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Morning Headlines 8/19/20

August 18, 2020 Headlines No Comments

Bridge Connector Raises $25.5 Million in Series B Funding to Advance Interoperability Layer for Health Care

Nashville-based interoperability platform vendor Bridge Connector raises $25.5 million in a Series B funding round, increasing its total to $45 million.

Change Healthcare Acquires Nucleus.io

Change Healthcare enhances its Enterprise Imaging Network with the acquisition of Nucleus.io, a cloud-based imaging and workflow software company.

WebMD and Krames Launch Back to Care Program, Connecting Patients with Prescription Assistance

WebMD and Krames launch WebMD Back to Care, which connects patients with available prescription payment assistance programs.

News 8/19/20

August 18, 2020 News 5 Comments

Top News

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Interoperability platform vendor Bridge Connector raises $25.5 million in a Series B funding round, increasing its total to $45 million.

The Nashville-based company will use the funding to continue the rollout of its new Destination integration service. It says it is on track to boost growth by 1,000% in 2020.


Reader Comments

From Cam Sandford: “Re: telemedicine. I think the pushback against online classes offers a value warning.” Students who are paying megabucks for college tuition are not happy at being taught over the equivalent of Skype at full price, even though their degrees will presumably be worth the same in the end. The convenience factor isn’t convincing students and their parents that trading the campus experience for home learning is a good deal. The biggest risk to telemedicine is that patients often still have to go somewhere as a result –pharmacy, lab, x-ray facility, ED, or specialist – and that cancels out much of their overall convenience. I also wonder how patient satisfaction fared in the telemedicine tsunami, especially when segmented into the “I just need a prescription” kind versus complex, ongoing patient management. Most of us don’t conduct our business virtually with lawyers, accountants, and financial advisors and we might have the same reluctance to turn our medical issues over to the flickering image on a video screen, especially if we are just assigned some random, available doctor that we don’t know, can’t contact for follow-up questions or concerns, and will never see again. It would also be interesting to compare the experience, credentials, and outcomes of doctors who are willing to sell telemedicine time to those who aren’t, just like you don’t see top-tier actors and athletes hawking custom video birthday greetings on Cameo.


Webinars

August 19 (Wednesday) 1:00 ET. “A New Approach to Normalizing Data.” Sponsor: Intelligent Medical Objects. Presenters: Rajiv Haravu, senior product manager, IMO; Denise Stoermer, product manager, IMO. Healthcare organizations manage an ever-increasing abundance of information from multiple systems, but problems with quality, accuracy, and completeness can make analysis unreliable for quality improvement and population health initiatives. The presenters will describe how IMO Precision Normalize improves clinical, quality, and financial decision-making by standardizing inconsistent diagnosis, procedure, medication, and lab data from diverse systems into common, clinically validated terminology.

September 3 (Thursday) 2:00 ET. “How Does A Global Pandemic Reshape Health IT? A Panel Discussion.” Sponsor: Intelligent Medical Objects. Presenters: Rob Wallace, chief product officer, IMO; Andrew S. Kanter, MD, MPH, chief medical officer, IMO; Lori Kevin, VP of enterprise IT and security, IMO; Sahas Subramanian, MCA, enterprise architect, IMO. As COVID-19 continues to spread, regulation changes, code system updates, and an increased reliance on technology are making it hard to stay on top of the many ways the pandemic is altering health IT. What’s more, we’re confronting challenges that rely heavily on technological solutions – like accurate reporting tools or telehealth adaptations – and we need those solutions now. The panel of subject matter experts across the enterprise will share insights on how the global pandemic is reshaping the health IT world.

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


Acquisitions, Funding, Business, and Stock

Perhaps this is telemedicine’s next acquisition, Medical cannabis telemedicine provider PrestoDoctor expands to Illinois after success in other states in selling medical marijuana cards for $50 to $200, depending on the state. It is fascinating to see how many buzzy startups sell nothing but rubber-stamped doctor prescriptions delivered impersonally online, adding minimal value and contributing little to drug safety and appropriate use by at least occasionally prescribing whatever the patient wants to keep the patient and their employer happy.


Sales

  • Michigan Medicine chooses Sectra for enterprise imaging.

People

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CloudWave promotes Erik Littlejohn, MBA to president/COO and Joseph Badziong, MBA to CFO.

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Ciox Health hires Nick Giannasi, PhD (Change Healthcare) as chief product officer.

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Todd Johnson (GetWellNetwork) joins Avia as SVP/practice leader.

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Nordic hires Jeff Buss, MS, MBA (EY) as CIO.


Announcements and Implementations

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WebMD and Krames launch WebMD Back to Care, which connects patients with available prescription payment assistance programs. The information will be included in end-of-visit patient education materials provided by Krames, which joined WebMD as part of its StayWell Company acquisition from drug maker Merck in March 2020.

Virginia Cardiovascular Specialists deploys PatientKeeper for reviewing patient information and capturing professional charges on mobile devices.

3M-owned MModal says that 150 healthcare organizations are using its virtual assistant technology that captures the doctor-patient conversation to automatically document the encounter.


COVID-19

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FDA warns labs and providers that Thermo Fisher’s TaqPath COVID-19 test kit can deliver false positive results unless labs apply software updates and follow the company’s instructions for vortexing and centrifugation.

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University of North Carolina at Chapel Hill moves undergraduate classes online just one week after the start of in-person classes. The university reported several COVID-19 breakouts in communal living areas and a 13.6% test positivity rate that quickly filled its isolation dorm. UNC had ignored CDC’s recommendations, declined to follow the county health department’s recommendation to delay in-person classes for five weeks, and didn’t tell faculty members about the health department’s warning that it should not bring students back to campus. The independent student newspaper published an editorial about the clusters of infection under the headline “UNC has a cluster****” on its hands,” except they used letters instead of asterisks in describing how the university should have know that students would immediately start behaving recklessly at parties even before last Monday’s class start. Football practice will continue, however, and a home game is scheduled for UNC’s largely closed campus on September 12.

North Carolina’s health department says Monday’s case count was lower than expected because a commercial lab was late in sending its data file, the second week in a row where testing numbers were wrong due to lab data problems.

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A ProPublica report says that cellphone tracking data shows that visitors to Las Vegas casinos, which re-opened on June 4, are likely spreading coronavirus to communities all over the country. Travel-related transmission cannot be easily detected by contact tracing, which is local rather than national in nature.

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Three  New Jersey hospitals implement thermal scanning to screen patients, visitors, and employees as they enter the premises, ignoring WHO’s conclusion that such scanners – which were never intended for medical use — do little except provide a false sense of security since many COVID-infected people are free of symptoms.


Other

Ohio-based contract Epic analyst Gurnee “GG” Green will be featured in the Democratic National Convention this week, explaining how her custom clothing boutique that she opened in December 2019 has struggled due to COVID-19.

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The bond rater of Wise Health System (TX) says that one reason the health system’s margin has slipped is the cost of replacing Cerner with Allscripts, which in addition to staffing expense, created $12 million worth of revenue cycle inefficiency. It notes, however, that Wise Health Surgical Hospital improved its revenue cycle performance in 2019 following the EHR implementation.


Sponsor Updates

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  • The Ettain Group donates laptops to the Dottie Rose Foundation in support of its STEM and family-assistance efforts.
  • Clinical Architecture will present during Logica’s Summer 2020 Virtual Meeting August 18-20.
  • Everbridge wins The Help Desk Institute’s 2020 Best Customer Experience Award.

Blog Posts


Contacts

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

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Morning Headlines 8/18/20

August 17, 2020 Headlines No Comments

Thirty Madison raises $47 million for its direct to consumer treatments of hair loss, migraines and indigestion

Consumer-facing telemedicine and prescription delivery startup Thirty Madison raises $47 million, bringing its total funding to $70 million.

Omnicell to Acquire Pharmaceutical Strategy Group’s Leading 340B Software-Enabled Service Business

Medication management vendor Omnicell will acquire Pharmaceutical Strategy Group’s 340B Link business for $225 million.

Patient Square Capital Formed To Become The Premier, Dedicated Health Care Investment Firm

Healthcare investment veteran Jim Momtazee announces the launch of Patient Square Capital, an investment firm that will focus on technology-enabled services, medical devices, digital health, providers, and consumer health.

Curbside Consult with Dr. Jayne 8/17/20

August 17, 2020 Dr. Jayne 1 Comment

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Sunday was National Rum Day. Alas, I spent it treating patients rather than enjoying fuzzy drinks in the sun somewhere.

Today was a case study on how broken the healthcare industry is. Given the economy, over the last few weeks we’ve seen a surge in people questioning their deductibles and trying to figure out what the cost of care might be prior to checking in to be seen. Of course we haven’t done anything remotely close to installing real-time eligibility checking and usually don’t have a clue what their benefits might be due to convoluted payer contracts, so they stand at the front desk and debate whether they want to be seen or not. I feel for them because most of them need care, but are feeling like they’re stuck between a rock and a hard place in deciding what to do.

We’re seeing a mix of patients who are terrified that they might have COVID, those who are likely to actually have COVID but don’t think it could possibly happen to them, and the usual things that come into an urgent care, such as lacerations, chest pain, and traumatic injuries. We’re also seeing patients at the urgent care who are terrified of going to the ED since the state is in a surge situation, so they stay at home too long with complicated problems. Tonight ended with an elderly patient who fell and whose family kept them at home due to those fears rather than seeking care. Ultimately, they did little more than prolong the patient’s pain and delay definitive care for her broken femur.

