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Book Review: Redefining the Boundaries of Medicine

April 25, 2023 Book Review 2 Comments

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Redefining the Boundaries of Medicine” is a Mayo Clinic Press book that was written by Paul Cerrato, MA (senior research analyst and communications specialist, Mayo Clinic) and John Halamka, MD, MS (president, Mayo Clinic Platform). The authors have collaborated previously on three books and several journal articles.

The book is written for readers who are knowledgeable about the “only in the US” healthcare mix of research, medical practice, consumerism, and hardcore capitalism where money has an outsized influence on both individual health and the business of healthcare. Its dense typography and layout is hardly inviting, but it provides an excellent history of how we got to where we are in healthcare (hint: often illogically, stubbornly, and parochially) and how healthcare can be improved.

The book delivers what its title promises. The authors are predictably precise in their citations and conclusions, and they are on the provider front lines rather than ivory tower academics. In addition, Mayo Clinic Platform is working actively to apply data science and technologies to healthcare.

I admit that I wasn’t aware of the previous books that these authors co-wrote and wasn’t exactly sure what Mayo Clinic Platform does or what happened with John Halamka after he left BIDMC three-plus years ago. But I think these authors might be the go-to-experts that the healthcare industry needs as it rushes headlong into artificial intelligence and re-examines itself with an opportunity (or requirement) to change dramatically.

Here are some of the notes I took.


Artificial Intelligence

The book leads off with a chapter on artificial intelligence, where the authors observe that the human brain cannot process the amount of new information from journals and conferences, much less apply it at the bedside, and can’t analyze all available information to arrive at an accurate diagnosis. AI is also better than humans in analyzing diagnostic images, although system training must be carefully designed in an environment that has never-ending changes in scanning technology, coding and terminology, EHR configuration, changed institutional practices or order sets, and a changing patient mix that may not be applicable elsewhere.

A fascinating idea is that all broad research, whether powered by AI or not, overgeneralizes to the entire population instead of digging into patient subgroups. For example, a large study on the effect of lifestyle modification on cardiovascular disease was abandoned when no differences were seen between the intervention and control groups, suggesting that lifestyle doesn’t matter. However, applying sophisticated analytical technique found that lifestyle intervention actually worked in two subgroups that were otherwise lost in the large numbers: patients whose diabetes is poorly controlled and in those with well-controlled diabetes who self-report their health as good.

They also note that FDA’s approval of AI devices is inconsistent and often involves retrospective and/or single-site studies.

The authors conclude AI algorithms need to be more equitable and better validated before being placed into clinical use.

Medical Knowledge

Medicine’s history in the US involves paternalistic physicians; diagnosis and treatment protocols that were based on GOBSAT (good old boys sat around the table); and slow acceptance of research findings in favor of personal experience, anecdotes, and opinions lacking evidence.

Randomized controlled trials, especially those that conclude that a therapy was not beneficial, have weaknesses such as too-small sample size and inclusion criteria that may introduce bias or reduce clinical usefulness. RCTs should be supplemented with real-world evidence and cohort studies. 

The “heterogeneity of treatment effect” acknowledges that treatment benefit and risk can vary widely among patients. Patients know their conditions and see the effects of treatments firsthand, so N-of-1 trials comparing active treatment with placebo are a good idea.

“Patients like mine” data can help support decisions in the absence of RCT or observational studies now that EHR data is widely available, although it may require experts to turn patient data into actionable evidence.

Rethinking Medical Expertise

The public questions the value of medical expertise. Experienced clinicians use Type 1 thinking, in which pattern recognition can lead to quick conclusions involving common conditions as “disease scripts.” But sometimes it fails dramatically when a patient’s symptoms fall outside the norm. Type 2 reasoning starts with a hypothesis that is refined via logic and critical thinking, which can be more accurate and avoid bias and thinking shortcuts, but takes too long to conduct in high-volume settings.

The authors cite previous studies that found that peer-reviewed journals often rejected research that turned out to be important, questioning whether that publishing process is the best way to gestate new ideas.

Replacing “One Size Fits All” with Personalized Medicine

Full genomic sequencing is increasingly useful. Some experts say it should be performed at birth, whereas now newborns are screened for a small number of genetic disorders.

Large studies on using the antiplatelet drug clopidogrel for blood clots found that the drug outperformed aspirin in just two of each 100 patients, but the real challenge is to identify those two instead of incurring the cost and risks of giving it to everyone.

“Normal” lab ranges are just a statistical convention, and each person’s “normal” may be different and deviation from it may not indicate the presence of disease. Insurance will often pay for only drugs and treatments that appear effective for broad segments of the population.

Researchers search for one or two primary causes of a disease, such as HIV as a cause of AIDS or striving to control the blood sugar of diabetics, and immediately refocus all research on those causes. The outliers are rarely studied, such as the people who are exposed to HIV but don’t develop AIDS and why that might be. Correcting the condition for a given patient doesn’t necessarily deliver the expected benefit.

Communication

Too many clinicians still practice the “doctor knows best” model when patients don’t agree with their evidence-based interventions. Policy decisions are rarely made on science alone since beliefs and core values will usually win.

FDA knows that most drugs that it approves offer only slight benefit, but consumers aren’t capable of analyzing studies, especially when faced with direct-to-consumer advertising. The public is easily confused by correlation versus causation and relative value versus absolute risk, such a miracle drug that reduces the risk of some disease by 50% that really means that one person instead of two out of 1,000 patients will get it, which is hardly impressive. Schools do not teach critical thinking skills and the US doesn’t follow the lead of other countries that teach media literacy.

Interdisciplinary Patient Care

Researchers and clinicians need to communicate better. Experts say that NIH-funded research focuses on silos for particular conditions of interest without looking at how they relate to, or are affected by, other factors, which is an outdated understanding of medicine. DARPA might offer a better model.

Clinician fragmentation increased with the growth of specialty medicine, medical group consolidation and insurance programs networks that separated people from their specific doctor.

More than three-fourths of chronic diseases are caused by or exacerbated by lifestyle choices that can’t be easily explained or encouraged in the allotted 15-minute office visit.

Patient-generated data should be fed into EHRs.


You will be stimulated by the ideas the authors express in this book if you are comfortable reading journal abstracts and understand clinical practice, especially if your specialty is informatics. It seems like a slim read at under 200 pages, but is packed with information in being free of self-aggrandizement and pontificating (and again, the typeface is pretty crammed, so it’s got more content than you might think). If you or your organization want to be considered disruptive in healthcare, the authors are giving you great ideas of where you might focus.

Morning Headlines 4/25/23

April 24, 2023 Headlines No Comments

CompuGroup Medical Buys Majority Stake in German Digital Healthcare Platform m.Doc

Germany-based CompuGroup Medical acquires patient communication software vendor M.Doc, also based in Germany, for an undisclosed sum.

ClaimsXten Becomes Lyric, Welcomes Raj Ronanki as Chief Executive Officer

Claims payment and editing software business ClaimsXten rebrands to Lyric and names Raj Ronanki (Elevance Health) CEO seven months after its sale by Change Healthcare to TPG for $2.2 billion.

Children’s Mercy Kansas City, GE HealthCare Launch Nation’s First Pediatric Hospital Operations Center to Improve Patient Care

Children’s Mercy Kansas City opens a 6,000 square-foot Patient Progression Hub, which uses AI-powered technology from GE HealthCare to monitor patient flow, manage staffing, and coordinate care.

