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Weekender 6/26/20

June 26, 2020 Weekender No Comments

weekender


Weekly News Recap

  • Kaufman Hall spins off its enterprise performance management software division as Syntellis Performance Solutions.
  • Public health officials in Austin, TX blame COVID-19 case counts that vary wildly by day on labs that are sending test results by fax.
  • The American Hospital Association loses its bid to stop the federal government from requiring hospitals and insurers to publish their negotiated prices, but will appeal.
  • Massachusetts eHealth Collaborative shuts down after 15 years.
  • CMS begins publishing a monthly Medicare COVID-19 Data Snapshot.
  • CMS announces the creation of CMS’s Office of Burden Reduction and Health Informatics.
  • Russian President Vladimir Putin calls for the healthcare system there to roll out out digital systems and to use artificial intelligence.

Best Reader Comments

While in theory I like the idea of requiring hospitals and insurers to publish their prices, I’m somewhat skeptical of the actual benefit this may provide to patients. To the majority of patients in this country who are insured by a commercial payor or CMS, unless the anticipated out of pocket costs are also provided, I suspect the published price itself will be ineffective in driving patients to lower cost alternatives … with health system monopolies and the ubiquity of employer-provided health insurance, patients simply don’t have much of a choice either where they get their care or who their insurance provider is, which will only cause prices to continue to rise. (Dr. Gonzo)

Administrator Verma’s heart seems to be in the right place and the tweets carry a lot of bite. But I am skeptical that asking current health systems players to take on the role of addressing social and economic factors of their patients is going to work. Those who know the system know very well that American health system has had its knee on the neck of racial minorities and economically disadvantaged for a long time. You don’t get to be a part of $4,000,000,000,000 annual industry without shattering a few million middle class dreams. (SeismicShift)

I would question how many companies are as worried now about how to “strategically reallocate those unused marketing dollars” but rather how to use those funds to meet a demanding payroll and to stay afloat until the markets are open and the economy levels out. (Just Wondering)

Healthcare is but one symptom of a system ripe for correction. What can we say about the richest nation in world history with currently 48 million of us lacking nutritious food on a regular basis, including 16.2 million children? USA needs to look long and hard at its fantasy that we all are existing on a level field. (Kevin Hepler)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Mr. H in Georgia, who asked for a robotic center for his school’s media center. He reported in February, “Thank you for your generous donation. It has truly exposed boys and girls in a variety of grade levels to how coding can be a fun learning experience. We have built the robots, practiced building block languages, and have even implemented different movements with the Kamigami Robots. An activity the students always look forward to in the program is playing tag with the robots. Each student has to use the coding language to try and disable the other robot in a specific time session. I am working to continue to create authentic and innovative activities that will promote their knowledge of computer science. The smiles on the students’ faces would not have been possible without your support.”

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Dermatologist and YouTube star “Dr. Pimple Popper” Sandra Lee, MD unsuccessfully tries to hide her social media tracks after insulting nurses everywhere.

In Russia, a nurse whose hospital employer reprimanded her for showing up for work in a see-through PPE gown with a sports bra and short underneath because she was getting overheated lands a modeling contract.

Columbia University ED doctors describe how to tame your email inbox using crisis resource management techniques:

  • Have one person summarize multiple status reports into a single email that is sent at the same time each day and with the same subject, format, and section headings.
  • Include the titles of everybody who is sent a group email or is added to thread.
  • If a recipient is being included just as an FYI for one message in a thread, use BCC so they don’t get future group messages.
  • Don’t just make broad requests for help – assign tasks to specific individuals with timelines and expectations on reporting back. Otherwise “email is commonly abused as a tool for putting work on somebody else’s desk without having to confirm that they can take it on.”
  • Add action requests to the subject line in brackets “[respond EOD].”
  • Ask why you are being added to an existing email chain and what expectations are involved.
  • Use the SBAR concept (situation, background, assessment, recommendation) to make communications concise.
  • Encourage people to speak frankly.

The former CEO of Union General Hospital (GA) and one of its doctors are sentenced to federal prison for their roles in scheme in which the doctor prescribed the CEO 15,000 doses of opioids in return for being paid for additional hospital work and being placed on its board.

A Colorado anesthesiologist gives up his medical license and serves 30 days in jail after turning off all the patient monitors in a hospital’s recovery room with a rant about how the noise creates alarm fatigue for nurses, then choking a nurse who told him to leave the machines alone.


In Case You Missed It


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Morning Headlines 6/26/20

June 25, 2020 Headlines No Comments

Kaufman Hall Software Becomes Syntellis Performance Solutions

Kaufman Hall spins off its enterprise performance management software division as Syntellis Performance Solutions, with investment from private equity firms Thoma Bravo and Madison Dearborn Partners.

Cedar Gate Technologies Acquires Citra Health Solutions

Analytics-focused, value-based care management vendor Cedar Gate Technologies acquires Citra Health Solutions and its EZ-Suite claims, benefits, and care management software.

Leidos receives $170M task to provide MHS GENESIS Stage 6 Enterprise Services

The DoD gives Leidos a $170 million task order for MHS Genesis services that will include program management, enterprise sustainment, license maintenance, and operational management services.

Mayo Clinic launches advanced care at home model of care

Mayo Clinic (MN) launches a home healthcare service using technology from Medically Home under its new Mayo Clinic Platform, an initiative that aims to create new ventures using the latest technologies.

News 6/26/20

June 25, 2020 News 3 Comments

Top News

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Kaufman Hall spins off its enterprise performance management software division as Syntellis Performance Solutions, with investment from private equity firms Thoma Bravo and Madison Dearborn Partners.

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Kaufman Hall’s Kermit Randa will move to the new company as CEO.

The business was created from Kaufman Hall’s Axiom Software and its recently acquired Connected Analytics practice of Change Healthcare.


Reader Comments

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From Barely Covered Enmity: “Re: Shafiq Rab leaving Rush University Medical Center. Interesting that his LinkedIn says he is a senior advisor to Michael Dandorph, the CEO of Wellforce. Bill Shickolovich is still listed as CIO, but Dandorph came from Rush. Wellforce is a relatively new player in MA, with Tufts Medical Center primarily on Siemens, Lowell General on Cerner, and Melrose-Wakefield on Meditech. Most affiliated providers are on eCW. They have announced plans to move all to Epic.”

From Generally Specific, MD: “Re: telemedicine EHR entries. Our billers tell us that we have to record three numeric entries in the vital sign section of our EHR to quality for telemedicine payment. You’re allowed to take the patient’s word on height and weight (yup). Some people will give you a temp, home blood pressure check, or data from Apple Watch or Fitbit. When all else fails, I see if they can feel a pulse (big one in neck if wrist fails) and have them count while I time 15 seconds on my phone. Or watch them breathe. If someone doesn’t look good, I have to get them seen in person anyway.”

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From Swag Seeker: “Re: conferences. Will HLTH cancel?” They already have. HLTH announced last week that the October event will be virtual (meaning: a flop.) HLTH has held just two conferences in its short existence, the first in May 2018. I would not want to be HIMSS, RSNA, or other non-profits that fill the bank mostly from their member conferences, but HLTH is even worse off in being funded by VCs and having no other line of business to fall back on. HLTH made some puzzling decisions about locations and dates early on but managed to lure a lot of healthcare luminaries and their expense accounted-fueled groupies to generally positive reception. They will now try again in Boston in October 2021, assuming that (a) they survive, and (b) that anyone cares by then. Conferences aren’t coming back strong until a year or two after a vaccine is proven to be effective, if ever, and we may have found better ways to spend the time and money of our employers by then.


HIStalk Announcements and Requests

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I’m watching and recommending  the Netflix medical documentary series “Lenox Hill,” which follows four doctors and their patients at Northwell Health’s Lenox Hill Hospital. Fun fact: Northwell pays featured neurosurgeons David Langer, MD (above) and John Boockvar, MD more than $2 million each per year. Google-stalking suggests that Langer’s summer house in the Hamptons, site of the retreat the doctors attended, is worth a cool $3 million. Still, they seem like highly competent, mostly nice guys, although I bet that being surgeons that some critical, loudly recited monologues to eyes-downcast co-workers were left on the virtual cutting room floor.


Webinars

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


Acquisitions, Funding, Business, and Stock

The Massachusetts EHealth Collaborative will sell its remaining assets and shut down operations. The non-profit sold its technology assets and customer accounts to population health management and analytics vendor Arcadia last month. The majority of its employees, including President and CEO Micky Tripathi, have joined Arcadia.


