake-free meeting.

K Health raises $48 million to apply AI to telemedicine

K Health, which offers consumers an AI-powered review of their symptoms and then paid telehealth visits, raises $48 million in a Series C funding round.

New EHR go-live date is July 2020, VA secretary says

The VA gives a new planned Cerner go-live date of July 2020, although Secretary Robert Wilkie has not committed to a specific date.

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News 2/28/20

February 27, 2020 News 9 Comments

Reader Comments

From Takeoff U. Hoser: “Re: UCSF Health. Has sent a letter to HHS supporting the proposed interoperability rule. The same organization provides de-identified patient data to Google for AI training of potentially highly profitable technologies, as was made public this week. That’s an interesting coincidence.”

From Hirepower: “Re: Allscripts. Online rumors say this is Day 2 of three days of layoffs. Any info?” I’ve seen nothing firm, although those unverified rumors say a few folks were let go from TouchWorks and Veradigm. The quarterly earnings report comes out Monday.

From Dollar Bill: “Re: COVID-19. What impact will it have on health systems?” I’m interested in hearing the financial impact that health systems expect. Most people who think they have (a) a life-threatening attack of COVID-19; and (b) insurance that covers their ED visit at minimal personal cost actually have; (c) neither. I think the biggest impact will be on people with insurance who will be left with crippling out-of-pocket costs for deductibles, co-pays, co-insurance, out-of-network costs, etc. It’s early in the insurance year to be running up a big ED tab when your deductible is thousands of dollars. The US healthcare system is rarely your friend, but is definitely your enemy when your expectations of invincibility are expensively dashed. I expect all the usual healthcare profiteers – including health systems – to make pandemic profits. China’s telemedicine companies are enjoying a stock boom from recent coronavirus-fueled usage growth, so there’s that.

From YouBoob: “Re: ZDogg MD’s Epic criticism. He talks over the CBS news profile.” ZDogg’s music parodies were pretty good back in the day when his Turntable Health clinic hadn’t yet failed and forced him to transition into an Internet celebrity selling “sponsorship, speaking, influencer, and video production packages.” He wields the scalpel of dripping sarcasm clumsily in this anti-EHR video in which he attempts impish cleverness in insulting Epic, its competitors, health systems, doctors, patients, and CBS. I couldn’t stand watching it all, but his main points seem to be:

Judy’s $3.6 billion fortune came from patients and health systems that bought Epic at a high cost, “whereas you can pick up an IPhone and pretty much do anything you want, anywhere.” The IPhone reference is just plain stupid (and last time I checked, the folks who sell those do pretty well financially, too) but the question might be what health systems should have implemented if it wasn’t Epic, Cerner, or Meditech (he complains about all three).
He scoffs at Judy Faulkner’s statement that Epic has to compete for technical talent against YouTube, Google, and Facebook in hiring developers for its “1990s era software” and built a great campus in the cow fields of Verona, WI to help do that. Every self-appointed expert thinks that anything written before Facebook must be useless by definition, but can never explain why the underlying technology matters one iota to anyone except a programmer who sees the actual source code.
“They haven’t made it usable. The client is not a doctor, the client is a health system.” I’m not sure what point he was making here, unless it’s that his peers should stop accepting paychecks from health systems that insist that they use software that meets their business needs.
“The only way you can share data from an Epic chart, your data – you’re the patient, you own this data – the only way is if you go to another health system that has Epic.” I’ve never tried this as a patient, but I would be seriously shocked if Epic data has never been shared with a hospital or practice that uses a different EHR.
He said this: “If Athenahealth or Modernizing Medicine, both of whom I’ve worked with, or Office Practicum, who I’ve worked with, I’ve done talks for, if they were the largest electronic health vendors in this country, I’d be picking on them too.” I interpret this as meaning that ZDogg cashed promotional checks from other EHR vendors without complaint and they get a free ride because they aren’t as successful as Epic.
He also said this: “When we were running Turntable Health, we had our own EHR that we built from scratch with our partners Iora, and patients had access to it, it was problem based, you could have a health coach and a doctor writing in it at the same time, there wasn’t a billing component to it, t was pure patient care. And it wasn’t perfect but it just worked. That’s what we need.” That would be a great supporting argument if (a) Turntable was more than a small primary care practice that didn’t accept insurance; and (b) it hadn’t gone belly up after three years. I share his admiration for Iora Health and the tools that work for them, but to compare their needs with those of health systems is unrealistic. Epic, Cerner, and Meditech have dozens to hundreds of specialty modules that support lab, anesthesia, labor and delivery, surgery, ED, oncology, etc. so any design must accommodate all of those services, not just ambulatory primary care visits.
ZDogg is right that EHRs weren’t designed to bring joy to doctors and that the CBS profile is a silly fluff piece (although it was just filler aimed at people sitting around on Sunday mornings watching network TV, to be fair). He’s wrong in forgetting that the job is the problem, not the tools that are required to support it. Doctors sold their independence and thus their right to have software designed to meet only their needs, while health systems are like any other business in being free to buy whatever IT systems they think are best for their organizations and patients.

