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Curbside Consult with Dr. Jayne 11/29/21

November 29, 2021 Dr. Jayne 2 Comments

The holidays are often a time for families to catch up and share recent happenings. Especially in the ongoing COVID-19 era, there is often a lot of catching up to do if people haven’t been seeing each other as recently as they did in the past, and if they haven’t been keeping up by other means. Although most of my older relatives are on social media (including one who has a Facebook account for each device she owns, because our attempts to explain how accounts work have not been well received), others spent the time catching up on their grandkids’ exploits. I always find it interesting to see how people in the same age bracket embrace technology differently.

In the early days of Facebook, I had avoided joining because I was super busy with a multi-hospital EHR conversion project and didn’t need one more thing to suck up excess time. I remember the night I finally signed up, sitting in a hotel room in the middle of nowhere during a hospital site visit. When it searched my contacts to try to find “friends,” the first person that came up was my then 88-year-old grandmother. It turns out that was the best way for her to see pictures of my cousin’s children, since they lived across the country. Even though she used a computer for little else, she saw the value in trying something new. She was also the kind of lady who spent part of her retirement auditing classes at the community college so she could learn new things, so I think that had a lot to do with it.

Fast forward to this year, and one of our relatives is struggling with a new iPhone that her son bought for her, seemingly without talking to her about it. She had been an Android user for years but her base model phone was low on memory and speed. Since she was on her son’s plan, he volunteered to help her pick out a new device, but it turned into him buying her what she thought she needed versus what she actually needed. Now she’s stuck with an expensive phone she doesn’t like, and the family dynamics make her not want to speak up about getting something else. The grandkids worked with her to do basic things such as connecting her phone to her house’s wi-fi network and doing some minor adjustments to voice-to-text settings, but I suspect she’s still going to struggle with it.

Most of my relatives don’t really understand what I do since I “gave up being a doctor,” so of course there were some conversations about that. I’ve given up on explaining how you can still be a doctor and not necessarily see patients. In the interests of simplifying the explanation, I’ve tried to explain that what I do is kind of like being a medical school professor who helps a resident learn a new surgical technique or a better way to treat a patient, and that sometimes I also work to help create the tools that doctors use to do their jobs. They still don’t get it, but that’s OK. I’m still the one they come to with all their medical questions, even in disciplines I know absolutely nothing about, so I guess I’m still a doctor after all.

There were of course the usual conversations about everyone’s chronic health conditions and the woes of choosing the wrong Medicare secondary policy. Since I’m working on a project that involves heavy use of a health system’s patient portal, I tried to get some information about whether and how my relatives might be using the ones they have access to. Use was all over the map, partly due to limitations in what their providers allow patients to access and partly due to lack of knowledge. It seemed like using it to send messages to the doctor was the most common, followed by prescription requests. No one was using it to read their visit notes, and none of them were aware of the ability to grant proxy access to a family member or caregiver.

The latter would be great for the other members of the family that are doing a lot of caretaking, so I hope they’re able to set this up in the near future. I’m not sure I would push them to read their visit notes since they would probably become aggravated by any inaccuracies or jargon. I recently had a visit at a large academic health system and there were at least five small errors in my note. I’m not going to get excited about it because it doesn’t change the treatment plan but I’m sure they would be less sympathetic if they saw something like that in their notes.

As with any technology, it takes time for adoption to occur, and I see wide variation in how different health systems are encouraging people to use their patient portals as well as in the support that they provide to users. Those that understand how much a well-configured patient portal can help office efficiency promote it more and are willing to spend more resources on development and configuration. Those that instead view it as something they have to provide and don’t want to cultivate likely have a lower return on investment as well as a less-fulfilling patient experience. This phenomenon shouldn’t be a surprise to anyone who has worked in healthcare IT, but I think sometimes people forget it as they’re planning projects.

Since I’m working on a project that assumes heavy use on the part of both patient and provider, I’m trying to learn everything I can about what works and what doesn’t work so I can help create the best solution for my client. In addition to talking to other CMIOs who have maximally leveraged their solutions, I’m taking some classes to really learn the details about what the system I’m working with can and can’t do. I’m working with some great analysts, but there’s always a chance they missed something or didn’t think about it in a way that a physician would, and my client is supportive of the approach.

In talking with a friend who does some clinical informatics work for his university, his institution restricts him from attending vendor classes. I think that’s absurd, especially if he planned to use his own continuing education funds to cover the cost of training. I get that they don’t want random people going to classes and demanding that they make changes that are problematic, but there’s a thing called “discussion” when people have ideas, and preventing staff from learning isn’t a good look for those in higher education. It’s also not a great recipe for stakeholder engagement, but I’ve known that his employer hasn’t cared about that for a very long time, so I’m not surprised.

I hope readers were able to at least get some down time this weekend, and that all the games of “refrigerator Tetris” were successful. What was the best thing you did over the holiday? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 11/29/21

November 28, 2021 Headlines No Comments

The NFL Is Giving Players Sensor-Laden Mouthpieces Instead of Just Lip Service to Study Concussions; Four College Programs Join In

Several NFL and college football teams are collecting impact data from sensor-embedded player mouthpieces to test helmet effectiveness and to influence future rule-making to reduce concussions.

MIT Catalyst Program welcomes new VHA Innovation Ecosystem Fellows

The MIT Catalyst program announces a new group of VHA Innovation Ecosystem Fellows, who will work to improve veteran care through need-driven biomedical research and innovation.

New Exa Platform Functionality Automates Decision Support, Insurance-Related Tasks for Enhanced Productivity and Profitability

Konica Minolta adds Appropriate Use Criteria for advanced diagnostic imaging to its Exa Platform, in which orders placed through its physician portal will be validated electronically against CMS criteria using logic from LogicNets.

Monday Morning Update 11/29/21

November 28, 2021 News 5 Comments

Top News

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Best Buy discloses in its quarterly earnings call that its cost to acquire remote patient monitoring technology vendor Current Health in October was $400 million in cash.


HIStalk Announcements and Requests

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Most poll respondents feel pretty good about how their employers will fare in 2022.To what degree will resignations and hiring challenges affect your employer’s prospects in the next few years?

New poll to your right or here: To what degree will resignations and hiring challenges affect your employer’s prospects over the next few years? This in response to a comment on last week’s poll in which a reader predicted significant long-term impact of organizations losing experienced health IT employees.


Webinars

December 8 (Wednesday) 1 ET. “What Lies Ahead for the EHR’s Problem List.” Sponsor: Intelligent Medical Objects. Presenters: James Thompson, MD, physician informaticist, IMO; Deepak Pillai, MD, MBA, physician informaticist, IMO; Jonathan Gold, MD, MHA, MSc, physician informaticist, IMO. The EHR problem list can be cluttered with redundant, missing, and outdated diagnoses, and displays don’t always help clinicians process the available data correctly. The presenters will discuss how improvements in creating, maintaining, and displaying problems could reduce errors and decrease the cognitive load of clinicians while continuing to optimize reimbursement.

