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Monday Morning Update 8/23/21

August 22, 2021 News 14 Comments

Top News

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Business Insider reports that Google Health will shut down after three years and will reassign its 570 employees across Google.

The group’s most noteworthy remaining employee was Chief Health Officer Karen DeSalvo, MD, MPH, MSc, who will be reassigned to report to Google’s chief legal officer. Google Health VP David Feinberg, MD, MBA was announced as Cerner’s new president and CEO on Thursday.

This is the second time Google has created and then quickly killed off a Google Health organization, the first being in 2011 when its personal health record failed to attract user interest.

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Google says its health work will continue within individual teams.


Reader Comments

From Go Knowles: “Re: David Feinberg. How would you grade Cerner’s CEO choice?” C at best, but even that is a better grade than I would assign to Cerner’s board. He has no experience as a for-profit or publicly traded company CEO; his medical background in psychiatry is not all that relevant to the vast majority of physicians or technologists; he acknowledged upon his hiring by Google that the company’s healthcare efforts had fizzled but he nevertheless left them shortly afterward with even less healthcare accomplishment; and he stated then that his goal was to use now-dissolved Google Health’s scale to help billions of people but then left to run a company without anywhere near that kind of influence. I don’t understand why Cerner’s board keeps hiring people without big-company CEO experience, fails to groom internal candidates in its succession plan, and can’t decide whether it wants to be a software vendor or would rather chase a new dream of selling patient data to drug companies. A career spent mostly running non-profit health systems is not the usual background found in publicly traded companies with 28,000 employees and a $25 billion market value. He is already guaranteed making a fortune and will make even more if the company’s shares perform well or if the company is acquired. I don’t know if Google Health dissolved because he was leaving or if he was lucky to find a gold-plated life raft at the perfect time.


HIStalk Announcements and Requests

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Few respondents said that HIMSS21 improved their perception of HIMSS, but at least “no change” outdrew “negatively.” One of the negatives was that people who paid registration fees for HIMSS20 but were concerned about attending HIMSS21 in person were not given the option to hold their credit until HIMSS22, forcing them into the digital version where they don’t gain access to the in-person session recordings.

New poll to your right or here: What was your reaction to Cerner’s hiring of Google Health’s David Feinberg as president and CEO? Tell us more by clicking the poll’s “Comments” link.


HIMSS21 Survey Results

I won’t over-analyze the responses since I received only around 50 of them, but here are some high points:

In-Person HIMSS21, Paid Attendees

  • Respondents gave it a B-minus grade.
  • All but one said their perceived COVID-19 risk was the same or lower than expected.
  • They liked the increased seating space, the higher-quality conversations that were possible since people weren’t rushed, and catching up with friends.
  • They didn’t like having the event spread over multiple venues, the quality of the CIO Summit compared to the previous CHIME event, and the empty spaces in the exhibit hall.
  • Interesting topics or vendors were few, but one respondent liked the nursing innovation “Shark Tank” event.
  • Twice as many attendees say they are more likely to attend HIMSS22 now than those who say they are less likely.
  • Exhibitor staff graded the conference lower, but enjoyed more-engaged participants. Negatives include convening a conference in a venue that allows indoor smoking, the lack of exhibitor value, lack of mask-wearing enforcement, the lack of qualified prospects, and using the Caesars building when the Sands complex had ample space. One questioned the diversity of presenters, especially among the HIMSS staff – anyone care to comment since I didn’t attend any presenter events?

Virtual HIMSS21 Attendees

  • Respondents gave it a D grade.
  • Comments: the conference was bland, the Accelerate app was poor but HIMSS was pitching it endlessly, not all sessions were available virtually, the forced banter and enthusiasm of the TV-style anchors with zero healthcare knowledge was annoying (this was a common theme), and company officials including those of HIMSS engaged in pontification of platitudes.

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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Cerner SEC filings outline the compensation package that its board is giving incoming President and CEO David Feinberg, MD, MBA, which adds up to nearly $35 million in his first 15 months:

  • $900,000 base salary.
  • Target cash bonus of $1.35 million.
  • $13.5 million in restricted shares for 2022.
  • $3.375 million in shares for Q4.
  • A one-time cash bonus of $375K.
  • A new hire award of $15 million in restricted shares to offset his equity loss with Google.
  • Use of Cerner’s jet.
  • Generous severance terms, such as change of control — two years salary, bonus, health insurance, and equity vesting.

In addition, outgoing CEO Brent Shafer gets his existing salary, bonus, and $2.5 million restricted shares for helping out during the one-year transition.


Sales

  • University of Colorado Medicine implements the RCxRules Revenue Cycle Engine at its 100 locations with 3,000 providers.

Government and Politics

In India, an executive of Apollo Hospital Group says that it has logged 10 million subscribers to its online health service after the government’s implementation of a national patient ID and a digital voucher system for patient payments. The company expects online pharmacy and telemedicine sales to increase significantly because of the digital healthcare strategy that was developed by Apollo and the government 10 years ago.


COVID-19

FDA will likely issue full approval to the Pfizer-BioNTech COVID-19 vaccine on Monday. Approval could help support company-required vaccination and possibly sway some unvaccinated people into getting the shot.

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Orlando’s mayor urges residents to stop watering their lawns and washing their cars to preserve supplies of liquid oxygen, which is used by the city’s utility provider to purify drinking water water, because it is desperately needed for COVID-19 hospital inpatients. The city faces a boil water advisory within a week if residents don’t comply.

Alabama reports a negative supply of ICU beds, Louisiana says that 28% of new COVID-19 cases involve children, and six of the biggest hospitals in Kansas are at 100% ICU capacity as unvaccinated COVID-19 patients fill beds.

Alabama’s UAB Medicine says that a record 39 unvaccinated pregnant women have been admitted to its ICU this month, nearly all of them undergoing forced early delivery due to COVID-19 damage. Two pregnant women died and nine lost their babies as doctors were forced to perform C-sections in the ICU on women who were on a ventilator or ECMO. None of the pregnant ICU patients are vaccinated.

Mississippi’s poison control center is seeing an increase in calls and at least one hospitalization related to ivermectin exposure. The state is asking people to stop buying the veterinary worm medicine from feed stores to self-treat COVID-19.

Abbott Laboratory ordered workers in its Maine factory to destroy existing inventories of its BinaxNOW rapid COVID-19 test in June and July, then laid off employees, cancelled supplier contracts, and closed the only other plant that makes the tests and laid off its 2,000 employees, all because sales were down. Abbott, which didn’t foresee the increased demand that is driven by the delta variant, now says it can’t provide enough tests. Abbott issued a statement saying that it did not destroy any finished product and that demand dropped because CDC advised people to avoid testing unless they had symptoms.


Other

Weird News Andy (WNA) is proud to announce the winners of the inaugural AHA! (Acronyms in Healthcare Awards) competition. His impartiality allows him to unashamedly choose himself as the winner, for which he says he’ll take himself out for a post-work ice cream cone.

  • Third place goes to Brian Too for HIM.
  • Second pace goes to RobertLS for CCHIT.
  • First place goes to WNA for HAPI.

Sponsor Updates

  • OptimizeRx names Kristen Mignon (Orbita) VP of account management.
  • DirectTrust names PatientPing VP Jitin Asnaani an Interoperability Hero as part of its inaugural awards program.
  • Vocera CMO Bridget Duffy, MD will present at the Ending Physician Burnout Global Summit August 24.
  • Well Health achieves four ISO certifications for ISMS and PIMS.

