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EPtalk by Dr. Jayne 1/28/21

January 28, 2021 Dr. Jayne 3 Comments

In response to my recent piece about hospital price transparency, Jenn clued me in about Turquoise Health and their pricing website. It’s still in beta and doesn’t have data for my area yet, but comparisons for a neighboring state were pretty easy to understand. It looks like they’re still building their insurance rate database, but their cash-pay display was clear.

A reader also sent some thoughts about the whole transparency situation. He notes that based on some vendor-side experiences, a large number of hospitals seem to be deliberately dragging their feet and don’t want to be the first in their market to show what’s behind the curtain. Either that, or they’re not able to meet all the requirements since many of them assumed that the rule would be killed or further delayed. He notes, “Many will presumably quietly delay until HHS starts embarrassing some folks with bad PR and the compliance / penalty process.”

He goes further to note that the online tool I mentioned in my piece isn’t compliant, since “the Rule requires that a consumer be able to access the pricing info for all contracted payers WITHOUT providing any identifying information or agreeing to anything.” He agrees that third-party aggregators (presumably like Turquoise Health above) will take the machine-readable files and create the equivalent of “Travelocity for Hospital Prices.” I think that’s going to be the best approach that will benefit consumers from an experience perspective, but agree with him that the behind-the-scenes benefit will be when plans and networks and benefits brokers can see the information and use it to drive pricing negotiations.

My reader predicts that price transparency will ultimately lead to hospital closures, as hospitals will no longer be able to “cross-subsidize underfunded services with high commercial rates.” I always love hearing from readers and understanding what’s going on in different parts of the country and this was a great discussion. Rather than watching hospitals close, I’m hoping that health systems will take this as a wakeup call and begin to help lobby for better public health infrastructure and more public funding for early prevention, screening, and treatments so that we can push back against the chronic diseases that are driving healthcare expenditures.

Unfortunately, that approach will erode the profits of hospitals and payers, and some people feel it smacks of “socialism” and we’ll see politics and economics forcing public health into the back seat again and again despite the fact that strong public health measures make good economic sense long-term. The resignations of public health officials across the country due to their COVID-fighting stances has been disheartening. I hope we’ve seen as much of that as we’re going to see for a while. I’ve enjoyed seeing Dr. Anthony Fauci smile again this week, though, so I’ll stay hopeful.


I had another round of healthcare adventures with Big Health System this week. The first was for a physician appointment with their academic faculty dermatology practice. I received my appointment reminder in Epic and completed the online check-in process, which was seamless. I was surprised that they’re not doing any virtual waiting room strategies and that I had to physically come to the office to check in and sit in the waiting room, which is very different than what my practice does. At least the wait was brief and I was impressed by the documentation of the cleaning protocol that was posted on the exam room door. Since this was a dermatology practice, they also had signage explaining how they do a full skin exam in the time of COVID and to keep my mask on — the physician would tell me when to take my mask off and reminded me not to talk when my mask was off.

The second encounter was an unsatisfactory pre-registration phone call prior to an upcoming MRI. Apparently, my data in the system journeyed through a portal to another time and reverted to values from 2018. I just had another radiology study at the same facility less than five months ago, when I updated everything on a lovely paper form that I assume would have been uploaded. Somehow today they had my employer from 2018 listed and the wrong emergency contact. Having been in the CMIO trenches there, I asked what system the registration agent was working from, since they still use another system for some financials and Epic for clinical. She said she was working in both systems, but the data in question was not in Epic. Apparently, they  don’t have a bidirectional interface, or no one updated the information provided back in August, or both, so I got to do it all over again over the phone with someone who wasn’t that interested in my responses and wasn’t really paying attention.

She also went through the same COVID screening questions I had just answered an hour earlier, and I asked her to verify that I was flagged in Epic as an emergency doc since this was an issue during some previous visits. She actually admitted that she really didn’t look at the screen because she’s just so used to asking the same questions over and over. When I clarified that yes, I’m regularly exposed to COVID in my work, she replied, “So, you currently have COVID?” and I had to explain again. Here’s hoping she was actually doing what she said she was doing and updating their revenue cycle platform rather than just going through the motions, because I don’t want to have to update everything again at my radiology visit at the crack of dawn on Friday. These were the kinds of issues I enjoyed fixing when I worked there – making the patient experience seamless. I wonder if anyone there even knows it’s messed up, and if they do, whether they really care.

I’m not exactly looking forward to having my molecules magnetically spun, but it is what it is when you’re playing the early cancer detection game. Usually I schedule the test first thing in the morning when I’m tired so I can sleep through it, which the technicians find hilarious since “no one ever sleeps through an MRI due to the noise.” Maybe they just don’t scan enough sleep-deprived urgent care docs to have a good sample size. I figure the first appointment of the day is also good for COVID-prevention purposes.

What’s your strategy for being a patient in the time of COVID? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 1/28/21

January 27, 2021 Headlines No Comments

RxRevu Closes Series B Funding Round to Support Growth and Expansion of Point-of-Care Price Transparency Solutions

Prescription decision support vendor RxRevu raises $7 million in a Series B round that brings its total raised to $28 million.

Exclusive: Alan Mnuchin-backed SPAC in talks to take Sharecare public

Sources say Falcon Acquisition Corp. is in talks to merge with digital health and wellness company Sharecare and startup in a deal that would take the newly combined business public at a $4 billion valuation.

Equality Health and General Atlantic Announce Strategic Partnership to Help Drive Continued Expansion of Equality’s Value-Based Primary Care Network and Technology Solutions

Equality Health, which manages a network of value-based, tech-enabled primary care practices, secures funding from General Atlantic and acquires consulting firm Daraja Services.

Nextech Announces Acquisition of MyMedLeads

Specialty-focused health IT company Nextech acquires patient engagement and marketing software developer MyMedLeads.

Baylor Scott & White Health targets another 1,700 jobs to reduce costs in non-core areas

Baylor Scott & White Health, the largest not-for-profit health system in Texas, announces another round of layoffs that will see two-thirds of affected workers transferred to third-parties that handle IT, RCM, and other support services.

Morning Headlines 1/27/21

January 26, 2021 Headlines No Comments

Clearlake-Backed Symplr To Acquire Phynd

Provider management, credentialing, and payer enrollment technology vendor Symplr acquires Phynd Technologies, which offers provider data management software.

HHS seeks formal approval for emergency COVID-19 portal

HHS seeks approval to make its July switchover in hospital COVID-19 reporting systems permanent, which would make the TeleTracking-developed system the standard in replacing CDC’s National Healthcare Safety Network.

Verily just bolstered its leadership team with a former hospital exec and a chief marketer as it comes off a turbulent year.

Former Aurora Health Care (WI) CIO Preston Simons joins Verily in a similar role.

News 1/27/21

January 26, 2021 News 1 Comment

Top News


Provider management, credentialing, and payer enrollment technology vendor Symplr acquires Phynd Technologies, which offers provider data management software.

The acquisition price was not disclosed. Phynd had raised $11.4 million in funding through a year-ago Series B round.

Symplr parent company Clearlake Capital Group had considered selling the company last July at a valuation of up to $2 billion.

The Phynd acquisition is Symplr’s sixth since Clearlake took ownership in 2018.

Reader Comments


From Long-Time Fan: “Re: Olive. I’ve been bombarded with ads for the company in news feeds, social media, and now a giant billboard. I’m astounded by the scale of their customer and recruitment campaigns and their ability to attract venture capital, but the company seems kind of fluffy and ambiguous. The most specific service I can understand is a claims scrubber, which is nothing earth-shattering. I thought you might jump on the case with an interview or something.” I suspect that an interview would not be fruitful, although I’m willing to talk with CEO Sean Lane, who has a stellar military background but no healthcare experience that I can find. They list a bunch of healthcare customers like Yale New Haven, Centura, and MedStar, so if you work there and have personally seen Olive’s impact and potential whether good or bad, tell me and I’ll keep both you and your employer anonymous.

HIStalk Announcements and Requests


Welcome to new HIStalk Platinum Sponsor LexisNexis Health Care. The Alpharetta, GA-based company helps providers meet interoperability goals and gives patients more control of their health data. It offers the most robust and accurate provider, patient, and member data in the industry. It helps improve patient engagement and outcomes through proprietary linking, claims analytics, SDOH data, and predictive science. The company’s identity access management platform helps protect patient identities and prevent fraud. Thanks to LexisNexis Health Care for supporting HIStalk.

I found this LexisNexis Health Care video that explains best practices for creating a Social Determinants of Health program.

