Donors Choose Updates 12/19/19

This will be a lengthy summary of this week’s Donors Choose activity, all of which was funded by HIStalk reader contributions. Donation instructions:

1. Purchase a gift card in the amount you’d like to donate.
2. Send the gift card by the email option to mr_histalk@histalk.com (that’s my Donors Choose account).
3. I’ll be notified of your donation and you can print your own receipt from Donors Choose for tax purposes.
4. I’ll pool the money, apply all matching funds I can get, and publicly report here which projects I funded, including teacher follow-up messages and photos.

Donations from Christina, Bill, Mike, Carla, and Diameter Health

These donations totaled $2,850. My Anonymous Vendor Executive matched their donations two-for-one, plus I found third-party matching (up to five-to-one) that allowed me to fully fund at least $30,000 worth of classroom projects. I choose mostly math and science teacher grant requests unless a teacher’s write-up moves me to meet a different type of classroom need.

• Physics lab supplies for Ms. S’s high school class in Hayward, CA
• A Lego station for Ms. S’s first grade class in Grants Pass, OR
• Headphones for Ms. M’s kindergarten class in Chandler, AZ
• Game buzzers and wobble cushions for Ms. H’s elementary school class in Pink Hill, NC
• STEM activity kits for Ms. A’s elementary school class in Glendale, AZ
• Programming logic games for Mr. C’s elementary school class in New York, NY
• Electronic white board technology for Ms. E’s elementary school class in West Sacramento, CA
• A programmable robot for Mr. L’s middle school class in Espanola, NM
• A document camera for Ms. R’s middle school class in Houma, LA
• A physics professional development course for Ms. S, a high school teacher in Hayward, CA
• Computer lab headphones for Ms. M’s pre-school class in Theodore, AL
• STEM kits for Ms.G’s first grade class in Los Angeles, CA
• Wiggle chairs for Ms. E’s first grade class in Richton, MS
• Osmo coding games for Ms. F’s first grade class in Ypsilanti, MI
• Dry erase boards for Ms. G’s technical high school class in Cleveland, OH
• Legos and K’Nex kits for Ms. P’s elementary school class in Stratford, CT
• STEAM lab kits for Ms. H’s elementary school class in Glenarden, MD
• Robotic programming kits for Ms. P’s kindergarten class in Moreno Valley, CA
• Headphones for Ms. S’s elementary school class in Miami, FL
• Math centers for Ms. T’s elementary school class in Frankfort, KY
• Robotic competition supplies for Mr. H’s high school class in San Francisco, CA
• Hands-on math activities for Ms. T’s pre-K class in Houston, TX
• STEM supplies and reading games for Ms. N’s elementary school class in Miami, FL
• A programmable scientific calculator for Mr. H’s high school class in Bakersfield, CA
• STEAM kits for Ms. C’s elementary school class in Las Vegas, NV
• A table for Ms. M’s middle school class in Palermo, CA
• Programmable robots for Ms. E’s first grade class in Emerson, GA
• Programmable robot for Ms. L’s pre-K class in Halifax, VA
• A projector and Chromecast for Mr. G’s middle school class in Penitas, TX
• A programmable robot for Ms. B’s middle school class in Phoenix, AZ
• Classroom supplies for Ms. G’s elementary school class in Bayonne, NJ
• A document camera for Ms. P’s elementary school class in Irvington, NJ
• A programmable robot for Ms. M’s elementary school class in Seguin, TX
• Composition supplies for Ms. C’s International Baccalaureate class in Hempstead, NY
• Dry erase boards and chart tablets for Ms. J’s elementary school class in Springfield, MA
• Headphones for Ms. K’s elementary school class in El Monte, CA
• Library carpet and seating for Ms. S’s kindergarten after-school program in Philadelphia, PA
• Math towers and indoor recess supplies for Ms. W’s all-girl fourth grade class in Bronx, NY
• A classroom library of books for Ms. O’s middle school class in Glendale, AZ
• A trip to the health museum for Ms. C’s high school class in Houston, TX
• A programmable robot center for for the elementary school library of Mr. H in Stockbridge, GA
• Wiggle chairs and math games for Ms. S’s kindergarten class in Cincinnati, OH
• Pep club supplies for Ms. M’s middle school class in Ayden, NC
• Multicultural learning materials for Ms. M’s preschool class in Fayetteville, NC
• Math games for Ms. H’s preschool class in Midland, MI
• STEM centers for Ms. S’s elementary school class in Brooklyn, NY
• Space learning materials for Ms. B’s elementary school class in St. Louis, MO
• STEM and coding resources for Ms. R’s elementary school class in Grand Prairie, TX
• An Apple TV for Mr. K’s high school class in Kansas City, MO
• An interactive learning tablet for Ms. M’s head start class in Kalamazoo, MI
• Lego kits for the library of Ms. G in Dallas, TX
• STEM kits for Ms. O’s elementary school class in El Paso, TX
• STEAM kits for Ms. W’s elementary school class in Chesapeake, VA
• Programmable robots for Ms. O’s elementary school class in Paintsville, KY
• Wi-Fi microscopes and headphones for Ms. W’s elementary school class in Cleburne, TX
• Math manipulatives for Ms. C’s preschool class in Blountstown, FL
• Programmable robot for Ms. K’s gifted elementary school class in Atlanta, GA

A Sample of Initial Teacher Responses

I want to thank you for contributing to this project. Thank you for caring for 28 girls you have never met BUT whose lives you have impacted.

This is my first experience with Donors Choose. What an amazing experience it has been! The idea that we, in public education, have partners who look for opportunities to fund learning activities for our students is life changing. Funds are hard to come by in an urban school. Our students will be building Lego projects in the library for years to come. Who knows where they’ll go from here? My heartfelt thanks.

Thank you for gathering my students in your arms and giving them a huge hug. Thank you for “dropping a stone” and creating a positive ripple in each of these kids’ lifelines.

Christmas came early in Room 305! Thank you so very much for your generous donation!! My students and I are so excited for the STEM activities to arrive! I can’t wait to see their little creative minds grow!

Thank you so much for your contributions that led to the funding of my project! Because of your contribution, I will be able to grade student work more efficiently, spend greater time planning dynamic, student-centered learning activities for my students, and introduce them to technology they will use increasingly more as they progress to more advanced math classes. Your donation will allow me to be more effective as a teacher by providing me with a valuable tool used in evaluating student work and in planning student learning. Thank you so much for this generous donation to my classroom!

I am overwhelmed by you generosity! This kind of project is something that will really motivate my students and I couldn’t have funded it without you. This is incredible news that will shape the rest of the school year. A classroom full of Kindergarten students says thank you, thank you, thank you

Words cannot express how appreciative of your generosity I truly am. My students will enjoy the ability to code and build using the new tools they will be getting thanks to your donation. Our classroom will be an energized, STEM class when our new tools get here. Thank you again for your support!

Thank you so much for supporting my students and their learning! I hope to be able to use these headphones to enhance their learning during Tech time and improve their scores in both Math and Language. They are going to be so very happy to have their own headphones now!

I’m overjoyed to be able to bring hands-on coding experiences to my youngest students. You made this possible with your generous donation. I plan to quickly implement lessons where the Code and Go Mouse kit and the board game will allow my students to fully comprehend coding while using computational thinking. Thank you for making this all possible!

Thank you so much for investing into the lives of the scholars in my classroom! Every Friday, we set up STEAM labs for scholars to rotate through where they are free to explore, create, and investigate. Thanks to your donation, we can continue to strengthen the curious minds of 20 scholars who come from environments where success is just a dream!

On behalf of the third grade students here at Cooke Elementary, we thank you for helping us achieve science greatness. We have learned to love science, but with the new microscopes it will deepen our love because we will be able to seen the unseen. The earphones will give us the opportunity to learn with disturbing others around us.

WOW is all I can say. You have made our dreams come true. I can see my students growing and learning by leaps and bounds. They love computer time and their biggest complaint was they wished they had headphones to hear better. The kids are blown away by your kindness. Thank you for the headphones and Happy Holidays.

This will make me and my class so happy!! These items will make coming back to school after break that much more exciting. You have no idea how appreciative we are. I can’t wait to show my mini engineers in action.

Thank you from the bottom of our hearts. Your kindness has warmed this cold day and made us all believe in the kindness of others. All I can say right now is WOW! You all have made our learning dreams come true. These supplies are going to motivate our students to think and dream big. They already LOVE learning. Thank you for the coding projects. Again, THANK YOU so much for supporting our class!

My students and I deeply appreciate you taking the time to make our dream come true. We are very excited about having an active Pep Club at our school. With your help, our Pep Club will be able to provide support to all of our teams at all of our events. You have helped ensure that our students will have a very Happy New Year. We wish the same to you.

Words can’t express the happiness I feel that my students get to experience this field trip. They would not otherwise been presented with an opportunity as this. Thank you very much for helping me to give another avenue for presenting my subject to my students. Thanks for your donation.

As an educator, it is very important for me to enhance my knowledge and teaching skills from time to time, to better serve my students. But the tuition sometimes withhold an educator. Your support is very appreciated. It will help me to do my job effectively. This course will enable me to learn new strategies to teach high school science by incorporating, math, and engineering in it. This will impact all my students by increasing their subject comprehension. Thank you once again!

I cannot thank you enough for your generosity! The supplies will provide my students will the tools that they need to understand the importance of physics concept-waves and relate it to real life. These supplies will help my students to do real science by experimenting ( and not just reading about it). Thank you so much for considering my project. The supplies will help me to teach science effectively.

Words can not express my gratitude toward you for fulfilling my project. Books are a very important part of a child’s education. I explained Donor’s Choose to my students and they are also very grateful and wanted me to thank you from them.

My students are going to love the STEM Kits you helped bring to our classroom. Preparing our children for the future is key and with your generosity, we are getting them on their way! We truly appreciate your support and thoughtfulness!

I couldn’t believe it when I opened my email and saw that my project was fully funded. My students are going to be so excited to be able use Legos and K’nexes to test and explore Science, and engineering concepts. Thank you again for supporting my students’ learning!

With these additional Osmo resources, my students will be able to work independently or collaborate with other students. These games will increase our coding skills, critical thinking, reading, and leadership habits. I can’t wait to watch my students get started!

