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News 7/31/20

July 30, 2020 News 2 Comments

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HIMSS reschedules its HIMSS21 conference to August 9-13 in Las Vegas. It was originally planned for March 1-5.

HIMSS22 reportedly remains on schedule in Orlando for March 2022, just seven months later.


Reader Comments

From Pearl Drops: “Re: HIMSS21. In August? In Las Vegas? Really?” My reaction:

  • Assuming the event actually happens a year from now, it will have been 30 months since the last live HIMSS conference. Relevance is a crapshoot given the ill will created by the HIMSS20 refund policies, the pandemic’s financial impact on exhibitors and attendees, and the many months everybody will have had to decide whether they should just show up lemming-like as usual or instead look harder at ROI. People have learned to live without restaurants, sports, and concerts in their absence with potentially permanent impact, so a full-fledged return to conference life is far from assured. 
  • The email says HIMSS22 will remain on track for March in Orlando, which would mean doing it all over again just seven months later, so the fatigue factor could be significant.
  • The revenue hit to HIMSS is surely monumental just from timing alone, not even considering a likely big drop-off in exhibitor and registrant revenue.
  • The timing of HIMSS20 could not have been worse for HIMSS since it coincided with the early start of a long pandemic, thus impacting at minimum both HIMSS20 and HIMSS21. RSNA20 moved to a virtual event in losing one live conference, but its 2021 conference will take place as planned unless 2021 is a full-year scratch, in which case HIMSS will be in even more trouble.
  • I visited my least-favorite city of Las Vegas in late June a few years back to scout HIStalkapalooza venues, and it was nuclear hot even then. I swear my flip-flops started melting while walking to the pool, which was steamier than any hot tub should be. Miserable outdoor heat is good for exhibitors and casinos, however.

From Concision: “Re: health IT articles. Have you noticed how long they take to get to the point and start off reciting the obvious?” I have. Writers are either short on skill or long on vanity when they can’t lead off with compelling information and instead meander around before making some questionably valuable point. I turned down a lot of Readers Write articles because of my #2 test (after #1, “don’t pitch your company”) – if three randomly chosen sentences don’t contain anything insightful or fresh, or if the opening sentences stiffly recap universally known facts, then you’re wasting the time of readers.

From Vaporware?: “Re: DoD. Fascinating update from Cerner earnings call, and a reminder that the CommonWell Vaporware Alliance was formed in March 2013 to address the DoD’s expressed desire for an interoperable EHR.” Cerner mentioned in the earnings call that DoD and the VA launched a joint HIE in April and will connect to CommonWell later this year.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Everbridge. The Burlington, MA-based company is the global leader for integrated critical event management (CEM) solutions that automate and accelerate organizations’ operational response to critical events to help keep people safe and businesses running faster. More than 1,200 hospitals rely on the Everbridge CEM Platform to deliver resilience on an unprecedented scale. With COVID-19, Everbridge is helping hospitals to safely resume care and establish a new normal with a robust risk mitigation and emergency response platform that offers automated contact tracing and wellness checks, safe and secure telehealth, critical events management platform, incident management response for cybersecurity risks, and digital wayfinding with blue-dot turn-by-turn navigation. Thanks to Everbridge for supporting HIStalk.


Webinars

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

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


Acquisitions, Funding, Business, and Stock

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Allscripts reports Q2 results: revenue down 8.6%, adjusted EPS $0.18 versus $0.17,  beating Wall Street expectations for both.

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Allscripts will sell its EPSi business unit to Roper Technologies-owned Strata Decision Technology for $365 million.

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Cerner reports Q2 results: revenue down 7%, EPS $0.44 versus $0.39, beating consensus earnings expectations but falling short on revenue. From the earnings call:

  • The company says its revenue came in lower than expected because the pandemic impacted sales or timing of some low-margin offerings, such as technology resale and billed travel.
  • Q3 revenue expectations have been reduced because of divested businesses and a larger-than-expected pandemic impact, but the company expects earnings to grow due to cost reduction.
  • The company says it won’t cut R&D spending.
  • Cerner says that while virtual go-lives work for simple implementations, the future model will be a hybrid, with fewer people on site who are supported centrally, which also reduces billable travel for the client. The company notes that employees are 25% more productive working remotely because avoiding two half-days of travel during the work week means they have five days billable per week instead of four.
  • Cerner is looking beyond its Amwell virtual visit partnership to virtual hospitals and ICUs that would involve its CareAware platform.
  • An analyst asked about a $35 million acquisition that he saw on the cash flow statement, which Cerner says was for a cybersecurity company that it can’t talk about otherwise.
  • Cerner is interested in acquisitions related to research data and analytics.
  • The grating phrase “new operating model” thankfully wasn’t uttered even once.

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Teladoc Health reports Q2 results: revenue up 80%, EPS -$0.34 versus –$0.41, beating revenue expectations but falling short on earnings. Expenses increased 63%, mostly in marketing, sales, technology, and acquisition costs, and the company projects a loss per share of $1.36 and $1.45 for the year.

Private equity firms TA Associates and Francisco Partners invest in healthcare clearinghouse operator Edifecs at a valuation of up to $1.8 billion.

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Private equity firm Leonard Green & Partners acquires a stake in WellSky from TPG Capital that values the company at over $3 billion.

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Ciox Health acquires NLP vendor Medal to enhance its real-world data business for drug companies and researchers with information extracted from unstructured EHR data. 

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NantHealth acquires OpenNMS, which offers an open source network management system.

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In-hospital specialty care telemedicine provider SOC Telemed merges with Healthcare Merger Corp. in a complicated transaction that will create a Nasdaq-listed company that values SOC at $720 million.


Sales

  • Australian Capital Territory government chooses Epic for implementation across Canberra’s public hospitals and community health centers in a 10-year, $80 million contract.
  • Summit Healthcare announces several new clients for its Summit All Access for web-based and mobile information sharing, including ADT notification, community data sharing, and downtime data access.
  • Franciscan Health chooses Accruent’s Connectiv software, based on ServiceNow, to manage its facilities and biomedical assets and devices.

People

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David Tucker. MHA, MBA (Huntzinger Management Group) joins 314e as VP of sales and client services.


Announcements and Implementations

WebPT adds 1,700 clinics to its rehab therapy platform in the first half of 2020 as the company rolled out a virtual visit system, a digital patient intake feature to minimize waiting room contact, and increased use of its patient relationship management solution. 

Diameter Health releases its turnkey FHIR Patient Access solution that allows payers to comply with CMS requirements that they give members access to their data using FHIR standards.

Goliath Technologies creates a managed service offering for remotely monitoring the availability of applications running under Citrix and VMware Horizon, which allows clients to make sure users aren’t having problems accessing business applications from home or other offsite locations.

InterSystems lists how its TrakCare health information system has been globally deployed in response to COVID-19, including rollout of a screening module that was installed on site in Beijing early in the pandemic, connecting labs and temporary hospitals in Madrid, creating interfaces between new COVID-19 testing machines to its lab system in 48 hours, and implementing TrakCare Lab Enterprise for the 118 COVID-19 labs of the UAE’s Pure Health in two weeks.

Premier enhances its crisis forecasting and planning technology to predict a given hospital’s COVID-19 patient census in near real time.

DirectTrust releases the draft of its Trusted Instant Messaging+ standard for testing.

Aiva offers customers of its in-room patient communication system – which is powered by voice assistants such as Amazon Alexa and Google Assistant — with caregiver-to-caregiver technology from Hillrom’s Voalte.

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Cerner will add Nuance’s virtual assistant technology to Millennium, allowing users to navigate by voice for chart search, order entry, and scheduling. 

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Intelligent Medical Objects launches IMO Precision Normalize, which standardizes diagnosis, procedure, medication, and lab data from diverse systems into common, clinically validated terminology.


Government and Politics

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An NPR investigation into HHS’s awarding of a $10 million contract to health IT vendor TeleTracking for a COVID-19 hospitalization data collection system finds several irregularities:

  • HHS first said the contract was sole source, but now says it was competitively bid among six companies that it declines to name using criteria that it declines to list.
  • The process HHS used to award the bid is normally used for innovative research, not the development of government databases.
  • TeleTracking’s CEO is a long-time Republican donor who is loosely connected to a company that financed billions of dollars worth of Trump Organization projects.
  • The contract ends in September and TeleTracking says it hopes for an extension, which could cost millions. The current contract is 20 times larger than all of TeleTracking’s previous federal contracts combined.