I lose thankfully few HIStalk sponsors, and most of those defections involve companies that have been successfully acquired by another sponsor (I admire this even though it’s depressing losing sponsors). I still fret over the others, who sometimes leave for good reasons (“we don’t have any money”) or bad reasons (the new marketing rep assigned to us has zero industry knowledge and has never heard of HIStalk but wants to look decisive by cancelling). Here’s a win-win for these pre-HIMSS21 times where we’re all just making it up as we go — if your company last sponsored more than a year ago, I’ll spiff you some extra months on your first comeback year. Contact me.


January 28 (Thursday) 12:30 ET: “In Conversation: Advancing Women Leaders in Health IT.” Sponsor: Intelligent Medical Objects. Presenters: Tabitha Lieberman, SVP of clinical and revenue cycle applications, Providence St. Joseph Health; Ann Barnes, CEO, IMO; Deanna Towne, MBA, CIO, CORHIO; Amanda Heidemann, MD, CMIO, CMIO Services, LLC. IMO CEO Ann Barnes brings together a panel of female health executives for a results-oriented discussion on how managers and C-suite executives can address diversity and inclusion in their organizations. From STEM education to mentoring and networking, the “COVID effect” on women in the workplace, to matters of equity, there’s no better time to talk openly about these issues to help generate meaningful change in healthcare.

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

Acquisitions, Funding, Business, and Stock


Health IT, supply chain, and consulting company Medsphere acquires Marketware, a developer of relationship management software and analytics for healthcare organizations. Marketware CEO Alex Obbard came to the company from patient relationship management vendor Solutionreach.

OptimizeRx, whose communications platform connects life sciences companies, physicians, and patients, expects Q4 revenue to increase 117% to $16 million.


  • RML Specialty Hospital (IL) selects Engage to provide cloud hosting for its upcoming implementation of Meditech Expanse.
  • La Rabida Children’s Hospital (IL) will integrate Emerge ChartScout and The Floating Hospital (NY) chooses Emerge’s data conversion services for its EHR implementation.
  • The MetroHealth System will implement Montreal-based Tactio Health Group’s CareSimple remote patient monitoring solution, integrated with Epic.


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Fern Health, which offers employers a digital platform for chronic back and joint pain, hires Brad Lawson, MBA (Marshalsea Health) as CEO. He replaces Travis Bond, who has joined dementia risk prediction technology vendor Altoida as CEO.


The Chartis Group promotes Catharine Wilder to VP of practice operations.


Interlace Health (fka FormFast) promotes Allison Reichenbach to president.


Lumeon names Tom Zajac as executive chair of its board.

Announcements and Implementations

Consulting firm ReMedi Health Solutions assists a Northeastern health system with a virtual Cerner go live across 23 facilities.


Halifax Health (FL) implements Pure Storage’s FlashArray to ensure the stability of its Meditech system during natural disasters.

The AMA’s technology development subsidiary AMA Innovations and Onyx Technology will develop a FHIR-based messaging solution to connect providers and social care networks, which it will enter in an HHS social care referral challenge.


A new CoverMyMeds report finds that 65% of patients have been impacted by the pandemic, 36% skipped medications and treatments to pay other bills, and more than 40% either diverted payments for essential items for prescriptions or stretched their prescriptions by taking fewer or smaller doses than were prescribed. Most asked their provider about price and affordability options and 43% checked a pharmacy price comparison app when a prescription cost more than they expected.

SOC Telemed launches a TelePulmonology consultation service through its Telemed IQ on-demand telemedicine platform..


A new CHIME-KLAS white paper on EHR interoperability finds that deep interoperability is progressing but still too low and most vendors have improved their ability to connect with outside EHRs. However, cost remains the most frequently identified provider barrier, especially in smaller health systems. The highest-valued interoperability method is public HIE, but that is followed closely by national networks and direct messaging. Use of FHIR APIs still lags proprietary APIs and mostly involves customers of big EHR vendors using them to exchange patient records and to support clinician and patient tools. Respondents identified deeper patient-record exchange and population health as the most-needed use cases in the next 2-3 years.



HHS seeks approval make its July switchover in hospital COVID-19 reporting systems permanent, which would make the TeleTracking-developed system the standard in replacing CDC’s National Healthcare Safety Network.


Several industries and companies are developing vaccination passport apps without national or international coordination, leading to the possibility that an individual might need to install and maintain several for specific purposes. Questions are also coming up about how to get electronic vaccination information into those systems without the possibility of fraud since the only official patient record in the US is a handwritten paper card.


Philadelphia’s health department ends its partnership with Philly Fighting COVID, the overseer of its largest vaccination site, after discovering that its registration website is operated by a recently formed for-profit arm whose privacy policy does not precluded disclosing the information of those who sign up. The site says the information entered by users – 60,000 of them so far – is shared with the city’s Health Department, which denies involvement with the site. Philly Fighting Covid originally performed COVID-19 testing, but quickly shut those locations down and cancelled appointments when it was chosen to administer vaccine. The organization was reported to have given shots to anyone who signed up regardless of their assigned priority.  A nurse claims that the CEO of both organizations, 22-year-old Drexel graduate student Andrei Doroshin who has no healthcare experience, took vaccine vials offsite to administer to private individuals, while a vaccination site volunteer said teenaged students were vaccinating each other and taking photos as the clinic ended. Doroshin also lists himself a filmmaker, an executive with a cell therapy company, a resort developer, and manager of an investment company.

CDC Director Rochelle Walensky, MD, MPH says that the federal government doesn’t know many doses of COVID-19 vaccine it has on hand, leaving state health officials to work blind in setting up vaccination sites, scheduling staff coverage, and issuing appointments without knowing how many doses they will receive.

A VA study finds that the mortality rate of COVID-19 patients in the ICU doubled when the unit was overloaded with coronavirus patients.

Google will donate $150 million to help promote COVID-19 vaccine education and equitable distribution, and will incorporate vaccination clinic locations and details in its Search and Maps tools starting with Arizona, Louisiana, Mississippi, and Texas.

The CEO of casino operator Great Canadian Gaming Corp. resigns after he and his wife were caught flying to Yukon Territory, skipping the mandatory self-isolation, and posing as motel workers so they could jump the COVID-19 vaccine line.



A longtime resident of Tiny Township in Ontario makes a $5 million donation to its Georgian Bay Hospital, $1 million of which will be used to upgrade the hospital’s record-keeping to Meditech Expanse.

Corporate therapists say that remote workers who use social media-resembling tools like Slack all day exhibit the same “mix of hyper-engagement and lack of empathy” as they might on Facebook. Company cultures are being lost as remote workers use company time and tools to argue politics, bully each other, ignore requirements to turn on their webcams during video calls, confront management, and spend their day chatting constantly in ways that might alienate older workers who were not raised sharing their whole lives electronically. Employment lawyers urge employers not to let use of online tools get out of hand to avoid lawsuits, offended co-workers, or unfair performance reviews.

Sponsor Updates

  • Healthcare Growth Partners advises Symplr in its acquisition of Phynd Technologies.
  • The UpTech Report features Saykara CEO Harjinder Sandhu.
  • Agfa HealthCare releases a new case study focused on enterprise imaging’s role in personalized, end-to-end care for cancer patients at IFO in Rome, Italy.
  • CereCore recognizes 13 team members with its annual Rock Solid Award.
  • NEJM Catalyst features the Arizona Surge Line and its innovative use of Central Logic technology to coordinate public health services across the state.
  • Cerner donates 100 laptops to Kansas City students.
  • Change Healthcare releases a new podcast, “The Policy Connection: Healthcare Policy and the Road Ahead for States.”
  • Clinical Architecture names Morgan Johnson to its Team Services group.
  • Hunt Scanlon includes Direct Recruiters on its list of “Top 40 Cyber Technology Search Firms.”
  • Divurgent releases a new podcast, “The Integration of Music Therapy in Biotechnology.”
  • Former health IT executive Tom Zajac joins Lumeon’s Board of Directors as executive chairman.
  • SOC Telemed adds tele-pulmonology consulting services to its Telemed IQ platform.
  • CoverMyMeds publishes the “2021 Medication Access Report.”
  • Wolters Kluwer Health launches Lippincott Connect, an interactive digital medical textbook.

Blog Posts


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


Morning Headlines 1/26/21

January 25, 2021 Headlines No Comments

Medsphere Systems Corporation Acquires Marketware Inc.

Health IT, supply chain, and consulting company Medsphere acquires Marketware, a developer of relationship management software and analytics for healthcare organizations.

How we’re helping get vaccines to more people

Google will donate $150 million to help promote COVID-19 vaccine education and equitable distribution, and will incorporate vaccination clinic locations and details in its Search and Maps tools.

