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HIStalk Interviews Jay Colfer, CEO, Fivos Health

September 8, 2021 Interviews No Comments

Jay Colfer is CEO of Fivos Health of West Lebanon, NH.

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Tell me about yourself and the company.

I’ve been in healthcare for 30-plus years. I joined Fivos Health last October as their CEO.

Fivos was previously known as Medstreaming or M2S, two companies that provide three things in the marketplace — a software solution for ultrasound specialties, a technology platforms for societies and registries, and data analytics for device manufacturers. The common thread is vascular medicine. Each business line solves for specific problems, but collectively they lead to driving towards quality in that specific area of vascular medicine. We have over 1,000 clients clients in the specialty providers of office-based labs and hospital and health systems, combined with medical societies, registries, and device manufacturers. 

We relaunched the rebrand of our company to Fivos recently as part of the “one company” initiative that we developed to help unify our clients and our employees and make it simpler for them to work with us. People ask what Fivos means and how we came up with it. The short answer is that it’s easier to come up with a name than finding an available URL. We wanted to make it a short. We didn’t want it to be something that began with an “M” because people would deviate back to the old M2S or Medstreaming. Fivos is an alternate name for the ancient Greek deity Apollo, which is the god of light, truth, medicine, and healing. It stuck with us because remind us what our focus is. Even though our roots are in vascular, we are focused on medicine and our commitment to create insights around healthcare and around quality, particularly in the vascular space and in some of the other modalities that we serve today.

How are registries populated and used?

A registry is typically formed by a society. We got our start partnering with the Society for Vascular Surgery. They formed a Vascular Quality Initiative that has 14 registries. A registry in this case might be for carotid artery stents, with a clinical site, a hospital site, contributing data around that clinical procedure and as well as follow-up information to that care.

Today, we have more than 800 healthcare organizations contributing to various registries on clinical procedures in the vascular space. It becomes a repository of data for clinicians to be able to figure out, how are we doing from a quality perspective? Are there things that we can do from a clinical outcomes perspective?

How do registries get information from provider EHRs?

There’s some complexity to that because there are multiple parts. An example is our work with device manufacturers. Because of our partnership with Society of Vascular Surgery, or SVS, we have the ability through their patient safety office to take that data from a quality perspective, anonymize it, and provide it to device manufacturers. They are looking to use quality clinical data for pre- and post-approval studies or device trials. We provide that data to them. A number of them use that specific data as they are working with the FDA for their regular regulatory and compliance issues.

Who pays for that movement of data?

Device manufacturers, via their patient safety office. The PSO is purchasing that anonymized data for their specific devices. That revenue is split between the technology company, Fivos, and the society, SVS.

Before registries, was the only available option for these kinds of projects the commissioning of new studies?

It was. The VQI was started probably 15 years ago and has evolved over time. It started in the Northeast. Our chief medical officer, Jack Cronenwett, MD, who was out of Dartmouth, was one of the founders. They started as a regional group that grew over time and expanded geographically to the point where they had to make that a formal organization with SVS. This vascular registry it is the largest one in North America.

What is involved in transforming hospital EHR into registry form?

One of the biggest issues is extracting data from the client’s EHR. A lot of our data sits in unstructured notes. For years, a lot of companies focused on on natural language processing and AI to try to figure out how to bring that back. We are working with our partner SVS with the major HIS vendors, leveraging our relationships where they are committing to building structured report templates as part of their base system that would provide an easy way for us to be able to extract information. Over the last 20 years, while there have been advancements in machine language and AI, part of the work is still extraordinarily manual. We are working with the major vendors to create that structured note to automate that data abstraction and that information can flow into the registries.

You must also need to avoid impeding the workflow of clinicians or adding extra work for them.

Correct. It takes time working with the vendors to say, how do you come up with a clinically appropriate templates that will capture the relevant information and not impede their normal practice? That’s a challenge.

What led to the decision to change Medstreaming’s business by acquiring a registry company and combining those business into something new?

As I mentioned, there are three parts to our business lines. Our workflow solutions started in vascular as a platform for being able to help reduce reporting times for providers. Our system helps build patient reports in an ultrasound modality that is complete with images and anatomical sketches and allows the documentation to happen as the exam is occurring. That then feeds into the EMR or EHR, depending on what the environment is, and allows for better and faster reporting times. As a patient, the frustrating part is having to wait on results when you’ve had that type of an ultrasound. That model for workflow solutions allows us to help quickly get reports back faster.

Where that ties in is that our workflow solutions have expanded from vascular to cardiovascular to women’s health, and we’re now looking at building for all general imaging modalities. From an ultrasound perspective, we create a baseline for a lot of clinical data in a structured environment that can then be fed into registries.

In our vascular world, we have 14 registries. We have expanded into neurovascular registries. We are having conversations with orthopedic societies that are starting registries.

We are looking to bring this under one brand to expand our general imaging modalities to be able to provide our technical platform for societies. Then, combine that with the whole data piece, with data abstraction as to being able to pull data from our workflow solutions into the registry, or directly from the EMR or EHR into the registry.

Those are the three growth areas as we take Fivos forward.

Where do you see the company going? 

Fivos has been around for 15 years, which probably surprises a lot of folks. We want to become agnostic as it relates to ultrasound platforms. There was an international organization that was looking to replace their ultrasound system. They told the five major ultrasound device companies, “All of your products are great, but if you don’t have the piece that Fivos provides, don’t participate in the tender or the RFP process.” We are building our brand with those organizations so that our solution can be the front end to getting information into the registries.

Then on the back end with the registries, to be able to look at that data from a quality perspective and say, what improvements can we make? Not only from a device manufacturer perspective, but also from a clinical perspective inside of research. Whether that’s vascular, cardiovascular, or neuro, we can analyze the data that contains that information.

We think there’s an ability to even enhance that for healthcare organizations that say, how do we marry up our clinical data with charge, cost, and pharma information and make that available back to our clients? They have a lot that data already inside their organizations, but how do we bring that together for them? We are going to be focused on that.

Morning Headlines 9/8/21

September 7, 2021 Headlines No Comments

Invitae to Acquire Ciitizen to Strengthen its Patient-Consented Health Data Platform to Improve Personal Outcomes and Global Research

Invitae will acquire Ciitizen, a consumer-focused health data startup, for $325 million.

Amazon has ambitious plans to bring in-person medical care to 20 more US cities

Amazon will reportedly offer in-home medical visits in 20 US cities later this year via its Amazon Care business.

Cityblock Health raises another mega-round of funding, tipping its valuation over $5 billion

Cityblock Health, which partners with payers to offer tech-enabled primary care to Medicaid patients, has raised $400 million, bringing its total raised to nearly $500 million.

News 9/8/21

September 7, 2021 News 8 Comments

Top News

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Invitae will acquire Ciitizen, a consumer-focused health data startup, for $325 million.

The genetics company will integrate Ciitizen’s technology as a health data collection and organization service for its patients.