COVID-19

The US now leads the world in number of COVID-19 deaths per day, averaging over 1,000 and most recently hitting nearly 1,500 as total US deaths crossed the 150,000 mark. The US has less than 5% of the world’s population, but nearly 25% of its COVID-19 deaths.

An HIStalk reader reports that their large Texas hospital has been forced yet again to change COVID-19 testing platforms due to a nationwide supply shortage, leaving clinicians and the IT folks scrambling. Delayed results force clinicians to assume that the patient is positive, which requires them to needlessly use PPE that is also in short supply.

The COVID Tracking Project says COVID-19 hospitalization data is now unreliable, partially due to HHS’s no-notice switch to a new reporting system:

  • Some states can’t report their data at all, some hospitals have stopped submitting data, and hospitalizations don’t always line up with local case counts.
  • HHS and state-reported hospitalization information is sometimes dramatically different, with HHS oddly reporting higher numbers much of the time.
  • HHS collects information of all COVID-19 hospitalizations, including suspected cases, but some states report only those cases in which COVID-19 is the primary diagnosis.
  • States that collect information from state hospital associations may not be reporting numbers from the VA or other federal hospitals.
  • Each state decides on its own which information to make public on dashboards and reports, which then feeds national dashboards such as that of the COVID Tracking Project.
  • Case, testing, and death data remain accurate because the information was not affected by HHS’s change.

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University of Colorado School of Medicine describes in a JAMIA article how it applied informatics interventions to meet UCHealth’s COVID-19 challenges, drawing on the relationships its doctors and nurses have with frontline staff and their experience in leading change. The team:

  • Used an electronic teaching tool to ramp up EHR training for nurses who were being prepared for inpatient roles.
  • Developed an electronic training guide for volunteer clinicians that included embedded videos and linked resources that covered, EHR, rounding, and common patient conditions.
  • Created new Epic-based pathways using AgileMD that included proning, clinical trials, convalescent plasma, antivirals, anticoagulation, intubation checklist, septic shock, and hyperinflammatory response treatment.
  • Added “indication for use” to discourage unapproved use of hydroxychloroquine and azithromycin.
  • Created a Virtual Health Command Center to train clinicians on its Epic-integrated Vidyo virtual visit system in two weeks.
  • Coordinated with the patient experience team to present training webinars on conducting video visits, including non-verbal communication and reflective listening.
  • Partnered with Masimo to deploy a wearable device for discharged patients to monitor respiratory rate, heart rate, and pulse oximetry.
  • Redeployed tablets to COVID-19 units to minimize staff exposure, to provide remote translator service, to help the palliative care team convene videoconferences with patients and families, to present group therapy for psychology and rehab, and to capture audio and video from non-networked monitors so that nurses can listen for alarms from the nursing station (pictured above).
  • Created a Microsoft Teams collaboration site for regional intensivists, which then led to creating a public website for community providers.
  • Developed logic for three levels of COVID-19 chart alerts based on patient check-in information.
  • Developed note templates to store patient advance directive status in a central location.
  • Helped nurses who were not able to work in the hospitals to use Epic Secure Chat to follow patients and then update their families, who were not allowed to visit.
  • Created a scoring tool to ration therapy if needed.
  • Studied EHR data for information that could be predictive of hospitalization rates. 

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Yale New Haven Hospital describes how it customized Epic’s antimicrobial stewardship module for COVID-19, developing patient lists, assessment tools, and a handoff process, all to support reviewing a large number of patients quickly and to optimize their management.

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Former FDA Commissioner Scott Gottlieb, MD raises an interesting economic point.

Wolters Kluwer Health uses clinical search activity in its UpToDate reference, along with online and mobility data, to predict COVID-19 outbreaks in specific areas.

Seventeen University of Florida Health anesthesiology residents and one fellow contract COVID-19 after attending a party that was attended by 20-30 residents. The health system refused to acknowledge either the outbreak or the party in inappropriately citing HIPAA.

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Former Republican candidate for President Herman Cain dies at 74 of COVID-19, for which he tested positive nine days after attending President Trump’s June 20 Tulsa rally without wearing a mask even though he was a Stage 4 colon cancer survivor.

The House of Representatives requires members to wear masks following the COVID-19 diagnosis of Rep. Louie Gohmert (R-TX), who previously refused to wear a mask for protection against the “Wuhan virus” and then speculated after testing positive that, “I can’t help but think that if I hadn’t been wearing a mask so much in the last 10 days or so, I really wonder if I would’ve gotten it.”

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Amazon Prime Air drone engineers design NIH-approved face shields that Amazon will sell at cost to frontline workers, saving them at least one-third over other reusable face shields at $2.65 each. The company is also offering an open sourced design package for 3D printing and injection molding.

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A Vanity Fair investigative report finds that a White House panel led by Jared Kushner developed a national COVID-19 testing strategy and ordered 3.5 million China-produced tests for $52 million from a company connected to the ruling family of the United Arab Emirates, but the tests were contaminated and unusable. The group’s national testing strategy was never announced and testing responsibility was eventually moved to individual states, to the group’s surprise. It called for federal distribution of test kits, oversight of contact tracing, lifting contract restrictions on where doctors and hospitals send tests so that any laboratory could perform testing, reporting all test results to a national repository as well as state and local health departments, and rapidly scaling up antibody testing to support returning employees to work. It also proposed establishing a “national Sentinel Surveillance System” with real-time identification of hot spots. The plan lost favor with President Trump, who insiders say was worried that more widespread testing would increase case counts that would harm his re-election chances. He favored optimistic coronoavirus models from Deborah Birx, MD that were eventually proven to be wildly wrong. The report also found that one member of Kushner’s team argued that a national plan would squander the political opportunity to blame Democratic governors of states that were being hit hardest early in the pandemic.


Other

Nacogdoches Memorial Hospital (TX) and Cerner agree on partial payment to settle the $20 million the hospital owes for an implementation it delayed repeatedly and finally cancelled.


Sponsor Updates

  • Diameter Health launches FHIR Patient Access to help payers comply with federal regulatory requirements to provide members with access to their health data using FHIR standards.
  • TriNetX will conduct a medical record review of 200 hospitalized COVID-19 patients to create a dataset that can be used to support drug treatment and vaccine research.
  • InterSystems introduces a new credentialing program for its products and technologies.
  • Fortune profiles the way in which Jvion re-focused its CORE technology to develop a COVID-19 community vulnerability map.

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 7/30/20

July 30, 2020 Dr. Jayne No Comments

It’s been a wacky week in the informatics trenches, as I had a run of non-clinical days in preparation for working three in a row this weekend. I used the time to attempt to catch up on email and voice mail. Although I’m still woefully behind, it’s a little more under control.

One of the voice mails that was left for me was priceless. “Hi, this is Kate from X Company. We’re one of your company’s approved vendors for staff augmentation services and wanted to talk to you about your upcoming projects and any staffing needs you might have.” Since I’m the person that would approve any vendors and had never even heard of this company, I just chuckled and hit delete. I wonder if this is the way they do business all the time, and if people actually fall for it.

I also had a chance to catch up with some of my colleagues across the country and get a feel for how they’re coping with either an extended first wave, or the beginnings of a second wave, of COVID cases. It seems the theme of the last couple of weeks has become “patients behaving badly,” with increased conflicts at the front desk from patients who refuse to wear masks. Especially entering a medical office, I think having a healthcare institution require a mask is no different from “no shoes, no shirt, no service” anywhere else (although I always wondered why they didn’t require pants, but that’s another discussion).

One colleague’s practice had to bonus their receptionists because they were threatening to quit due to the stress of having people come in and yell at them. Another physician friend told a story about coming around the corner in the office and having a patient raging in the hallway about being refused a rapid test, because his son is a major league sports player and the dad needs a documented negative to be able to interact with him. The kicker – dad was standing in the hallway with no mask on in a healthcare facility that has a 20% positive return rate on tests. You can’t make this stuff up.

In other news you can’t make up, rumor has it that HIMSS is moving the HIMSS21 conference from spring to August next year, but still in Las Vegas. A friend mentioned it after seeing it in Modern Healthcare, but HIMSS didn’t bother to put an announcement on its website or send anything out to members, including our local chapter president. Seems like their communication is really improving since the debacle of this spring.

That would make it almost a year and a half between HIMSS meetings, which is plenty of time for vendors to come up with new and creative offerings. Still, it remains to be seen how many companies will actually exhibit, given how much money was lost on HIMSS20 and the potentially limited pool of attendees if international travel is still snarled and domestic institutions aren’t eager to allow their employees to head to a 40,000 person Petri dish. I spoke with my favorite traveling technology consultant the other day and his employer has him grounded, even though he’s amenable to travel and clients are requesting him on site.