Curbside Consult with Dr. Jayne 4/24/23

April 24, 2023 Dr. Jayne 1 Comment

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As a primary care physician at heart, I know how important it is for patients to learn how to make better food choices. A friend clued me in to the Plateful app, which helps consumers make better choices by providing information that may be more understandable than the typical “Nutrition Facts” label. Once a user scans the UPC found on a packaged food, or uses the PLU code on a fruit or vegetable, the app displays a Nutrition Value and an Eco Value, each of which ranges from 0 to 100. In addition to the numbers, star values also display to help users understand the relative value of a food choice.

The Nutrition Value is based on the Tufts Food Compass Score, which was validated over nearly two decades. I wasn’t familiar with it before seeing the Plateful app. This isn’t surprising given the huge lack of nutrition education at medical schools when I was in training. I think we had a four-hour block to cover the entire topic, and you can bet that people paid less attention to it than they did to competing educational priorities like the surgical skills lab or cramming for the USMLE licensing exams. If I remember correctly, it was tacked on to the end of second year almost as an afterthought.

Although medical education has become more well-rounded since then, I’d bet that nutrition still gets less coverage than it probably should. Some of the most damaging chronic health conditions, including coronary artery disease, stroke, diabetes, and certain cancers can be impacted by nutrition, but it seems that our society would much rather spend its healthcare dollars on pills and injections rather than addressing the root causes of the diseases.

The Tufts Food Compass looks at 54 attributes across nine categories, including: ingredients, nutrient ratios, vitamins, minerals, fiber/protein, lipids, phytochemicals, additives, and processing. Foods with a higher Food Compass Score are associated with more favorable Body Mass Index, blood pressures, lipid profiles, and fasting blood glucose values as well as being associated with lower all-cause mortality rates. The validation studies were performed with a nationally representative sample of nearly 48,000 adults aged 20-85 in the US.

As you may guess, whole foods get higher scores, where heavily processed or additive-laden options get lower scores. Consumers are encouraged to use the app to scan similar foods and compare them. One of the use cases mentioned on the app’s website is comparing two loaves of bread to see which one has a higher Nutrition Value. The Eco Value looks at a food’s relative level of environmental friendliness, with a nod to climate, land, and water impacts. Foods with an Eco Value of more than 50 are more associated with a sustainable food system. While reading the website, I was surprised to learn that some foods that are conventionally thought of as healthy are actually less great for the environment due to water and climate impacts.

According to the website, parent company Opsis Health has more cool tools on the horizon, including the ability to take a picture of a plateful of food and have it converted to detailed nutrient information. That’s going to be a lot more accessible to most people than weighing or measuring food, which is often the first step in trying to take control of your eating habits. We’ve had so much portion inflation in the US that people often have no idea what a realistic serving of anything is any more. (I had to guess the weight of the amazing bone-in pork chop I had in Chicago, so I’m among the masses who might benefit from this innovation.) Turning your phone into essentially what is a 3D food scanner sounds a lot cooler than logging things into Nutritionix or MyFitnessPal or any of the other tools that are out there.

In learning more about Plateful and the company, I liked the website’s clean look and bright colors, and the amazing food photos as well. I also liked the fact that I had to dig pretty deep before I saw mention of AI as being part of the upcoming solution. It seems like many other companies are entirely in-your-face with AI-this and AI-that, so it was refreshing to find that it’s part of the solution but they’re not leading with it. I’m looking forward to following them over the coming months to see how the solution evolves and will definitely have fun doing some food comparisons in the coming months.

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For the chocoholics out there who may be wondering, my go-to “survival chocolate” vendors were pretty much neck and neck, with the Hu Kitchen Salty Dark Chocolate (vegan, paleo) leading with a slightly higher Nutrition Value while the Ghirardelli Intense Dark Sea Salt Almond squares squeaked by with a higher Eco Value. I give them both five stars for their mental health boosting properties, so it would be a toss-up to choose one over the other. As the Plateful website says, “Lower NV foods, eaten on occasion, can fit into a healthy eating pattern if the majority of foods you eat over time are nutritious.” Sometimes you just need a little bit of dark chocolate to get you through the day.

It would be interesting to learn about the business model for the coming solution and whether it will be presented as a consumer-driven offering or whether it will be made available as part of an employee benefits plan or as part of a payer-based offering. The latter two would be smart as potential enhancements to reduce overall healthcare costs. I don’t have a frame of reference for what kind of databases are out there to create the library of UPC codes, PLU codes, and nutritional values, let alone what the R&D lift looks like for the “scan your plate” app that will be coming. I always enjoy learning about something that’s not in my usual lanes of EHR, HIE, and patient portal, so learning about this was a welcome diversion. Knowing that it may be able to help patients with healthy food choices, which is one of the solutions to healthcare crisis of our times, was a bonus.

Is your organization doing anything to promote nutrition education or healthy eating? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Interviews Frank Harvey, CEO, Surescripts

April 24, 2023 Interviews 1 Comment

Frank Harvey, RPh, MBA is CEO of Surescripts of Arlington, VA.

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Tell me about yourself and the company.

I have been interested in healthcare since I was six years old. My father used to take me on Saturday mornings to the soda fountain at the local pharmacy. I was interested in what our local pharmacists were able to do with patients and the members of the community. From that time on, I’ve wanted to be in healthcare, specifically as a pharmacist.

I’ve been in pharmacy throughout my career. I have been fortunate to be a part of life sciences, with Lilly and Hoffman-LaRoche, and companies such as Liberty Medical and Mirixa, which is a medication therapy management company. I ran my own venture fund for bit. I was excited to get the opportunity to come to Surescripts because it’s such a wonderful company. Surescripts is a mission-driven health information network that is focused on enhancing the prescribing process and forming care decisions. Our mission is to continue to lower the cost of healthcare, improve patient safety, and improve the overall quality of care.

How has the role of the pharmacist, along with the technologies and data that are part of their work, changed?

During COVID, pharmacists really raised their level and used the full scope of practice of their degree. It was critical during that time, because in many cases, physicians weren’t available because they were tied up with so many COVID patients. Pharmacists stepped in to do much more, such as administering vaccines and  counseling chronic care patients.

We expect pharmacists to continue operating through the full scope of their license, particularly because there’s such a shortage not only of primary care physicians, but also of endocrinologists and rheumatologists. We’re seeing a burnout of physicians and many of them are retiring. Pharmacists will have the opportunity to step up their level of their practice to be operating more at the full scope of their license.

How has the Surescripts network changed over time?

When Surescripts first came into being over 22 years ago, prescriptions were transferred back and forth, either by patients carrying the prescriber’s handwritten prescription to a pharmacy or having it called in. Surescripts was put in place to make that process electronic, as the first health interoperability network, if you will. Now the vast majority of prescriptions go from the physician to the pharmacy electronically through our health information network. 

We have continued to expand far beyond that to help with price transparency and to support pharmacists and physicians being able to message each other electronically, with no more faxes or having to jump on the phone. We’ve continued to focus on enhancing the prescribing process and informing the care decisions that physicians, nurse practitioners, and PAs make by providing medication histories of the patients to the physician.

Has the launch of a competing e-prescribing network changed your strategy?

No. We will continue to focus on being a mission-driven company and will continue to enhance the prescribing process and informing that care decision. Competition is always good. We welcome competition that helps move our mission forward. Whether it’s Surescripts doing it or other companies doing it, we’re happy about that.

How will you continue to enhance the Surescripts network?