Ciitizen has raised $20 million since launching four years ago. It acquired HIE vendor Stella Technology in May.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Olive. The Columbus, OH-based automation company is creating the Internet of Healthcare. It is addressing healthcare’s most burdensome issues through automation, delivering hospitals, health systems, and payers increased revenue, reduced costs, and improved efficiency. People feel lost in the system today and healthcare employees are essentially working in the dark due to outdated technology that creates a lack of shared knowledge and siloed data. Olive is driving connections to shine new light on healthcare processes, improving operations today so everyone can benefit from a healthier industry tomorrow. Thanks to Olive for supporting HIStalk.

I found this YouTube demo of using Olive to automate prescription refill requests.


We had a family get-together last week, with a dozen of us traveling to a place we had rented. All of us who are eligible have been fully vaccinated and we all tested negative before arrival with the BinaxNow rapid COVID-19 test. A four-year-old whose family stayed only through the first weekend became symptomatic and tested positive last Monday. Her infection almost certainly came from close contact the week before with an unvaccinated preschool teacher (the school was waffling on its mandatory vaccination plans and was not forthcoming with parents about staff vaccinations). Luckily everybody else in our group tested negative. Testing is once again a US problem as drive-through sites have shut down and not all stores have the $10 BinaxNow tests (CVS had the complicated, expensive, and reportedly less-reliable Ellume tests in limited supply). Not to mention that not all families can afford to buy and keep boxes of tests at home. Other countries are providing the many brands of tests their governments have approved (versus a handful here) at no charge, even mailing them to homes, so that infected people can avoid exposing others, but of course here even people with positive tests can’t be trusted to be responsible. Abbott must be making a fortune even at $10 per test since it looks like maybe 75 cents worth of product and packaging whose fixed cost component has long since been covered. Coronavirus capitalism is interesting.


Webinars

September 16 (Thursday) 1 ET. “Patient Acquisition and Retention: The Future of Omnichannel Virtual Assistants.” Sponsor: Orbita. Presenters: Harris Hunt, SVP growth product, Cancer Treatment Centers of America; Patty Riskind, MBA, CEO, Orbita; Nathan Treloar, MSc, co-founder and COO, Orbita. Consumers want the same digital healthcare experience from healthcare that they get in online shopping, banking, and booking reservations, and the pandemic has ramped up the patient and provider need for frictionless access to healthcare resources and services. Health systems can improve patient acquisition and retention with the help of omnichannel virtual assistants that engage and delight. Discover how to open and enhance healthcare’s digital front door to offer care that goes beyond expectations.

September 16 (Thursday) 1 ET. “ICD-10-CM 2022 Updates and Regulatory Readiness.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, VP global clinical services, IMO; Theresa Rihanek, MHA, RHIA, mapping manager, IMO; Julie Glasgow, MD, clinical terminologist, IMO. IMO’s top coding professionals and thought leaders will discuss the coding changes in the yearly update to allow your organization to prepare for a smooth transition and avoid negative impacts to the bottom line. The presenters will review new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines, and review modifier changes.

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


Acquisitions, Funding, Business, and Stock

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Urgent care appointment-booking software vendor Solv raises $45 million in a Series C funding round, bringing its total raised to $95 million.

Medication management software vendor Omnicell opens a software development center in India.

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A new KLAS report on ambulatory surgery center EHRs finds that HST Pathways and Surgical Information Systems lead in adoption with high usability although falling short on anesthesia documentation, while Provation performs highly for specialties.


Sales

  • Virginia Hospital Center selects Phunware’s digital front door technology.
  • Athenahealth makes ConnectiveRx’s ScriptGuide point-of-care prescription savings messages available through its EHR.

People

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Former EMT and health IT long-timer John Danahey joins Picis Clinical Solutions as EVP.

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CipherHealth names Mandana Varahrami (RapidDeploy) chief product officer.

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Industry long-timer Scott Lenz, who retired from NetApp in 2016, died Friday at 59.


Announcements and Implementations

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Mount Sinai Health System’s IT department develops the patient-facing MyMountSinai app.


Government and Politics

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Ireland’s national health service has almost totally recovered from the May ransomware attack that severely impacted services across the country for several weeks. Some facilities are still dealing with cancelled appointments, and employee email access has yet to be restored. The hackers ended up giving the HSE the encryption key for “free” after it refused to pay the $20 million ransom.


COVID-19

Hawaii’s COVID-19 case counts are being reported incorrectly as its systems are stressed by volumes as well as inconsistency in how reporting systems – including more than 100 labs – send their data. Not all systems support HL7 and those that do may apply different rules to individual data elements. Another issue that in the absences of a national patient identifier, a misspelled name can cause one person’s multiple test results to be counted as multiple cases. State epidemiologists suggest using seven-day case averages to smooth out one- or two-day swings caused by inconsistent reporting times.

Scripps hospitals in California report that they experienced their highest-ever single day deaths this past weekend, all 19 of them involving patients who were not fully vaccinated. Its employees say they are being called liars by some patients who don’t believe they are infected.


Other

Amazon will reportedly offer in-home medical visits in 20 US cities later this year via its Amazon Care business.


Sponsor Updates

  • Ascom hires Lori Lyons as director of marketing engagement.
  • CareSignal wins the HIMSS 2021 Global Maternal Health Tech Challenge.
  • CHIME releases a new Digital Health Leaders Podcast featuring MedStar health SVP and CIO Scott MacLean.
  • Dimensional Insight receives a high overall rating in the 2021 “Gartner Peer Insights Voice of the Customer: Analytics and Business Intelligence Platforms” report.
  • Divurgent celebrates its 14th anniversary.
  • Spok offers a new e-book, “Solving the critical test result workflow challenge with closed loop communication.”

Blog Posts


Contacts

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

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HIStalk Interviews Stephen Hau, CEO, Newfire Global Partners

September 7, 2021 Interviews 2 Comments

Stephen Hau, MS is chairman and CEO of Newfire Global Partners of Cambridge, MA.

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Tell me about yourself and the company.

I’m a serial entrepreneur and an experienced company operator. Much of my misspent youth was dedicated to building companies and bringing innovation into the marketplace. Today, at nearly 50, I’m the CEO and chairman of Newfire Global Partners, a company that, you guessed it, helps clients build companies and bring innovation to the marketplace.

Newfire is headquartered in Cambridge, Massachusetts, with nearly 400 team members worldwide in Europe, the Americas, and Asia. Our services include advisory work, staff augmentation, managed services, pivots and turnarounds, and de novo starts. About 80% of our business is in healthcare, spanning provider, payer, consumer, and life sciences. Much of our work includes elements of data engineering, data science, and replatforming. We are expanding our US footprint, opening an office in Canada, and exploring operations in Singapore to support our global supply chain of the best talent. We envision having thousands of team members within the next three years.

What are the challenges and benefits of operating in several countries?