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Perhaps by August 2021 we’ll see a healthcare implementation of smart glasses again. Remember the exciting times of Google Glass and when wearables were just coming on the market? We need some cool offerings to get us excited again. Vuzix has an industrial application that includes Bluetooth connectivity and voice recognition, which might be attractive in healthcare. Apparently, several healthcare institutions in the US are already piloting the device and it’s also being used internationally. Battery life is supposedly 16 hours, which is pretty impressive. It uses the same chip as Google Glass, but seems more rugged and can be disinfected with alcohol-based products so it meets the COVID challenge. If they’re looking for a sassy urgent care doc to give it a try, I might know someone. It might also find interesting applications in education, since it looks like many school districts across the nation will be embracing distance learning this fall.

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I attended the Health Impact Summer Forum and really enjoyed the keynote speech with Wendy Dean MD, who is a psychiatrist and co-founder of the non-profit group The Moral Injury of Healthcare. I’ve written a couple of times about moral injury and it’s gotten even worse with COVID. Organizations are still rationing personal protective equipment and we’re still operating under crisis standards of care, seven months into this pandemic. Clinical workers are risking their lives daily, often for patients who don’t care and who may be hostile to them. One local practice refused a physician’s request to put up signs asking patients to keep their masks on in the exam room while waiting because it would be perceived as “unwelcoming.” This is nonsense, plain and simple, and Dr. Dean validated the negative impacts of decisions like this.

She commented that calling healthcare workers “heroes” makes the public think we can do anything, when in reality our “superpower” is our humanness. She commented on the business challenges that are impacting clinical care as well. The pandemic certainly highlighted the broken pieces of our healthcare system in the US and identified opportunities for improvement. She notes that there is no clearly drawn road map that gets us where we want to go and proposes that we start orienteering with our moral compass as our guide and excellent patient care as our true north.

As someone who knows her way around a map and compass but who has been lost in the healthcare trenches for years, that definitely resonated with me. I really enjoyed Dr. Dean’s commentary on the issue and just having my feelings validated gave me hope. There’s another Forum in the fall and I’ve already signed up.

Is your employer taking any steps to combat moral injury as the pandemic rages on? How are your support structures? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 7/30/20

July 29, 2020 Headlines No Comments

Humana invests $100 million in telehealth start-up Heal

App-based house call and virtual primary care company Heal announces a $100 million investment from Humana, which will offer the company’s services to its members.

Cerner Earnings Beat, Revenue Misses In Q2

Cerner announces Q2 earnings per share of $0.63 on revenue of $1.33 billion, down slightly from analyst expectations of $1.36 billion.

Using population health analysis to improve patient care brings Sema4 a $1.1 billion valuation

Mt. Sinai Health spin-off Sema4 raises $121 million, earning the precision medicine and analytics company a $1.1 billion valuation.

SOC Telemed to Merge with Healthcare Merger Corp.

Special purpose acquisition company Healthcare Merger combines with SOC Telemed under the acute-care telemedicine company’s brand, which will be listed on the Nasdaq at an initial valuation of $720 million.

Morning Headlines 7/29/20

July 28, 2020 Headlines No Comments

Withings raises $60 million to bridge the gap between consumer tech and healthcare providers

Withings will use a $60 million Series B funding round to building out its Med Pro division, which offers remote patient monitoring devices to programs run by providers, payers, and employers.

TA, Francisco Partners join hands in $1.4bn-plus deal for Edifecs

Francisco Partners and TA Associates invest in health IT company Edifecs, giving them a combined 51% interest in the company.

Ciox Health Acquires Biomedical Natural Language Processing Pioneer, Medal, Inc.

Health records retrieval company Ciox Health acquires Medal, which specializes in using AI to process unstructured data from medical records.

DOE, HHS, VA Announce COVID-19 Insights Partnership

HHS and the VA will use the Department of Energy’s high-performance computing and AI resources to analyze health data and conduct COVID-19 research.

News 7/29/20

July 28, 2020 News 2 Comments

Top News

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Withings raises $60 million in a Series B funding round led by Gilde Healthcare. The investment will go towards building out its Med Pro division, which offers remote patient monitoring devices to programs run by providers, payers, and employers.

The company pivoted largely from consumer wearables to medical-grade products when several of its original founders and investors re-acquired it from Nokia in 2018.


Webinars

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

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


Acquisitions, Funding, Business, and Stock

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Transformative raises $1.7 million to further develop and gain FDA clearance for software that can predict cardiac arrest in pediatric patients. The company plans to eventually launch similar capabilities for other life-threatening conditions.

Connecticut Children’s Medical Center and consulting firm Guidehouse will launch an RCM software and services company for pediatric healthcare facilities.


Sales

  • Allegheny Health Network (PA) selects prescription-savings software from Medicom Health.
  • Sana Behavioral Hospitals (AZ) will implement Medsphere’s CareVue EHR and RCM Cloud technologies.
  • Cooper University Health Care (NJ) selects Nuance’s Dragon Ambient EXperience, which includes app-based virtual assistant and clinical documentation capabilities.

People

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Tim Conroy (Refocus Data) will join Cary Medical Center (ME) as CIO.

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Optimum Healthcare IT names Brenda Ashley, RN (Impact Advisors) VP of its Last Mile Training program.

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Don Pettini (Change Healthcare) joins Trio Health as CTO.


Announcements and Implementations

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The University of California, Irvine Medical Center equips its new 16-bed unit with EHR-integrated digital whiteboards and interactive bedside technology from Sonifi Health.

In Chicago, the Midwest Institute for Minimally Invasive Therapies implements Saykara’s voice-enabled, mobile AI assistant for physician charting.

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Summit Healthcare announces GA of All Access software to help providers better comply with CMS Conditions of Participation and access data during downtimes.


COVID-19

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Texas health officials who approved the $295 million purchase of contact-tracing software from MTX Group say they are now running into technical difficulties that prevent its widespread use. Workers hired to help with the Texas Health Trace program have reportedly been left with little to do, citing confusing instructions and, presumably, poor training.

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The New York Times paywalls what is presumably a profile of disgraced vascular surgeon Sapan Desai, MD, PhD one of three collaborators that put together an influential COVID-19 treatment study published and then retracted by The Lancet and New England Journal of Medicine after fault was found with underlying data provided by Desai’s now-shuttered company Surgisphere.

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Clinicians at Yale New Haven Hospital in Connecticut share how they repurposed their Epic system’s antimicrobial stewardship module to care for a surge in COVID-19 patients.

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XPrize launches a six-month Rapid Covid Testing competition that will award $5 million to teams that develop faster, cheaper, and easier to use COVID-19 testing methods.


Other

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HIMSS is considering a new date for HIMSS21, currently scheduled to take place March 1-5 in Las Vegas. The society has promised more concrete details by the end of the week. Should the conference be pushed out to August, we’ll get to enjoy average daily temperatures of around 104°. UPDATE: a reader forwarded an email HIMSS reportedly sent to exhibitors confirming a new HIMSS21 date of August 9-13. I’ve asked HIMSS to confirm.


Sponsor Updates

  • The Chartis Group promotes Mike D’Olio to director.
  • Cumberland Consulting Group achieves HITRUST CSF certification to further mitigate risk in third-party privacy, security, and compliance.
  • Dina wins the 2020 Transition of Care Challenge put on by Tulane Health System and the New Orleans Business Alliance.
  • OptimizeRx makes its digital health information, including prescription savings and treatment information, available through Change Healthcare’s Intelligent Healthcare Network.
  • Hillrom integrates its Voalte clinical communication platform with Aiva’s voice assistant technology.
  • Health Catalyst makes available financial impact recovery applications to help providers manage elective backlogs and evaluate performance.

Blog Posts


Contacts

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

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Morning Headlines 7/28/20

July 27, 2020 Headlines No Comments

Ro, a 3-year-old online health provider, just raised a new round that values it at $1.5 billion

Health, wellness, prescription delivery, and telemedicine company Ro raises $200 million.

Transformative Raises $1.7M Seed Round After Developing Technology That Predicts Sudden Cardiac Arrest

Transformative raises $1.7 million to further develop and gain FDA clearance for software that can predict cardiac arrest in pediatric patients.

Connecticut Children’s Medical Center and Guidehouse Form New Company to Deliver Revenue Cycle Management Improvements to the Pediatric Healthcare Industry

Connecticut Children’s Medical Center and consulting firm Guidehouse launch an RCM software and services company for pediatric healthcare facilities.