We’re also seeing a total breakdown in the primary care infrastructure. Patients can’t get in touch with their providers to determine the best place to seek care. We’re seeing more and more patients relying on us for basics and necessities such as medication refills and quarterly labs.

Despite everything that is supposed to be going on in the realm of value-based care and management of costs, it feels like things are upside down and we’re just lighting money on fire rather than delivering coordinated care. If we as a society can’t manage something as straightforward as medication refills, I’m not sure how we think we’re going to motivate patients to make major health-related changes or meet their growing psychosocial needs as the pandemic rages on.

I struggle to figure out the answer. I’m certain technology isn’t the full answer, although I’m eternally grateful that Epic has essentially taken over the market in our area. Nearly every patient has a phone and can access MyChart, so those of us in the urgent care trenches can figure out what’s going on. Except for those patients who flit around the urgent care market between CVS Health Hub, the Walgreens clinic, and the handful of urgent cares in town, in which case all bets are off. Most patients don’t know that they can coordinate their MyChart accounts though and pull in data from the different health systems, so it feels like I do a fair amount of technology teaching some days as we try to see an integrated picture of patients who seek care across the different systems.

I have noticed an improvement in the medication history information we can receive back through Surescripts, which helps quite a bit when you’re trying to figure out how compliant your patients are. Our prescription drug monitoring program database also continues to perform like a champ, which helps bridge the gaps. Still, the bottom line is that I’m usually in at least three or four different systems trying to do my job, which doesn’t seem right in the middle of a public health crisis that should be driving us towards greater sharing and improved patient care.

I’ve also noticed an increase in patients who want to discuss politics during their visits. It always gives me a little chuckle when they ask me whether I think COVID is as bad as the media make it out to be. My double mask and the face shield should be an indicator. Still, it doesn’t seem like there’s much realization that healthcare workers are desperate to not take the virus home to their family members, or that we are stressed to the max and both physically and mentally exhausted, given the complaints that we get when anyone has to wait more than 30 minutes for their visit.

We’re squandering resources right and left as colleges and universities mandate COVID testing, but on a clinically inappropriate timeline. A negative test 10 days before move-in day is meaningless unless the students have been quarantining. We’re also still seeing employers that demand patients who have negative tests get a second negative test to return to work despite the CDC updates that occurred more than three weeks ago that say this is unnecessary. I’m sure the local school district’s HR department is far wiser than infectious disease experts, so we do what has to be done regardless of whether it makes sense or is a good use of resources or not.

I had an interesting conversation with my scribe today, I didn’t realize he is a COVID survivor. He was pretty sick and spent a couple of weeks in the hospital, receiving convalescent plasma and not requiring intubation. He’s glad to be recovered, but worries about the long-term consequences of the disease, especially since he’s under 30 and hopefully has many years ahead of him. He’s focused on making it to medical school in a year or so and I can’t help but think that his experience will make a difference in the kind of physician he grows into.

He had never heard of clinical informatics, so I was able to do some education there. It’s good for those who aspire to join the healthcare team to know the underpinnings that try to hold it all together. We talked about some of the work I’ve done in the past, which had me hankering for a good lab interface build or maybe some kind of a legacy EHR conversion. It’s funny how the things we thought were arduous at the time take on a whole new look when we’re faced with something that has changed our perspective as radically as COVID has.

Regardless of how tedious our days seem or how frustrating some of the interactions might be, the reality is that we’re dealing with someone’s mom, dad, grandmother, daughter, sister, and more. It’s a unique privilege to care for people. I’m hoping we will eventually be able to elevate our game and find a better path forward.

What is your employer doing to change the big picture of healthcare or drive innovation forward? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 8/17/20

August 16, 2020 Headlines No Comments

Firm Helping Run U.S. Coronavirus Database Refuses Senators’ Questions

Citing an NDA, health IT vendor TeleTracking refuses to answer the Senate Health Committee’s questions about its $10.2 million contract to develop a HHS COVID-19 hospitalization reporting database to replace one used by CDC.

HHS CIO Arrieta unexpectedly resigns

HHS CIO Jose Arrieta resigned unexpectedly Friday night after 16 months on the job, saying he wants to spend time with his kids.

Epic Systems consolidating four departments into one division

Epic notifies employees that it will immediately consolidate its training, implementation, QA, and technical communications under an application services division.

Medical Debt Collection Firm R1 RCM Hit in Ransomware Attack

Revenue cycle company R1 RCM works to recover from a ransomware attack that occurred just as the company was preparing to release its quarterly financial results.

Monday Morning Update 8/17/20

August 16, 2020 News 15 Comments

Top News

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Health IT vendor TeleTracking refuses to answer the Senate Health Committee’s questions about its $10.2 million contract to develop a HHS COVID-19 hospitalization reporting database to replace one used by CDC.

TeleTracking says it signed an NDA that prohibits it from explaining to Congress how it collects and shares data, the nature of its proposal to HHS, and communication it may have had with the White House or other government officials.

The Pittsburgh-based company directed such inquiries to HHS, which has not responded to a June 3 inquiry from Senator Patty Murray (D-WA), who asked why the government was creating what seemed to be a duplicate data collection system.

HHS CIO Jose Arrieta, who defended the contract and insisted that the work was bid competitively despite appearances that it was not, resigned Friday.

TeleTracking’s contract runs just five months, after which it can bill the government for an extension.


Reader Comments

From Concerned Exhibitor: “Re: HIMSS21. What are companies doing now that it has been moved to August? The contract says that if HIMSS21 cancels for any reason, HIMSS will keep 50% of exhibitor payments. Wondering if people will be attending, or will it be a vendor pool?” I’ll make that my weekly poll below, but based on the one I did a couple of weeks ago, nobody will decide anything until they can assess the pandemic situation.

From Minesweeper: “Re: HIMSS21. You should get them to sponsor the return of HIStalkapalooza – bet that would get people back in the mood to attend the conference!” I’ve never missed the headache and financial risk that was involved with throwing a party for everybody else for 10 years, so I’m happy to abrogate that responsibility.


HIStalk Announcements and Requests

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Two-thirds of poll respondents say they would not return to campus if so required by their employer, although skeptics might observe that respondent bravado might not evidence itself in a “get in here or you’re fired” scenario, possibly also noting that Epic employees who were (at that time) being forced back to campus for reasons they might not find adequate may have worked to get out the vote.

New poll to your right or here: Health system / provider employees: do you think you’ll attend HIMSS21? (assume COVID isn’t a factor by then). I realize that the unknowns are significant at this point, but I’m curious about those who have a pretty good idea of which way they’re leaning if pandemic issues are excluded. If the pandemic is still active, then it might just be exhibitors talking to cardboard cutouts.

Listening: new from Fantastic Negrito, the stage name for 52-year-old, Grammy-winning blues singer Xavier Dphrepaulezz (clearly the rebrand was justified). He had a rough upbringing and supported himself with various illegal activities over the years, but has turned into a thoughtful observer of society and the power of individuals to change it.

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Welcome to new HIStalk Platinum Sponsor Capsule Technologies, which is upgrading from Gold. The Andover, MA company offers Medical Device Information Platform, which provides device integration, vital signs monitoring, and clinical surveillance solutions. It captures streaming clinical data from connected systems and transforms it into context-rich information for clinical documentation, alarm management, patient surveillance, decision support, predictive analytics, clinical research and more. The company’s 2,900 global clients use its platform to improve patient safety, simplify workflows, and raise satisfaction. The company recently announced its Ventilated Patient Surveillance workstation, launched at Yale New Haven Health System, that allows staff to monitor live streaming data from ventilators to minimize in-room exposure and PPE consumption for patients in temporary ICU rooms that don’t have hallway windows or easily-heard alarms. CEO Hemant Goel is an engineer by training with 30 years of healthcare IT leadership experience. Thanks to Capsule Technologies for supporting HIStalk.


Webinars

August 19 (Wednesday) 1:00 ET. “A New Approach to Normalizing Data.” Sponsor: Intelligent Medical Objects. Presenters: Rajiv Haravu, senior product manager, IMO; Denise Stoermer, product manager, IMO. Healthcare organizations manage an ever-increasing abundance of information from multiple systems, but problems with quality, accuracy, and completeness can make analysis unreliable for quality improvement and population health initiatives. The presenters will describe how IMO Precision Normalize improves clinical, quality, and financial decision-making by standardizing inconsistent diagnosis, procedure, medication, and lab data from diverse systems into common, clinically validated terminology.

September 3 (Thursday) 2:00 ET. “How Does A Global Pandemic Reshape Health IT? A Panel Discussion.” Sponsor: Intelligent Medical Objects. Presenters: Rob Wallace, chief product officer, IMO; Andrew S. Kanter, MD, MPH, chief medical officer, IMO; Lori Kevin, VP of enterprise IT and security, IMO; Sahas Subramanian, MCA, enterprise architect, IMO. As COVID-19 continues to spread, regulation changes, code system updates, and an increased reliance on technology are making it hard to stay on top of the many ways the pandemic is altering health IT. What’s more, we’re confronting challenges that rely heavily on technological solutions – like accurate reporting tools or telehealth adaptations – and we need those solutions now. The panel of subject matter experts across the enterprise will share insights on how the global pandemic is reshaping the health IT world.