When we started the company, it was quite organic. A company that I was associated with was getting acquired. The acquiring company, which was much larger, decided to release the engineers, who were in Eastern Europe. They were great engineers, so I sent out 50 job offers, and about 35 of them stayed. I just thought they were great engineers. I didn’t even have work for them, but I have lots of friends who are venture capitalists, private equity people, and CEOs who run technology companies, so we just did some matchmaking.

Over the course of the last few years, it’s grown from 35 to now nearly 400 people. We’ve chosen our locations strategically. I like certain profiles in Eastern Europe, especially in areas around data science and engineering. We have dual offices in Ukraine and Croatia. We have an office in Costa Rica and of course we operate in the United States. We have an office in Kuala Lumpur, Malaysia, and we’re probably opening an office in Singapore. Having these locations also provides redundancy. For a lot of our customers, I represent a key part of their supply chain, so we have gone to great lengths to protect that pipeline chain to have as much diversity as possible.

How are digital health companies working around any limitations they find in interoperability and data maturity?

Our customers represent a subset of the market, but if I generalize from my personal experiences, interoperability is key. New companies in this space discover the challenge pretty quickly. More experienced folks appreciate that it’s just part of the cost of doing business in this space. The good news is that maturity of tools and options exists. FHIR is not yet a perfect solution, but it has given a lot of technological optionality and advantage to digital health companies, especially new entrants.

In terms of data maturity, that is a common theme that we see across clients that we work with. A common theme in healthcare is data, data, data. People incorporate data as their primary strategy, or they may be a company that has been operating for a while and see data as a new opportunity. In both situations, there is a challenge of data maturity and sometimes what I call data liquidity, which is having data in computable form that can be used to fuel things like predictive analytics and machine learning and so forth.

For data maturity, there are many elements to support clients. Some of it includes things that are not particularly glamorous, such as data cleansing, which quite frankly is extremely manual. What a lot of people don’t realize is that in this vision of a data-driven future, there is a lot of behind the scenes work that requires a fair amount of manpower.

How do you see the ecosystem shaping up between big EHR vendors like Cerner and Epic and all those well-funded startups?

It’s an interesting dynamic for sure. It’s hard to predict how the future will play out. Obviously the existing EHRs have tremendous market share and there is a high switching cost to convert to something that is maybe more modern or innovative. Obviously it is difficult to innovate when you have so much installed base. Those are all challenges.

Some exciting new capabilities are being developed by new entrants into the market, companies that may only be four or five years old. Some of the tools can be tremendously helpful to the healthcare ecosystem and ultimately drive impressive outcomes to help patients and consumers. I’m a free market guy, so my hope is that the duality can coexist. The market will adjust to allow the innovative technology to be utilized and incorporated by the existing players.

What influence do you see coming from big technology companies like Microsoft and Google, whose healthcare involvement seems to come and go?

These big horizontal players historically have come in, they’ve left, and sometimes they come back again. That highlights or spotlights the unique aspects of the healthcare ecosystem. In our own journey, we’ve seen the market from the provider perspective and the payer perspective. In some ways, they are two sides of the same coin of some of the problems that they’re trying to address. On the provider side, they think in terms of prior authorization, while on the payer side, they’re thinking in terms of utilization management.

This is an example of why it’s so difficult for a horizontal to come in and to think that there’s a “one size fits all.” These large players obviously bring tremendous resources and pretty cool innovation. But the reality is that it has to be focused on specific, achievable, valuable problems in our market to be relevant, then move the needle in a way that it can provide lasting value and then become a longstanding player in this space.

What are the keys to success for new health IT entrants?

I’m a believer that the investment fuels innovation. Obviously I’ve been a beneficiary of venture capital in my career. Where we are now comes down to outcomes. We gave a lot of new ideas and a lot of old ideas being reapplied. At this point, there is a real focus on what actually moves the needle. One example is that, over the last 10 or 15 years, we have seen a rise in consumerism, and that has led to many cool opportunities. We have seen a class of wellness applications or applications that allow consumers to support their own health. We have seen some great examples of companies that have made a positive impact.

The focus now is that people are shifting from acknowledgement of great ideas to whether they ultimately translate to improved patient outcomes. That will ultimately be a filter for many companies in the market to decide which companies survive and continue and which ones do not.

What does it feel like to see PatientKeeper still going strong 25 years after you founded it?

I started PatientKeeper in 1996 with Joe Bonventre, MD, PhD, a professor at Harvard Medical School. I started Shareable Ink 2008 with Vernon Huang, MD, who’s a former medical director at Apple. Both of my co-founders are physicians. Our teams did some amazing work and we had some fun. But at the same time, it’s a little bittersweet for me because I never got to use the products that we worked so hard to build because I’m not a clinician. I’m sure many of your readers can relate to that.

In contrast, what’s exciting about Newfire is that I have been a consumer of the services we provide. Our product is extremely relatable to me, which gives me an advantage in terms of how we support our customers.

What’s in the future for the company?

We are in a golden age for technology in healthcare. I have a privileged vantage point because I’ve gotten to work for the leaders — providers, payers, consumer, and life sciences. We are seeing some real opportunities for meaningful innovation. It is inspiring to watch the management teams of these companies turn ambition to reality. My hope for Newfire is that we will continue to be a trusted partner for our clients that supports them in their journey to bring innovation into the marketplace.

Morning Headlines 9/7/21

September 6, 2021 Headlines No Comments

HSE cyber-attack: Irish health service still recovering months after hack

Though Ireland’s health service has recovered almost completely from the May ransomware attack that hindered services across the country, its facilities are still dealing with cancelled appointments and lack of employee email access.

WELL Health Continues US Expansion with Proposed Acquisition of Majority Stake in WISP, a Rapidly Growing National Telehealth Leader Specializing in Women’s Health

Canadian Well Health Technologies will acquire US-based Wisp, a women’s telehealth and e-pharmacy company, for $41 million.

Solv raises $45 million for same-day medical appointments

Medical appointment-booking software vendor Solv raises $45 million in a Series C funding round, bringing its total raised to $95 million.

HIStalk Polls 2007-2012

September 6, 2021 News No Comments

A reader asked if the results of my weekly reader polls are available as an archive. They aren’t because of limitations of the tool I use, but I went back and recapped some of the more interesting ones from the earliest of those years. These are listed in order of oldest (2007) to newest (2012). Sorry for the somewhat fuzzy screenshots, but the tool doesn’t have good bulk export tools.

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Morning Headlines 9/6/21

September 5, 2021 Headlines No Comments

Use of artificial intelligence for image analysis in breast cancer screening programmes: systematic review of test accuracy

A BMJ-published review of using AI for breast cancer screening finds that 34 of 36 reviewed systems were less accurate than a single radiologist and all performed more poorly than two radiologists.

Achieve Partners Buys Cybersecurity Service Provider Metmox

Achieve Partners acquires cybersecurity services vendor Metmox to develop a training and mentorship program, the same reason it acquired Optimum Healthcare IT in July.