Curbside Consult with Dr. Jayne 7/27/20

July 27, 2020 Dr. Jayne 5 Comments

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I’m not sure if I ever thought I’d reach this point, but today marks my 1,000th post for HIStalk. I should have hit it earlier in the year, but without daily posts from HIMSS it took a little longer than anticipated. I’ve been struggling with what to write about, since I felt like it should be something with gravitas for a momentous occasion. I don’t think any of us thought we’d be in the middle of a global pandemic this year, and that our industry would be going through all kinds of changes as the world’s healthcare system is pushed to the breaking point. After floating in the neighbor’s pool for a couple of hours, which is marvelous for achieving clarity, I decided to do a little tour down memory lane.

My first post appeared on January 8, 2011, when we were deep in the world of Meaningful Use. Browsing through my first few months of writing, I came across a quote that certainly applies to 2020. “The life of a CMIO is never dull; there’s always a fire to be put out somewhere, and usually an angry physician behind the scenes holding a lit match.” Over the last nine and a half years, the physicians have become less angry about IT projects, but now they’re burned out and frustrated from the challenges of treating a brand-new and deadly virus in less than ideal circumstances. I don’t envy members of technology teams that have to try to deploy new solutions in this challenging new environment.

The next year brought such adventures as the transition to the HIPAA 5010 transaction standard and the beginning of Medicare allowing its claims database to be used for provider report cards. August 2012 brought the passing of astronaut Neil Armstrong, and I had a few things to say about his passing that still ring true today:

His death was marked in a way that matched the way he lived – quietly and with little fanfare. By commanding the Apollo 11 mission and being the first person to walk on the moon he had earned the right to be celebrated. The amazing part of his story however is what happened after July 20, 1969. He didn’t dance in the end zone or become tabloid fodder. He went back to work and back to his roots. I’m touched by a quote from an article marking his passing. In an interview in February 2000 he said:

I am, and ever will be, a white socks, pocket protector, nerdy engineer. And I take a substantial amount of pride in the accomplishments of my profession.

We should all take a substantial amount of pride in the accomplishments of his profession. Not to take anything away from the astronauts, but I’m talking about the engineers. NASA’s steely eyed missile men sent people to the moon using chalk boards and slide rules. They didn’t have anywhere near the technology that most of us carry in our pockets today, but they changed the world.

Those of us working in health care IT today are up to our eyeballs in technology. It feels like things are moving so fast we will never catch up. As hospital leaders we are challenged to deploy the latest “thing” regardless of quality or outcomes. I have many friends in the medical software industry ranging from developers to CEOs. The aggregate of their skills and creativity could propel us into a new era of patient care. Instead we seem mired between the twin terrors of governmental compliance and simply improving yesterday’s products. I want to see the software equivalent of the space race where vendors are competing for the best designers and engineers and working to deliver a superior product.

Rather than the challenge of getting a man to the moon and returning him safely, the goal should be to deliver patients safely through the health care experience while we collect all the telemetry data needed to make the next trip with even better safety and quality. Another challenge – it’s easy to forget that as broken as our health care delivery system is, it is still better than what is available in some parts of the world. Let’s figure out how to make those leaps for all mankind.

It really got me thinking about whether we’ve really made the great leaps we could have been making over the last eight years. Although there are some nimble companies innovating, from the physician end-user perspective, it feels like we’re still dealing with marginal improvements on older products. The exam room of the future has not yet come to pass for the more than a handful of physicians, and although we can ask Alexa for the weather forecast, we certainly can’t ask her to predict when we’ll actually see the results of the COVID swab we just ordered. We’ve had a substantial missed opportunity as far as improving the lives of our end users, who have largely slipped into the mode of learned helplessness.

Thumbing through posts from around Thanksgiving in that year, I had a moment of sadness as I read “Dr. Jayne’s Holiday Recipe Guide.” I think it’s safe to say that the days of the office potluck are over for the foreseeable future. I treasure those times spent with my team as well as the delicacies shared – whether it was Bianca Biller with her “Hot Bacon Dip” or Paul the Intern with his “Crave Case” of White Castle hamburgers, there was always a variety of interesting things to eat and a lot of laughter.

Don’t get me wrong, things can still be fun and relationships can be built in the virtual world, they’re just different. In a world built around virtual meetings, I certainly wouldn’t have been able to clink glasses with both Jonathan Bush and Judy Faulkner within 10 minutes of each other (thank you, HIStalkapalooza 2013). There’s something about the bonding that happens when you stroll the HIMSS exhibit hall with a friend (especially one wearing a beauty queen sash that he won the night before), whether you’re trying to do serious work or just making fun of the insanity that is our industry. There’s also something about trying to get your shoulder back into its socket after dancing with Matthew Holt, but that’s another story for another day. Perhaps one day we’ll be able to do those things in-person again, and when we do, I’ll have the sassy shoes I purchased for HIMSS20 at the ready.

To my readers, thank you for being part of my world for the last 1,000 posts. I hope that each of you is able to stay safe, healthy, and sane during the great dumpster fire that is 2020. Whether you’re on the clinical front lines or in a supporting role, I appreciate your contributions to the care of patients around the world. The practice of medicine would be substantively different without everyone in the healthcare IT family. And so, I raise my virtual martini glass to each of you – here’s to the next 1,000 posts, and to better times ahead.

Email Dr. Jayne.

Morning Headlines 7/27/20

July 26, 2020 Headlines 3 Comments

WELL Health Forms New Business Unit Focused on Digital Health Apps and Provides Management Update

Well Health Technologies, Canada’s third-largest EHR vendor, forms a new subsidiary focused on discovering and investing in digital health apps.

Prevalence of unprofessional social media content among young vascular surgeons

The Journal of Vascular Surgery apologizes for and retracts an article titled “Prevalence of unprofessional social media content among young vascular surgeons” after doctors complained it was discriminatory and should not have passed peer review.

StuffThatWorks nabs $9M for crowdsourced insights on health conditions

Israel-based StuffThatWorks, which combines crowdsourcing and AI to give actionable data to people with chronic diseases, raises $9 million.

Monday Morning Update 7/27/20

July 25, 2020 News 3 Comments

Top News

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The Journal of Vascular Surgery apologizes for and retracts an article titled “Prevalence of unprofessional social media content among young vascular surgeons.” Some doctors complained that the article was discriminatory and should not have passed peer review.

Three male screeners created fake Facebook, Twitter, and Instagram accounts to search postings from graduating vascular surgery residents – who had not given permission to being reviewed — that contained content they determined was unprofessional and possibly eventually career-damaging.

“Clearly unprofessional” content included posting profanity or making offensive comments about colleagues, work, or patients. Being photographed with alcoholic drinks, making controversial comments, or wearing inappropriate attire were considered “potentially unprofessional.” 

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Doctors protested with social media posts of themselves wearing swimsuits and drinking margaritas tagged #MedBikini.


Reader Comments

From Twitterati: “Re: digital health startup. An author asked people on Twitter to say what that means to them. You?” The “startup” part leads me to assume that the company has attracted investors, which means they have some (likely overstated) degree of revenue, customers, and future prospects, but also suggests that it is still in need of someone else’s money to shed the “startup” label and make predictable profits, probably from a business model in which someone other than patients pays since the users themselves rarely see enough value in digital health products to want to spend their own money. That depends, of course, who is labeling a company as a startup – fanboys, founders, or excessively exuberant media? Equally soft is “digital health,” which is often in the self-serving eye of the beholder, like badly aging companies in the early 2000s that suddenly declared themselves dot-coms because they put up a website. I have zero experience working in digital health or for startups, but I would be embarrassed as a CEO to hide behind either label in trying to earn a trophy for participating.


HIStalk Announcements and Requests

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Getting a haircut tops the list of COVID-risky activities that poll respondents undertook in the past month, followed by eating inside a restaurant and attending gatherings. My only transgression was a one-time lunch with a visiting relative in an admirably cautious restaurant, but it was less enjoyable than I expected beyond the nostalgia factor now that I’ve learned to enjoy eating entirely at home.

New poll to your right or here, paying homage to those #MedBikini folks — which existing online information, if any, do you fear could eventually harm your career?

A relative of mine was struggling to pay for her $1,300 per month injectable medication, so her doctor sent her prescription to a legitimate, customer-centric pharmacy in Canada that is best known for providing insulin at a fraction of US prices. They shipped the same brand-name medication for $400.