Thank you so much for your donation and support of Donors Choose, public school, and my classroom. I cannot tell you how much this means to my students and classroom. Having adequate and functional workspace is so important to student learning and classroom culture. Thank you, thank you! My students are going to be thrilled. I cannot wait to tell them the good news. Thank you for your generosity.

These multicultural books and posters that will give my students exposure to the world around them. The posters are real and relevant pictures of real families from around the world and the diverse photos of people of all ages and cultures from all over the world! I could not provide the hands on materials my young students nee without donors like you and Donors Choose. I am externally grateful!

We have really been working on math skills and helping families so that they can work with their child at home too. We are so excited to be able to offer fun games and activities to families during our March into Math event!

Thank you so much for your generous donation! I cannot wait to start implementing this interactive board and I am excited for all the possibilities to further engage my students. This device can be used in math, ELA, science, and all other content areas. I know my students will be incredibly excited to use this!

My students will be able to truly see their work come alive in front of them. Their level of understanding is going to jump by leaps and bounds. Their ability to read and be successful writers is going to be so much more obtainable. I thank you for taking a part in our future leaders and being so selfless to change the trajectory of a child’s future.

My students will be very happy when they use the kits to develop their programming skills. They are going to show their coding skills to their parents and friends. It is the best Christmas gift for my students and my school. Thank you.

Thank you so much for funding my Wobble and Buzz project! My students are super excited about the wobble seats and buzzers so they can wobble and buzz themselves to success. My students will be more attentive during activities involving our buzzers by using the wobble seats to help them stay focused.

We are excited to learn all about space with the many goodies we will receive! I know students will enjoy counting astronauts, putting together the spaceship gears, and listening to the many space stories coming our way. The planets will be perfect for when we learn all about them! Thanks again.

Headphones will benefit my students tremendously since many of them have a reading deficit and need passages and questions read to them. This will be another learning tool that will be beneficial in learning centers and online interventions. Thank you again for your generosity!!

With your help we are building a robotics problem that is free for the students and their parents or guardians. These items help build a robot that the students can compete against more well-funded high schools. Thanks again for your support.

We are so appreciative and thankful that you chose to fund our project! There are so many amazing things that we will be able to do with these supplies! We will use these supplies in ALL of our learning centers! Thank you again and again!!

I am in shock, and so grateful that my students will be able to have these dry erase board to use in class! These dry erase boards will allow my students so many opportunities in class! Thank you so much, once again this means the world to both myself and to my students.

I am beyond grateful for the opportunity to bring 21st century skills into my gifted classroom! I am always on the lookout for innovate resources to enrich and engage my gifted students. Students will be so excited to dig into coding when we return from Winter Break.

EPtalk by Dr. Jayne 12/19/19

There’s a battle raging in Colorado over the Drug Enforcement Agency’s ability to access data within the state’s prescription drug monitoring program. In the course of investigating pharmacies, the DEA requested the data via a subpoena rather than a search warrant. The state claimed that the DEA request was indiscriminate, requesting six years’ of data for over 200,000 prescriptions. They offered to provide anonymized data and to comply with more specific requests with names.

The American Civil Liberties Union has entered the fray in Colorado district court, claiming that tight standards are required to protect privacy and requesting that patients should be alerted that the data will be disclosed or that the court should require a search warrant. The prescription drug monitoring databases have been a significant benefit for clinicians – it’s much easier to identify patients who might be inappropriately using controlled substances. This can lead to earlier interventions and improved outcomes. Let’s hope the legal battles have a favorable outcome that doesn’t take away from the important

A recent JAMA Network Open research letter looked at EHR usability, finding that progress is slow and sometimes nonexistent. The authors looked at 70 vendors who had participated in the Meaningful Use program over multiple years, finding that a good number fell short in usability testing. Only 27 vendors met the inclusion criteria, which included having a computerized provider order entry system, certification according to the safety-enhanced design criteria, and a reported System Usability Scale (SUS) for 2014 and 2015 usability requirements. They found that “there was no statistical improvement in EHR SUS scores between products certified according to 2014 and 2015 standards. One-third of 2014 products and one-quarter of 2015 products fell below the average benchmark SUS score.”

Despite the implications of EHR dissatisfaction on clinician burnout and patient safety, SUS scores decreased for 44% of vendors from 2014 to 2015. The authors note that the study has limitations, including that the SUS scores were vendor-reported and may not fully reflect EHR satisfaction. They go on to conclude that, “An increased focus on clinician end users during product design and development as well as optimized certification requirements are needed to improve usability.”

My personal, albeit anecdotal experience with usability is that for many vendors, it improves in fits and spurts. When they’re under the gun with certification requirements, they focus on it less, and when there is more breathing room, they seem to make a little progress. Given the amounts of money that health systems have spent on EHRs, they’ve created captive EHR users who are basically stuck with what they have. Even if it’s a failure, there’s little money left to make a change.

I enjoyed this Forbes piece on “Why Big Tech Companies Won’t Solve Healthcare’s Biggest Challenges.” Google and Apple are trying to disrupt healthcare, and both have the potential of significant earnings in the process. Still, it remains to be seen whether they truly understand the complexities of healthcare and whether they’re going to be able to set aside profit motive for altruism when it counts. There are also concerns about companies with obvious retail and profit motives having as much access to personal data as they might have moving forward.

The piece brings up some interesting points about whether patients should share in the profit from the use of their data. They point out the situation of Henrietta Lacks, whose cancer cells were used for decades of research without appropriate compensation. If you’ve never read it, “The Immortal Life of Henrietta Lacks” is worth a read. Hopefully we can all look back in a decade or two and see that good things have happened with the tech giants, but I agree that they’re not likely to find magic solutions for all our healthcare and technology problems.

I’m working on a project with a client where I’ve been asked to cull through potential technology solutions for a new service line they hope to take on. I’ve been sifting through websites, marketing collateral, and the pedigrees of various company leaders trying to determine whether the solutions are even viable. There are a lot of cool technologies out there, but some companies don’t look like they will have much staying power in the market.

We’ve moved into demos from some of the vendors, and I was shocked today to find myself on one where the demo data was not only nonsensical, but offensive. The patient scenarios used were degrading and it left me wondering whether they actually have any physicians on staff to guide them. Even if you’re a startup, spend a little money on physician expertise to ensure you don’t look foolish to potential clinical end users. If you’re not ready for a full-time physician on staff, there are plenty of clinical informatics experts who do contract work.

Despite the overwhelming coverage of impeachment proceedings, Congress is still getting other work done. The Telemental Health Expansion Act of 2019 has been introduced and referred to the Energy and Commerce Commerce. The Act would expand Medicare coverage for mental health services delivered via telehealth, and include the patient’s home as an acceptable “originating site” for services. This is much more useful to patients than having to go to a PCP or other office to receive telehealth services from another provider. There are several similar bills already working their ways through the halls of Congress, so perhaps one of them might be successful.

Tis the season of giving, and many of us are looking for ideas for our friends, family, and coworkers. I thought this piece on “Thoughtful and Useful Gift Ideas for Doctors” might be helpful. The first suggestion was a book on preventing burnout, which was a turn off. Much more interesting was their list from last year, which lead off with “caffeine and booze.” Some of the other items on the list were snoozers, although giving the gift of a defensive shooting class caught my attention.

In other holiday news, there’s support for why some of us dread listening to holiday music. There’s data showing that increased repetition of songs can lead to oversaturation and negative responses. Adding this to existing holiday stress and the effects can be compounded. According to data from Consumer Reports, nearly a quarter of Americans dread holiday tunes. I certainly enjoy holiday music in live performances, but the versions typically heard while shopping can be annoying.

Email Dr. Jayne.

Morning Headlines 12/19/19

Streamline Health(R) Announces Signing of Definitive Agreement to Sell Enterprise Content Management (ECM) Business to Hyland

RCM vendor Streamline Health will sell its enterprise content management business to Hyland.

Blue Button 2.0 API Update

CMS temporarily shuts down the Blue Button 2.0 system after a developer notifies the agency of a bug that may have improperly exposed Medicare beneficiary data.

NTT DATA Services to Acquire NETE, Expanding Digital Transformation Capabilities in the Federal Healthcare Sector

NTT Data Services will acquire 300-employee NETE, which provides digital services including analytics and cybersecurity to NIH, CMS, and HRSA.

LifeLabs users wise to worry about fraud, ID theft after mass data breach say experts

Canada’s largest laboratory testing company notifies patients of an October ransomware attack that compromised a server used for online appointment bookings.

HIStalk Interviews Laura O’Toole, President, Santa Rosa Consulting

Laura O’Toole is president of Santa Rosa Consulting of Franklin, TN.

Tell me about yourself and the company.

I’ve been with Santa Rosa Consulting for 10 years and have played many roles here. I’m a passionate person. I pride myself on being a good mother and I live my life every day with gratitude and an appreciation for our industry because I’m a breast cancer survivor.

Santa Rosa is a professional services company that focuses on outcomes-based solutions for our clients. As of late, we are leading with more niche and meaningful services that we think our clients need to pivot to in continuing to be successful.

How did your experience as a patient with breast cancer change your perception of the healthcare system?

It has changed it a lot. It has certainly given me more appreciation for the importance of integration and communication among providers. That was a point that was very frustrating to me. Even as well as I can navigate the system, it also got me to see, upfront and center, how important it is to be an advocate for yourself. As a patient, you have to make a conscious choice to engage in your own care.

As somebody who has grown up in this industry and made it my whole career, it gave me a sense of empathy and almost a sadness for patients who don’t know as much as I do and the number of their questions that don’t get answered along the journey of being sick.

But mostly it gave me an appreciation for this industry and for what we all do. I do believe all of us — regardless if you’re a vendor, a professional services company, or whoever you are in this space that serves patients — want what’s best for patients. We as an industry have an obligation to do more to keep that patient at the center and to focus on the importance of clinical workflow.

It changed my life being sick, frankly. It made me look at everything differently. I live my life with a level of gratitude that I never had before. There’s still a lot to do in our space to make it better for patients.

How did you see the importance of technology as a patient versus what you expected?

Technology is the cornerstone of the building and at the center. Even as someone who operates every day in health IT, I never realized how important it is. If clinicians and providers could embrace technology as much as their IT counterparts do, we would start to see some real magic.

How has the demand for consulting services changed in the past few years?