Post Acute Analytics Announces Series B Funding Led by Concord Health Partners and Dorilton Capital

Lewisville, Texas-based Post Acute Analytics will use a Series B funding round to expand its management team and further develop its AI-powered analytics for care coordination in the post-acute space.

Readers Write: How COVID-19 is Driving Innovation in our Behavioral Health System

January 25, 2021 Readers Write No Comments

How COVID-19 is Driving Innovation in our Behavioral Health System
By Eric Meier

Eric Meier, MBA is CEO of Owl Insights of Portland, OR.


Our nation was facing a behavioral health (BH) crisis even before the COVID-19 pandemic. According to the National Institutes of Health, 51.5 million American adults were living with a diagnosable mental illness in 2019, with fewer than half having received treatment in the previous year. Interestingly, the Commonwealth Fund reports that as of mid-November, 2020, “states with the lowest infection rates per capita are Medicaid expansion states, where there is better access to care and providers.” Non-expansion states were suffering the highest rates per capita. This highlights one of the biggest issues in BH: lack of access.

Now enter COVID-19 and the crisis has escalated exponentially. In a July 2020 poll conducted by Kaiser Family Foundation, 54% of all adults in the US said the pandemic had negatively impacted their mental health. This is up from 32% from just four months earlier. A survey by the CDC supports this finding. It reports that the number of adults in the US suffering from an anxiety or depressive disorder has quadrupled since before the pandemic. Experts now predict that the economic fallout from COVID-19 may cause tens of thousands of additional deaths by suicide or drug abuse in the years to come. In an article published by The Kennedy Forum, former US Representative Patrick J. Kennedy warns that the pandemic has unleashed “a new wave of mental health and substance use disorders in the US.”

Times of crisis often highlight weaknesses in existing systems. An article published by Harvard Business Publishing says, “The places where things could be done better or more efficiently become glaringly obvious. All of a sudden, opportunities for innovation are staring us in the face.” Telehealth is a prime example. The rollout of social distancing requirements was one of the first challenges brought about by the pandemic. Providers scrambled to implement virtual care technology and associated processes in order to keep themselves, their staff, and their patients safe. Because of recent surges, telehealth is still in use. But not all telehealth solutions are the same. To be effective, providers need more than just a video app, especially when treating individuals with BH whose conditions are often more complex than individuals with non-BH conditions where screening and triage are more straightforward.

This is where innovative BH technology shines, by helping providers perform systematic screening via integrative telehealth solutions across all BH conditions, allowing them to proactively identify, diagnose, and treat those at risk through evidence-based practices. Providers can better match treatment to each patient’s unique symptoms, medical history, social determinants of health, and comorbidities. Not only does this produce improved outcomes, it also helps reduce gaps in care and provides more efficient care pathways.

How innovative BH technology improves the effectiveness of remote care:

  • Provides actionable, evidence-based outcomes data within the telehealth session.
  • Collects patient outcomes in advance of a telehealth visit to target treatment.
  • Supports telehealth billing by providing clinical documentation.
  • Screens patients and their care team members before or during telehealth visits.
  • Provides access to additional distress and anxiety measures relevant to the BH impact of COVID-19.
  • Remotely identifies patients who are not responding, deteriorating, and require immediate intervention.

Innovative BH telehealth technology gives providers the ability to easily screen, track, analyze, and guide treatment while enabling patient reported outcome measures (PROMs) and enhancing clinical confidence.

COVID-19 has had a devastating impact on all populations across our country and experts agree that the mental and economic fallout could last for years to come. Now that mass vaccinations are underway, we can finally see the light at the end of the pandemic tunnel. Healthcare systems and community organizations must act now to implement technology solutions that can help scale resources to meet the urgent needs of a quickly expanding population living with BH conditions. The bottom line is that we would be greatly remiss to allow ourselves to revert to the “old normal” of pre-pandemic BH. This is our chance to make lasting change and innovation will lead the way.

Curbside Consult with Dr. Jayne 1/25/21

January 25, 2021 Dr. Jayne 3 Comments

Many of my healthcare IT colleagues are deeply involved in their organizations’ COVID vaccine administration efforts. They’re involved in creating pre-registration and wait list systems, running analytics to determine who should be invited to receive a vaccine next, managing outreach efforts, then scheduling those patients. It’s a massive effort that, like many IT projects, can be subject to external disruptions.

One of our local health systems just went through a massive cancellation of vaccination appointments after they received fewer doses from the state than they anticipated. The sheer volume of appointments that had to be canceled and rescheduled created havoc. As their API-driven chatbot was reaching out to patients to offer them new appointments, it was creating temporary locks on the appointment slots that were being offered, which is standard when you’re doing scheduling outreach. However, the magnified consequence of trying to reschedule thousands of patients at once prevented the call center from being able to reschedule anyone else, including patient-facing healthcare providers who were needing to also reschedule after missing vaccine appointments while awaiting negative COVID tests.

The answer to the latter problem became decidedly low-tech, with the system standing up a temporary walk-in vaccine clinic to accommodate the healthcare providers with its remaining available doses. A Google Doc was used to keep track of the employees who were approved to come to the clinic and what time they planned to come, so that the vaccination team could coordinate with the call center to ensure that the correct number of doses were available real time. Since they weren’t running the public-facing vaccine clinic, they had a surplus of workers who could handle the manual scheduling, but the fact that the situation arose at all shows how much difficulty the US is having with the last mile of vaccine distribution.

With recent stories about vaccine spoilage due to temperature issues, those running the vaccination operations could learn from their IT colleagues. A Veterans Affairs hospital in Boston recently had a freezer failure from multiple contributing causes. First, a pipe burst leading to a water leak in the building, which led to the arrival of a cleaning crew who had to move a freezer to get to some standing water. The power cord for the freezer apparently wasn’t properly secured to the freezer, causing it to disconnect. Then the freezer’s alarm system didn’t function properly, which coupled with the lack of daily monitoring, led to the loss of 1,900 doses of vaccine.

The VA is still investigating why the alarm failed, but proper daily human monitoring could have saved the vaccines since the freezer was unplugged for several days before being discovered. Any small-practice primary care physician who has had to maintain thousands of dollars of vaccine inventory knows that even though you have thermometers with alarms, you still need to have someone check the logs daily and document the ranges. It’s shocking that a larger organization that is responsible for such a precious commodity didn’t have the right processes in place. However, based on some of the IT failures I’ve seen over the last several years, I’m not surprised.

Many healthcare organizations have complex automated backup systems and sophisticated disaster recovery systems that promise a rapid fail-over to sustain clinical operations. However, they may not test them often enough, and some organizations don’t test them at all. We’ve all heard horror stories of clients who went to restore from a backup, only to find that the backup contained no data or was corrupted in some way.

We’ve also encountered the unforeseen. Early in my career, a car that was involved in a police chase crashed into our hospital’s data center, which led to a small fire, which led to discharge of the fire suppression system and a complete shutdown of the building. There was a failure of the network switches that should have rerouted everyone to the disaster recovery site as well, which led to a multi-hour outage since no one could get in there to see if they could switch things manually since the building was now a crime scene. I’m sure “what if the building becomes a crime scene” was never in the minds of those who designed the downtime policies and systems, but you can bet it’s on the checklist for my consulting clients.

Organizations may also be missing physical safeguards that are needed for their systems to be effective, like the VA hospital’s freezer was missing a couple of screws that could have prevented the vaccine loss. I worked with a client not too long ago that thought they were creating nightly backups of their system. They were using removable hard drives as the media. An employee would come in every morning and disconnect the drive, place it in a manila envelope with the date, then pull the oldest backup drive and connect it to the system. They failed to lock the door to the data room consistently, however, resulting in the disappearance of the box full of envelopes and drives.

As I tell these stories, I feel a bit like a Monday-morning quarterback. However, except for the crime scene part, the preventive maneuvers for these situations are already well documented. HIPAA requires a Security Risk Assessment where covered entities must look at physical, administrative, and technical safeguards for protected health information. Participation in federal and state vaccine programs requires signing agreements on vaccine storage and accountability. Although there were technical failures in the situations above, the human error component is strong as well.

This story out of Boston isn’t the only vaccine loss story out there. Much larger losses were recently documented in Maine and Michigan. The COVID vaccine is such a scarce commodity. If I were in charge of an organization that was a vaccinator, you can bet that I would have daily touch points with the leaders involved to ensure accountability and that systems were in place to approach zero waste. Every dose that doesn’t go to someone who wants it is a tragedy in the making.

My parents and elderly relatives are scheduled for vaccines over the next two weeks. I’m crossing my fingers that they don’t get caught in one of these situations. Based on the horrors I see in my clinical role, I’ll be holding my breath to some degree until everyone in my family is fully vaccinated.