December 9 (Thursday) 1:30 ET. “Cone Health: Creating Extreme Efficiencies in Surgical Services.” Sponsor: RelayOne. Presenters: Wayne McFatter, RN, MSN and Sharon McCarter, RN co-directors of perioperative services, Cone Health. The presenters will discuss how they have empowered the entire surgical care team, including vendor representatives, to get real-time access to surgery schedules and case requirements in the palms of their hand. RelayOne CEO Cam Sexton will also present the findings of a recent study of 100 hospital leaders regarding their operating room optimization plans for 2022.

December 14 (Tuesday) 1 ET.  “Using Cloud to Boost AI and Enterprise Imaging.” Sponsor: CloudWave. Presenters: Larry Sitka, MS, VP/CSIO of enterprise applications, Canon Medical Informatics; Jacob Wheeler, MBA, senior product manager, CloudWave. Enterprise imaging has remained a holdout of data center complexity despite the benefits the cloud offers. The presenters will discuss innovative ways to reduce complexity and lead with disruptive technology using AI, enterprise imaging, and the cloud.

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


People

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Alexander Scarlat, MD (Codixim) joins Mitre as principal data scientist of its health IT group. He wrote the “Machine Learning Primer for Clinicians” series for HIStalk a while back.

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Matt Lungren, MD, MPH (Stanford Center for Artificial Intelligence in Healthcare) joins Amazon Web Services as principal for clinical AI and machine learning for worldwide public health.


Announcements and Implementations

Konica Minolta adds Appropriate Use Criteria for advanced diagnostic imaging to its Exa Platform, in which orders placed through its physician portal will be validated electronically against CMS criteria using logic from LogicNets. 


Government and Politics

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The MIT Catalyst program announces a new group of VHA Innovation Ecosystem Fellows, who will work to improve veteran care through need-driven biomedical research and innovation.

Medical University of South Carolina sues six of its oncologists and HCA Healthcare, alleging that the doctors – who will leave MUSC on December 1 to take jobs at HCA-owned Trident Medical Center — stole confidential information such as case logs and patient lists to help their new employer create a competing head and neck oncology program. MUSC said the doctors used its email servers to send confidential preference card information to Trident officials.


Other

Several NFL and college football teams are collecting impact data from sensor-embedded player mouthpieces, pairing the force, speed, direction, and location information with video to test helmet effectiveness and to influence future rule-making to reduce concussions.

In Canada, Peterborough Regional Health Centre lays off 84 employees as part of its Epic implementation. The hospital says it is eliminating a “limited number of clerical roles.” The hospital is one of seven Central East Ontario health systems, representing 14 hospitals, that will go live on Epic on December 3.

A Wall Street Journal article titled “It’s Time to Get Rid of the IT Department” says that the typical IT department is a bureaucratic island that hinders innovation, digital transformation, and customer focus, making these points:

  • Separating the IT department – both organizationally and physically – from the core business doesn’t make sense, even if the group is given a sexy new name like “global digital solutions.” Technology is no longer optional.
  • Treating IT as a partner to the business encourages it to be judged using metrics that are often irrelevant to long-term business outcomes, such as budget, uptime, and project completion. “Meeting specs” doesn’t correlate with success, and businesses isn’t driven by owning, building, and managing IT systems.
  • Business units can’t predict their technology needs months or years in advance as required by IT budgeting, making it impossible for siloed IT departments to meet expectations for being faster and more flexible.
  • Most IT employees work there because they love technology rather than the company’s core business, creating a culture gap that ignores the fact that the business is the technology and vice versa.
  • Some companies are moving toward focusing on realizing value from IT within business units instead of rewarding the IT department for centrally managing it. This makes more sense as cloud computing relieves IT from managing physical assets such as data centers and servers and low-code software development reduces the need for programming talent.
  • Companies are organizing their missions around groups that include embedded technical experts, which encourages innovative thinking, deeper subject matter expertise, and fewer handoffs.
  • IT decentralization comes with “freedom within a framework,” such as requiring use of standardized development tools, architecture, and security protocols.

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RSNA expects 19,000 attendees to attend this week’s in-person conference at Chicago’s McCormick Place, with another 4,000 participating virtually. The exhibit hall will showcase 500 vendors. The last in-person meeting, RSNA 2019, drew 52,000 registrants, with exhibitor personnel making up nearly half of the total.


Sponsor Updates

  • In England, North Tees and Hartlepool NHS Foundation Trust implements TrakCare electronic prescribing and medication administration technology from InterSystems.
  • CHIME honors HCA Healthcare and Meditech with its Collaboration Award.
  • OptimizeRx wins two Digital Health Awards.

Blog Posts


Contacts

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

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Morning Headlines 11/25/21

November 24, 2021 Headlines No Comments

HHS Announces $35 Million for Telehealth in the Title X Family Planning Program

HHS allocates $35 million to help Title X family planning providers enhance and expand their telehealth infrastructure and capacity.

Peterborough Regional Health Centre lays off 84 as new digital records system rolls out

Peterborough Regional Health Centre, one of seven hospitals in Ontario preparing to go live on Epic in early December, lays off 84 employees in a move management says is necessitated by changes brought on by the new software.

Disclosures reveal Current Health was sold for $400m

Records reveal that Current Health, which offers remote patient monitoring, telehealth, and patient engagement technologies, was acquired in September by Best Buy for $400 million.

Morning Headlines 11/24/21

November 23, 2021 Headlines No Comments

San Diego-based startup LifeVoxel raises $5 million seed funding for its AI diagnostic visualization platform

Remote diagnostic software startup LifeVoxel raises $5 million in seed funding.

Luma Health Raises $130 Million In Series C Funding To Unify, Automate, And Transform Patients’ Healthcare Journeys

Patient engagement software vendor Luma Health raises $130 million in a Series C round that brings its total funding to $160 million.

ImagineSoftware Announces Strategic Growth Investment from Marlin Equity Partners

Medical billing automation vendor ImagineSoftware secures an undisclosed amount of funding from Marlin Equity Partners.

News 11/24/21

November 23, 2021 Headlines No Comments

Top News

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Private equity firms Bain Capital and Hellman & Friedman will acquire Athenahealth from Veritas Capital and Evergreen Coast Capital for $17 billion.

Veritas and Evergreen will retain a minority investment in the company. The management team will remain in place.

Hellman & Friedman’s health IT portfolio includes Change Healthcare and PointClickCare, while Bain Capital’s includes HST Pathways.