CliniComp and Veterans Health Administration Renew Clinical Information System Contract

The VA renews its CliniComp contract for another five years.

Monday Morning Update 9/6/21

September 5, 2021 News 3 Comments

Top News

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A BMJ-published review of using AI for breast cancer screening finds that 34 of 36 reviewed systems were less accurate than a single radiologist and all performed more poorly than two radiologists.

Excluded from the review were studies that used the same data for training and validation, which likely perform worse in analyzing new data.

The authors conclude that AI is “a long way from having the quality and quantity required” to use in clinical practice, especially without further radiologist review, such as in screening “normal” mammograms.


Reader Comments

From New Vince Fan: “Re: Vince Ciotti’s HIS-tory. Will be continue to be available on HIStalk?” Yes. Vince and I had agreed two years ago that his HIS-tory was in danger of being lost when stored as individual PowerPoints that he had created over several years, so I spent a day assembling them all into a single PDF that is permanently available from the top menu under Navigation / Information (or directly here). Vince cheerfully admitted that his memory of events from 40-50 years ago wasn’t perfect and someone who worked within one of the companies he wrote about would be more knowledgeable of specific details that he speculated about, but Vince had a rare broad view of the industry having worked in much of it, known most of its pioneers, and seen with clarity what went right or went wrong with corporate decisions. It was touching when he told me that he considered his HIS-tory series to be his legacy after a 50-year career.


HIStalk Announcements and Requests

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I just couldn’t find a sensible way to word the question I asked last week about who companies might hire for a CEO position – triggered by Cerner’s two-for-two in hiring people in their first-time CEO job – so I’ll allow the answers to speak for themselves. My poorly worded question even confounded the issue at hand – David Feinberg had CEO experience before Cerner named him to that job, but it was for a non-profit health system.

New poll to your right or here: Which of these HR actions have happened to you?

Listening: the first new music from ABBA since 1982, accompanied by a sweetly reminiscent look back at their history via photos and video from when the then-married couples donned spacey costumes and eyeliner to sing with Swedish accents the best Europop of that era and perhaps any other. They don’t look quite like the members you remember since they’re in their mid-70s now, but they sound fine. The band had refused the richest contracts in history to reunite over fears that fans would be disappointed, but they have reconciled their personal differences to record a new album and an avatar-powered concert experience that will be backed by live musicians. I will say as a music fan that ABBA’s was fresh more than skilled (though written by Benny and Bjorn with an immensely strong commercial pop ear) and was mostly just a lot of youthful fun with the occasionally darker overtone later in their career, but I still like it (my favorite album: 1981’s “The Visitors,” which was their last, and my favorite song “Slipping Through My Fingers” from that same album). The BB boys have always called the shots, made fortunes in commercial music ventures, and are the active participants in this reunion, while the girls (Frida and Agnetha) provided the most memorable performing component but then chose a quiet, mostly non-musical life and seem to have a background role in the new content. I’ll say that the boys could just write their songs and then stay home and count their money and I would be equally happy watching AA bring them to life without them. BB are making fortunes from songwriting royalties and finding new ways to resell the group’s old music.


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

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Webinars

September 16 (Thursday) 1 ET. “Patient Acquisition and Retention: The Future of Omnichannel Virtual Assistants.” Sponsor: Orbita. Presenters: Harris Hunt, SVP growth product, Cancer Treatment Centers of America; Patty Riskind, MBA, CEO, Orbita; Nathan Treloar, MSc, co-founder and COO, Orbita. Consumers want the same digital healthcare experience from healthcare that they get in online shopping, banking, and booking reservations, and the pandemic has ramped up the patient and provider need for frictionless access to healthcare resources and services. Health systems can improve patient acquisition and retention with the help of omnichannel virtual assistants that engage and delight. Discover how to open and enhance healthcare’s digital front door to offer care that goes beyond expectations.

September 16 (Thursday) 1 ET. “ICD-10-CM 2022 Updates and Regulatory Readiness.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, VP global clinical services, IMO; Theresa Rihanek, MHA, RHIA, mapping manager, IMO; Julie Glasgow, MD, clinical terminologist, IMO. IMO’s top coding professionals and thought leaders will discuss the coding changes in the yearly update to allow your organization to prepare for a smooth transition and avoid negative impacts to the bottom line. The presenters will review new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines, and review modifier changes.

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


Acquisitions, Funding, Business, and Stock

The Global X Telemedicine and Digital Health ETF gained 1.7% in the past month versus the Nasdaq’s 3.7% rise. EDOC shares were launched nearly a year ago and have risen 19% since versus the Nasdaq’s 36% gain.

Achieve Partners acquires cybersecurity services vendor Metmox to develop a training and mentorship program, the same reason it acquired Optimum Healthcare IT in July.


Sales

  • The VA renews its CliniComp contract for another five years.

People

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Adirondac Health (NY) names Aaron Kramer, MS as president and CEO. Most of his career has been spent in IT, including work as an IBM systems administrator, an IT director, and CIO of Adirondac through June 2019.

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Susan Salahshoor, RN, MMIS (PatientSafe Solutions) joins TransformativeMed as VP of clinical success.


Announcements and Implementations

McLaren Northern Michigan goes live on Vocera, deploying its Vina smartphone app and Smartbadge voice-controlled wearable.


COVID-19

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HHS reports that most states have 25% or more of their ICU beds occupied by COVID-19 patients (dark red above), requiring 25,000 beds nationally of 85,000 available. Seven-day deaths per 100,000 population are highest in Louisiana, Nevada, Arkansas, Georgia, South Carolina, Oklahoma, and Texas.

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Eric Topol wonders why we have to base US decisions on data from Israel (reason: they collect it, we don’t). Another challenge here is that vaccine records are not reliably centralized and tied to a national patient identifier, which is not surprising when the main proof of vaccination is an easily counterfeited paper card with scrawled handwriting that focused on product information rather than the recipient.

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Texas has only 81 pediatric and 200 adult ICU beds available for its 29 million residents, as schools have reported 50,000 new student cases in two weeks and a dozen school districts have closed temporarily. Eight counties are using refrigerated trucks to store the bodies of COVID-19 patients.


Other

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TechRepublic profiles Rush University Medical Center’s use of Amazon HealthLake to track COVID-19 cases. HealthLake, which became generally available in July, includes FHIR connectivity.

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University of Connecticut profiles UConn Health interim CIO Adam Buckley, MD, MBA (University of Vermont Health Network) who joined the health system in July in replacing interim Chuck Podesta, who is now CIO at Renown Health (NV).

Four of six traveling ICU nurses that were contracted by Providence St. Joseph Hospital Eureka (CA) to care for COVID-19 patients quit the next day, which CEO Roberta Luskin-Hawk, MD says is due to their unfamiliarity with its EHR even though it is “used by many hospitals.” Still, she says, “We are excited to be transitioning to a more widely used electronic medical record system in the coming weeks.”