Blog Posts


Contacts

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

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Weekender 8/20/21

August 20, 2021 Weekender 2 Comments

weekender 


Weekly News Recap

  • Cerner announces that Google Health VP David Feinberg, MD, MBA will be its next president and CEO.
  • Verily announces that it will acquire SignalPath.
  • CDC announces creation of the Center for Forecasting and Outbreak Analytics.
  • Inovalon announces that it will be taken private by an equity group at a valuation of $7.3 billion.
  • Commure acquires PatientKeeper.
  • QGenda acquires CredentialGenie.
  • Unite Us acquires Carrot Health.
  • Streamline Health Solutions acquires Avelead.
  • A report says a health system shut down a diabetes management app in which it had invested $12 million because its success would have threatened the hospital’s fee-for-service revenue.
  • Optum offers virtual care and prescriptions direct to consumers, offerings that will compete with investor-funded storefronts like Ro and Hims.
  • Labcorp acquires Ovia Health.
  • CMS announces that hospitals will be required to self-attest their compliance with the SAFER Guides for EHR safety starting next year.

Best Reader Comments

As a customer of Cerner, this appointment [of David Feinberg as president and CEO] is massively disappointing. (Justa CIO)

As for Feinberg, he made this move for the compensation. Shafer was at Cerner for a little under three years and made more than $30M in total compensation. He got the company right-sized for the financial folks. Feinberg is 59 and this is his chance to create dynastic wealth for his family. I’d bet his compensation will be even more lucrative than Shafer’s because Cerner will be sold during Feinberg’s tenure which should drive the stock option he gets higher as well as the executive parachute he’ll get as a part of any M&A. Work 3-5 years and bank $30-$50M. (Lazlo Hollyfeld)

Today Google Health head left and Apple scaled back its app. A few months back Amazon’s joint venture imploded. The only reason we are discussing such failures is because certain reporters hype tech’s every step in healthcare. (Chinmay A. Singh)

I think Feinberg has decided that getting anything done at Google is impossible and that if he gets out now he can combine the Geisinger & Google pixie dust / reality distortion field, and parlay that into a public company CEO job. Who knows, Cerner may hit an upswing, and if not, I don’t think anyone is expecting too much. (Matthew Holt)

A bit strange that Kareo sold its managed billing service a year ago and now acquired a startup that promises to … manage its customers’ billing? (IANAL)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. S in Texas, who asked for math materials for her bilingual pre-K classroom. She reported in December, “Our class is made up of in-person as well as remote learners, but we have gone through one class quarantine and three full class remote learning weeks. Every single time we are learning from home, all our students have been able to use their materials for counting, making sets, creating patterns, and sorting colors and sizes. Thank you for making sure every student in my class has access to hands on materials.”

A Chicago pharmacist who worked for a COVID-19 vaccine distributor is arrested for selling 125 authentic CDC vaccination cards for $10 each on EBay. He has been charged with 12 counts of theft of government property and faces 10 years in prison for each count.

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Sandro Platzgummer, a 24-year-old student of a medical school in Austria who never played college football and is trying to earn a running back spot with the New York Giants, breaks out an explosive 48-yard run from his own one-yard line against the Jets.

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An obese patient who has been hospitalized at Wentworth-Douglass Hospital (NH) since May hopes to lose enough weight to be discharged in September. The hospital is suing to try to get him to free up his bed, where he was admitted despite needing no acute care because EMS wouldn’t allow him to try to get back to his second-floor apartment and he refuses to live elsewhere. He wants to stay until he loses enough weight to undergo bariatric surgery. Jack Bocchino hasn’t walked for four years and still weighs 450 pounds after losing 114 pounds. He will not accept the hospital’s offer to find him a first-floor apartment or one with an elevator.

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Texas bans in-state nurses and travel nurses who were recently assigned to a state hospital from taking in-state jobs with federally funded COVID-19 disaster management programs. Texas is hoping to fill 6,500 positions with out-of-state or retired in-state nurses. In a related item, Arizona reports nursing shortages as in-state nurses take travel jobs paying four times their hospital salary plus housing and food.

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A 37-year-old Boston NICU nurse leaves her job at a hospital that ordered her to stop posting racy photos on pay sites such as OnlyFans. Her co-workers bought a subscription, then sent screenshots to her boss, who demanded that she close her online accounts. She says she doesn’t need nurse money anyway since she’s making $200,000 per month from OnlyFans. She’s also a Navy veteran, gets help with her online work from her husband, and has the support of their children, aged 12, 17, and 18.

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This press person’s email subject misspelling at least got my attention.

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TikTok videos of a former New Jersey gang member turned hospital phlebotomist singing for ICU patients go viral. Enrique Rodriguez started in housekeeping at Robert Wood Johnson University Hospital in 2012 and taught himself to play guitar and piano by practicing with patients. 


In Case You Missed It


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Morning Headlines 8/20/21

August 19, 2021 Headlines No Comments

Cerner Announces Appointment of David Feinberg, M.D. as President and Chief Executive Officer

Cerner hires David Feinberg, MD, MBA (Google Health) as president and CEO, effective October 1, 2021.

Verily to Acquire SignalPath, Expanding Company’s Clinical Research Capabilities

Verily acquires Raleigh, NC-based SignalPath, which offers a clinical trials management system.

CDC Stands Up New Disease Forecasting Center

CDC announces creation of the Center for Forecasting and Outbreak Analytics, which will analyze and communicate data for public health decision-making to mitigate threats such as social and economic disruption.

News 8/20/21

August 19, 2021 News 15 Comments

Top News

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Cerner hires David Feinberg, MD, MBA as president and CEO, effective October 1, 2021.

He has been VP of Google Health since January 2019. Before that, he was president and CEO of Geisinger from 2015 to 2019.

Cerner also announces that President Donald Trigg will leave the company.

Cerner’s board has separated the roles of chair and CEO with the hire. William Zollars will become independent board chair on October 1, while Feinberg will become a board member.


Reader Comments

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From Inanimate Object: “Re: HIMSS. What does it mean that they said only three attendees tested positive? There was no contact tracing, random post-event testing, and no mass email asking people to let them know if they had symptoms or tested positive.” A HIMSS broadcast email says that three HIMSS21 participants have tested positive, one during the conference and two afterward. It was not a self-congratulatory email, so kudos for that, but perhaps naive in thinking that anyone would bother to notify HIMSS upon becoming symptomatic and/or testing positive. Some have observed that HIMSS, as a health technology cheerleader, should have encouraged use of a contact tracing app. I would add that some post-conference voluntary surveillance would be nice in considering upcoming in-person conferences, including HIMSS22, to determine how effective the HIMSS21 policies were in avoiding spread since it was one of the first big in-person healthcare gatherings since the spring of 2020. Of course for HIMSS, three is a good number that could only be spoiled by further review.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Clearwater. Clearwater is the leading provider of cybersecurity, risk management, and HIPAA compliance software, consulting, and managed services for the healthcare industry. Its solutions enable organizations to avoid preventable breaches, protect patients and their data, meet regulatory requirements, and optimize cybersecurity investments. More than 400 healthcare organizations, including 70 of the nation’s largest health systems and a large universe of physician groups and digital health companies, trust Clearwater to meet their cybersecurity and compliance needs. For health IT and digital health companies, the company offers the ClearAdvantage managed services program that transforms the burden of cybersecurity and HIPAA compliance from a liability into a competitive advantage. Led and executed by expert healthcare privacy and security professionals leveraging our award-winning SaaS-based software platform IRM Pro, the company provides organizations with the benefits of an integrated and efficiently executed, best-in-class cybersecurity and HIPAA compliance program at 25% to 50% of the cost of traditional approaches.ClearAdvantage was designed not only to protect your organization and its data and meet HIPAA compliance requirements, but also to do so in a way that meets three important business objectives – better, easier, and less expensive. Thanks to Clearwater for supporting HIStalk.