Sales

  • Idaho will integrate its PDMP data into statewide EHR and pharmacy systems using Appriss Health’s PMP Gateway solution.
  • Teleradiology company Rapid Radiology selects OpenText’s EMR-Link software to ensure smoother transfer of imaging results to providers at long term care and skilled nursing facilities.
  • The University of Illinois Hospital and Health Sciences System will implement PhysIQ’s PinpointIQ remote patient monitoring technology to monitor employees for signs of COVID-19, and high-risk COVID-19 patients for signs of deterioration.
  • Wexford PHO goes live on the all-payer population health management solution of SPH Analytics.
  • Fairfield Medical Center (OH) chooses Updox for patient flow management, in-office productivity, and virtual care.
  • The DoD gives Leidos a $170 million task order for MHS Genesis services that will include program management, enterprise sustainment, license maintenance, and operational management services.
  • Texas Health Aetna will use the SMS/IVR technology of CareSignal for remotely monitoring patients with diabetes, hypertension, and asthma.

People

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Cambridge Health Alliance names Hannah Galvin, MD (Beth Israel Lahey Health) as CMIO.

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Shannon Werb (Virtual Radiologic) joins DispatchHealth as COO.

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The HCI Group names Will Conaway (Prime Healthcare) VP of provider delivery.


Announcements and Implementations

The Froedtert & the Medical College of Wisconsin rolls out a remote patient monitoring program for pregnant patients using technology from Babyscripts made available through digital health prescription vendor Xealth, which includes the health system among its investors.

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PatientPing launches an e-notification service for patient admissions, discharges, and transfers that ensures providers are compliant with the Condition of Participation laid out in the final Interoperability and Patient Access rule from CMS.

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Nordic develops an evaluation and management transition service to help health systems comply with CMS’s E/M updates, set to take effect January 1.

UCI Health (CA) adds Everbridge’s MediNav wayfinding technology to its My UCI Health app.

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MuleSoft announces GA of Accelerator for Healthcare, a set of prebuilt APIs, integration templates, and best practices that can help developers more easily integrate data from different EHRs into healthcare projects. Salesforce acquired the company in 2018 for $6.5 billion.

Mayo Clinic (MN) launches a home healthcare service using technology from Medically Home. The service falls under the health system’s relatively new Mayo Clinic Platform, an initiative led by John Halamka, MD that aims to create new ventures using the latest technologies.

Healthcare voice AI vendor Suki launches a new voice service that it says will deliver faster, more accurate company responses from normal physician speech. Its digital clinical assistant has also been enhanced with ICD-10 coding, Epic integration, and delivery of an app for Android smartphone users.


COVID-19

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Texas Governor Greg Abbott bans elective surgeries in Bexar, Dallas, Harris, and Travis counties to free up bed space for the state’s rapidly expanding epidemic. Texas Medical Center says it will need to tap surge capacity this week and is on track to exceed total capacity within two weeks. The governor will also halt further reopening phases, acknowledging the state’s “massive outbreak” after it rushed to reopen despite increasing numbers. Abbott said two weeks ago that there was no reason to worry about reopening because “we have so many hospital beds available to anybody who gets ill.” Texas allows churches, governments, daycare centers, and camps to operate without occupancy limits, while bars, sporting events, swimming pools, libraries, and amusement parks can operate at 50% occupancy. Restaurants are limited to 75% capacity. Abbott, who previously refused to require mask-wearing and barred local officials from implementing their own mask requirements, encouraged Texans to wear masks in announcing his executive order Thursday. Perhaps it bears repeating that being discharged alive from a COVID-19 hospital stay doesn’t preclude a shortened lifetime of suffering, never-ending medical interventions, and hugely diminished quality of life. The ability to get an ICU bed and ventilator should not provide a false sense of security.

Public health officials in Austin, TX blame COVID-19 case counts that vary wildly by day on labs that are sending test results by fax, requiring their employees to re-enter the information manually. County officials want to know which labs are involved for possible enforcement of the state law that requires digital reporting.

COVID-overwhelmed Arizona is experiencing the same problems that other states ran into early in the pandemic — long lines for testing, a shortage of testing capacity, and a lack of coordination among hospitals and doctors offices to match testing demand to availability.

West Virginia Governor Jim Justice fires Cathy Slemp, MD, MPH, commissioner of the state’s Bureau of Public Health, claiming that her office unintentionally inflated COVID-19 case counts by failing to exclude recovered patients.

CVS Health announces GA of Return Ready, a customizable COVID-19 screening, testing, and analytics program for employers and universities that also offers digital tools for symptom monitoring and contact tracing.

Bars are increasingly looking like a COVID-19 breeding ground in states where they are open, with factors being close quarters, fearless young customers who don’t wear masks, proprietors who flout distancing and crowd size mandates, and loud conversations that spray more droplets. Patrons who don’t know they’ve been infected are spreading the infection to people who are more cautious.

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COVID-19 is forcing health system to change their plans for developing hotels to house elective surgery patients and visitors, many of them cash-paying residents of other countries. Miami’s $500 million, 680-foot tall Legacy Hotel and Residence will feature a 256-room hotel, a 100,000 square foot medical center, condos, bars, restaurants and shops, but its CEO says he doesn’t use the term “hospital” for reasons that go beyond the legal one of not offering emergency services — “You’re in a luxury hotel. You don’t want to be around people who are dying.”


Other

The American Hospital Association loses its bid to stop the federal government from requiring hospitals and insurers to publish their negotiated prices. AHA had argued that the White House did not have the legal authority to require such disclosure, that compliance would create overwhelming administrative burdens, and that such transparency might increase prices. The federal judge disagreed, ruling that informed customers should drive prices down and that hospitals attack transparency measures in general to keep patients in the dark about pricing. Hospitals are appealing the ruling.

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A review of the VA’s HIT-related outpatient diagnostic delays over several years finds five key high-risk areas: overwhelming EHR inbox notifications and communications and lack of coverage for absences; lack of interoperability and visible surfacing of important information; technical problems; data entry issues; and systems that don’t track test results. It cites previous studies in which PCPs reported missing abnormal test results because of an overloaded EHR inbox that requires more than an hour per day to work through. Specific cases were interesting:

  • Physicians who were notified by note to correct an EHR entry sometimes signed off without actually making the correction.
  • One clinician missed an abnormal test result that was among the 200 inbox notifications they received in one day.
  • Results were sent to clinicians who were on leave or who had left the organization with no one assigned to cover their inbox.
  • Use of note templates sometimes caused the recipient to miss important information.
  • Clinicians missed information due to delays in obtaining records, missing fax reports, delays in outside organizations posting diagnostic information to record-sharing portals, and failure to notify the clinician to review records that had been scanned.
  • Clinicians sometimes failed to review abnormal test results in subsequent encounters.
  • One clinician had customized the EHR to display only abnormal results, but missed one abnormal result because an abnormal cutoff value had not been defined.
  • Inactive radiology codes failed to trigger notification.
  • Abnormal result warnings were set to disappear when opened, so clinicians lost track if they were interrupted.

Sponsor Updates

  • VMblog features an interview with Goliath Technologies CMO Stacy Leidwinger.
  • Google Cloud hires Kathy Bonanno (Palo Alto Networks) as finance lead.
  • Halo Health publishes a case study, “Schedule-Driven Communication Improves Collaboration for Great River Health System.”
  • Pivot Point Consulting expands its telehealth services to offer end-to-end solutions, from strategy to platform selection to implementation.
  • Hyland CEO Bill Priemer shares his thoughts on potential challenges and the unknowns around working from home.
  • The Boston Globe features Imprivata CEO Gus Malezis in an article assessing COVID-19’s impact on office work.
  • Seeking Alpha profiles digital prescription savings and patient engagement company OptimizeRx.
  • Vocera partners with Mediaplanet to launch the “Empowering Our Healthcare Heroes & First Responders” media campaign.
  • PMD successfully completes its annual SOC 2 Type II and HIPAA security audits.

Blog Posts


Contacts

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

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EPtalk by Dr. Jayne 6/25/20

June 25, 2020 Dr. Jayne 4 Comments

This week has been absolutely crazy, with plenty of firefighting of both the informatics and clinical varieties.

A client that I did a quality project for last year is in the middle of an EHR go-live with “virtual elbow support,” but they had no physician super-users identified. Hard to believe, but there are still physicians out there who feel like they really need to learn it from a physician. For the client, figuring that out right before the go-live was a big miss. I’ve been playing WebEx Whack-a-Mole with a couple of physicians who won’t listen to the resources right in front of them and trying to convince them to get with the program. I’m always happy to help clients who are in a rough place, but it’s exhausting.

At the same time, my clinical practice has been having record-breaking days that make the “Flumageddon” season of a couple of years ago look like a cakewalk. They’re constantly pleading for people to come in on their off days, and I’ve covered a couple of times just so the physicians who are scheduled can have a break to sit down, eat, and have a minute to themselves. Still, it’s a never-ending revolving door of COVID swabbing, antibody testing, and processing of lab results as well as following up on infectious patients. Add in the usual summertime orthopedic injuries, lacerations from whacking the back of your head on a diving board while trying to execute the perfect cannonball jump, and a couple of ruptured appendixes in patients who were “afraid to go to the hospital” and it’s a recipe for disaster.