The landscape has really changed. We have seen that as some firms are still around and some aren’t. Back in the day, everybody was focused on Meaningful Use because there was a lot of opportunity. I believe now that the healthcare professional services space needs to continue to put their clients at the center, but specifically to define value-add, niche, or bolt-on services.

So many of our clients now have implemented their core EHR. How do you take them to that next level? The consulting firms that can provide the most value to their clients are the ones that are looking out past where our client is today and listening to the client and what isn’t working for them.

We think the timing is right for test automation. Our clients simply cannot meet the escalating demand for the comprehensive testing that is required of the complex IT ecosystems that we’re seeing, along with the frequency of upgrades and releases from their EHR vendors. Clients don’t have the money or the resources to have armies of people, additional testers, and pulling their subject matter expects out of their day jobs away from being out in front with their business partners solving problems.

I believe that niche offerings like test automation — built from the ground up exclusively for healthcare and workflow centric — can give our clients more time, more energy, and more focus on their projects and patients. This is where the services for consulting companies need to go.

Integration as a service is critically important for our clients. Being able to fill a client’s needs just in time and to help them on the talent curve is also important.

The company does a lot of Meditech work and that company has made big changes to both its products and leadership team. How will their new professional services offering affect your business?

Certainly a large part of our business is around Meditech. We are a 6.1 Expanse partner. We have a detailed implementation methodology. I think we are the only firm that is confident enough in our delivery that we can provide that implementation on a fixed-fee basis. Meditech is transforming their business and their company. I believe they will be one of the three players left standing.

It’s interesting to me that they have focused on professional services. We believe it’s better to have an independent third party supporting our clients. We believe it drives better outcomes for our clients and that the client should always be at the center.

That said, we have great appreciation for what Meditech is trying to do. We will work alongside them, and with them, to continue to serve our clients and to do what’s right. I love the Expanse platform. It will take many of the Meditech clients that move to that platform to a whole other level of interoperability and care for their patients, so I commend them.

Are your clients asking for help with the industry’s move to the cloud?

Anything that we can do, or that vendors can do, to support interoperability for clients is the right thing to do. If you think back even if a few years ago, we had big health systems not wanting to share data and vendors not wanting to share information. But the constituents that need to share data are our patients and our clinicians. The more that we can evolve and support even bolt-on solutions or capabilities that provide interoperability is what is best. The cloud, and moving as much as we can to create a landscape that allows for more interoperability, is the right thing to do and what we all need to focus on. For our clients where that makes sense, that is our recommendation.

We also advise our clients that they need to look at other solutions and some bolt-on solutions that can take them up the delivery curve to best serve their patients and their physicians. It’s not always about the core vendor. Certainly that’s the cornerstone of the building, if you will, but there’s still a lot that can be done to make a difference and to get more niche services that can provide the optimum value.

How you determine the right time to develop a service line around a particular technology based on its maturity?

In professional services, it is “some days peanuts, some days shells.” You have to take the time to listen to your clients. We have built our company around several flagship accounts where we have done work from our inception as a company. We will continue to do that. We regularly talk with and use a core set of great talent within our client base to hear what their problems are, to try to get ahead of that curve.

There will be some that you will hit on, some that you will miss on. As I mentioned, test automation and the results and benefit for a client are just undivided. Clients like Novant Health, one of the leaders in the implementation of Epic, have realized dramatic improvements and time savings in their testing capabilities. They have been results driven and have the opportunity to reduce real risk in patient safety in clinical care and in revenue cycle integrity.

There’s a whole host of secondary benefits to that. Education and training. Everyone uses the word optimization. I don’t like that word, but taking their EHR up the value chain for their providers, for their clinicians, and improving data quality. If you focus on the core of what will make a health system successful and keep it around those offerings that can reduce time, save them money, and propel them into the future, you are doing the right thing for your clients.

You will always have some that that hit and some that don’t. You have to have a core base of flagship clients that know you, trust you, and know that you mean what you say and say what you mean. It becomes a personal commitment to serve them well. If you have that as the basis of who you are, you will do well, figure it out along the way, and as some offerings catch and some don’t, ride that wave and continue to do good work.

Do you see any little-recognized developments that could take the industry in a different direction?

I don’t see a tremendous amount on the horizon from a regulatory perspective as we did in the rear view mirror of the past. All of the clients that I talk to are trying to figure their integration and  governance strategy for telehealth. I think that will propel us. You’ll see a lot more in home health and outside the traditional box. Integration and integration as a service is an area we’ll focus on. 

You have to be able to plug and pull and have time available when a client needs it. They are just like us in going through ebbs and flows. There will be a dramatic need for high degrees of flexibility because our clients need to be able to provide quality care and some of them are struggling to get there without looking at the full landscape of everybody that is providing care in their ecosystem. Telehealth will be an interesting dynamic over the next several years.

Do you have any final thoughts?

I love our industry. All of us in healthcare want to provide value for our clients so that they can better serve their patients. Being a patient myself, I’ve gained such an appreciation for that and a gratitude for what providers and clinicians do every day to serve our clients. I look forward, as does Santa Rosa, to staying a part of that industry that supports care and makes a difference for people.

At the end of the day, we all have people who we love and care about that we want to see healthy. Healthcare is a beautiful place to be and I’m delighted to be a part of that industry and to serve it.

Morning Headlines 12/18/19

Announcing ICD-10-CM and RxNorm Ontology Linking for Amazon Comprehend Medical

Amazon Web Services adds ICD-10 and RXNorm linking to its Amazon Comprehend Medical natural language processing service.

Nashville executive lands head job at CMS innovation center

Aspire Health co-founder Brad Smith will become the new head of the Center for Medicare & Medicaid Innovation.

Fujifilm to buy Hitachi’s diagnostic imaging business

Fujifilm will reportedly buy Hitachi’s diagnostic imaging business for $1.5 billion to improve its competitive position against Siemens, GE, and Philips.

Tidelands Health network impacted by malware attack

Computer systems of three-hospital Tidelands Health (SC) are apparently still down following a malware attack of an unspecified nature last Thursday.

1-800 Contacts Enters Agreement to Acquire Revolutionary Vision Start-Up 6over6 Vision

1-800 Contacts acquires 6over6 Vision, whose smartphone app allows consumers in certain non-US countries (including Canada) to perform their own eye exams.

News 12/18/19

Top News

Amazon Web Services adds ICD-10 and RXNorm linking to its Amazon Comprehend Medical natural language processing service.

Developers can use the API-driven, pay-per-use services to extract codes from unstructured text with higher accuracy than rules-based systems, according to AWS.

I’m impressed at how deeply AWS is pushing into terminology and semantics issues so early in its health IT work. Comprehend Medical was announced a year ago.

Reader Comments

From Jan Madrid: “Re: evidence-based medicine. You asked in your interview with Mr. Alkire from Premier why employers have to use the financial level to get health systems to follow accepted good practices. I found the answer enlightening – they are just now considering it.” Healthcare has always been slow (at best) or resistant (at worst) to insist that physicians practice according to widely accepted evidence in the inevitable tension of science versus art. Every doctor and hospital either thinks they’ve figured out the secret sauce for best outcomes (highly unlikely) or they are just too tied to business as usual to think through doing a better job. The percentage of medical decisions that can be based on available evidence is pretty small, but even then the practice variation is wide. One of our hospital’s lesser-skilled doctors told me rather defiantly a few years ago that he liked prescribing opiates to people with colds, adding that he was the doctor and nobody could second guess him. Many doctors, especially the older ones and surgeons, were trained to think they are infallible, God-like super-scientists who float in a higher plane than their peers and the rest of us. I don’t think medical education, especially residencies, is training doctors to become science-based, patient-centered team players, but then again, we don’t make their paycheck dependent on it (and in fact, it’s exactly the opposite since drug companies happily reward irrational prescribing). That’s the raison d’être for Premier’s Contigo Health as mentioned in the interview, i.e. the businesspeople who pay employee medical bills are asking doctors to behave rationally.

From AnonMD: “Re: Verge Health. Mark Crockett, MD has exited as CEO. Connie Moser has been appointing acting CEO.” Unverified. The company’s executive page and the respective LinkedIn profiles remain unchanged. I’ve emailed the company but haven’t heard back. UPDATE: verified by the company, with a press release to follow in 1-2 days.

From Boring Pants: “Re: VCU Health. Going to Epic, which will replace a Cerner implementation that has been in place for more than 15 years. IDX for rev cycle will be wiped away as well.” Unverified, but the source is internal.

From Value-Added Reseller: “Re: patient portals and Meaningful Use. Your note was on target. I hated it when practices answered the ‘why do you want an EMR?’ question with ‘we want the government to pay for it.’ I knew they wouldn’t expend the effort to make the EMR useful and productive and would then blame the vendor. Clients that view the EMR as a strategic asset tend to be most successful.” Many or most doctors, to be blunt, are terrible businesspeople, grabbing impulsively at anything that looks like it will put cash in their pockets. But in this case, it did exactly that, as long as they were willing to claim they were using the EHR meaningfully even when they weren’t. It’s also true when you think about it that the vast majority of doctors are using an EHR they didn’t choose or maybe didn’t even want, whether it’s in a medical practice, a hospital, or elsewhere. 

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Central Logic. The Sandy, UT-based company’s pioneering, purpose-built Transfer Center platform helps health system transfer centers connect with their referring facilities to improve transfer efficiency, decrease costs, and realize revenue opportunities. Transfer Center is seamlessly integrated with On Call Scheduling (customizable calendars and schedules that can be shared, combined, and redeployed) and Advanced Reporting (real-time reporting of actionable information). Patients get routed quickly to the appropriate health system resources and the health system benefits from higher acceptance rates and the better load-balancing. Case studies include Mercy Medical Center – Des Moines, which replaced its outsourced transfer center with an internally managed solution, increasing transfers by an average of 9% per year and allowing analysis of external referral sources and the ability to perform case reviews. Thanks to Central Logic for supporting HIStalk.

Here’s a Central Logic explainer video I found on YouTube.

I’m embarrassed that I didn’t mention Donors Choose donations before Monday given that I have received quite a few new donations since, all of which will enjoy a two-for-one match from my Anonymous Vendor Executive (AVE). Unless otherwise instructed, I always mention only the first names of individual donors without their specific donation amounts, but I list the company and donation for those who mention their employer. Thanks to Christina, Bill, Mike, and Carla. Thanks also to Diameter Health, which provided an amazing $2,000 for classroom projects (which by the magic of AVE matching, will fund at least $6,000 worth of teacher projects). I’ll choose the projects – nearly $9,000 worth with the matching, plus I always find additional matching funds — and report back where the money went this week. I am confident that the butterfly effect of these donations will help turn some of these kids of today into tomorrow’s scientists, leaders, parents, musicians, teachers, or passionate pursuers of whatever interests them.