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


Acquisitions, Funding, Business, and Stock

Starboard Value, the activist investor whose purchase of just 1.2% of Cerner shares convinced the company to give it four board seats in April 2019, reduces its CERN holdings to 2.6 million shares, about 0.8% of the outstanding shares, worth less than $200 million. CERN shares have gone up 16% since the day Cerner capitulated, although the Nasdaq has moved up 38% in the same timeframe.


People

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Karen Mellin (Swisslog) joins Harris Computer as EVP.


Announcements and Implementations

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India Prime Minister Narendra Modi announces the National Digital Health Mission, in which all citizens will be issue a health ID card that links to a hospital-stored record of doctor visits, prescriptions, and tests. The voluntary program’s six systems include HealthID, DigiDoctor, Health Facility Registry, Personal Health Records, E-Pharmacy, and Telemedicine, of which all but the last two are already running. The government will issue specifications to allow companies to develop FHIR-connected solutions for the system. 


Government and Politics

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HHS CIO Jose Arrieta resigned unexpectedly Friday night after 16 months on the job, saying he wants to spend time with his kids. It was the first CIO job for Arrieta, whose background was technology contracting.

Also resigning Friday were CDC’s chief of staff and deputy chief of staff, political appointees who had been accused by the White House of being insufficient loyal. They are forming a consulting firm.


COVID-19

The US death count ran past the 160,000 mark this weekend in 5.3 million cases.

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COVID Tracking Project says Texas testing numbers are out of whack, with the number of tests dropping by 50% over a 10-day period followed by a record number of new tests on August 13 even as cases didn’t decline much. State-level data does not match that of the five countries with the highest volume of testing to date. The project reviewed the state’s data file and speculate that a state system upgrade to an electronic lab reporting system caused some tests to be uncounted in mishandling “pending assignment” tests. Questionable numbers from Texas are skewing national data because of the state’s size and significant COVID-19 outbreak.

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FDA issues emergency use authorization for the SalivaDirect COVID-19 rapid diagnostic test that was developed by the Yale School of Public Health. The test offers major supply chain benefits since samples can be collected in any sterile container, it does not require a RNA extraction kit that is prone to shortages, and it can use a variety of common reagents and instruments. It also does not require use of a long nasal swab for sample collection. Yale will provided the test as an open source protocol to anyone who wants to manufacture it. Material cost is about $1 to $4 and results take just three hours. The NBA has been using the test since June.

Researchers prove that N95 masks can be cleaned for re-use by using multi-cookers such as the Instant Pot, which inactivated 99.9% of virus in a 50-minute dry heat cycle without pressure. Filtration capability was not affected after 20 cleanings.

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Google Cloud extends free access to its COVID-19 public datasets through September 15, 2021.

CDC Director Robert Redfield, MD warns that public health will be jeopardized in the fall if Americans don’t start wearing masks, distancing, and improving the 50% flu shot rate to 65%. Otherwise, he says the combination of COVID-19 and flu could overwhelm some health systems.

Trials of promising antibody drugs to treat COVID-19 are being delayed by hospitals that are reassigning researchers to patient care roles as well as patients who are reluctant to participate. Companies that hoped to start shipping antibody doses by September are now looking toward the end of the year. Delayed test results are excluding prospective study patients because the drugs must be started within a few days of symptom onset. Hospitals also express concern about giving researchers on-campus space and bringing infected patients to campus for their infusions. Patients are passing in some cases because they assume they’ll get better on their own and don’t want to bother with participating if they might get a placebo anyway.

A CDC survey finds that 31% of unpaid caregivers for adults and 22% of essential workers considered suicide in previous 30 days.


Other

Revenue cycle company R1 RCM is apparently hit by a ransomware attack.

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Epic notifies employees that it will immediately consolidate its training, implementation, QA, and technical communications under an application services division.

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Cerner-sponsored Life Aid, which was launched in March to address veteran and first responder suicide, will be featured in a Discovery Channel special on August 30.

Bizarre: cosmetic surgeons are being overwhelmed with patients have who noticed sags and droopy eyes on their Zoom calls and want to trade their Botox for the scalpel. Some patients have realized that distancing and face masks are ideal for hiding post-op bruises and swelling. One 62-year-old woman spent $20,000 on a tummy tuck and breast job, rationalizing that she isn’t spending money on gas and shopping. Demand is also up for liposuction to address pandemic-driven weight gain.


Sponsor Updates

  • CI Security publishes its “2020 H1 US Healthcare Data Breach Report.”
  • OpenText reports fourth quarter and fiscal year 2020 financial results.
  • PerfectServe announces bidirectional integration between its clinical communication platform and Nuance’s PowerConnect Actionable Findings solution within the radiologist’s Nuance PowerScribe reporting workflow.
  • Relatient adds virtual waiting room capabilities to its patient engagement platform to meet the need for contactless and remote patient arrivals.
  • CNBC’s Mad Money features SailPoint CEO Mark McClain.
  • Spirion wins 2020 Tech Ascension Awards for Best SecOps and Best Compliance Solutions.
  • TriNetX opens registration for the virtual TriNetX Summit September 22-23.

Blog Posts


Contacts

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

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Weekender 8/14/20

August 14, 2020 Weekender No Comments

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Weekly News Recap

  • MDLive announces plans to go public early next year.
  • Health Catalyst announces its acquisition of Vitalware for $120 million.
  • Epic reverses its mandatory return to campus policy, approving working from home through at least the end of the year.
  • Waystar will acquire ESolutions, valuing the company at $1.3 billion.
  • Craneware raises $100 million for acquisitions.
  • Providence Services Group acquires Navin Haffty.
  • VA OIG recommends that the VA work on increasing its use of VA Direct and improve oversight of its VHIE community coordinators.

Best Reader Comments

The most surprising aspect of the Teladoc-Livongo deal is how investors and healthcare analysts don’t seem to understand the telehealth market. The walk-in or urgent care telehealth visit has a razor thin margin for telehealth companies. Almost 100% of the $50  fee charged to consumers goes to pay the physician labor or pay for the ads. The market is national, so any telehealth agenecy can join if they are willing to spend the ad dollars or offer slightly cheaper visits for a brief period as telehealth is uniquely price shoppable. On the other hand, your average physician is used to being protected from national competition by having a very local, captive market and they have many options when it comes to keeping their income above say 120 grand a year. Plus consumers prefer in person visits if the cost and convenience are the same, so providers always can fall back to that. It is very hard to reduce provider labor cost. So the telehealth agency gets squeezed between a price sensitive consumer, a provider who demands the bulk of the revenue from consumer, and the cost of ads which are raised by investors repeatedly dumping their money into new telehealth companies driving up demand on the ads displayed when people search video doctor. So every telehealth company that has lasted more than a few years has some strategy that gets them out of the urgent care market. (detroitvseverybody)

[Teladoc acquiring Livongo for $18.5 billion] reminds me of the post-deregulation period in the airline business, 1980s into the 1990s, when airlines fetched this kind of insane money from all over. I was there for that and it didn’t end well. (Deetelecare)

Providence Services Group now owns two MEDITECH focused service organizations while Providence is in process of migrating multiple MEDITECH hospitals to Epic. Plus, Providence is large Epic client. So basically MEDITECH helps fund a large Epic client since NHA and Engage are two of its partners. (Chris Hill)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. G in Ohio, who asked for white boards for her high school class in urban Cleveland. She reported in late February, “I cannot express how much these white boards have helped my students in class. We use them every day in order for them to practice different concepts in class. These white boards allow for my students to have immediate feedback in class and work through concepts even faster. They have taken pride in their work and have grown so much since having these white boards available in class. Thank you so much for allowing my students the opportunity to use these white boards every day in class.”

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A COVID-19 hospital in India lists its challenges: relatives keep barging in rooms to bring isolated patients meals, air conditioners don’t work in the sweltering heat and humidity, new patients are housed with those known to be infected, families sit curbside with the bodies of family members waiting for funeral home pickup, and armed guards protect the hospital administrator. 

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An Alabama neurosurgeon crashes his $200,000 sports care while doing 138 miles per hour in a 45 zone, killing his 24-year-old medical school passenger. He’s charged with manslaughter. Police say the doctor was intoxicated and suffered only minor injuries.

Chicago chose a politically connected company to develop a temporary 2,750-bed COVID-19 hospital in the McCormick Place convention center at a cost of $66 million, passing on another company that offered to do the work without fees. Federal taxpayers will foot 75% of the bill for the hospital, which saw just 38 patients. Wielding influence in the selection was the private company that oversees Navy Pier, which is run by political allies of former mayor Richard Daley.

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A medical practice in England discovers why patients aren’t answering its phone calls – a phone system error caused its Caller ID to show the name of a massage parlor.

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Can’t wait for Las Vegas at HIMSS21? MGM hotels is offering “Viva Las Office,” a work-from-Vegas package that includes discounted flights, rooms in the Bellagio or Aria hotels, and a personal concierge. Big cheeses can blow their company’s cash with “The Executive” package, which includes a luxe suite, $75 food and beverage credit, a discount on JSX semi-private jet travel, a day’s cabana rental, a poolside massage, and a mask and hand sanitizer. Plus you can study COVID-19 in person since 95% of new Nevada cases originated in the city, comping visitors from all over the country with yet another situation that happens in Vegas but doesn’t stay there.


