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HIMSS Confirms President Trump for HIMSS20 Kickoff

March 2, 2020 News 23 Comments

HIMSS announced Monday afternoon that President Trump will become the first sitting US president to deliver an address at its annual conference.

The President will speak at 4 p.m. on Monday, March 9 in the Valencia Ballroom of the Orange County Convention Center.

That Monday is the pre-conference day. The President’s speech will begin before the pre-conference education sessions have concluded and will precede the opening reception at 5:30 p.m.

President Trump will likely talk about interoperability in conjunction with an HHS announcement about its new interoperability rules. He is also sure to talk about COVID-19.

The President’s Orlando campaign rally last year disrupted flights at Orlando International Airport and created rush-hour traffic problems on major roads. HIMSS20 attendees who are flying in on Monday will probably experience delays, while Secret Service security procedures could impact Orange County Convention Center for much of the day.

Planning for a presidential visit takes weeks, Orlando’s police chief said before last year’s rally, so it’s likely that the President has planned to speak all along  but wasn’t announced until now by HIMSS.

HIMSS Says HIMSS20 Remains On Track and President Trump May Speak

March 2, 2020 News 12 Comments

A HIMSS update on HIMSS20 and COVID-19 says that an expert panel of medical professionals will provide recommendations for its conference planning. Those experts will “further advise our evidence-based decision-making and to ensure the safety of the healthcare community currently planning to assemble in Florida for HIMSS20.”

Meanwhile, HIMSS announced that President Trump has been invited to speak at the conference, with further details following later today. A White House reporter says the President is planning to attend and time slot of Monday, March 9 at 4:00 p.m. has been rumored. That’s the pre-conference day, with the only scheduled all-attendee event being the opening reception at 5:30.

Health IT regulations have been published immediately before or during previous HIMSS conferences, leading to speculation that announcements will be made that week about the proposed interoperability rules of HHS/ONC.

Curbside Consult with Dr. Jayne 3/2/20

March 2, 2020 Dr. Jayne No Comments

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We’re definitely in the pre-HIMSS doldrums, with very little going on and even less news about it. Anyone who has a major announcement is going to hold it for the big show, even though odds are it will get lost in all the noise. Or the silence, if HIMSS chooses to cancel the event.

Most of the non-IT news out there in the healthcare realm is about the novel coronavirus and its transition to community spread within the US. Lots of chatter about how organizations are gearing up to identify and track it, but there are still serious challenges as far as how healthcare organizations are actually going to manage the patients especially given shortages of masks, gowns, and other critical supplies.

We finally had some surgical masks appear in our workplace this weekend, although it’s not clear if the supply will hold out or if the office will be replenished if we run out again. Most of the time we’re using them to help reduce the risk of flu transmission.

I was glad to see the most recent CDC numbers show a sharp decrease in positive flu tests. However, I think some of that downturn might be driven by people who aren’t coming in to be tested because they know just about everyone they’ve come in contact with has flu, so they’re just assuming a diagnosis and staying home. Several local schools have closed for deep cleaning as well, so at least they will be well practiced when coronavirus arrives. Our practice is as busy as ever with multiple providers covering extra shifts to make up for those who are out with flu.

Mr. H mentioned in his Monday Morning Update that Cisco is canceling, and there are plenty of rumors about other companies that are bailing out but haven’t announced it yet. HIMSS has been uncharacteristically slow in sending out invites (or “sorry, you’re not invited” notices) for many of their breakfast and lunch events, which is annoying both to the attendees who tried to register for them as well as the vendors who are paying for them. I’ve heard of many companies that had previously decided to downsize their exhibit hall presence and were planning on sending fewer employees than past years, so it would be less of a loss if they decide to cancel.

For those of us who aren’t being subsidized by a vendor or employer and who attend out of pocket, it’s not a small financial hit. Even if it is canceled, I have half a mind to go anyway and just enjoy being somewhere warm with a pool. On the other hand, I could stay home and catch up on all the things I haven’t been able to do since flu season has been so exhausting. I have some Maintenance of Certification questions I need to do for my boards and I would no longer have an excuse to dodge them. There’s also taxes to file and a shower to re-caulk, so the possibilities are endless for fun and excitement.

In the event that HIMSS goes forward, and a good chunk of exhibitors decide to show, I always get the question about what I’ll be looking for or what I want to see at the event. Here’s a short list of things I’m interested in:

  • Ambient intelligence, smart exam rooms, and the like. How close are they to being able to make this work for in-the-trenches primary care practices? Are the solutions able to handle the scenarios where anything could walk through the door, and most of the time patients present with multiple and complex problems? Are they able to integrate with multiple EHR platforms or just the big ones? There are thousands of physicians across the US who are in need of such solutions but who don’t have Epic or Cerner.
  • Telehealth. What do consumer-facing organizations have planned for the next five years? Will hospitals and health systems continue to try to do internal programs, or will they partner with some of the national players? Will the institutionally-focused vendors merge or partner with the consumer-facing ones? Will they be able to thrive financially, or will they continue to run on thin margins?
  • Patient engagement. Are vendors really able to drive the needle for deliver patient outcomes, or is it all flash? Do the apps have staying power for patients or are they like fitness trackers and other solutions that patients use for a few weeks or a few months and then abandon?
  • Helping the “little guys” succeed. What solutions are out there to help small practices or organizations that aren’t in the 800-pound gorilla range? What’s out there for people that don’t have half a billion dollars in the bank ready to spend on IT solutions?
  • And finally, one of the least provider-facing but very important topics. What’s new in terminology, taxonomies, and all the “guts” that make the systems run while trying to facilitate interoperability and data exchange? I’ve heard that there may be some cool things on the horizon that could be transformative from the informatics perspective. I do love the logic and organization of a well put-together system, and if there are tools that can make that better, I say bring them on.

We should know soon whether HIMSS is a go or no-go and people can start adjusting their plans accordingly. If you’ve already decided you’re not going to attend, how do you plan to spend your time? Will you play catch-up on projects or are you so busy that staying home will just keep you from falling behind? Leave a comment or email me.

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HIStalk Interviews David Fast, President, Agfa HealthCare North America

March 2, 2020 Interviews No Comments

David Fast is regional president, North America and VP/CFO/COO of Agfa HealthCare of Morsel, Belgium.

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Tell me about yourself and the company.

I joined Agfa HealthCare 11 years ago as the North American CFO. After a couple of years, my role was expanded to cover the CFO role for our Latin American business. I spent a couple of years supporting them, then refined it back to North America and added the COO title to the North American operations. For a few years, I was doing CFO/COO for Agfa HealthCare IT in North America. Just over 12 months ago, I assumed the role of president of the North American region.

How much of the company’s focus involves imaging?

Our customer base is still very much radiology imaging, but customers have been asking us to expand our expertise to help manage all imaging across the enterprise. There are actually over 70 service lines in a typical health network that produce medically required images. Managing all that imaging data is a huge and costly undertaking for CIOs and their IT departments. Our new enterprise imaging platform is designed to reduce complexity throughout all image producing service lines or “ologies” if you will. Our goal is to provide the complete patient imaging record in a health system’s EHR, whether the images come from radiology, cardiology, point of care imaging such as ultrasound, surgery, or wherever medical imaging contributes to the care plan.

Consensus seems to be that artificial intelligence will support rather than replace the clinicians who interpret images. Will the workflow component be the key element?

I would say so. We prefer to use the term augmented intelligence, as our focus is to assist clinicians in making informed decisions, not to replace them.

And, you are absolutely correct: Workflow will be key since the technology will only be useful if it becomes part of the clinician’s routine. We have people focused on augmented intelligence, most recently in the mammography area, where our customers have found that the technology can assist and aid the clinicians in making better decisions earlier on in analysis of these images, which can be complex to read. We think it will augment rather than replace the kind of care they can give.

What level of integration exists between imaging and imaging workflows and the EHR?

The whole industry is evolving for sure and this has been a key focus area for Agfa. We find our enterprise imaging solution must be connected to the EHR in each subspecialty are in order to maximize the benefit for the clinician and ultimately the patient. Our technical teams routinely work with the major EHR vendors on integrations that either we or healthcare providers ask for.

How will patients carrying their own images on CDs from one provider to another be replaced with more sophisticated imaging interoperability?

We have a solution today called Engage Suite that addresses just that issue. It is quite typical, unfortunately, for a patient to get a CD from a small imaging clinic and then have to run across town or across state to bring that image to another viewing physician in order to receive timely care.

Engage Suite is an interface with our enterprise imaging platform that facilities connections to various venues, such as remote clinics or big hospital groups. They can exchange images, view, archive, and move them around electronically. There’s no more need for CD burning and running the CD across town. We see the ubiquitous sharing of medical images as a differentiator.

Do use cases exist for using imaging and related information in population health?

I would say so. For the most part, we still see imaging in a traditional sense of being imaged by professional technicians in order to advise a diagnosis. But more and more you’re seeing that both physicians and patients, as with people in general, are using their cell phones to take pictures and send them in. That will broaden the horizon of how we address patient care. It’s at the early stage but will evolve. We call these medical selfies and they can contribute to an increase in patient engagement and satisfaction in their care.

What do radiologists see as their most pressing challenges and their greatest opportunity?

There’s a lot of consolidation going on in the industry. From that perspective, institutions are looking for the ability to have systems that can not only be enterprise-wide from a facility perspective, but that are also scalable and sustainable when it comes to their acquisitions. From the radiologist’s s perspective, they want to be able to retrieve images quickly from wherever they came from and have the best view of that image on their screens as quickly as possible.

We have a good solution in terms of our universal viewers and the whole workflow piece that you mentioned earlier. That is critical when it comes to the radiologist being more efficient. Getting more done more quickly and more accurately is the name of the game in healthcare today.

Are radiologists prone to burnout from the time and accuracy pressures? How do the technologies they use impact their stress levels?

It’s dependent on the individual, but the focus of radiologists is productivity. They define their success in being able to read images quickly, but also effectively, so that they’re giving patients the best care possible. But at the same time, it’s disheartening for them when their systems create delays.

The key for our environment is that we make them more efficient, not less efficient. That means having a system that is responsive and very quick, with viewing and reporting capability. They are constantly demanding systems that will make them more effective and more efficient and our job is to help them do that.

What will be the most impactful changes in the next five to 10 years?

We had the vision of this enterprise-wide solution a few years back. We were primarily a radiology PACS company, so we were primarily supporting the radiology department. We had a cardiology solution as well, but now that we have this enterprise-wide solution, we’re just scratching the surface. It’s mind-blowing to think of how much we could get done in adding other service lines and anything related to imaging that happens in a healthcare system and what that would do for patient care.

Radiology and cardiology are probably still the biggest imaging departments that are touched in one system. But as we go forward over the next two or three years, forget about five to 10 years, the whole platform of enterprise-wide imaging solutions is going to take off dramatically. You’re going to see a very different world not too long from now, less than five years away.