We’re leading the region with antibody (serology) testing, and I have to say I have mixed feelings about it. The visits take a tremendous amount of time, as we counsel patients to understand that having a positive antibody test isn’t the immunity passport that they thought it would be based on what they saw on Facebook. Many of the patients had respiratory infections in January or February and we have to explain that with that timeline, it’s much more likely that they had flu or bronchitis or one of the other garden-variety illness that was going on.

The rates of positive antibody results in my area are low, and although it’s good data from the public health perspective, it doesn’t do anything for the management of individual patients and it sure adds a lot of cost to the healthcare system. Since most insurers are covering it 100%, patients are eager to feel like they’re “doing something.” The American Medical Association continues to be vocal in spreading the word that antibody tests aren’t the path back to our old normal. We still know too little about what protection antibodies might provide or how long it may last, and there are risks for both false-positive and false-negative tests.

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The traditional July 1 start date for new interns and residents is less than a week away, and I don’t envy them the weirdness that they’re walking into. I was glad to read this heartwarming piece about a mother and daughter who both graduated from medical school this spring and matched together for residency. The elder Dr. Kudji had been a registered nurse and a nurse practitioner prior to entering medical school in her 40s and matched in family medicine. The younger Dr. Kudji will be pursuing a residency in general surgery.

Another piece sent by a reader tugs at the heart strings: A pediatric cardiologist in Bolivia was challenged to find a machine to create implanted devices to fix heart defects through a non-invasive procedure. He turned to the country’s indigenous women to weave the amazing devices by hand, often using a single piece of wire. It’s worth the watch just to see the devices in action as they deploy.

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Less heartwarming was the invitation I received from the American Telehealth Association for their virtual conference, a mere three days before the multi-day meeting was to start. They must be desperate for attendees because they offered a code for $350 off the regular $650 registration price. I don’t know of too many physicians who can clear their schedule with just a couple of days’ notice. InTouch Health did a must better job promoting their upcoming conference with more than a month notice. The July conference is free and features multiple tracks, including a COVID one.

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This week, CMS announced the creation of the Office of Burden Reduction and Health Informatics. It’s designed to continue the “work of reducing regulatory burden to allow providers to focus on patients instead of paperwork and reducing healthcare costs.” It appears to stem from the Patients over Paperwork Initiative (with CMS stubbornly refusing to capitalize the O, for some reason).

The CMS press release touted its successes, but as a frontline urgent care clinician, absolutely nothing has changed as a result of this ongoing work. My staffers are still collecting plenty of data elements that aren’t helpful at the point of care for the conditions I’m treating in the majority of my patients. There may have been benefits in reporting and streamlining of conflicting initiatives, but that doesn’t help us in the exam room.

CMS Administrator Seema Verma was quoted as saying the new office will “increase the use of health informatics” and I’m as eager as the next person to see what they have in store. Perhaps we could start with a nationwide unique patient identifier, since CMS says that “fostering innovation through interoperability will be an important priority.” That will also help with their goal of “new tools that allow patients to own and carry their personal health data with them seamlessly, privately, and securely throughout the healthcare system.”

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From Just Betty: “Re: BJC HealthCare. Check out this data breach notification letter from one of its flagship hospitals. The return address on the letter is for a construction company in Sacramento, CA. Do you think it’s a scam?” There’s nothing quite like following one unfortunate event with another one. In this case, some suspicious activity in employee email accounts resulted in an investigation that was “unable to determine whether the unauthorized person actually viewed any emails or attachments in the employee email accounts.” Compliance officers reviewed the contents of those email accounts and found patient information that may have been accessible, including patient name, date of birth, account number, diagnoses, medications, providers, treatments, and facility locations. It’s hard to believe people are still emailing files around that contain PHI. The return address does indeed belong to a construction company 2,000 miles away from the corporate headquarters. In addition to looking for some employee training to prevent phishing, I bet they’re also looking for a breach notification vendor.

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A reader sent me a link to a paywalled article about a “recovery area” at New York City’s Mount Sinai Beth Israel hospital. Designed for healthcare workers who need to escape, it features recliners, music, and aromatherapy to reduce stress. They’ve opened more than 10 rooms at different facilities and note a self-reported reduction in stress after only a 15-minute visit. Since this was the week I was supposed to be volunteering at a camp which is instead holding “Virtual Summer Camp,” I’m de-stressing in my yard. Today’s challenge was to build a camp gadget or campsite improvement. I’m not sure what my neighbors think of my COVID-essentials dispenser, but my fellow virtual campers enjoyed it.

What’s your favorite knot or lashing? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 6/25/20

June 24, 2020 Headlines No Comments

MAeHC Winds Down Operations After Over 15 Years of Helping Health Organizations Innovate Through the Use of Information Technologies

After selling certain assets and transitioning the majority of its employees to population health management company Arcadia, the Massachusetts eHealth Collaborative will sell off its remaining assets and shut down.

Somatus Raises $64 Million in Series C Financing to Transform Kidney Care

Kidney care company Somatus raises $64 million in a Series C funding round, bringing its total raised to $105 million.

FDA Announces First of Its Kind Pilot Program to Communicate Patient Reported Outcomes from Cancer Clinical Trials

The FDA launches Project Patient Voice, a website that offers cancer patient-reported data about symptoms experienced during clinical trials.

Morning Headlines 6/24/20

June 23, 2020 Headlines 1 Comment

Trump Administration Issues Call to Action Based on New Data Detailing COVID-19 Impacts on Medicare Beneficiaries

CMS Administrator Seema Verma says that analysis of Medicare claims confirms that socioeconomic status, race, and ethnicity of COVID-19 patients affect their likelihood of complications.

Cerner’s ‘transformation’ work continues with more layoffs in KC, across the country

Cerner conducts another round of layoffs, this time involving 100 employees.

DispatchHealth Raises $135.8 Million in Series C Financing

High-acuity house call provider DispatchHealth raises $136 million in a Series C funding round, increasing its total to $217 million.

CMS Unveils Major Organizational Change to Reduce Provider and Clinician Burden and Improve Patient Outcomes

CMS creates the Office of Burden Reduction and Health Informatics, which will look at the burden of meeting CMS compliance requirements, fostering innovation through interoperability, and using technology to create new patient-friendly, data-sharing tools.

News 6/24/20

June 23, 2020 News 1 Comment

Top News

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CMS Administrator Seema Verma says that analysis of Medicare claims confirms that socioeconomic status, race, and ethnicity of COVID-19 patients affect their likelihood of complications.

Verma says the US health system needs to transition from fee-for-service to value-based care and to hold providers accountable for outcomes.

CMS has started publishing a monthly Medicare COVID-19 Data Snapshot. The initial release indicates that 325,000 Medicare beneficiaries were diagnosed with COVID-19 through May 16, with 110,000 of them being hospitalized. Blacks were hospitalized at a rate four times that of whites.

CMS also announces the creation of CMS’s Office of Burden Reduction and Health Informatics, which will look at the burden of meeting CMS compliance requirements, fostering innovation through interoperability, and using technology to create new tools to allow patients to own and carry their health data and to give clinicians their complete medical history.


Reader Comments

From Wilson’s Gremlin: “Re: telehealth visits. I’m wondering what percentage have deficient pre-screenings performed (temperature, blood pressure) because appointments are remote? Or that require patients to leave home afterward for follow-up (for blood to be drawn or for a nasal swab)?” Good question – maybe someone knows. That would lead me to wonder whether traditional practices had to reconfigure their EHR to make in-person measurements such as temperature optional rather than required. It would also be interesting to know how many physical trips a virtual visit generates (lab, pharmacy, X-ray, PCP, etc.) although most of those would have been required even with a face-to-face visit.


HIStalk Announcements and Requests

Newbie vendor prospecting and marketing people are working energetically from home with minimal supervision and mentorship, so I’ll provide these tips:

  • Do not “circle back” if a health IT executive didn’t find your first unsolicited email interesting enough to respond the first time.
  • Do not hound people on LinkedIn with unsolicited connections and boilerplate messages.
  • Do not send unsolicited calendar appointments.
  • Whatever your company sells may well be the most important part of your universe, but the provider world is dealing with decimated revenue and COVID-19 challenges, so you aren’t anyone’s top priority.
  • Those books on lead generation, sales funnels, and social media marketing that you ordered from Amazon push ideas that are not only ineffective in selling to the health system C-suite, but often detrimental.
  • Focus on their problems, not your needs.
  • It is risky for an industry newbie to pursue a conversation with someone who has decades of health IT leadership. Your unfamiliarity with the industry’s lingo, lack of broad knowledge, and insecurity-driven adherence to the company-approved conversational script makes success unlikely even if you get someone on the phone.

Webinars

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


Acquisitions, Funding, Business, and Stock

Cerner conducts another round of layoffs, this time involving 100 employees. The nails-on-blackboard corporate phrase “new operating model” was uttered yet again as an explanation.