Webinars

December 9 (Thursday) 1:30 ET. “Cone Health: Creating Extreme Efficiencies in Surgical Services.” Sponsor: RelayOne. Presenters: Wayne McFatter, RN, MSN and Sharon McCarter, RN co-directors of perioperative services, Cone Health. The presenters will discuss how they have empowered the entire surgical care team, including vendor representatives, to get real-time access to surgery schedules and case requirements in the palms of their hand. RelayOne CEO Cam Sexton will also present the findings of a recent study of 100 hospital leaders regarding their operating room optimization plans for 2022.

December 14 (Tuesday) 1 ET.  “Using Cloud to Boost AI and Enterprise Imaging.” Sponsor: CloudWave. Presenters: Larry Sitka, MS, VP/CSIO of enterprise applications, Canon Medical Informatics; Jacob Wheeler, MBA, senior product manager, CloudWave. Enterprise imaging has remained a holdout of data center complexity despite the benefits the cloud offers. The presenters will discuss innovative ways to reduce complexity and lead with disruptive technology using AI, enterprise imaging, and the cloud.

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


Acquisitions, Funding, Business, and Stock

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Health technology and services company Edifecs will acquire Health Fidelity, which offers natural language processing-enabled risk-adjustment technologies and consulting services. Edifecs will add Health Fidelity’s assets, along with similar offerings from recently acquired Talix, to its Encounter Management software for payers.

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Digital musculoskeletal care company Sword Health raises $163 million in a Series D funding round, bringing its total raised to over $300 million at a valuation of $2 billion.

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Remote diagnostic software startup LifeVoxel raises $5 million in seed funding.

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Patient engagement software vendor Luma Health raises $130 million in a Series C round that brings its total funding to $160 million.


People

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Cerner names Johnny Luu (Google Health) as chief communications officer.

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Healthcare Triangle hires Jason Polli, MBA (Leidos) as VP of client success.

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Albany Med (NY) promotes Kristopher Kuschem MEng to VP/CIO.


Announcements and Implementations

Ascom announces GA of its Digistat clinical workflow software in North America.

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Monument Health (SD) implements Healthcare Triangle’s Readable.AI technology for automated document processing.

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The Ohio Department of Mental Health and Addiction Services launches TreatmentConnection.com, an online mental health and addiction treatment screening and provider locator available through technology developed by Bamboo Health.


Sponsor Updates

  • Medcare Orthopaedics & Spine Hospital in Dubai goes live on InterSystems TrakCare.
  • Jvion shares predictions for how AI will continue to shape healthcare in 2022.
  • The First Coast Connect Podcast features Availity CTO Jack Hunt.
  • Cerner releases a new podcast, “What does it take to be a real-time health system?”
  • CHIME’s 2021 Digital Health Most Wired Trends Report reflects the rapid digital transformation of and growth in patient engagement.
  • AHLA’s latest Speak of Health Law Podcast, “Legal Liabilities of Enterprise Cyber Risk Management,” features Clearwater founder and executive chairman Bob Chaput.
  • KLAS Research and Arch Collaborative release a case study featuring Baptist Health and Divurgent.
  • Everbridge will exhibit at the National Healthcare Coalition Preparedness Conference November 30-December 2 in Orlando.
  • Fortified Health Security names Audra Barnes security compliance analyst.
  • FeaturedCustomer’s “Fall 2021 Hospital Communications Software Customer Success Report” includes Halo Health as a top performer.
  • Healthwise wins several Digital Health Awards.
  • Visage Imaging will introduce Visage 7 Video Reports at RSNA21.

Blog Posts


Contacts

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

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Morning Headlines 11/23/21

November 22, 2021 Headlines 8 Comments

Athenahealth, Healthcare Technology Leader, to be Acquired by Hellman & Friedman and Bain Capital for $17 Billion

Private equity firms Bain Capital and Hellman & Friedman will acquire Athenahealth from Veritas Capital and Evergreen Coast Capital for $17 billion.

Edifecs Enters Into Definitive Agreement to Acquire Health Fidelity

Health technology and services company Edifecs will acquire Health Fidelity, which offers natural language processing-enabled risk-adjustment technologies and consulting services.

Sword Health Raises $163M and Reaches $2B Valuation as the Fastest Growing Digital MSK Company

Digital musculoskeletal care company Sword Health raises $163 million in a Series D funding round, bringing its total raised to over $300 million.

Curbside Consult with Dr. Jayne 11/22/21

November 22, 2021 Dr. Jayne 1 Comment

As health systems continue to refine strategic planning for a potential upcoming influenza season or yet another wave of COVID-19 infections, telehealth is undoubtedly part of nearly everyone’s strategy. As a consultant, it’s interesting to see how different organizations have decided to use it.

For some, it’s strictly for acute visits and urgent-care type services that they can’t accommodate due to packed office schedules. For others, it’s an adjunct to their offerings for chronic care visits, which depending on the condition may be less likely to require a physical exam. Others are using it to grow their business by reaching out to previously untapped patient populations. A small number are using it as an option for physicians and other providers who may not be able to work in-person due to a personal health issue that precludes face-to-face contact with patients, or potentially having a family member at home who is at risk for infection.

I know a number of physicians who are going through cancer treatments or who are otherwise immune compromised and being able to practice virtually has kept them from going on disability or leaving medicine altogether. It’s an option that few physicians had previously and might be one of only a handful of good things that have come out of enduring a global pandemic. Not only is the option good for those individuals, but it’s good for care delivery organizations who would have otherwise lost capacity. When those physicians can keep their own panels it’s ideal since there can still be continuity, but I know that’s not always the situation, such as in the case of physicians who are in procedure-based subspecialties.

Still, there are growing concerns about how telehealth fits into the care landscape. Concerns with the cost of telehealth compared to in-person visits have been fairly straightforward, but questions about the clinical care provided have been less well defined. A recent report from Quest Diagnostics reviewed one of the concerns in more detail. The report, titled “Drug Misuse in America 2021: Physician Perspectives and Diagnostic Insights on the Drug Crisis and COVID-19,” found that almost 70% of physicians worried that signs of drug misuse were missed during pandemic-related care disruptions. The drugs in question include both prescribed substances as well as those obtained illegally.

Researchers looked at some 5 million test results performed by Quest Diagnostics, including 475,000 from the year 2020. They combined that data with survey results from the Harris Poll, which queried more than 500 primary care physicians. The report concluded that physicians are concerned about their ability to manage patients given the risks of drug misuse. In addition to worrying that they missed warning signs of drug misuse during the pandemic, 94% of primary care physicians state they are seeing an increased number of patients with mental health issues during the pandemic and “fear a correlation between rising mental health issues and prescription drug misuse.” Additionally, 98% of physicians are concerned about issues with controlled substances as a whole, compared to 75% who are concerned about opioid medications.