Do you have any final thoughts?

We have a fantastic opportunity and a good future in front of us to truly contribute to reducing total cost of ownership of imaging systems and reducing complexity in health IT. Our solution and the technology that we have developed is getting to maturity. We are doing a lot of terrific work in our labs and development centers on value-adds to that platform. I see a huge potential, particularly here in North America, the area that I oversee. Agfa HealthCare is a Belgian company, but we have very much turned our focus on the North American market, and with that will come additional investment that will drive the results and our market share here in North America.

Morning Headlines 3/2/20

March 1, 2020 Headlines No Comments

Cisco at HIMSS 2020

Cisco withdraws from HIMSS20 due to COVID-19 concerns.

Wellpepper acquired by Caravan Health in sign of growing market for digital patient treatment plans

ACO development company Caravan Health acquires Wellpepper, which offers technology to create digital patient treatment plans.

Health Catalyst Reports Fourth Quarter and Year End 2019 Results

Health Catalyst reports Q4 results: Revenue up 21%, EPS –$0.39 vs. –$16.33, beating Wall Street expectations for both and sending HCAT shares up 9.5% on Friday.

Thousands locked out of Pentagon and VA benefits websites

The Defense Department acknowledges that a problem with a common login system has prevented military members, retirees, veterans, and their families from logging in to the Tricare Online Patient Portal and to its MHS Genesis Cerner system for several days.

Coronavirus Reveals Limits of AI Health Tools

Vendors of AI-powered symptom checkers and chatbot struggle to update their algorithms with COVID-19 information.

Monday Morning Update 3/2/20

March 1, 2020 News 16 Comments

Top News

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Cisco withdraws from HIMSS20 due to COVID-19 concerns.

HIMSS filed its most recent coronavirus update Thursday, reporting a registrant cancellation rate of 0.6%. This may be misleading, however, since the organization offers refunds only to registrants from specific countries, meaning that most people who have changed their minds about attending would not necessarily bother to notify HIMSS.

Any potential cancellation of HIMSS20 would probably need to be announced in Monday’s update to allow time to notify registrants. HIMSS has not given any indication that it plans to cancel the conference.

Several companies that are scheduled to exhibit have recently cancelled their own user and sales meetings. HIMSS20 exhibitor Workday, for example, cancelled its sales kickoff meeting that was scheduled for March 2-4 in Orlando. Readers have said that Intel, Salesforce, and Amazon won’t participate, although those companies have not made any announcements.

Most respondents to this week’s snap poll – which is not vetted — say they haven’t changed their HIMSS20 plans, although 15% of respondents indicate that they are US residents who won’t attend as planned after all.

Readers who are epidemiologists or public health experts and are registered to attend HIMSS20 – will you still attend, and if so, will you take any non-obvious precautions? I’m also interest in hearing from employees of companies who have decided not to send employees to Orlando.


Reader Comments

From Wizened Sage: “Re: MDLive. Changes at the top – chief medical officer, CEO, CFO.” Rich Berner is still listed as CEO on the exec page, but a reader said his resignation was mentioned on a medical directors’ call. CFO/COO Dan Monahan left in November after 10 months and Chief Medical Officer Lyle Berkowitz, MD moved on last month after a couple of years. Comparing the executive web page from April 2019 to the current version shows that seven of the 13 are no longer listed.

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From Doc X: “Re: HIMSS exhibitor press release upload portal. My upload failed and I noticed that it accepts only .doc files, which were superseded in Word in 2003 by .docx. So a state of the art health IT conference is using 23-year-old information exchange infrastructure?” I’m actually surprised that the third-party service HIMSS uses accepts Word documents at all instead of requiring PDFs, where formatting is consistent and the threat of malware micros is zero. PR people sometimes email me announcements as Word documents, which even if I wasn’t worried about malware, would go right to my trash folder anyway because it means they are greenhorns. I’m not blaming HIMSS since the technology still works as long as the submitter is willing to do a “save as.” I also think there may have been a time when non-Microsoft word processors such as Open Office and maybe even Apple Pages could export only as .doc files, so this might actually be a commendable interoperability provision.

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From Being There: “Re: ZDoggMD’s claim that patients can’t share their Epic data with providers that use a different EHR. I can say as a user of an Epic-enabled mobile app through my PCP that this is categorically untrue. The Share Everywhere option on the mobile app gives any provider one-time, limited access to meds, allergies, health issues, and immunizations. They can even write a clinical note to my care team.” ZDogg also ignores Carequality EHR-to-EHR data sharing, which in also being connected to CommonWell allows sharing information with just about any EHR whose vendor wants to support doing so. I wonder if the EHR that ZDogg designed for his failed Turntable Health had interoperability capability since he’s so passionate about it. 

From Midship: ”Re: HIMSS20. What is the financial impact to registrants if it is cancelled?” HIMSS policy is that you don’t get a registration fee refund – it rolls over to HIMSS21. Hotel reservations booked through HIMSS are non-refundable, so you’re out those costs along with flights unless you bought comprehensive travel insurance, which may or may not cover you anyway unless you got the expensive “cancel for any reason” coverage or purchased before COVID-19 became a known event that is therefore excluded. Employers pay the tab for most attendees, so the paperwork required will vary, but you’ll have all week to complete it.


HIStalk Announcements and Requests

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Poll respondents say the best way by far to get people into your HIMSS booth is to deploy friendly, alert reps (hint: reps who stare longingly into the eyes of their phones are neither). 

New poll to your right or here, following up on the KLAS survey: Which of the following patient engagement technologies have you personally used in the past year? I probably should have excluded dentists since they are far better users of consumer-facing technology than their medical counterparts.

I’m looking for a few good companies that are interested in signing up for HIStalk webinar services and sponsorships. Startups get a first-year discount because Lorre decided that would be nice for the little guys. We always get more interest right before and after the HIMSS conference as companies are paying more attention to the comparative effectiveness of reaching an audience of actual decision-makers. Contact Lorre.

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Geek gadget alert: I read that resetting your router occasionally will ensure good Internet speed. Mine isn’t in a handy location, so I thought about plugging it into a mechanical timer like you do for Christmas tree lights and having it power off early in the morning and then on again a minute later. I then ran across these smart plugs,  which allow you to control the plug over WiFi with a slick app, with Alexa or Google Home, and even IFTTT. I think it even has as one of its programmable elements sunset time, so that you might turn on a lamp at sunset and then turn it off at 11 p.m. A four-pack costs just $25, they were a snap to set up in just a few seconds, and they are working perfectly so far. The only caveat is that they work only on 2.4 GHz WiFi networks.

Listening: The Equatics, high school kids from Hampton, VA who recorded a single funk-soul album in 1972. I heard them on Hulu’s “High Fidelity,” which I’m enjoying a lot (Zoe Kravitz is excellent, at least while I’m waiting for Tony nominee Da’Vine Joy Randolph to steal every scene in which she appears.) The soundtrack is all deep cuts and oddities from obscure LPs like this one and the playlist is on Spotify.


Webinars

March 4 (Wednesday) 1 ET: “Tools for Success: How to Increase Clinician Satisfaction with HIT Solutions.” Sponsor: Intelligent Medical Objects. Presenter: Andrew Kanter, MD, MPH, FACMI, FAMIA, chief medical officer, IMO. Dr. Kanter will explore how striving to achieve the Quadruple Aim (by focusing on the provider experience) can improve clinician satisfaction and population health needs while also reducing per capita healthcare costs. Attendees will learn how to set providers up for success with new technology, the potential unforeseen consequences of purchasing without the clinician in mind, and the factors that are critically important to clinicians who are using new health information systems.

March 4 (Wednesday) 1 ET: “Healthcare Digital Marketing: Jump-Start Patient Discovery and Conversion.” Sponsor: Orbita. Presenters: Victoria Petrock, MBA, MLIS, principal analyst, EMarketer; Kristi Ebong, MBA, MPH, SVP of corporate strategy, Orbita. Does your digital front door capture consumers who search for health-related information one billion times each day? Do you have actionable steps to convert them into patients? Do you understand voice and chat virtual assistants? The presenters will explore the consumer challenges involved with finding, navigating, and receiving care, discuss why healthcare marketers need to embrace conversational voice and chatbot technologies, and describe how new technologies such as conversational micro-robots can improve engagement.

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


Acquisitions, Funding, Business, and Stock

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Health Catalyst reports Q4 results: revenue up 21%, EPS –$0.39 vs. –$16.33, beating Wall Street expectations for both and sending HCAT shares up 9.5% on Friday.


Sales

  • Ontario Mental Health Partnership will upgrade its Meditech system to Expanse.
  • MatrixCare will integrate NVoq’s speech recognition solution to its home health and hospital EMRs.

Government and Politics

The Defense Department acknowledges – after initial denials – that a problem with a common login system has prevented military members, retirees, veterans, and their families from logging in to the Tricare Online Patient Portal and to its MHS Genesis Cerner system for several days. The ID platform DS Logon is working from inside the DoD’s network, but not from outside computers.


Privacy and Security

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A Consumer Reports investigation finds that prescription discount coupon vendor GoodRx sends patient information to 20 online companies that include Google, Facebook, and a marketing firms. Most surprising is that consumers and doctors interviewed by the magazine somehow think that HIPAA protects medical information everywhere, missing the major point that it binds only covered entities and their business associates, not discount websites. GoodRx reacted to the unwanted publicity with an apology, the hiring of a data privacy VP, reduction in the information it shares with Facebook and Google, and new user options for opting out and deleting their data as required by California’s privacy laws. The company says it will make sure the third parties to which it sends patient data follow HIPAA standards, which I’m not quite sure I understand.

CNN resurfaces the two-year-old story in which a Facebook bug was found by health IT expert Fred Trotter as having exposed the membership lists of its closed, private groups – as was found with a breast cancer gene support group – to developers and marketers. Facebook changed its closed group settings, but denies that the existence of a privacy loophole even though it admitted that developers had access to membership lists, saying that users shouldn’t use its Groups product if they are worried about privacy. The Federal Trade Commission has not yet responded to the December 2018 complaint filed by Trotter and healthcare attorney David Harlow.

HHS will review the St. Louis Fire Department’s participation in the TV show “Live Rescue” following HIPAA-related privacy concerns about its depiction of accident victims in near-live broadcasts. The fire department accepted legally responsibility for any HIPAA violation in its deal with the TV show’s producers,  an agreement that pays the city nothing for its participation.


Other

Vendors of AI-powered symptom checkers and chatbot struggle to update their algorithms with COVID-19 information.

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A small Reaction Data survey of health system clinicians and C-suite leaders finds that most respondents expect HHS’s proposed interoperability rules to have a positive impact. Epic users are more favorable to the ruling than those of any other EHR vendor. The rule’s biggest health system supporters are clinicians and executives, and while IT leaders were less enthusiastic, they don’t feel all that strongly about it either way. Respondents were pretty much equally split as to whether patients should control their own information versus hospitals and clinics doing it for them.