How does your organization approach disaster recovery planning? Do you have plans in place if you need to execute a massive rescheduling operation if vaccines are lost or delayed? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Interviews Kevin de la Roza, MD, Anesthesiologist, Arnold Palmer Hospital for Children

January 25, 2021 Interviews No Comments

Kevin de la Roza, MD is a pediatric cardiac anesthesiologist at The Heart Center at Orlando Health Arnold Palmer Hospital for Children, assistant professor of anesthesiology at the University of Central Florida College of Medicine, and SVP/GM of Vocera’s Ease business unit.


Tell me about yourself and your work.

I’m a pediatric cardiac anesthesiologist at Arnold Palmer Hospital for Children in Orlando, Florida. I take care of babies and children that have congenital heart defects when they have heart surgery and any other type of surgery.

How is the Ease app that you developed being used?

It has been quite a remarkable journey for us. We created this from the need that, as anesthesiologists, we are the last person to take family members to surgery and away from their loved ones. We thought it was pretty barbaric the way that families are being ignored, whether they were just getting a phone call once in a while or maybe never when their kids or their adult loved ones were off to surgery, or had a board that they were looking at that didn’t tell any information.

The app is used universally in any location. We made it nimble and user-friendly for not only the families, but also the nurses. It fits in well with their clinical workflow and with the physician’s workflow. It has become an efficient way for us to communicate. You could be communicating with a loved one while I’m talking to you right now — via text or even a photo or a video or something like that — and it wouldn’t disrupt your workflow. We wanted to bring in the modern way of communicating from our world into a HIPAA compliant and secure way to do it in healthcare.

You see that moment on TV or in movies where the surgeon dramatically enters the waiting room full of anxious family members. How is the mindset different for the surgical team when they have the ability, and maybe then the responsibility, to provide regular updates to family members who may not be in the same city or even the same country?

We are all so connected now, whether it’s online or otherwise, that we are ready for instant information and instant gratification with knowing what is happening with our loved ones. We can track our package from Amazon, so why can’t we track our loved one’s progress and know what’s going on? 

When you talk about the care team, there are two aspects. There’s the surgeon and anesthesiologists, then the nurses. Vocera Ease is the modern way of communicating. It is a non-disruptive and it doesn’t bother their workflow. A nurse is used to taking essentially a snapshot or a barcode on the patient’s wristband and scanning it and getting a medication. We created the app to be the same way, so that whenever the patient or the nurse wants to send a communication, they scan a wristband and send off the message. That could be from the surgery or medical floor, because the program is now in the ICUs, medical floors, radiology, the cath lab, and obviously surgery, where it was born.

It’s a non-disruptive way for the nurses to communicate. Previously, if they were able, they would have to stop what they were doing, get on a phone, and call the families. Sometimes they answer, sometimes they don’t. Then have a two-way conversation, which can be disruptive. The surgeon might go out to the waiting room and the families aren’t even there.

You alluded to the fact that we have so many loved ones in other states and other locations who can’t be there. The great thing about Vocera Ease is that it sends one-way messages from the clinicians out to the family members that give them a step-by-step story of what happened, whether it’s on the floor, in the ICU, overnight, or in surgery. It is a remarkable way to communicate and increases efficiency. When those surgeons go out to the waiting room, the families already know what happened, so it’s a short, efficient conversation. The surgeon can move on to whatever is next in their busy schedule.

Do the messages go beyond simply “we’re starting anesthesia” or “we have made the first incision?” I can see where it might be dangerous to convey conclusions early in a procedure.

We reflect milestones. Let’s say your wife or your loved one needs surgery. First, there’s the emotional impact of, “Oh my gosh, they’re going to have this.” Then the surgeon will tell you in their office or wherever preoperatively, “These are the steps of what’s going to happen as it happens.” The day of surgery, you meet your anesthesiologist, who tells you, “This is what I’m going to do. I’m going to take you there. I’m going to give you some IV medicine and get you off to sleep,” et cetera. The patient and family members have a vague idea of what there is, and that vague idea can become fearful when you don’t understand, you don’t see what’s happening, and you don’t have that checklist of what’s happening.

Ease allows them to receive these one-way communications, such as “The patient is in the operating room” with maybe a little picture with a thumbs-up before they fall asleep. Then we will send them, “The patient is safely under anesthesia. Bill is now prepped and ready for surgery and Dr. So-and-So is about to walk in.” When Dr. So-and-So is scrubbed and over the drapes, we might take a little picture of him about ready to start. Then if it’s an orthopedic procedure, we might take a picture of an x-ray and say, “This is the fractured hip. This is what’s going to be repaired.” Then we can show after the fact that the implant is in place and the repair is in place. They have a vivid understanding of what’s happening as it’s happening.

Does Ease offer advantages over consumer video tools such as FaceTime to help families communicate with their loved one who they can’t visit because of COVID precautions?

Ease is literally created for something like what the pandemic has brought about, which is communication with people who are unable to be in the hospital. The operating room or the ICU are isolated areas don’t offer much access and don’t have a lot of information coming out of them. Now the entire hospital has become like those areas with COVID and visitor access restrictions. We have put Ease in these locations and added — beyond one-way communication via text, pictures, and videos — a FaceTime or video chat feature, where there can be two-way interaction.

Ease is HIPAA compliant and HITRUST certified. We set the standard for what security should be in this kind of communication, and we were the first to be able to do it. We are proud of what we were and how we could position our solution to help families out during this time of crisis. Out of necessity, hospitals started using Zoom, WhatsApp, and all these non-secure ways of messaging that they never would have done in an era outside of the pandemic. With Ease, they can do that safely and securely.

What IT technologies do you find most impactful or useful to your practice?

It depends on the problem that you are trying to solve. When it comes to communication, which is what we were focused on, anesthesiologists are in the perfect position to solve this communication issue from the operating room. I have to balance the patient’s safety, making sure that the environment for the surgeon is correct for them. I even talk to the nurses a lot to communicate how we send the family about this, that, or the other to let them know what’s going on. It’s quarterbacking everything to give the surgeon the right environment so that they can operate and do what they need to do. In that milieu, I think it was perfect for us to — my partner and I, Dr. Hamish Munro — to come up with the Ease solution for solving the communication problem and using healthcare IT in that way.

We have many health IT initiatives that we are using now in the operating room, whether they be just simple things like timeouts and keeping track of things. The EMR has become such a useful tool to help us with that. But this one problem with communication wasn’t solved until we brought our solution on board.

You created a health IT product and company and then successfully sold them. Will you get involved in other health IT projects?

I would love to be involved in something like that. We created a team. My partner Dr. Munro and I came up with the idea together. Then my brother Patrick became the CEO of our company. He has an MBA, a background in IT, and was an administrator at a hospital before that. These talents came together. We created a team that can foster new ideas. 

With my background in medicine, that would be an amazing thing to see. I don’t have any idea just yet, but I love thinking about different solutions we can find, thinking about problems with the environmental impact of hospitals and how we can help that. That’s where my brain is going, but we’ll see where it goes. It’s an exciting time to help find solutions to problems that have been around for a long time, or that are just starting to come to the surface.

Are you still involved with the product under Vocera?

Yes. I’m a clinical consultant for them and I help them out with anything that they need with regards to the platform.

Do you have any final thoughts?

In the journey we’ve had with what is now Vocera Ease, from eight years ago to today, it was about finding a strong problem and then putting the components together to find a solution for it. One-way communication via text, video, and pictures is the perfect way to communicate outside of healthcare because it’s non-disruptive and gets things out there, so how do we go about this? Let’s go read about HIPAA. Let’s go read about HITRUST. How do we create apps? Everybody downloads apps, everybody knows how to text.

From there, you start creating the solution to the problem, as opposed to creating the solution and then trying to find a problem to fix. It was created from a place of empathy, from a place of need. We saw these poor family members struggling when they weren’t with their kids who were in the NICU for a long time or they were in surgery. It’s important to find that strong problem and then hopefully an elegant solution to fix that problem.

Morning Headlines 1/25/21

January 24, 2021 Headlines No Comments

HHS Announces New Synthetic Health Data Challenge

ONC opens a challenge project to create realistic patient data for the open source Synthea synthetic health data engine.

GigCapital2 Announces $285M Capital Raise as Part of Business Combination With UpHealth Holdings, Inc. and Cloudbreak Health, LLC

Special purpose acquisition company GigCapital2 raises $285 million as part of its previously announced intent to merge with Cloudbreak Health and UpHealth Holdings to create a telemedicine company valued at $1.35 billion.