Here’s a Clearwater explainer video I found on YouTube.

I’ll wrap up my “HIMSS21 Attendee Feedback” survey soon, so spend a couple of minutes answering 10 questions and you’ll be part of the summary that will appear here soon.

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This is from the self-laudatory “About” section of the LinkedIn profile of a guy I ran across. I can’t decide if the misspelling is more attention-grabbing than the the no-subject, third-party writing that brags about his generic attributes (“motivates and influences others to achieve.”)

Listening: drummer Aric Improta, recommended by Alex Scarlat, MD as “the best drummer still alive.” I’m not a big fan of drum solos since they often involve a lot of frenzied but musically pointless thrashing, but this guy is amazing. He plays for the wildly energetic Fever 333 as well as Night Verses. This reminds me of the Who’s Pete Townshend complaining that his live playing was limited to being an efficient rhythm guitarist because Keith Moon was drumming all over the place instead of keeping time and John Entwistle played “every harmonic in the sky” by treating his bass guitar as a lead instrument, making the deceased former members “f***ing difficult to play with.”


Webinars

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


Acquisitions, Funding, Business, and Stock

Healthcare analytics platform vendor Inovalon will be acquired by an equity consortium at a valuation of $7.3 billion, a premium of 24% over the average share price through July 26 when media speculation surfaced the rumor. Founder and CEO Keith Dunleavy, MD will remain a shareholder, board member, and CEO after the take-private transaction. The transaction is expected to close in late 2021 or early 2022.

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Healthcare connectivity platform vendor Commure will acquire mobile provider technology developer PatientKeeper from HCA Healthcare, which will make an investment in Commure. Commure will migrate PatientKeeper’s platform to its cloud infrastructure and will license it to continued customer HCA, which will participate in its further development. Commure is a portfolio company of General Catalyst. Commure founder and executive chairman is billionaire investor Hemant Taneja, a managing partner of General Catalyst who was the lead investor in Livongo when it was sold to Teladoc for $18.5 billion last October.

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Verily acquires Raleigh, NC-based SignalPath, which offers a clinical trials management system. Co-founder and CEO Brad Hirsch, MD, MBA is an oncologist who formerly worked as a Duke informatics director and senior medical director of Flatiron Health. Verily president of clinical studies platform Amy Abernethy, MD, PhD – who until recently was FDA’s principle deputy commissioner of food and drugs and acting CIO – also is an oncologist who held leadership roles at Duke and Flatiron.

Workforce management systems vendor QGenda acquires CredentialGenie, which offers a provider credentialing system.

Apple is reportedly scaling back its HealthHabit app that allows its employees to track fitness goals, talk to health coaches, and manage hypertension, with the 50 Apple Health employees who are assigned to the project facing reassignment or layoff. A Wall Street Journal review from a few weeks ago found that the app’s employee users weren’t engaged and didn’t trust the health data from Apple’s clinics that was used to develop the product.


Sales

  • Sentara Healthcare will contribute de-identified patient data to England-based Sensyne Health for AI life sciences research. Sentara will become a partner and shareholder in Sensyne Health, joining 11 NHS trusts, St. Luke’s University Health Network, and University of Colorado Health.

People

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Hospital operational management software vendor Hospital IQ hires Nate Kelly, MBA (Cerner) as chief commercial officer and promotes Jason Harber to COO and chief strategy officer.


Announcements and Implementations

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Harvard Medical School and Israel’s Clalit Research Institute establish a joint precision medicine effort, with the US arm being led by Isaac Kohane, MD, PhD, chair of HMS’s Department of Biomedical Informatics.

Medical scales vendor Seca will deploy user authentication from Imprivata.

Healthcare Triangle announces a ready-to-deploy healthcare block chain network called Blockedge, which can operate on any public cloud.

Ellkay releases LKAggregate, a data aggregation solution, to Epic App Orchard. It sends data to Epic Healthy Planet from disparate EHRs.


Government and Politics

WEDI asks HHS to issue expedited guidance on how providers can submit a good faith estimate of their charges to health plans under the No Surprises Act. WEDI also asks for clarification on the compliance date, which transactions will be used to exchange advanced determination requests and responses, and how HHS will handle cases where multiple providers are involved.

Indiana’s health department notifies 750,000 residents that their COVID-19 contact tracing information was exposed in a security company’s “unauthorized access,” which the company says actually means that the state was storing the data unsecured on the Internet and took it offline when the company gave it a heads up.


COVID-19

CDC announces creation of the Center for Forecasting and Outbreak Analytics, which will analyze and communicate data for public health decision-making to mitigate threats such as social and economic disruption. Experts have recently said that CDC is not equipped to provide the type of real-time data analysis that is needed to to make quick decisions in a fast-changing pandemic, so this is a significant change for CDC.

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Florida’s COVID-19 hospitalization continues to climb far above previous pandemic peaks, as deaths also surpass previous highs and rolling seven-day test positivity is at 37%.

Seventy-three Mississippi hospitals ask the state for 1,450 healthcare workers to offset staff shortages, saying they could open another 1,000 beds if they had enough people. Mississippi has issued an order that allows EMTs to perform some in-hospital services. The state has the highest number of hospitalizations since the pandemic began and Neshoba County has the highest per-capita case count in the country at 263 per 100,000, which officials says is because the recent county fair had thousands of mostly mask-free people packed into events, some of them political, while the county has just 22% of its residents fully vaccinated. Mississippi hospitals had six ICU beds available Wednesday morning with a 46-patient waitlist.

The Texas Education Agency tells school districts that they don’t need to perform contact tracing or broadly notify parents when a student comes down with COVID-19. TEA says data shows that students don’t spread COVID-19 to other students at a significant level, although the public health data that was used to make that assessment predated emergence of the delta variant.  Schools are allowed to conduct rapid tests of staff and can also test students if their parents have provided written permission.

A survey of US nurses finds that 75% trust COVID-19 vaccines as safe and effective, but many have questions about duration of protection, whether boosters are needed, and long-term effects. While 88% say they are or will be vaccinated, the biggest questions among those who won’t involve long-term vaccine effects, lack of safety information, and mistrust about their development and approval process. Not many unvaccinated nurses say that FDA approval would change their mind.

Samsung and the Commons Project Foundation add SMART Health Cards that display COVID-19 vaccination status to Samsung Pay.

Washington state hospitals are reaching near maximum capacity, partly because many patients have no family members to care for them at discharge and understaffed nursing homes won’t accept transfers.