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CoverMyMeds finds in a comprehensive prescription access report that 70% of patients have made sacrifices to obtain their medications, while 30% of providers say their patients are unable to pay for meds. COVID-19 has caused changes – 20% of patients paid cash for prescriptions; two-thirds say they are more likely to use telehealth going forward; 30% of providers say their biggest telehealth challenges are privacy concerns and lack of EHR integration; and 80% of providers say their telemedicine use is hampered by patients who lack technology skills. Patients who are prescribed specialty medications report delays of up to several weeks waiting for prior authorization. Most prescribers don’t trust the formulary and insurance benefit information contained in their EHRs and 86% of them say their office bears a “high” or “extremely high” workload burden in managing prior authorization requests.

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High-acuity house call provider DispatchHealth raises $136 million in a Series C funding round, increasing its total to $217 million. It offers home visits that can include lab work, EKG, infectious disease tests, medications, IV placement, breathing treatments, suturing, catheter placement, and splinting.  The company operates in 19 cities and accepts many insurances, leaving patients an out-of-pocket cost that averages $5 to $44.


Sales

  • Billings Clinic (MT) will implement TransformativeMed’s specialty- and disease-specific EHR workflows, which include notification, messaging, and a COVID-19 app. The company will also be developing a nursing handoff app.

People

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Physician practice change analytics vendor Empiric Health hires Spiro Papadopoulos (Stanson Health) as VP of business development.

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Shally Pannikode (WellStar Health System) joins Humana as CVP/CIO of healthcare services.

Rush University Medical Center SVP/CIO Shafiq Rab has resigned, according to his LinkedIn.


Announcements and Implementations

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AbleTo launches population-based virtual mental health services to payers.

PatientKeeper develops its Charge Capture software into a FHIR-based app that is embedded in Cerner, allowing clinicians to launch the charge entry screen within their Cerner workflow to record patient charges.


COVID-19

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US COVID-19 infection doubling time has dropped from 60 days last week to 52 days now, with 31 states reporting an expanding epidemic. Deaths are at their lowest levels in three months, however, leading to interesting speculation as to why. Most likely answer – younger people are getting increasingly infected without becoming seriously ill, but the infection’s spread to more vulnerable populations in the absence of mitigation strategies is inevitable. Most optimistic but unlikely answer – treatments and care management are improving outcomes.

Coronavirus seems to be infecting people under 50 at higher rates than were observed in the Northeast, with 50% of hospitalized patients and 30% of those in ICUs being under 50 in the Dallas-Fort Worth area. The median age of people who are testing positive in Florida has dropped from 65 years in March to 35 now, which may be a function of more widespread testing, but also possibly because older people are protecting themselves better. Florida hospitals are admitting more COVID-19 patients in their 20s, 30s, and 40s.

Texas Children’s Hospital starts admitting adult patients to free up Houston-area beds for the expected surge of COVID-19 patients. Houston Methodist Hospital says COVID-19 admissions have tripled since Memorial Day.

A preliminary report suggests that oral dexamethasone – which is cheap, readily available, and low in significant side effects — can reduce mortality in hospitalized COVID-19 patients, especially those who are ventilated or receiving oxygen.

The European Union is likely to add the US to its list of countries whose citizens will be barred from entering its 27 countries because of out-of-control COVID-19 spread. Travel restrictions will be loosened on July 1 for countries whose new infections in the previous 14 days meet or beat the EU’s average of 16 per 100,000 residents. The US is at 107.

A COVID-19 congressional hearing finds that President Trump hasn’t spoken to the government’s key pandemic players in several weeks, including NIAID Director Anthony Fauci, MD and FDA Commissioner Stephen Hahn, MD. CDC Director Robert Redfield, MD declined to answer when asked.


Other

A White House executive order suspends issuance of H-1B work visas through at least the rest of the year, prohibits US companies from transferring foreign executives to long-term US assignments, and blocks US entry of spouses of foreign-born workers. The federal government says the order will keep 525,000 people out of the country to protect American jobs. The H-1B employer program is for highly educated people in specialty occupations, most of them in technology, medicine, academics, and engineering.

Cerner VP of Government Services Julie Stoner says the VA’s rollout will take 10 years.


Sponsor Updates

  • Pivot Point Consulting performs a virtual Epic go-live at Carle Foundation Hospital (IL).
  • Central Logic CEO Angie Franks will describe health system telehealth use cases in a presentation this week to the virtual American Telemedicine Association Conference & Expo.
  • Health Catalyst joins the FDA’s COVID-19 Evidence Accelerator.
  • Optimum Healthcare IT and University of North Florida create an EHR apprenticeship program called Last Mile Training.
  • Capita Healthcare Decisions adds Healthwise’s evidence-based information to its Salus Universal patient engagement and relationship software.
  • The Chartis Group publishes a new white paper, “After the Surge: Five Health System Imperatives in the Age of COVID-19.”
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, releases the latest edition of its Critical Care Obstetrics Podcast, “DKA Made Simple.”

Blog Posts


Contacts

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

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Morning Headlines 6/23/20

June 22, 2020 Headlines No Comments

Cedar Accelerates Growth with $102M in Series C Funding Led by Andreessen Horowitz and New Innovation Partnership with Novant Health

Patient payment vendor Cedar raises $102 million and announces a contract with Novant Health in North Carolina.

Proprio Raises $23 Million in Series A Funding Led by DCVC

Augmented surgical imaging company Proprio raises $23 million in a funding round led by Data Collective.

OIG Strategic Plan: Oversight of COVID-19 Response and Recovery

The HHS Office of Inspector General publishes its oversight strategy for COVID-19 response and recovery, which includes protecting the integrity and security of IT systems and health technology.

Apple introduces new Covid-19 features: Hand washing guides and a mask-wearing emoji

Apple debuts several health-related Watch features at its virtual developers conference, including one that will help users wash their hands for the recommended amount of time using the proper technique.

HIStalk Interviews Suresh Venkatachari, CEO, Healthcare Triangle, Inc.

June 22, 2020 Interviews 2 Comments

Suresh Venkatachari is chairman and CEO of Healthcare Triangle, Inc. of Pleasanton, CA.

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Tell me about yourself and the company.

Healthcare Triangle combines two great companies, each successful but stronger together. One is rooted in proven healthcare and business methodologies, and the other is a born-in-the-cloud early adopter turn global leader. Together, we are a 360-degree solution with the know-how and innovation capacity to meet technology, data, care delivery, and business operation needs.

We offer solutions to three core healthcare customers — hospitals and health systems, health insurers, and life sciences companies. I’m proud of our commitment to support each one’s respective effort to improve health outcomes by enabling the adoption and optimal use of new technologies, data enlightenment, business agility, and response to immediate and emerging business needs and market trends.

I have 30-plus years of experience in creating and managing businesses in cloud, ecommerce, IT solutions and consulting services in healthcare, life sciences and banking. But nothing compares to the excitement of today’s healthcare innovative landscape.

How does the combination of traditional health IT consulting, such as EHR implementation and optimization, and cloud transformation and security benefit clients?

I am incredibly excited by this combination and its advantages. Our traditional consulting background helps us understand the complex challenges that are facing healthcare CIOs in the current ecosystem. Our technology expertise in cloud transformation and security in the life sciences space means we understand the power of cloud transformation in highly regulated environments.

The combination also guides our clients on a practical and achievable roadmap of digital transformation. For one hospital, for example, our work focus might be disaster recovery and backup, while simultaneously leading higher-level discussions on end-to-end managed healthcare IT services with the C-suite executives. Simply stated, we are all about alleviating a lot of headaches for the CIO with solutions for operational efficiencies and lowered costs.

What’s really thrilling is that bigger picture, the healthcare industry is on the cutting edge of realizing a monumental pivot among healthcare providers and life sciences. Significant high-tech advancements are happening in personalized healthcare at every stage of the patient’s healthcare journey. Innovative and customized solutions are reshaping delivery of better access to smarter and more effective care to everyone.

What pandemic-driven technology challenges and opportunities will health systems see in the near future?

We’ve recently highlighted key challenges with technology extensively in our “Return to Revenue” series. But underlying that, the greatest challenge will be maintaining the business agility that is needed to react quickly and deploy those technologies that have an impact on patient safety and are demanded by the patients themselves.

Our clients succeeded in meeting the COVID-19 crisis head on by rapidly adopting and adapting telehealth technology. Next, we recommend that they go to the next level by deploying virtual waiting rooms and exam rooms, in-home monitoring, and data solutions. Traditionally, these types of projects take years to plan and implement, but we’re seeing increasing need to drive change in weeks and even months. HTI is their enabler to continue to iterate quickly and set a roadmap for continuous practical innovation.

On the life sciences side, we witnessed two immediate COVID-19 related challenges. First, the need to analyze data extremely rapidly. Second, the need for rapid deployment of digital health technologies.