Specific to telehealth, 75% of physicians are concerned that telehealth visits limit their ability to identify whether patients are at risk for or already having issues with prescription drug misuse. Where 91% of physicians feel they can recognize warning signs during in-person visits, only 50% feel they can recognize issues during a telehealth visit. In my experience as a physician, most of the warning signs I’ve identified come from the patient’s history and discussion of their current situation rather than from the physical exam, so I find this phenomenon interesting. Beyond the information gathered from the patient’s story, I’ve used data such as refill patterns or information from prescription drug monitoring program records to identify potential misuse. Although I don’t question how some physicians feel, I’d be interested to understand more deeply why they feel this way and what they find lacking in a telehealth visit.

Another angle that was brought up was the idea that physicians are less willing to prescribe opioids during the pandemic, as well as the lack of alternatives for treatment for chronic pain. Nearly 80% of them are concerned that patients will turn to illicit fentanyl if they can’t get prescription medications, with 86% of them being concerned that illicit fentanyl will lead to higher death rates than prescription opioids. I totally understand not wanting to prescribe controlled substances during a non-face-to-face visit, especially since I was fairly strict in traditional practice as far as random drug testing during visits, and agree that we need better options for treating chronic non-cancer pain. The illegal drug crisis is real and it’s important for physicians to have strategies to identify such drug use, but I don’t think that a telehealth visit rules out that ability.

The report went on to look at drug testing as a component of treatment, with 81% of physicians seeing it as critical to prevent overdose deaths. However, more than half of physicians aren’t following up when presumptive drug tests are positive, and it’s not clear why. Given the capabilities of EHRs to include flowsheets for medication management as well as trackers and prompts for drug surveillance testing, I wish more of my peers would take advantage of those features so that they could more confidently care for patients. Additionally, only a third of physicians felt confident in prescribing naloxone to treat potential opioid overdose. It’s pretty easy to configure order sets that include both opioid pain medications and naloxone, so failing to do so is another missed opportunity to leverage technology. Existing clinical guidelines can be built into the EHR to help with clinical decision making and screening for changes in prescribing patterns.

I think it’s important to not overlook telehealth as a potential adjunct to pharmaceutical pain management. There are many providers out there who offer psychotherapy via telehealth, which could help as part of team-based care to identify patients who might not have their needs met with current pain management regimens. With the potential of using lower-cost resources such telehealth therapy versus in-person physician visits, patients could have more frequent check-ins about their needs as well as the ability to learn additional techniques to better manage their pain. Other options like telehealth-enabled physical therapy could be added for patients who might not be able to participate in traditional physical therapy appointments due to time or logistical limitations.

I polled a few primary care colleagues about the report, and their consensus opinion was that identifying drug misuse was more about having a relationship with the patient and ongoing contacts than it was about being in-person versus virtual. They were significantly more concerned about fragmented care as a risk factor for drug misuse as opposed to telehealth. I’d be interested to hear if any reader institutions are looking further at this issue, and whether they’re reaching different conclusions.

Have any thoughts on the connection between telehealth and prescription pain medication abuse? Leave a comment or email me.

Email Dr. Jayne.

Readers Write: Medical Devices are Evolving, and How They are Managed Needs to Evolve, Too

November 22, 2021 Readers Write No Comments

Medical Devices are Evolving, and How They are Managed Needs to Evolve, Too
By David Klumpe

David Klumpe, PharmD is president of clinical asset management of TriMedx of Indianapolis, IN.

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Technological advancements in healthcare come at a rapid pace. While there are benefits to this, technological evolution can also bring challenges for healthcare systems that strive to run efficiently while maintaining quality care.

The management of medical devices is one such challenge. As devices become more complicated and increasingly get connected to the internet, how they are best managed becomes more complex. Optimum-use decisions are guided by lifecycle factors and cybersecurity risks, not the age of a device on a spreadsheet list or other simple factors.

To best meet the future of technology and retire inefficient practices, health systems can employ a clinical asset management solution to optimize their device fleets, increase staff productivity, and improve patient care.

Let’s talk about inventory accuracy and why detailed visibility into your fleet is the core element to driving efficiencies at scale.

The fundamental task of inventory visibility is knowing exactly what medical devices you have and where they are located. Healthcare staff lose valuable time and become frustrated searching for a device. Are the insulin pumps in this storage closet on this floor? Or on another floor? While caregivers search, patient care suffers.

But inventory visibility is at the heart of capital expenditure decisions, maintenance choices, and cybersecurity needs. A clinical asset management solution can provide real-time visibility and deep insights into the status of a healthcare system’s fleet. Software algorithms can help optimize asset life and disposal timing. By analyzing age, repair history, parts availability, amount of inventory, usage patterns, FDA recalls, cybersecurity risks, and other factors, clinical asset management solutions can establish the true useful life of a medical device and guide decisions on whether it should be replaced.

Perhaps instead of being replaced the device can be upgraded, typically a less-expensive choice than replacement. Clinical asset management teams can weigh factors such as device age, condition, and options for software and hardware upgrades to recommend options.

Visibility also gives insight into which devices should be disposed. Unused equipment still requires maintenance. A better option may lie in selling the equipment to other health providers.

Best use also entails making sure devices are available at the right place and at the right time, at the unit, hospital, and health system level. Meeting demand with existing assets maximizes revenue opportunities while avoiding additional capital expenditures such as medical equipment rental expenses.

Few recent technological advances present as much risk as the internet and the internet of things. The slew of rising cyberattacks with more profound effects is drawing the attention of consumers, businesses, and governments alike.

The threat to medical devices is intensifying as well. At first, the risk of connected medical devices was a vulnerable gateway into a health system where hackers could steal or hold ransom financial, patient, and other sensitive records. In recent years, the threat escalated to target medical devices themselves and render them inoperable. Worse now is the potential for far more maliciousness. Earlier this year, McAfee researchers discovered vulnerabilities in two types of infusion pumps that might allow hackers to deliver double doses of medicine to unsuspecting patients.

Cybersecurity provided by clinical asset management solutions can monitor, detect, prevent, and respond to cyberthreats in real-time. But what can be particularly valuable is a cybersecurity assessment for each device. Manufacturers at some point often no longer support a device, so a patch may be unavailable. What a clinical asset management team needs to know is the seriousness of the vulnerability. The cybersecurity assessment can evaluate the medical device profile, device behavior, and potential impact to patient safety and drive recommendations on whether to replace, upgrade, or dispose of the device to best prevent deadly cybersecurity downfalls.

A key component of the real-time status assessment of every medical device in a fleet is avoiding downtime. When equipment is down, hospital efficiencies suffer. When equipment is down, caregivers become frustrated because doing their job becomes more complicated and time-consuming. When equipment is down, patients grow more irritable with the delays, and quality of service suffers.