Listening: Trans-Siberian Orchestra. I took Mrs. HIStalk to see them recently and it was the most sensory-overloading, musically satisfying concert I have ever seen. Forget that their theme is Christmas – instead of Mariah Carey yodeling her way through a description of what she wants for Christmas (spoiler: it’s me), it’s like Pink Floyd and Van Halen rocking out while surrounded by lasers and pyro like you can’t even imagine. We will no doubt see them again every chance we get.

Webinars

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

Acquisitions, Funding, Business, and Stock

HealthStream-owned credentialing vendor VerityStream acquires seven-employee competitor CredentialMyDoc for $9 million.

1-800 Contacts acquires Israel-based 6over6 Vision, whose smartphone app allows consumers in certain non-US countries (including Canada) to perform their own eye exams, skipping a trip to the eye doctor for new prescriptions for glasses and contact lenses. 1-800-Contacts already offers Express Exam, a $20 smartphone exam that is reviewed by a remote doctor. The American Optometric Association is, not surprisingly, is very much against having its members bypassed and has asked the FDA to shut Express Exam down. Purely out of concern for patient safety, you understand.  

Fujifilm will reportedly buy Hitachi’s diagnostic imaging business for $1.5 billion to improve its competitive position against Siemens, GE, and Philips.

Sales

• BJC HealthCare chooses Sectra’s enterprise imaging solution for 14 of its hospitals.

People

Ryan Allen, MHA (State of Alabama) will join UAB Health System (AL) as CISO.

Announcements and Implementations

HIMSS and Forrester Research announce a research project (meaning an online survey) that will look at “the evolving digital doctor-patient relationship.” The survey is available via an open web link and doesn’t seem to limit who participates, so I’m not too sure I would trust the results. It’s also hard to believe that two big organizations did such a shoddy job designing the survey instrument – available responses for the very first question (above) are not only illogical, no combination of answers I chose allowed me to proceed to the second question. Clearly HIMSS needs some usability help.

A KLAS report on the care management component of population health management notes that Athenahealth, Allscripts, Epic, and Cerner aren’t delivering adequate customized workflows, leading to the success of Arcadia in supplementing their functionality.

Government and Politics

ONC posts the agenda for its annual meeting on January 27-28 in Washington, DC.

HHS publishes a report describing its plans to improve internal data sharing.

Privacy and Security

Computer systems of three-hospital Tidelands Health (SC) are apparently still down following a malware attack of an unspecified nature last Thursday.

The City of New Orleans lays out the effects of having the city’s 4,000 computers taken offline to remove ransomware from an attack last Friday: the police can’t run background checks, EMS phone lines are down, municipal and traffic courts are closed, Healthcare for the Homeless can’t see patients because its EHR is offline, WIC vouchers won’t be issued, online job search is down, businesses must file monthly sales tax forms manually, and all payments must be made via check or money order. Maybe HIMSS will move the annual conference there in sympathy again like it did in 2007, when the city was clearly not ready for prime time given the obvious shortage of hotel and restaurant workers and “don’t drink the water” signs all over the convention center due to another in a long string of infrastructure failures.

Other

Tim Kelsey, CEO of the Australian Digital Health Agency, resigns after a couple of years to take a job as SVP of analytics with HIMSS. He oversaw the country’s MyHealthRecord project (which cost $1.5 billion plus $300 million in annual maintenance) that has had a lot of issues with security problems and poor public acceptance. He also co-founded Dr. Foster Intelligence, a UK analytics firm that reviewed NHS performance data.

Thailand’s largest healthcare group will provide video second opinions for residents of China in a partnership with China’s Ping An Good Doctor. The service, “Overseas Top-Tier Doctors,” will be available for purchase on Ping An Good Doctor’s mobile app. The hospital group manages 48 hospitals and employs 12,000 doctors. Ping An Good Doctor has more than 60 million active users.

The CEO of continuous glucose monitoring manufacturer Dexcom apologizes for the Thanksgiving weekend failure of its Follow data sharing function, which allows people (often parents of young children) to monitor a user’s glucose results. He says the company moved the function to a new cloud service without configuring it for optimal performance, causing it to fail. The company will also roll out an in-app messaging feature and dedicated update page for its website following complaints that it did not notify users for hours and even then only via a Facebook update.

Another “only in America” healthcare story – a man who performed thorough research into his hip replacement insurance coverage still gets a surprise bill for $3,000 – the certified registered nurse practitioner who entered the room to help out while the man was under anesthesia was out of network. The CRNP’s hospital-contracted employer said it rarely contracts with insurers. The hospital, showing either its incompetence or embarrassment at being called out, says the bill was a mistake and cancelled it, but only after a reporter started asking questions.

Sponsor Updates

• CoverMyMeds employees help Gladden House deliver food for holiday meals to 110 seniors in Franklinton, OH.
• InstaMed announces that Billie Jean King will keynote the Healthcare Payments Summit May 5-6 in Philadelphia.
• AdvancedMD publishes an e-guide, “The ABCs of Patient Engagement.”
• Frost & Sullivan honor Avaya with its 2019 Customer Value Leadership Award for Customer Journey Intelligence.
• Wolters Kluwer adds Clinical Insights content from UpToDate to its Lexicomp drug information system.
• Thomas Health (WV) goes live with Meditech Expanse.

Blog Posts

• How a Community Connect Program Can Help ACOs (Optimum Healthcare IT)
• Enable Multidisciplinary Care With Smarter Team Tools (Mobile Heartbeat)
• Survey Points to Major Burnout Concerns Among Clinicians (Health Catalyst)
• Agfa-Dedalus announcement – further clarification (Agfa Healthcare)
• Performance Matters – How Disk Throughput and IOPS Impact Your Business (Atlantic.Net)
• Isn’t it Time to Flip the Script in Your Contact Center? (Avaya)
• How telehealth connects patients with Santa, what happens when product teams and doctors bump heads, and why traditional providers still have the advantage over big tech (Bright.MD)
• Top 3 Cloud Compliance Takeaways from AWS re:Invent (Datica)
• How to Evaluate All-Flash Storage Array Vendors (Burwood Group)
• Helping organizations focus on care, not IT: Discussing Meditech’s cloud journey (Meditech)
• A One-Stop Solution Provider: The Answer You’ve Been Looking For (ChartLogic)
• Embracing the Spirit of the New Discharge Planning Rule (Collective Medical)
• How Analytics Can Help During Flu Outbreaks (Dimensional Insight)
• Closing the Data Gap to Improve Outcomes (EClinicalWorks)

Contacts

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

Morning Headlines 12/17/19

Bankrupt uBiome preliminarily sells patents for 1% of the poop-testing startup’s original valuation

Once valued at $600 million, bankrupt microbiome-testing startup UBiome auctions off its patents and intellectual property for $7 million to a consumer DNA testing company.

CMS Made an Estimated $93.6 Million in Incorrect Medicare Electronic Health Record Incentive Payments to Acute-Care Hospitals, or Less Than 1 Percent of $10.8 Billion in Total Incentive Payments

An OIG audit finds that, because of inaccurate hospital calculations, CMS paid out $93.6 million in incorrect Medicare EHR incentive payments to acute-care hospitals between 2013 and 2017.

Evaluating Improvements and Shortcomings in Clinician Satisfaction With Electronic Health Record Usability

A study of 70 EHR vendors with the most Meaningful Use attestations finds that physician satisfaction with EHRs is diminishing for nearly half of the products.

Curbside Consult with Dr. Jayne 12/16/19

Winter has arrived in the Midwest, and with it the end-of-year slowdown in healthcare IT news. While sales-focused teams are scurrying to complete end-of-quarter sales to bolster their final financials, marketing folks seem to be holding anything remotely interesting until we get closer to HIMSS. That leaves us with a smattering of governmental and regulatory news items.

I admit sometimes I miss these kinds of items because of the noise of all the other things going on in the industry, so maybe it’s a good thing that we’re headed into a less-frantic time (at least until March, that is).

Sneaking into the news on Friday was the FDA approval of Tandem Diabetes Care’s predictive software that bridges the gap between continuous glucose monitors and the company’s insulin pump. Why is this a big deal? It’s the first insulin dosing software approved under a new FDA interoperability pathway, which gets interesting because different companies make components of the so-called “artificial pancreas” systems that result. You could be using one company’s glucose sensor, another’s pump, and a third-party algorithm between the two.

Tandem is already working with Dexcom Inc. and Abbott Laboratories to coordinate. This is great for patients whose insurance may only cover certain brands of one device or another, and who otherwise might not be able to take advantage of the newest technology. Typically payers only cover insulin pumps every four years, so being able to update a control algorithm rather than having to obtain a completely new device is a pretty cool thing.

Also in the news this week: glitches in the Healthcare.gov system where many people have to sign up for insurance coverage. It’s possible that up to 100,000 users were impacted by technical issues on the first day of open enrollment. CMS had to add a “waiting room” to the site to help manage traffic flow, and as of December 7, there have been 6 percent fewer enrollments compared to last year.

Patient advocates were concerned about the typical last-minute surge of enrollments and whether the site would be able to handle the traffic before the deadline. I haven’t seen any updated numbers this morning, but I’m sure there will be a lot of spin placed on whatever data becomes available this week.

A recent approval by the Federal Communications Commission is raising concerns. The group voted last week to create 988 as a nationwide suicide prevention hotline telephone number, much like 911 for emergency services. It would replace the existing number for the National Suicide Prevention Lifeline. The thought is that a shorter number would enable more people to call, but there are anticipated downsides: an increased number of callers would also increase the costs for crisis centers staffing those phones and many centers are struggling to make ends meet as it is.

The hotline is funded by the Substance Abuse and Mental Health Services Administration (SAMHSA). Theoretically more people would be calling 988 rather than 911, so that’s a cost savings since fire and emergency services won’t be dispatched for a potential suicide attempt. It could also lead to significant societal savings by preventing loss of life, but those savings aren’t immediately passed to those institutions bearing the cost, based on the calculus of healthcare math. Another example that healthcare is complicated, y’all.