We have a customer, Stay Smart Care, who is the perfect example of digital health excellence. Their business purpose is to help people safely age in place in their home. Stay Smart Care offers remote patient monitoring, with real-time sensor data, dashboards, and chat functions. We built the entire digital health platform, from the digital health management application to the secure, compliant patient communication application. This technology offers amazing potential in multiple areas of telehealth.

My team has a deep knowledge of the healthcare system, cloud technology, and digital health applications,. We are advising our clients about solutions that will help them navigate and succeed in the next normal of telehealth.

How have the data sourcing and analytics needs of life sciences companies and researchers changed as they address COVID-19?

COVID-19 has dramatically fast-tracked research toward treatment and prevention. New collaborations are springing up to protect public health. Not surprisingly, researchers and life sciences companies find themselves having to obtain, analyze, and share a high volume of test results and other data rapidly and safely. The solutions we offer for cloud transformation make management and analysis of that data less challenging and allow researchers and life sciences companies to focus on what counts most, which is saving lives.

Specifically, our DataEZ solution – a data lake as a service, if you will – is used by five of the largest global pharma firms. It allows rapid analysis of clinical trial information, for example. One client went from conducting clinical trial to submitting the reports to compliance agencies in a matter of weeks. Before this, the process required several months.

Health system IT departments have quickly rolled out new technologies such as telehealth, chatbots, and remote worker support, delivering quick wins rather than the more typical implementation projects that can take years. Will this experience change how those IT departments manage projects and technology going forward? 

We did see some very quick technology implementations over the last few months. I hear health system leaders talking positively about the quick consensus-building and lean approach to implementation that it took to make that happen. It is a very agile approach to deploy a solution and iterate on improving it over time based on real-life experience impacting productivity and costs. We focus on delivering business agility whether we are supporting a cloud migration, providing data insights, or optimizing an EHR workflow, and I hope that momentum is sustained going forward.

How will cloud-based services change the job of the health system CIO over the next five years?

We’ve been saying for years that the role of the CIO is changing from functional technology leader to business strategist and transformationalist. Trends in innovation driving that change are digital health, personalized healthcare, telehealth, remote monitoring, data-driven decision support systems, and blockchain innovation. Cloud is the key that unlocks the capacity in our client CIOs.

Taking advantage of cloud technology and automation means that CIOs can focus on full-scale organizational transformation and drive business agility into their technology platforms. Instead of 30-day cycle to spin up a server, we’re talking seconds on the cloud. And that’s a cascading effect, right? Every win along the journey to the cloud allows the organization to transform faster and faster in today’s changing environment and our client CIOs to drive that change rather than constantly react to it.

What are your medium-term goals for the company?

We want to drive the conversation centered around digital transformation into a new phase of bold action. The disruption to the industry and our communities demands that we use technology to strengthen our ability to deliver healthcare despite the impact of external forces. We are flexible and practical. We will meet clients wherever they are in their digital transformation and make great advancements together accelerating the value that they see from technology.

The drive to improve care delivery and business agility in healthcare is limitless. I know that we are ready as an industry to deploy new technologies, gain enlightenment through data insights, and push toward the next frontier of digital innovation. That’s what Healthcare Triangle is here to do — to reinforce healthcare progress.

Readers Write: Major Trade Shows Continue to Cancel or Go Virtual, So Now What?

June 22, 2020 Readers Write 3 Comments

Major Trade Shows Continue to Cancel or Go Virtual, So Now What?
By Jodi Amendola

Jodi Amendola is founder and CEO of Amendola Communications of Scottsdale, AZ.

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As major healthcare and health IT conferences such as HIMSS, AHIP, RISE, MGMA and others continue to cancel their live events or go virtual, marketers and sales leaders are now faced with the new challenge of where to put the money that was originally slated for sleek exhibition booths, networking events, and all of the promotional activities leading up to these in-person events.

For many companies, trade shows eat up half of their marketing budget, so the decision about if and how to reallocate those dollars requires careful consideration in these uncertain, unprecedented, and budget-conscious times.

Trade shows get more expensive and more arduous to prepare for every year. But they are also one of the highest-value ways to network and to build new business relationships while renewing old ones. They can be a source of good leads that move the needle to influence important buying decisions. Importantly, for many companies, trade shows are where companies go to be seen.

Trade shows will eventually return, although when and in what form is still an unknown. In the mean time, they are not the only path to visibility and credibility with prospects, or even the most effective. What follows are some recommendations for re-allocating your trade show spend.

Public Relations

Most B2B sales have larger price tags and longer sales cycles than consumer products. Before making an investment in health IT, providers, health plans, and government agencies need to trust that a purchase will answer a need or solve a problem.

Coverage in credible media outlets is still where you get the biggest bang for your buck in B2B.

Peer-to-peer endorsements carry a lot of weight with buyers, and customer success stories — especially if you make the story almost entirely about the customer — are media gold. The same story can be approached from a number of angles to make it appealing to various media outlets with different audiences that align with your target markets.

You should also aim for getting thought leadership coverage—bylines, commentary, and other contributions on the big issues of the day. Thought leadership is most effective when it’s authentic and not afraid to take a stand, so avoid corporate-speak.

HIT leaders are increasingly interested in how PR impacts share of voice against the competition, and what the sentiment is in earned media coverage—positive, neutral, or negative. That can be measured, even by specific topics, with media monitoring and tracking tools such as Meltwater.

This measurement can help you understand how you’re dominating (or not) the most pressing conversations in the industry and media landscapes. Right now, the most pressing topic is of course COVID-19. You can assess your media reach compared to the competition on specific topics such as the pandemic. You can drill down even further on subtopics such as vaccine development, predictive analytics, and primary care that relate to COVID-19.

You can extend the shelf life of media wins by promoting your media placements to decision-makers and key influencers across social media and on your website, and by leveraging for lead gen and nurturing via e-newsletters, emails blasts with landing pages, electronic reprints for virtual conferences, and more.

Lead Generation Campaigns

Gated content, which requires whoever is interested to give up their name and email to obtain it, can capture far more qualified leads than those picked up at a trade show by a “claw” who really just stopped by for your cool giveaways. Examples of high-value content that can be placed behind a form for lead gen includes case studies, smart briefs, white papers, major reports and study results. and on-demand webinars, to name a few.

Targeted digital ad campaigns that promote the right content to the right audiences also are a powerful lead gen tool. One of the most exciting capabilities of digital advertising is how specifically you can target your outreach (as political campaigns like to do), but A/B testing is still needed. This is an area that often comes up short when trade shows need to be paid for, but now would be a great time to leverage those unused dollars to test these campaigns until they hit the right mark.

Marketing Asset Development

If there’s a bright spot in the time we’ve spent sheltering in place, it’s the interesting videos and podcasts we’ve discovered. For many of us, listening to a podcast at a certain time every day will be a permanent part of our schedule post-pandemic. Simply produced Zoom interviews are also likely to be a mainstay, having been validated by broadcast news channels while studios were closed.

Why not spend a portion of your newly freed trade show budget on commissioning some of these assets yourself? Over time, a series of thought leader podcasts or videos with provocative themes can elevate brands and thought leadership.

Surveys are another marketing asset to check off your marketing bucket list. Not only do they give you a current read on target audience sentiment, the findings can be newsworthy enough to promote via media outreach and nab more coverage.

When it comes to trade shows, nothing replaces human interaction. But now is the time to strategically reallocate those unused marketing dollars to take advantage of alternate strategies that can increase awareness and generate leads for your business.

Curbside Consult with Dr. Jayne 6/22/20

June 22, 2020 Dr. Jayne 2 Comments

Former CMS Administrator Donald Berwick was featured in the Journal of the American Medical Association last week, writing about “The Moral Determinants of Health.” I was glad to see it, as I sorely needed a break from COVID-related literature and from the ongoing firefighting related to the pandemic’s many downstream impacts. Given the level of turmoil in our society right now, coupled with a disease that is disproportionately affecting various segments of the US population, it was just the read that I needed.

Many of us chose careers in medicine because we wanted to make a difference. Those of us who selected the realm of primary care knew we were taking on the challenge of being among the lower-paid and often less-respected subspecialties, but that was often balanced out by the knowledge that what we would be doing would be important.

For many of our patients, we would be the first member of the healthcare team they would turn to. Our training would help us be uniquely positioned to help solve their problems, through promotion of healthy behaviors or the recommendation of medication therapies or surgeries when needed. We didn’t choose to fight insurance companies or administrators, but as we left residency training for the real world of healthcare, it was obvious we were going to have to operate in an environment for which we were ill prepared.

Whether or not a patient is insured often dictates the care a patient receives, and that quickly creates a line between the haves and the have-nots. My generation of physicians didn’t learn about social determinants of health (SDOH) in our training, but SDOH always formed an undercurrent as we rotated through various clinics and offices in different parts of town. Depending on the ZIP code, the care we recommended varied widely and was largely tied to factors that led certain patients to be sicker than others and whether they could afford to have the care the needed. I had been in practice for nearly a decade before I ever heard a label for this phenomenon.