Even in the last four years, we’ve improved the quality of prescribing, the prescriptions coming across, by about 85%. We continue to focus on enhancing that prescribing process. The other thing we continue to work on is ensuring that, from an administrative standpoint, we’re providing the right information at the right time to physicians, so they don’t have to cull through volumes of information to get to what’s important at care decision time.

How much emphasis is placed on inserting the connectivity result into the prescriber’s EHR workflow?

It is really critical that it’s in the workflow. We’re integrated in every EHR across the country. Last year, over 2 million practitioners prescribed over 7 billion transactions. All of those were integrated into the electronic health record that the physician was working with.

An example is that at the time of prescribing, when the physician is with the patient, transparency apps allow the physician to see not only the therapeutic alternatives, but also the pricing of each based on the insurance coverage that the patient has. It allows a physician to make the right therapeutic decision for the patient as well.

Are you seeing benefits for both the prescriber and the patient?

Absolutely. That’s one of the most important things about having a real-time prescription benefit tool in the physician’s EHR. They can see everything about the prescription and the therapeutic alternatives. Before, they would write a prescription without understanding the price consequences. The patient would take it to the pharmacy, find that they couldn’t afford that medication, and then ask the pharmacy to call back to have the prescription changed to a different medication that they could afford. Integrating that into the overall workflow cuts down a lot of demonstrated burden of the physician, the pharmacy, and the physician staff.

Have you seen statistics documenting outcomes improvement since cost issues might have led to the patient either not having the prescription filled or taking it in lower doses to stretch it out?

We absolutely have. Most recent studies shows that the prescription pickup rate increases by 3% to 5% with use of a price transparency tool with real-time prescription benefits. The patient knows what they are facing from a pricing standpoint, they’re more likely to pick it up, and the doctor is more likely to have written a medication that is affordable to the patient. The most expensive medications are the ones that the patient never picks up, because they never get their health condition taken care of. These tools help the patient.

How has the federal government influenced interoperability?

Micky Tripathi and his team have done a tremendous job. They have so much energy behind their efforts. Interoperability is so critical in being able to get that full patient’s record. A new proposed rule focuses on advancing that interoperability and improving transparency, supporting the access and exchange of electronic health information. 

The role that Micky and his team have played has been critical to moving us forward more rapidly than would have happened without their participation, their urging, and their hard work over a long time. We are a great example of what interoperability does, with 21.7 billion transactions a year across all of our products. We are looking forward to everything that’s happening with TEFCA.

What will the company’s strategy be over the next few years?

We are going to continue to focus on what has been our bread and butter, which is our mission of improving the quality of care, improving patient safety, and lowering cost. We will do that by broadening the areas that we work on across enhancing prescribing as well as informing care. We are looking to work to help broaden the care team, to enable the care team as it expands and pharmacists take a more active role, to make sure that they’ve got the right data to make the right decisions and can communicate that information back into the health record. We will continue to lobby for the right legislation to be in place to enable and empower pharmacists to do what they’re able to do, in partnership and collaboration with physicians, nurse practitioners, and physician assistants.

Healthcare in this country is at a critical phase. We are seeing the continued burnout of our healthcare practitioners and a lack of enough healthcare practitioners, particularly in rural and urban areas. We have areas where patients may have to travel 100 miles to see a physician. It will be important that pharmacists can play a larger role. I believe that we will see, over the next five years, that the healthcare team will continue to evolve, and that will be the best thing for the patient.

Morning Headlines 4/24/23

April 23, 2023 Headlines No Comments
    The VA pauses its Oracle Cerner implementation indefinitely until issues at its live sites are resolved, and stresses that “everything is on the table” as it negotiates the scheduled five-year extension of the original 2018 contract.

Oracle Appoints Seema Verma to Lead Oracle Life Sciences

Oracle hires former CMS Administrator Seema Verma, MPH as SVP/GM of life sciences, which includes leading the Oracle Cerner Enviza business.

Electronic Health Information Exchange:Use Has Increased, but Is Lower for Small and Rural Providers

An analysis from the US Government Accountability Office points out that TEFCA may help small and rural providers overcome some barriers that keep them from exchanging health information at the rate of their larger, more metropolitan counterparts.

Monday Morning Update 4/24/23

April 23, 2023 News 4 Comments

Top News

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The VA pauses its Oracle Cerner implementation indefinitely until issues at its live sites are resolved.

It also says “everything is on the table” as it negotiates the scheduled five-year extension of the original 2018 contract.

Oracle EVP Mike Sicilia indirectly placed blame for the delay on the VA, responding with a statement that Oracle supports the VA’s use of the time to “institute governance, change management, and standardization changes … similar to what DoD did a few years ago.”


Reader Comments

From Bonhomie: “Re: paying your way to HIMSS. Have you considered monetizing your presence by offering vendors the opportunity to purchase booth interviews or social media coverage from you, in order to offset your expenses?” That seems unbelievably slimy to me, although I’ve seen plenty of folks who were clearly taking money for interviewing company executives, hosting events, or shooting out suspiciously laudatory tweets. At least their sites and outlets are not known for covering actual news anyway, so reputational damage is minimal. Still, I would rather pay my own way, remain anonymous, and leave with my soul unsold.

From Phone Waver: “Re: HIMSS23. You didn’t mention booth people staring into their phones.” Two reasons: (a) I don’t think it happens as much as it used to, or maybe I’m so accustomed to it that I no longer notice; and (b) I’m more empathetic to exhibitor staff who have tasks they can accomplish online while waiting for someone to show interest. However, I still maintain that the free time that allows you look at your phone is created by your unapproachability in doing so, and your employer bought an exhibit booth rather than a telephone booth (OK, I admit that’s a dated reference).


HIStalk Announcements and Requests

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Most poll respondents aren’t using ChatGPT regularly. I’m not a power user, but I stay logged in in case I want it to check my wording, summarize what a company does given its web address (the fact that the website isn’t clear enough to easily tell is its own issue), or suggest interview questions that are not very good. I’ve also used it to plan events and to find obscure bands I might like, while Mrs. HIStalk jumped on it immediately to to help plan a complex vacation to Europe involving drives among several countries. I’ll add that the amazingly fast rise of ChatGPT means that the dabblers who evangelize their experiments are already yesterday’s news, with the new table stakes being actually accomplishing something with it that wasn’t previously possible.

New poll to your right or here: How would you grade your in-person attendance of HIMSS23? I would probably give it an A for the first time since 2019. HIMSS is surely happy that its relevance seemed little diminished, at least based on attendance, exhibitors, and general energy, when situations both within and outside its control had created an opening for competing events. My early read is that the HIMSS and ViVE conferences will co-exist with differing attendee demographics, but with enough business case for both to attract exhibitors.

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HIMSS23 was the first opportunity see my Apple AirTag in action as it tracked my checked bag from the plane to the luggage carousel, a pretty slick and multi-use technology for $29. Mrs. H and I use the Find My app and our phones to tell if we’ve left work or the grocery store or whatever, so I’m sure many other AirTag use cases exist that I haven’t thought of.

I was annoyed that the #HIMSS23 Twitter hashtag was hijacked by some would-be “technology influencers” to constantly spout random conference updates and tourism recommendations without actually being at the conference. Blocking them doesn’t seem to hide them from Twitter search results.

I mentioned previously that HIStalk’s searchable history goes back to 2007, so it’s the one place you can find significant news events without the fluff, see what we’ve said about long-ago HIMSS conferences, or ponder the life cycle of companies, technologies, and even people that have gone from fame to forgotten. Suggestions: search for anything of interest or scroll through the very long article archive.