Healthcare in America: a man and his three-year-old daughter who underwent mandatory US government quarantine after returning from Wuhan, China find a pile of hospital, radiologist, and ambulance bills waiting when they finally got home. The government didn’t have a plan for who pays for being forced into quarantine in a non-government facility, and since the man has no health insurance since his China-based employer doesn’t offer US coverage and he’s lived in that country for years, he’s looking at a $4,000 expense so far. The biggest chunk of the bill, $2,600, was from a short ambulance ride provided by American Medical Response, which was sold to private equity operator KKR in 2017 for $2.4 billion in cash. He was coughing and his daughter was blinking excessively in a TV interview, which he would like to have checked out if he can qualify for Medicaid.

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I had a double gotcha on this story in the Venice, FL paper. The first was that I thought it was about telehealth – it’s actually about architects for a new hospital trying out the design on employees using virtual reality. My second thought is that those cataract sunglasses that are ubiquitous among Florida’s senior citizens have gotten awfully large.

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Paging Weird News Andy: Maryland police arrest a man who stabbed a woman with a syringe full of semen in a grocery store. Tom Stemen (!) told the woman when she confronted him, “It felt like a bee string, didn’t it?”


Sponsor Updates

  • Meditech adds a Hypertension Management Toolkit to its Expanse EHR.
  • Health Catalyst announces that former UPMC CFO Rob DeMichiei will join its board as a strategic advisor.
  • Clinical Computer Systems, developer of the Obix Perinatal Data System, will exhibit at the AWHONN Missouri Section Conference March 5 in Chesterfield.
  • The Greenville Chamber honors OmniSys founder Jerry Ransom with its 2019 Worthy Citizen award.
  • Experian Health will exhibit at Quorom Solutions Expo March 4 in Litchfield Park, AZ.
  • Phynd adds six new health system clients in Q4.
  • Impact Advisors is named a Workday Alliance Services Partner.
  • Redox releases a new podcast, “Using transportation to improve healthcare access and outcomes with Ankit Mathur of Roundtrip.”
  • Relatient will exhibit at Nextech Edge March 5-7 in Orlando.
  • Surescripts will exhibit at the 2020 PBMI National Conference March 2-4 in Orlando.
  • Rare disease patient data platform Raremark partners with TriNetX to bring more clinical trials to its community.
  • SAS Health integrates Wolters Kluwer Health Language portfolio of data-quality solutions with its analytics software.

Blog Posts


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Contacts

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

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Weekender 2/28/20

February 28, 2020 Weekender 1 Comment

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Weekly News Recap

  • HIMSS announces that HIMSS20 will continue as scheduled with added on-site precautions to address coronavirus-related concerns.
  • Medical chat service K Health raises $48 million in a Series C funding round.
  • MIT Technology Review announces its 10 most promising breakthrough technologies, which include hyper-personalized medicine and AI-discovered molecules.
  • The VA says it hopes to go live with Cerner at its first site in July 2020, months after the originally announced date.
  • AMA releases a patient records access guide for medical practices.
  • HHS and ONC publish a report on reducing the provider burden of health IT.

Best Reader Comments

Shame on the state health system hiring Vendor A without a thorough background check of their employees and shame on Vendor A for hiring 1099 contractors who work for other companies that are bidding for the Epic work. I’m not an attorney; therefore, I don’t know if this is illegal vis-a-vis taxpayer’s or anyone’s money. However, it sure smacks of unethical practices. Independent HIT advisory consultants should have NO ties to any HIT companies, period. (Woodstock Generation)

Being in an enclosed space with 40,000 of your closest friends and their dirty germs with uncertain handwashing habits takes its toll. If they moved it to April I think we’d all be better off anyway, maybe something to think about for next year. (HIT Girl)

The entire clinical informatics community depends on places like Vanderbilt to advance the field. To see how they have restructured and refocused after their Epic implementation is exciting. We all benefit when an institution embraces their system and sets aside resources for clinical informatics research on it. (Andy Spooner)

Vendors should always compensate healthcare providers for their data with equivalent value in some form or another, including product discounts, in order to remain legally compliant. (Grant)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Mr. L in New Mexico, who asked for programmable robots for his sixth grade class. He says, “From your generosity, students collaborated in learning coding software, developed an understanding that making mistakes can be fun, and that by sharing laptops and robots, everyone could participate. Students had to figure out and practice several math concepts such as angles, degrees and decimals. On Saturday, January 18, 2020, students participated in a Play Shop or Robotics Workshop on the Northern New Mexico College campus. At this Play Shop, a daughter managed to teach her father coding, and a son demonstrated how to navigate a robot through a maze to his father. This resource provided a positive moment for fathers to participate in the learning process. Moments like these will always be cherished by the family. And what about hanging out with your best friends in the classroom and on a college campus? As you can imagine, there were smiles and clapping when a student opened the package containing the robot. Everybody wanted to be the first to touch and code the robot. The next steps will be to continue to share the robot, learn much more of the coding during the day and after school, participate at a RoboRave Rally on the Northern New Mexico College in March, and to participate in the RoboRave Regional Competition.”

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People are following homemade YouTube and Facebook instructional videos to perform at-home fecal transplants, which include instructions on how to find a donor and the proper use of kitchen appliances for mixing (you might want to pass on their dinner invitations).

An ophthalmologist sues a former employee for $2 million for posting a negative Yelp review that accused the doctor of making patients return for unneeded extra visits to inflate bills. The employee, who left after two months on the job, had signed an employee confidentiality agreement (thus the breach of contract part of the lawsuit) and refused to take her review down.

Digital health: police arrest a Gulf Coast Hospital (FL) employee after an elderly patient wakes up to find him licking her toes. The man, who was a sitter in the patient’s room, said he dropped his phone under her bed and accidentally touched her while retrieving it. Meanwhile, a woman sues the Florida hospital where she had received emergency mental health treatment, claiming that a male employee groped her and then asker her how much money and drugs she would need to have sex with him.

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HIMSS coronavirus recommendations or not, this is way too weird for me to even consider at HIMSS20. I would prefer the Namaste gesture, Japanese-style bowing, or that up-and-back-once head nod acknowledgment thing, if indeed any physical gesture is really needed to greet a colleague or exhibitor when you’re already looking at each other and saying hello.

Speaking of HIMSS20, Orlando weather is all over the place, with highs around 70 on some days and then 90 degrees expected mid-week. Last year’s weather on March 9 was overcast with a high of 77 and low of 64. You won’t need a coat unless you’re going home somewhere cold.


In Case You Missed It


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Morning Headlines 2/28/20

February 27, 2020 Headlines No Comments

HIMSS Update on the Coronavirus

HIMSS will proceed as scheduled March 9-13, though it will be a handshake-free meeting.

K Health raises $48 million to apply AI to telemedicine

K Health, which offers consumers an AI-powered review of their symptoms and then paid telehealth visits, raises $48 million in a Series C funding round.

New EHR go-live date is July 2020, VA secretary says

The VA gives a new planned Cerner go-live date of July 2020, although Secretary Robert Wilkie has not committed to a specific date.

News 2/28/20

February 27, 2020 News 9 Comments

Top News

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HIMSS provides a coronavirus update for HIMSS20:

  • The conference will proceed as scheduled March 9-13.
  • CDC has deemed the coronavirus health risk for the general public as low.
  • The conference will be a handshake-free meeting, with appropriate education and reminders. In a breaking news development, HIMSS recommends the “HIMSS elbow tap” instead of handshakes, apparently deciding that the Ebola fist bump was due for an upgrade.
  • HIMSS is allowing registrants from Level 3 alert countries (China and South Korea) to cancel. Orlando International Airport will not allow foreign nationals who have traveled to China 14 days before their US arrival into the country, per President Trump’s February 3 proclamation.
  • The cancellation rate is at 0.6%.
  • CDC-established screening will be conducted on site, although details of what than entails weren’t provided. Attendees whose screening suggests risk will be immediately isolated.
  • The conference will have health professionals on site and hospitals available.
  • Hand sanitation stations and wipe-down disinfection wipes will be provided.
  • Information booths will provide medical-grade face masks to anyone who wants them.
  • Facilities will be disinfected throughout the conference.

Reader Comments

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From Takeoff U. Hoser: “Re: UCSF Health. Has sent a letter to HHS supporting the proposed interoperability rule. The same organization provides de-identified patient data to Google for AI training of potentially highly profitable technologies, as was made public this week. That’s an interesting coincidence.”

From Hirepower: “Re: Allscripts. Online rumors say this is Day 2 of three days of layoffs. Any info?” I’ve seen nothing firm, although those unverified rumors say a few folks were let go from TouchWorks and Veradigm. The quarterly earnings report comes out Monday.

From Dollar Bill: “Re: COVID-19. What impact will it have on health systems?” I’m interested in hearing the financial impact that health systems expect. Most people who think they have (a) a life-threatening attack of COVID-19; and (b) insurance that covers their ED visit at minimal personal cost actually have; (c) neither. I think the biggest impact will be on people with insurance who will be left with crippling out-of-pocket costs for deductibles, co-pays, co-insurance, out-of-network costs, etc. It’s early in the insurance year to be running up a big ED tab when your deductible is thousands of dollars. The US healthcare system is rarely your friend, but is definitely your enemy when your expectations of invincibility are expensively dashed. I expect all the usual healthcare profiteers – including health systems – to make pandemic profits. China’s telemedicine companies are enjoying a stock boom from recent coronavirus-fueled usage growth, so there’s that.