Other

AI expert Alex Scarlat, MD ingeniously applies an AI model to a Medicare claims database that he ran across that shows outlier claims or beneficiaries that suggest fraud. This is pretty brilliant – our “pay and chase” model results in the occasional high-profile arrest for something that should have been caught and stopped almost immediately, like a general practitioner who is mass producing prescriptions for expensive compounded scar cream or upcoding all visits to the most complex.

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I’ve seen no photos from HIMSS21 sessions, so here’s one from LinkedIn user Les Jordan, chief product and strategy officer for MobileSmith Health. I would enjoy this open space since my biggest reason for not attending HIMSS educational sessions is getting trapped between seemingly miles of knees in a presentation that screams “dud” five minutes in. I’m guessing this photo isn’t representative of education sessions in general, but since I didn’t attend any, feel free to describe your experience. It will be interesting to see attendance numbers from the HLTH conference in Boston in October, especially since CHIME has shifted its HIMSS conference participation to the new ViVE conference with HLTH March 6-9 in Miami Beach, a week before HIMSS22 in Orlando. It’s a terrible time to be in the conference business.

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UPDATE: HLTH and CHIME just opened their call for ViVE presenters, saying that the March conference will gather 5,000 attendees, 450 sponsors, and 300 speakers in Miami Beach. Some of the sponsors and supporters listed so far include Allscripts, Athenahealth, CereCore, Cerner, Clearsense, Divurgent, Ellkay, Fortified Health Security, Healthcare Triangle, Impact Advisors, Imprivata, InterSystems, KLAS, Lumeon, Meditech, Nordic, Optimum Healthcare IT, Pivot Point Consulting, Quil, and The HCI Group.


Sponsor Updates

  • Vizient will offer its hospital members the remote patient monitoring and virtual care platform of VitalTech.
  • KLAS Research’s First Look Report reveals that Redox’s EHR integration drives fast outcomes for its digital health customers.
  • Lumeon wins two Bronze Stevie Awards in the 2021 International Business Awards.

Blog Posts


Contacts

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

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EPtalk by Dr. Jayne 8/19/21

August 19, 2021 Dr. Jayne 1 Comment

HIMSS sent out its HIMSS Digital survey this week in an attempt to gather attendee feedback. The questions were predictable around whether the conference met expectations, whether the content was unique or valuable, if it was thought-provoking, and whether attendees can use what they learned in their organizations. Some of the areas they asked about I hadn’t heard of or seen promoted on any of the Digital communications, so I hope someone got something out of them.

I also received the “Important HIMSS21 Health & Safety” Update email, notifying attendees of several attendees who tested positive either on the way out of town or upon arriving home. If there really were only three cases that would be outstanding, but I suspect there might be quite a few mildly symptomatic or asymptomatic people out there. Judging from the people I’m seeing for testing (thanks to a touring musical act who shall remain nameless but did require testing or vaccination to attend the show) there are quite a few asymptomatic positives out there. My community’s transmission rate is rather high at the moment, so I’m not at all suspicious that they are false-positive results.

Desk jockeys, take heart: a new study in the American Journal of Physiology Endocrinology and Metabolism looks at the concept of “interrupted sitting” as a way to help mitigate negative impacts of sedentary work. Although the study was small with only 16 adults, it showed promising results. For 10 hours daily, participants were prompted to get up every 30 minutes. The active group had fewer extreme blood sugar values, suggesting that even small amounts of intermittent activity can be beneficial. I’ve been working on a big EHR build lately and often feel like I’m strapped to my desk, so I’m making it a point to try to get up regularly even if it’s just to walk to the kitchen to put more ice in my water glass or to drop a journal in my recycle bin.

I have to say that I’m really enjoying working on the build project. It’s different from what I usually do, and I am working with an outstanding team who gets it as far as understanding what clinicians want and need from their EHR. Several of them have clinical roots, so it’s not surprising that they know what needs to get done. Unfortunately, it’s a short-term gig and all good things will eventually come to an end, but it will have been fun while it lasted.

On the flip side, I established a micro practice earlier this year after leaving my urgent care job. It’s a way to have a place to hang my shingle so I don’t run afoul of the regulatory and licensure folks in my state. It’s also a way to experiment with new technologies and see how they play out in actual patient care. I’m test driving an EHR right now that can only be described as atrocious. It reminds me of some of the first systems I used in the late 90s, which were a cross between FileMaker Pro and an electronic prescription pad. For what I’m doing, I don’t need a certified system, but I certainly miss things like CPOE and clinical decision support that I think the majority of clinicians take for granted.

Two journal articles caught my eye this week. The first, in the Journal of the American Board of Family Medicine, reinforced the idea that perhaps breakfast is the most important meal of the day after all. Researchers analyzed existing mortality data from the NHANES 1999-2002 data sets, looking at overall mortality, cardiovascular mortality, and fiber intake. Nearly 83% were identified as breakfast eaters, and on the whole, they were older, had lower body mass index, and ate more calories and fiber daily than non-breakfast eaters. The study certainly doesn’t show causation, but the association of breakfast eating (especially when individuals consume more than 25g of fiber daily) with lower mortality rates seems solid.

The second article, also found in the Journal of the American Board of Family Medicine, looked at the practice of incorporating patient narratives in the medical record. It caught my eye because it took place in the Netherlands. One of my outdoorsy gal pals hails from that part of the world and is always sharing stories about how life is different in her home country. According to the article, the Netherlands is the home of the world’s oldest practice-based research network and contains over 300,000 patient-years of data gathered from 2.2 million encounters documented between 2005 and 2019. During the registration process, the practices gathered contextual information such as country of birth, level of education, family history, and trauma history and added it to the EHR.

Looking at data from early in the COVID-19 pandemic, they analyzed patient-reported reasons for encounters and found that episodes of pneumonia most often started with a complaint of cough. When documentation showed both cough and fever, the incidence of pneumonia was even higher. Cough with concomitant pulmonary disease was also a strong predictor of pneumonia, as was low socioeconomic status. Throughout my journey in the EHR world, people frequently minimize the need to have structured data in chief complaint and history of present illness fields. This just goes to show that maybe that data might be usefully mined after all.

I’m pool-sitting this week and have definitely enjoyed some quality time in a lounge chair in between long stretches of conference calls. I haven’t yet been bold enough to take a call from the pool deck, but looking at what’s on the agenda for the rest of the week, I just might. Any noises that might make it onto calls can’t be worse than what I’ve been hearing lately, as my remote colleagues seem to have become increasingly more casual. One co-worker has had a toddler on almost every call for the last few months, which makes me wonder how much work he’s getting done unless he’s cramming it all in while his son is asleep.

Do you think remote workers have become more casual during the pandemic? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 8/19/21

August 18, 2021 Headlines No Comments

Commure + PatientKeeper: Fixing Fragmentation to Accelerate Innovation Across Healthcare

HCA Healthcare sells EHR optimization vendor PatientKeeper to cloud infrastructure company Commure.

QGenda Acquires CredentialGenie, Becoming First Company to Bring Provider Scheduling and Credentialing Together

Healthcare workforce management software vendor QGenda acquires CredentialGenie, which offers cloud-based provider credentialing.

EqualizeRCM Acquires A Cord Billing & Business Solutions, LLC

Texas-based EqualizeRCM acquires A Cord Billing & Business Services, which offers RCM solutions to physician practices in Oklahoma.