Other government news includes the impending release of millions of dollars in disputed Medicare hospital payments that were withheld due to a payment policy that was struck down in court. The American Hospital Association estimates that $380 million will begin flowing as Medicare Administrative Contractors start reprocessing claims that were paid at reduced rates. Reprocessing begins January 1, so get your data and claims engines running!

Just when I thought I was out of government news, I came across news about the recent report by the US Department of Health and Human Services, Office of the Inspector General, regarding concerns around chart reviews looking at Medicare Advantage payments. Not surprisingly since billing is such a game, claims were reflecting sicker patients and more comorbid conditions than patients might actually have. Apparently payers are adding diagnosis codes for conditions that aren’t documented in physician or hospital records and this occurred in 99.3% of chart reviews.

Medicare Advantage is a big piece of the Medicare spending pie — approximately $210 billion of the $711 billion spent last year went to Medicare Advantage plans. There are concerns not only about overbilling, but that plans are functioning like the HMOs of the past to deny care as a means of increasing profits. There are also concerns that if the patients actually have the conditions added by payers (which aren’t reflected in the medical records) that patients aren’t receiving adequate care.

The audit looked at data from 2016 to assess the financial impact in 2017. As payers get more creative, it’s possible the problem could be even more rampant now. A particularly damning sentence from the report: “Although limited to a small number of beneficiaries, almost half of all Medicare Advantage organizations reviewed had payments from unlinked chart reviews where there was not a single record of a service being provided to the beneficiary in all of 2016.” At least fee-for-service payment models require the patient to be in front of you before you bill for services.

HHS recommends that CMS provide oversight of organizations that had payments resulting from chart reviews where beneficiaries received no services; conduct audits to validate diagnoses; and reassess the practice of allowing unlinked chart reviews being used as a source of diagnoses for determining risk. CMS accepted these recommendations.

There’s one piece of governmental news that’s front and center right now, although patients aren’t talking about it. Influenza is on the rise, with 2.6 million illnesses, 23,000 hospitalizations, and 1,300 deaths so far. I can’t count the number of patients who said “I never get the flu shot” a couple of months ago who are now showing up at the office sick and miserable. There’s not a lot we can do for influenza, other than providing supportive care and symptomatic relief. For small children, there’s even less we can do. Please do your part – wash those hands and stay home if you are sick. And next year, consider a flu shot.

Email Dr. Jayne.

Readers Write: The Case for Compassion in Healthcare

The Case for Compassion in Healthcare
By Frank Myeroff

Frank Myeroff is managing partner of Direct Recruiters, Inc. of Solon, OH.

Working in the healthcare space my whole career, over 30 years, and having always been on the IT side, I always felt I was in healthcare. During my days, I have written code, supported systems, implemented all kinds of applications, managed IT teams, and run large implementations. My view changed when I moved to the staffing space to get off the road for my family. I felt it was a great opportunity to view the healthcare space from another perspective, and it was.

Then that view changed again as the result of a three-minute phone call that truly immersed me and allowed me to see what healthcare really means.

The ultrasound technician told me as I walked out after my test, “The doctor will be calling you today.” That three-minute phone call conveyed a diagnosis and led to immediate surgery and an ongoing treatment plan.

As professionals in healthcare — doctors, nurses, healthcare staffing, healthcare operations, healthcare IT professionals, etc. — we are largely in tune with the processes that go into the healthcare system. As a patient, the experiences are far different, and far more emotional, as I quickly found out.

Being thrust into the patient side unexpectedly has been invaluable in my career. What I realized from all of this is that while IT really impacts patients, we in IT need to work with our clinicians and teams to understand the impact of what we do and the compassion and sensitivity that is needed to pair with innovative technologies for successful patient outcomes.

The roles of healthcare IT professionals go beyond implementing applications and systems. They are responsible for developing and driving technology in the healthcare setting, but also for giving clinicians the tools they need to provide individualized care plans and to ultimately achieve efficient and improved quality of care. The final piece of that puzzle requires compassion and communication from healthcare professionals to patients.

Data and technology are essential. However, if clinicians only focus on the data and ignore the communication and explanation of that data to patients, we are missing something huge. According to a Harris Poll in the Wall Street Journal, and cited in “Compassionomics” by Stephen Trzeciak and Anthony Mazzarelli, three times the number of patients value human connection and caring from their physician versus valuing the prestige of the institution where the physician was trained. Another study showed that 85% of patients report that compassion is important to them when making a healthcare decision. Compassion and empathy are important in healthcare, which is clear to me from both the studies my own experience.

Whatever side of healthcare you’re on, keep in mind the factors that play into quality patient care. The experiences I have had as a patient not only make me proud of what we in IT to help people, they also help me to understand the true usage that in return helps provide better solutions. Healthcare IT professionals influence patient care and have a great impact on all who serve in the hospital.

We should all be proud of what we do and the tremendous impact we have on patients, providing quality care, compassion, and better outcomes. Isn’t that what really matters?

HIStalk Interviews Michael J. Alkire, President, Premier

Michael J. Alkire, MBA is president of Premier of Charlotte, NC.

Tell me about yourself and the company.

I’ve been at Premier for about 16 years, filling a number of roles. My current role as president is focused on driving the two big strategies that we laid out at the beginning of the year. We are technology-enabling the supply chain for our healthcare systems. We are also building out enterprise analytics, embedding machine learning and artificial intelligence into an analytics platform that helps our healthcare systems reduce costs, improve quality, and migrate to new payment delivery models.

What is the ownership structure of the company now that it is publicly traded?

Our healthcare system member owners hold 46% of the Class B shares. As of our last 10-Q filing in September 2019, we have 155 member owners. The remainder of shares are held by the public.

What challenges do employers have in managing their healthcare costs?

The rising cost of healthcare is the primary reason that large employers are looking for alternatives to how healthcare is provided to their employees. 

Our journey for Contigo Health started about 18 months ago. A very large, self-insured employer came to us. They spend billions of dollars on healthcare and believe that 20% of that spend involves unnecessary variation and waste in the system. They would call out things like wanting a total knee or total hip in Orlando done the same as it is in Fargo. The way they described it is that there’s huge cost variation and huge clinical outcomes variation. They had an interest in building a high-value network of healthcare providers, both healthcare systems as well as other providers, to participate in this network.

They provided interesting statistics. From an oncology standpoint, 10% of their employees who are diagnosed with cancer don’t actually have cancer. Of those who are diagnosed with cancer, 30% are placed on the wrong regimen. Not only is the patient not receiving the right medical attention, the employer bears a huge cost. The patient may miss work due to being on the wrong medication and then getting established on the right regimen. They use that as an example of lack of standardization of care across the country.

They also talk about OB and C-section rates. Somewhere around 30% of all US births are done via C-section. In western Europe, the C-section rate is 22% or 23%. CDC says that C-section rates should be near 20%. This employer studied markets in which C-section rates were more than 50%. This creates significant cost as well as significantly more risk to the mother.

The prevalence of data that is available to these large employers is helping them understand where variation is occurring. They are looking for a partner that can help them manage this variation. I think they came to Premier because of our history of using discharge data from 45% of all US hospitals and our work with physicians and their quality reporting to Medicare. They liked the idea that we have the data. They also liked the idea that we have been working in collaboration with our healthcare systems for the better part of 15 years in improving the standard of care.

Is it an awkward conversation to tell health systems, which may be Premier’s members or owners, that your employer customer thinks they charge too much and don’t practice evidence-based medicine?

When this large player came to us and we built this collaborative that was the precursor to Contigo Health, we reached out to 35 healthcare systems that represented 440 hospitals. We said, “Very large employers are interested in building this high-value network, but we need your data, your claims data, and your electronic health record data.” We had clinical and safety data for many of them, but we needed to build data capability for this initiative.

At least 90% of the folks who participated in those first meetings provided us with their data or their interest in sharing their data with us. I think their reasons are twofold. One, they know that the market is moving in this direction, where the necessity for care to be standardized across the country is an imperative to drive down the cost of healthcare globally. Two, being part of a high-value network provides them leverage when they are negotiating with the payers in their markets. Saying that they adhere to and implement these standards and that they use the highest, best capable analytics to implement clinical protocols will differentiate them in their markets.

I don’t think that the idea is that employers will demand lower costs. They see so much variation in how care is being provided that their interest is reducing waste and standardizing the approach to providing care, as opposed to a negotiated perspective of wanting procedures done at a lower cost. The initial goal is to create a high-value network of a high standard of care.

Does this involve offering fixed prices for certain procedures, and similar to what Walmart is doing, sending employees out of their local geography to receive care from providers whose cost or quality may be better?

Payers are providing a lot of ancillary benefits to the employees of large employers, who aren’t taking advantage of them. Think about smoking cessation. We have the ability, given our Stanson Health acquisition, to write detailed analytics into the workflow. Large employers are interested using these workflow protocols to help ensure that employees are taking advantage of the ancillary benefits that they have access to. When an employee meets with the physician, it pops up on the screen that they work for Employer X, which has a smoking cessation program that they would like this patient to enroll in. There’s a free benefit that’s helping them do that. We will focus on these ancillary benefits as we get the Contigo Health programs started.

Then I think there will be two parallel paths. We will create this high-value network for things like maternal health, which will be nationally based and will involve certain protocols that these large employers would like these providers to follow. Second is exactly what you said. Large employers like Walmart call them centers of excellence, where they send employees out of geography for specific services. There will be a path for that in the short term.

But I will tell you that unless it’s something that’s very serious, very rare, or where the expertise just doesn’t exist in the local or regional markets, these large employers have an interest in getting care provided as close to the patients as possible. You will have these centers of excellence in the short term and mid term. They are nationally based today, but you’ll see more regionality of these centers of excellence, where you’ll have them in pockets along the various regional geographies of the US. Eventually I think they will become more localized to the extent that those geographies actually have the providers who can provide those services.

Premier’s health system customers should have been able to recognize and address their clinical variation given the reports you send them that highlight it. Why did employers have to apply the financial pressure to make them take action?

We work with some of the largest IDNs in the country, many of which span states and regions. They have their own focus on driving standardization of care across the entire healthcare system.

As healthcare systems are moving more towards taking downside risk, it’s imperative for them to standardize the way that care is being provided. It provides a benchmark for them to improve from. For quality outside of healthcare, such as in the automotive or high tech industries, you want to have that basis way to produce product, use that as the baseline and then always innovate off of that baseline. That’s what healthcare systems are attempting to do when they are trying to create that baseline. It’s two- sided risk.