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From YouBoob: “Re: ZDogg MD’s Epic criticism. He talks over the CBS news profile.” ZDogg’s music parodies were pretty good back in the day when his Turntable Health clinic hadn’t yet failed and forced him to transition into an Internet celebrity selling “sponsorship, speaking, influencer, and video production packages.” He wields the scalpel of dripping sarcasm clumsily in this anti-EHR video in which he attempts impish cleverness in insulting Epic, its competitors, health systems, doctors, patients, and CBS. I couldn’t stand watching it all, but his main points seem to be:

  • Judy’s $3.6 billion fortune came from patients and health systems that bought Epic at a high cost, “whereas you can pick up an IPhone and pretty much do anything you want, anywhere.” The IPhone reference is just plain stupid (and last time I checked, the folks who sell those do pretty well financially, too) but the question might be what health systems should have implemented if it wasn’t Epic, Cerner, or Meditech (he complains about all three).
  • He scoffs at Judy Faulkner’s statement that Epic has to compete for technical talent against YouTube, Google, and Facebook in hiring developers for its “1990s era software” and built a great campus in the cow fields of Verona, WI to help do that. Every self-appointed expert thinks that anything written before Facebook must be useless by definition, but can never explain why the underlying technology matters one iota to anyone except a programmer who sees the actual source code.
  • “They haven’t made it usable. The client is not a doctor, the client is a health system.” I’m not sure what point he was making here, unless it’s that his peers should stop accepting paychecks from health systems that insist that they use software that meets their business needs.
  • “The only way you can share data from an Epic chart, your data – you’re the patient, you own this data – the only way is if you go to another health system that has Epic.” I’ve never tried this as a patient, but I would be seriously shocked if Epic data has never been shared with a hospital or practice that uses a different EHR.
  • He said this: “If Athenahealth or Modernizing Medicine, both of whom I’ve worked with, or Office Practicum, who I’ve worked with, I’ve done talks for, if they were the largest electronic health vendors in this country, I’d be picking on them too.” I interpret this as meaning that ZDogg cashed promotional checks from other EHR vendors without complaint and they get a free ride because they aren’t as successful as Epic.
  • He also said this: “When we were running Turntable Health, we had our own EHR that we built from scratch with our partners Iora, and patients had access to it, it was problem based, you could have a health coach and a doctor writing in it at the same time, there wasn’t a billing component to it, t was pure patient care. And it wasn’t perfect but it just worked. That’s what we need.” That would be a great supporting argument if (a) Turntable was more than a small primary care practice that didn’t accept insurance; and (b) it hadn’t gone belly up after three years. I share his admiration for Iora Health and the tools that work for them, but to compare their needs with those of health systems is unrealistic. Epic, Cerner, and Meditech have dozens to hundreds of specialty modules that support lab, anesthesia, labor and delivery, surgery, ED, oncology, etc. so any design must accommodate all of those services, not just ambulatory primary care visits.
  • ZDogg is right that EHRs weren’t designed to bring joy to doctors and that the CBS profile is a silly fluff piece (although it was just filler aimed at people sitting around on Sunday mornings watching network TV, to be fair). He’s wrong in forgetting that the job is the problem, not the tools that are required to support it. Doctors sold their independence and thus their right to have software designed to meet only their needs, while health systems are like any other business in being free to buy whatever IT systems they think are best for their organizations and patients. 

HIStalk Announcements and Requests

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Snap poll for HIMSS20 registrants: how will coronavirus concerns change your attendance plans? I included a fake vote option so curious folks can see the poll’s results without having to make a misleading choice. Add a comment after voting if you like.

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I’m always puzzled by HIMSS’s “Conference Deal” emails, which I think they rolled out years ago when Groupon was still a big thing. What’s the “deal” in being invited to see a booth demo?


Webinars

March 4 (Wednesday) 1 ET: “Tools for Success: How to Increase Clinician Satisfaction with HIT Solutions.” Sponsor: Intelligent Medical Objects. Presenter: Andrew Kanter, MD, MPH, FACMI, FAMIA, chief medical officer, IMO. Dr. Kanter will explore how striving to achieve the Quadruple Aim (by focusing on the provider experience) can improve clinician satisfaction and population health needs while also reducing per capita healthcare costs. Attendees will learn how to set providers up for success with new technology, the potential unforeseen consequences of purchasing without the clinician in mind, and the factors that are critically important to clinicians who are using new health information systems.

March 4 (Wednesday) 1 ET: “Healthcare Digital Marketing: Jump-Start Patient Discovery and Conversion.” Sponsor: Orbita. Presenters: Victoria Petrock, MBA, MLIS, principal analyst, EMarketer; Kristi Ebong, MBA, MPH, SVP of corporate strategy, Orbita. Does your digital front door capture consumers who search for health-related information one billion times each day? Do you have actionable steps to convert them into patients? Do you understand voice and chat virtual assistants? The presenters will explore the consumer challenges involved with finding, navigating, and receiving care, discuss why healthcare marketers need to embrace conversational voice and chatbot technologies, and describe how new technologies such as conversational micro-robots can improve engagement.

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


Acquisitions, Funding, Business, and Stock

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K Health, which offers consumers an AI-powered review of their symptoms and then paid telehealth visits, raises $48 million in a Series C funding round. The system, which was trained on patient data from an Israel health fund that is one of its investors, is rolling out a co-branded version for Anthem so that patients can “text with a doctor for less than a co-pay” at $19 for a single visit or $39 for unlimited chats for a year. The company says it has served 3 million users and is now available in all 50 states.

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Spok reports Q4 results: revenue down 9%, EPS –$0.50 vs. $0.01.


Sales

  • Northside Hospital (GA) will implement sepsis-monitoring software from Ambient Clinical Analytics.

People

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Fax and documentation automation vendor Concord Technologies hires Christopher Larkin, MS (Elsevier) as CTO.


Announcements and Implementations

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KLAS surveys 300 people about the patient engagement technologies they use and the changes they would like to see. Patients who see their provider relationship as collaborative value patient portals and technologies that allow them to stay connected without a face-to-face visit, while patients who are more transactional are happier with online bill pay, automated prescription refill requests, provider search, self-scheduling, and eventually price transparency tools. The patient portal is most impactful today because Meaningful Use money got them deployed, but patient adoption is limited and patients would prefer a consolidated version that includes all of their providers and all common functions related to lab results, billing, appointments, and secure messaging. Their second-most desired technology is telehealth. Most interesting to me is that money has driven the process – providers rolled out the minimum patient portal that earned them MU money for “having” rather than “using,” they aren’t about to share information with competitors, and they haven’t shown much interest in making themselves available outside of face-to-face visits because nobody pays them otherwise. They also don’t offer telehealth, leaving patients to use standalone services with doctors they don’t know, which is one possible reason for low usage.

The Providence healthcare system opens an innovation center in Hyderabad, India.


Government and Politics

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The inspectors general at the DoD and VA announce that they will begin conducting a joint audit of efforts by the departments to roll out an interoperable EHR from Cerner. Government officials insist the audit isn’t the result of complaints, but rather an effort to ensure that the EHR modernization will enable interoperability among the departments and private sector providers.

The VA gives a new planned Cerner go-live date of July 2020, although Secretary Robert Wilkie would not commit to a specific date to a House VA committee. Programming has been completed for just 19 of the 73 required interfaces.


Other

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In Canada, Vancouver-based RealWear partners with Chinese technology company Tencent to adapt its headsets for medical use, giving healthcare workers on the frontlines of the COVID-19 outbreak in China access to hands-free, voice-activated software that offers remote viewing and connects to Tencent’s WeChat app.

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MIT Technology Review announces its 10 breakthrough technologies for 2020.

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Georgia’s lieutenant governor says it’s not improper that he talked about selling a health IT application to health and wellness platform vendor Sharecare, which is paid $14 million per year to run a digital health program for state employees. The talks didn’t pan out. Geoff Duncan is a former CEO of employee wellness technology vendor Wellview Health and remains a company director.

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Wired looks at the ways Chinese radiologists are relying on AI from Infervision to screen for COVID-19 symptoms, especially pneumonia. Software originally developed to detect cancerous nodules in lung scans has been repurposed by hospitals that are overwhelmed with patients.


Sponsor Updates

  • Elsevier will use Global Medical Device Nomenclature data to provide important clinical and vigilance information on medical devices.
  • EClinicalWorks will exhibit at the AAPM Annual Meeting through March 1 in National Harbor, MD.
  • Redox partners with Welldoc, giving providers the ability to view data from users of Welldoc’s BlueStar diabetes management app from within their EHR workflows.
  • The Chartis Group names David Howard (Grant Thornton) director and practice leader for its ERP and Technology Innovation practices.
  • Hayes Management Consulting will work with search and AI-powered analytics vendor ThoughtSpot to develop revenue cycle and compliance solutions for providers.
  • Wolters Kluwer Health Language publishes a new executive brief, “Unlock Your Data: Prepare Your Organization for the New Era of Transparency.”
  • Healthcare Growth Partners advises Symplr in its acquisition of The Patient Safety Company.
  • Healthwise will exhibit at the HealthTrio User Group Summit March 2-4 in Tucson.
  • Hyland completes its acquisition of Streamline Health’s enterprise content management business.
  • Imprivata further expands identity and access management capabilities for the UK healthcare market with the launch of its new Identity Governance solution.
  • VentureFizz features a “CxO Briefing” with Kyruus CEO and co-founder Graham Gardner, MD.

Blog Posts


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Contacts

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EPtalk by Dr. Jayne 2/27/20

February 27, 2020 Dr. Jayne 1 Comment

I’m always on the lookout for good outcomes from all the work that goes into EHRs. I enjoyed reading about an EHR “nudge” that was shown to reduce inappropriate testing for the nasty C. difficile infection. The system flags patients with contraindications to testing and the authors looked at data across four hospitals ranging two years before and after the intervention. The percentage of inappropriate orders fell by 2% with the intervention, and overall orders were down 21%.

I attended a medical seminar this week and was surprised that no one is modifying their behavior in response to flu season or even fears of coronavirus. Still a lot of hand shaking going on and a couple of people gave me the side eye when I declined to shake hands. I guess everyone has forgotten the pandemic flu of 2009 when everyone was doing elbow bumps instead. CDC has raised their level of dialogue around coronavirus preparedness and HIMSS has followed suit by announcing it will be a handshake-free meeting. I anticipate some other behavior changes around whether people will accept samples of food or candy and whether people will even want to travel to such a large event. HIMSS notes that registrations are up over 2019 and the cancellation rate is below 0.05%.

Still, HIMSS has announced its preparedness plan, including collaboration with ED physicians, onsite support from the Florida Department of Health, onsite screening and isolation as needed, and more. They plan to have three medical offices at the convention center, with one of them dedicated to flu-like symptoms. There will also be an increased number of hand sanitation stations, increased wipe-down of commonly used surfaces, and the availability of medical-grade face masks at the information booths.

That’s more masks than I currently have at my office, which makes me sad. I’m a bit of a prepper already, so making sure I have enough personal supplies stocked in wasn’t a stretch, and I’ve warned my younger colleagues who rely on DoorDash and GrubHub for every meal that they might want to consider having at least a small ramen noodle supply at home. The next couple of weeks should be interesting.

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CDC is also circulating their infographic about the proper fit for high-end masks. I had no idea some of these facial hair styles even had names.

Anyone who has ever worked in hospital IT knows the fear that an upcoming visit from The Joint Commission strikes into the hearts of coworkers. There are many accrediting organizations out there, and often they are cited as the source of rules and regulations that don’t actually exist, leading to frustration for operational and technology teams alike. A recent report notes that CMS plans to strengthen oversight of accrediting organizations due to concerns about conflicts of interest. Some of the organizations provide both accreditation and consulting services which can be an issue, and CMS Administrator Seema Verma also called out accrediting organizations that use standards that are different from the CMS conditions of participation. The Joint Commission is one such organization that has created requirements above and beyond the CMS standards.

Verma also mentioned the upcoming Meaningful Measurement 2.0 program, which is a follow-up to the 2017 Meaningful Measures program. (Language nerd side note: Why did they have to change it from Measures to Measurement? That’s going to be annoying.)