Morning Headlines 8/18/21

August 17, 2021 Headlines No Comments

ClosedLoop.ai Raises $34M Series B to Usher in AI-enabled Healthcare and Tackle Trillion-Dollar Healthcare Problem

ClosedLoop.ai, which has developed AI-powered predictive data modeling software, raises $34 million in a Series B funding round.

Unite Us acquires analytics leader Carrot Health to become the only nationwide solution to truly integrate health and social care

Care coordination and social services referral company Unite Us acquires analytics vendor Carrot Health.

Maven Clinic Raises $110 Million In Series D Funding Ushering In The Digital Era For Women’s And Family Health

Tech-enabled women’s and family healthcare company Maven Clinic raises $110 million in a Series D funding round led by Dragoneer Investment Group and Lux Capital.

News 8/18/21

August 17, 2021 News 11 Comments

Top News

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Streamline Health Solutions, developer of pre-bill coding audit technology, acquires RCM software and consulting firm Avelead for $20 million.

Avelead President and CEO Jawad Shaikh will remain in those roles, reporting to his Streamline counterpart Tee Green, co-founder and former head of Greenway


Reader Comments

From Borlander: “Re: HIMSS21. A vendor rep I was supposed to meet with after HIMSS just tested positive for COVID. Who could have predicted that?” I was relieved that my antigen test was negative while simultaneously wondering if other attendees are getting less-cheery news.


HIStalk Announcements and Requests

HIMSS tells me that total HIMSS21 in-person attendance was 19,000, a lot more than it seemed on the ground.


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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ClosedLoop.ai raises $34 million in a Series B funding round, bringing its total raised to $45 million. The startup, which has developed AI-powered predictive data modeling software, won the CMS AI Health Outcomes Challenge earlier this year.

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Care coordination and social services referral company Unite Us acquires analytics vendor Carrot Health.

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The Washington Post describes what can happen when non-profit hospitals “experiment as venture capitalists” via technology investment, describing the $12 million spent by Cone Health (NC) to successfully develop diabetes management app Wellsmith. The health system shut the startup company down because its product wasn’t competitive and its success at keeping people healthy would have jeopardized the health system’s predominantly fee-for-service revenue. Former Wellsmith CEO Jeanne Teshler lists problems with having a health system as its key investor:

  • Cone was not willing to be a customer of Wellsmith because only a minority of its patients were covered by value-based care such as Medicare Advantage and ACOs and thus Cone could not bill insurers for the service.
  • Patients had to purchase home devices that weren’t covered by insurance.
  • Wellsmith released a software update that was a “dismal failure.”
  • Cone was considering an ultimately failed merger and its financial commitment to Wellsmith was uncertain.
  • Health systems that have venture funds won’t buy products that are funded by other health systems.

Sales

  • UnityPoint Health (IA) will implement Premier’s PINC AI technology, supply chain services, and service line analytics, and will join its GPO.
  • Ellis Medicine (NY) offers patients access to virtual mental healthcare using technology from AptiHealth.
  • ChristianaCare (DE) joins Premier’s supply chain service network.
  • In the UAE, Medcare Hospitals & Medical Centres will implement InterSystems TrakCare as a Service in its four hospitals and 16 medical centers. Its first hospital is already live in Sharjah.

People

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Cerner hires Lisa Collins, MBA (Accenture) as SVP of global services and Nithya Narasimhan (ADP) as SVP of client relationships in the East region.

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L. Hayley Burgess, PharmD, MBA (HCA Healthcare) joins clinical surveillance company VigiLanz as chief clinical officer.

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Robert Millette, MBA (Lee Health) joins Integrated Care Solutions as VP of delivery innovation.

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Cantata Health Solutions names Scott Anderson, MBA (Netsmart) SVP and GM of managed services and Adam Feldman (Qualifacts) SVP of sales.

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Symplr hires Kristin Russel, MBA, MPA as chief marketing officer.


Announcements and Implementations

Qardio launches QardioDirect, a remote patient monitoring and telemedicine service for patients with chronic conditions.

Ciitizen announces GA of its Cures Gateway, software designed to help HIEs comply with medical records requests initiated by patients.

Children’s National Hospital (DC) earns URAC’s first pediatric hospital telehealth accreditation.

UnitedHealth’s Optum subsidiary revamps its Optum Store to add direct-to-consumer services such as virtual care and prescriptions for people without insurance, including offerings that will compete with investor-funded storefronts such as Ro and Hims.


Government and Politics

CMS has sent warning letters to 165 hospitals that haven’t posted their negotiated prices, although it has not issued fines. A patient advocacy group’s study found that 94% of hospitals haven’t complied and are theoretically liable for a fine of $300 per day, although CMS has suggested that the penalty isn’t enough and wants to increase it to $10 per bed per day for larger hospitals.


COVID-19

CDC numbers suggest that the predicted plateau in new COVID-19 cases has likely occurred and cases are beginning to trend down, although hospitalizations and deaths lag by weeks.

Texas orders five refrigerated mortuary trailers that will be staged from San Antonio. The state has 12,000 COVID-19 patients in hospitals which also contain the most pediatric COVID-19 patients of any state at 239.

A public health study in Canada finds that while teens are more likely than babies and toddlers to carry coronavirus into their homes, it’s the younger children who are more likely to spread it to other household members, probably because those children require more hands-on attention and cannot be isolated when they exhibit symptoms.

Hillsborough County, FL reports that 5,600 students and 300 employees were in isolation or quarantine as of Monday morning after just four days of school.


Other

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Memorial Health System works to recover from a ransomware attack early Sunday morning that caused it to shut down its IT systems, divert emergency patients, and cancel surgeries and radiology exams at its facilities in Ohio and West Virginia.

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Johns Hopkins Medicine clinicians and IT staffers develop a Video Visit Technical Risk Score in Epic to determine which patients might be in need of technical support ahead of their virtual care appointments. The score, automatically calculated using EHR data, can be displayed as part of a user’s schedule view.

Weird News Andy challenges readers to come up with the most inappropriate healthcare acronyms and will judge submissions to select a winner. He kicks it off with HAPI (hospital-acquired pressure injury).


Sponsor Updates

  • Elsevier adds new features to its ClinicalKey medical resource search engine, including a new user interface, improved search functionality, and significant point-of-care content.
  • AdvancedMD publishes the 2021 edition of its “MACRAnyms” e-book.
  • The Empowered Patient Podcast features Capsule’s head of clinical informatics, John Zaleski.
  • Cerner releases a new podcast, “Supporting digital innovation in children’s healthcare.”
  • OptimizeRx partners with Demandbase to expand its direct-to-physician, account-based digital touchpoints for life sciences.
  • CHIME’s latest podcast features CHIME board member, boot camp faculty member, and healthcare leader George “Buddy” Hickman.
  • Dina will exhibit at the Rise West Medical Advantage Senior Leadership Conference August 30-September 2 in Colorado Springs.
  • EClinicalWorks releases a series of podcasts focused on “How Health Centers Nationwide are Improving Access to Care.”
  • Ellkay will exhibit at Epic UGM August 23-25 in Verona, WI.

Blog Posts


Contacts

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

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Morning Headlines 8/17/21

August 16, 2021 Headlines 1 Comment

Kareo Acquires PatientlySpeaking to Add RPA-Powered Capabilities for Billing Companies and Medical Practices

Ambulatory health IT vendor Kareo acquires PatientlySpeaking, which offers automated billing solutions to physician practices and billing companies.