Berwick notes how significant these factors are, stating that “the power of these societal factors is enormous compared with the power of healthcare to counteract them.” He mentions the “subway map” view of life expectancy, where life expectancies decline for every minute of a subway ride between the “have” and “have not” areas of cities such as New York or Chicago.

Berwick describes the lack of logic in how wealthy nations address health. Although science can identify social causes for poor health, we spend our resources on “expensive repair shops” including medical centers and emergency care, rather than on prevention. He notes a lack of political will to date in shifting the focus of spending upstream, where a difference could be truly made. He mentions the concept of moral determinants of health, one of which is “a strong sense of social solidarity in the US.” In this construct, “Solidarity would mean that individuals in the US legitimately and properly can depend on each other for helping to secure the basic circumstances of healthy lives, no less than they depend legitimately on each other to secure the nation’s defense.”

He goes on to describe the foundations of a “morally guided campaign for better health,” which includes such concepts as the US catching up with the rest of western democracies on such topics as ratification of international treaties and conventions on basic human rights, action on climate change, and statutory support for healthcare as a human right. He notes that “no sufficient source of power exists to achieve the investments required other than discovery of the moral law within… the status quo is simply too strong. The vested interests in the healthcare system are too deep, proud, and understandably self-righteous; the economic and lobbying forces of the investment community and multinational corporations are too dominant; and the political cards are too stacked against profound change.”

Berwick ponders what it means for healthcare to stay in its lane and whether health leaders should take on these social challenges. He believes that the healthcare community needs to go beyond caring for illness, and that “it is important and appropriate to expand the role of physicians and healthcare organizations into demanding and supporting societal reform.” He calls on the healthcare community to spend less time lobbying for regulatory relief and improved reimbursement and more time lobbying for universal health insurance coverage. He calls for the healthcare workforce to use the ballot box to drive change. He closes with this:

Healers are called to heal. When the fabric of communities upon which health depends is torn, then healers are called to mend it. The moral law within insists so. Improving the social determinants of health will be brought at least to a boil only by the heat of the moral determinants of health.

The physician community is a microcosm of our society, and I know plenty of physicians who would rapidly align either for or against these ideas. I spent time this weekend with a surgeon who is “so over this whole COVID thing” and just wants to operate, and also with a psychiatrist who is helping others deal with the trauma they’ve experienced from having multiple family members die due to the pandemic. They’ve had dramatically different exposure to the downstream effects of the pandemic, even though both “healers” live in the same ZIP code and their kids go to the same school. We have to find a way to get past the polarization and to see things from other’s perspectives rather than just shutting them out because we have different experiences that may have driven different viewpoints.

I’ve learned of healthcare organizations that are tackling these issues head on and others that are trying to go back to the pre-pandemic, pre-protest era we lived in prior to 2020. It will be fascinating to see how strategies evolve and what organizations are willing to shift revenue upstream to public health and community projects that might just eliminate good portions of certain service lines.

Berwick has certainly given us food for thought, and it’s an ambitious list of actions he proposes. However, we just picked one of them, such as the idea that healthcare should be a human right, and figured out how we could come to consensus, we would still be in a much better place.

Is your organization addressing the moral determinants of health, the social determinants of health, or just trying to figure out how to get elective procedures scheduled again? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 6/22/20

June 21, 2020 Headlines No Comments

Kaia Health gets $26M to show it can do more with digital therapeutics

Virtual physiotherapy startup Kaia Health raises $26 million in a Series B funding round led by Optum Ventures.

Philadelphia-area health system says it ‘isolated’ a malware attack

Crozer-Keystone Health System (PA) suffers a ransomware attack by hackers who have threatened to auction the stolen data off on the dark web if their demands aren’t met within six days.

Putin calls for artificial intelligence to be used in healthcare

Russian President Vladimir Putin calls for the healthcare system there to roll out digital systems and to use artificial intelligence.

FEMA IT Specialist Charged in ID Theft, Tax Refund Fraud Conspiracy

A federal grand jury indicts a Detroit man for the 2014 hack of UPMC’s HR system, where he is accused of selling the information of 65,000 employees on the dark web to conspirators who used it to file fraudulent tax returns.

Monday Morning Update 6/22/20

June 21, 2020 News 4 Comments

Top News

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In Russia, President Vladimir Putin calls for the healthcare system there to roll out out digital systems and to use artificial intelligence.

Putin told health workers in a videoconference that Russia should use its experience in successfully addressing coronavirus to improve the overall reliability of its healthcare system.


Reader Comments

From Options Exercise Program: “Re: PatientPing’s delayed funding announcement. If you’re going to disclose a raise, make it timely. When public companies do this, we (the investor research community) used to call it ‘painting the tape.’ It matters because the backdrop between now and then is very different. Raising the money during this current time (COVID) sends a very different signal of optimism than it did when the raise occurred. Same quarter plus or minus is fine, but not 16 months.”


HIStalk Announcements and Requests

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More than half of poll respondents expect the use of virtual provider visits to increase in the next year over today’s already-increased levels, although two commenters correctly observed that the challenges are not related to technology limitations, consumer or provider preference, or clinical outcomes – it’s all about payments by CMS and insurers.

New poll to your right or here: For those who have had a recent telehealth visit: how was pre-visit information (allergies, meds, recent history, current problem, etc.) collected?

Listening: new from Travis, a Scotland-based (“Glaswegian,” a new word to me) indie band that has been around for 30 years. They couldn’t make a video for the new tune because of coronavirus lockdowns, so singer Fran Healy and his son drew their own.


Webinars

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


People

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Arcadia promotes Debbie Conboy to VP of risk adjustment and quality products and hires Catherine Turbett, MHA (Lumeris) as VP of ACO and health plan account operations.


Announcements and Implementations

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KLAS didn’t send me its “US Hospital EMR Market Share 2020” report, so I’ll summarize what its blog post says. Only Epic and Meditech had a net gain in hospitals in 2019. Epic has won most of the new big-hospital decisions over several years, but Cerner bagged the DoD/VA elephant. KLAS says there is room for another market entrant, but it glosses over the time, money, and determination that would be required to develop, sell, and install a new hospital EHR. On an unrelated note, I have a minor grammatical quibble with KLAS for writing “multi-tenet” instead of “multi-tenant.”


COVID-19

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The New York Times reports that nursing homes are taking advantage of being off limits to ombudsmen during the pandemic by evicting low-profit residents — such as those on Medicaid — to free up beds for profitable COVID-19 patients. Some facilities have discharged residents with no notice to unregulated boardinghouses and cheap motels, sometimes without notifying their families. Nursing homes make much of their profit from post-surgery rehab patients who are covered by private insurance, the supply of which has dwindled as hospitals halted non-essential services. Seventy percent of US nursing homes are for-profit businesses, with 11% of them being owned by private equity firms.

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Former FDA Commissioner Scott Gottlieb, MD says that the 10 states that are seeing record-high new COVID-19 cases (AL, AZ, CA, FL, NV, NC, OK, OR, SC, TX) are losing control of the epidemic, as doubling time has fallen to under 10 days. He questions whether the governments of those states possess the political will to implement mitigation steps that could slow the spread. Researchers have noted that states that have higher mobility and low testing and tracing are more likely to be experiencing outbreaks. Arizona’s positive test rate is at 17% and its case count has turned sharply upward, far more than any other state. Thoughts that COVID-19 will throttle itself back in the heat – which were already questionable given its early impact in warm areas of the globe – should consider Arizona (highs in Phoenix are at 110 degrees) as evidence to the contrary, or perhaps more specifically, that congregating indoors under air conditioning without masks once lockdowns have eased is great viral exploit.

President Trump tells attendees of his Tulsa rally that he ordered government officials to slow down COVID-19 testing. He explained, “When you do testing to that extent, you’re going to find more people. You’re going to find more cases. So I said to my people, slow the testing down, please.”

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The American Red Cross says blood donations have dropped sharply due to lockdowns and coronavirus fears, and as an incentive to lure donors back, is offering them a free COVID-19 antibody test.

A Harvard working paper finds that the COVID-19 mortality rate of black people ranges from seven to nine times higher than that of white people, depending on age group, meaning that the “years of potential life lost” of both blacks and Hispanic / Latino populations are higher than that of whites despite their much smaller population. 

ProPublica reports that 12% of New Jersey’s nursing home residents died of COVID-19, along with 6% of all nursing home residents in New York, when the states ordered unprepared nursing homes to take all hospital transfers and prohibited them from testing prospective residents for COVID-19 in a “reverse triage” attempt to free up hospital beds. State officials based their order on federal guidance that allowed such transfers if the nursing home met a list of criteria, but nobody was sure who was responsible for assessing their readiness. A Wall Street Journal investigation found that 50,000 of the country’s 122,000 COVID-19 deaths have involved long-term care residents and employees.

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Former FDA Commissioner Robert Califf, MD says that while the US is applying impressive technology expertise to COVID-19, we’re ignoring the basics, such as wearing masks and distancing.