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Morning Headlines 8/14/20

August 13, 2020 Headlines No Comments

Teladoc rival MDLive is preparing to go public next year

MDLive plans to launch an IPO early next year, encouraged by Teladoc’s announced $18.5 billion acquisition of Livongo.

CancerIQ Raises $5M in VC Funding, Adds Strategic Hires to Epic Integration Team

Precision medicine software startup CancerIQ will use a new $5 million investment to further scale its oncology-focused technology, add staff members to its EHR integration team, and seek out new genomics partners.

Craneware Plans Bumper Placing As It Eyes Acquisition Opportunities

Scotland-based Craneware will raise $100 million, about 20% of its market value, to fund potential acquisitions from a small number of opportunities it has identified.

Epic Systems Reverses Course On Mandatory In-Person Work Policy

Epic makes its planned return to campus optional, reversing its previous decision and allowing employees to work from home through at least the end of the year.

News 8/14/20

August 13, 2020 News 18 Comments

Top News

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Health Catalyst reports Q2 results: revenue up 18%, adjusted EPS -$0.15 versus -$0.21, beating Wall Street expectations for both.

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Health Catalyst also announced that it will acquire RCM software and services vendor Vitalware for $120 million in cash and shares. The purchase marks the company’s third acquisition this year, having acquired Able Health for $27 million in February and Healthfinch for $40 million last month.

The company also announced that Northwell Health has signed up for its Data Operating System analytics and applications platform.


Reader Comments

From Hope Springs Eternal: “Re: Ascension. Announced at an all-hands meeting Tuesday that the service desk, server, and network operations teams will be eliminated and outsourced to Accenture and HCL. The process will be completed by November 25, 2020, with affected associates getting severance and training assistance. I don’t know if the service desk calls will be handled in India as the coding now is.” Unverified, but also reported by a few folks on TheLayoff.com who noted that Ascension started down this path a couple of years ago.

From Ring Ring: “Re: CHIME. I’m hearing that it is looking to fully separate itself from HIMSS. Not necessarily news since they operate separately, but I’m more interested in the political presentation. Will CHIME no longer be held in conjunction with HIMSS and co-present the CIO of the Year award? Feels like there’s a story there, but I’m just not sure what it is.” Unverified.

From Demand Management: “Re: Medlio. What happened to them? We had them set up for our FHIR implementation and got the app downloaded and working, but now the app isn’t working and has been removed from the Apple store. The company’s website also doesn’t launch. We use TouchWorks and Medlio is still on their vendor list.” Medlio’s website is indeed down, their Twitter went silent a year and a half ago, and one of the founders seems to have taken a full-time job elsewhere, according to LinkedIn. Medlio has also been removed from the Allscripts app store, it appears. I’ve emailed the company but haven’t heard back. Seems like they would have let folks know if they are kaput.

From Daddy Sang Bass: “Re: Deep Purple. Begs the question, best rock bass player of all time?” My top five, in order: Chris Squire (Yes), John Entwistle (The Who), Geddy Lee (Rush), Geezer Butler (Black Sabbath), and Flea (Red Hot Chili Peppers). Honorable mention: Gary Thain (Uriah Heep), Carol Kaye (The Wrecking Crew), Mike Rutherford (Genesis), Paul McCartney (The Beatles), and Tony Levin (King Crimson). I can’t think of any contenders from newer bands, but I don’t claim to listen to many of them – maybe Joe Dart from funk band Vulfpeck.


Webinars

August 19 (Wednesday) 1:00 ET. “A New Approach to Normalizing Data.” Sponsor: Intelligent Medical Objects. Presenters: Rajiv Haravu, senior product manager, IMO; Denise Stoermer, product manager, IMO. Healthcare organizations manage an ever-increasing abundance of information from multiple systems, but problems with quality, accuracy, and completeness can make analysis unreliable for quality improvement and population health initiatives. The presenters will describe how IMO Precision Normalize improves clinical, quality, and financial decision-making by standardizing inconsistent diagnosis, procedure, medication, and lab data from diverse systems into common, clinically validated terminology.

September 3 (Thursday) 2:00 ET. “How Does A Global Pandemic Reshape Health IT? A Panel Discussion.” Sponsor: Intelligent Medical Objects. Presenters: Rob Wallace, chief product officer, IMO; Andrew S. Kanter, MD, MPH, chief medical officer, IMO; Lori Kevin, VP of enterprise IT and security, IMO; Sahas Subramanian, MCA, enterprise architect, IMO. As COVID-19 continues to spread, regulation changes, code system updates, and an increased reliance on technology are making it hard to stay on top of the many ways the pandemic is altering health IT. What’s more, we’re confronting challenges that rely heavily on technological solutions – like accurate reporting tools or telehealth adaptations – and we need those solutions now. The panel of subject matter experts across the enterprise will share insights on how the global pandemic is reshaping the health IT world.

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


Acquisitions, Funding, Business, and Stock

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Waystar will acquire Medicare-focused revenue cycle technology vendor ESolutions in a deal that values the company at over $1.3 billion. Francisco Partners acquired ESolutions in January 2015.

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Care pathway automation company Lumeon raises $30 million in a Series D investment round, bringing its total funding to $79 million. The London-based company plans to expand its US presence.

Scotland-based Craneware will raise $100 million, about 20% of its market value, to fund potential acquisitions from a small number of opportunities it has identified.

AI-powered healthcare messaging vendor MPulse Mobile raises $16 million in a Series C funding round.

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MDLive’s CEO says the company plans to launch an IPO early next year, encouraged by Teladoc’s announced $18.5 billion acquisition of Livongo.


Sales

  • NorthBay Healthcare will implement PeraHealth’s Rothman Index patient surveillance technology at its two hospitals in Solano County, California.
  • Northwell Health (NY) selects Health Catalyst’s Data Operating System.

People

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LexisNexis Risk Solutions promotes Todd Garlitz to head of marketing for its healthcare business.

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Provider search and scheduling vendor Kyruus hires Jamie Kiggen (Yotpo) as CFO.

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Orleans Community Health (NY) promotes CIO Marc Shurtz to interim CEO/CFO.


Announcements and Implementations

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Philips announces GA of Rapid Deployment Equipment Kits to help ICUs ramp up patient monitoring capabilities in the event of a COVID-19 surge.

Medhost expands its price transparency solution to allow providers to comply with the requirement to publicly post charges for 300 shoppable services by January 1, 2021.


Government and Politics

DirectTrust President and CEO Scott Stuewe tells me via email that while the VA OIG’s report on HIE use blamed low Direct use in the VA on lack of training from DirectTrust, along with facilities whose community partners don’t use it, DirectTrust doesn’t offer end-user training. DirectTrust is a membership and standards body and relies on vendors to train users on their specific implementation of Direct Secure Messaging. The DirectTrust EHR Roundtable, in which VA participates, recognizes the variability in utilization and is creating a best practices guidelines document to advance usability and use of Direct Secure Messaging.


COVID-19

CDC warns that face masks that are equipped with exhalation vents, like those typically made for construction workers, are not effective for preventing coronavirus spread. A previous study found that “neck gaiters” that pull up from the neck to cover the mouth and nose are ineffective for the same reason they are comfortable – they don’t restrict air flow, making them even worse than not wearing a mask at all.

Cedars-Sinai tweaks a predictive analytics tool originally developed to forecast staffing needs to track hospitalization volumes, supplies, and confirmed cases. It also helps providers tailor treatments and pinpoint patients likely to be readmitted.

WHO says that even though health authorities in China have found coronavirus on the surface of frozen food, evidence does not indicate that food or the food chain is involved with virus transmission.


Other

Epic makes its planned return to campus optional, reversing its previous decision and allowing employees to work from home through at least the end of the year. The county public health department says the 50 complaints it received from Epic employees led it to ask questions about why the return to campus was necessary in light of the county’s emergency order that calls for remote work “to the greatest extent possible.”

The latest national analysis of telemedicine visits from The Chartis Group finds that utilization has fallen from its peak visit level of 50% in mid-April to between 18 and 20% as of late July. Virtual visits in COVID-19 hot spot states like Florida, Texas, and Arizona have remained above the national average.


Sponsor Updates

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  • Nordic volunteers help The River Food Pantry distribute over 100 pounds of curbside emergency food and supplies per household.
  • Gartner gives Dimensional Insight a high rating in the Gartner Peer Insights “Voice of the Customer: Analytics and Business Intelligence Platforms” report.
  • To help prevent readmissions, PatientPing partners with Real Time Medical Systems to offer skilled nursing and post-acute care facilities real-time care notifications and identification of high-risk patients.
  • Healthcare Growth Partners publishes its “HIT July 2020 Insights.”
  • In the UK, Bolton NHS Foundation Trust pilots Imprivata’s Identity Governance technology.
  • New Mexico’s Bernalillo County selects Netsmart’s CareManager technology to help coordinate care for people transitioning out of its correctional facilities.
  • Medhost expands its Price Transparency solution to help providers comply with the updated Price Transparency Policy from CMS.
  • Phynd receives Avia Health’s Vetted Designation for 2020 for its Phynd 360 provider data management platform and Phynd Provider Search software.
  • Central Logic will host the online AO2 Summit on September 15.
  • PatientPing partners with Real Time Medical Systems to reduce hospital readmissions from skilled nursing and post-acute care facilities.
  • Audacious Inquiry marks a decade as one of America’s fastest-growing private companies.
  • Empericus incorporates Wolters Kluwer Health’s Health Language Reference Data Management capabilities into its Health Intelligence EHR for athletes.
  • New data from Experity customer sites shows record urgent care patient volumes in July.