A modern clinical asset management solution uses powerful, real-time analytics to optimize device usage and prevent downtime. Spreadsheets or databases provide only a list, widening the risk that device upkeep falls through the cracks. A clinical asset management solution, on the other hand, provides a lifecycle and cybersecurity assessment of every device in the system to maximize device efficiencies in a fleet today and tomorrow.

Readers Write: How to Fill Staffing Gaps Without Hiring

November 22, 2021 Readers Write No Comments

How to Fill Staffing Gaps Without Hiring
By Hadi Chaudhry

Hadi Chaudhry is president and CEO of CareCloud of Somerset, NJ.

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According to the US Bureau of Labor Statistics, nearly 500,000 workers have left the field since the start of the pandemic. Furthermore, burnout continues to plague the workforce. Clinicians and support staff are suffering, but administrative teams are feeling the stress as well. Jobs that were lost when revenues fell off a cliff are now hard to refill. Many furloughed workers have decided to explore other industries or leave the workforce entirely, either to stay home with their families or to avoid vaccine mandates.

As a result, back-office workers have become stretched thin. Claims processing, especially due to new challenges like COVID lab tests, number in the millions of extra claims every week.

New alternatives are helping to ease the two-sided problem of unfilled positions and overworked staffers. Robotic process automation (RPA) is one tool for offloading mundane and repetitive tasks that plague support and administrative workers. Robotic processes can handle everything from claims denials and payment processing to document management. On the clinical side, RPA can automate wellness checks, medical uploads, and CPT code verifications.

RPA can be immensely productive for any healthcare organization. The microbots in RPA solutions are capable of increasing revenue by working through backlogs of thousands of transactions or claims in a single day. Underpayments, appeals, and filing limits are all candidates for RPA automation.

Another solution to staffing gaps is temporary or long-term workforce extension services. These outsourced services take routine, repetitive tasks off the backs of existing workers, saving practices up to 80% in resource costs.

Many payers and revenue cycle companies already depend on workforce extension services, and their use in provider organizations is accelerating. Many workforce extension providers offer talented, highly trained staff that are fully trained in scores of EHR, billing, and practice management systems. Solutions can be very specific and quickly mobilized, with specialists available for a hospital’s specific host applications.

Automation and on-demand workforces perform best when organizations work collaboratively with consultants and service providers. When considering RPA, medical groups should work alongside service providers to address the most repetitive tasks, such as  checking claims status, pre-authorizations, and insurance discoveries.

Organizations can use RPA for the most mundane tasks, leaving on-demand staff to handle more complex duties where a human touch is needed. Oftentimes the 80/20 rule applies — automation can resolve 80% of all routine back-office tasks, while the remaining 20% may require involvement of skilled revenue professionals.

It’s critical that solutions are implemented earlier rather than later. Hoping that situations will resolve themselves is misguided. Both automated platforms and workforce extensions typically take two to four weeks to implement, but the timeline for workforce extension will depend on the size of the incoming team. The longer an organization waits, the more difficult it is to work through backlogs and prioritize results.

On-demand and automated solutions can help with many challenges healthcare employers face, from adequately supporting remote workers to reducing stress and enabling employees to concentrate on patient engaging and revenue-increasing tasks. Small practices, large medical clinics, hospitals, and health systems alike are aware that we’re in a challenging hiring environment. Filling gaps with automation and supplemental staffing is the best way for weary workers, as well as their employers, to succeed.

Readers Write: How Hospitals and Healthcare Systems Can Curb Violence Against Staff

November 22, 2021 Readers Write No Comments

How Hospitals and Healthcare Systems Can Curb Violence Against Staff
By Terri Mock

Terri Mock, MS, MBA is chief strategy and marketing officer of Rave Mobile Safety of Framingham, MA.

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Hospitals and healthcare facilities are seeing an uptick in violence, no doubt attributable in part to frustration caused by the pandemic. Healthcare workers, lauded as frontline heroes 18 months ago, are now at higher risk of violent incidents. For instance, the National Nurses United found that 31% of hospital nurses have faced a small or significant increase in workplace violence, up from 22% in March 2021.

To prevent harm and abuse in the workplace, hospital and healthcare leaders must re-evaluate emergency response plans, adopt better mass communication tools, and support staff more effectively in dealing with abusive or potentially violent patients and aggressive visitors. These interventions are essential if we aim to keep healthcare professionals, especially nurses, from leaving the field.

On the emergency response front, leaders must ensure their teams are prepared and aware of the protocols that exist for dealing with violence in the building. If specific emergency response plans don’t exist for addressing violence, those should be created as soon as possible. If they exist within a bigger collection of emergency procedures and protocols, it’s worth considering when they were last updated and how easy it is for workers to access that information in the midst of a chaotic situation.

Emergency plans should be readily available and tailored to individual roles across the hospital or healthcare network. For larger organizations, it often makes sense to put emergency plans in a central digital repository that staff can access through mobile apps and online portals. That way, workers don’t have to chase down physical documents or navigate an unwieldy file system. They can pull up what they need, look up phone numbers, and take action according to their unique role.

Regarding communication tools, it’s time to go mobile and modern. Hospitals and healthcare systems today need to notify staff of critical incidents wherever they are located. Modern communication platforms enable staff, patients, and even visitors to collaborate in real time using two-way mass notification systems across multiple channels, including SMS, email and voice calls, anonymous reporting, push notifications, audience segmentation, and more.

These platforms also provide mobile apps for personal safety and secure communications. In an emergency, nurses or other healthcare professionals could easily alert security for assistance, give helpful details, and provide ongoing updates, if needed.

Finally, leaders must empower healthcare workers to improve their personal safety. We’re already suffering through a country-wide nursing shortage and burnout. By 2030, we may be short over one million RNs, according to a study conducted by Good Call.

Administrators have to educate staff on the importance of reporting violent incidents and follow through in taking those reports seriously. To carry out their responsibility for duty of care, healthcare organizations need the ability to locate and check on the wellbeing of their employees. Technology can be helpful here to solicit a healthcare worker’s real-time location and status when they may need help.

The ability to locate and contact a mobile, remote, and traveling healthcare workforce can be accomplished using a geo-polling feature available in a mass notification system. Healthcare organizations can require information from their workers with simple poll questions via SMS, email, and voice calls. The responses are collected to ensure every individual’s status and location is made known.

Should a nurse answer that they are in danger or need assistance, security personnel can identify who they are and where they are located, then trigger two-way communications to coordinate a response and facilitate their safety. A follow-up geo-poll can be sent to individuals who did not respond or to obtain further information to direct the appropriate response to their needs. With geo-polling, every healthcare worker’s status and location are known so you can protect and keep them safe.