The Network for Regional Healthcare Improvement and Strategic Health Information Exchange Collaborative Announce Affiliation; New Organization to be named Civitas Networks for Health

The Network for Regional Healthcare Improvement and the Strategic Health Information Exchange Collaborative will merge to form a new HIE organization called Civitas Networks for Health.

Streamline Health Expands SaaS Portfolio Through Acquisition of Avelead

Streamline Health Solutions acquires RCM software and consulting firm Avelead for $20 million.

Curbside Consult with Dr. Jayne 8/16/21

August 16, 2021 Dr. Jayne 1 Comment

Earlier this week, a friend shared a Health Affairs blog piece looking at the future of innovation at the Centers for Medicare and Medicaid Services. The blog is co-authored by Chiquita Brooks-LaSure, MPP, incoming administrator of the Centers for Medicare and Medicaid Services.

It starts by explaining the creation of the Center for Medicare and Medicaid Innovation, also known as the Innovation Center, as part of the 2010 Affordable Care Act. The primary role of the Center is to create movement towards a healthcare system in the US that revolves around value-based care, the core of which is reducing spending while delivering high quality care. The forces behind the creation of the Center tell a hard truth – that healthcare in the US is expensive and doesn’t always deliver high quality outcomes.

I enjoyed the summary of what has happened over the last several years. For some of us who live this day to day, you kind of lose the forest for the trees. I didn’t realize that there have been more than 50 alternative payment models launched. I can probably only think of a couple off the top of my head, so it would have been interesting to see a list of all of them. The authors describe having “taken stock of lessons learned” as they begin to map out value-based care plans for the next decade.

Looking at the past so we don’t continue to repeat our mistakes is already a good thing. I hope they looked beyond clinical and cost outcomes to also see what the impacts (positive or negative) have been on clinicians. It’s important to understand whether programs that achieve the stated goals promote a stable physician workforce or whether they become just another factor that drives good people to reduce their schedules or to leave medicine altogether.

They note that six models have created a statistically significant savings for Medicare and US taxpayers:

  1. ACO Investment Model
  2. Home Health Value-Based Purchasing Model
  3. Medicare Care Choices Model
  4. Maryland All-Payer Model
  5. Pioneer ACO Model
  6. Repetitive, Prior Authorization of Repetitive, Scheduled Non-Emergent Ambulance Transport Model

I had only heard of two of these and only had more than a passing familiarity with one, so am interested to learn about the rest of them.

The authors “explicitly acknowledge health equity as a central goal for this vision.” We’ve known about the challenges for medically underserved populations and areas for many decades now and I’m eager to hear how they plan to improve care delivery in those communities. They note six key takeaways from the lessons of history:

  1. “The Innovation Center should make equity a centerpiece of every model.” This means going beyond Medicare and those organizations that have had the resources to participate and drawing in Medicaid, rural, and safety net providers.
  2. “Offering too many models is overly complex, particularly when models overlap.” Apparently, there are 28 models running concurrently, which can create conflicting incentives as well as making it difficult for participants to figure out drivers and outcomes. They will focus on offering fewer models going forward.
  3. “The Innovation Center needs to re-evaluate how it designs financial incentives in its models to ensure meaningful provider participation.” For most of the Meaningful Use period, my practice simply opted out. The burden to providers was far more than the penalty, so we took the penalty and moved forward. The authors admit that there have been challenges in testing some of the models because providers don’t join or opt out when they think they will lose money.
  4. “Providers find it challenging to accept downside risk if they do not have the tools to enable and empower changes in care delivery.” One future goal is to have manageable levels of risk for providers as well as providing supports needed to help providers take on more risk.
  5. “Challenges in setting financial benchmarks have undermined our models’ effectiveness.” They are looking at ways to modify the current risk adjustment methodology and to make sure that models aren’t leading to overpayment. I know that my colleagues will likely be excited about the former, but not so much the latter.
  6. “Innovation Center models can define success as encouraging lasting transformation and a broader array of quality investments, rather than focusing solely on each individual model’s cost and quality improvements.” They plan to scale practices that work in models by adding them to other models, to Medicare, and to Medicaid.

They go on to say that “in order to deliver on the promise of putting people at the center of their care, we need a health system that meets people where they are, keeps people healthy and independent, and coordinates care seamlessly and holistically across settings.” That statement sounded suspiciously like everything I was taught in my family medicine residency training, and I remembered how enthusiastic and idealistic I was when I graduated. Those feelings were quickly beaten out of me as I grappled with the world of prior authorizations, difficulty getting my employer to allow me to spend what I needed to hire high-quality office staff, and the crush of trying to coordinate it all while seeing 30 patients a day.

I paused for a few minutes to reflect on that before I read the rest of the blog because I wanted to see what the Innovation Center was going to propose to counter the forces that drove me out of traditional primary care.

They have identified five strategic objectives:

  1. “Drive Accountable Care.” They hope to reduce fragmentation by rewarding coordinated and team-based care the delivers high-quality outcomes. Accountable Care Organizations are a central part of this plan.
  2. ”Advance Health Equity.” Elimination of health disparities is a key goal, with one action being the active engagement of providers who have not historically participated in value-based care incentive programs. Another action is ensuring that application processes and eligibility criteria include organizations that care for disadvantaged populations. Partnership with Medicaid will be a key activity.
  3. “Support Innovation.” They propose delivering tools that help close care gaps, including addressing mental health and social determinants of health. These tools may include access to real-time data to support providers, flexibility in rules, and looking at targeted approaches to impact specific populations.
  4. “Address Affordability.” The goal is to not only lower spending for Medicare and Medicaid, but also to lower patients’ out of pocket costs. This may mean waiving cost-sharing for certain services, controlling drug prices, or reducing low-value care that is wasteful.
  5. “Partner to Achieve System Transformation.” I love me some clinical transformation, but know that the devil will be in the details for this one. CMS knows that it needs partnership with not only Medicare and Medicaid but with patients, providers, payers, and community-based organizations. The people problem is often one of the most difficult to solve, so I wish them well.

It will certainly be interesting to see what the next decade brings, especially with the ongoing challenges from a global pandemic that shows no signs of stopping, a completely burned-out clinical workforce, and tip of the spear care delivery organizations that are stressed to the max. Many healthcare organizations are not ready to take on one more thing, especially when it puts more strain on the system. I’d be interested to see if readers have any insight or thoughts to offer.

Who’s ready for the next evolution of value-based care? Leave a comment or email me.

Email Dr. Jayne.

Readers Write: When Hospitals Leave Patients in the Wild West, They Turn to Dr. Google

August 16, 2021 Readers Write 1 Comment

When Hospitals Leave Patients in the Wild West, They Turn to Dr. Google
By Mike McSherry

Mike McSherry is co-founder and CEO of Xealth of Seattle, WA.

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Good or bad, everyone has a memorable care experience. This unites us all. The division comes with how it is handled. Viewing the patient as a customer is not a new concept. So why don’t more systems anticipate our needs? Think of your experience with Google or Instagram ads. Scrolling through websites or social media, I think they may know my habits better than the doctor.

I spent 20 years in consumer technology, co-founding companies such as Boost Mobile and Swype, before joining the Providence health system as an entrepreneur in residence. I understand digital innovation in the age of immediacy. With so much information at the patient’s fingertips, it seems like a no-brainer to consult the internet. Why go to an in-person appointment when Dr. Google is just a house click away?