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 8/13/20

August 13, 2020 Dr. Jayne No Comments

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For many practices, it’s a COVID-related surprise and not necessarily a fun one. New national requirements for COVID-19 testing data went into effect August 1. Ordering physicians now have to supply demographic information to help public health agencies track the disease’s spread and identify areas that are seeing large number of cases.

The requirements were included in the Coronavirus Aid, Relief, and Economic Security (CARES) Act. It requires that laboratories that test for COVID or its antibodies report 18 data elements to HHS. Some of them don’t typically appear on a lab requisition, such as race, ethnicity, and county of residence. There are also “ask at order entry” questions to identify whether the patient is a healthcare worker, whether they are housed in a residential setting, whether they are pregnant, or if they have been hospitalized.

Labs are pushing back on practices to supply this information when tests are ordered rather than having to track it down manually. Depending on how up-to-date your EHR is and how well it supports the use of these fields during laboratory ordering, you may or may not be compliant.

I worked with several practices this week who were not compliant and were trying to become so after receiving complaints from their lab vendor. Fortunately, I was able to do some workarounds for the paper requisitions that accompany specimens, but I won’t be able to modify the lab interfaces without support from the vendor.

My participation in the ONC Tech Forum this week was interrupted by the crisis with the lab requisitions, although I would have stepped away and helped my client regardless of whether the conference was in-person or virtual. That’s one of the joys of doing what I do in healthcare IT, as I help practices and organizations navigate the many challenges that get thrown their way.

I was glad to hear National Coordinator for Health IT Don Rucker talk about the utility of health information exchanges in dealing with the COVID pandemic. He acknowledged that we have a way to go before we’re going to be able to make the most of data exchange and the ability to share patient information. He called out the ability for HIEs to receive data for organizations that might not be top of mind for care delivery, such as group homes and shelters. My state has a long way to go with regards to HIE, so I’m fairly convinced that having a truly functioning system that shares data from all physicians at any point before I retire is just a pipe dream.

This week has been all about preparing proposals for potential consulting gigs, so I’m actually looking forward to going back to the clinical trenches this weekend. What I’m not looking forward to are the hundreds of charts awaiting my signature for the shifts I worked prior to vacation. I tried to work on them while I was out of the office, but our Citrix platform is unstable unless you access it from the internal network. They don’t have any incentive to investigate the issue since it doesn’t matter to them how arduous the chart signing process might be. The ongoing message is for us to be happy we haven’t had pay cuts or layoffs, so most of us are just staying quiet. Such is the state of healthcare in the US these days, and my colleagues elsewhere are sharing the same kinds of stories.

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The American Medical Informatics Association has booked Anthony Fauci, MD for a special fireside chat at its Virtual Annual Symposium to be held November 14-18. The session will only available to registered conference attendees. I’m sure it will have a lot of people on the edges of their seats. The man was already a legend prior to COVID and having served as an advisor for six US presidents speaks for itself. I enjoy his matter-of-fact style and can’t wait to see what he has to say. Apparently I’m not the only one that likes his style since the Dr. Anthony Fauci Fan Club group on Facebook has over 150,000 members.

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A friend of mine knows that I’ve been checking out various virtual conferences since the pandemic started and invited me to visit something a little out of my subject matter area. The QSO Today Virtual Ham Expo was the gathering place for thousands of amateur radio operators over the weekend. I have to admit I really liked their platform. They had a virtual expo hall where you could see various “booths” and click on them for a virtual visit and even a live chat. Accessing speaker sessions was very easy even after the conference ended, with the sessions presented as embedded videos within the agenda.

Since amateur radio operators tend to be pretty techy, most of the videos I sampled had reasonably good production values and excellent audio. It was interesting to see how another industry is handling the problems we face, and with over 21,000 registrations, it’s certainly comparable to a healthcare conference.

A couple of friends at software companies say they are working on their own platforms for virtual user groups. I hope they are doing plenty of usability testing and focus groups with prospective attendees. I’ve been to good conferences and bad ones, and there’s definitely a negative impact if the tech isn’t good, the speakers aren’t prepared, or the background filters are doing funky distracting things.

Most of the vendor user groups that I’ve attended are part education, part rah-rah sessions to try to bond users to the company and help them forget all the crummy things the software does to them on a daily basis. It’s going to be hard to get that vibe going virtually unless they really work at it with specific engagement sessions and bulk-mailed swag like they did with the recent InTouch Health / Teladoc conference.

I’d love to hear from vendor folks about how they are planning to approach virtual user groups and the challenges they are facing. I promise to keep you anonymous. If you’re a potential attendee, what are you looking forward to or dreading with virtual conferences? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 8/13/20

August 12, 2020 Headlines No Comments

HHS Announces Investments for Health Information Exchanges to Strengthen their Ability to Support State and Local Public Health Agencies

HHS announces a $2.5 million funding opportunity to help state and local public health agencies strengthen their connections to HIEs.

Health Catalyst Reports Second Quarter 2020 Results

Health Catalyst announces a Q2 revenue increase of 18%, as well as adjusted earnings per share that beat analyst expectations by $0.07.

Waystar to Acquire eSolutions, an Industry Leader in Revenue Cycle & Medicare Analytics

Waystar will acquire Medicare-focused RCM vendor ESolutions in a deal valued at over $1.3 billion.

Morning Headlines 8/12/20

August 11, 2020 Headlines No Comments

Navin, Haffty & Associates and Engage Join Forces to Provide Clients Complete MEDITECH Solutions

Providence-owned Providence Services Group acquires Meditech-focused consulting firm Navin Haffty.

Lumeon Raises $30M in Funding to Support U.S. Growth

Care pathway automation company Lumeon raises $30 million in a Series D investment round that brings its total funding to $78.6 million.

Health Catalyst Announces Agreement to Acquire Vitalware, a Revenue Workflow Optimization and Analytics SaaS Technology Solution

Health Catalyst will acquire RCM software and services company Vitalware for an undisclosed sum.

mPulse Mobile Announces Closing of Series C Funding of more than $16 Million, Led by Optum Ventures

AI-powered healthcare messaging vendor MPulse Mobile raises $16 million.

News 8/12/20

August 11, 2020 News 18 Comments

Top News

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Providence-owned Providence Services Group acquires Meditech-focused consulting firm Navin Haffty.

Providence had previously acquired Meditech hosting and services vendor Engage, which will allow the combined companies to offer consulting, service desk, application support, staff augmentation, and technical services.

Providence also owns Epic consulting firm Bluetree and runs an Epic Community Connect hosting business.

The health system said last year that it planned to create a $1 billion business from its non-clinical investments. It  has 51 hospitals, over 1,000 clinics, and 120,000 employees.


HIStalk Announcements and Requests

Listening: new from Deep Purple, not excavated from a 1970s music vault along with related artifacts such as Hammond A-100s and Gibson SGs, but rather offering a fresh-sounding entry in the barren wasteland of new hard rock. It will be a certain nose-scruncher for most folks who were raised on Auto-Tuned singer-dancers and hip-hoppers, but let’s see how those musicians hold up after 50+ years, 21 albums, and one original member left (72-year-old drummer Ian Paice, a much lesser figure than former members Jon Lord and Ritchie Blackmore). Just turn it up to 11 and hope you end up being a cool septuagenarian like these grandpas who can take you back if you’ve been, or take you there if you haven’t. The part at 2:13 is a dead ringer for Yes’s “Starship Trooper.” 


Webinars

August 19 (Wednesday) 1:00 ET. “A New Approach to Normalizing Data.” Sponsor: Intelligent Medical Objects. Presenters: Rajiv Haravu, senior product manager, IMO; Denise Stoermer, product manager, IMO. Healthcare organizations manage an ever-increasing abundance of information from multiple systems, but problems with quality, accuracy, and completeness can make analysis unreliable for quality improvement and population health initiatives. The presenters will describe how IMO Precision Normalize improves clinical, quality, and financial decision-making by standardizing inconsistent diagnosis, procedure, medication, and lab data from diverse systems into common, clinically validated terminology.

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


Acquisitions, Funding, Business, and Stock

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Private equity firm K1 Investment Manager makes a significant investment in Rethink Autism, which offers a development disabilities platform that includes assessment, treatment planning, e-learning tools, analytics, and practice management. Rethink recently acquired pediatric therapy telehealth provider TheraWe. Rethink’s co-founders came from a company that provided labels and tags for the retail clothing industry.

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Investors are noting that the combined market value of Teladoc and Livongo has dropped nearly $10 billion in the week since the former’s $18.5 billion acquisition of the latter was announced. Above is the one-year share performance of Teladoc (blue, up 188%), Livongo (red, up 212%), and the Nasdaq index (green, up 38%). It’s uglier over the past five days, where TDOC and LVGO have dropped 25% and 19%, respectively, since the announcement. 