Healthcare has always been a high-risk industry, and events over the past 18 months have exacerbated many of the challenges healthcare workers face. By updating emergency response plans, adopting better communication technology and giving staff more ways to report violence, leaders can protect the personal safety, decrease risk, and improve conditions for those on the front line.

Morning Headlines 11/22/21

November 21, 2021 Headlines No Comments

Bain, Hellman & Friedman Near Deal to Buy Athenahealth

The Wall Street Journal reports that two private equity firms are close to a deal to acquire Athenahealth for $17 billion, including debt.

Nuance Announces Fourth Quarter and Fiscal Year 2021 Results

Nuance announces Q4 results: revenue up 8%, adjusted EPS $0.09 versus $0.14.

Avodah Closes $7 Million Seed Round to Scale Digital Healthcare Platform with AI Capabilities

Avodah will use a $7 million seed round to further develop its AI-powered AvodahMed technology, which includes remote pre-visit administration, patient monitoring, and care management.

CenTrak Advances Managed Services with Infinite Leap Acquisition

RTLS vendor CenTrak acquires healthcare IT consulting and managed services company Infinite Leap for an undisclosed sum.

Monday Morning Update 11/22/21

November 21, 2021 News No Comments

Top News

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The Wall Street Journal reports that two private equity firms are close to a deal to acquire Athenahealth for $17 billion, including debt.

Bain Capital and Hellman & Friedman LLC are reported to be the high bidders in an auction of the company, which its owners planned to have completed in early 2022.

A private equity firm and hedge fund took Athenahealth private four years ago after they forced the ouster of CEO Jonathan Bush, combining the company with a GE Healthcare unit it had acquired and renamed to Virence Health. Their  total acquisition cost was $6.8 billion.


HIStalk Announcements and Requests

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The significant concern poll respondents have about remote patient monitoring is that they will need services that aren’t readily available, which explains why investor-backed companies are springing up to provide paramedics and other licensed people to visit patient homes for the hands-on component that would otherwise require a trip to a provider’s location. IANAL questions why a patient would choose care at home when it is perceived as inferior and may not save the patient money, while Paula says triaging will be important since not all recoveries or home situations support at-home care. I agree with both comments – it may be that at-home care isn’t appropriate for many or most patients and will never deliver on “hospital at home” expectations, but could provide a way to reduce the length of hospital stays and make some patients happier. Payment will likely drive adoption as it always does in healthcare, so the ball is in the hands of CMS and insurers.

New poll to your right or here: How are your employer’s 2022 business prospects looking compared to 2021?


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

I was curious about the stock performance of digital health companies that have gone public in the last couple of years, so I asked Chris McCord of Healthcare Growth Partners – which is my go-to source for brilliant market analysis – if he could save me some legwork with a list of companies. I excluded those that I consider marginally tech related, such as Medicare Advantage insurers and primary care operators, which left me with this list:

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  • About half of the companies are trading at below their initial offering price.
  • Companies that went public via a SPAC merger performed much worse than those that did an IPO. SPAC popularity as a mechanism to go public has plummeted in the last few months, with some of the shell companies failing to find acquisition targets within the required timeframe.
  • Buying an equal number of shares of each company at their IPO price would have increased the investment by about 37%, but obviously over various time periods.
  • While Phreesia is the big winner in price change, Doximity has earned the highest market cap at nearly $13 billion after just five months of public trading.
  • Livongo fell off the list since it was acquired by Teladoc Health, whose share price has increased 516% since its July 2015 IPO even though share price is down 56% from its January 2021 high.

Nuance announces Q4 results: revenue up 8%, adjusted EPS $0.09 versus $0.14. The company’s acquisition by Microsoft is expected to close in early 2022.


People

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Population health management platform vendor AssureCare hires Ankit Rohatgi, MD, MBA (Medpulse) as chief clinical officer.


Announcements and Implementations

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Vocera releases a skill for Amazon Alexa that allows patients to reach the right care team member and obtain stay information using voice requests made to an in-room Echo device.

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Spok launches GenA, a one-way alphanumeric pager that includes a high-resolution display, advanced encryption, and over-the-air remote programming to provide reliable, survivable, and affordable critical communications capability regardless of cell coverage.


Sponsor Updates

  • Clearwater publishes a new report, “Connecting the Dots Between Cyber Risk and Patient Safety.”
  • PMD celebrates its 23rd anniversary.
  • Sonifi Health publishes a new case study, “How technology can improve HCAHPS Scores: A 5-year impact case study.”
  • Sphere releases the results of a consumer survey focused on the use of online payment tools for medical bills.
  • HIStalk Sponsors exhibiting at RSNA November 28-December 1 in Chicago include Agfa HealthCare, Change Healthcare, Elsevier, Lyniate, Mach7 Technologies, Nuance, OneMedNet, Sectra, Visage Imaging, and Wolters Kluwer Health.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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Weekender 11/19/21

November 19, 2021 Weekender 2 Comments

weekender 


Weekly News Recap

  • Athenahealth’s private equity owners are reportedly in final discussions to sell the company for up to $20 billion.
  • Healthcare payment options platform vendor PayZen raises $15 million.
  • HIMSS estimates that modernizing public health IT systems will cost $30 billion.
  • The US Coast Guard completes its Cerner implementation.
  • Healthcare API company Ribbon Health raises $43.5 million.
  • QGenda acquires Schedule360.
  • Lightbeam Health Solutions acquires CareSignal.
  • Medidata Solutions co-founder Glen de Vries dies in a plane crash.

Best Reader Comments

[Amazon Care] sounds like how employees get care from their local doctor’s office through employer-provided insurance? Except with another megacorp inserted into the mix to soak up some healthcare dollars. I guess the home visits are unique but that will last only as long as the option doesn’t have any real utilization. (IANAL)

Just to be clear, Teladoc paid almost no cash for Livongo — about $11 cash a share which was then valued at $150. The rest was in stock. Still a great sale by Glen Tullman but there’s doubtless an alternative universe where the two companies are going after each other, with one paying up to build out a chronic care management operation and the other building a telehealth service. (Matthew Holt)

Medicine shouldn’t be a lousy job, but from what you write, it clearly is in many cases. I would think that telemedicine will become very common particularly in true health systems where providers across the whole system are using the same EHR – telemedicine, urgent care, ER, PCPs, specialists, and everyone else. I get my care from a such a system and it is comforting to know that however I need to get care for a particular thing, my up-to-date and comprehensive records will be available as long as I’m getting care in system. (West Coast Vendor Mgmt)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. D in Arkansas, who asked for supplies, furniture, and math kits for her special education high school class. She reports, “I can’t tell you how much your donations have impacted my class. Being in special education, I deal with a low budget and many needs. So many of them have excess energy and now they are able to fidget around on their new stools without disturbing others. This has given them the opportunity to focus on the assignment rather than being constantly distracted by being redirected for making noise. The analog clock has been used by every class as we work in calculating the time and the time difference in word problems. The foam bag is a favorite of every student! They can relax, read and enjoy a break from the typical chairs and tables. Our students learn best with hands-on activities and the construction paper has given us the ability to build and create scenes from books, work geometry, and bring numerous projects to life in science. We are forever grateful for your kind generosity and will pay you back with our success in the future as productive members of society.”