Other

A federal grand jury indicts a Detroit man for the 2014 hack of UPMC’s HR system, where he is accused of selling the information of 65,000 employees on the dark web to conspirators who used it to file fraudulent tax returns. The LinkedIn of Justin Sean Johnson says he is a Oracle PeopleSoft expert who worked as a a self-employed cybersecurity researcher for several years, now employed as an IT specialist at FEMA.


Sponsor Updates

  • Premier develops Intersectta, an oncology-focused group purchasing organization to source cancer and other specialty drugs.
  • Relatient publishes a new case study, “Cherokee Health Systems Powers Telehealth with Patient Engagement, Goes Live Across 24 Locations During COVID-19.”
  • CareSignal publishes a case study titled “How Mercy Built a Technology-Enhanced Care Management Model to Scale Care Management and Increase Patient Engagement.”
  • Saykara congratulates customer OrthoIndy on receiving the Healthgrades 2020 Patient Safety Excellence Award.
  • Spok appoints Brett Shockley (Journey.AI) to its board.
  • TriNetX will partner with Parexel to advance real-world data use in clinical development.

Blog Posts

Sponsor Spotlight

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Get-to-Market Health is a specialized consultancy focused exclusively on accelerating sales and driving revenue growth for healthcare solution providers. We work with business leaders to simplify the complexity and unique buying patterns of the healthcare market. Bringing deep, broad experience and valuable network connections, the partners at Get-to-Market Health are industry experts. We have worked at and with dozens of healthcare technology businesses ranging from small startups to large, established companies. We help our clients navigate the challenges they face as they work to drive revenue and market innovation.

(Sponsor Spotlight is free for HIStalk Platinum sponsors).


Contacts

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

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Cerner News

June 21, 2020 News No Comments

Cerner conducts another round of layoffs, this time involving 100 employees. The nails-on-blackboard corporate phrase “new operating model” was uttered yet again as an explanation. (6/24/20)

The VA gives Cerner a $99 million task order for sustainment support of hardware and software associated with its $10 billion EHR modernization project. (6/12/20)

A GAO review finds that the VA has implemented effective configuration decision-making in its Cerner implementation by holding national workshops and creating 18 EHR councils, but needs to improve representation at local workshops. The report also notes that while the VA and DoD both user Cerner, coordination is needed to allow sharing of information and tasks, such as VA’s requirement to maintain durable orders for life-sustaining treatment across patient encounters that is not supported by the DoD’s Cerner configuration. (6/8/20)

Congressional sources say the VA probably won’t restart its Cerner rollout until the fall because of COVID-19 demands. (6/5/20)

RCM company R1’s shares jumped over 9% on the news that it will acquire Cerner’s RevWorks business in a transaction valued at $30 million. As part of the deal, Cerner will offer R1’s software and services to customers and prospects. In an April 2019 earnings call, company reps said RevWorks had grown stagnant, contributing $200 million in annual revenue. Cerner had been using its RevWorks offerings “to more tightly align the client to Cerner” for additional sales of its software and services. (6/5/20)

North Central Health Care (WI) will implement Cerner’s Behavioral Health EHR in three multi-specialty behavioral facilities. (6/3/20)

Cerner hires Jerome Labat (Micro Focus) as CTO. (6/3/20)

Forty-nine municipalities in Sweden’s Västra Götaland region will implement Cerner Millennium. (5/29/20)

Cerner develops COVID-19 re-opening and social distancing projections for 60 countries using data from sources that include CDC, Johns Hopkins, Definitive Healthcare, and the COVID Tracking Project. (5/29/20)

Cerner joins the Fortune 500 largest US companies by annual revenue, coming in at #498. (5/20/20)

Cerner will begin moving employees back on campus Monday, starting with 10% of its workforce and aiming for no more than 50%. Employees will be encouraged to wear masks, fitness centers and cafeterias will be closed, elevators will be limited to two passengers, and staircases will be designated as one way. The company says positions in its consulting and client support areas may remain virtual permanently. (5/18/20)

Cerner announces that its annual conference, scheduled for October 12-14, will be conducted as a virtual event. The conference, one of Kansas City’s largest, is among 78 that have cancelled so far during the pandemic. City officials estimate that the cancellations will cost the local economy $137 million in lost hotel room bookings alone. (5/15/20)

Weekender 6/19/20

June 19, 2020 Weekender 1 Comment

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Weekly News Recap

  • Health Care Service Corporation, the country’s fifth-largest insurer, will create a Payer Platform to connect its health plans to Epic-using health systems.
  • Epic cancels UGM 2020.
  • Proteus Digital Health, once valued at $1.5 billion, files Chapter 11 bankruptcy.
  • Walmart acquires the technology assets of online pharmacy CareZone for a rumored $200 million.
  • Surgisphere, the tiny company whose questionably sourced aggregated EHR data was responsible for two major research article retractions, appears to have shut down.
  • Milliman acquires Wisconsin-based employee health monitoring technology vendor Healthio.

Best Reader Comments

I can’t help but wonder how this will affect minor telephone calls with doctors. In the past, I would occasionally call a doctor on the phone to check in on a test result or ask about a medicine and so on. These were relatively quick, focused calls for which there was no charge. But going forward, if telehealth becomes an accepted modality for paid services, what’s to stop a doctor from billing me for each of those calls? (Ben)

If you want providers to do something, you have to pay for it. I’ve got some nice cushy corporate insurance, so I can get my PCP to throw in a couple of freebie phone calls after he’s price gouged me on a few visits. If I had an ACA exchange plan, I doubt I’d get the same level of customer service. I’d rather the billing for telehealth and chat services gets formalized so that the people on government or skimpy plans can push for and get it. Otherwise it’s just going to be a perk for good employer plans, which means it won’t affect anything. (IANAL)

I am appreciative that CMS has relaxed some of the constraints for telehealth services billing during the pandemic but those rules were inane restrictions to begin with. Why should a patient ever have been precluded from getting telehealth at home, simply because they don’t live in a designated rural area? (ValueBasedSkeptic)

As to the hype around value-based payments, we’ve lived through this before with different names and slightly different variants. Improving quality sounds great, but we still can’t define or measure quality well, even for very clear-cut conditions. We’ve spent untold money and efforts on quality measures with lots of content from CMS, NQF and others. Yet for some specialties, there are few if any viable measures. Whether it’s framed as improving population health or some other positive sounding initiative, the main goal has always been shifting costs onto the backs of providers. (ValueBasedSkeptic)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. H in North Carolina, who asked for game buzzers and wobble cushions for her fifth-grade ADHD students. She reported in February, “My students come in every day begging to use the wobble cushions, as well as wanting to know if we will be playing a game with the buzzers. We will continue using these resources daily in our classroom until the end of the school year. I know my future students will be just as excited next year using the wobble cushions and game buzzers.”

Federal authorities arrest a Chinese citizen at LAX as he attempts to board a flight to China, charging him with obtaining a UCSF post-doctoral fellowship position so he could record lab layout details that could be replicated in China. The man, who turned out to be a major in the People’s Liberation Army, admitted that he had been stealing information in his year of employment there. His laptop contained UCSF study information and he had wiped his WeChat phone messages right before arriving at the airport. He is charged so far only with visa fraud.

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Four ICU nurses sue Landmark Hospital (GA), claiming that the hospital ordered them to perform COVID-19 test swabbing incorrectly to ensure that the tests would come back negative.

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NASA’s next Mars rover, scheduled for launch on July 20, will bear a plate that honors those who are on the COVID-19 front lines.


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Morning Headlines 6/19/20

June 18, 2020 Headlines No Comments

Nation’s Largest Member Owned Health Plan to Launch Epic Platform to Improve Patient and Provider Experience

Health Care Service Corporation will create a Payer Platform to connect its health plans to Epic-using health systems for reviewing patient data, managing claims payment and prior authorization, and facilitating care management.

All of Us Research Program launches COVID-19 research initiatives

NIH’s All Of Us research project adds three COVID-19 data collection components for researchers who are approved to study data from its 350,000 participants.

This Amazon-owned company says it will bring 500 jobs to Boise area by 2021

Online prescription drug delivery company PillPack will bring 500 jobs to Meridian, Idaho when it opens a 78,000-square-foot customer service center there next year.

News 6/19/20

June 18, 2020 News 5 Comments

Top News

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Member-owned health plan Health Care Service Corporation will create a Payer Platform to connect its health plans to in-network Epic-using health systems for reviewing patient data, managing claims payment and prior authorization, and facilitating care management.

HCSC is the country’s fifth-largest health insurer, with 16 million members enrolled in Blue Cross Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma, and Texas.

HCSC acquired care management solutions vendor Medecision for $121 million in mid-2008 and is a partial owner of clearinghouse operator Availity.