Sales

  • New Mexico’s largest county will implement Netsmart’s CareManager for post-incarceration population health and care management.

People

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Clearinghouse operator Jopari hires Tom Turi (The SSI Group) as chief sales and marketing officer.


Announcements and Implementations

Stanford University’s Stanford Center for Health Education launches “AI and Healthcare,” an online, four-course certification program that will be taught by its medical school faculty. Courses in the Coursera program include “Introduction to Healthcare,” “Introduction to Clinical Data,” “Fundamentals of Machine Learning for Healthcare,” and “Evaluations of AI Applications in Healthcare,” which are followed by a capstone project. The only cost specified is the $79 per course Coursera certificate fee.

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Philips announces Virtual Care Station, a telehealth environment for public areas such as stores, libraries, and universities. The company developed the technology for the VA’s ATLAS program, which offers virtual clinics to American Legion and VFW posts.


Government and Politics

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I wondered what happened to former Rep. John Fleming, MD (R-LA), who President Trump appointed to the newly created position of deputy assistant secretary for health technology in 2017. He seemed uncertain about the job when it was announced, initially stating that he was interviewing to become national coordinator, but then admitting, “I think it’s the same or a similar position – I really don’t know.” He apparently didn’t last long there – President Trump appointed him to become Assistant Secretary of Commerce for Economic Development in 2018, and then in March 2020 he was appointed Assistant to the President for Planning and Implementation. I can’t find any evidence that his former ONC position still exists. I interviewed him in January 2018.

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Cerner VP of Strategic Growth Amanda Adkins, who took a leave from the company to seek a US House of Representative seat, wins the Republican primary and vows to defeat Rep. Sharice Davids, who is serving her first term. The healthcare platform of Adkins, a former state Republican party chairwoman, supports creating a national COVID-19 response plan and says the ACA is a failed experiment that increased cost. She says healthcare should be smarter, more transparent, and more affordable, but I haven’t seen her plan for achieving that.


COVID-19

Russia approves a COVID-19 vaccine that has not undergone widespread clinical trials and for which no Phase 1 and Phase 2 clinical trials data has been published, raising concerns that President Vladimir Putin may be placing national pride and political gain ahead of consumer safety. Another theory is that Russia is trying to goad the US into rushing its own vaccines to market or to confuse the issue following its rumored disinformation campaigns. Russia says it will start vaccinating teachers and medical workers this month with Sputnik-V, the name it chose for the vaccine that reflects the world’s surprise in October 1957 that the Soviet Union had launched the first artificial Earth satellite, which triggered a space race with the US.

Former FDA Commissioner Scott Gottlieb, MD notes that the US might get just one shot (pun intended, I assume) with a vaccine in a given season since it would be difficult to mount two vaccination campaigns in a short period. He says he would not take a vaccine like Russia’s that has been tested on only a few hundred people and says Russia is certainly not ahead of the US in that regard.

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The New York Times questions whether federal government newcomer and FDA Commissioner Stephen Hahn, MD has the fortitude and political savvy to stand up for patient safety under White House pressure to release a COVID-19 vaccine quickly. Hahn is not allowed to speak to the press by phone without having HHS spokesperson and longtime Trump supporter Michael Caputo on the line. FDA has been criticized for delaying approval of alternative COVID-19 diagnostic tests after CDC’s were found defective, allowing untested antibody tests to flood the market with minimal oversight, and for granting emergency use approval – revoked three weeks later – for using hydroxychloroquine in hospitalized patients.

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California public health director Sonia Angell, MD, MPH resigns for unspecified reasons, one week after the state reported that it had underreported new cases due to a technical issue with electronic lab reports.

Mexico’s high COVID-19 death count is understated because residents are justifiably afraid of hospitals. Mexico City’s hospitals report that 40% of patients who are admitted with confirmed cases die in house and half of those deaths occur within 12 hours of admission. People who die at home aren’t tested and thus aren’t counted as being among the country’s 53,000 COVID-19 fatalities, although Mexico reported 71,000 more deaths than were expected in the spring. President Andres Manuel Lopez has urged citizens to stay home and use religious amulets instead of going to the hospital, and 70% of people say they would not feel safe taking a loved one to the hospital, some because of conspiracy theories involving genocide and organ harvesting.

An eight-state review of COVID-19 cases in nursing homes finds that higher staffing levels – but not health inspection scores or quality measure ratings – are associated with fewer cases. I would be interested in seeing an expanded analysis that considers ownership since I would bet that for-profit homes, especially those owned by private equity-backed chains, fall short in areas like staffing levels and infection control.

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One-third of polled Americans, including more than half of Republicans, say they would not take a free FDA-approved COVID-19 vaccine. On a slightly optimistic note, a 1954 survey about the then-new polio vaccine yielded about the same result.

A new study by Johns Hopkins Bloomberg School of Public Health finds that an area’s density (population plus employment divided by land area) isn’t the primary driver of COVID-19 infection rates – it’s the degree of an area’s crowding into tight spaces, such bars, restaurants, sporting and entertainment events, and beaches. The authors believe that while density increases the incidence of close contact that theoretically should increase infection rate, that isn’t the case because people who live in dense areas are better at social distancing and wearing masks. They also conclude that evidence does not exist to support the move of city dwellers and businesses to the suburbs to avoid COVID-19.

The beginning of the end may be near for the fall 2020 college football season as the Big Ten postpones all fall sports, with football to be played in the spring if at all. The other four Power Five conferences haven’t announced their plans, although insiders say the PAC-12 has also decided not to play and doubts that spring football will happen either. 

University of Florida researchers detect live coronavirus in air samples taken up to 16 feet from hospitalized COVID-19 patients, raising the possibility of air-only spread, although the low viral quantities make it unclear whether people would likely become infected. The six-foot distancing recommendation assumes that only large droplets carry the virus. 


Other

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Epic delayed its mandatory employee return to campus after the county health department warned the company that “remote work” does not mean sitting alone in private, on-campus offices as Epic had interpreted. The health department told Epic that such action might violate the county’s order. They’ve asked Epic to justify why it needs employees to work from the office starting September 21, not mentioning the first wave of returnees that was to have taken place this past Monday or the 4,000+ employees that were already working voluntarily on campus.

In the Philippines, the government-owned universal health coverage insurer says the agency is losing $50 million per week due to corruption that is enabled by weak IT systems. The anti-corruption commission says that PhilHealth’s executives and employees are filing claims for non-existent patients, while hospitals are upcoding visits to obtain higher payment and are falsely claiming to be treating COVID-19 cases to obtain emergency funds. The agency denies charges that its executives pocketed $300 million last year.

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Two former employees of Talkspace, which offers text messaging based psychiatric counseling provided by contractors, claim that the company mines session transcripts for marketing purposes. Other former employees say that the company, which was getting stung by bad app store reviews, asked employees to create fake positive reviews and gave them burner phones to avoid getting caught. Talkspace’s executives deny the claims. Some of its contract providers complain that the company advertises 24/7 therapy even though it tells them they can set their own business hours; gives users a “I need help now” button that therapists must respond to quickly to avoid having their pay docked; and advertises therapy services even though a former version of its user agreement made it clear that it offers a “therapeutic conversation” but not “therapy.” The company charges $260 per month for unlimited asynchronous message response or $396 with four live, 30-minute sessions.


Sponsor Updates

  • Health Catalyst will participate in the virtual Verity Research HCIT/Services Conference on August 12, and the Canaccord Genuity Annual Growth Conference on August 13.
  • BioWorld profiles the use of Saykara’s voice-enabled mobile AI assistant at MIMIT Health, which reports a 500% productivity boost. 
  • CareSignal and Innovaccer partner to combine population health data technology and deviceless remote patient monitoring.
  • The Chartis Group promotes Laura Stearns to VP of talent development.
  • Norway’s Directorate of Health relies on Everbridge’s Public Warning software to alert citizens traveling internationally to mitigate COVID-19 risks.

Blog Posts


Contacts

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

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Morning Headlines 8/11/20

August 10, 2020 Headlines No Comments

Shares In Senior-Focused Oak Street Health Jump 90% In Market Debut

Primary care company Oak Street Health’s IPO raises $328 million, earning it a $5 billion valuation.

Medix Launches Medix Technology, Combining Medix IT and Alidade Group to Offer Clients Expanded Tech Solutions

Medix merges two of its divisions to create Medix Technology, which will offer health IT recruiting, consulting, and integration services.

Navicent Health’s Virtual Hospital to let some COVID-19 patients receive care from home

In an effort to free up beds for the acutely ill, Atrium Health (NC) expands its “Virtual Hospital” to partner organization Navicent Health (GA), enabling some COVID-19 patients to recover at home with around-the-clock remote patient monitoring.

Sift Healthcare secures $2.8 Million in funding

Milwaukee-based healthcare payments software startup Sift Healthcare raises $2.8 million.

Curbside Consult with Dr. Jayne 8/10/20

August 10, 2020 Dr. Jayne 1 Comment

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I thought I had previously registered for ONC’s tech forum this week, but when I noticed I didn’t have any meeting information, I figured I should double check. Turns out I didn’t register.