Hospitals in Israel are dealing with incidents of mass violence such as parking lot gunfights, mobs attempting to force their way into EDs that are treating crime victims, and a funeral that turned into a shootout in which participants then stormed a hospital.

CDC predicts that when total ICU bed capacity reaches 75% in the US, 12,000 excess deaths can be expected in the following two weeks, while exceeding 100% of ICU capacity could be associated with 80,000 excess deaths.

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Apple profiles Northwell Health’s use of T6, an IPad trauma care app that was previously used only by the military. The app’s name refers to the six hours in which a traumatic injury requires medical intervention to achieve the best outcome. Northwell Health trauma surgeon Omar Bholat, MD, MS – who is also an Army reserves command surgeon who has deployed on six combat tours – says, “T6 is going to help streamline the flow of data from the point of injury to the ICU and everywhere in between. That’s going to be huge for trauma medicine, whether that’s civilian or military.”


In Case You Missed It


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Morning Headlines 11/19/21

November 18, 2021 Headlines No Comments

Athenahealth sales process is said in final stages

Sources report that several private equity firms are vying to acquire Athenahealth in a deal that could bring sellers Veritas and Evergreen Coast Capital as much as $20 billion.

SignalFire Backs ‘Care Now, Pay Later’ Pioneer PayZen to Fuel Healthcare Affordability

Healthcare payment options platform vendor PayZen raises $15 million in a Series A round.

Tech suppliers chosen for £5bn NHS digital records framework

The UK’s NHS selects 46 companies, including Nuance, Conduent, Hyland, and 3M Modal, to provide digital document services and related hardware and software.

Medicom Technologies Closes Oversubscribed $21.8M Series B Financing

Medicom, a health information network specializing in medical image sharing, raises $21.8 million in a Series B funding round.

News 11/19/21

November 18, 2021 News 5 Comments

Top News

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Healthcare payment options platform vendor PayZen raises $15 million in a Series A round.


Reader Comments

From Clicker: “Re: clicks. You have said you track certain clicks on the site. I’m wondering which had the highest numbers.” I usually count clicks for announcement of a new sponsor, a webinar, or anything for which I’m trying to gauge reader interest for future coverage. The most-clicked items (3,000 to 4,000 clicks each) were new sponsor announcements (which make up the top five spots), webinars (six), top-of-page banner clicks (two), and an interview (one). The question made me wonder about our webinar recordings, where I found that the one Frank Poggio and the late Vince Ciotti did in 2014 about Cerner acquiring Siemens Health Services has drawn 8,700 views, including one from me today as I enjoyed hearing Vince’s voice again.


HIStalk Announcements and Requests

HIMSS22 starts in 116 days. Early bird in-person pricing of $895 is good until January 10. I’m still waffling on whether it’s worth my time and money to attend, so I haven’t registered or booked a place to stay. You?


Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


Acquisitions, Funding, Business, and Stock

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Aptihealth, which matches health plan and health system customers with behavioral health providers, raises $50 million in a Series B funding round.

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MedArrive, which offers at-home care from licensed professionals such as paramedics as an adjunct to virtual visits, raises $25 million in Series A funding. Co-founder and CEO Dan Trigub spent short stints at Uber Health and Lyft before starting the company last year.

Precision medicine vendor Tempus announces that eight institutions are live on integration with Epic’s genomics module, which embeds Tempus test ordering and genomic data delivery into existing clinical workflows. The companies say that integration timelines will be reduced from months to weeks in 2022.

CVS will close 900 of its stores over the next three years, nearly 10% of its total, as online shopping has reduced customer demand for near-home convenience and the additional of in-store health services creates new demands for layout and location.

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Teladoc’s investor day presentation predicts that consumers will expect virtual-first encounters whose quality equals in-person ones and that offer them a variety of coordinated care services. The company says it has evolved from fee-for-service video visits and will become a partner with its customers in offering whole-person care at under value- and risk-based arrangements. It says it will be “the first place consumers turn to for all healthcare needs” for “whole-person care that is personalized, convenient, and connected.” TDOC shares dropped 8% on the day and have shed 25% in the past 12 months, with the company’s market value being $20 billion versus the $18.5 billion in cash it paid to acquire Livongo in late October 2020.


Sales

  • Northeastern Center (IN) chooses the SmartCare EHR of Streamline Healthcare Solutions.
  • Luminis Health (MD) will implement Cedar’s post-visit patient engagement and payment platform, integrated with Epic.

People

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Ochsner Health hires Denise Basow, MD (Wolters Kluwer)  as its first chief digital officer. She has been president and CEO of Wolters Kluwer’s clinical effectiveness business unit for six years and was previously with UpToDate, which was acquired by Wolters Kluwer Health in 2008, since 1996.


Announcements and Implementations

The UK’s NHS chooses 46 companies to provide digital document services and related hardware and software. Among those named for the nearly $7 billion program are Nuance, Conduent, Hyland, and 3M MModal.

A HIMSS report estimates that the federal government will need to spend $30 billion to modernize federal, state, local, and tribal public health reporting and data systems, recommending that Congress provide a minimum of $1.57 billion per year for technology and workforce development. The funding would support electronic case reporting and contact tracing, laboratory information management systems, syndromic surveillance, electronic vital records (births and deaths), a national notifiable disease surveillance system, analytics and visualization staffing, creating incentives for provider data exchange.

HIMSS creates a certification program in digital health transformation strategy, with CPDHTS joining its existing offerings CPHIMS and CAHIMS. Cost ranges from $1,099 to $1,399, while the two-year renewal requires 45 clock hours of continuing education and a payment of $299 or $399.

A review of the de-identified Cerner EHR records of 490,000 COVID-19 patients finds that the use of SSRI antidepressants was associated with a 28% lower relative risk of death.

Three entrepreneurs, including Ricky Caplin (The HCI Group), form The Aurora Forge, which will grow seed-state healthcare and government technology companies and donate the majority of its profits to charity. Several health system CIOs are among its advisors.


Government and Politics

The US Coast Guard finishes its deployment of Cerner as part of the DoD’s MHS Genesis project.