CloudMD Closes Acquisition of Canadian Medical Directory, the Largest Medical Directory in Canada

CloudMD will integrate Canadian Medical Directory’s online directory with its Juno EHR, billing, and telemedicine software.

Monday Morning Update 1/25/21

January 24, 2021 News 5 Comments

Top News


ONC opens a challenge project to create realistic patient data for the open source Synthea synthetic health data engine.

Synthea creates simulated lifelong health records that can be used by developers and researchers to support patient-centered outcomes research while they are waiting for access to real clinical data.

Up to six winners will be chosen for prizes of $10,000 to $50,000.

Reader Comments

From Maybe Going: “Re: HIMSS21. No registration page yet?” The conference site says that registration will open in January. The latest entry on the “Conference News & Announcements” page is from five months ago. We are just over six months away from the scheduled start of HIMSS21. HIMSS22 is scheduled for seven months later in March 2022 in Orlando.

HIStalk Announcements and Requests


Most poll respondents who have worked for an acquired company say their jobs got worse afterward.

New poll to your right or here: Have you argued with, criticized, or publicly disagreed with someone on Facebook who you have never met personally? Background: I don’t understand the perceived benefit of arguing publicly online and I can’t identify with how someone’s political or social beliefs can be so defining to their self-worth that they need defend them to faceless strangers, but Facebook fight-picking seems to be everybody’s favorite pastime. Mrs. HIStalk sometimes gets worked up over some clearly stupid or trolling comment and wants to respond, but I always provide my unsolicited advice: (a) you’ve never had your mind changed by a stranger’s Facebook comment and neither has anyone else; and (b) do you really want to spar with some keyboard warrior who can find our address from your name? I would consider social media to be a place for thoughtful discussion only if (a) everybody had to register with one and only one account using their validated name and address; and (b) I could click any comment to mute the author permanently.

I’m puzzled at why I’ve seen the city of “St. Louis” – its legal name – spelled out several times in the last week or two as “Saint Louis” by folks whose tendency seems to be to erroneously shorten rather than lengthen words (“Saint Louis University” is correct only because it is named after the actual saint and not the city). The city’s pronunciation is equally vexing – it should be “loo-EEE” given that it was named by French speakers who were referring to their king, whose delight would probably be diminished upon hearing that ‘Murcans mispronounce his name as LOO_us. Even the state’s name is illogically converted by some residents to Missou-ruh. It’s interesting that we choose names from other languages, but then mispronounce them intentionally or otherwise to make them uniquely ours (see Texas, just north of “I see an X so I’m saying an X” Mexico).

It’s a slow-to-no news day compared to the usual HIMSS-focused seasonal burst of PR activity. Enjoy the few minutes you will save as a result.


January 28 (Thursday) 12:30 ET: “In Conversation: Advancing Women Leaders in Health IT.” Sponsor: Intelligent Medical Objects. Presenters: Tabitha Lieberman, SVP of clinical and revenue cycle applications, Providence St. Joseph Health; Ann Barnes, CEO, IMO; Deanna Towne, MBA, CIO, CORHIO; Amanda Heidemann, MD, CMIO, CMIO Services, LLC. IMO CEO Ann Barnes brings together a panel of female health executives for a results-oriented discussion on how managers and C-suite executives can address diversity and inclusion in their organizations. From STEM education to mentoring and networking, the “COVID effect” on women in the workplace, to matters of equity, there’s no better time to talk openly about these issues to help generate meaningful change in healthcare.

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

Announcements and Implementations


Eighteen hospitals of Steward Health Care complete their virtual implementation of a regionally shared Meditech Expanse EHR.

Divurgent launches a Virtual Patient Support Solution to help providers manage COVID-19 vaccination scheduling calls.

A Mass General / Harvard Medical School study that was performed using real-world data from the TriNetX global health research network finds that people who have autoimmune or immune-suppressing rheumatic conditions are less likely to experience severe COVID-19 outcomes. The authors, who reviewed the de-identified information of 8,500 patients, also noted that the death risk to those patients remains substantial at 5-6% within 30 days of diagnosis.


Beverly Knight Children’s Hospital goes live on Vocera Ease for connecting parents with their NNICU babies. Employees applied for and received a Pampers Bright Beginnings NICU Connectivity Grant to fund the project.


Sunday’s COVID-19 hospitalizations in the US dropped to 110,628, new deaths to 1,940, and new cases the lowest other than on Christmas Day since December 1 at 142,949. The numbers are likely retreating after holiday-caused spikes, but the lull may be temporary as the B117 variant increases in prevalence. The US death count is at 417,000.

CDC reports that 20.5 million COVID-19 vaccine doses have been administered of 41.4 million distributed (50%). The federal government says that vaccine availability won’t improve until April due to manufacturing capacity, so experts urge the government focus on fixing state and local vaccination center problems that can’t even get existing limited supplies into arms.

The New York Times warns that the US should learn from Britain’s experience of hospitals becoming overwhelmed with patients, partly driven by the more contagious B117 coronavirus variant. One example is overloaded liquid oxygen pipes, caused by the use of high-flow oxygen for COVID-19 patients in trying to avoid the use of ventilators. The article also notes that hospitals have been reluctant to delay elective procedures, causing staff burnout, and quotes doctors who worry about how COVID survivors can be rehabilitated.

Sponsor Updates

  • OptimizeRx will present at the B. Riley Securities 2021 Vision Day Virtual Conference January 28.
  • PatientPing publishes a new white paper, “CMS Direct Contracting: Preparing for the New Model & How to Succeed with Real-Time Data.”
  • Arcadia congratulates Micky Tripathi on his new leadership role as National Coordinator for Health Information Technology with the Department of Health and Human Services.
  • TrustRadius has recognized Pure Storage’s FlashArray for Best Customer Support and Best Usability.
  • Relatient publishes a new case study, “The Warren Clinic Leverages Epic and Relatient to Distribute COVID-19 Vaccines.”
  • Spirion will host a series of virtual events January 26-28 in support of Data Privacy Day.
  • MD Tech Review names Zen Healthcare IT a “Top Healthcare Interoperability Solution Provider of 2020.”

Blog Posts


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


Katie the Intern 1/22/21

January 22, 2021 Katie the Intern No Comments

Hi, HIStalk! This week’s column is a Q&A with Kyna Fong, PhD, CEO and co-founder of Elation Health. This is the first column I’ve conducted in a written question and answer format. We touched on Elation Health, the evolution of primary care, COVID-19’s long-term impacts, and more. This column is a bit longer than usual, but I hope you find it to be an impactful and insightful read!


Dr. Fong’s journey with healthcare began at a young age, as her father served as a physician in Canada and the United States. As a teenager, Dr. Fong helped with in-house clinical services, which inspired her to become an assistant professor of economics at Stanford University. She and her brother then started Elation Health to deliver technology for independent primary care practices. 

Elation Health is a platform for primary care success, serving over 15,000 clinical users for their data management. The EHR is a collaborative, clinical-first system that supports physicians by managing clinical workflows, practice management, patient experience, and quality care. 

“Clinical-first is the radical idea that the quality of patient care matters and that supporting physicians is the path to that quality,” Dr. Fong said. “Our systems aren’t about upcoding, billing, and RVUs at the sacrifice of care. They’re about strengthening the patient-physician relationship and enhancing the craft of primary care.”

I asked Dr. Fong about technology that goes into running an EHR with a clinical-first outlook. Elation is a SaaS or cloud-based platform that relies on internet access. APIs (application programming Interface, noted) work behind the scenes to run data analytics and visualize information in real time. Dr. Fong said that Elation keeps the technology behind the scenes so users can focus on quality primary care. 

From Dr. Fong’s perspective, primary care and its evolution is the future of healthcare, and healthcare IT and holds the key to unlocking sustainable healthcare in the US. She cited studies that prove good patient-provider relationships lead to reduced healthcare costs and better livelihood. In this 2016 study, “Gordon and Beresin asserted that poor outcomes flow from an impaired doctor-patient relationship.” This understanding also leads to the conclusion that better healthcare relationships save time and money.

“That relationship drives reduced hospitalizations, less duplication of procedures, fewer medical errors, better prevention, increased chronic disease reversal, and more family involvement and trust in health decisions,” Dr. Fong said. 

The application of primary care is becoming more digital every day, growing at an exponential rate through telehealth’s application due to COVID-19. But not every area of the United States has been able to keep up with this digital move. Rural areas often have a higher population of underserved communities, and mom-and-pop healthcare practices are the only services available for miles. Dr. Fong says traditional EHR vendors require significant resources and technical support to successfully implement their services, and without large subsidies (which usually go to larger health systems), rural clinics struggle comparatively. Improving access and providership to underserved areas is important to assist rural practices in making the much-needed move to digital care. 