According to Comprehensive Psychiatry, “Googling symptoms results in an escalation of concerns and excessive worrying about symptoms.” It’s our job as healthcare purveyors to ensure the best experience possible for the patient. This experience should be comprehensive, forward-thinking, and, most importantly, conveniently available at 2:00 a.m. when a concerned father wants to know about his child’s fever.

Many times, patients are required to go for an in-person appointment for something they see as simple. Then, wait weeks or longer for that appointment. Once there, physicians have just 15 minutes to address the visit reason, and then … what? If the patient forgets something said or thinks of a question later, there are typically three choices: play phone tag with the office, wait until the next appointment, or consult Dr. Google.

Who is stepping in to fill that information void between appointments? People trust their doctors, but will search online if there is no simple way to get the answers they seek, finding who knows what in their Wild West Web search. Hospitals and health systems would benefit through offering a thorough digital experience. Not only would patients be receiving credible information, it will also give one more touch point, tightening the patient relationship while reducing office phone tag.

Garnering patient trust requires that health organizations update the user experience to accommodate immediacy and convenience. Think of your own care experience. While physically in the office, everything you are told either sounds great or could be confusingly technical. A few hours later, you question certain details or lose the paper print out. It is all too enticing to do a quick search.

Health technology can extend clinical time beyond the office and to the patient. The pandemic drove that point home, along with care options. There are several ways a doctor can be present, along with prescribing apps, health monitors, Ace bandages, diets, or anything that could improve the patient experience. This way, patients can continue receiving clinicians’ recommendations rather than an article Aunt Ada saw on Facebook — thank you, Aunt Ada.

Adding communication channels from the care team, especially digital ones, instantly raises questions from some hospitals. Who will handle the extra workload and will this hurt reimbursement? With the former, automation can handle much of this with triggers based on appointment type and diagnosis codes. Digital tools should be scalable, enhance service lines, and extend care, helping health organizations provide live-saving programs outside their four walls.

Healthcare may be the only industry where the person ordering the treatment is different from the one who uses it, who is also different from who is paying (try that at a restaurant). While no one likes to talk about it, the money for digital solutions must come from somewhere.

CMS now reimburses for several virtual tools, with commercial payers following suit. Further, open lines of communication and accurate, timely information can prevent emergency room readmissions, assisting quality scores and reimbursement.

There are also the more long-term benefits of patient satisfaction, one metric in determining reimbursement rates, and recommendations. As with other areas of our lives, we want to go where people know our names. Meeting people where they are with targeted, accurate health information furthers the patient bond and keeps the Dr. out of Google.

Readers Write: Creating Resiliency Among the Newest Generation of Clinicians

August 16, 2021 Readers Write 1 Comment

Creating Resiliency Among the Newest Generation of Clinicians
By Acey Albert, MD

Acey Albert, MD is director of clinical content for the Epocrates business of Athenahealth of Watertown, MA.

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Healthcare is facing an immediate crisis that threatens to undermine our ability to deliver care: a massive clinician shortage that grows larger with each passing day. If that isn’t enough, the COVID-19 pandemic accelerated an alarming rate of burnout, trauma, and disillusionment. In fact, according to Athenahealth’s recent Physician Sentiment Index, the fiscal responsibilities of practicing compounded by the pressure of delivering high-quality patient care contributed to feelings of frustration, with 46% of the nearly 800 physicians participating in the survey reporting feeling burned out a few times a month or more.

While there’s no magic wand that could suddenly wave away this multifaceted challenge, there are small changes we can make today to address some of the immediate drivers of this trend head-on.

Support distracted, fatigued minds with “peripheral brains”

Early in clinical training, there arises a certain bravado about memorizing every rare “zebra” condition in the textbooks. Students and residents are interrogated in front of their colleagues about the most obscure causes of a symptom, reinforcing this drive. At every career stage, the pressure to know it all persists. Rote memorization of obscure facts can distract clinicians from using their brains for what really matters: critical thinking, creative problem solving, and building the clinician-patient relationship.

When clinicians are mentally fatigued, access to clinical decision support tools, or peripheral brains, is more vital than ever. Medical knowledge is growing exponentially. For drug therapies alone, there is an endless flow of journal articles updating the indications, dosing, drug-drug interactions, and side effects. Keeping up with medical knowledge that doubles, by recent estimates, every 73 days is a Herculean task, even before a novel coronavirus emerged to spread devastation and confusion across the globe.

Trusted technology resources have made it possible to compile all of that practical clinical information onto a mobile device. Practicing clinicians are digital omnivores, leveraging access to their desktop and laptop computers, smartphones, tablets, and smart watches, among others. With these digital platforms at hand, clinicians are increasingly becoming managers of medical information rather than mental repositories of it.

Reduce clinical decision time through quick-access mobile solutions

If you think about a typical 15-minute office visit in a busy practice, clinicians must call on a large knowledge base in just a few brief moments: perhaps a few minutes during the patient history, another minute or two during the exam, and then — most importantly — in the last moments of the visit while making a diagnosis and developing the treatment plan. Positioning easily accessible reference data at a clinician’s fingertips means they no longer have to comb through their bookshelves or scour the internet to search for key information vital to their decision-making.

Any tool used during those moments of care needs to be quick, accurate, and intuitive. Certain user preferences can help clinicians rapidly and efficiently access the most-valued and most time-sensitive information. Time spent clicking, scrolling, and typing, or worse, figuring out some novel interface, is time not spent meaningfully interacting with patients. Through the use of familiar interaction models common in non-medical apps, such as swipe right or swipe left navigation, medical app interfaces could be leveraged to more expeditiously deliver guidance. Simple favoriting functions and other self-curation tools can also speed access and create shortcuts for busy clinicians.

Increase patient face-time with mobile technology

Throughout the COVID-19 pandemic, clinicians have increasingly been using mobile apps, both to maintain contact with their patients and as a source of trusted information that goes wherever they do. Compared with a desktop or laptop computer, mobile devices keep priorities clearer between clinicians and their patients, whether used in person or virtually.

Providers can easily integrate clinical decision support tools into the patient visit — it’s not necessary to hide them out of sight. Patients typically appreciate when clinicians demonstrate that they are using the latest technology on their behalf. Mobile medical reference apps can be used in the exam room or at the bedside, so the clinician and patient can view the screen together to look at drug interactions, pricing information, and even side effects. Time spent using these resources and apps together can enhance the clinician-patient interaction.

The future role of mobile medical apps in supporting resiliency

It’s anticipated that clinicians will continue harnessing technology like mobile medical reference apps long after this global health crisis subsides, since they can be updated more rapidly than non-cloud-based electronic health records or typical institution-based reference resources.

During the current pandemic, a super-rapid updating pace is vital to combating the even faster, ever-evolving misinformation surrounding COVID-19. Mobile medical apps offer opportunities to increase clinician knowledge and productivity in real time. Expanded use of these technologies holds potential for improving clinicians’ experience of practicing medicine, expanding their skillsets, and ultimately enhancing the quality of care delivered to their patients.

Readers Write: Why Healthcare Organizations Can’t Afford A Data Breach Caused by Human Error

August 16, 2021 Readers Write 1 Comment

Why Healthcare Organizations Can’t Afford A Data Breach Caused by Human Error
By Tim Sadler

Tim Sadler, MA, MSc, MEng is co-founder and CEO of Tessian of London, England.