Webinars

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


People

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Oracle hires former CMS Administrator Seema Verma, MPH as SVP/GM of life sciences, which includes leading the Oracle Cerner Enviza business.

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In England, physician and digital health pioneer Elizabeth Murray, MSc, PhD dies of cancer at 63. She studied the impact of the internet on doctor-patient communication at UCSF in 2001 and set up an e-health unit at University College London in 2003.


Other

Bizarre, as forwarded by a reader. A data scientist at healthcare revenue integrity vendor Multiplan – improbably named Jack McQuestion — is charged with impersonating an FBI agent after trying to lure an OnlyFans adult performer from her house claiming to be an FBI agent with a warrant for her arrest. He left when she called police, but police used his doorbell camera image to find him and his Madison, WI apartment, a search of which turned up phony FBI credentials, pepper spray, and a garrote that he had ordered from Amazon. His job history before his data scientist job includes being an “artistic model” and a Pizza Hut delivery driver. Searching Amazon for “garrote” turns up sellers offering those products for supposed non-strangulation purposes that include cheese slicing and sculpting, but the seller’s choice of search keyword says a lot.


Contacts

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

Morning Headlines 4/21/23

April 20, 2023 Headlines No Comments

Augmedix Secures Strategic Financing from HCA Healthcare and Redmile Group

Ambient medical documentation company Augmedix secures a $12 million investment from HCA Healthcare, which will help with product development as it pilots Augmedix technology in emergency rooms at two of its hospitals.

ADHD prescription startup Done pivoting to in-person care following DEA rule change

Online ADHD prescription company Done pivots to a hybrid care model care in light of the May 11 expiration of the Public Health Emergency, after which physicians must see certain patients in person before prescribing controlled substances.

SA Health investigating 30-hour data outage that left hospital staff in limbo

In Australia, SA Health officials begin investigating a 30-hour computer systems outage and why backup systems were not turned on.

From HIMSS with Dr. Jayne 4/20/23

April 20, 2023 Dr. Jayne 3 Comments

Wednesday opened with me feeling a little draggy, which wasn’t surprising since my trusty Garmin watch revealed that I had walked more than 13 miles the day before. Looking through my past HIMSS activity histories, that’s about par for an opening day and it wasn’t anything a couple of ibuprofen couldn’t resolve.

A change in the weather and my meeting plans led me to take the shuttle from the hotel to McCormick Place. It was a quick trip down Michigan Avenue, but a long and winding trip around the underbelly of the convention center as the bus reached its unloading area at Gate 20-something. I ignored the signage and just picked a random escalator that popped me up in the middle of the exhibit hall, which was much better than the “up down and all around” journey from yesterday.

I started the day with some casual meetings, both with former colleagues who are in various places in the industry, but whose spheres overlap my current one. Topics were far ranging and included rural health, clinical terminology, regulatory issues, and suggestions for good books to read. We’re all doing our best to keep up with what’s going on in healthcare and how it applies to our individual IT roles, but it’s daunting.

Still, it was good to catch up and get some advice from seasoned professionals that I trust. I’m also helping with some matchmaking magic, trying to introduce clinical informatics friends looking for work to vendor friends who might benefit from their knowledge.

From there, it was on to the exhibit hall, where the Ellkay team wins the “friendliest” title for the day by having people actually say good morning to those walking past.

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I found the Puppy Park in the North exhibit hall. It was populated by some energetic doggos. The people playing with them all seemed to be having a good time.

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Less exciting was the grime next to one of the pillars in the South exhibit hall, which was quite visible due to the lack of carpet. I was also annoyed by the large blue open-topped bins in the hall that were marked “recycle” but had no specialized drop slots for cans, paper, etc. which led to them being used as all-purpose trash cans. The only designated recycling bins that I could find that were being used as designed were in the lobbies by the escalators or over in the West building.

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I was amazed to capture the bright shoes and even brighter suit all in one photo.

I had lunch at the CXO experience lounge in the West building, meeting some new CIO friends and learning about the projects their organizations are working on. The lounge was hopping and seating was at a premium – they definitely could have a larger area next year and still fill it. Top themes include chronic disease management, avoiding ransomware attacks, trying to meet behavioral health needs, and updating their telehealth strategies pending the end of the public health emergency declaration.

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From there it was off to my annual booth crawl with Nordic Consulting’s Chief Medical Officer Dr. Craig Joseph. We checked out the art at the Epic booth then started combing the aisles for things that were interesting or at least eye-catching. We noted only two multi-story booths this year. Nuance’s double-decker featured a theater complete with people waiting in line to get in. Pure Storage also had a two-level booth, but we missed their bourbon tasting.

From there, we headed to the Edifecs booth to check on the progress of their #WhatIRun message wall. It was filling up with messages of what attendees run at home and in their work lives. I give full credit to the person running their son’s den meetings. As someone who has spent a bit of time in the scouting world, I know how much work that can be. Mentions of the #WhatIRun hashtag trigger donations to BrightPink.org which is an advocacy organization for breast and ovarian cancer.

When hanging out with Craig Joseph, you never know where the conversation might go. Topics included adventures in specialty pharmacy, patient education solutions (triggered by a stop by the Healthwise booth to look at their new Healthwise Advise offering), the Mastodon social network, and more. We definitely went down the social media rabbit hole, and I introduced him to networking resources for the physician mom interested in casual (or not so casual) doomsday prepping – talk about your niche audience. We decided that in the event of a zombie apocalypse we would barter our physician skills for survival, so perhaps it’s time to practice our laceration repair and minor surgery skills.

After dropping him off at his booth, I needed a little rest and found a mysteriously large area in the South exhibit hall that had grass-colored carpeting and park benches. It seemed like an odd use of real estate in a high-traffic part of an exhibit hall that otherwise had inadequate seating areas. It made me wonder if a vendor had backed out and they were trying to fill the space, but I was grateful for a place to sit for a few minutes and find the last remaining ibuprofen at the bottom of my conference bag.

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Matthew Holt and the team at First Databank sent their submission for best shoes.

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Unfortunately for them, however, IMO dominated again with this submission, earning the company the “best all-around footwear of HIMSS23” championship title. I’m glad so many people have joined the challenge to find the best HIMSS shoes and receiving your pictures definitely puts a smile on my face. After two full days of exhibit hall adventures plus miles of walking on Monday, I’m ready to put my feet up, then pack my suitcase and get ready to head home.

If you’re at HIMSS, what has your favorite part of the conference been? Leave a comment or email me.

Email Dr. Jayne.

From HIMSS 4/20/23

April 20, 2023 News 4 Comments

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Tell me without telling me that today is the last exhibit hall day of HIMSS23.

Today is also when all of the previously defended booth swag is dumped out on the table for anyone to take (even other vendors) to avoid dragging it back home, which is how I ended up with socks from document management vendor Vasion, whose booth person urged me to take one small step to reduce his two suitcases full of them to a manageable number. I also had a nice conversation with folks from Amazon S3 data recovery vendor Clumio, who wanted to hand off one of their bags that I now realize is actually quite nice.

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Of course I had to scan the QR code on the HIMSS bus window. It went to a website that described how to get out in an emergency. I think I would find a way out more quickly, approved or my own, than reading a website or watching a video.

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It wouldn’t be a HIMSS conference without the always-entertaining Magic Boy in the booth of Hyland, although I don’t think he was involved with the company’s pre-conference magic trick of making 1,000 employees disappear.