Atlanta-area telehealth nurses tell a local TV station that they lack clinical training and are telling patients “hold while I review your records” and then are frantically Googling their symptoms. Nurses report that hold times are up to one hour as high numbers of callers are turned away in EDs and urgent care centers. One nurse says, “We have no knowledge of childhood illnesses, diseases, or parameters of vital signs and I just felt that that’s a very dangerous situation” as better trained nurses haven left for higher-paying jobs.


Sponsor Updates

  • Clearwater publishes a new case study, “Digital Health Company CaringWays Partners with Clearwater for Cybersecurity and HIPAA Compliance.”
  • EClinicalWorks publishes a new customer success story, “Using EClinicalWorks Tools to Measure Quality for Shared Savings at Innova Primary.”
  • Change Healthcare offers a new Supporting Accurate Claims content hub.
  • OptimizeRx CEO Will Febbo will present at the Lake Street Capital Markets’ The Best Ideas Growth Conference September 14-15, and at the Piper and Sandler 2021 Heartland Summit September 29-30.
  • Symplr publishes a new case study, “Baystate Health’s New Digital Peer Referencing Integration is a Dream Come True.”
  • Protenus publishes a new case study, “Seattle Children’s Hospital Uses AI to Protect Pediatric Patients’ Privacy.”
  • Seniors at Douglas County Health Center stay connected using technology from Sonifi Health.
  • Data-protection vendor Spirion announces its inclusion in seven 2021 Gartner Hype Cycle reports.
  • WebPT becomes The Alliance for Physical Therapy Quality and Innovation’s first at-large member and strategic partner.

Blog Posts


Contacts

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

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Morning Headlines 9/3/21

September 2, 2021 Headlines No Comments

Baxter to Acquire Hillrom, Expanding Connected Care and Medical Innovation Globally

Baxter International will acquire Hillrom for $10.5 billion in cash plus assumption of debt that values the transaction at $12.4 billion.

Clearlake Capital-Backed Provation Acquires endoPRO Software Portfolio from PENTAX Medical

Provation acquires Pentax Medical’s EndoPro endoscopy software.

Accenture Acquires Gevity to Bolster Health Transformation Service Capabilities in Canada

Accenture acquires Canada-based healthcare technology consulting firm Gevity.

UC San Diego Health Launches New Center to Spur Patient-Centered Technologies

UC San Diego Health launches the Center for Health Innovation to develop, test, and commercialize technologies.

News 9/3/21

September 2, 2021 News 7 Comments

Top News

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Baxter International will acquire Hillrom for $10.5 billion in cash plus assumption of debt that values the transaction at $12.4 billion.

The announcement emphasizes Hillrom’s recent refocus from manufacturing hospital beds to remote patient monitoring and connected care solutions.

Hillrom previously acquired cardiac monitoring company Bardy Diagnostics for $375 million, patient monitoring vendor EarlySense for $30 million, and clinical communications vendor Voalte for $180 million.


HIStalk Announcements and Requests

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I was saddened to learn from Bill Bogutski that Vince Ciotti has died. Vince retired in 2019 after a 50-year health IT career, much of it spent working with Bill and other principals of the HIS Professionals consulting firm. The photo of Vince above is from a reunion of former employees of Shared Medical Systems in 2019. Vince spent considerable time over several years, starting in 2011, documenting health IT’s first decades for HIStalk readers in his engrossing HIS-tory series. I interviewed him two years ago and it’s still an entertaining read that will give you a feel for Vince’s filter-less, cynical humor. I asked him then what he wanted his epitaph to say:

If I could be remembered for anything, it would probably be my HIS-tory files, which I thank you for posting over such a long time, two and a half years. I hope some of the future CIOs read them and learn from them. I hope that’s what they remember me by, the guy that warned them about not repeating these mistakes of the past.


Webinars

September 16 (Thursday) 1 ET. “Patient Acquisition and Retention: The Future of Omnichannel Virtual Assistants.” Sponsor: Orbita. Presenters: Harris Hunt, SVP growth product, Cancer Treatment Centers of America; Patty Riskind, MBA, CEO, Orbita; Nathan Treloar, MSc, co-founder and COO, Orbita. Consumers want the same digital healthcare experience from healthcare that they get in online shopping, banking, and booking reservations, and the pandemic has ramped up the patient and provider need for frictionless access to healthcare resources and services. Health systems can improve patient acquisition and retention with the help of omnichannel virtual assistants that engage and delight. Discover how to open and enhance healthcare’s digital front door to offer care that goes beyond expectations.

September 16 (Thursday) 1 ET. “ICD-10-CM 2022 Updates and Regulatory Readiness.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, VP global clinical services, IMO; Theresa Rihanek, MHA, RHIA, mapping manager, IMO; Julie Glasgow, MD, clinical terminologist, IMO. IMO’s top coding professionals and thought leaders will discuss the coding changes in the yearly update to allow your organization to prepare for a smooth transition and avoid negative impacts to the bottom line. The presenters will review new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines, and review modifier changes.

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


Acquisitions, Funding, Business, and Stock

Healthcare Triangle files for an IPO that will raise up to $50 million.

Provation acquires Pentax Medical’s EndoPro endoscopy software. 

Accenture acquires Canada-based healthcare technology consulting firm Gevity. 


Sales

  • Coalition of Asian-American IPA chooses CarePort Connect for care coordination.

People

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SOC Telemed promotes Chris Gallagher, MD to CEO. He replaces John Kalix, who resigned his CEO and board positions.

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Transcarent hires Snezana Mahon, PharmD (Evernorth) as COO.

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Stephanie Solich (Zipari) joins VisiQuate as VP of client development.

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Patient payment and engagement platform vendor Millennia names Dave Dyell as chief strategy officer and Doug Sundlof (Cloudmed) as SVP of sales.

LexisNexis Risk Solutions promotes Jeff Diamond, JD to president and GM of its healthcare business.


Announcements and Implementations

UC San Diego Health launches the Center for Health Innovation to develop, test, and commercialize technologies.


COVID-19

A University of California San Diego Health review of employee health records finds that COVID-19 vaccine effectiveness against symptomatic infection dropped from 90% in June to 66% in July, which the authors attribute to emergence of the delta variant, waning immunity suggesting the need for booster doses, and the ending of masking mandates. Adding to the argument for booster doses is that those healthcare workers who were vaccinated earlier were infected at a higher rate.

A New York attorney is suing hospitals that refuse to administer ivermectin to ventilated COVID-19 patients whose families insist.