“These practices are so deeply invested in their communities,” Dr. Fong said. “Our goal is not only to see them survive, but to help them thrive, be recognized for high-quality patient care, and be paid what they deserve.” She believes that these underserved areas host tremendous opportunity for improvement, and with support, can begin to play catch-up in their digital development. I asked Dr. Fong what could be done to support rural areas and health systems in the switch to electronic records and how long would this take. 

In Elation and Dr. Fong’s experience, the answer lies in asking providers what they need and how they best tailor healthcare application to their communities. She said most rural providers and systems want “a healthcare structure that recognizes they are small businesses and not mini hospitals.” They want a system that reduces administrative burdens, offers purpose-built technology that is easy to develop and implement, makes data sharing and collaboration with larger systems easier, completes parity in pay for both in-person and digital / virtual healthcare in the pandemic, and offers support and pathways for moving to value-based care. 

The move to value-based care is also part of the problem in the evolution of primary care. Urban areas can sometimes have an easier time moving from FFS to VBC, but Dr. Fong tries not to see rural versus urban settings in this case. She views the challenge as being “more from the limited resources available to a small practice versus a large system, and the heavy financial and technical lift required of many health IT vendors’ legacy solutions to support alternative payment models.” Dr. Fong noted that smaller practices have a harder time getting the attention of payers to be able to invest in the shift to VBC. But for both large and small healthcare systems, monetary struggles and unmet incentives (such as reimbursement for VBC) can often hinder the move from a comfortable FFS model. 

As seen throughout the pandemic, the move to digital care can be done quickly and effectively. COVID-19 has in some ways leveled the playing field for the move towards value-based care. Primary care providers and their ability to practice have been supported by financial innovation to keep them afloat for their patients, Dr. Fong said. 

“We’ve seen big moves toward capitated and value-driven agreements for independent practices offered by payers across the country,” she observed. “The pandemic showed us starkly that the specialty-driven, fee-for-service model of healthcare fails to keep patients healthy when it really matters.”

Other surprising benefits of COVID-19’s presence have been technological advances and transitions. Movement to telehealth technology like Zoom and video-based platforms and the integration of these systems into EHRs were enhanced by the pandemic. This helped practices adopt new workflows to increase their treatment ability and reimbursement. She also said the shift towards telemedicine showed the world how quickly medicine can evolve when given the right incentives and support. 

“Primary care has a massive role to play in our national recovery from this pandemic in the years to come,” Dr. Fong said. 

Overall, the development of primary care is happening right before our eyes, she believes. Delivering the best possible outcome while also reducing cost of care are leading drivers in primary care’s evolution, and the pandemic has helped fuel that drive to make the switch faster and become a higher priority. Telemedicine, slowing the spread, and vaccine development are all just examples of the good that primary care does and glimpses into the future of its application. 

Lastly, Dr. Fong expressed her gratitude to those providers who have served the masses during this pandemic. “I see their sacrifice and their resilience, from practices in our community and my own dad’s clinic. Along with appreciation, they deserve support in helping build our country’s healthcare future.”


That’s it, HIStalk! I’ve got some exciting ideas for some virtual interviews coming up, so if you have interest in watching 10-15 minute interviews or listening to some of my columns from a podcast POV, let me know! As always, I appreciate you and thank you for letting me learn about this industry. 

Katie The Intern


Email me or connect with me on Twitter.

Weekender 1/22/21

January 22, 2021 Weekender 2 Comments


Weekly News Recap

  • Micky Tripathi is named National Coordinator.
  • The co-founder of The COVID Tracking Project says that the recently implemented HHS Protect COVID hospital status database is working well and urges the Biden administration to continue its use.
  • Philips announces plans to acquire medical device integration vendor Capsule Technologies for $635 million in cash.
  • ONC says it will invest $20 million in vaccine-related interoperability projects.
  • An appeals court vacates MD Anderson’s $4.3 million civil money penalty for losing three unencrypted mobile devices that contained the PHI of 35,000 patients, challenging HHS’s ongoing interpretation of HIPAA requirements and its method of setting penalty amounts.
  • Cerner replaces its chief client and services officer and chief legal officer and hires a CFO.

Best Reader Comments

I’ve been arguing with my health law friends that HHS and the conservative compliance lawyer mindset were wrong viewing HIPAA violations a some form of strict liability. I feel vindicated for now since I think the Fifth Circuit got this correct. 1. The technical requirements are met by simply not being negligent. You have implemented encryption? you make reasonable efforts to encrypt the data? Good enough. Perfection isn’t required. Doing more isn’t required. 2. Disclosure is an affirmative action, not merely just loss. It’s active. It’s participative. This construction fits nicely inside the framework. It also addresses the risk of loss to nation-state actors or those who are intent on stealing data. That’s not a punishable “disclosure” that’s a theft. 3. And I realize that HHS updated its penalty guidance, but this makes it very clear: outside some intentional acts, the penalties aren’t business-ending penalties. Yay for reasonableness of courts. (HIPAA Relieved)

The concept that that would not be considered a breach is mind boggling. I fully support the capriciousness but it shouldn’t be allowed to be pushed down to the staff level. In 2017 we all knew that we had to dictate it from an IT organization. (Jeremy)

Cerner Chairman and CEO Brent Shafer may wish to check out his own uCern “ideas” space to get a sense of how his peeps are doing on “strengthening relationships, delivering on promises, innovating faster, and executing on strategies.” There are loads of ideas that are no-brainers and/or have had significant support for many (5+) years, yet are not yet implemented or have been rejected as not on the road map. Other ideas point out serious safety risks, but are said to be working as designed (WAD), although they would be better termed WAHD (working as horribly designed). (CernerClient)

Watercooler Talk Tidbits


You as an HIStalk reader provided Ms. S’s elementary school class in Mississippi with 30 sets of individual, high-quality headphones in responding to her Donors Choose teacher grant request. She explains why she needed them: “Each year, I’ve bought headphones for my students completely out of pocket. The headphones which I get are usually a cheaper brand, which don’t tend to last long. I am so thankful for your support on this project! My students absolutely loved opening up the box and finding the beautiful headphones inside! Thank you for believing in us, and thank you for supporting our cause.”


California’s UCI Health will spend more than $1 billion to build 144-bed UCI Medical Center Irvine-Newport. That is $7 million per bed.


The state of Colorado dismantles a temporary COVID-19 hospital that was built in April 2020 inside Denver’s Colorado Convention Center, which the state leased for $60,000 per day for a year. None of its 2,000 beds were ever occupied.


A St. Louis TV station profiles 65-year-old pulmonologist Steven Brown, MD, who monitors 100 ICU patients per night – most of them on ventilators with COVID – from his living room as a physician with Mercy’s Virtual Care Center. He says it is hard to watch patients die remotely, in one case seeing four patients expire in a single hour.


A husband and wife who had been married for 70 years die together and within minutes of each other of COVID-19 in Riverside Methodist Hospital (OH), three days before their appointment to receive COVID-19 vaccine on would have been the husband’s 90th birthday. The family said in their obituary, “We are devastated to lose them both at the same time. But, we are blessed that they walked together, hand in hand, through the Gates of Heaven into Eternity, never having to face ‘Until Death Do Us Part.’”

A 29-year-old nurse who inspired her hospital co-workers by singing “Amazing Grace” after a 12-hour shift caring for COVID-19 patients – captured by a colleague in a video that went viral – sings it again in scrubs at the Lincoln Memorial Reflecting Pool to President-elect Biden and a national TV audience in the National COVID-19 Memorial. Lorie Marie Key, RN works for St. Mary Mercy Livonia Hospital (MI).


Acclaimed rapper-songwriter Lazarus encourages his fans to get COVID-19 vaccine, a recommendation that carries extra credibility because his other job is as Kamran Rashid Khan, DO, a Las Vegas family medicine physician.

In Case You Missed It

Get Involved


Morning Headlines 1/22/21

January 21, 2021 Headlines No Comments

Pieces Acquires Bowtie Business Intelligence to Fuel Continued Growth and Fulfill Data-Driven Mission of Creating Healthier Communities

Healthcare outcomes and community service connection vendor Pieces acquires Bowtie Business Intelligence, which offers a data management platform.

Healthcare tech-focused SPAC Compute Health Acquisition files for a $750 million IPO

Compute Health Acquisition, a SPAC that will focus on healthcare technology, files for a $750 million IPO that will value the company at around $1 billion.

Hillrom Announces Planned Acquisition Of Bardy Diagnostics, Inc.