HIStalk Announcements and Requests

Snap poll for HIMSS20 registrants: how will coronavirus concerns change your attendance plans? I included a fake vote option so curious folks can see the poll’s results without having to make a misleading choice. Add a comment after voting if you like.

I’m always puzzled by HIMSS’s “Conference Deal” emails, which I think they rolled out years ago when Groupon was still a big thing. What’s the “deal” in being invited to see a booth demo?

Webinars

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

Acquisitions, Funding, Business, and Stock

K Health, which offers consumers an AI-powered review of their symptoms and then paid telehealth visits, raises $48 million in a Series C funding round. The system, which was trained on patient data from an Israel health fund that is one of its investors, is rolling out a co-branded version for Anthem so that patients can “text with a doctor for less than a co-pay” at $19 for a single visit or $39 for unlimited chats for a year. The company says it has served 3 million users and is now available in all 50 states.

Spok reports Q4 results: revenue down 9%, EPS –$0.50 vs. $0.01.

Sales

Northside Hospital (GA) will implement sepsis-monitoring software from Ambient Clinical Analytics.

People

Fax and documentation automation vendor Concord Technologies hires Christopher Larkin, MS (Elsevier) as CTO.

Announcements and Implementations

KLAS surveys 300 people about the patient engagement technologies they use and the changes they would like to see. Patients who see their provider relationship as collaborative value patient portals and technologies that allow them to stay connected without a face-to-face visit, while patients who are more transactional are happier with online bill pay, automated prescription refill requests, provider search, self-scheduling, and eventually price transparency tools. The patient portal is most impactful today because Meaningful Use money got them deployed, but patient adoption is limited and patients would prefer a consolidated version that includes all of their providers and all common functions related to lab results, billing, appointments, and secure messaging. Their second-most desired technology is telehealth. Most interesting to me is that money has driven the process – providers rolled out the minimum patient portal that earned them MU money for “having” rather than “using,” they aren’t about to share information with competitors, and they haven’t shown much interest in making themselves available outside of face-to-face visits because nobody pays them otherwise. They also don’t offer telehealth, leaving patients to use standalone services with doctors they don’t know, which is one possible reason for low usage.

The Providence healthcare system opens an innovation center in Hyderabad, India.

Government and Politics

The inspectors general at the DoD and VA announce that they will begin conducting a joint audit of efforts by the departments to roll out an interoperable EHR from Cerner. Government officials insist the audit isn’t the result of complaints, but rather an effort to ensure that the EHR modernization will enable interoperability among the departments and private sector providers.

The VA gives a new planned Cerner go-live date of July 2020, although Secretary Robert Wilkie would not commit to a specific date to a House VA committee. Programming has been completed for just 19 of the 73 required interfaces.

Other

In Canada, Vancouver-based RealWear partners with Chinese technology company Tencent to adapt its headsets for medical use, giving healthcare workers on the frontlines of the COVID-19 outbreak in China access to hands-free, voice-activated software that offers remote viewing and connects to Tencent’s WeChat app.

MIT Technology Review announces its 10 breakthrough technologies for 2020.

Georgia’s lieutenant governor says it’s not improper that he talked about selling a health IT application to health and wellness platform vendor Sharecare, which is paid $14 million per year to run a digital health program for state employees. The talks didn’t pan out. Geoff Duncan is a former CEO of employee wellness technology vendor Wellview Health and remains a company director.

Wired looks at the ways Chinese radiologists are relying on AI from Infervision to screen for COVID-19 symptoms, especially pneumonia. Software originally developed to detect cancerous nodules in lung scans has been repurposed by hospitals that are overwhelmed with patients.