Second is the movement to ACOs and capitation. A number of our healthcare systems that are creating partnerships with ACOs know that they have to be on the hook to provide standardized care across the communities that they serve.

The final driver will be differentiation. I spoke about this earlier in terms of their leverage with commercial health plans, but organizations that can prove that they are standardizing care and can prove that their outcomes are different than the big brands in their markets — or in some cases, bigger and smaller systems in the market — are the ones that are going to be the winners in the long term.

All of this is going to become transparent. That’s the fourth aspect, that healthcare systems are becoming aware that their outcomes are going to be transparently shared with the communities that they are serving.

Clinicians don’t always believe or follow evidence that is accepted elsewhere, or they think evidence needs to be tailored to local practices. How will you weigh the available evidence for a national group of health systems that haven’t followed it so far?

Stanson Health’s CEO is Scott Weingarten, MD. He was CEO of Zynx, which was all about creating standards of care, trying to standardize different protocols, and those kinds of things. They have had a very successful run. We were interested in Stanson because it takes those clinical decisions that come from the analytics and embeds them into the workflow.

For the first time, you will see a lot of this evidence-based clinical decision information show up in the workflow, when the physician is practicing or at the point of having conversations with their patients. They will see the clinical evidence at their fingertips.

The tool itself is unique. If organizations don’t want to use it from a proactive standpoint to provide alerting and other capabilities to the clinicians during the time of care, then a function on the back end can audit whether clinicians are following standard protocols that they have set up. Technology has allowed us to take this issue to the next level, both in being proactive at the point of care and to understand whether clinicians are following the standards of care.

Do you have any final thoughts?

Premier is working to fix US healthcare from the inside. We believe that healthcare needs to be consumer centered and provider led. Leveraging the providers, the data, and the analytics that we deliver to providers, along with the ability for them to collaborate, is the best way to solve our national healthcare issues.

Morning Headlines 12/16/19

NJ’s largest hospital system forced to pay ransom in cyber attack

Hackensack Meridian Health, New Jersey’s largest health system, admits that it has paid a ransomware hacker to regain access to its computer systems.

GV Backs Kindbody As The Company Expands Employer Benefits Offering

Fertility clinic and technology company Kindbody secures financing from the former Google Ventures, bringing its total funding to $32 million and enabling it to further scale its direct-to-employer service.

US health insurance firm Cigna is using AI to check if patients are taking their medications but experts fear the controversial scheme may be used to cancel policies or avoid paying out

Privacy experts are concerned that Cigna’s new AI-powered medication adherence monitoring program will be used for the benefit of the payer’s bottom line rather than improved patient care.

VirTrial Acquires SnapMD and Bolsters Virtual Care Management Platform

Virtual clinical trial company VirTrial acquires telehealth vendor SnapMD.

Monday Morning Update 12/16/19

Top News

Hackensack Meridian Health, New Jersey’s largest health system, admits that it has paid a ransomware hacker to regain access to its computer systems.

Some of those systems remain down two weeks after the attack began.

The health system did not reveal the amount paid, but says it carries insurance for that purpose.

Meanwhile, the city of New Orleans declares a state of emergency after shutting down all of its servers and websites following ransomware threats.

Reader Comments

From Student Union: “Re: new jobs listed in the ‘people’ section. Why do some of them not include a link to the announcement?” I learn of some of them via LinkedIn notifications from my 3,000 connections and I don’t link in those cases. My criteria for mentioning someone’s new job are: (a) I only list VP and above since I would be overwhelmed with job changes otherwise; and (b) the person has to be recognizable to many readers based on their healthcare history.

From Pleiades: “Re: Monarch Medical Technologies. FDA has recalled both of their EndoTool glycemic management / insulin dosing software products. They only offer these two products and can’t implement them at any hospital because of the open recall.” FDA recalled EndoTool IV in June 2019 because of calculation errors and and recalled EndTool Subq in November 2019 because it was distributed without FDA’s approval or clearance.

From Meaningless Use?: “Re: patient portals. A recent HIStalk interviewee said they were important because they were part of the Meaningful Use requirement. How is that important? Also, where would we be today without the HITECH Act and Meaningful Use? Many of those in the industry who started pre-MU know no other reality.” My thoughts:

• The stimulus-focused MU program artificially goosed EHR demand similarly to the “cash for clunkers” program. Although to be fair, MU payments were tied to use rather than purchase – if you already had an EHR, you could get free money by simply using it per federal government requirements.
• Sales jumped for products nobody wanted when they were spending their own money, encouraging vendors to lie and providers who were anxious to lap at the taxpayer trough to buy products without due diligence or commitment to process change.
• Innovation was stifled because the industry’s collected wad was shot on the same old systems that weren’t selling before.
• Health IT was chosen as a shovel-ready project that could pump a lot of stimulus money into the economy quickly, and those involved made an earnest but fumbled attempt to give taxpayers $35 billion worth of benefit by conditioning the payouts on accomplishments (or lies about accomplishments via unverified attestation) on metrics that did little to improve patient outcomes, access, or cost. Providers were thinking only of their taxpayer welfare payments rather than the welfare of their patients when they bought these systems and attested that they were using them magnificently.
• Patient portals seemed sexy to an industry with a poor technology track record, but nobody bothered to ask patients if they wanted them or demanded that providers do more than to simply offer them to earn their taxpayer payday.
• Portals also gave providers an excuse for doing nothing else to improve communication with their patients, They could simply pat themselves on the back and cash their checks for turning on a portal that few patients signed up for and far fewer actually used. People do what they are paid to do – no more, no less.
• But as with most technology, it’s the people rather than the tools that are the problem. Providers like Kaiser embraced both EHRs and portals and have delivered pretty amazing benefits to patients, to the point that its portal is extensively used for patient-provider messaging, routine refill and appointment requests, and inquiries. They made their portal a competitive differentiator because it was profitable for them to do so.
• Patient portals are the technological manifestation of healthcare paternalism – patients are expected to use them (a separate one for each provider) even though the doctors may or may not, those multiple providers don’t exchange information, they are just as provider-protective since providers don’t promise quick or detailed responses to portal-posted patient concerns, and users still get a clipboard full of blank forms shoved in their face when they show up for a visit. You would likely change banks if the best technology they could come up with looked anything like a patient portal.
• Without MU, EHR sales would have picked up more gradually and smaller medical practices would probably have opted out. But that would have forced vendors to improve their products and encouraged new entrants to offer something better. The market was speaking before MU artificially manipulated it.
• I would be uneasy claiming in the absence of evidence that EHR adoption has improved outcomes, access, or cost to any extent, much less $35 billion worth. I would also cite endless surveys showing minimal patient use of portals and minimal improvement in any type of outcome as a result.

From Darth Vader: “Re: UnitedHealth Group. With all this talk about reducing healthcare costs, why isn’t anyone in Congress talking about UHG, and in particular, Optum? How ingrained is this organization in every nook and cranny of the US healthcare ecosystem?” We’ve societally accepted that US healthcare is a business in which patients are the widgets of production, so it was inevitable that the whole mess (or at least the most profitable parts of it) would be controlled for maximum profit by publicly traded companies, private equity firms, and profit-admiring health system executives. Those groups are also big political donors and advertisers. The track record of a constituent-focused member of Congress dismantling a hated and excessively profitable monopoly, at least in the past few dozen years, isn’t very good. One person’s excess costs is someone else’s income and the latter don’t readily give it up.

HIStalk Announcements and Requests

Most poll respondents believe that patients own the data that providers record about them. Actually I should probably say that they wish it were true, but are aware that legally (and with ownership, that’s all that counts) patients have no such claim. Reader Conflated added a poll comment that provides a thorough overview of the issue:

It seems like three concepts are being conflated in this conversation. One is ownership of the records of the services performed by a provider (“the data”). The second is rights to access the data. The third is rights to “do stuff” with that data.

It would seem the original copy of the records stored on a provider’s EHR (or the paper records in their record closet) belong to the provider. The patient doesn’t own that copy of the records. It documents the work the provider did, the observations and results the provider captured, the medical recommendations the provider made, and is the basis of mounting a legal defense if the provider is sued for malpractice. Not to mention, there are record retention requirements the provider is required to follow, another hallmark that they own those records.

However, the patient also has a right to access and copy ALL of the provider’s records about them. That copy belongs to the patient.

Taking these two points together, then, it seems like the provider and the patient both have a right to own a copy of the same data. On a right to “do stuff” with the data, this is the more complicated thing, and the area in which HIPAA most needs a refresh. Just because a provider “owns” their copy of the records doesn’t inherently give them rights to “do stuff” with it. We have also seen some legislation that the provider has an obligation to do some stuff at the direction of the patient with said data (e.g., securely transmit it to another provider), but the provider still gets to retain a right of ownership of their copy of the data.

New poll to your right or here: What data sharing issues, if any, did you experience in your 2019 provider visits?

The “like” button you see on each article tells me that the most-liked HIStalk items in the couple of years I’ve been using it (like votes minus dislikes) are, in order:

1. Pretzel Logic 9/30/19
2. Readers Write: To Douse the Flames of Physician Burnout, Target the Four Biggest Time-Wasters in the EHR
3. A Machine Learning Primer for Clinicians — Part 1
4. Book Review: Bad Blood
5. Readers Write: A Prescription for Poor Clinician Engagement with Health IT: Stop Communicating and Start Marketing
6. Neal Patterson’s Final CHC Speech — November 16, 2016
7. HIStalk Interviews Vince Ciotti, Retired HIS-torian
8. The Smokin’ Doc Celebrates a Successful HIMSS
9. Readers Write: The Big Fib
10. CIO Unplugged 3/21/18

My Anonymous Vendor Executive (AVE) offered to provide more Donors Choose matching money, but I’m stymied since I still have nearly $10,000 of AVE’s previous donation in my account. Reason: most of the larger donations I’ve received came from HIMSS-related activities, such as lunch with a CIO or other promotional event, and I haven’t done those lately. I propose that we put that money to work as follows:

• I will (since the AVE suggested it) match donations $2 for every $1, and other matching will surely increase the bang for your donation buck.
• For company donations of $1,000 or more, I’ll include a text message of your choice in an HIStalk update email in addition to the usual thank-you message on the site.