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I don’t know how many takers Jeron Electronic Systems got for its factory tours, but I thought the offer was smart. The family-run business makes nurse call and other healthcare communications systems right here in the Chicago area, with no supply chain product delays.

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I went by the Ellkay booth many times and not only were employees paying heads-up attention, I was greeted every time. I didn’t eat anything but booth snacks all day until late afternoon all this week, so I got through Day 1 purely on their honey-caramel popcorn.

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Hybrid infrastructure vendor Element Critical provided a great “Live Lucky” hat and fun conversation. 

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Today was goodbye group photo day, or video in the case of Clearsense. They had a sharp-looking booth. The quick video, which popped up on LinkedIn, is a super idea.

This observation is supportive even though it might sound critical, but for folks in the startup area’s mini-booths, HIMSS23 could have been your best chance of the year to find prospects, partners, investors, and employees. I know it’s hard to remain alert, make eye contact, and initiate friendly conversation versus staring at your phone or conversing with your co-worker, but to be here otherwise doesn’t accomplish much. If your space holds two people, one of them should be someone who can confidently and energetically draw people in. I walked through the startup area several times and nobody seemed all that interested in initiating a conversation. If you’re going to be there anyway, take advantage of the foot traffic just to shoot the breeze with whoever walks by if nothing else.

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These guys from Rocket.chat didn’t get a great booth location as a first-time exhibitor, but they were friendly and positive. The company’s HIPAA-ready messaging app supports communication with patients, colleagues, and vendors. They offer a free self-hosted team collaboration version.

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The reps from digital transformation services vendor Cardinal Integrated earned our “Tiny Booth but Great People” award, as the person on the left admirably worked the perimeter to cheerfully engage passersby and her colleagues were quick to join in.

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The rep at first-time exhibitor Solid, which offers public safety communications technology, was outgoing, informative, and energetic despite light foot traffic and reps in neighboring booths being lost in phoneland. The company offers a guide to improving poor cell service to support BYOD and bandwidth for IoT and 5G.

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The friendly, sequined folks at Raleigh, NC-based Bandwidth were happy to describe the company’s messaging, voice, and emergency telecom platform.

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Doximity provided today’s lunch. Their cupcake bites are like finger-scooping cake batter from the bowl, then repeating with the icing before shoving it home.

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Avadin, which sells solutions for senior care agencies, uses AI – and now, apparently, ChatGPT – to listen for “help me” requests, monitor for falls, assess mood, and allow remote check-in.

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I was initially a bit put off by HIMSS turning its tweeting over to someone who is actually good at it instead of old-school stuffy, but I’ve grown to like it.

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Where have all the vendor puffer vests gone? Gone to Goodwill, all but one.


Conversations Overheard

According to one executive, the respective CEOs of CHIME and HIMSS never got along all that well after Hal Wolf took over at HIMSS, but it was the refusal of HIMSS to cancel the 2020 conference until the last minute that sent CHIME off to form the competing ViVE conference with HLTH.

I overhead high-level executives of two significant companies saying that HIMSS23 has been a good conference for them, but also expressing delighted surprise at how much business they expect to generate from the ViVE conference. Both reported that in both conferences, their booths were packed, their scheduled events were waitlisted, and even casual booth-lookers ended up being significant decision-influencers who will likely result in new business. Both said that the secret is in booking meetings long before the conference starts, guaranteeing that the booth will generate ROI no matter what.

Someone commented that unlike HIMSS, ViVE provided water bottles and food freely to all attendees. However, those water bottles reportedly cost ViVE $500,000.

I overheard from two different executives that unlike HIMSS, repping the company at ViVE didn’t seem like actually working.

Someone described how the HIMSS conference has changed in the last 20 years by citing similarly sized gaudy booths back in the day, but with provocatively clad booth staff, jugglers, and booths that were turned into near restaurants with endless trays of deli food. It was also recalled how once upon a time HIMSS closed the exhibit hall during education sessions. I overheard one person lamenting the demise of HIStalkapalooza, which reminded me that I’m staying near the best place that we ever had it at the House of Blues Chicago. That also reminds me that I have recaps of all HIMSS conferences and HIStalkapaloozas starting at 2008 on the site, and although the earlier ones disappeared with a platform change in 2007, it’s a pretty engrossing memory lane of trends, companies, and people that in some cases are no longer with us.

A rep eating lunch was telling someone how surprised he was that Microsoft has suddenly starting dominating healthcare with Azure, its Nuance acquisition, and now its work with generative AI.

A vendor executive said they personally pledged to remain visible in their booth any time the exhibit hall is open instead of retreating to conference rooms or off-campus lunches.

Folks were speculating whether HIMSS will admit that the “no-carpet HIMSS23” was an mistake that will be corrected next year. I heard more people speculating that HIMSS didn’t want to pay overtime for carpet installation and decided to skip it with an unrelated excuse. One vendor said they were happy to have had their booth setup finished before the weekend, when overtime rates became exorbitant.


News

HCA Healthcare is piloting Augmedix’s ambient medical documentation system and has invested in the company in a $12 million funding round. AUGX shares jumped 90% on the news, valuing the company at $128 million. It went public in a SPAC-like reverse merger in 2020, with shares down 15% since their first day of trading.

From HIMSS with Dr. Jayne 4/19/23

April 19, 2023 Dr. Jayne No Comments

Tuesday was a strong first day for the exhibit hall at HIMSS, and for the first time in a couple of years, I found myself wishing I had more time planned for the exhibit hall.

Today I had quite a few sessions and meetings on my dance card, with very little time to visit vendors. That means I have to cram it all in tomorrow since I’m leaving on Thursday. Even going back to pre-pandemic HIMSS meetings, the exhibit hall had been feeling a little lackluster, and then last year it felt like the conference was struggling to recover from COVID. I have some key things I need to get home for, so I decided to just do two days at HIMSS, but now I’m having some buyer’s remorse.

On the other hand, now that I think things through, it’s likely my first-day enthusiasm talking. By Thursday, it’s likely that the exhibit hall will have lost a lot of its energy, so we’ll have to see how tomorrow shapes up. I’ve got a couple of booth crawls planned for tomorrow that I’m really looking forward to.

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Today was a strong day for shoe sightings, with Intelligent Medical Objects (IMO) bringing its absolute A game. Do note their contrast against the bare concrete floor, which was a prominent feature of the exhibit hall this year. Only the main aisles were carpeted, with the smaller aisles being left bare. That created not only tired feet, but trip hazards with the transition to the carpeting in the booths and with exposed service panels in the floors. One of my companions tripped over a taped-down wire that would have otherwise been under carpet and had to get ice for her ankle.

Stories on the reasoning behind the lack of carpet ranged from “wanting the exhibit hall to be more green” to “not wanting to pay the setup crews overtime.” Regardless, it created not only an aesthetically unpleasing environment, but also a dangerous one in places. I hope HIMSS rethinks its flooring decisions prior to the next iteration of the conference. I spent some time looking at the IMO Studio offering, and in particular their value set authoring tool, and I’m looking forward to being able to use some of the tools.

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Edifecs brought back their #WhatIRun theme, but this year added some Dolly Parton to the mix. I wholly endorse their message. Life’s too short to be walking down the wrong road, for sure. From there I caught up with some friends at First Databank and then swung over to the Epic booth, which feels a little smaller than in past years, but it was still packed. Even dropping by later in the day it remained full, so I’ll try to say hi to my friends there tomorrow.