Sponsor Updates

  • Glytec will host “Time to Target: Uniting Around Patient Safety,” its inaugural conference on glycemic innovation and collaboration October 26-27.
  • Everbridge wins two Silver 2021 Stevie Awards in the categories of customer service department of the year and customer service team of the year.
  • The HCI Group releases a new DGTL Voices with Ed Marx podcast, “Soul-Stirring Kilimanjaro Clinic.”
  • Healthcare IT Leaders publishes a new guide, “15 Tips for Patient Accounting System Project Success.”
  • Ideawake releases a new video, “3 Health Systems Transforming Patient Care via Bottom-Up Innovation Programs.”
  • Imprivata makes its digital identity solutions One Sign and Confirm ID available on Microsoft Azure.
  • Infor publishes a new case study, “Bozeman Health raises quality of care and reduces waste with Infor.”
  • InterSystems releases a new podcast, “How Can Healthy Data Save Healthcare?”
  • Medicomp Systems releases a new Tell Me Where It Hurts Podcast featuring CPSI CMO William Hayes, MD.
  • NextGate names Minakshi Tikoo, PhD (NYC Department of Health and Mental Hygiene) director of product management.

Blog Posts


Contacts

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

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EPtalk by Dr. Jayne 9/2/21

September 2, 2021 Dr. Jayne No Comments

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The American Medical Informatics Association is putting out a call for submissions for its 2022 Clinical Informatics Conference, scheduled for Houston in May. The CIC conference is known for being clinically focused, with lots of practical presentations about clinical informatics. Included focus areas are informatics-driven value-based healthcare; usability, efficiency, and user experience; clinical decision support and analytics; organizational challenges; emerging technology and technical infrastructure; and leadership, advocacy, and policy.

I’ve never attended, and while Houston isn’t one of my favorite cities, it might be on my list if we make it through this winter without crazy COVID and flu peaks. I can certainly appreciate any learning about organizational challenges since I seem to be having a number of them with my clients lately. Potential presenters have until November 30 to submit.

With all the stresses on healthcare organizations, mental health is at the forefront of many discussions. I was interested to read about Nike closing its corporate offices for a week to allow employees to take a break. While corporate office employees are receiving a week of paid vacation, retail employees didn’t get the same consideration. I would propose that the customer-facing retail employees probably need some bolstering of their mental health as well. If sick patients aren’t willing to mask and distance at their physician’s request, I can’t imagine being a retail employee who has to engage with people who don’t want to practice social distancing or wear masks. I’d be more impressed if they gave all employees extra time off, not just those in the corporate office.

Healthcare providers behaving badly: New York area hospital workers have been purchasing fake COVID-19 vaccination cards for $200 each. The Manhattan District Attorney’s Office announced the filing of charges against a New Jersey woman for the cards and against a New York medical worker who would enter the person’s data into the New York state immunization registry for an additional $250. The co-conspirator is alleged to have entered fraudulent immunization records on at least 10 individuals. Those purchasing the fake vaccination records were also charged, and include workers at hospitals, medical and nursing schools, nursing homes, and other critical environments. The fraudulent documents were sold through Instagram accounts and prosecutors call on social media platforms to assist in the crackdown. The idea that someone would enter fraudulent data into the state registry is so offensive – I hope the penalties are severe.

For those of us who deal with search algorithms and learning systems on a regular basis, the report that the Amazon algorithm was directing users to ivermectin, and other COVID-19 misinformation sites is also offensive. CNBC reports that not only are user reviews listing false claims, but that since the autocomplete functionality on Amazon’s search field are driven by customer activity, searches that start with “IV” are bringing up ivermectin products due to high search volumes. Amazon is supposed to be blocking those autocomplete entries to help mitigate the issue. Users searching for “ivermectin for humans” and “ivermectin covid” should also receive a warning that the FDA has not approved ivermectin to treat or prevent COVID-19.

Several of my clients have added informational banners and callouts in their patient-facing platforms and websites, letting patients and potential patients know that the group will not prescribe ivermectin off label. It’s largely an attempt to avoid angry situations in the office which have been happening with increasing frequency, as well as to lower the volume of calls that patients are making in the hopes they get them.

One physician reported to me that an angry parent called wanting to interview her as a potential pediatrician for their child, but they had already called 20 pediatricians and didn’t want to see anyone who was going to try to recommend a COVID vaccine or who wouldn’t prescribe ivermectin or hydroxychloroquine. Since my client is squarely in the camp of evidence-based medicine, her practice opted to add banners to the website and informational posts on social media so that they could hopefully avoid other calls. I guess the fact that every pediatrician the parent had talked to had the same opinion had no sway on his thinking. When I asked my client about this, she noted that the caller told her she must be in the pockets of big pharma since she was a vaccine proponent and that he would keep calling around.

I’ve known a lot of front-line pediatricians and I can tell you that not a single one seems to be in the pockets of big pharma or any other financial influencer. When you stroll through the physician parking area at the hospital, you can pretty much predict that the well-loved Honda Accords and Toyota Camrys belong to the pediatricians, family physicians, or geriatricians. Primary care physicians tend to do what they do because they genuinely care for patients and want to see people lead longer healthier lives and are willing to make a lot less money than their colleagues to do so. Many of them have worked consistently through the pandemic with less-than-ideal personal protective equipment and have taken huge financial hits, so to accuse them of being compromised by some facet of industry is laughable.

Speaking of laughable, I receive a lot of emails asking me to look at new products or check out websites in the hopes that I’ll promote them. I would highly recommend that you spell-check and grammar-check all copy that you plan to put on your website, and then have at least two people other than the author read it to find anything that the computer missed. One recent request led to multiple errors in the first paragraph of copy on the website. As a physician, once I see that, I’m done. If you don’t have the attention to detail to make sure your copy reads well, I’m not about to consider using you as my patient engagement solution because I can’t trust that you won’t send nonsense to my patients.

Big hugs to my colleagues who are trying to get their practices back up and running after being hit by the recent hurricane and storms. Many can’t even practice remotely or via telehealth due to infrastructure issues and the level of helplessness that some of them feel is agonizing after everything they’ve been through in the last year and a half. Here’s to a speedy restoration and recovery effort.

Has your organization had to cope with storm damage or other recent natural disasters? How are things going from an IT standpoint? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 9/2/21

September 1, 2021 Headlines No Comments

Healthcare Triangle, Inc (HCTI) Files for up to $50M IPO

Healthcare Triangle, a cloud, security, advisory, and implementation services company, files for a $50 million IPO.

Wellbe Inc. receives Series A funding from HealthX Ventures and WISC Partners to accelerate innovation and growth

Madison, WI-based digital care management vendor Wellbe raises $2 million in a Series A funding round.

Telemetrix Completes $1M Seed Round of Funding

Remote patient monitoring startup Telemetrix secures $1 million in a seed round of financing led by South Florida Health.

98point6 CEO Robbie Cape is no longer with the company in abrupt shakeup at telemedicine startup

98point6 co-founder and CEO Robbie Cape leaves the company unexpectedly after having helped it raise $247 million.

Morning Headlines 9/1/21

August 31, 2021 Headlines No Comments

DirectTrust Acquires Assets of SAFE Identity

DirectTrust acquires the assets of Safe Identity, an industry consortium and certification body for digital healthcare credentials.