Webinars

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

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


Acquisitions, Funding, Business, and Stock

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Israel-based StuffThatWorks, which combines crowdsourcing and AI to give actionable data to people with chronic diseases, raises $9 million.

Haemonetics sells its blood banking and hospital software business Inlog Holdings France SAS to a private equity firm.


People

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Industry long-timer Steve Pratt of S&P consulting died on July 16 at 60.


Announcements and Implementations

UPMC implements RxRevu’s SwiftRx Direct patient cost transparency technology, which will allow its doctors to review lower-cost prescription alternatives based on real-time access to the patient’s benefits through UPMC Health Plan.

PatientKeeper develops a FHIR-based, Cerner-embedded version of its physician charge capture software, working with Baystate Health’s TechSpring innovation center.

Redox adds access to 500,000 Carequality-enabled physicians to its network, allowing Carequality participants to join the network, exchange clinical summaries, use a simple API to integrate participants and providers, and onboard quickly without going through Carequality’s certification process.


COVID-19

FDA gives emergency use authorization to LabCorp’s home collection COVID-19 PCR test for use in symptom-free people and to be used in pooled sample testing.

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An overwhelmed hospital on the US-Mexico border says that it has formed an internal committee that will decide whether a given COVID-19 patient is treated or sent home to die. It is fascinating to see how ill-prepared or unwilling our health system is to move a patient from an overwhelmed public hospital to available beds in private hospitals and even emergency COVID field hospitals. The percentage of patients who die in the same hospital that they were originally admitted to must be huge since transferring elsewhere, even when medically possible or advisable, has always been  an option that is rarely exercised by either hospital or patient.

CDC issues a strong call to reopen schools two weeks after President Trump criticized its original recommendations as “very tough and expensive.” Insiders say an HHS working group included some of CDC’s original recommendations, but put the mental health-focused Substance Abuse and Mental Health Services Administration in charge of the guidance while excluding the participation of CDC, which was determined to be overly cautious about viral spread. Harvard’s Ashish Jha, MD, MPH says the new document contains no clear information about the risk to students and school staff and does not include a strategy for preventing infection via screening and testing.

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The NFL’s only physician player, Kansas City Chiefs right guard Laurent Duvernay-Tardif, MD, becomes its first player to announce that he will sit out the 2020 season, explaining, “Being at the front line during this offseason has given me a different perspective on this pandemic and the stress it puts on individuals and our healthcare system. I cannot allow myself to potentially transmit the virus in our communities simply to play the sport that I love. If I am to take risks, I will do it caring for patients.” Staying on the sidelines will cost him $2.6 million in salary.


Other

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Georgia State University describes how its nursing faculty quickly moved the clinical experience component of its program online using the VSim for Nursing simulator from Wolters Kluwer, which it uses over videoconferencing to allow students and faculty to work together.


Sponsor Updates

  • Saykara’s founder and president are interviewed about the future of AI in healthcare and its use in the company’s speech-recognition powered physician charting app.
  • Premier Inc. recommends FDA and DEA reforms to prevent drug shortages.
  • Redox Product Designer Nick Hatt will present a session, “Making the Healthcare Developer Experience Awesome to Achieve Interoperability,” during the virtual API Days New York event July 28-29.
  • InterSystems introduces an exam-based certification program for HealthShare Health Connect HL7 Interface Specialist and IRIS Core Solutions Developer Specialist.
  • Relatient publishes a new case study, “University Physicians’ Association Increases Patient Payments 43% with Mobile-First Billing.”
  • Summit Healthcare hires Kyle Madden as a regional sales manager for the West Coast.
  • Waystar appoints retired Xerox CEO Ursula Burns to its board.

Blog Posts


Contacts

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

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Weekender 7/24/20

July 24, 2020 Weekender No Comments

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Weekly News Recap

  • Symplr’s owner considers selling the company at a valuation of up to $2 billion.
  • Publicly traded HCA Healthcare books a $1 billion Q2 profit, boosted by $822 million in federal CARES act stimulus money.
  • Cerner announces CommunityWorks Foundations, a fixed-fee, quickly implementable version of Millennium for Critical Access Hospitals.
  • HHS activates a new COVID-19 hospitalization data website that replaces the one that was previously operated by the CDC.
  • WellSky’s private equity owner decides not to sell the company and instead will bring in an additional investor.
  • Researchers ward that sloppy health system implementation of screening for social determinants of health could cause patient harm.

Best Reader Comments

Interesting that in late 2019 CPSI commented that Cerner was competing less aggressively in their market. Then mid-2020, Cerner comes out with a streamlined install for that market. (PeanutGallery)

Opposition to a national identifier is deeply rooted in the American psyche. It might be easier to amend the constitution to eliminate the electoral college than to get a national ID. To be technically feasible a national ID would need to be provided at birth and be (unlike SSN) unique and immutable. Countries in Europe have had systems for this for many years and they work well. In Sweden the “personnummer” is assigned at birth and used everywhere. (Richard Irvin Cook)

It could also be a federated national ID. Each state has an unique ID and identity database. If you are receiving care in X state, your provider queries X state system for matching info based on your ID. Recognizing your ID is from a separate state, your state queries the other states database through a federal broker. The feds don’t see the data, just the ID and a random sample of enough of the query to make sure everybody is following the rules. Data updates are propagated only to those states that have queried for the ID before. If you don’t leave your state, the feds never see your ID or any query info for you. System is bootstrapped based on voting/drivers Id cards. Verification and resolution of identity info takes place at the resident’s state level. Federal block grants conditional on the performance of the states identity system. Health providers keep their own records clean as they are already supposed to. (Boondogle)

The interoperability problem is as Kevin identified, but a significant part of that is also the fact that the solutions do not interpret the data the same way; by schema, domain, structure, dictionary, enumeration, workflow, etc. So in handing your thumb drive over to them, they have no way to bring that data into their system. Unless, it is the same system, configured the same way, with the same dictionaries, and, and, and… (Brody Brodock)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. W in Texas, who asked for hands-on learning activities for her pre-kindergarten class. She reported in late February, “I cannot begin to express how grateful we are to have received these items. These resources have made small groups a blast. The interaction between the students and the various activities are very useful. We are able to provide differentiated activities for them. The reactions was priceless as we opened the box. The new materials even improved some behavior issues. We had a brief lesson on how to take care of our items and how to properly use them.“

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NBC News profiles the “recharge rooms” of Mount Sinai Health System (NY), which give stressed employees a place to relax in a simulated beach or forest. The doctor who came up with the idea provides advice on doing the same thing at home – designate a no-phone sanctuary space, add some artificial plants and aromatherapy diffusers, use noise-cancelling headphones if living in close or noisy quarters, and reserve the bed for sleeping only.

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COVID unit Nurses at 198-bed Virtua Marlton Hospital (NJ) are summoned to a Zoom work meeting, where they are surprised to be treated to a personal concert from country star Tim McGraw as part of Spotify’s “The Drop In” series.

A former sales rep for drug maker Novartis AG who turned whistleblower against his employer for bribing doctors to prescribe its products will get $109 million as his share of the company’s $678 million settlement.

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A suppose this supports the “less is more” theory. A nurse in Russia who reported to work in a coronavirus unit wearing only underwear beneath her see-through PPE because it was too hot gets a job as a TV weather presenter on top of a previously signed sportswear modeling contract. She says she still wants to be a doctor.

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Employees of Stony Brook Southampton Hospital (NY) who are looking for storage space in an old dialysis unit storeroom are startled to find a “King Tut’s tomb” of more than 100 works of art that had been donated by some of the world’s most renowned abstract expressionist artists in the 1950s through the 1980s. The lithographs, drawings, and wood block sculptures – many by artists who lived and worked in the Hamptons back when it was cheap — could fetch up to $1 million to benefit the hospital and the local history museum. A frequent donor was Willem de Kooning, who spent a lot of time in the hospital as a patient in the 1970s due to various alcohol-fueled mishaps, including falling down stairs and passing out in a snow bank.


In Case You Missed It


Get Involved


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Morning Headlines 7/24/20

July 23, 2020 Headlines No Comments

Clearlake explores Symplr stake sale, seeking $2bln valuation

Clearlake Capital Group considers selling provider management, credentialing, and payer enrollment technology vendor Symplr, which it acquired in 2018 at a $550 million valuation.

HealthEdge Software Acquires The Burgess Group

Insurer software vendor HealthEdge acquires The Burgess Group, which offers a payment integrity system.