I attended a HIMSS corporate focus group today. Although I really enjoyed the discussion, the setup of the room was less than ideal, with rows of seats behind the main U-shaped table that led to awkward turning around by those who were seated in front of the extra rows. There were plenty of open seats at the table, so I wish the facilitator had asked those in the seats to move up with the rest of us, but it was a missed opportunity. There was also a loud conversation going on in the service corridor behind the focus group room and it was quite distracting.

The focus group included a box lunch with a salad option, which was much appreciated since finding decent food choices at HIMSS is often a challenge. I’ve been to a number of HIMSS focus groups over the years and this one was located deep within the bowels of the convention center, in an area of Level 1 that I could only find by going up two escalators, across the building, and back down to Level 1. Little did I know that I’d have to make that trek again at the end of the day when I decided the bus was a better option back to my hotel than my tired feet.

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A cooler full of free beer in the middle of the morning is always an attention getter.

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My favorite women’s shoes of the day were cute and springy yet comfortable. I think they were described as “like walking on clouds,” which is always appreciated on a day when you might be walking more than a couple of miles.

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The “Most Engaging Booth Staff” award of the day goes to Relatient, whose staff was not only friendly, but quickly figured out which of their solutions might be useful to a CMIO and doubled down on it to gather my interest. Kudos to the rep who explained the complexities of orthopedic surgery scheduling decision trees like a pro. I also liked the texture of their mossy green backdrop, which was a nice counterpoint to the previously mentioned bare concrete throughout the exhibit hall.

After a brief nap on the bus back to my hotel, I put my feet up for a few minutes then was off to a regional dinner at a legendary steakhouse. The bone-in pork chop did not disappoint, and I met some new friends and had great conversations, which is what HIMSS is really all about. I’m looking forward to a big day tomorrow, starting with a walking meeting in Grant Park. The weather is looking promising, and I plan to meet up with a couple of my vendors, so it should be a good day.

Email Dr. Jayne.

From HIMSS 4/19/23

April 19, 2023 News No Comments

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This is how the main aisles look in the exhibit hall, which I’m mentioning again since I heard a lot of complaints today. This is apparently a live electrical line that ends up in a booth, but starts somewhere underground in a McCormick Place tunnel. I’m not saying that I don’t buy Hal Wolf’s “save the environment” excuse for ditching aisle carpet while still requiring exhibitors to rent it for their own areas, but a 10-year-old article I found says that conference supplier Freeman doesn’t automatically trash carpet after a single use even though it is cut to specifications – they “re-seam” it back into a single roll and rent it all over again, up to 4-5 times until it’s too far gone.

I’ll also say that the exhibit hall wasn’t 100% ready for its opening on Tuesday. Freeman people were dodging attendees during show hours as they delivered equipment throughout the hall, and I saw several booths with shipping boxes, electrical gear, and luggage piled up near the main aisle.

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I don’t know what a Digital Health Technology Partner is, but I’m sure it involves writing a check.

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The puppies were in their play area today, helping raise money for the Anti-Cruelty Society.

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Pure Storage and Veritas are offering “HIMSS 2023 Bottoms Up!” each afternoon.

The coat check rooms were stacked high with suitcases on Wednesday, which suggests that quite a few folks are heading home today. Exhibitors are required to staff booths for the shortened exhibit hours Thursday, but it will probably be dead in the hall (and suitcases will be piled up there, too).

NFL player Damar Hamlin, the HIMSS23 Friday morning keynote speaker who nearly died on national TV after suffering cardiac arrest from an on-field collision with another player, is cleared to play and says he will return to the game.

I got bored and bailed early today, enjoying a late lunch / early dinner at Il Porcellino, mostly because it was a short walk from the hotel. It was actually pretty amazing – the grilled calamari in arrabbiata was excellent and the lasagna is the best I’ve had anywhere. It was way too much to finish, but the price was entirely reasonable, especially for the neighborhood. The server said they have seen a bump in business from the HIMSS conference.


News

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JTG Consulting Group hires Susan Mize, MBA (Bridgeway Benefit Technologies) as chief services officer.

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Children’s Hospital Los Angeles promotes interim CIO Conrad Band to SVP/CIO.

Morning Headlines 4/20/23

April 19, 2023 Headlines No Comments

Electrical failure causes electronic medical record system Sunrise to be offline at South Australian hospitals

SA Health reverts to downtime procedures after a structural fire in the South Australian government’s data center causes service disruptions to several systems, including the health system’s Sunrise EHR.

Third Way Health Raises $1.55M in Pre-Seed Funding for End-to-End Medical Practice Front Office Solution

Front-office practice management startup Third Way Health raises $1.55 million in pre-seed funding, which it will use to launch US operations via pilots with practices in California and New York.

Settlement reached with telehealth company Visibly over accusations of deceptive business practices

Online eye exam company Visibly will pay $500,000 to the FDA to settle allegations that it misrepresented customer satisfaction rates and satisfaction guarantees, marketed its tests without required clearance or approval, and claimed that its tests were as accurate as in-person exams.

Healthcare AI News 4/19/23

April 19, 2023 News No Comments

News

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OSF HealthCare (IL) selects AI-powered Cortex utilization management technology from Xsolis.

UPMC CTO Chris Carmody says the health system plans to use AI to connect patients with clinical trials based on EHR data analysis, develop digital twins for improved treatment planning, enhance telemedicine offerings, and create automated visit summaries using technology from UPMC Enterprises spinoff Abridge. I interviewed Abridge founder and CEO Shiv Rao, MD earlier this month.

Amazon announces new tools for building with generative AI on AWS. Amazon Bedrock offers foundation models from Amazon and other companies that address use cases such as text generation, chatbots, search, text summarization, image generation, and personalization.

EClinicalWorks will integrate its EHR/PM solutions with ChatGPT, cognitive services, and machine learning models from Azure OpenAI Service.

Microsoft and Epic announce that they will work together to bring generative AI into Epic’s applications via Azure OpenAI Service. UC San Diego Health, UW Health, and Stanford Health Care are already using an initial solution that automatically drafts message responses. Another solution will add natural language queries and interactive data analysis to Epic’s SlicerDicer self-service reporting tool.

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A recent Stanford computer science graduate creates HealthGPT, a test case for connecting generative AI to Apple Health data to support answering user questions, such as, “How should I train for a half marathon?”


Research

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University of Florida Health researchers are working with Nuance and its Precision Imaging Network to create and fine-tune AI solutions for radiologists, specifically in the areas of interpretation reporting and ensuring that algorithms perform effectively.

Carnegie Mellon researchers develop an Internet-connected OpenAI tool that correctly developed a plan to synthesize ibuprofen, aspirin, and aspartame and to control the lab technology required to manufacture them. They also had the system develop a new cancer drug that was not tested. The authors warn that such a system is promising, but could be used to create illegal drugs or bioweapons. Not surprisingly, they also credit ChatGPT for creating the first draft of the article.

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A survey of 1,039 adults finds that 20% have experienced healthcare enhanced by AI, with younger patients making up the bulk of that group. Nearly half believe the use of AI in healthcare to be somewhat or very trustworthy.


Opinion

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Headspace Health Chief Product and Design Officer Leslie Witt says AI won’t replace its mental health professionals any time soon, though the company is working to incorporate more AI-powered features into its meditation and mindfulness app. Headspace acquired Sayana, an AI-based competitor, last year.


Other

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OpenAI launches a bug bounty program that will pay users between $200 and $20,000 to report vulnerabilities, bugs, or security flaws found in ChatGPT. Users have so far reported 31 vulnerabilities with an average pay out of $650.