I’m open to other ideas as well. Let’s spend AVE’s money on a great cause. If you want to donate, here’s how:

1. Purchase a gift card in the amount you’d like to donate.
2. Send the gift card by the email option to mr_histalk@histalk.com (that’s my DonorsChoose account).
3. I’ll be notified of your donation and you can print your own receipt for tax purposes.
4. I’ll pool the money, apply the matching funds, and publicly report here (as I always do) which projects I funded.

Webinars

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

Acquisitions, Funding, Business, and Stock

Blue Cross Blue Shield of Massachusetts integrates its member app with Amazon’s PillPack pharmacy, allowing members who take multiple medications to order their prescriptions, pay for them, and schedule their delivery. The app will encourage those patients to switch their pharmacy to PillPack, in which case all of their information will be automatically transferred.

Sales

• DHR Health Institute for Research and Development (TX) joins the TriNetX global health network to improve clinical trials access to Hispanic residents of the Rio Grande Valley.

People

Rx Savings Solutions promotes Daron Sinkler to VP of sales.

Announcements and Implementations

Partners HealthCare announces a five-year digital health initiative that includes online appointment scheduling, video visits, implementation of OpenNotes, procedure and imaging cost estimates, improved interoperability, posting of ED wait times, and customized patient communications. The program also includes an incubator component. The Boston paper says the program will cost at least $100 million

Other

An article in Wired predicts the end of drug trials that use a placebo group, i.e. patients who receive no actual treatment for their conditions to determine the benefit to those who do. EHR data can identify similar patients, then compare the new product’s results with those of the existing standard of treatment as a “synthetic control arm.” The author wisely notes that this is probably why drug company Roche paid nearly $2 billion to acquire oncology EHR vendor Flatiron Health in early 2018, having foreseen the use of real-world data for drug approvals now that EHRs are ubiquitous.

I like this proposed rework of HIPAA that appeared in the Health Affairs blog last week. It calls out HIPAA’s most glaring deficiencies in falling short of broad patient privacy protection – it regulates only covered entities and those covered entities get a free pass under “treatment, payment, and operations.” Not to mention that the US lags behind in failing to protect the information of its citizens via Europe’s GDPR.

Florida pain management practice chain Korunda Medical will pay $85,000 to settle HIPAA charges that it ignored a patient’s request to send an electronic copy of their medical records to a third party, then charged the patient an excessive amount for the paper copies it sent. The patient filed a complaint in March 2019, OCR provided penalty-free “technical assistance” to the practice and closed the complaint, but the patient filed a second complaint four days later when Korunda ignored the records request again.

Cigna will implement an AI-powered medication adherence monitoring program in January. The company says knowing whether patients are taking their meds as prescribed will allow it to improve care, while privacy experts worry that the objective of insurers is always to pay less and that the “digital dystopia masquerading as healthcare” will allow Cigna to cancel policies or avoid paying claims. Cigna paid $54 billion to acquire pharmacy services vendor Express Scripts earlier this year.

A PGY-1 osteopathic resident at AdventHealth Orlando and self-proclaimed “influencer” apologizes for pitching several healthcare products on his social media accounts, one of them a sketchy nutritional supplement for rave music festival attendees that he sells as a company rep. He explains, “It makes a lot of sense that I shouldn’t be using my medical degree as a platform to sell products. But no one teaches you this stuff.” He’s also planning to use his experience to start a business that will monitor medically related social media posts for appropriateness.

An interesting New York Times article describes how Amazon Web Services “strip mines” startups by copying their software, especially open source, and then selling it themselves. AWS generated $25 billion in revenue last year and is Amazon’s most profitable business.

In Pakistan, several cardiac inpatients die when hundreds of lawyers in their customary black suits storm a hospital, angered that one of their peers told them he had been mistreated when he brought a relative in for treatment. At least 200 lawyers vandalized hospital property, damaged vehicles, set fire to a police van, and beat several doctors. Physicians and employees then fled the hospital, leaving patients unattended, and the hospital then closed when the doctors mounted a protest strike.

Sponsor Updates

• Redox releases a new podcast, “An interview with Dr. Fatima Paruk, Microsoft’s Chief Medical Innovation Officer.”
• OmniSys launches the Pharmacy Talk newsletter.
• PatientPing releases a new customer success video featuring UI Health Senior Director, Care Continuum, Rani Morrison.
• Academic Radiology features an editorial from Visage Imaging’s MingDe Lin, “Accelerating the Translation of Artificial Intelligence from Ideas to Routine Clinical Workflow.”

Blog Posts

• Seasonal Depression Awareness Month (Lightbeam Health Solutions)
• Hospital Budgets 2020: Resist the Cost-Cut Bias and Invest for Success (Loyale Healthcare)
• Helping organizations focus on care, not IT: Discussing Meditech’s cloud journey (Meditech)
• Survey Points to Major Burnout Concerns Among Clinicians (Health Catalyst)
• Enable Multidisciplinary Care with Smarter Team Tools (Mobile Heartbeat)
• Physical Therapists, Physical Therapy Assistants, Physical Therapy Aides – Looking at the Core Clinical Workforce of a Practice (MWTherapy)
• Top integration challenges in healthcare IT (OpenText)
• Five Keys to Planning EHR Go-Live Support for Providers (CereCore)
• 4 ways to boost patient engagement (Experian Health)
• What Are Millenials Looking for During Patient Payment Collections? (PatientBond)
• Three Decades of Nursing: Looking Back to Move Forward (PatientSafe Solutions)
• Satisfied Patients Say What??? (Patientco)
• #GetToThePoint: Six strategies to take action on tests pending at discharge (TPADs) and prevent potential harm. (Pivot Point Consulting)
• The Role of Patient Engagement in Remote Patient Monitoring (PerfectServe)
• Identity Goes to Vegas: Gartner IAM (SailPoint Technologies)
• Managing diabetes: High-touch, high-tech collaboration between patient and care team (StayWell)
• The Critical Importance of Patient Matching Capabilities (Summit Healthcare)
• 2018 Progress Report Myths v. Reality: How Healthcare Providers are Using Powerful Solutions to Deliver Better Care Nationwide (Surescripts)
• Beyond the Electronic Health Record: Human-Centered Design to Reduce Clinicians’ Cognitive Burden (Vocera)
• 4 Facts Every PT Should Know About Telehealth Compliance (WebPT)

Contacts

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

Weekender 12/13/19

Weekly News Recap

• Hackensack Meridian Health (NJ) brings its clinical systems back online after a downtime of several days, rumored to be the result of a ransomware attack.
• Former Outcome Health EVP Ashik Desai pleads guilty to wire fraud and agrees to cooperate with prosecutors.
• Emergency medical services technology company ESO acquires trauma registry software vendors Clinical Data Management, Lancet Technology, and Digital Innovation.
• Proteus Digital Health’s previously announced restructuring will include eliminating 292 jobs and closing several facilities by January 18.
• The DoJ will look into Google’s $2.1 billion acquisition of Fitbit for possible antitrust violations.
• Partners HealthCare (MA) will spend $100 million on a five-year digital health initiative focused on developing self-service technologies for patients.
• BJC HealthCare (MO) lays off 200 employees as it outsources some IT services to an unnamed managed service provider.

Watercooler Talk Tidbits

The DoJ charges 10 former NFL players for alleged fraud after they filed nearly $4 million in claims for medical equipment that was never purchased or received through a health reimbursement account plan set up for former athletes. Claims were filed for hyperbaric devices, ultrasound equipment used for imaging on pregnant women, and electromagnetic therapy devices used on horses.

Former debt collection agency employee Shaunna Burns takes to TikTok to share advice on dealing with medical debt collection. In just a few weeks, she has gained over 100,000 followers and over 1 million likes. “The fact that there are people out there thinking debt equals deadbeat … debt doesn’t equal deadbeat,” she says. “I’m not a deadbeat, and I have great credit, and I’m still having to deal with debt collection. I literally spent hours a week fighting with insurance companies over stupid bills that shouldn’t have been charged … having to do all that is annoying and frustrating, and I thought if I could help one person [with the TikToks], it would be worth it.”

Zuckerberg San Francisco General Hospital notifies 1,174 patients of a months-long privacy breach resulting from employees who failed to shred patient-identifying meal tray tickets, instead throwing them away in regular garbage bins.

Harvard Medical School geneticist George Church develops dating app technology designed to pair users based on their DNA. Church says the app could help wipe out inherited diseases.

Advocate Children’s Hospital  (IL) launches the Santa Connection program with help from Burwood Group and Cisco.

In Case You Missed It

• News 12/13/19
• EPtalk by Dr. Jayne 12/12/19
• HIStalk Interviews Michele Perry, CEO, Relatient
• News 12/11/19
• Curbside Consult with Dr. Jayne 12/9/19
• HIStalk Interviews Doug Cusick, CEO, TransformativeMed
• Monday Morning Update 12/9/19

Get Involved

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

Morning Headlines 12/13/19

Partners HealthCare Launches Digital Health Initiative

Partners HealthCare (MA) will spend $100 million on a five-year digital health initiative focused on developing self-service technologies for patients.

Senate confirms Trump’s nominee to lead FDA

The Senate confirms MD Anderson Chief Medical Executive Stephen Hahn, MD to lead the FDA.

Caresyntax to Acquire Operating Room Analytics Provider, Syus

Surgical automation and software vendor Caresyntax acquires OR analytics company Syus alongside a $45 million funding round.

BJC outsources IT services, cuts 200 jobs

BJC HealthCare (MO) lays off 200 employees as it outsources some IT services to an unnamed managed service provider.

NextGen Healthcare Announces Agreement to Acquire OTTO Health

NextGen acquires telemedicine vendor Otto Health.

News 12/13/19

Top News

In Boston, Partners HealthCare plans to spend $100 million on a five-year digital health initiative focused on developing patient self-service technologies including online appointment scheduling, ED and urgent care wait times, and cost estimates; virtual care via text and video; and access to aggregated medical records including OpenNotes.

Reader Comments

From Darth Vader: “Re: Optum/UHG layoffs. See UHG latest results? Talk about systemic risk. With all this talk about reducing healthcare costs, why isn’t anyone in Congress talking about UHG and in particular Optum? Just how ingrained is this organization in every nook and cranny of the US healthcare ecosystem?” Vader’s observation comes just a few days after OptumRx’s purchase of Diplomat Pharmacy for $300 million.