Hillrom will acquire ambulatory ECG monitoring vendor Bardy Diagnostics for $375 million in cash.

MPulse Mobile Acquires The Big Know

Healthcare conversational AI vendor MPulse Mobile acquires health video course developer The Big Know.

News 1/22/21

January 21, 2021 News 2 Comments

Top News


The Biden administration chooses Micky Tripathi, PhD, MPP as National Coordinator for Health Information Technology. He replaces Don Rucker, MD, MS, MBA, who was named national coordinator in April 2017.

Tripathi was chief alliance officer for Arcadia, which last year acquired the assets of the closed Massachusetts EHealth Collaborative, of which Tripathi served as CEO for 15 years.

Tripathi has resigned from the boards of Datica, HL7 FHIR Foundation, CommonWell, and The Sequoia Project.

Reader Comments


From Rad Idea: “Re: PACS. Mach7 (which acquired Client Outlook and its eUnity viewer last year) won the enterprise viewing RFP from Trinity Health this past November, with an option to add VNA, diagnostic viewer, and worklist. It’s a big deal since Trinity does 60% more studies than the big academic radiology heavyweights.” Thanks. Australia-based Mach7, which restructured and fired its CEO a couple of years ago in a cost-cutting effort, has an impressive roster of big customers. Trinity signed a seven-year, $5 million contract for its enterprise viewer in November. Shares in M7T, which trade on the ASX, value the company at $313 million.


From PEI: “Re: Nano-X. Ever run across them? I’ve heard some interesting stories and wondered about your thoughts.” The technology explanations of Israel-based Nano-X goes way over my head, but it involves low-cost and portable diagnostic imaging, which has yet to earn FDA approval. The chairman and CEO apparently invented wireless phone charging. NNOX did its IPO in August 20 and shares are up 166% since, valuing the company at $2.7 billion. Fun reading of the “interesting stories” variety (but of unverified validity) is the analysis of fraud chasers Citron Research, which calls the company “Theranos 2.0” with just 20-odd employees and “nothing more than a science project with a simple rendering, minimal R&D, fake customers, no FDA approval, and fraudulent claims that are beyond the realm of possibility.” Perhaps readers have more information to contribute.

HIStalk Announcements and Requests


Dr. Jayne’s office chair write-up spurred me to long-deferred action to replace my old, cheap Office Depot model, whose defective height-adjusting mechanism made it a poor man’s carnival drop tower ride. I was happy to find a local office furniture store that buys used chairs from closed or relocated businesses, refurbishes them, then sells them cheap with a one-year warranty. My new chair is a fully tricked out Herman Miller Celle that came from a closed Blue Cross Blue Shield office that turned in 1,000 of them. The retail price is $750, so $199 seemed like a bargain. I didn’t realize how un-ergonomic and cheap-feeling my old chair was until I sat in a decent, highly adjustable one where my back actually touches the chair.

Listening: new soul / R&B from Grammy winners Black Pumas, which I ran across before finding that they played virtually at the inauguration this week.


January 28 (Thursday) 12:30 ET: “In Conversation: Advancing Women Leaders in Health IT.” Sponsor: Intelligent Medical Objects. Presenters: Tabitha Lieberman, SVP of clinical and revenue cycle applications, Providence St. Joseph Health; Ann Barnes, CEO, IMO; Deanna Towne, MBA, CIO, CORHIO; Amanda Heidemann, MD, CMIO, CMIO Services, LLC. IMO CEO Ann Barnes brings together a panel of female health executives for a results-oriented discussion on how managers and C-suite executives can address diversity and inclusion in their organizations. From STEM education to mentoring and networking, the “COVID effect” on women in the workplace, to matters of equity, there’s no better time to talk openly about these issues to help generate meaningful change in healthcare.

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

Acquisitions, Funding, Business, and Stock

HealthStream will acquire policy management technology vendor ComplyAlign for $2 million in cash.


Text chat-based telehealth vendor K Health raises $132 million in a Series E funding round that values the company at over $1 billion. K Health offers unlimited online doctor chats for $9 per month, also offering pediatrics in 15 states and single urgent care visits for $19. Co-founder and CEO Allon Bloch, MBA previously started several online businesses, none of them related to healthcare.


UnitedHealth Group reports Q3 results: revenue up 8% to $65.1 billion with Optum as its biggest percentage contributor, EPS $2.51 versus $3.90, beating estimates for both. The company said in the earnings call that its OptumCare business will add another 10,000 employed and affiliated physicians to its existing 50,000 in 2021. It expects the combination of its acquired Change Healthcare and OptumInsight to allow it to introduce evidenced-based criteria into clinician workflow.

Healthcare outcomes and community service connection vendor Pieces acquires Bowtie Business Intelligence, which offers a data management platform.

Compute Health Acquisition, a SPAC that will focus on healthcare technology, files for a $750 million IPO that will value the company at around $1 billion. The company is led by Intel Chairman Omar Ishrak, PhD, who was formerly CEO of Medtronic. Medtronic is interested in buying 1.5 million shares in the company, he says.


Hillrom will acquire ambulatory ECG monitoring vendor Bardy Diagnostics for $375 million in cash.

Healthcare conversational AI vendor MPulse Mobile acquires health video course developer The Big Know.


  • Community Care Plan chooses CareSignal’s Deviceless Remote Monitoring program to send self-management text messages to its Medicaid members.
  • New York State Office of Mental Health chooses Cerner’s hosted revenue cycle management solutions in a 10-year contract that covers 23 inpatient and 155 outpatient facilities.



Cerner hires Mark Erceg (Tiffany & Company) as VP/CFO. He replaces Marc Naughton, whose departure was announced last fall. Cerner’s entire executive team has now been replaced since Brent Shafer was hired as chairman and CEO in January 2018, with the exception of Don Trigg, who was then president of Cerner Health Ventures and is now president of Cerner.


David Tavares, founder and CEO of alarm and event notification vendor Connexall, died last week at 73.

Announcements and Implementations


Jvion launches its COVID Vaccination Prioritization Index, which helps public health officials determine which areas need more vaccines based on an AI-powered analysis of each community’s makeup. I randomly chose Roane County WV, which is high priority as explained in the graphic above.


AI researchers from Facebook work with NYU Langone Health to develop software that analyzes chest x-rays to predict if COVID-19 patients will deteriorate or require oxygen. The researchers say their models are research solutions rather than products and will make them open source to allow hospitals to tune them using their own data.


The local TV station covers how SSM Health Saint Louis University Hospital allows the family members of patients to send photos electronically to their in-room entertainment system. The video doesn’t mention the interactive patient system vendor that does the heavy lifting, but freeze-framing the video shows that it’s PCare.

Government and Politics

Implementation of HHS’s December 10 rule that reduces the time providers have to give patients copies of their records will be delayed for 60 days in a Biden administration review of all recent HHS actions.

HHS OCR will not impose HIPAA penalties related to use of online scheduling to make COVID-19 vaccination appointments.


The COVID Tracking Project shows 122,700 people hospitalized in the US, with the trend continuing down. Deaths hit a daily record 4,409 as the US total increased to 406,000.

CDC shows as of Wednesday that 16.5 million COVID-19 vaccine doses have been administered of 36 million distributed (46%).

Amazon offers in a letter sent to President Biden to use its operations, IT, and communications to help get people vaccinated.

Experts question the COVID-19 vaccination plan of Washington, D.C. – which is already struggling with vaccine distribution problems – to open up priority slots to anyone who is overweight, which would be more than half of the district’s residents. An obesity researcher says that “it’s not much of of a discriminator any more if you define a co-morbidity as something that almost everybody has.” The city will also use the honor system in requiring those showing up for a vaccine to answer two questions – are you a resident, and do you have at least one priority chronic condition – with no proof required.


The White House publishes its 200-page national COVID-19 strategy, in which the federal government will:

  • Provide expert-led, science-based public briefings and CDC-led communication and guidance.
  • Give states more support and funding to “convert vaccines into vaccinations.”
  • Expand vaccine production and purchasing.
  • End the policy of holding back second doses and encourage states to move quickly through the priority groups.
  • Create as many vaccination venues as are needed, including federally run centers in stadiums and conference centers, drugstores, VA hospitals, physician office, hospitals, urgent care centers, and mobile clinics.
  • Compensate providers fairly for administering the vaccine, expanding the FMAP to 100% for Medicaid enrollees and assigning CMS to review whether payment rates are appropriate.
  • Strengthen the federal government’s approach to vaccination data collection.
  • Have CDC and FDA perform real-time safety monitoring of vaccines through expanded systems.
  • Expand provider scope-of-practice laws and waive licensing requirements to meet community workforce needs.
  • Require masks and distancing within federal buildings and lands and require mask-wearing on planes, trains, and other public transportation.
  • Develop a COVID-19 treatment discovery and development plan.
  • Establish a US Public Health Jobs Corps to provide 100,000 contact tracers, community health workers, and public health nurses.
  • Provide technical help with the use of technology and data to guide response.
  • Invoke the Defense Production Act to fix supply problems with vaccination and testing supplies and PPE.
  • Implement a national strategy to support the safe reopening of schools, with most K-8 schools to be open within 100 days, including Congress-approved funding.
  • Provide emergency funds to help hard-hit childcare providers remain open and to support higher education operation.
  • Restore the US’s participation in the World Health Organization.