Sponsor Updates

Elsevier will use Global Medical Device Nomenclature data to provide important clinical and vigilance information on medical devices.
EClinicalWorks will exhibit at the AAPM Annual Meeting through March 1 in National Harbor, MD.
Redox partners with Welldoc, giving providers the ability to view data from users of Welldoc’s BlueStar diabetes management app from within their EHR workflows.
The Chartis Group names David Howard (Grant Thornton) director and practice leader for its ERP and Technology Innovation practices.
Hayes Management Consulting will work with search and AI-powered analytics vendor ThoughtSpot to develop revenue cycle and compliance solutions for providers.
Wolters Kluwer Health Language publishes a new executive brief, “Unlock Your Data: Prepare Your Organization for the New Era of Transparency.”
Healthcare Growth Partners advises Symplr in its acquisition of The Patient Safety Company.
Healthwise will exhibit at the HealthTrio User Group Summit March 2-4 in Tucson.
Hyland completes its acquisition of Streamline Health’s enterprise content management business.
Imprivata further expands identity and access management capabilities for the UK healthcare market with the launch of its new Identity Governance solution.
VentureFizz features a “CxO Briefing” with Kyruus CEO and co-founder Graham Gardner, MD.

Blog Posts

The Importance of Optimizing One’s Supply Chain Management (SCM) (Engage)
The Challenges of Growth: Where to Begin? (EClinicalWorks)
Goliath Technologies Makes Troubleshooting the End-User Experience Faster and Easier with Latest Release (Goliath Technologies)
Nordic teammates discuss diversity, inclusion, and equity in healthcare (Nordic)
What’s New in the Federal Health IT Strategic Plan? (Clinical Architecture)
Benefits of Artificial Intelligence and Machine Learning in Healthcare (Optimum Healthcare IT)
What Makes a Good Provider Champion? (Healthfinch)
Nordic teammates discuss diversity, inclusion, and equity in healthcare (Nordic)
Leading change to EMRAM Stage 7: Northeast Georgia Health System (Hyland)
Natural Language Processing (NLP) Driving SDOH Adoption (Imat Solutions)
Best Practices for EHR Implementation Training (Impact Advisors)
Changing the Payer – Provider Relationship (InterSystems)
Letting clinicians “speak clinician” (Intelligent Medical Objects)

Contacts

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

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9 Comments

EPtalk by Dr. Jayne 2/27/20

February 27, 2020 Dr. Jayne 1 Comment

I’m always on the lookout for good outcomes from all the work that goes into EHRs. I enjoyed reading about an EHR “nudge” that was shown to reduce inappropriate testing for the nasty C. difficile infection. The system flags patients with contraindications to testing and the authors looked at data across four hospitals ranging two years before and after the intervention. The percentage of inappropriate orders fell by 2% with the intervention, and overall orders were down 21%.

I attended a medical seminar this week and was surprised that no one is modifying their behavior in response to flu season or even fears of coronavirus. Still a lot of hand shaking going on and a couple of people gave me the side eye when I declined to shake hands. I guess everyone has forgotten the pandemic flu of 2009 when everyone was doing elbow bumps instead. CDC has raised their level of dialogue around coronavirus preparedness and HIMSS has followed suit by announcing it will be a handshake-free meeting. I anticipate some other behavior changes around whether people will accept samples of food or candy and whether people will even want to travel to such a large event. HIMSS notes that registrations are up over 2019 and the cancellation rate is below 0.05%.

Still, HIMSS has announced its preparedness plan, including collaboration with ED physicians, onsite support from the Florida Department of Health, onsite screening and isolation as needed, and more. They plan to have three medical offices at the convention center, with one of them dedicated to flu-like symptoms. There will also be an increased number of hand sanitation stations, increased wipe-down of commonly used surfaces, and the availability of medical-grade face masks at the information booths.

That’s more masks than I currently have at my office, which makes me sad. I’m a bit of a prepper already, so making sure I have enough personal supplies stocked in wasn’t a stretch, and I’ve warned my younger colleagues who rely on DoorDash and GrubHub for every meal that they might want to consider having at least a small ramen noodle supply at home. The next couple of weeks should be interesting.

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CDC is also circulating their infographic about the proper fit for high-end masks. I had no idea some of these facial hair styles even had names.

Anyone who has ever worked in hospital IT knows the fear that an upcoming visit from The Joint Commission strikes into the hearts of coworkers. There are many accrediting organizations out there, and often they are cited as the source of rules and regulations that don’t actually exist, leading to frustration for operational and technology teams alike. A recent report notes that CMS plans to strengthen oversight of accrediting organizations due to concerns about conflicts of interest. Some of the organizations provide both accreditation and consulting services which can be an issue, and CMS Administrator Seema Verma also called out accrediting organizations that use standards that are different from the CMS conditions of participation. The Joint Commission is one such organization that has created requirements above and beyond the CMS standards.