Cerner’s New Cloud-Based Technology Helps Rural and Critical Access Hospitals Reduce Costs, Save Time

Cerner announces CommunityWorks Foundations, a fixed-fee, cloud-based version of Millennium for Critical Access Hospitals that can be brought live in six months.

News 7/24/20

July 23, 2020 News 5 Comments

Top News

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Clearlake Capital Group considers selling provider management, credentialing, and payer enrollment technology vendor Symplr, which it acquired in 2018 at a $550 million valuation. Reports suggest it hopes to sell at a $2 billion valuation.


Webinars

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


Acquisitions, Funding, Business, and Stock

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At-home, blood-testing kit startup Tasso will use some of a $17 million Series A funding round to develop a companion app that will help users share their data with providers. The Fred Hutchinson Cancer Research Center is using Tasso’s devices in a COVID-19 antibody testing study, enabling patients to stay at home instead of traveling to a clinic.

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For-profit hospital operator HCA Healthcare made more than $1 billion in Q2 profit, boosted by $822 million in federal stimulus money from the CARES act for pandemic relief. HCA says it received a total of $1.7 billion in CARES act funds.

Insurer software vendor HealthEdge acquires The Burgess Group, which offers a payment integrity system.


Sales

  • BJC Healthcare (MO) selects Patientco’s patient payment technology and services.
  • DFW Faith Health Collaborative (TX) will implement cloud-based referral and case management software from Pieces.
  • University Clinical Health (TN) selects InteliChart’s patient portal, intake, and communications technology.
  • Guadalupe Regional Medical Center (TX) will work with Pelitas to develop and deploy virtual patient intake capabilities.
  • Oklahoma State University Medicine will work with TeleHealth Solution to staff virtual physicians at five hospitals in rural parts of the state.

People

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Central Logic hires Jeanne Rogers (RevSpring) as VP of sales.


Announcements and Implementations

Cerner announces CommunityWorks Foundations, a fixed-fee, cloud-based version of Millennium for Critical Access Hospitals that can be brought live in six months.

Novant Health (NC) implements Epic test automation with help from Santa Rosa Consulting.

VCU Health (VA) launches a remote patient monitoring program for post-acute care patients using telemedicine software from Dictum Health.

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WakeMed (NC) adds MapQuest technology from Comtech Telecommunications to its Epic MyChart app to better enable patients to find and check in to EDs.

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Franciscan Missionaries of Our Lady Health System (LA) goes live on Kyruus ProviderMatch for Consumers, giving patients a more efficient way to find and schedule appointments with providers that meet their needs.

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Allscripts-owned precision medicine software vendor 2bPrecise announces v3.0, which allows oncologists to assess patient risk for secondary cancers as well as family risk.

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A new KLAS report on health IT vendor performance in responding to COVID-19 finds that the most relied-on health system solutions are virtual care, acute care EHR, and analytics. Vendors who are outperforming their historical satisfaction ratings during the pandemic are CareCloud, Cerner, IBM Watson Health, Philips, RxStrategies, and WellSky, while the worst-performing vendors are Agfa HealthCare, Allscripts, and EClinicalWorks. Budget-strapped health systems report significant budget cuts, but most say they will continue to invest in new technology as new demands arise. Above is the right upper quadrant (higher overall satisfaction, higher COVID satisfaction – click to enlarge).


Government and Politics

HHS will form the National Testing Implementation Forum to gain private-sector feedback on COVID-19 testing and diagnostic efforts, with a particular focus on supply chain issues.


COVID-19

The COVID Tracking Project reported 70,000 new cases on Wednesday, as hospitalizations neared the all-time peak at 60,000, and 1,126 new deaths were reported for the day. The US now has over 4 million cases, up 1 million in the past 15 days.

The federal government will pay $2 billion to order 100 million doses of a COVID-19 vaccine from joint developers Pfizer and BioNTech, with the deal being conditional on the vaccines being proved safe and effective by earning FDA’s approval.

States are looking for alternatives to the two big lab testing companies, especially Quest Diagnostics, that are taking a week or more to deliver results, which at that point are mostly irrelevant for diagnosis or surveillance.  Quest says it is bottlenecked by a global shortage of testing machines and reagents.


Other

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Only in America. The father of a University of Colorado Boulder college senior verifies that her hospital, surgeon, and clinic are within his insurer’s network before sending her off for outpatient meniscus repair. The for-profit HCA hospital billed $96,000, for which it accepted $3,200 from the insurance company and $360 from the family as payment in full. Then the father got a $1,170 bill from an out-of-network, independent surgical assistant that the surgeon had brought along. Most interesting is that use of such out-of-network, unlicensed assistants is so profitable that private equity is buying up the companies that provide them, following the playbook of (a) seeking situations where the patient doesn’t have a choice; and (b) making sure not to accept insurance so they can charge the patient directly for whatever amount they want.


Sponsor Updates

  • IT and cloud managed services vendor SSI selects Goliath Technologies to support its go-to-market service and strategy.
  • Relatient joins post-acute care EHR vendor Casamba’s partner network.

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 7/23/20

July 23, 2020 Dr. Jayne 1 Comment

The big news of the last week has been the unexpected and mandatory shift in COVID-19 data reporting away from the Centers for Disease Control and directly to the US Department of Health and Human Services. It was done with minimal communication and in the middle of a pandemic, which isn’t the ideal scenario for any IT project. I guess the contractor involved had never heard of setting up a parallel system and validating data or having a robust cutover plan, let alone involving stakeholders and end users in the testing.

Needless to say, more than 100 industry groups have signed on to a letter asking the White House to reverse the shift. The major concerns revolve around transparency and data availability, but the undercurrent of public health policy versus politics is a factor as well.

Small news of the week includes a reprieve for Elizabeth Holmes, whose trial might be delayed until 2021 due to COVID-19 concerns. The trial was scheduled to start in October, but attorneys argued via Zoom that moving ahead with a trial would create risk. More than 170 people from 14 different states are on the witness list, with more than a dozen of them being high risk due to age. An August hearing will determine the exact date for a new trial.

This week has driven me to the maximum level of frustration with regards to COVID-19 testing. We are now seeing patients who have had five or more COVID tests because they continue to engage in risky behavior and “just want to get checked out.” We’re also running into employers who are requiring negative tests before allow patients to return to work. Those who have multiple positive tests but who are no longer considered contagious by the CDC standards are subjected to unnecessary medical procedures as they continue testing, which also takes away supplies from other patients. Employers are requiring testing of workers who have even remote contacts with potential patients, wasting more supplies.

We have been out of rapid testing kits for weeks, but somehow the NFL, NBA, their respective employees and the media have access to them. This is in the context of announcement that the US is trying to reduce unnecessary COVID testing. As far as I’m concerned, the message can’t get to these employers soon enough.

I also had my first patient come back in for a visit hours after he was texted with his positive COVID result, for a re-test “just to be sure, because it might be a false positive.” Hate to tell you, sir, but (a) you are still quarantined regardless of the outcome of this second test; and (b) congratulations on exposing my office staff, me personally, and everyone you might have come into contact with along the way. We had a difficult conversation which I’m sure will lead to a one-star or zero-star review, but at this point I say “bring it,” because in many ways, it would be relief to just get fired by my ratings-centric employer. I hate that the pandemic is turning something I used to love (seeing patients in person) into something I sometimes dread, and that it’s being driven largely by economic forces.

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I found some time to recharge my batteries this week and enjoyed attending the Telehealth Innovation Forum on Tuesday and Wednesday. It was a welcome break from what I’ve been doing for the last several months. The sessions were engaging as well as fun. Tuesday’s end-of-day session included a live martini class, where we learned tricks of the trade. I was glad to learn that the way I shake my martinis is how the pros do it, but apparently I’ve been holding my jigger wrong.

Wednesday we had our volunteer activity of decorating backpacks that will be filled with school supplies and sent to Puerto Rico, while learning about the World Telehealth Initiative. As much as we think about telehealth as a convenience in some countries, it’s striking to realize how much of a true game-changer it can be in developing nations. Thanks to the many sponsors that made this activity possible and to Teladoc Health for putting it all together.

The US is still pretty keyed up about the promise of telehealth, although a new survey from Sage Growth Partners and Black Book Research highlights that many organizations anticipate a decline in telehealth volumes over the next year. Respondents cited lack of integration and/or interoperability as a key reason for dissatisfaction, along with a lack of data needed for continuity of care. Payment issues also made the list.

I say the jury is still out, because we have no idea what will happen when flu season starts and other respiratory pathogens start rolling in. If you’re still using Zoom to try to deliver virtual visits and haven’t begun the transition to an integrated system or one that at least plays nice with your EHR, I suggest you start looking.