Ellipsis Secures $26 M in Series A Funding to Pioneer New Clinical Standard in Mental Health Care

Ellipsis Health, which has developed AI-based voice recognition technology to detect signs of depression and anxiety, raises $26 million in a Series A funding round.

Bamboo Health – Combination of Proven Care Collaboration Leaders – Unveiled to Enable Payer-Provider Collaboration for Whole Person Care

Appriss Health rebrands to Bamboo Health following its acquisition of PatientPing.

News 9/1/21

August 31, 2021 News 2 Comments

Top News

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Sources report for the second time in as many months that Baxter will acquire medical equipment company Hillrom for nearly $10 billion. Last month’s initial offer put Hillrom shares at $144 apiece, while this more recent bid inches closer to $150. The deal may be announced before the holiday weekend.

Hillrom has in the last several years ventured beyond its hospital bed roots into health IT, acquiring cardiac monitoring company Bardy Diagnostics for $375 million, patient monitoring vendor EarlySense for $30 million, and clinical communications vendor Voalte for $180 million.

I interviewed Hillrom SVP Mary Kay Ladone, a nearly 30-year Baxter veteran, in March.


Webinars

September 16 (Thursday) 1 ET. “Patient Acquisition and Retention: The Future of Omnichannel Virtual Assistants.” Sponsor: Orbita. Presenters: Harris Hunt, SVP growth product, Cancer Treatment Centers of America; Patty Riskind, MBA, CEO, Orbita; Nathan Treloar, MSc, co-founder and COO, Orbita. Consumers want the same digital healthcare experience from healthcare that they get in online shopping, banking, and booking reservations, and the pandemic has ramped up the patient and provider need for frictionless access to healthcare resources and services. Health systems can improve patient acquisition and retention with the help of omnichannel virtual assistants that engage and delight. Discover how to open and enhance healthcare’s digital front door to offer care that goes beyond expectations.

September 16 (Thursday) 1 ET. “ICD-10-CM 2022 Updates and Regulatory Readiness.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, VP global clinical services, IMO; Theresa Rihanek, MHA, RHIA, mapping manager, IMO; Julie Glasgow, MD, clinical terminologist, IMO. IMO’s top coding professionals and thought leaders will discuss the coding changes in the yearly update to allow your organization to prepare for a smooth transition and avoid negative impacts to the bottom line. The presenters will review new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines, and review modifier changes.

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


Acquisitions, Funding, Business, and Stock

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Tele-genetics testing and counseling company Genome Medical raises $60 million and acquires GeneMatters, which offers genetic counseling via video visit, as well as care delivery and patient engagement software.

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Summit Healthcare reports that revenue and sales have exceeded expectations for the first half of the year, with 18 health systems recently signing on for the company’s data integration and exchange, automation, and business continuity services.

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The tit for tat between NextGen Healthcare’s board members continues, with the company publishing an email from the chair of its nominating committee to board member Lance Rosenzweig to further demonstrate that Rosenzweig and company founder and board member Sheldon “Shelly” Razin are in fact trying to obstruct board operations.

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DirectTrust acquires the assets of Safe Identity, an industry consortium and certification body for digital healthcare credentials.

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Ellipsis Health raises $26 million in a Series A funding round. The startup has developed AI-based voice recognition technology that detects signs of depression and anxiety.

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Appriss Health rebrands to Bamboo Health following its acquisition of PatientPing.


Sales

  • Vizient signs a two-year contract with Ascom, giving its members access to pre-negotiated pricing and terms for the Ascom nurse call and monitoring system.
  • Lee Health (FL), LifeBridge Health (MD), MedStar Health (MD), MercyOne (IA), Moffitt Cancer Center (FL), and MultiCare (WA) sign on for Avia’s membership-based, digital healthcare transformation consulting services.

People

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LexisNexis Risk Solutions, Healthcare CEO Josh Schoeller takes on the additional role of Elsevier Clinical Solutions president.

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The VA promotes Neil Evans, MD to acting CIO.

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Twistle President and COO Matt Revis also joins the Health Catalyst leadership team. Health Catalyst acquired Twistle in June.


Announcements and Implementations

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Spok announces GA of its ReadyCall Text waiting room pager, alongside enhancements to its Spok Go clinical communications platform.


Government and Politics

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The FBI issues an alert about Hive ransomware, which has attacked nearly 30 healthcare organizations since first detected in June. The alert may have been spurred by the mid-August attack on Memorial Health System (OH), which ended up paying the hackers to regain access to internal systems that include 800 servers and 3,000 personal devices used by physicians.


COVID-19

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A pre-print analysis of 24 statewide COVID-19 vaccine incentive programs finds no significant change in vaccination rates within those states, and no significant difference in vaccination trends between states that did and did not offer incentives.

A church youth camp and concurrent (though separately located) men’s conference held by the same organization in June has been linked to 180 confirmed and probable COVID-19 cases, most of whom were unvaccinated. Those cases ultimately led to 1,000 people in four states being exposed through attendance or close contact. The host organization did not require testing or vaccination for either event.


Other

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Southern Louisiana hospitals in the path of Hurricane Ida have reported extensive roof damage, inoperable phone systems, power failures, and the need to enact staffing emergency staffing protocols. Hospital operations teams were especially concerned about the storm’s impact coupled with a surge in COVID-19 patients. More than 2,400 COVID-19 patients were hospitalized across the state as of Sunday.

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Jury selection has begun in the trial of Theranos founder Elizabeth Holmes. Set to start on September 8, the trial has been postponed several times since she was charged with multiple counts of conspiracy and fraud in 2018. This article offers a quick refresher on what led up to the legal proceedings.

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A study published in Contraception looks at the growing trend in at-home IUD removal and the corresponding uptick in DIY videos on Youtube and TikTok. Top motivators for the at-home option include the expense of an in-office procedure, side effects, a desire to get pregnant, and even unwillingness on the part of some providers.


Sponsor Updates

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  • Ellkay has sponsored the Cerner Foundation’s Westport Bounce, which provides funding for equipment, medicine, surgeries, travel, and wellness screenings to students.
  • Spok publishes a new e-book, “The ROI of the Spok Go clinical communication and collaboration platform.”
  • CereCore wins ClearlyRated’s 2021 Best of Staffing client and talent awards for service excellence.
  • Cerner CIO Bill Graff wins CIO of the Year in the Orbie Awards’ large enterprise category.
  • CHIME’s Digital Health Leaders Podcast features Monument Health CIO and CMO Stephanie Lahr.
  • Clearwater publishes a new case study, “A Clear Success: Strong Cybersecurity & HIPAA Compliance Program Positions CaringWays for Growth.”
  • Clinical Architecture celebrates its 14th anniversary.
  • Dimensional Insight’s Smarter Healthcare Podcast features Mass General Brigham Chief Digital Health Officer Alistair Erskine, MD.
  • Cooper University Health Care (NJ) expands its use to Nuance’s Dragon Ambient Experience to 475 physicians and APPs.
  • EClinicalWorks releases a new podcast, “Improving Patient Safety by Reducing Uncoded Allergies.”