Starting July 5, New York City will begin enforcing a law that requires employers to disclose the use of automated employment decision tools to job candidates during the hiring process. Companies that wish to use such AI-based tools must first have them audited for bias by the city’s Department of Consumer and Worker Protection.

Elon Musk creates X.AI Corp., a company rumored to be an eventual competitor with OpenAI, which Musk co-founded in 2015 and left three years later to avoid conflicts of interest with Tesla.


Contacts

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Get HIStalk updates.
Send news or rumors.
Contact us.

From HIMSS 4/18/23

April 18, 2023 News 10 Comments

Tell me anything interesting you’ve seen or heard since I need to plan my Wednesday and possibly Thursday if I don’t skip out.

I was standing outside in the cold barely after sunrise this morning, wondering where the HIMSS shuttle would be stopping since it wasn’t marked on the street. The HIMSS app wasn’t updating the bus status, and when it finally did, it showed a 15-minute wait on top of the 10-15 minutes I had already waited, so the planned 15-minute intervals didn’t actually happen even in light traffic.

I got my badge quickly, took a stroll around (my IPhone says I took 22,000 steps Tuesday by mid-afternoon), and then waited around for the exhibit hall to open at 10 a.m. I realized afterward the apparent extinction of the ball cap girls who used to forcefully thrust the show daily from Healthcare IT News at every passerby, almost defying you not to take a copy that you didn’t really want.

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I also noted that the Starbucks line stretched endlessly and never died out completely, even in the late afternoon when I can’t imagine wanting coffee of any temperature.

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My first action was to hike what seemed like miles to get a look at the lake and skyline. It was a beautiful, spring-like day that quickly erased memories of yesterday’s snowy gray.

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Tell me without telling me that the HIMSS conference is in Chicago this year.

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I saw this guy outside the exhibit hall. I saw a couple of other dogs in or near booths and HIMSS had a puppy play area that was being used to solicit donations for The Anti-Cruelty Society, although I disappointingly didn’t time it right to seem them playing in their fenced-in yard.

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This is either (a) HIMSS23 attendees right before the exhibit hall doors opened, or (b) runners awaiting the starter’s pistol in the Fairly Well Dressed 5K. I have zero fashion sense or interest, but bright brown shoes and tight suits or blazers over jeans are current looks that look better than the baggy, three-piece charcoal gray suits and mirror-polished black shoes of yesteryear.

This is the first HIMSS conference that felt normal by 2019 standards. People were everywhere, almost nobody wore masks, booths were laid out with slightly wider aisles but normal spacing otherwise, and I didn’t see a single elbow bump in lieu of a handshake. Most of the hygiene theater of the dark ages of 2020 and 2021, which was of questionable scientific merit even then, has since been proven pointless and was quickly abandoned.

HIMSS says attendance is already up hugely over 2021 and nearing 2019 levels, but then again, why wouldn’t they say that when we “trust, but verify” types can’t investigate whatever number they throw out there? Regardless, the increase feels directionally correct. The exhibitor list shows 1,215, although some of those companies bought only meeting rooms rather than booths.

I started out with a packed ClosedLoop.ai session in the north hall. The anchor booths were in the south hall, but a few bigger vendors got the north hall, including Google Health.

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Nice color coordination, Orion Health. I like it.

I attended a Sodexho presentation on having hospital staff initiate conversations with patients and then report back through the company’s Experiencia tool, which gives executives a real-time dashboard and alerts of patient issues while they can still be fixed. They said that nobody likes filling out a survey, especially if it’s likely nothing will happen anyway, so they use in-room conversations and text messaging to let staff either resolve or explain a problem, freeing up clinical staff who would otherwise be dealing with the hotel side of being hospitalized.

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The exhibit hall was full of bare floors, weird dead ends, and unattractive HIMSS ghost town spaces. Tegria got a terrible location that was nearly impossible to find even when following the hastily erected directional sign, and Ellkay had a “this way” sign several aisles over like a highway exit. That reminded me of a HIMSS conference years ago in Las Vegas, where the downstairs Hall G was drawing so few people that HIMSS was shamed into adding extra signs and offering lunch discounts for enticing visitors to head downstairs into what resembled a poor student’s basement rumpus room.

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The Microsoft-Nuance booth was busy.

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I overheard several folks lamenting, as was I, the apparent end of an era, as Oracle has apparently expunged the Cerner and Oracle Cerner names in favor of Oracle Health.

I went to a session about the CoMET AI-based patient monitoring solution by Nihon Kohden by the doctor who developed it. He mentioned an interesting fact from a study – training a sepsis model on a hospital’s surgical ICU data had zero predictive value for the same hospital’s medical ICU, and vice versa. Models don’t work if they were trained on data from multiple hospitals or even multiple areas of the same hospital. I’m curious why that would be, so I’ll have to dig up the paper.

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I think ChatGPT’s straight vertical growth and endless publicity have HIMSS23 vendors too little time to feature generative AI in their booth materials, other than EClinicalWorks anyway.

Giveaways were interesting this year. I forgot my battery-powered phone charger that I got at a HIMSS conference years ago, but nobody was handing them out. Chapstick and stress balls were in limited supply. I did score some Garrett’s popcorn, however.

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Someone asked me, “Do you want a beer” from a booth at barely past noon, which I answered in wondering if the question was rhetorical given the hour. The person at the Silex booth assured me, “You wouldn’t be the first person to say yes,” so I took one from the ice chest to sip as I watched another vendor’s presentation. I’m sure the price they pay the concessionaire for each beer is astronomical, so I made sure to enjoy it.

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You pay thousands of dollars to attend a conference, another $20 for a prison-grade lunch, and this as your seating choice if you want to eat, charge your phone, or allow your introversion to be soothed. I really don’t understand why we as attendees tolerate this. It isn’t like Las Vegas, where everything revolves around keeping you in the casinos, so putting out more tables and chairs surely wouldn’t upset the business model. I’m sure McCormick Place has buildings full of unused furniture.

The going-home Red shuttle line was pretty poorly marked in the convention center halls, so I finally found the bus after a few wrong turns and near-constant doubt that I was in the right place.

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A Chicago reader agreed with my assessment that deep-dish pizza is awful (not my style, as El Presidente would say) and suggested tavern style instead, a Midwest-only specialty that I unfortunately haven’t found in River North that seems to favor Neapolitan style at steep prices. However, that person also urged me to go to Al’s or Portillo’s for Italian beef, so I left the convention center early, walked over to Al’s Italian Beef on N. Wells, and had a wet beef with sweet peppers and a large side of perfect hand-cut fries. I heard people talking all day about the sumptuous dinners their employers would be underwriting Tuesday evening, making me even happier with my self-paid $15 one that I consumed with gusto away from other badge-wearers. All that was missing was a working man’s ice-cold draft PBR or Heileman’s Old Style.

Conversations Overheard

A lady said she decided not to renew her membership in women’s group Chief because it was going to cost $9,000, which she was paying out of her own pocket, and she felt that the two women who started the organization made an unexpected fortune but didn’t deliver much afterward. She told someone that the organization had done nothing that benefited her in one year of membership.

Someone said that a few CIOs told they they were going to stop attending the HIMSS conference in favor of ViVE, saying that HIMSS didn’t recognize the threat of having its CIO track at HIMSS turned into CHIME’s own conference. The person said that the HIMSS conference would become an event for provider managers and directors who might then report what they learned about vendors and products to the decision-maker back home, to which I responded was often the HIMSS model anyway since CIOs often don’t roam the floor and instead dispatch underlings as scouts.