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There are strong feelings out there about the way that technology is escalating the medicalization of things that were previously “normal” physiological process. From smart toilets that analyze stool patterns to diet and nutrition trackers, technology is everywhere. I’m part of an online group that mentors young mothers and nearly everyone either has or wishes they had a multi-hundred dollar smart bassinet to help their babies sleep better. A recent Washington Post article looked at the impact of AI baby monitors on nervous parents. It’s gone beyond the walkie-talkie style units of the past, with camera systems that transmit data to parents while they are away and also those that process the video to determine whether infants are in risky positions or getting tangled with blankets. Privacy advocates are concerned about the sharing of such private data and clinicians are worried that monitor companies are promising a level of safety that is not supported by research.

I’ve definitely noticed a heightened level of anxiety in the moms in my group, although I recognize that to some degree it might self-select anxious mothers since they’re participating in the group in the first place. Some of them are desperately trying to track and quantify every element of their babies’ existence, from feeding to diapers, sleep, and developmental milestones. I’ve seen mothers who have lost the ability to trust their instincts and are relying too much on data.

It’s similar to when physicians are in training and have to learn to “treat the patient, not the numbers.” The privacy issue is certainly a big one, with parents having no control over the images of their children once they’re transmitted to the vendor. Definitely food for thought.

Speaking of the quantified self, approximately a third of fitness trackers are abandoned after a while, winding up in nightstand drawers or the landfill. Recycle Health, affiliated with Tufts Medical School, has collected more than 5,000 wearables for redeployment to exercise and nutrition programs for low-income patients. Vendors have gotten into the act, with Fitbit, Fossil, and Withings sending excess inventory. Apple has not donated. In addition to individual donations, they also gather unclaimed lost devices from theme parks and tourist sites, which is a novel approach. Corporate wellness programs donate as well.

In other wellness news, recent research shows that odd-shaped parks may be better for public health. The authors used satellite imagery, cause of death statistics, and residence near a green space larger than 900 square feet as indicators. They found a decrease in deaths for every percentage point increase in green space. They found that irregular parks were beneficial because they might be more appealing to be in, or might be easier to stumble upon compared to formal parks with limited entrances. Complex-shaped parks were also linked to reduction in chronic health conditions. Recommendations for civic planners include finding ways to connect small or fragmented parks via greenways or other natural features.

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I always enjoy when a scholarly publication has a sense of humor, and a recent article in the Journal of Surgical Education did not disappoint. In “The Sorting Hat of Medicine: Why Hufflepuffs Wear Stethoscopes and Slytherins Carry Scalpels,” the authors surveyed surgical coordinator and residents to score various personality traits that tend to define medical specialties. There were more self-reported Slytherins in surgical subspecialties, particularly in orthopedic surgery. Family medicine had no Slytherins, which is not surprising. I don’t think students are going to start selecting their specialties based on their Hogwarts sympathies, but it was an amusing read.

Lots of chatter among the scribes in our office this week as the folks at Mayo Clinic Medical School mistakenly sent acceptance letters to 364 applicants. The school is blaming it on a technical glitch and said that as soon as they knew about it they withdrew the offers via email. Everyone affected has also been contacted by phone. The letters went to everyone who had interviewed, and there are typically only 46 actual spots available for students, with initial offers usually being made by phone.

The medical school admissions process isn’t something I would wish on anyone. It’s an emotional roller coaster and it’s expensive. Based on the fact that they were invited to interview, the applicants affected are generally qualified to attend, and I feel bad for them.

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I got a chuckle out of reader Matt’s comment on my post about HIMSS shoes. He recommends HOKA, but notes that “they’re not inexpensive so you may have to add laser hair removal to your practice, add retail vitamin sales, or go into orthopedics.” You have to love a company that has a shoe named “Speedgoat” and their color combinations are certainly appealing.

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Morning Headlines 2/27/20

February 26, 2020 Headlines No Comments

Joint Audit of the Department of Defense and Department of Veterans Affairs Efforts to Achieve Electronic Health Record Interoperability

Inspectors general at the DoD and VA will conduct a joint audit of efforts by the two departments to roll out an interoperable EHR.

Ribbon Health Raises $10.25 Million; Launches Cost And Quality Solution

Ribbon Health raises $10.25 million and announces GA of health data aggregation software that can be used to bolster provider directories, referral management, and care navigation for providers, payers, and digital health vendors.

Spok Reports Fourth-Quarter and Full-Year 2019 Operating Results; Wireless Trends Continue to Improve; Sequential Improvements in Software Operations Bookings and Expense Management Trends

Clinical communications vendor Spok reports a slight dip in software bookings and revenue on the heels of the launch of its Spok Go technology.

First-Time HIMSS Attendee Tips

February 26, 2020 News 3 Comments

From Mr. H (reader thoughts follow)

“What tips do you have for a first-time HIMSS conference attendee?” a physician researcher asked me via LinkedIn after her employer approved her attendance at the last minute.

I instantly thought of Vietnam war movies, where the fresh-faced recruit asks the battle-hardened veteran (he looks like R. Lee Ermey from “Full Metal Jacket” except unshaven and gaunt), what’s it like to be in combat? I’m not sure anything I can say will prepare her for the front lines. You just have to experience some things firsthand and do the best you can.

The biggest and truest cliché about the HIMSS conference is the “three blind men describing an elephant” analogy. The conference offers many tracks, experiences, and opportunities to network. Your HIMSS20 won’t be similar to my HIMSS20 except for some keynotes (assuming I go, which I usually don’t) and way too much time spent roaming aimlessly in the exhibit hall. It’s like one of those hipster-trendy food halls crammed with wildly different restaurants and bars that share only a common seating area. HIMSS20 will be 25 unrelated conferences that share only an exhibit hall.

Which is my first observation. The conference is really a boat show that is surrounded by just enough semi-educational opportunities to convince provider attendees that they aren’t stealing from their employers when they expense the whole junket. Exhibitors foot the bills, so it’s like a Las Vegas hotel – no matter where you want to go, you have to walk the intentionally winding path through the casino, or in this case, the exhibit hall.

I tell attendees to set their dials on three conference activities that compete for their time — education, exhibit hall, and socializing. Decide upfront what you would like to gain from each, hopefully with your expense-bearing provider employer and their patients in mind. What combination of  new industry education, specific product and company knowledge, and fond memories of eating, drinking, and shouting too much would make HIMSS20 a success? Are you really planning to accomplish actual work there, or is it just your employee bonus with few strings attached?

I admit that I nearly always leave HIMSS conferences feeling guilty that I mostly goofed off, or at least used my time inefficiently despite higher initial ambitions. I always vow to attend an ambitious list of education sessions and to perform serious vendor research, but I end up walking zombie-like miles of deep exhibit hall carpet filling up my trick-or-treat bag with vendor ChapStick and pondering just how cheaply I value my time. Or I sign up for some vendor party in picturing a grand evening under swaying Orlando palms that sounds swell in winter’s dark back home, but realize once I’m there that parties really aren’t my thing and I’d rather feed my introversion some quiet time.

I’m too lazy to put a lot of thought into my HIMSS conference advice, so I’ll divide it into two parts. First are my off-the-cuff thoughts, then the suggestions of readers who chimed in at my behest (because it’s less work to ask them to come up with ideas than me doing it myself.)


Before Leaving Home

I’m speaking to my fellow males here. Get a pedicure the week before the conference. I admit that I was squirming with discomfort the first time Mrs. HIStalk insisted that I get a pre-HIMSS foot tune-up. She made me a bourbon and lemonade in a Solo cup that I brought in with me for liquid courage (which was actually pretty cool at 11 a.m.) She had her nails done in the adjacent chair and tolerated my trite newbie observations about why nail techs are always from VIetnam and how it’s odd seeing a roomful of women all staring longingly at their phones while having their feet worked on by another woman. But it was shocking how much calloused, dead skin they shaved off with the cheese grater and how my walking and balance improved in return for my $30, which included a sugar scrub and hot stones that seemed pointless but felt good.

Pack a backpack or briefcase. You’ll get a free one when you pick up your badge, but the one they handed out last year was useless. Your bag will serve as a temporary home for vendor collateral, which you take in a moment of either camaraderie or temporary interest and then toss into the trash when packing for home.

Bring a phone charger battery. Phone batteries drain fast when slugging it out for a signal in packed rooms. Use low-power mode if you think of it.

Wear comfortable clothes, especially shoes, unless impressing someone is on your list of activities. Don’t wear anything that won’t get you through 10 miles of walking and standing each day. Forget high fashion unless you’re working a booth or interviewing for a job — nobody will be impressed that you busted out your high heels or best suit for walking a half-marathon each day (literally in many cases) on exhibit hall carpet.

Bring business cards, especially if you are among the significant percentage of attendees who are hoping to get a better job than the one provided by the organization that covered their attendance expense (ironic, isn’t it?) 

Getting There

Drive your own car instead of flying if you’re within a 12-hour car ride. I dislike the inefficient stress of flying for business, crammed into tiny seats surrounded by sugared-up, screaming kids wearing Mickey Mouse ears or testosterone-jacked tire salesmen heading off to their Las Vegas hooker and machine gun getaway. The elapsed time from leaving for the airport to setting foot in your Orlando lodgings may not be much less than driving, especially if your flight isn’t direct.

I think of driving as an extended meditation session, where I let Waze tell me what do while I reflect on life in general. I don’t worry about overweight or lost luggage, missed connections, security lines, and the mile-long cab line at MCO. I can leave the conference for home whenever I want, which is important since I usually bail out even earlier than I planned.

I hate milling around sterile HIMSS hotels with all the other nerdy, badge-wearing lemmings, so I always book a condo via Aibnb or VRBO. It feels much more like home or a vacation than solitary confinement and it costs less than a hotel.

Staying There

Hit the nearest Publix for full week’s worth of food and drinks. You’ll spend about the same as you would for one hotel dinner or room service. Then come back to your condo, savor the attendee-free quiet, and enjoy time in front of Netflix, the lake, or a local bar where tourists never tread (having your car provides options).

When you buy those groceries, get breakfast items and snacks. You’ll save time and money eating breakfast before you head out each morning and a granola bar will get you through the mid-morning, low-glucose woozies. You’ll save even more time and money by drinking your coffee while relaxing in your condo instead of staring at the suited butts of 500 of your fellow caffeine addicts who are ahead of you in the Starbucks line. Bonus points if you bring an insulated cup and take extra coffee to the convention center for more deliberate slurping.

Check out the HIMSS bus routes since your rental place may be near a stop and thus your chariot will await. HIMSS says the buses are only for people who booked their hotel through HIMSS, but the driver doesn’t care. Prepare for frustration, however, especially on the first day of the conference when everybody is headed to the convention center at the same and the full buses drive by without stopping. Going home can be a chore if your stop is way down on the list. Bus stops aren’t usually covered, so if it’s raining in the morning, call an Uber or Lyft to avoid starting your day bedraggled and wet.