The non-profit, Tulsa-based MyHealth Access Network protests the state’s selection of Orion Health to provide a statewide HIE platform for $49.8 million, which is nearly $30 million more than its own bid. ONC warned the state in a January 6 email that scrapping MyHealth and starting over was a bad idea. MyHealth bid $106.6 million on December 30, 2019, then lowered its price nine months later to $41.7 million when the state asked for its best and final offer, then lowered its price again to $19.9 million. The federal government will pay 90% of the cost.


I mentioned that health IT long-timer Amy Gleason had a big role in the successful implementation of HHS’s COVID hospital data reporting system as part of the US Digital Service. She invites other industry folks to join the group. I’m fantasizing about how cool it must be to casually name-drop “The White House” as a current or previous employer when meeting someone.

Sponsor Updates

  • Everbridge launches its enhanced Public Warning System.
  • Experity adds distribution phase information to its state-by-state COVID vaccine plan tracker.
  • The HCI Group hires Blake Richardville as a business development executive, and Eli Lemkin as an account executive.
  • Kyruus adds online consumer scheduling for COVID-19 vaccine visits to its patient access platform.
  • Lumeon publishes the “US Patient Access Leadership Report 2020/21.”
  • Medicomp Systems sponsors the awards section of the Physician Burnout Symposium through January 29.
  • Meditech customer Northeastern Vermont connects the full birth experience with Expanse Labor and Delivery.

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EPtalk by Dr. Jayne 1/21/21

January 21, 2021 Dr. Jayne 1 Comment


I took time out this week to listen to the tolling of the funeral bell at the Washington National Cathedral. The bell tolled 400 times, once for every 1,000 COVID deaths in the United States. The 12-ton bell creates a deep and somber tone, intended to help mourn but also celebrate the lives of the lost. The recording was accompanied by video of the paper doves that form the Les Colombes installation by artist Michael Pendry, which is located in the Cathedral’s nave. It’s likely that we’ll see another 150,000 deaths by summer unless something changes significantly.

To the relief of many, Inauguration Day passed without any serious incidents, with the new US president getting straight to the business of trying to manage the COVID pandemic. I’m interested to see if the tone at the Centers for Medicare & Medicaid Services changes, since nearly every email that I’ve received over the last several years had a headline or opening paragraph celebrating the administration’s accomplishments. I suspect the new leadership may be a little more humble, and hopefully they’re getting the right kinds of leaders in place to help steer the massive bureaucracy to a more functional and productive place.

Many healthcare organizations are holding their collective breath to see if there will be major changes to policy or additional federal funds targeted towards vaccine administration. From people I’ve spoken to who have boots on the ground across the country, administration continues to be chaotic. We’ve finally been able to get my family members scheduled — they range in age from 75 to 95 — but it remains to be seen whether there will be vaccines shipped and available for their scheduled appointments.

Speaking of vaccinations, two Michigan marijuana dispensaries are offering free joints to customers who are vaccinated for COVID-19. The Detroit Free Press reports on the “Pot for Shots” campaign and its attempt at “blunting the curve.” The participating locations are Greenhouse in Walled Lake and UBaked Cannabis of Burton. You have to love a business name that clearly defines the brand.

Back to the realm of healthcare IT, I had a chance to catch up with a friend this week. We were bouncing ideas around as far as what sectors of the market might actually be heating up. Although most of my friends on the vendor side say that none of their prospects or clients is in a buying mood, there are indications that there will be money to be made. Intel Chairman Omar Ishrak is building a $1 billion war chest for a special purpose acquisition company IPO to target health technology deals. Prior to Intel, he was at Medtronic, so he’s not a stranger to the marketplace. Goldman Sachs Group Inc. is putting together the IPO. It seems that lately we’ve been hearing a lot about SPACs and I suspect this will be one to watch.


I enjoyed reading the recent blog penned by my long-term crush Farzad Mostashari. Aledade’s premise is that primary care is the foundation of an effective health system, and that it must be strengthened if we are to deliver better patient care and lower healthcare costs. Since 2014, the company has expanded to 27 states.

The blog notes that shared savings payments have been a way for primary care practices to stay afloat while fee-for-service payments have dropped due to decreased volumes during the pandemic. Aledade hopes to grow that savings from $50 million last year, doubling it this year and tripling it for the next. Investors are taking note, resulting in a $100 million funding increase that will drive an ambitious agenda that includes a 50-state growth strategy, expanded remote patient monitoring, predictive analytics, continuation of telehealth, and upgrades to Aledade’s software. It’s exciting to watch a truly mission-driven company do well, and I wish them continued success.

The Office for Civil Rights of the US Department of Health & Human Services will not be imposing penalties for potential HIPAA violations when healthcare organizations use online or web-based scheduling applications as long as they are “used in good faith and only for the limited purpose of scheduling individual appointments for COVID-19 vaccinations during the COVID-19 nationwide public health emergency.” That’s good, because my employer was one of the potential violators. In order to try to rapidly schedule employees for the 300 doses of vaccine that we received (which had to be given within 36 hours of receipt, since it had already been thawing at another health system) they used the Calendly platform. The so-called “enforcement action” does not include appointment scheduling systems that connect directly to the EHR, but encourages healthcare providers and their business associates to continue to guard the security of protected health information.

HIMSS announces a new recognition program, the HIMSS Changemaker in Health Awards. The award recognizes “inspiring senior healthcare executives who rigorously challenge the status quo in their journey to build a brighter health future.” Recipients will be determined by peer voting and will receive a “symbol of recognition” as well as coverage in HIMSS publications and seminars. They also must agree to contribute to HIMSS content including articles, podcast interviews, and participation in webinars. I was surprised to see that candidates can nominate themselves. If you know someone who is making change, or think you’re hitting it out of the park yourself, nominations are open through February 16.


In COVID news, the internet is full of cures and treatments that haven’t necessarily been proven. I’m interested in further research on this one, which purports that chemical compounds found in dark chocolate may interfere with COVID virus replication. Researchers at North Carolina State University are continuing to investigate, although they note that no human trials have been conducted yet. I’ve already got at least one reason to want to visit the Carolinas, so I’m happy to volunteer as a research subject.

If you’ve been holding off on travel due to COVID, what’s the first place you’d like to visit? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 1/21/21

January 20, 2021 Headlines No Comments

K Health Launches ‘K for Parents’ Pediatric Care and Raises $132M Series E

Chat-based telemedicine company K Health raises $132 million in a Series E funding round.

Administration Unveils Senior Tech and Acquisition Leaders

Former Arcadia Chief Alliance Officer Micky Tripathi will serve as the national coordinator for health IT.

CareXM Announces Acquisition of TouchPointCare

Nurse triage and telemedicine company CareXM acquires remote patient monitoring vendor TouchPointCare.

Signify Health Files Registration Statement for Proposed Initial Public Offering

Clinical, behavioral, and social care coordination company Signify Health files paperwork with the SEC to go public on the New York Stock Exchange.

HealthStream buys policy management software firm

Training and talent management platform vendor HealthStream acquires ComplyAlign, a cloud-based policy management software vendor, for $2 million.

Morning Headlines 1/20/21

January 19, 2021 Headlines No Comments

America’s Most Reliable Pandemic Data Are Now at Risk

The co-founder of The COVID Tracking Project urges the new administration to continue using the HHS Protect system instead of switching back to the CDC’s National Health Safety Network hospital reporting database.

Philips to expand its leadership in patient care management solutions for the hospital with the acquisition of Capsule Technologies, Inc.

Philips will acquire medical device integration vendor Capsule Technologies for $635 million in cash.

HHS Awards Funds to Expand Immunization Information Sharing Collaboration

ONC will invest $20 million in projects related to helping communities share COVID-19 vaccine-related data, and supporting immunization-related collaborations between HIEs.

Aledade Raises $100 Million Series D to Help More Primary Care Practices Thrive in Value-Based Care

ACO operator Aledade raises $100 million in a funding round that increases its total to $294 million and values the company at over $2 billion.

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