In other telehealth news, I received an email announcing the “HHS Telemedicine Hack,” which is apparently a 10-week virtual learning community aimed at accelerating telemedicine implementation among ambulatory providers. The program includes various online panels and presentations along with virtual discussion boards. It runs from July 22 to September 23. I wonder if I’m the only one who thought it was weird that they announced it after it had already started. I read my CMS emails pretty religiously and searched both my voluminous inbox and my trash without finding any other announcements.

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The American Board of Surgery admits a complete meltdown of its online general surgery board qualification exam last week. Candidates describe a “nightmare” scenario where morning test-takers finished Day One of two, but afternoon testers had technical issues, so the entire test was canceled early Friday morning. The Board promises to “regroup and develop a new process.” Candidates were also frustrated that the Board was communicating via Twitter rather than directly with them through email, citing delays in mass emails to over 1,000 impacted surgeons as an explanation.

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The absolute highlight of my week was a care package from the folks at Medicomp Systems. The company is a Founding Sponsor of HIStalk, a former sponsor of HIStalkapalooza, and has supported our favorite charities as we’ve competed on their game show stage at past HIMSS conferences. Along with a UV sanitizing bag for my constantly rotating supply of masks, they managed to source some coveted N95 respirators from 3M as well as classily embroidered multi-layer masks that have both a bendable nosepiece and adjustable straps. They are the “little black dress” of masks.

Given our current situation, I’m thinking of shifting my love of shoes to one of stylish masks. A patient had on a bedazzled mask last week, so there’s plenty of opportunity for creativity and style. I’m touched that they would think of me and sincerely appreciate the additions to my PPE wardrobe.

What’s the sassiest mask you’ve seen? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 7/23/20

July 22, 2020 Headlines No Comments

Hair loss treatment vendor Hims seeks deal to go public: sources

Online prescription delivery and telemedicine company Hims considers going public through a merger with an unnamed company.

Tasso raises $17 million for home blood-testing kits

At-home, blood-testing kit startup Tasso will use a $17 million Series A funding round to develop a companion app that will help users share their data with providers.

Walmart Health Expands to Florida, Bringing Affordable and Accessible Care to Local Communities

Walmart Health will expand into Florida next year, with additional openings slated for locations in Illinois.

Readers Write: Achieving True Interoperability Transparency May Depend on Adopting a National Patient Identifier System

July 22, 2020 Readers Write 14 Comments

Achieving True Interoperability Transparency May Depend on Adopting a National Patient Identifier System
By Kevin Hutchinson

Kevin Hutchinson is CEO of Apervita of Chicago, IL.

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Let me say one thing right out the gate: I am typically not a fan of forcing industry-wide uniformity via burdensome and overly instructive government mandates. However, sometimes there’s too much at stake in healthcare and the private sector just can’t agree on standards on their own. So was the case with e-prescribing over 15 years ago, and so is the case now with interoperability.

When I was founding CEO for Surescripts and before I was a member of the inaugural ONC-created National Health Information Technology Standards Committee, it was hard to get stakeholders to agree on standards, as the EHR industry was generally slow to adopt anything. However, after we created the initial standards for e-prescribing via the National Council for Prescription Drug Programs (NCPDP), set firm deadlines, and CMS tied e-prescribing to MIPPA incentives, the different factions within the healthcare industry (all of whom had different agendas) came together and abided by a system that largely still works today.

So it makes sense for CMS and ONC to impose strict mandates and timelines — albeit with some COVID-caused relaxation — for interoperability compliance, because the fragmentation of health records is as dangerous as it has ever been to patients. But while each deadline moves us closer to a more integrated and transparent system, it’s not until the payer-to-payer interoperability deadline in January 2022 where we’ll finally be in our best position to eliminate costly problems created by siloed health data. We may finally see some health record consolidation.

However, like all kinds of sweeping reforms, the devil is in the details. I believe that it might not be as “successful” as we expect it to be unless the federal government steps up and mandates a national patient identifier (NPI) system.

Just because one’s health insurer is sharing data with their previous insurer doesn’t ensure a holistic record. It’s not outlandish to think that any American could have up to 10 different health insurers over their lifetime, especially given rising health costs, socioeconomic inequities, and an increasingly volatile job landscape. That’s 10 different organizations with 10 different technology infrastructures, data protocols, and health IT standards. Not to mention the complexity of a patient’s health record strewn across multiple EHR systems, that change over time, as well as patients changing doctors creating new patient chart IDs and no standardized format for those patient chart IDs.

Who is responsible for making sure IDs match up? Who is responsible for identifying potential health record duplication errors? These are small data nuances that can have life-or-death consequences.

I can tell you first hand that even after national standardization, there have been instances in e-prescribing when records for John Doe I were assumed to be a part of John Doe II’s record, which could have resulted in life-threatening medical errors if not caught and corrected. NPIs would make life easier and safer for patients, payers, and providers, but yet they still aren’t part of the interoperability equation.

The NPI debate isn’t new. In fact, it’s been around for more than 20 years. But it seems like now we may actually be moving in the right direction. Late last year, representatives from many NPI-supporting organizations signed on to a letter urging Congress to take action, arguing, “The absence of a consistent approach to accurately identifying patients has also resulted in significant costs to hospitals, health systems, physician practices, long-term post-acute care (LTPAC) facilities, and other providers, as well as hindered efforts to facilitate health information exchange.” As a result, the House of Representatives voted to remove the ban on funding NPI organizations.

As for payers, some would likely argue that NPIs would help them as well. Many within the payer community think NPIs could improve member safety, reduce overutilization and fraud, and help them understand how members performed in previous payer’s quality-based programs.

However, NPI opponents will often counter with concerns over privacy and security, higher costs, and serious medical errors due to human error. The costs, they argue, would be incurred from building a new IT system from scratch while also having to align on policies and standards to govern it. To that argument, I would just remind critics that there have already been huge costs incurred because we haven’t achieved full interoperability yet, and then ask them to imagine the wasted money if all current mandates and compliance initiatives ended up not solving the core problems.

As for the medical errors argument, fragmented health records are much more dangerous. Again, I don’t think we can be as successful with interoperability without an NPI system.

But it’s that last and most prevalent argument on privacy and security that makes me raise an eyebrow. We constantly hear that we can’t have NPIs because if the number is compromised, the patient’s entire health record would be accessible in one location. That argument falls a bit flat for me. There are already medical record numbers on pretty much everything. In today’s interoperability world, we use easily accessible patient information (names, address, gender, dates of birth, etc.) to create a universal patient ID and match disparate patient information the best we can.

The whole argument on NPIs should really be fought on the cybersecurity front. Why not implement data encryption standards that lock data down to the field level, so that each piece of information in an NPI record is its own walled garden? We’ve already seen the mistakes made by other consumer industries such as banking, which many have responded with increasingly deep levels of data encryption. It’s completely logical and viable for the healthcare industry to implement the same level of security available in other industries to ensure our sacrosanct health information is protected. If we did, then that would be good for all and put an end to the security debate on NPIs.

Morning Headlines 7/22/20

July 21, 2020 Headlines 2 Comments

An Open Letter from the American Medical Informatics Association and the American College of Medical Informatics Regarding Public Health Reporting Deficiencies During the COVID-19 Pandemic

AMIA publishes an open letter that expresses dismay that HHS moved hospital COVID-19 reporting from CDC’s National Healthcare Safety Network to HHS Protect, saying that a pandemic isn’t the best time to go live on a new, untested system.

Allscripts cut to Sell at Goldman

Goldman Sachs issues an almost unheard-of “sell” rating to shares of Allscripts, which it says has an unfavorable health IT market position and questionable growth prospects.

Rush University Medical Center Set to Share New “Agile Adapt” Model Powered By CipherHealth for Pandemic Response in Underserved Communities

Rush University Medical Center develops Agile Adapt for its COVID-19 response, using CipherHealth’s patient engagement and communication platform to flex ICU capacity, coordinate with community services, support critical staff, monitor patients across all settings, and anticipate care needs.

News 7/22/20

July 21, 2020 News No Comments

Top News

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HHS activates a new COVID-19 hospitalization data website that replaces the one that was previously operated by the CDC.

HHS says CDC’s old system collected data from just 3,000 of the country’s 6,200 hospitals, but the new one will report information from 4,500 hospitals that are submitting information using HHS’s newly mandated HHS Protect system.