I would have definitely remembered, because I thought their registration form was a little problematic. First, one of the required fields for registering is a Twitter handle. Of course, one could just put junk in that field, but I found it odd that it was the first field required past name and email address. Another required field was “Affiliation” without any indication of what they were looking for. Did they mean employer?

I’m becoming quite the connoisseur of virtual conferences and have enjoyed doing a few more of them than I might otherwise have done had travel been required. For those of us who foot the bill for our own conferences and education rather than charging it back to an employer, it’s all about making the most of your time and your travel resources.

Speaking of, I cancelled my hotel for HIMSS21 “spring edition” today and worked on making my reservation for HIMSS21 “roasting hot desert summer edition.” Unfortunately, my hotel of choice isn’t taking reservations just yet, but I was able to book a backup for reasonably cheap. Like Mr. H, I’m a little uncertain on exactly where the conference will take place since the official notice includes Caesars Forum and Wynn as venues as well as the expected Venetian-Sands Expo Center. I loved my stay at The Venetian a couple of years ago, but it’s not in my current budget. My new hotel is fully refundable, as was the previous one (and the credit was already showing up in my online account before I had booked the next reservation).

The flight is in my budget, however, as I’m sitting on several thousand dollars of unused plane tickets that were supposed to take me to all kinds of interesting places this year. Now the challenge will be to use them before they expire. Some airlines have been more generous than others in pushing their expiration dates well into 2022, but I anticipate more than one will just become a loss. I’ve found charities that you can donate miles to, but haven’t figured out a way to donate tickets since they’re supposed to be nontransferable. If anyone has ideas, let me know. I doubt I’ll be rescheduling my trip to the Vancouver area anytime soon, given the current status of coronavirus transmission in the US.

Once I finished moving my hotel reservation, I was in an administrative mood, so I spent some time trying to do forecasting for what I’ll be doing the rest of the year. It’s a difficult time to be an independent consultant. Earlier in the year, I watched six months’ of bookings evaporate in a single afternoon, and it hasn’t been easy replacing that business. Many of my ongoing clients are mid-sized organizations that are in dire financial straits as they wrestle with continued shortages of personal protective equipment and struggle to try to figure out how to kickstart their revenue streams during failed economic re-openings across the US. My larger clients are experiencing across-the-board project freezes after furloughing internal staff. They’re more likely to reactivate those staffers than to use an external consultant, which is understandable.

For those clients who are continuing to have me work, I’ve seen some fairly extreme layoffs and restructuring, with one client literally moving the work of two departed project managers onto the one remaining one. The remaining project manager is struggling under the workload, but is afraid to complain because he fears he might be next. As you can imagine, the project management that’s occurring is fragmented, behind schedule, and generally ineffective, because you simply cannot just pile work on people and expect them to work magic. I’ve had a couple of conversations with the director of the program management office about it, but she just throws her hands up because she doesn’t have the authority to challenge decision-makers who still want all the projects running.

It feels like everything we’ve learned about happy staff being productive staff has been thrown out the door in the last few months, and people are operating from a position of desperation. This is only being magnified as various parts of the country head back to school and working parents are trying to figure out how they’re going to juggle childcare with assisting children who are expected to learn at home. I have a lot of friends who are able to work their IT jobs from home and have been successful during the pandemic, but all bets are off when they’re expected to support their elementary aged students in virtual learning plans that have varying degrees of planning and forethought.

Despite industry players like Epic pushing to have workers return in person in the name of “culture,” it feels like most of the health system folks I speak with are happy to let people work at home as long as possible while making plans to jettison the soon-to-be-unused office space and its associated costs.

Two more of my physician friends made plans to close their offices this week. One was already struggling with health issues when the pandemic hit, and the stress has definitely worsened her condition. Another is retiring early to move in with her physician daughter to help with her grandchildren. Both of these physicians thought they had much more time in their careers. Their patients will certainly miss them.

The local health systems have all stopped acquiring practices and one has laid off dozens of physicians, so there wasn’t an option to sell the practices. Since they each carry several thousand patients on their panels, I’m not sure where all those patients are going to receive specialty care, and they only have the state-mandated 30-day notice period to figure it out.

We’re certainly living in strange times. Although my practice hasn’t had to lay anyone off, they’ve made it clear that physicians aren’t getting any extra money regardless of our insane patient volumes and that we should be happy we are employed and working a normal number of shifts each month. They did give generous bonuses to the staff, which we appreciate, but you would think physicians seeing an extra 20-30 patients a day might be worth a little financial boost. I suspect that more than one of us is planning to depart after the end of the year because you can only work at this pace for so long before you start to crack.

In the mean time, it’s all about keeping your chin up, your mask on, and putting one foot in front of the other. We’re all looking forward to the time when this pandemic is under control . We are crossing our fingers that it’s not going to be confounded by a hellacious flu season once we ease into winter. Normally we start our flu vaccination campaigns in September and October, so only time will tell on this one.

Are you preparing to cope with children learning at home? Have any good strategies to share with the rest of us? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 8/10/20

August 9, 2020 Headlines 2 Comments

Improving VA and Select Community Care Health Information Exchanges

A VA OIG report on how VA facilities and their community providers use HIEs finds utilization lacking for a number of reasons, and that the Cerner switch-over will improve the ease of exchange among VHA, DoD, and community providers.

Samaritan still dealing with effects of malware two weeks later, slowly restoring applications

Samaritan Medical Center (ME) brings its EHR, PACS, medication management, and care communication systems back online after a July 25 ransomware attack.

Epic adjusts staff’s return to work time frame

Epic changes its Monday mandatory return to campus, allowing employees who feel that their personal situation makes it unwise for them to return safely to campus to continue to work from home while Epic awaits further guidance from the county health department.

Monday Morning Update 8/10/20

August 9, 2020 News 7 Comments

Top News

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VA OIG looks at how VA facilities and its community providers use HIEs.

The report finds that all 140 facilities have access to VA Exchange and VA Direct, but only 28 are using the latter because they weren’t offered training from DirectTrust or none of their community partners are using DirectTrust.

Twenty-two of 48 lower-acuity facilities still exchanging information via scanning, faxing, or mailing.

Users of Joint Legacy Viewer complain about cumbersome sign-on and poor data quality.

VA has 56 contracted VHIE community coordinators, but noted high turnover and engagement that “ranged from a high level of participation to little or no participation.”

OIG concludes that the Cerner implementation will improve the ease of exchange among VHA, DoD, and community providers.

The report recommends that the VA review barriers to using VA Direct, evaluate VA Exchange and VA Direct training programs, increase the number of community partners including other HIEs, and evaluate the work of the VHIE community coordinators. The VA accepted all four recommendations.


Reader Comments

From All the Marbles: “Re: newly rich Livongo executives. Does it even matter since they were all loaded before?” I’m speculating since I don’t know what it’s like having that kind of cash, but my reaction:

  • Assets, not income, makes you wealthy, since you then have financial autonomy that nobody can take from you. Whoever signs your paycheck could stop doing so tomorrow. These folks are set for life.
  • Everybody can find ways to spend ever-increasing amounts of money, but at some point pretty early in the wealth continuum, diminishing returns would kick in and the pleasure of buying a fourth house or third luxury car wouldn’t provide much of a thrill. I speculate that money makes things easier to some point, then starts making them harder and causes stress over losing a chunk of it via bad investment.
  • Self-made people with big fortunes feel the psychological need to prove that earning it wasn’t a fluke, so they rarely sit poolside like a trust fund brat knowing they can’t outspend their interest and instead try new ventures (either the rich-person’s hobby kind or something a team can run day to day for them).
  • I suspect rich, older folks realize that you don’t see hearses pulling U-Hauls, so they look for benevolent ways to publicly spend their money instead of bringing out the worst in squabbling, greedy family members.
  • Everybody has some magic number that, given their personal expenses and ambitions, would allow them to live out their days comfortably free of job worries. In that sense, just as time is money when you’re making it, money is time when you want to stop making it. That might be a $1 million net worth for one person or a $50 million net worth for another and the combination of risk taken, luck, and the time value of money is what will or won’t  you there, hopefully in time to enjoy the result. I suspect that every one of those newly minted Livongo centimillionaires passed that point long ago, so while I’m sure they are thrilled to be sitting on an even larger embarrassment of riches today than last week, it won’t change their daily lives.

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From Prime Spot: “Re: hospital parking. Lots of Twitter chatter about how it’s expensive and unfair to charge patients and families to park.” Hospital parking is always a mess, and I was shocked the first time I took a job with a health system that charged employees and even visitors for parking. My reactions then:

  • Hospitals never have enough parking due to an absurdly large number of employees, doctors coming and going, patients and visitors coming in for ambulatory services on the same campus, and car-driving salespeople running around all over the place. We did an analysis of where employees and visitors were parking off campus and it was shocking — they would walk a half-mile to park in a residential neighborhood, either to find an available space or to avoid paying.
  • Sometimes as an employee you can’t get a spot even though you’re paying monthly for one, and if you’re really unlucky, you might get relegated to offsite parking that involves a bus ride each way that isn’t nearly as nice as  its off-airport counterpart
  • Hospital and university transportation services departments, like most bureaucracies, keep finding new ways to spend money on employees, vehicles, and infrastructure because they seem themselves as generating big profit, and all of that profit comes from permits and tickets.
  • Hospital garages and parking lots are often located in areas where unrelated parking is in high demand or as part of a school where students will take up any available space, meaning that visitors wouldn’t get a spot if the per-hour charge wasn’t a deterrent to those with less motivation. Hotels charge paying guests $40-80 for overnight valet parking given the same demand with lack of alternatives.
  • Hospitals sometimes don’t own their on-campus garages or contract out parking / valet services (I always picture mob involvement).
  • It’s always funny that despite all the ways hospitals extricate money from patients under sometimes questionable circumstances, the only services for which bitter comparisons are made are parking and cafeteria.
  • I personally would avoid on-campus appointments whenever possible, foreseeing sitting in traffic amidst impatient employees and lost visitors and then hiking quickly knowing I’ll be late (assuming I even know where I’m going from the bowels of the parking garage, like the “follow the yellow lines to the blue elevator, go up one floor, then cross the annex bridge and go down one floor” kind of hospital directions). I don’t like having my first aggravating customer experience before it even begins. Buy a dying mall and stick your doctors there.