Reader Comments

From Cellular Terrorist: “Re: COVID-19. You should call out the states that refused to apply sound public health measures and are now having record-breaking case numbers.” The problem with the federal government allowing states to do whatever they want is that we as a country can’t or won’t curtail unencumbered travel, so a Florida resident or visitor who parties down mask-free could spread COVID to more responsible areas in the “weakest link” theory. COVID-19 has demonstrated that we Americans don’t care much about science and can’t be bothered with inconveniences like wearing masks unless they promise to save us instead of someone else, so perhaps the “we’re all going to get it eventually anyway” crowd is right. What happens in Vegas doesn’t unfortunately stay in Vegas when it comes to coronavirus.

From Contact Tracy: “Re: contact tracing. See this press release for what my company is about to launch.” As an occasional bearer of bad news, allow me to level-set you: (a) use of any contact tracing app in the US will be under 15% and will drop quickly, making zero difference, and what little adoption there is will be all Apple and Google; and (b) contact tracing in general in the US won’t work because nobody trusts anybody, especially anyone connected with government in any form, enough to give them any personal information, much less their contact names and information, and they won’t even answer phone calls and emails from public health officials. We had better excel at developing a vaccine since every prevention strategy that worked elsewhere — lockdowns, masks, widespread testing, contact tracing, travel limitations, and immunity passports – requires nearly universal adoption and won’t fly in a fatally divided country like ours. Not to mention that we are a lot unhealthier than much of the developed world and will experience a higher rate of coronavirus-related deaths as result. We’re at 120,000 now, more than two Vietnam Wars’ worth (and to paraphrase Chief Brody said in “Jaws,” you’re gonna need a bigger wall). 


HIStalk Announcements and Requests

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The grocery chain pharmacy (those are always cheaper than drugstore chains in my experience) filled my 360-day prescriptions for blood pressure and cholesterol meds with a 91-day supply even though I wanted a full year’s worth and was paying cash using a GoodRx coupon. They said GoodRx rejected the 360-day quantity, so I called GoodRx and was quickly connected to a pleasant, actual human who verified that some vaguely described policy limits fills to a 91-day supply in some cases. She could not describe those cases or explain why the app would issue a coupon that was not valid. I still got a year’s supply, paying $82 instead of the expected $60, and only then because the pharmacist found a coupon from a GoodRx competitor. At least the recent federal change that prohibits PBMs gagging pharmacists from telling patients about lower-cost options worked for me and I was impressed with GoodRx’s customer service. Meanwhile, CNBC reports that the software guys who started GoodRx have built a business worth $3 billion in finding yet another illogical loophole in our illogical healthcare non-system.


Webinars

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


Acquisitions, Funding, Business, and Stock

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PatientPing confirms the reader rumor that I recently ran: the $60 million Series C fund raise that it announced last week was actually completed in February 2019. The company told me that it held the announcement “to peg it to exciting company milestones and product capability rollouts,” which was explained to the Boston business paper as waiting on CMS to publish legislation that requires hospitals and EDs to send ADT notifications, a core capability of PatientPing. That CMS action was delayed, so the announcement was held as well. Experts note that private companies like PatientPing can announcing funding whenever they want or can skip an announcement altogether. It doesn’t feel right to me to hold off for 16 months, but only because a prospect might infer overly optimistic business conditions during a pandemic in which health systems have been nearly shut down for months.

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Redox confirms a reader-reported rumor I sent their way, acknowledging that it laid off 44 people, about 25% of its headcount, on Tuesday. The company says it had planned to double its size in 2020 as it had in 2019 and hired accordingly, but COVID-19 changed the focus of financially strapped health systems. Redox is working with customers and partners to place those of its employees who were affected  –contact christine@redoxengine.com.

Social services referral software vendor Unite Us acquires Staple Health, an analytics company that focuses on social determinants of health.

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Signify Research reviews the plan of Mednax to sell its radiology groups and Virtual Radiologic teleradiology business, with the company renaming itself back to its original name of Pediatrix Medical Group as a pediatrics and obstetrics business. Signify notes that the company paid $500 million for VRad in 2015, added 10 practices, and grew revenues by 10% to $3.5 billion, but piled on debt and saw EBITDA slide 24% over the four years. VRad is the world’s largest teleradiology provider. The company announced in early April that it would cut executive salaries, furlough and reduce the pay of non-clinical employees, and cut non-essential expenses in reaction to COVID-19. Signify expects VRad to benefit from its work on AI algorithms over the past several years.


Sales

  • MultiCare Connected Care (WA) selects Innovaccer’s Data Activation Platform and InGraph population health analytics.
  • Stonewall Memorial Hospital District (TX) selects CPSI’s Evident EHR and TruBridge RCM software and services.
  • AdventHealth will implement Virtustream’s Healthcare Cloud to power its new Epic system.

People

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Craig Joseph, MD (Avaap) joins Nordic as chief medical officer.

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Arcadia promotes Debbie Conboy to VP of risk adjustment and quality products and hires Catherine Turbett (Steward Health Care) as VP of ACO and health plan account operations.


Announcements and Implementations

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OrthoIndy (IN) implements Saykara’s AI-based physician charting app.


COVID-19

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NIH’s All Of Us research project adds three COVID-19 data collection components for researchers who are approved to study data from its 350,000 participants:

  • Testing at least 10,000 samples from recent enrollees for COVID-19 antibodies, hoping to determine rates of exposure by region.
  • An online survey that asks about COVID-19 symptoms, stress, social distancing, and economic impact that participants can take monthly to understand effects over time.
  • EHR data analysis from the 200,000 participants who have shared their information, with plans to standardize the information to investigate patterns, symptoms, associated health problems, and the outcome of drugs and other treatments.

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Scientific American explains the accuracy rates of COVID-19 antibody tests, which are particularly important since the results are often considered reliable without verification. The authors explain that false-positive results, which are the most impactful, are more likely with low infection rates. Example: the same test that has 95% specificity (few false positives) and 95% sensitivity (few false negatives) will give a false-positive rate of 14% when the infection rate is 25%, but will issue falsely positive results 50% of the time when the infection is 5%. In other words, COVID-19 antibody tests are likely to issue a lot of false positive results that may encourage people to return to normal life because they think they are immune (not to even mention that nobody has proven that people who have COVID-19 antibodies are immune from reinfection).

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FDA will participate in the COVID-19 Diagnostics Evidence Accelerator, a real-time diagnostic testing evaluation program that is a companion to the previously announced Therapeutic Evidence Accelerator.

The Equal Employment Opportunity Commission says that employers can’t require employees to take COVID-19 antibody tests before returning to work, basing its decision on CDC’s warning that antibodies don’t equate to immunity and therefore testing for them should not drive workplace decisions.


Other

It’s not just COVID-related fears that are keeping people away from medical practices and hospitals – the New York Times reminds readers that millions of Americans have lost jobs, income, and health insurance during the pandemic and can’t afford the high cost of healthcare, especially after reading about the aggressive debt collection practices of hospitals and practices. I’ll add one more item – even those who are able to get new health insurance will see their deductibles reset, meaning that someone with an ACA plan could be looking at several thousand dollars of deductibles before insurance starts paying anything.

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Epic employees will return to the company’s headquarters in Verona, WI in four stages during July and August. Over one-third of the company’s employees have already returned to office work. The company says it is slowly resuming essential travel.

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Researchers note that patient race and ethnicity are often used by algorithms that drive clinical decisions even though nobody knows whether underlying genetics are causing the observed differences in outcomes. The researchers caution that it’s not wise to simply apply a race-based digital fudge factor without knowing if genetic differences are responsible rather than societal issues, economic factors, or past inequities. Otherwise, minority patients may be denied services because of misinterpreted risk factors or the assumption of suboptimal outcomes.


Sponsor Updates

  • RamSoft adds QliqSoft’s virtual visit technology to its RIS/PACS solutions.
  • Healthwise receives five Digital Health Awards during the Health Information Resource Center’s 2020 spring competition.
  • Intelligent Medical Objects publishes a new white paper, “The Evolution of the EHR.”
  • Medhost joins the Amazon Web Services Partner Network as a Technology Partner.
  • Black Book ranks Netsmart #1 in 10 categories across behavioral health and post-acute settings, including top overall post-acute care IT services and solution vendor.
  • BridgeHealth offers its members access to flexible physical therapy solutions through WebPT’s Networks program.
  • MDLive CMO Cynthia Zelis, MD joins the NCQA’s Taskforce on Telehealth Policy.

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Reader Comments

  • David Lareau: The concepts in the graph database need to be mapped to the relevant vocabularies and code sets for the different domain...
  • Joe Magid: If you've not had a chance to watch Rachel Maddow on MSNBC, she had a pretty steady stream of video tales from the trenc...
  • nirvous: Sure, graph databases are hip. But how does reformulating a proprietary clinical vocabulary as a graph database solve th...
  • Brody Brodock (Adapttest): While I do agree that the current EHR schemas are not the best at categorization or enabling clinical decision making, I...
  • Frank Poggio: Re: The old ways of building EHRs to support tracking of transactions for billing will not suffice... If I have hear...

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