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AMIA publishes an open letter that expresses dismay that HHS moved hospital COVID-19 reporting from CDC’s National Healthcare Safety Network (which AMIA’s letter incorrectly referred to as National Health and Security Network) to HHS Protect, saying that a pandemic isn’t the best time to go live on a new, untested system. It also questioned the requirement that hospitals provide 20 new data elements explaining why they are needed or how they will be used. 

More than 100 healthcare-related groups asked in a letter to Vice-President Pence, Coronavirus Task Force Response Coordinator Deborah Birx, MD, and HHS Secretary Alex Azar that the administration reverse its decision and leave data collection and reporting to the CDC. AMIA signed that letter as well.


Reader Comments

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From Surly Bonds  of Mirth: “Re: AMIA’s open letter about COVID-19 hospital data reporting. This just-published piece explains why open letters are pointless.” An opinion piece in The Atlantic says that “the genre of open letters should die” because they are generically written with the dead language that is required to get more signatures; signers should just publish their own individual opinion instead; and such letters appear cowardly in a “safety in numbers” sort of way. AMIA labeled its editorial as an “open letter” but it really isn’t — it wasn’t addressed to a particular person or organization and it wasn’t signed, so it’s just an uncredited editorial. 


HIStalk Announcements and Requests

It must be tough sledding out there for ad-supported websites given that I can’t view many of them on my IPad all of a sudden because of errors caused by their increasingly intrusive pop-up ads and embedded video. The home page of one site I used to look at occasionally has six ad zones, pop-up ad video, an overlay banner, and a long list of graphics-heavy sponsored content articles. Clicking on an individual article brings up a ton more of the same, plus it displays comments from an ad-supported service that throws up still more ads. Safari crashes about 50% of the time, especially if I dare touch the screen during the many seconds it takes for the junk to fully load. To further diminish the signal-to-noise ratio are “sponsored content” articles, where the site owner sells editorial space for puff pieces from companies that are labeled “partners” to make selling out seem less odious. Facebook and Twitter have endless faults, but I admit that I spend more time checking them than crudely monetized websites that offer little value amidst the electronic shrieking, low-value content that is memorable only because it is so poorly written.


Webinars

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


Acquisitions, Funding, Business, and Stock

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WellSky’s private equity owner changes its mind about selling the company and instead brings in a new unstated investment from another private equity firm.

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Goldman Sachs issues an almost unheard-of “sell” rating to shares of Allscripts, which it says has an unfavorable health IT market position and questionable growth prospects. MDRX closed down 8% Tuesday versus the Nasdaq’s 1% loss following the announcement. The company will announce Q2 results next week.


Sales

  • Home health, hospital, and infusion provider Evolution Health chooses Dina’s Staff Screening and Check-In solution to automate its employee wellness and health screening process.

People

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Cerner hires Peter Liebert, MS, MPA, MSc (California State Guard) as VP/CISO.

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Mental health digital engagement vendor JourneyLabs hires Tim Bush (GE Healthcare) as CEO.

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Ellkay promotes Shreya Patel to chief innovation and product officer and Ajay Kapare, MBA to chief strategy and marketing officer.


Announcements and Implementations

In England, Clinical Architecture is added to the supplier suite of the Greater Manchester Digital Platform, which is part of the national Local Health and Care Record program.

Rush University Medical Center (IL) develops Agile Adapt for its COVID-19 response, using its long-time vendor CipherHealth’s patient engagement and communication platform to flex ICU capacity, coordinate with media, support family-patient communication, coordinate with community-based servicers, support critical staff, monitor patients across all settings, and anticipate care needs.


Government and Politics

Medicare’s Part A trust fund, which pays for inpatient care, could run out of money as early as 2022, as swelling unemployment ranks have reduced payroll tax contributions and Congress tapped Medicare’s reserves to fund COVID-19 relief this past spring.

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The defense department’s DARPA contracts with Duality Technologies to develop a privacy-preserving analytics that allow ML models to be trained without exposing personally identifiable information, such as in studying DNA attributes and COVID-19 symptoms.


COVID-19

CDC antibody testing analysis covering 10 states finds that the number of people infected with COVID-19 in the US is 2-13 times the reported rate, but those numbers are still far too low to confer herd immunity. Mississippi’s infections are an estimated 13 times the reported rate, meaning that the state has no way to find the asymptomatic spreaders and making distancing and mask-wearing even more important. Researchers emphasize, however, that US coronavirus testing is still in disarray, some commercially available tests are unreliable, and “convenience testing” is inherently biased, with results that are not necessarily generalizable.

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President Trump restarted regular COVID-19 briefings Tuesday evening without the presence of the coronavirus task force or any health expert. The President admitted that the “China virus,” which he also called “the plague,” will probably “get worse before it gets better,” but pledged to provided states with needed supplies and touted the likelihood of quick vaccine development and distribution. He also said that tests are being rolled out that can deliver results in 5-15 minutes, which should alleviate the testing backlog. He also said “we did a lot of things right” in keeping deaths so far at 140,000 instead of “double, triple, or quadruple” that number. Reading from prepared remarks, the President said, “As one family, we mourn  every precious life that has been lost. I pledge in their honor that we will develop a vaccine and we will defeat the virus … my administration will stop at nothing to save lives and shield the vulnerable.”

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The New York Times looks at a temporary COVID-19 hospital in Queens that cost $52 million (with a potential final tab of $100 million to federal taxpayers) but treated just 79 patients because of bureaucracy and turf battles. The city decided after the fact that patients would receive better care at crowded existing hospitals; the state didn’t operate a centralized program to transfer patients out of overwhelmed hospitals; the field hospital wasn’t equipped to accept ED patients; it couldn’t use its own ambulances to pick up transfers from hospitals since those facilities have exclusive agreements with specific ambulance companies; and doctors at public hospitals were told not to transfer patients out because the hospitals would lose revenue. The field hospital’s doctors were paid up to $732 per hour to complete paperwork and computer training with few patients to see, while one nurse practitioner says she felt guilty being paid $2,000 per day to look at Facebook.  

Facebook suspends the 10,000-member group account of Unmasking America, which calls masks a form of enslavement, claims that masks limit oxygen intake, and advertises the sale of fraudulent “face mask exempt cards.”


Other

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Medical practices in Germany are locked out of reviewing payer claims and encounter data for eight weeks because the security certificate of an in-office hardware component had expired. Global IT firm T-Systems, a subsidiary of Deutsche Telekom (which is not related to US health IT vendor T-System), was forced to send technicians to 80,000 practices since they were unable to apply the software update remotely. The article was written by former CMS Innovation Center health IT lead Lisa Bari, MBA, MPH.

University of Pennsylvania medical school researchers say that screening patients for social determinants of health hasn’t improved outcomes, but may have created patient harm from sloppy implementation. The authors note that assigning untrained health system employees to fire off a list of privacy-encroaching standardized questions to patients could cause them trauma, discrimination, and legal consequences, not to mention that health systems may be setting unrealistic expectations in asking about needs they can’t fulfill. The authors advise health systems to perform an initial screening with a tablet-based app that allows easily data collection and aggregation, then follow up with a personal conversation when indicated. They also warn that more widespread SDOH screening may cause a rise in mandatory government reporting — for deportation or child welfare investigation, for example – and allow data-driven discriminatory practices, such as diverting ED patients to less-expensive care or allowing insurers to cherry-pick lower-risk patients.

A survey finds that few Americans think its OK for hospital-employed doctors to ask patients for hospital donations, for hospitals to pass patient names along to their fundraising office, or for the fundraising office to perform financial background checks to target wealthy prospective donors. All of these actions are legal, however. Respondents were split over whether a million-dollar donor should get room upgrades, fast-tracked appointments, and their doctor’s cell phone number.


Sponsor Updates

  • Capsule Technologies receives an Authority to Operate declaration from the Defense Health Agency for its clinical surveillance and medical device connectivity technologies.
  • Central Logic will host the virtual Summit on Healthcare Access and Orchestration September 15.
  • The Chartis Group promotes Melissa Anderson to director.
  • Jvion becomes a founding member of the AIMed Community Group.
  • OptimizeRx appoints former Walgreens Boots Alliance President and CEO Greg Wasson to its board.
  • CareSignal publishes a case study titled “How UnityPoint used CareSignal to Remotely Monitor COVID-19 Patients Safely from their Homes.”
  • Collective Medical partners with Fallon Health to support better transitions of care for its high-risk members.
  • Clinical Computer Systems, Inc. launches Obix BeCa fetal monitor in a cooperative agreement with Huntleigh Healthcare Limited, in which CCSI will be the sole US distributor.

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