Most of the common hallways of the exhibit hall were uncarpeted, exposing spray-painted labels, hazard tape covering wires, and metal plates in the floor. Apparently Hal Wolf said in the opening session that it was an environmental decision based on the need to otherwise manufacture, install, and dispose of carpet. Sort of the same argument that hotels use in trying to convince you that re-using your room towels is for the environment’s benefit, not their own.

A top vendor executive emailed me today to say, “I hope you will be writing about the absolutely pathetic bare floors across the halls here at HIMSS. Vendors are required to pay for flooring in our booths (carpet, vinyl, wood, etc.) but HIMSS felt they didn’t have to do it? Ridiculous. We have never exhibited at an event where the exhibit hall felt incomplete until HIMSS23.“ I agree, and the environmental excuse seems iffy given the carbon footprint of endless flights for an in-person event compared to every other conference that somehow manages to lay down carpet. It’s beginning to seem like this was a “recover financially from HIMSS20” year for HIMSS in staying home in Chicago for making the exhibit hall look like a underfunded indoor flea market. I’m curious if anyone has seen other examples of apparent belt-tightening.

A long-time reader checks in: “Judy Faulkner recommended HIStalk to 30 of us in a conference room when she taught us about the ‘Epic culture’ in 2003. I have read every week, nearly 20 years! Thank you for writing.” Thank you for reading. My insistence on remaining anonymous and avoiding self-promotional activities means that HIStalk to me is an empty screen in an empty room, and writing it feels like scrawling in a diary that I don’t intend for anyone else to read. I like it that way, but I appreciate those few times each year when someone shares what their side of my screen looks like since I have no idea.

Someone asked if anyone was hearing anything about HIMSS Accelerate. Negative.


News

The VA’s Oracle Cerner system goes down for five hours on Monday, apparently joined by the same downtime for the DoD’s instance of Oracle Cerner.

Memora Health gets a $30 million investment from investors that include General Catalyst and two big health systems.

A recent Stanford computer science graduate creates HealthGPT, a test case for connecting generative AI to Apple Health data to support answering user questions, such as, “How should I train for a half marathon?”

Morning Headlines 4/19/23

April 18, 2023 Headlines No Comments

Memora Health Announces $30M Investment To Scale Intelligent Care Enablement Platform With New Health System Partners

Automated care management software vendor Memora Health raises $30 million, bringing its total funding to $80.5 million.

VA electronic health record system hit with five-hour incident

Oracle Cerner-powered EHR systems used by the VA and DoD experience a five-hour service disruption marked by latency issues and freezing within certain workflows.

Scan.com, which gives patients direct access to private medical imaging services, raises $12M

Shortly after launching in the US, London-based medical imaging referral startup Scan.com raises $12 million in a Series A investment round.

From HIMSS with Dr. Jayne 4/18/23

April 18, 2023 Dr. Jayne No Comments

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It was a slow start at HIMSS on Monday. I attended a couple of conference calls for my day job and got a little work done in the morning. I waited by my designated shuttle stop and never saw a bus, so decided to take the multi-mile walk from my hotel to the convention center.

Although it was a little breezy, it was definitely good to be out and moving. I had planned ahead and had a headband to control my hair and keep my ears warm, so that was a plus. Not to mention that I know I’ll be well off script this week with my eating habits, so getting ahead with some exercise was likely a good plan. The sidewalks were dry and the snow flurries were actually kind of pretty. Had I taken the shuttle, I would have missed this interesting art installation with headless forms that was on the north side of Michigan Avenue.

With my early afternoon arrival, there was virtually no line at the badge pickup station I found. Apparently, there are several throughout the complex, and it felt like every time I turned around, I was running into one. The conference bag was standard issue, blue this year, but I took a pass since I brought my usual trusty tote. The only other giveaway was a pen.

I scored a notebook at the Slack “scan your badge and win a prize” kiosk that was also dispensing PopSockets and other trinkets. It was nearly empty by the time I stopped by. Hopefully, they will restock it for future arrivals. Being at McCormick Place felt strange and unfamiliar. I was struggling to remember the last HIMSS conference I attended here. It feels like there’s been a bit of construction since the last one, or maybe my post-pandemic memory just isn’t what it once was.

I had an unexpected encounter with an old friend that led to a long discussion of hobbies and life outside of work, which was refreshing indeed. I clued him into a niche business that I’m working with that has quite a backstory and which provides an interesting case study for entrepreneurs being in the right place at the right time. Following that, I had a pre-scheduled meeting and used the CXO Networking Lounge in the West building. It was nice to have a space where I could plan a meeting and know that there would be chairs rather than wandering in search of seats like I’ve had to do at other conferences. The Lounge was nearly empty, but I suspect it will be hopping later in the week.

My plan for the week includes attending multiple sessions, chatting with a number of vendors and organizations that I’d like to do business with, and looking for new solutions that will inspire or delight me while also bringing value to the patients I serve. Normally I try to attend a number of social events, but this year, I’m opting for quality over quantity, planning some deep catch-ups with colleagues and some regional HIMSS events.

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The opening reception actually kicked off a little early, which was good given the crowds massing outside the doors. The entryway featured a garden theme with women whose heads were obscured by large balls of flowers. Once you made it past that, a woman was riding some kind of “wine cycle” that had glasses in the umbrella area and had an automated pouring mechanism that tipped the bottle. It was gimmicky, and I’m not sure how it fit into the theme or if it was meant to just be attention-grabbing. It also featured an apparatus on the back that looked like a gramophone trumpet full of flowers, so I’m still trying to figure it all out. I ran into half a dozen old friends who also couldn’t quite sort it out, so if you know more about the wine cycle, please let us know.

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My time at the reception was truncated by an urgent phone call, but not before I spotted my first pair of pink socks for the event and also some sparkly sneakers. Once I had everything squared away with the call, it was time to head out for my dinner reservation at Girl and the Goat. One of my local BFFs had scored us a reservation there on short notice, which turned out to be a chef’s table type experience as we were seated right in front of the pastry station, just adjacent to the wood-fired oven. The meal was amazing. The pretzel pull-apart bread taught me that I needed more caramelized onion mustard jam in my life, and the chickpea fritters did not disappoint. The sauteed green beans were divine and the staff surprised us with a complimentary order of goat empanadas. Being able to sit right at the pass was amazing and it was clear that the staff took pride in their work and enjoyed interacting with customers.

From there it was a quick Uber back to my hotel to rest up for what tomorrow brings including keynotes, meetings, panels, and of course the exhibit hall.

Email Dr. Jayne.

Morning Headlines 4/18/23

April 17, 2023 Headlines No Comments

Best Buy lays off hundreds of store employees as shopping trends shift

Best Buy will lay off hundreds of store workers, citing a shift in consumer shopping habits and a desire to prioritize its health business and Totaltech membership program.

Global Healthcare Exchange Announces Plan to Acquire Prodigo Solutions

GHX will acquire UPMC-backed supply chain and data enablement technology company Prodigo Solutions.

Microsoft and Epic expand strategic collaboration with integration of Azure OpenAI Service

Epic integrates Microsoft’s Azure OpenAI Service with its EHR, offering end users ChatGPT-enhanced workflows in the initial areas of drafting message responses and self-service reporting.

HHS Launches New Cybersecurity Awareness Resources

HHS develops new resources for cybersecurity best practices to help healthcare organizations secure their digital networks.

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