Once you’re on your way home to your hotel or condo, take off your badge and put it in your non-HIMSS backpack to create an instant shield of anonymity. Breathe deeply as a traveler, not as an identically labeled conventioneer or obvious tourist. That smell is freedom.

Education Sessions

I don’t attend sessions in which any speaker is a vendor (sorry, “market supplier.”) I don’t doubt their commitment or intelligence – I have just been burned too many times by speakers who recited the company line or whose world view bore little resemblance to my reality. Seek them out in the exhibit hall presentations instead, where the audience is smaller, the topic is more focused, they can talk more about their company and competitors, and you don’t waste a full hour in a packed conference room. I sometimes enjoy those exhibit hall talks, which is rarely true of the big room sessions.

Choose sessions based on who’s presenting rather than topic. Interesting, insightful presenters can make any topic worthwhile, while under-accomplished slide-readers can’t save even the most contemporary presentation from becoming a snooze-fest. It’s hard to separate the wheat from the chaff, however, since the native language of some big industry names is “platitudes,” while some fearless no-names might actually express some original thoughts.

Attendees get audio recordings of most sessions after the conference at no charge, so you don’t have to physically attend everything. Or anything, for that matter. Just play back what seems interesting afterward at double speed. You don’t even have to climb across 50 sets of legs to escape a dud session. Try not to think about the cost and effort involved in traveling to the conference that brags on “education” that could have been distributed as MP3 files.

Sit where you can escape easily if the session bombs in the first five minutes, which is usually the case. Remember that the presenters had to submit their talk many months in advance, so not only is their content stale, they have over-rehearsed and end up reading their slides like a “follow the bouncing ball” monotone sing-along. I have no patients for presenters who write out full sentences as bullet points, read them in a grade schooler sing-song, turn their backs on the audience to look at the screen, and add zero value to just reading the PowerPoint printouts on your own.

Leave as soon as the presenter is finished since the Q&A attracts suck-ups who have no questions, only statements in which they attempt to demonstrate the depth of their knowledge. You’ll see them creeping up to the microphone before the speaker is even finished, oxygenating with deep breaths so they can at first opportunity rattle off a multi-minute pontification without coming up for air or asking an actual intelligent question (I’ve seen them spew their self-congratulatory nonsense and then leave the room before the speaker even finished answering them, seriously). Don’t try to make your way to the podium for glad-handing the speaker when they launch their uninvited monologue because you’ll get run over by the masses who are running faster for the doors than if someone shouted “Fire!”

Have a backup session in mind in case the room is packed or the handout looks less interesting that you thought. I usually just pick something randomly in a nearby conference room since it won’t disrupt my planned, miles-long route from one room to the next. Some of the best sessions I’ve attended were ones where I just stumbled into the first room with a lot of empty chairs.

Lunch

Bring something from your rental condo refrigerator or plan to eat really early. Every convention center food outlet will be mobbed throughout the hours that might be considered lunch, say from 11:00 a.m. to 2:00 p.m. You will pay $12 for a chicken Caesar salad in a plastic coffin that is handed over by a clearly unenthused worker, after which you will sit on the floor in an unused corner of the building because every single table, chair, or flat surface on which you or your food might have been placed has been appropriated by an equally desperate attendee seeking horizontality. It’s the casino analogy again – vendors want you roaming the exhibit hall, not lingering over your sandwich and telephone on a comfy chair, so chair-seekers outnumber chairs by about 100 to one. On the other hand, feeling like an outcast grade schooler in the cafeteria is humbling, and quite a few attendees could use a serious dose of that.

Lunchtime frustrates me more than any other time during conference week. It takes way too much time, the food is mostly not good and usually unhealthy, I hate scouting for a freshly vacated seat at a debris-laden table full of people screwing around on their laptops trying to look important, and I end choosing the food venue with the shortest line and quickly realize why the crowds went elsewhere. On the other hand, one Orange County Convention Center food stand remains easily the best I’ve ever had at a conference, with food that is fresh, ample, and more cutting edge. Its existence is binary – it is either closed or packed with people – but I still think of that place years after I last ate there. I’m not telling you which one because longer lines will send me fleeing to yet another greasy personal pizza from a chain I would never patronize at home.

Exhibit Hall

Decide what do you need from your exhibit hall experience. Fake adulation from booth people who see you as either a sales prospect or an insufferable bore who is fun to jack around? A celebration of your admirable existence that allows you to earn a salary for wandering through neon gulches of unreality while fueled by free snacks? Actual information in the form of product and vendor research, at least while waiting for exhibit hall happy hour to kick in?

What I like about the hall is that whatever you learn there sticks. You probably won’t forget what you were told. I also like that I’m in charge of choosing what interests me and walking away when I lose interest (just tell the overzealous rep that you’re running late for a scheduled meeting, never mind that it’s 9:43 a.m.) Most of the reps are nice people and are just as bemused as you by the futility of creating a meaningful exhibit hall experience, at least when they aren’t staring at their phones in boredom or in anger that they have no chance of earning commission given the heavily non-decision maker HIMSS attendance. Just don’t let the time get away from you in wandering around. It’s easy to feel like you are networking and learning while high on carpet glue and salesperson cologne, but afterwards realize that it was mostly an illusion.

I’m a contrarian in refusing to schedule meetings with vendor people. Schlepping a mile to their booth can eat up more time than it’s worth. Just show up when you feel like it and risk that you’ll have to talk to a lesser god, knowing that it’s their job to be flexible when a customer or prospect is involved. They’ll find you.

Seek out the little booths in Siberia, or at least stop paying lip service to disruption and innovation if you are embarrassed to be seen in a booth that doesn’t feature an attended espresso bar and foot-deep carpet that’s crawling with glad-handing suits. Visit booths whose size is inversely proportional to the degree of risk your organization historically accepts  — employees of risk-averse health systems (was that redundant?) might as well stick to the main aisles because there’s no way they are buying anything from people in 10×10 booths like I used to pay for.

The exhibit hall is a meat market for people trying to get new jobs. Reason: because it works, especially if you work for a vendor or would like to.

Social Events

I long ago decided that I’m not willing to sacrifice an entire evening jostling around strangers just to earn a couple of beers and to hear the most inoffensively white-bread music imaginable, but that’s just me. Social events abound, and listen closely through the day and you’ll heard about them. Some require a vendor’s invitation and thus a sneaky strategy to obtain one as a non-prospect. Vendor employees aren’t welcome to most events since nobody wants to pay to entertain competitors, which is why HIStalkapalooza was such as success even if it was a huge pain to manage.

I usually skip the HIMSS opening reception because it’s too big, too loud, and too boring, especially when the conference is in Orlando and the entertainers are Disney day-jobbers channeling Cirque du Soleil. Still, it’s like the clock in Grand Central Terminal as being a good place to pre-arrange meeting colleagues on fly-in day, and with the retirement of the old two-drink ticket system, it’s fun to watch ever-louder attendees getting hammered before they’ve even checked in to their hotels.

Don’t do anything that would embarrass your employer if you are wearing  a badge with their name on it. Whether that means behaving or taking your badge off is your call.

The Last Day

I rarely stay for the final day since it’s short and usually pointless, especially since the exhibit hall isn’t open (and HIMSS without the exhibit hall isn’t exactly a thrill ride). However, it’s also a relaxing, no-pressure day and maybe you’re sticking around to avoid the departing masses. I usually enjoy it, although my expectations are modest. It’s tougher to find food venues, though. An even better idea is to take a two-hour drive over to Florida’s west coach beaches and eat a grouper sandwich on a restaurant’s Gulf-front patio, then leave at your leisure over the weekend.

Wear your most obnoxiously casual (and therefore comfortable) clothes on the last day you’re attending. Nobody cares at that point, assuming they ever did, and you may be heading straight to the airport. Now’s the time for shorts, Hawaiian shirts, and sandals since it’s Florida (change into warmer clothes in the bathroom if you’re going home to freezing weather). Plus people might mistake you for an investor — a valuable HIMSS lesson is that the startup guys who need investor money dress look like children whose parents made them dress up for a formal British wedding, while the people who actually have money look like they just popped in from a members-only golf course or a bottomless mimosa breakfast buffet.

Back Home

Don’t be depressed because you think that you or your employer are underachievers compared to the swaggering experts you saw riding the podia or vendor lecterns. Most of those people are harmless blowhards working for organizations that are just as clueless as yours. Being an effective, innovative provider organization in the dysfunctional US healthcare non-system is like being the tallest jockey. You are probably just as effective as anyone else, just less skilled at bragging.

Make up a convincing answer when your boss and co-workers ask you how the conference was. You have to make them think you were working as hard in Orlando as they were back home.

The Part Where I Get Less Cynical

Go home with new energy and commitment. If watching an A-Rod keynote or eating too many exhibit hall pastries does it for you, then that’s your business.

Embrace the diversity of attendees who are young, from other countries, and who consider themselves caregivers first. It wasn’t that way for most of the formative years of HIMSS.

Expect vendors and their employees to be enthusiastic about their products and services. Agree or not, you wouldn’t want them there otherwise.

Perfection is the enemy of good. Don’t get dragged down because EHRs, interoperability, the government, and your employer aren’t perfect. Don’t let anyone convince you that they offer something perfect, either. We are all making it up as we go and nothing about your careers is likely to earn a spot on your tombstone.

Respect the truly remarkable result of HIMSS people who spend years planning every conference so well that you don’t even notice the work involved. Nothing you will see or do happened without a lot of planning, arguing, executing, and monitoring. Every memory you take home was made possible by someone who sweated the details.

Patients make the industry, the conference, and your job possible. Be a good steward of the resources with which you’ve been blessed and always ask yourself, what would patients want? Find another job if it’s just another job.


From HIStalk Readers (add your own comments below)

Set up meetings ahead of time.

Search out patients or patient advocates.

Go to as many educational sessions as you can.

Make the most of interactions – in line, on the bus, while grabbing coffee, when attending sessions. So much of HIMSS is about making connections, sharing interest and becoming engaged with one another and the opportunity to do so is all around you. Follow up with a LinkedIn connection request or a Twitter follow.

Plan for curiosity. HIMSS is hectic and a pre-planned schedule will help you remain focused but do schedule time to be engage with last minute vendors, sessions, conversations that spark your interest.

Let vendors know you want to demo or attend in-booth activities to maximize your time on the show floor. Most vendors offer pre-scheduling tools via email and/or their website to facilitate this; use it.

You’ll miss many things. Sign up for post-HIMSS webinars and seek out blogs for what you missed and insights on this year’s topics- HIStalk of course being among the most useful sources of HIMSS coverage.

Many vendors offer breakfast briefings, lunches and social events, all of which are additional means of expanding your learning and networking without missing educational sessions.

Follow #HIMSS20 across LinkedIn and Twitter.