Other

A retiree from Vietnam who was stranded in the US for 18 months because of the pandemic is stuck with a $38,000 emergency glaucoma surgery bill even though the daughter he was visiting had bought him traveler’s medical insurance that had preauthorized the procedure. The insurer declined to pay, saying that his condition was pre-existing even though it hadn’t been previously diagnosed. His only income is a $260 per month pension. The man’s daughter, who had bought him plane tickets home on 14 flights that were eventually cancelled, may be on the hook to pay his bill even though he was finally able to return home because of California’s filial responsibility laws.

In Canada, Halifax family physician Ajantha Jayabarathan, MD wins a family medicine “Big Ideas” contest for her GIS-powered Health Geo-View, which allows virtual visit doctors to visualize the patient’s neighborhood for socioeconomic information, proximity to health services, and environmental risk factors.


Sponsor Updates

  • Olive offers its customers the ability to leverage DARVIS solutions including rapid hygiene check, bed logistics, medical inventory, and sterile equipment completeness.
  • LexisNexis Risk Solutions will work with secure data collaboration company Karlsgate to develop a secure identity resolution platform for the healthcare market.
  • Everbridge introduces the next generation of its Travel Risk Management Solution for business, healthcare, and government customers.
  • Lumeon’s Remote Home Monitoring solution earns Gold in the 2021 EHealthcare Leadership Awards in the Best Business Process Improvement Products category.
  • Magnolia Regional Health Center (MS) adds Prelude Software’s PayPilot to its Meditech Expanse EHR to save time and increase revenue.
  • CareSignal publishes a case study titled “Utilizing Deviceless Remote Monitoring Within a Medicaid Managed Care Plan to Identify Rising Risk for Early Intervention with Promising Results.”

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
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EPtalk by Dr. Jayne 11/18/21

November 18, 2021 Dr. Jayne 2 Comments

Road warriors, get ready. United Airlines has resumed sales of hard liquor on flights after resuming sales of beer and wine in June. Other airlines continue to hold off on serving alcoholic beverages as incidents involving disruptive passengers continue to rise. American Airlines plans to suspend alcohol service in the main cabin until at least January 18. There is still plenty of alcohol for sale in the nation’s airports, and several where I’ve recently traveled now allow passengers to drink the gate area instead of just within specified areas. I’m one of those people who keeps my mask on the entire flight and doesn’t snack or drink except for an occasional sip of water. Hopefully, the changes won’t bring an uptick in bad behavior, but only time will tell.

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HIMSS continues to try to push its Accelerate platform through email blasts. Honestly, I have absolutely no desire to join another social media platform, let alone one that is controlled by HIMSS. I was in the beta group for Accelerate and didn’t find the content to be useful. As for joining the groups they’re pushing now, I already participate in groups through my medical specialty society and through the American Medical Informatics Association, so I sort of feel like I have all the connections I need unless something really crazy happens. If readers have found value in Accelerate, drop me a line – I’d love to hear about your experiences.

From Jimmy the Greek: “Re: monitoring. I recently worked with an organization that was planning to roll out a software package that was embracing its Big Brother tendencies. It monitors how much time you spend in each application on your laptop, how much active typing/mouse time you have, etc. and provides a dashboard to your manager.” The system in question was advertised as allowing employees to “understand your personal work habits allowing you to maximize your workday and reach your potential.” For employees who are in roles that involve a certain amount of throughput, such as medical billing specialists, coders, claims processors, etc. this kind of solution might make sense if people are struggling with meeting their goals and need tools to understand their productivity.

In other roles, I question the need for it unless people aren’t getting their work done. Solutions like that that score people on how much they are “doing” don’t give any credit for the cognitive time preparing to do something or for analysis or strategic thinking. It doesn’t reflect any work done that doesn’t involve the laptop, such as diagramming on the white board, having non-electronic meetings with co-workers, or all the fabulous things that process improvement folks do with Post-It Notes and flipcharts. It’s one more way in which employers can devalue the actual thinking that people do for their jobs.

In medicine, we’re used to it since the cognitive specialties typically get paid far less than the procedural ones, but I don’t think such a focus on “doing” at the expense of “thinking” or “planning” is necessarily a good thing. Of course, it’s all about how the manager uses it, but as an employee, I’d be pretty annoyed by the concept.

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I attended a small gathering this evening with some former co-workers from my last clinical position. Except for me, everyone is still working full time, pulling 12- to 14-hour shifts as COVID-19 cases start to rise again in our community. It was a departure from our usual sessions since most of the attendees brought their children for some s’more making around the fire pit as well as photos with a 10-foot-tall inflatable turkey. It was quite a spectacle, but it was good to see people getting away from the office and doing some normal things with their children (at least until bedtime approached and the meltdowns started).

I daresay none of us at the bonfire think that COVID-19 is “no big deal” or “fake” or any of the things clinicians continue to hear from patients on a daily basis. Most of us are glad we haven’t been infected, and if we have, that our cases have been mild because that’s not always the case with our patients. After I returned home, I was scanning through email and came across an article in the Journal of the American Medical Association that put things in perspective and made me want to tell the moms and dads to hug their children tighter. The piece is titled “Thousands of US Youths Cope With the Trauma of Losing Parents to COVID-19.” It’s something people don’t like to talk about but that those of us in the trenches have seen. In our area, we’ve had several situations where children lost both parents to the pandemic, which is for most of us an unimaginable tragedy.

The article details some of the COVID-19 specific factors that make the situations even more tragic, such as children only being able to interact with dying parents via video calls and inability to hold memorial gatherings. Recent data indicate that more than 142,000 children have lost a parent, custodial grandparent, or grandparent caregiver due to the pandemic, looking at dates from April 2020 through June 2021. The worldwide estimate counts more than 1.1 million children losing a parent or custodial grandparent.

The piece goes on to contrast the losses due to COVID-19 with those from natural disasters or mass tragedies, where intense mental health services are available and where the causative incident is limited. The authors note that surviving children may be “extremely fearful that the virus will kill a surviving parent or siblings or claim their own lives.” They also describe feelings of “intense anger or shame” that may be felt by children mourning the loss of a parent who was unvaccinated or who refused to mask or distance.

As we move into the holiday season, it’s important to pause and think about those families whose holidays will be different this year due to the loss of loved ones. Unfortunately, the death toll continues to climb, mostly among unvaccinated individuals. For those on the fence about vaccination, I would offer the suggestion that becoming vaccinated might be the best gift you can give your family and yourself. I’m looking forward to spending time with my vaccinated and boosted family members who are in their 70s, 80s, and 90s as well as doing the traditional holiday things we usually do, some of which are a bit kooky, but that’s what family is all about.

What are your plans for the holiday season? Leave a comment or email me.

Email Dr. Jayne.

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