Verma also mentioned the upcoming Meaningful Measurement 2.0 program, which is a follow-up to the 2017 Meaningful Measures program. (Language nerd side note: Why did they have to change it from Measures to Measurement? That’s going to be annoying.)

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There are strong feelings out there about the way that technology is escalating the medicalization of things that were previously “normal” physiological process. From smart toilets that analyze stool patterns to diet and nutrition trackers, technology is everywhere. I’m part of an online group that mentors young mothers and nearly everyone either has or wishes they had a multi-hundred dollar smart bassinet to help their babies sleep better. A recent Washington Post article looked at the impact of AI baby monitors on nervous parents. It’s gone beyond the walkie-talkie style units of the past, with camera systems that transmit data to parents while they are away and also those that process the video to determine whether infants are in risky positions or getting tangled with blankets. Privacy advocates are concerned about the sharing of such private data and clinicians are worried that monitor companies are promising a level of safety that is not supported by research.

I’ve definitely noticed a heightened level of anxiety in the moms in my group, although I recognize that to some degree it might self-select anxious mothers since they’re participating in the group in the first place. Some of them are desperately trying to track and quantify every element of their babies’ existence, from feeding to diapers, sleep, and developmental milestones. I’ve seen mothers who have lost the ability to trust their instincts and are relying too much on data.

It’s similar to when physicians are in training and have to learn to “treat the patient, not the numbers.” The privacy issue is certainly a big one, with parents having no control over the images of their children once they’re transmitted to the vendor. Definitely food for thought.

Speaking of the quantified self, approximately a third of fitness trackers are abandoned after a while, winding up in nightstand drawers or the landfill. Recycle Health, affiliated with Tufts Medical School, has collected more than 5,000 wearables for redeployment to exercise and nutrition programs for low-income patients. Vendors have gotten into the act, with Fitbit, Fossil, and Withings sending excess inventory. Apple has not donated. In addition to individual donations, they also gather unclaimed lost devices from theme parks and tourist sites, which is a novel approach. Corporate wellness programs donate as well.

In other wellness news, recent research shows that odd-shaped parks may be better for public health. The authors used satellite imagery, cause of death statistics, and residence near a green space larger than 900 square feet as indicators. They found a decrease in deaths for every percentage point increase in green space. They found that irregular parks were beneficial because they might be more appealing to be in, or might be easier to stumble upon compared to formal parks with limited entrances. Complex-shaped parks were also linked to reduction in chronic health conditions. Recommendations for civic planners include finding ways to connect small or fragmented parks via greenways or other natural features.

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I always enjoy when a scholarly publication has a sense of humor, and a recent article in the Journal of Surgical Education did not disappoint. In “The Sorting Hat of Medicine: Why Hufflepuffs Wear Stethoscopes and Slytherins Carry Scalpels,” the authors surveyed surgical coordinator and residents to score various personality traits that tend to define medical specialties. There were more self-reported Slytherins in surgical subspecialties, particularly in orthopedic surgery. Family medicine had no Slytherins, which is not surprising. I don’t think students are going to start selecting their specialties based on their Hogwarts sympathies, but it was an amusing read.

Lots of chatter among the scribes in our office this week as the folks at Mayo Clinic Medical School mistakenly sent acceptance letters to 364 applicants. The school is blaming it on a technical glitch and said that as soon as they knew about it they withdrew the offers via email. Everyone affected has also been contacted by phone. The letters went to everyone who had interviewed, and there are typically only 46 actual spots available for students, with initial offers usually being made by phone.

The medical school admissions process isn’t something I would wish on anyone. It’s an emotional roller coaster and it’s expensive. Based on the fact that they were invited to interview, the applicants affected are generally qualified to attend, and I feel bad for them.

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I got a chuckle out of reader Matt’s comment on my post about HIMSS shoes. He recommends HOKA, but notes that “they’re not inexpensive so you may have to add laser hair removal to your practice, add retail vitamin sales, or go into orthopedics.” You have to love a company that has a shoe named “Speedgoat” and their color combinations are certainly appealing.

Email Dr. Jayne.

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Do these Nordic Healthcare systems concentrate the risk of a new system more that would certainly happen in the more…

I appreciate the new and approved medical terminology for my daughter who is "increasingly fussy" (and has been since she…

You're right about it feeling like groundhog day EHR to AI Medical Scribes. You highlighted one comparison. How they're going…

I want to highlight this passage: "It’s a classic parallel to what we experienced back in the early days of…

With this Oracle roll-out in Sweden, and the Epic roll-outs in Denmark, Finland, and Norway, I wonder if anyone has…

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