HIStalk Announcements and Requests

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HIMSS21 attendance is, for the most part, out of the control of HIMSS and instead will be driven by pandemic status, poll respondents say.

New poll to your right or here: For those assigned to work from home: would you return to campus if the company required it in the next few weeks? Basically a yes/no answer is the only one an employer will offer, so do you feel strongly enough about not returning that you’ll accept termination for refusing?

Thanks to the following companies that recently supported HIStalk. Click a logo for more information.

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Several readers saw my mention of new Donors Choose projects and sent generous donations to fund another round of them, with their dollars boosted by matching funds from my Anonymous Vendor Executive as well as third-party matching sources. Here’s what I fully funded:

  • A document camera for Ms. E’s elementary school class in Salinas, CA.
  • A webcam, laptop stand, and wireless keyboard for Ms. H’s elementary school class in Timbo, AR.
  • Lighting, headset, device mount, and easel for Mx. Smith’s third grade class in Las Vegas, NV.
  • Digital resources for Ms. G’s elementary school class in Seagoville, TX.
  • Digital resources for Ms. D’s kindergarten class in Hoskinston, KY.
  • Five headsets for Ms. S’s elementary school class in Santa Ana, CA.
  • Daily journals for online sharing for Ms. M’s second grade class in Oxnard, CA.
  • Math manipulatives for remote learning for Ms. S’s elementary school class in Waco, TX.
  • Classroom supplies for Ms. D’s middle school class in Collinsville, IL.
  • Flocabulary vocabulary learning for Ms. H’s elementary school class in Las Vegas, NV.
  • Digital resources for Ms. R’s elementary school class in Philadelphia, PA.
  • Agriculture books for Ms. J’s middle school class in Kinston, NC.
  • Math manipulatives for Ms. F’s elementary school class in Wyandanch, NY.
  • 50 take-home library books for Ms. C’s elementary school class in Calumet City, IL.
  • 25 sets of headphones for Ms. S’s elementary school class in Houston, TX.
  • A document camera for Ms. E’s elementary school class in Steelton, PA.
  • Remote video learning equipment for Ms. R’s elementary school class in Oklahoma City, OK.
  • Social distancing and teaching supplies for Ms. B’s elementary school class in Irving, TX.
  • A document camera for Ms. T’s elementary school class in Apopka, FL.
  • Sight word games for at-home use for Ms. C’s elementary school class in Hempstead, NY.
  • A webcam, microphone, and earphones for online instruction for Ms. T’s middle school class in Chicago, IL.
  • Online language proficiency tools for Ms. M’s elementary school class in Fairdale, KY.
  • Digital social studies content for Ms. K’s middle school class on Connellsville, PA.
  • Lighting for teaching virtual classes for Ms. T’s elementary school class in Mission, TX.
  • STEM kits for Ms. A’s kindergarten class in Sacramento, CA.
  • Headphones and a USB camera for Ms. N’s elementary school class in Harbor City, CA.
  • A USB headset for Ms. B’s elementary school class in Kenner, LA.
  • Take-home math materials for Ms. H’s elementary school class in Madera, CA.
  • 20 magic boards and binders for Ms. M’s elementary school class in Chicago, IL.
  • Math and science books for recording for online lessons for Ms. P’s elementary school class in Philadelphia, Pa.

Webinars

August 19 (Wednesday) 1:00 ET. “A New Approach to Normalizing Data.” Sponsor: Intelligent Medical Objects. Presenters: Rajiv Haravu, senior product manager, IMO; Denise Stoermer, product manager, IMO. Healthcare organizations manage an ever-increasing abundance of information from multiple systems, but problems with quality, accuracy, and completeness can make analysis unreliable for quality improvement and population health initiatives. The presenters will describe how IMO Precision Normalize improves clinical, quality, and financial decision-making by standardizing inconsistent diagnosis, procedure, medication, and lab data from diverse systems into common, clinically validated terminology.

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


Sales

  • NIH will extend its use of OpenText’s Content Suite and AppWorks for electronic document management and workflows.
  • Transaction Data Systems chooses Waystar for claims processing by its independent pharmacy customers.

People

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Mee Memorial Healthcare System (CA) promotes Rena Salamacha, MS to CEO. She previously served as IT director, CIO, and chief strategy and technology officer, COO, and interim CEO.

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Lisa Crymes, MBA (Change Healthcare) joins Preventric AI as chief marketing officer.


Announcements and Implementations

Elsevier expands its integration of its ClinicalPath (formerly Via Oncology) oncology decision support tool with Epic, including launching from Epic using SMART on FHIR, applying cancer staging data from Epic, navigating within Epic, queuing up treatment within Beacon protocols to reduce manual order entry, and documenting details as a note.


COVID-19

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A New York Times analysis of CDC’s count of higher-than-expected death counts – probably caused by COVID-19 along with the situations it has created – at over 200,000 from March 15 through July 25 versus the official count of 161,000. This is a good full-impact number that would include the pandemic’s effect on stress, failure to seek medical care for other conditions, financial challenges, and failure to correctly account for deaths. I assume that it this number would also be subject to undercounting given the presumable decrease in deaths by accidents.

The field hospital created at Sacramento’s Sleep Train Arena sees just nine patients in 10 weeks, with $12 million in cost from rent paid to the Sacramento Kings, facility upgrades, and payment to 250 staffers. One traveling nurse company billed $428,000 to provide five pharmacists and five pharmacy technicians. Those involved say there was never a real plan on how to integrate with possibly overburdened hospitals and the state admits that it should have used local data to determine how to set up its 15 field hospitals.

Bill Gates says US COVID-19 tests are “complete garbage” because of delays in getting results, suggesting that paying companies for them only if the results come back in 24-48 hours would “fix it overnight.” He is optimistic overall, however, predicting that diagnostic and therapeutic innovation in the “rich world” will end COVID-19 by the end of 2021, with the rest of the world following a year later. However, he says it will take years to bring the global economy back to the levels of early 2020. He also notes that he would want remdesivir or dexamethasone today if hospitalized for coronavirus, but in 2-3 months the tool chest will expand with other antivirals and antibody therapy.

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It’s been a busy COVID-19 week for one Georgia high school:

  • The school suspended two students for taking a photo that showed a packed school hallway and sharing it to social media.
  • After a national outcry, the school lifted the suspensions.
  • Six students and three employees reported to the school that they had tested positive.
  • Two brothers who reported experiencing symptoms were found to have gone to school Monday without wearing masks or social distancing, with a family member saying they didn’t realize the severity of the virus and weren’t encouraged to wear masks.
  • The school moved to distance learning only for Monday and Tuesday while awaiting the results of contact tracing. They have told parents that they will notified Tuesday evening whether in-person instruction will resume.

Other

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Epic changes its Monday mandatory return to campus, allowing employees who feel that their personal situation makes it unwise for them to return safely to campus to continue to work from home while Epic awaits further guidance from the county health department. Epic says Cleveland Clinic, a public health expert, and an epidemiologist are reviewing Epic’s plan, which originally called for bringing the first group of employees back to their offices on Monday and all employees working on campus by the end of September except for those at high risk, who could request an extension through November 2.

China’s Communist Party newspaper warns readers to “beware of health-tech firms’ snake oil,” which is pretty good advice. Its points, as written by a health policy lecturer in the London School of Economics:

  • Big US tech companies have promised that analytics and AI will reduce costs and improve outcomes, but individual patient data is subject to subjective clinical judgment and is often plagued with missing records and lack of standardization.
  • Those big US tech companies don’t know much about healthcare, and they rarely back up their black box algorithms with studies that prove their value.
  • Predictive models are only as good as the data they are given, and since their assumptions are based on what is already know, they are best at reviewing the past and present rather than predicting the future.
  • AI developers are, intentionally or not, just as biased as the rest of us, and using current healthcare data makes those systems prone to replicating past failures and successes.
  • Hospitals and regulators shouldn’t just turn over patient data to developers – they should be actively involved in the design and deployment process.

Sponsor Updates

  • The Dealmakers Podcast features PatientPing co-founder and CEO Jay Desai.
  • Pure Storage’s Pure Good Foundation celebrates its fifth anniversary and announces that it has raised $2.3 million for charitable contributions.
  • The Voice First Health Podcast features Gabe Charbonneau, MD and his use of the Saykara AI Assistant.

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