Attend your HIMSS chapter event.

Hand sanitizer is your friend. Apply frequently and liberally.

It has become a humble-brag for established companies, a hot air balloon ride for smaller ones. I genuinely think they forgot about mid-sized ‘buyers’ along the way, especially end-user doctors. It’s insular, it’s full of self-promoting blow-hards, it really lacks any actual value from almost any perspective.

If you see someone on jeans, they are probably financing most of the ‘cool’ startups you are seeing. People in suits have the real jobs.

As a researcher, just let us all know when you find novel technology that has actually conducted research on the outcomes / benefits of their solution. Because in 14 years of attending, I never once saw actual research, just a bunch of cherry-picked stats provided by a ‘beta’ client that was generously compensated for the data. (and yes, reduced fees for a product is compensation, IMO).

Morning Headlines 2/26/20

February 25, 2020 Headlines No Comments

AMA playbook to aid record-sharing with patients

The American Medical Association releases its Patient Records Electronic Access Playbook, which aims to dispel HIPAA myths and help practices understand their patient records request obligations.

Prepared Health is now Dina

Prepared Health rebrands as Dina, the name it previously used for its digital assistant that analyzes patient assessments from home and makes evidence-based recommendations.

Nuance Announces the General Availability of Ambient Clinical Intelligence

Nuance announces GA of Dragon Ambient Experience (DAX), its “exam room of the future” where “clinical documentation writes itself.”

News 2/26/20

February 25, 2020 News 8 Comments

Top News

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The American Medical Association releases its Patient Records Electronic Access Playbook, which aims to dispel HIPAA myths and help practices understand their patient records request obligations. Some points:

  • Physicians must allow patients to connect their health apps to the practice’s EHR.
  • Deploying a patient portal don’t necessarily make a practice HIPAA compliant.
  • Medical images must be provided if they are stored in the practice’s system, even if they originated elsewhere.
  • Practices are required to provide patient information only in the “readily producible” form; they are not obligated to pay an EHR vendor for new capabilities. However, they cannot give paper or PDF copies just because they don’t know how to use available electronic options.
  • EHRs that are certified under 2015 Edition criteria must provide API access, the ability for patients to view and download their information online, and an option to send information via secure email.
  • Practices cannot refuse to send information to a patient via unsecure email or insist that they choose another delivery method, as long as the patient acknowledges the security risk verbally or in writing.
  • Information should not be copied to the patient’s own USB drive because of malware risk.
  • Patients must be given the ability to view, download, and transmit their information within four business days of their request and to receive copies within 30 calendar days (with an optional 30-day renewal). More stringent state laws are common and override HIPAA defaults.
  • Third-party requests, such as those from life insurance companies, are not subject to the HIPAA right of access requirements.
  • Patients can be charged the lessor of state-specified “reasonable” fees or the practice’s actual copying costs, including employee time, media costs, and postage. Practices should not charge a retrieval or records maintenance fee.
  • The report includes forms to calculate the cost of providing medical records copies, a list of state-allowed medical records copying charges, and sample forms for patient requests and the practice’s response.

Reader Comments

From Concerned Vendor: “Re: HIMSS20. Companies across the globe are pulling out of industry conferences. The vendor and provider community needs to put pressure on the HIMSS organizers to cancel or at least postpone HIMSS20.” I don’t think that cancelling HIMSS20 two weeks out is logical, from either a public health or a business point of view. I’ll defer to epidemiologic experts, but avoiding public gatherings and using US border security as a protective moat probably won’t help much (HIMSS says less than 1% of registrants are from countries that are under a travel ban). It’s late in the game to consider cancelling or rescheduling when it’s a domestic trip for the majority of attendees and the odds of problems are low. The conference is the primary money generator for HIMSS; people have already paid for hotel rooms, flights, and other non-refundable travel items; and conferences stay on schedule during much deadlier epidemics, such as the flu. There’s no way HIMSS20 could simply be rescheduled given the years of planning required. HIMSS should:

  • Offer free respiratory masks and perhaps handkerchiefs (exhibitors, there’s your last-minute giveaway idea, especially if you put fun slogans on the masks to make them less ominous). It’s going to be weird to see the convention center full of people whose faces aren’t visible, at least if you aren’t from Asia where masks have been common for a long time, but we’re medical people after all.
  • Put out plenty of handwashing stations and hand sanitizer squirt stands.
  • Encourage attendees to use Ebola-nostalgic fist bumps instead of handshakes.
  • Suggest that immunocompromised registrants consider the possibility of added risk.
  • Make sure people know that medical teams will be on site and hospitals will be on call.
  • Urge attendees to stay in their hotel rooms if they have flu-like symptoms. The good news is that unlike some other infections, transmission risk seems to run parallel with symptom severity, so COVID-19 being spread by people who don’t know they are sick seems unlikely, and few examples of person-to-person transmission have occurred in this country.
  • Avoid checkpoints and mandatory thermometer gun inspections since they don’t work well.
  • Calm everyone down with a reminder that our only majorly deadly communicable disease outbreaks in the past 100+ years US were AIDS in the 1980s and Spanish flu in 1918 (which wiped out a third of the world’s population). Hysterical media coverage aside, swine flu, bird flu, Ebola, SARS, MERS, Zika, etc. were not big killers and have been mostly forgotten. Worry more about interruption of our drug supply chain, which is more driven by China’s steps than ours.

Meanwhile, feel free to cast unpleasant looks at anyone who sneezes or coughs without covering – droplet exposure is the biggest risk. Skip the theme parks if you have global paranoia. The latest sitreps show that we’ve had only a few dozen COVID-19 cases in the US, nearly all of those being returnees from Diamond Princess or recent trips to China, and nobody has died. Meanwhile, the media-unsexy plain old flu has this season caused 29 million US illness episodes, 280,000 hospitalizations, 16,000 deaths, and zero calls to cancel HIMSS20. Perhaps a measured, long-term approach would be to question whether the cost, effort, and carbon footprint involved in dragging people to a specific building to talk about technology (such as remote visits and online digital services, ironically) are worth it even without outbreak threats.

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From Illuminati: “Re: Atrium Health. All of Atrium’s primary enterprise (Carolina Medical Center and most of Atrium-owned facilities) have been using Cerner Millennium EMR for years and added Epic revenue cycle about four years ago. That last piece, allowing Atrium to use revenue cycle without Epic clinicals, is unique. It allowed Atrium to buy licenses to all Epic products, implement the full suite in some managed facilities, and then offer it to Navicent. It was also attractive to the full primary enterprise. It’s a big loss for Cerner, but it took a few years and Epic was already more widely deployed on the acute care side than Cerner.”


HIStalk Announcements and Requests

A reader who is a physician, researcher, and professor got last-minute approval to attend the upcoming HIMSS conference as a first-timer. She messaged me for any tips I might have. Your assignment is twofold: (a) send me useful, lesser-known tips — we all know to wear comfortable shoes – of the type that clickbait sites might refer to as “hacks,” especially anything that is pertinent to her specific background; and (b) let me know if you want to extend an invitation to her for whatever velvet ropes you control, be they social or educational, that would enrich her experience. I’ll write up the tips I receive plus my own in the next day or two. I admit that my ego soared in an impostor syndrome kind of way when I saw her wealth of clinical credentials on LinkedIn along with her being in the HIStalk Fan Club group that reader Dann set up forever ago (and noticing that the group has 3,700 members).

Give me some advice here. A reader alerted me to a potential conflict of interest with large, state-funded RFP in which Epic consultants are to be engaged. The health system hired Vendor A in an advisory role to manage the selection, and quite a few of Vendor A’s people were involved in various committees and oversight groups. Some of Vendor A’s employees are actually 1099 contractors who work for other companies that are bidding for the Epic work. Neither Vendor A nor the health system’s compliance department have responded to my inquiries, but my question is this – what line would you draw in describing a situation like this as either unethical or illegal versus just how business works when taxpayer money is involved? I assume (maybe incorrectly) that Vendor A doesn’t have people on the selection team and won’t be allowed to bid on the services work, but is sending the employees of bidding companies on site while wearing Vendor A badges unusual? I’ve seen the bidder list and quite a few companies have a vested interest in the outcome.


Webinars

March 4 (Wednesday) 1 ET: “Tools for Success: How to Increase Clinician Satisfaction with HIT Solutions.” Sponsor: Intelligent Medical Objects. Presenter: Andrew Kanter, MD, MPH, FACMI, FAMIA, chief medical officer, IMO. Dr. Kanter will explore how striving to achieve the Quadruple Aim (by focusing on the provider experience) can improve clinician satisfaction and population health needs while also reducing per capita healthcare costs. Attendees will learn how to set providers up for success with new technology, the potential unforeseen consequences of purchasing without the clinician in mind, and the factors that are critically important to clinicians who are using new health information systems.

March 4 (Wednesday) 1 ET: “Healthcare Digital Marketing: Jump-Start Patient Discovery and Conversion.” Sponsor: Orbita. Presenters: Victoria Petrock, MBA, MLIS, principal analyst, EMarketer; Kristi Ebong, MBA, MPH, SVP of corporate strategy, Orbita. Does your digital front door capture consumers who search for health-related information one billion times each day? Do you have actionable steps to convert them into patients? Do you understand voice and chat virtual assistants? The presenters will explore the consumer challenges involved with finding, navigating, and receiving care, discuss why healthcare marketers need to embrace conversational voice and chatbot technologies, and describe how new technologies such as conversational micro-robots can improve engagement.

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


Acquisitions, Funding, Business, and Stock

Bloomberg Businessweek visits a Walmart Health center in Georgia, which offers a $30 medical checkup, $25 teeth cleaning, and $1 per minute psychological counseling, with prices clearly displayed in the 12-room, 6,500 square foot facility that has its own entrance. Walmart changed direction after opening just 19 Care Clinic urgent care centers because they provide little value, especially for chronic conditions. It accepts insurance, but patients often save money by paying cash given high deductibles and co-pays. Beyond medical, dental, and eye care, the center also performs X-rays, hearing checks, and lab tests. Walmart says patient volume is running above expectations and that it has lowered costs by 40% by reducing “all that administrative baloney,” with one of its doctors saying that paperwork takes her 25% less time than in hospitals.


Sales

  • Arizona’s Health Current statewide HIE chooses NextGen Healthcare’s Health Data Hub for sharing and aggregating patient information. It includes clinical content management, an API-first design, a user portal, consent and data protection, and AWS cloud hosting.

People

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Continuous monitoring solutions vendor EarlySense hires John Dragovits (Allscripts) as SVP of strategic partnerships.

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Price transparency and provider rating vendor Healthcare Bluebook hires Scott Paddock (GuideWell Connect) as CEO. He replaces founder Jeff Rice, who will become executive chairman.