Blog Posts


Contacts

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

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Morning Headlines 8/31/21

August 30, 2021 Headlines No Comments

Baxter Is in Advanced Talks to Buy Hill-Rom for About $10 Billion

After similar talks fell apart last month, Baxter will reportedly acquire medical equipment company Hillrom for nearly $10 billion.

Biden-Harris Administration Invests $10.7 Million in American Rescue Plan Funds to Expand Pediatric Mental Health Care Access

HHS allocates $11 million to expand its Pediatric Mental Health Care Access program, giving pediatric teams across the country access to telemedicine-focused consultation, training, technical assistance, and care coordination services.

Genome Medical Announces Acquisition of GeneMatters and Closing of $60 Million Series C Financing

Virtual genomics provider Genome Medical raises $60 million and acquires GeneMatters, which offers genetic counseling via video visit, and care delivery and patient engagement software.

Curbside Consult with Dr. Jayne 8/30/21

August 30, 2021 Dr. Jayne 3 Comments

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During the past couple of weeks, I have spent some quality time doing decidedly low-tech things. I know I’m going to be starting a big project soon and plan to be heads-down for many months, so I’ve been trying to get as much adventure on the calendar as I can.

Camping is one of my low-tech pastimes and sometimes it’s just good to get away from the hustle and bustle, although I did enjoy having the option of firing up the hotspot and getting a little work done while I was away. I can’t say I enjoyed the ridiculous humidity or the high number of spiders that wanted to join me in my tent, but overall, it was a good couple of days away.

I also had the opportunity to take an 80-year trip back in time. The Union Pacific “Big Boy” 4014 locomotive has been touring the US, delighting tens of thousands of fans as it carves a figure eight covering Wyoming, Nebraska, Kansas, Oklahoma, Texas, Louisiana, Arkansas, Missouri, and Colorado. Having spent a good chunk of my career in healthcare IT, I’m a fan of complex systems. However, you haven’t seen a complex operation until you’ve seen what it takes to run an 80-year-old steam locomotive in the modern world. The Big Boy class of steam locomotives was the largest ever built, and they were originally used to haul freight over the Wasatch mountains. At the time, supporting infrastructure along the route would have included water tanks to keep the boiler full as well as maintenance facilities that could handle such a beast.

Needless to say, nothing like that exists in the US any more, so the train is accompanied by fuel trucks that can supply the recycled oil it runs on after being converted from coal. It also runs with multiple water cars to supply the 100 gallons it goes through each mile as well as a customized tool car that contains nearly everything it takes to keep it running. The train stops every couple of hours for maintenance and lubrication and is accompanied by a “helper” diesel engine to supply dynamic braking so that the antique doesn’t wear out its own brake shoes, since they have to be changed from below and nowhere on the tour has a roundhouse that can support a 1.2-million-pound locomotive. Stopping every couple of hours also allows people all over the US to come out and see it.

Just looking at all the piping, valves, gaskets, and hardware on the locomotive reminds me of the most complex and ancient IT systems I’ve worked with – those where any number of points of failure can bring the system to its knees and there are only a handful of people with the knowledge and skills to keep them running. During the stop I visited, I was able to see the Union Pacific “pit crew” in action getting the Big Boy ready to move out. In addition to replacing a gasket and refilling the water cars, they also performed some “percussive maintenance” on a couple of parts. and I think we can all sympathize with systems that we want to hit with a hammer at times, although the Union Pacific Steam Team gets to do it for real.

Seeing the Big Boy’s crew in action was also a great study in team dynamics. They clearly have made it to the performing stage of team development and were working in 100-degree heat with complete focus and dedication. The head of the team was spotted stabilizing a ladder for another crew member, which reminded me of some of the hospital administrators that I most enjoyed working with, those who weren’t afraid to roll up their sleeves and get to work when things got tough.

In between tasks, they were being peppered with questions from the crowd, which they always answered with a smile. Since they’re essentially rock stars of the railroading world, they were also being asked to autograph all kinds of memorabilia. Watching them interact with the children in attendance, many of whom were dressed like the crew, was priceless. One of the highlights was watching the team’s leader stand on the roof of the cab and capture video of the crowd. Seeing thousands of people come out to admire your work has to be a pretty big rush, I’d imagine.

I was also happy to learn about some of the problem solving that had to happen during the locomotive’s restoration. Much like our work in healthcare (and especially in healthcare IT) if the team didn’t have what they needed to get the job done, they had to figure out how to create it. Where they might be fabricating replacements for 80-year-old parts (as well as the tools to service them) we’re often creating solutions to problems that at times feel like they’re being randomly thrown in our direction. Since patient care is at stake, we don’t have the option of not solving them, so we have to get creative and sometimes cobble things together to get the job done. Those of us supporting legacy systems have to learn how to do things we never thought would be on our plate, and it was a good reminder that every day is a new adventure.

As dark as some of my healthcare days have been over the past year and a half, seeing the crowd at the display event gave me a lot of hope. The Big Boy brought out people of all ages, from newborns in carriers to a woman who was 99 years old, as well as different social, economic, and cultural groups. Despite a mix of masked and unmasked attendees at the outdoor event (although masks were required for those entering the actual railcars) and despite the heat and the fairly crowded conditions, I didn’t hear a single negative word about anything. People were so intent on just experiencing the wonder of the situation that everything else was secondary. When people were inadvertently jostled or bumped, apologies were given from both sides, which is seemingly rare in these days. Union Pacific kept the crowd well supplied with ice water and places to rest in the shade and provided golf carts for those who needed assistance. There was no jockeying for places to take pictures, everyone waited their turn, and it was just a pleasant time to experience a taste of the past. Best of all it was free, so kudos to Union Pacific for an outstanding public relations event that gave a lot of people great joy.

I’ll definitely go into this week with a new appreciation of the concept of hard work, as well as a boost in my mood based on my encounter with the Big Boy and all of its fans. Here’s to better times where everyone can rally around something that unites us and puts a smile on all our faces.

Have you ever heard a steam whistle that rings right through to your soul? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 8/30/21

August 29, 2021 Headlines 1 Comment

Google confirms it’s pulling the plug on Streams, its UK clinician support app

Google shuts down its DeepMind-developed Streams app that displays patient information to UK clinicians.

Olive Launches Olive Ventures, an In-House Venture Studio

Olive launches an in-house venture studio for startups that are developing solutions for its automation platform.

Justice Department Settles with Large Health Care Organization to Resolve Software-Based Immigration-Related Discrimination Claims

Ascension pays $85,000 to settle charges that it violated federal immigration laws because of a software programming error that caused its employee eligibility verification software to send automated emails to all of its non-citizen employees whose documents were set to expire, requesting them (some erroneously) to submit proof of continued work authorization.

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Reader Comments

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