Webinars

None scheduled in the coming weeks. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

Tampa Bay Lightning owner and former hedge fund manager Jeff Vinik invests $5 million in health IT integration vendor Bridge Connector, bringing its total funding to $25 million. Vinik is also a minority owner of the Boston Red Sox.

Surgical automation and software vendor Caresyntax acquires OR analytics company Syus alongside a $45 million funding round.

Proteus Digital Health’s previously announced restructuring plans will include eliminating 292 jobs and closing several facilities by January 18. According to the local paper, the company will turn its focus from digital therapeutics for blood pressure, hypertension, and cholesterol to infectious disease and oncology, “expensive therapies that tie payments to the actual use of the drug.”

BJC HealthCare in Missouri lays off 200 employees as it outsources some IT services to an unnamed managed service provider. The health system cut about 10% of its IT workforce in July 2018 after wrapping up an Epic roll out.

NextGen acquires telemedicine vendor Otto Health.

LeanTaas raises $40 million in a Series C funding round led by Goldman Sachs. The Silicon Valley company has developed predictive analytics for optimal utilization of ORs, infusion centers, and labs.

Pharmacy benefits manager Express Scripts develops a list of recommended digital health tools for payers and providers organized into treatment categories that include depression, anxiety, asthma, and diabetes. Products and services from Livongo, Omada Health, Propeller Health, and WellDoc are among the initial group of recommended solutions.

The Chartis Group acquires The Greeley Company, a consulting and staffing firm based in Boston.

Sales

• Lakeland Regional Health (FL) will implement care team coordination technology from Andor Health.
• The NC HealthConnex HIE will use CarePort Health’s real-time care notifications and reporting capabilities to improve care coordination at UNC Health Care’s 12 hospitals.

People

CynergisTek names Tony Douglas (Symantec) SVP of sales.

Gregory Adams becomes chairman and CEO of Kaiser Permanente after serving in the interim role since the unexpected death of CEO Bernard Tyson last month.

NIH names Joshua Denny, MD (Vanderbilt University Medical Center) CEO of the All of Us research program.

Charlie Greenberg (Merck) joins PatientPoint as SVP of campaign quality and compliance.

Announcements and Implementations

Faith Regional Health Services (NE) goes live on Epic.

Government and Politics

The Justice Department will look into Google’s $2.1 billion Fitbit acquisition for possible antitrust violations related to amassing data on American consumers.

Privacy and Security

Korunda Medical (FL) will pay OCR $85,000 to settle potential HIPAA violations related to multiple complaints from the same patient that it wanted an unreasonable fee for medical records, and failed to provide the records in the requested format in a timely manner.

Other

Baxter Regional Medical Center (AR) will use a donation from community members to fund in-house development of an interface between its Cerner EHR and 400 smart IV pumps.

Avante Skilled Nursing and Rehabilitation Centers (FL) pilot the Furry Palz Program from Thrive Behavioral Sciences. Designed to rest in the laps of dementia patients, simulated breathing sounds from the robotic pets help to relieve symptoms of agitation, isolation, and depression.

Sponsor Updates

• AdventHealth Waterman and Sentara Virginia Beach General Hospital showcase reductions in hypoglycemia and glycemic practice variation utilizing Glytec’s glucose management technology and services.
• Healthwise receives a Gold Digital Health Award for a patient education video in the Health Information Resource Center’s 2019 fall competition.
• InterSystems releases a new PulseCast podcast, “Dave Menninger: Discovering the Hidden Dollars Within Your Data.”
• Vanguard profiles Intelligent Medical Objects General Counsel Charlotte Tart.
• Nordic releases a new podcast, “Avoiding common pitfalls of an affiliate extension program.”
• Arcadia congratulates its ACO customers in achieving over $423 million in Medicare Shared Savings Program savings in 2018.
• Wolters Kluwer Health adds Clinical Insights with enhanced content from UpToDate to its Lexicomp drug information resource.

Blog Posts

• Key Benchmarks for Process Improvement & Success (EClinicalWorks)
• EPSi welcomes Mosaid Healthcare, Mercy and Texas Health Resources to AWS (EPSi)
• Healthcare data exchange increases access through Intergy (Greenway Health)
• Why Troubleshooting Tools are Important to Any Citrix Upgrade (Goliath Technologies)
• This Groundbreaking Program Proves the Value of Health Literacy (Healthwise)
• Rethinking IT infrastructure in healthcare (Hyland)

Contacts

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

EPtalk by Dr. Jayne 12/12/19

My bedtime routine includes checking HIStalk for comments and doing some light Web surfing on my phone, so my attention was captured by yesterday’s JAMA article entitled “Matters of the Mind – Bedtime Procrastination, Relation-Induced Anxiety, Lonely Tweeters.” No surprise, studies linked smartphone use with bedtime procrastination. The piece also looks at how relaxation can be stressful for individuals with anxiety and depression, as well as how Twitter posts could help identify loneliness. These are areas of research many of us wouldn’t have dreamed of a decade ago. I’ve thought frequently about consumer technology (particularly smartphones) and how it’s collectively one huge experiment, albeit one without an Institutional Review Board to make sure the participants aren’t harmed. I think we’re just scratching the surface at learning what technology does (or doesn’t) do for or to us.

Jenn clued me in to this article about startups focusing on nurses as a target audience. There are 3.8 million nurses in the US, so it makes sense that companies would start designing around their needs. Clove is one of them, and their name is an inside joke as well – the C with a line over it is medical shorthand for “with” so their products are “with love.” The name is subtle but the medically-inspired design of its shoes aren’t – although they’re a running style, they have a solid smooth surface over the toe area which is great to protect from the spills and goo of the job. Ventilation holes are relocated to the sides, where splashes and drips are less likely.

The company is savvy in other ways, showing that they understand healthcare folks by shipping a three-pack of pens with every pair of shoes. The pens are marked “For Borrowing Only.” Anyone who keeps a spare (and usually crummy) pen in their pocket to deal with people who ask to use your pen and who are unlikely to give it back knows what I’m talking about. Nike also recently launched a healthcare shoe, but it’s not nearly as cool. I was a little put off by their unisex sizing as well as their use of the “star of life” logo most commonly used by emergency medical services. In contrast, Clove has both women’s and men’s sizing as well as color names that make clinicians smile: Grey Matter, Night Shift, and Pink Up.

Public health informatics is a big part of clinical informatics, and I was shocked to learn about a measles outbreak on Samoa, where measles is running rampant. The country has a population of around 200,000 and nearly 4,900 people have become ill with 71 dying. Similar outbreaks are also occurring in Tonga, Fiji, and American Samoa. Several of the Pacific island nations have vaccine rates below World Health Organization recommendations. There are numerous reasons for the low vaccination rates, but my thoughts go out to those who are sickened and their caretakers. Hopefully the outbreak is a brief one.

In other news, analytics folks must be cheering at the possibility that flu season could peak early this year. The Centers for Disease Control and Prevention’s FluSight Forecasting initiative gives it a 40% chance of peaking this month, as flu levels have been at or above the national baseline for several weeks. The chance it will peak in January is 30% and February is 20%. I’ve significantly reduced my clinical work for January and February because I loathe driving in icy conditions, so we’ll see if I played the odds right or not.

Intelligent Medical Objects has launched IMO Precision Sets, which are designed to allow clients to quickly define various value sets needed for quality work and value-based care. Based on IMO’s solid terminology and maintained by their dedicated clinical terminologists, they are available in various sets – Oncology, Reporting, Behavioral Health, Chronic Conditions, Perioperative, and Acute Conditions. I spent way too much time in a past life trying to maintain those groupings for reporting, through ICD codes and SNOMED codes. IMO’s original Problem IT product was the only solution I ever deployed as a CMIO where my providers proactively reached out to say thank you, so I’m a big fan of their work.

Congress is looking for feedback on a new bill nicknamed “Cures 2.0,” which is designed to go beyond the content of the original 21^st Century Cures Act to address topics like digital and connected health platforms. They also plan to focus on real-world evidence in the FDA’s approval process, and to speed up coverage of FDA-approved drugs by payers. Feedback is requested by December 16 at cures2@mail.house.gov if you’re interested in sharing your thoughts.

As we approach the end of the year, it’s a time for many to reflect on the months that have passed and our hopes for the coming year. Since we work in healthcare technology, we’re not immune to the influence of various trends and fads, especially where health-related tech is concerned. Like many, I’ve had my adventures with wearable tech, startups, and various apps that proposed to make my life better. Lots of people have stories to tell about how we can live our “best lives,” from tech gurus to TV personalities. In a fit of decluttering I had my Marie Kondo moment, so I giggled when I came across this article about “The life-changing magic of making do.” I’m a frugal person (as evidenced by writing this wearing 20-year old pajamas on a 20-year old sofa, watching Netflix on a TV smaller than some computer monitors), but was shocked by some of the statistics in the article as far as sheer consumption in North America.

The piece’s comments on the lack of fixability with technology resonated with me – it’s one of the reasons I hope my geriatric washer and dryer never fully give up the ghost – I don’t need something with a motherboard to control how my clothes are cleaned. (I’ve had enough of that drama with the refrigerator to last a lifetime). I’ve rehabilitated both the washer and the dryer courtesy of Repair Clinic and its videos. (Have you ever seen inside a gas dryer? It’s pretty crazy in there.) It gives me hope for what I want to do professionally in the next year – to help healthcare organizations get the most out of the resources they’ve already paid good money for and that they might not be using to the fullest. It’s a good goal, but difficult for some organizations because it often involves hard work. It’s much easier to throw out a “problem” technology when the real problem is the people or processes that govern its use. We’ll see how that plays in the New Year.

What are your reflections on the past year and hopes for the coming one? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 12/12/19

Bridge Connector Increases Total Financing to $25 Million with Investment From Jeff Vinik & Axioma Ventures

Bridge Connector will use its $25 million in financing to help scale a new integration platform-as-a-service that connects health data systems without the need for code.

Proteus Digital Health plans hundreds of job cuts, facilities closures

Proteus Digital Health’s previously announced restructuring will include eliminating 292 jobs and closing several facilities by January 18.

U.S. Justice Department to review Google’s deal for Fitbit: source

The DoJ will look into Google’s $2.1 billion acquisition of Fitbit for possible antitrust violations.