Announcements and Implementations

Nuance announces GA of Dragon Ambient Experience (DAX), its “exam room of the future” where “clinical documentation writes itself.” Dig deeper by reading my interview with Nuance CTO Joe Petro a few weeks back, including the interesting tidbit – the company got the idea 5-6 years ago from Epic President Carl Dvorak, who “floated the notion of a room being able to listen.”

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Prepared Health renames itself to Dina, the name it previously used for its digital assistant that analyzes patient assessments from home and makes evidence-based recommendations. The company is a first-time exhibitor at HIMSS20 and will co-present with Jefferson Health. I interviewed CEO Ashish Shah — who worked a long time at Medicity before co-founding what is now Dina in 2015 —  last year about the concept of “healthcare with no address.”

Medhost adds COVID-19 screening tools to its systems, including travel-related screening questions in its Enterprise EHR and EDIS.

Allscripts announces GA of TouchWorks EHR 20.0.

Waystar launches Hubble, an AI and robotic process automation platform that will reduce the labor required for revenue cycle management. It is being used in 10 of its RCM solutions so far.

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Apple and drug company Johnson & Johnson launch a study to see if people on Medicare who use the Apple Watch have a lower risk of stroke via early detection of atrial fibrillation. It’s a two-year study, so expect the same lack of conclusive results that have plagued similar studies because their study group wasn’t representative and dropout rates were high, not to mention that Android phone users are excluded even though they outnumber the IPhone crowd.


Government and Politics

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ONC publishes its health IT priorities for research (full report).


Other

CBS runs a flattering, consumer-oriented review of “Epic, the software company that’s changed the sharing of medical records (including, probably, yours.” They got nice shots from a campus visit, interviews and demos from staff, and a rare on-camera extended interview with the “76-year-old genius behind Epic” Judy Faulkner, who “built this curious place in her own curious image.” It’s a decent overview, Judy came across well, and the look back at the era of paper records flying around a hospital via pneumatic tube is fun. Judy also mentioned the “Hey, Epic” voice assistant that the company is developing.

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A Twitter war erupts between UK healthcare chatbot and doctor referral vendor Babylon Health and user @DrMurphy11 (oncologist David Watkins, MBBS), who called out problems with its symptom checker that offers advice for chest pain and other conditions. Babylon Health, which was founded by an investment banker, says its “anonymous detractor” (who has since revealed himself) found just 20 serious errors in 2,400 tests in “trying to trick our AI.” Interestingly, the company footnoted its document with its standard warning that “Our AI tools provide information only and do not provide a medical diagnosis, nor are they a substitute for a doctor.” The company has apparently expanded to the US.

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Healthcare in America. A Miami guy fresh off a China work trip develops flu-like symptoms and heads to the hospital ED. He asks them to run a flu test first since he had purchased non-ACA (aka “junk”) insurance as allowed by White House policy changes and didn’t want to run up extra charges. The blood draw and nasal swab proved that he had the plain old flu. He then received a bill for $1,400 from his insurance company, which discounted the hospital’s charge of $3,270 on the condition that he provide three years’ worth of medical records to prove that his flu wasn’t a pre-existing condition. Meanwhile, the hospital says more bills are headed his way but couldn’t explain when or for what (like $3,270 wasn’t enough for a couple of low-cost items). The big finish is this – he works for a medical device company that doesn’t offer its health insurance to its employees.


Sponsor Updates

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  • Kyruus team members help out at Cradles to Crayons Massachusetts.
  • Avaya wins the 2020 Channel Influencer Award from Channel Partners and Channel Futures.
  • CoverMyMeds will exhibit at the 2020 American Glaucoma Society Annual Meeting February 27-March 1 in Washington, DC.

Blog Posts

Sponsor Spotlight

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At CloudWave, we’re on your team. It’s your mission to provide the technology and tools your caregivers need to delivery quality care. That’s our mission, too. CloudWave helps hospitals bring public, private, and cloud edge resources together into a single operating environment with hosting, disaster recovery, security, backup, and archiving services. Let us help you fulfill the promise technology makes to healthcare – by enabling and empowering the delivery of care to your community. (Sponsor Spotlight is free for HIStalk Platinum sponsors).


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Contacts

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Get HIStalk updates.
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Morning Headlines 2/25/20

February 24, 2020 Headlines No Comments

Verizon and Emory Healthcare light up nation’s first 5G healthcare lab

Emory Healthcare will use 5G capabilities supplied by Verizon to help its Healthcare Innovation Hub partners develop connected ambulances, remote physical therapy, and next-generation medical imaging.

National health information technology priorities for research: A policy and development agenda

ONC publishes its policy and development agenda for better enabling healthcare research through the use of healthcare IT.

Sharecare acquires Visualize Health to drive better patient outcomes

Digital health engagement company Sharecare acquires Visualize Health, which offers quality reporting, practice analytics, and value-based care program management.

Curbside Consult with Dr. Jayne 2/24/20

February 24, 2020 Dr. Jayne 2 Comments

A new report from the UPMC Center for Connected Medicine finds that only four in 10 providers feel that digital technology is being successfully integrated into the overall patient experience. The team at UPMC surveyed more than 130 health systems and found that many of them are experiencing challenges around the costs associated with purchasing, implementing, and maintaining digital tools. Integration remains a concern due to interoperability issues with third-party applications. Unsurprisingly, organizations are ranking patient engagement tools as high priority projects and hope they will assist with major clinical initiatives such as chronic disease management.

According to Katie Scott, vice-president of digital strategy and innovation, UPMC Enterprises, “Patients now assume they’ll have the same digital experience in healthcare that they get everywhere else in their lives, and they’re dissatisfied when we don’t deliver. Increasingly, if hospitals and health systems can’t provide a feature-rich and seamless digital experience for their patients, those individuals are going to look elsewhere for care.”

Based on recent experiences with two patient portals, I can’t say I disagree. One of the portals took me in circles as I tried to figure out what was going on with a bill for a date of service that occurred more than eight months ago. Apparently the organization’s Division of Ophthalmology follows billing rules from some other universe, and according to the folks I had to call for help, these delayed bills are pretty much routine.

The other one allowed me to access data from two practices, both of which had different access settings for my information. While one practice had shared full office notes and lots of discrete data to the portal, the other only had lab results, but there were no annotations on the results. I ended up clicking dozens of links trying to figure out what my blood pressure might have been running over the last couple of years, and ultimately wound up with two useful data points and a lot of frustration. Although more than 80% of organizations cite the patient portals as one of the top three currently implemented technologies, it’s unclear how much benefit patients and practices are truly receiving from them.

The UPMC Center for Connected Medicine is a joint venture between UPMC, GE Healthcare, and Nokia. Other findings of the survey include: more than 75% of organizations are offering at least one digital health tool to patients, with 25% offering four or more tools; of the quarter of organizations who haven’t deployed digital health tools, 97% of them have plans to do so; half of respondents labeled digital tools as critical or high priority, with larger organizations more apt to call them critical; and less than one-third of organizations agreed that their organizations are able to deliver a digital experience that is “on par with the best digital consumer experience.”

There have been a couple of articles discussing the results of the report, and all of them focus on the perceived advantages held by organizations that are leading with digital health tools. They also predict that organizations that don’t embrace digital tools will be left behind as patients vote with their feet to move to organizations with a more seamless experience.

This reminds me of how hospitals were behaving years ago as they all competed based on their beautiful birthing suites, on-demand dining, and bedside entertainment systems. They may have gotten people to look twice, but I’m not sure it really made a difference in how patients selected their hospitals,since often that decision is driven by insurance contracts or where physicians have chosen to be on staff.

As patients have become consumers and people are increasingly sensitive to the cost of healthcare, I’d like to propose a new paradigm in hospital competition. Rather than pushing for just price transparency and infection rates, let’s get some real competition. Let’s get hospitals to publish their data on accurate billing, clean claims, and responsiveness to patient inquiries. In addition to your wait time in the emergency department, what is your wait time when you have to call about a bill from six months ago that finally dropped? How quickly can you deliver medical records upon request? How do your score on the ability to deliver those records in the format patients want?

Let’s create some metrics for care team communication with families, adequate discharge planning, and appropriate end-of-life decisions and get them circulating in the community. As far as other metrics, how quickly does someone answer the patient call light/bell, and how efficiently can someone help an elderly or immobilized patient to the bathroom? Let’s get that metric up on a billboard just like the emergency department wait times.

For anyone who has ever been an inpatient or had to closely take care of a hospitalized family member, let’s add some other ones like timeliness of medication administration, the percentage of time that handwashing is done properly, and the speed with which staff can silence or otherwise address the alarm on an IV pump.

I’m now at the point in my career where I’ve spent more time as a clinical informaticist than I did as a “regular” physician, and trust me, I do love the technology side of things. But as we are with so many things in our society, we’re focused on the wrong things. Is digital technology just a distraction from other issues? Are we trying to use it as a proxy for the actual healthcare that our patients deserve? Do patients really want an interactive, immersive experience or do they just want to get out of the hospital without a hospital-acquired infection? Do they really need online bill pay or would they be much happier with a bill that was simply understandable and accurate?

I’m curious what others think about this and what your organization’s relative spend is on digital patient engagement versus what many of us would consider the staples of running a healthcare organization. Do you spend more on technology than infection control? How does it compare to salaries for nursing staff and other critical patient care resources? Are we just experiencing the healthcare equivalent of bread and circuses? Leave a comment or email me.

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Email Dr. Jayne.

Morning Headlines 2/24/20

February 23, 2020 Headlines No Comments

Strategy on Reducing Burden Relating to the Use of Health IT and EHRs

HHS and ONC publish “Strategy on Reducing Regulatory and Administrative Burdens Relating to the Use of Health IT and EHRs,” meeting the requirement of the 21st Century Cures Act that HHS address government-imposed burdens on EHR use.

Queen’s notifies 2,900 patients their medical information was inadvertently shared

Queen’s Health Systems (HI) notifies 2,900 patients that their information was exposed by an employee who emailed an attachment to the wrong address.

MO HealthNet receives $9.3 million to help hospitals and providers electronically connect patient information

The MO HealthNet HIE will use $9.3 million in federal funding to develop a Provider Health Information Exchange Onboarding Program, which will subsidize connection and subscription fees for member providers.

MTBC Announces Telehealth Division, Appoints Leadership Team to Drive Growth

Health IT vendor MTBC launches a telehealth division and announces its three-member leadership team.

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Reader Comments

  • Jennifer: I think you are correct that Hyatt is the problem, not OnPeak or HIMSS. We booked rooms at 2 hotels for HIMSS. I notic...
  • Modern CIO: Re: DON With all due respect, get your facts right before lumping those two together. Its clear you don't know Belmo...
  • IANAL: Because he is clearly a good salesman....
  • Don: Ok, here's the truth, Ed Marx and Chris Belmont have probably created some of the biggest disasters in healthcare techno...
  • CovidStopper: Sorry to hear about Cesar Capule in WI. I've worked with many of these traveling Epic "ATE" support folks during implem...

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