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$9.42 million. That’s how much a healthcare data breach now costs, a staggering $2 million more than it was a year ago. According to IBM’s 2021 Cost of Data Breach report, data breaches in the healthcare industry are the highest across all industries today. 

While ransomware attacks have dominated the headlines in recent months, the leading cause of data breaches in the healthcare industry is actually miscellaneous errors, with the most common of these mistakes involving an email or file attachment being sent to the wrong person.

We’ve all been there. Faced with looming deadlines and overwhelming to-do lists, you think to yourself, “I’ll just quickly send that by email.” But with healthcare professionals now responsible for more data than ever before, the stakes are high. 

Employees are the gatekeepers to highly sensitive and valuable information, such as people’s personal and medical records, intellectual property, and research and development. With many clinics sharing patients’ information among colleagues or with third-party partners via email, a simple typo could result in lost data, a serious cybersecurity incident, and significant reputational damage. 

This was the case with a gender identity clinic in the UK. An employee accidentally exposed the personal details of nearly 2,000 people because they CC’d recipients instead of BCC’ing them. In addition to damaging patient trust, a mistake like this can cause major legal problems, like violating HIPAA and HITECH laws.

Many IT and security teams may not even realize the scale of the problem that human error poses to their organization. IT leaders surveyed by my company estimated that 480 misdirected emails were sent in their organizations each year. In reality, at least 800 emails are sent to the wrong person in companies with 1,000 employees each year. What’s more, one in five healthcare professionals say they’ve made a mistake that has compromised security while working remotely that no one will ever know about. 

It’s not accidents causing problems. Security leaders know that the vast majority of employees are well intentioned, but there are some people who knowingly exfiltrate data from the organization. In fact, 35% of employees working in the healthcare industry admit to downloading, saving, or sending work-related documents to personal accounts before leaving or after being dismissed from a job. Our platform indicates that at least 27,500 non-compliant, unauthorized emails are sent every year in organizations with 1,000 employees. Security leaders estimated just 720.

Visibility into the threat is sorely needed. You can’t defend against what you can’t see. 

To prevent security incidents caused by human error and avoid the eye-watering costs associated with a data breach, healthcare organizations need to start putting people at the heart of their security strategies and consider how they can best support their riskiest and most at-risk employees. 

Constantly reinforcing security awareness training is an important first step in improving people’s security behaviors. Training can’t be a one-size-fits all, tick-box exercise; it has to be contextual and relevant if it’s ever going to resonate with employees and enforce long-lasting behavioral change. 

Then create and maintain a security culture that empowers employees to make the right cybersecurity decisions. Arm people with the tools and knowledge they need,  in the moment they need it most, to avoid making risky mistakes that can compromise data security. This could mean alerting people to think twice before clicking, rewarding employees for spotting threats, and creating a safe space for people to admit when they’ve a mistake.

Businesses are digitally transforming and ways of working are changing, but one thing remains the same — people are in control of the data and systems. Their behaviors will make or break a company’s security posture. With the cost of a healthcare data breach continually rising year on year and with people being responsible for more data than ever before, IT leaders can’t no longer afford to neglect security at the human layer in their organization.

Morning Headlines 8/16/21

August 15, 2021 Headlines No Comments

Talkdesk Valuation Triples to More Than $10 Billion, Appoints First Chief Financial Officer

Customer experience software vendor Talkdesk completes a Series D funding round that values the company at $10 billion.

Labcorp Extends Leadership in Women’s Health With Acquisition of Ovia Health

Labcorp acquires Ovia Health, which offers health plans, employers, and individuals services that include women’s health coaching and apps for fertility, pregnancy, and baby development tracking.

SOC Telemed Reports Second Quarter 2021 Financial and Operating Results

Acute care telemedicine vendor SOC Telemed reports Q2 results: revenue up 84%, EPS –$0.16 versus –$0.30.

Memorial Health System Experiences Cyber Attack

Memorial Health System puts its emergency departments in Ohio on diversion and cancels surgeries and radiology exams following a cyberattack early Sunday morning.

Monday Morning Update 8/16/21

August 15, 2021 News 3 Comments

Top News

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CMS will require hospitals to attest that they have completed an annual self-assessment of their compliance with the SAFER Guides for EHR safety. The requirement starts with the EHR reporting period in CY 2022.

The nine categories of the Guides are:

  1. High-priority practices
  2. Organizational responsibilities
  3. Contingency planning
  4. System configuration
  5. System interfaces
  6. Patient identification
  7. Computerized provider order entry with decision support
  8. Test results reporting and follow-up
  9. Clinician communication

The SAFER Guides were developed by Dean Sittig, PhD; Joan Ash, PhD, MLS, MS, MBA; and Hardeep Singh, MD, MPH with the support of ONC. They first published the SAFER Guides in early 2014.


Reader Comments

From Recapper Rick: “Re: HIMSS21. Hot topics from the exhibit hall?” That’s always subjective, but I’ll try (and encourage others to chime in), remembering that low exhibitor count means underrepresentation of some topics:

  • Hot: telehealth, remote patient monitoring, cybersecurity, AI, interoperability, health equity, population health management, patient payments, digital front door, cloud, hospital data for life sciences.
  • Not: EHRs, big data, blockchain, wearables.

HIStalk Announcements and Requests

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Take these results with a grain of salt since some non-providers missed the “healthcare providers” part of the poll and responded about their non-provider workplace. That’s perfectly fine – basically across the industry, it’s a fairly even split of requiring vaccination proof.

New poll to your right or here: How did HIMSS21 change your perception of HIMSS?

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I checked out some of the HIMSS21 videos on the HIMSS Accelerate platform. They are posted as unlisted YouTube videos and stream embedded from there, although the Alex Rodriguez keynote doesn’t work since it has been blocked by Warner Music Group. I don’t know if A-Rod has anything to do with WMG, so maybe it has something to do with background music or something.

I still haven’t seen a HIMSS21 attendee count, although they said that 18,000 people had registered for both the in-person and online versions. Since HIMSS didn’t provide a count of onsite, paid attendees, I’ll throw out my guess of 8,000 given the expanse of empty space in the exhibit hall and hallways. Let me know if you have better information.

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One final HIMSS21 to-do item – complete my quick 10-question survey about your experience with either the in-person or virtual version. I’ll summarize the responses shortly. Thanks.

My vaccinated, COVID-infected relative is feeling a good bit better although with brain fog, but she learned from emails from others in her camping trip group that at least 60 of them have been infected, which makes it a superspreader event. The other relative who was infected last week from an unknown source now has three of four family members testing positive and symptomatic, for which they initiated a telehealth visit (filled out an online form, paid $90, got a telephone call back two days later) with the controversial America’s Frontline Doctors, who prescribed a Z-Pack and hydroxychloroquine.

HIMSS21 returnees, consider following Dr. Jayne’s suggestion to isolate until the fourth day after you left the conference, then take a COVID-19 test on that day for the all-clear. Walmart sells the BinaxNow self-test at $20 for two, and given present circumstances, it’s unlikely that the second one will expire unused.

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I set a reminder to see if anyone had analyzed HIMSS conference tweet counts as a proxy for general conference interest and participation. Ottawa-based medical writer Pat Rich did.

I’m disappointed that nobody Photoshopped the “Chris Christie on the closed beach” meme onto his HIMSS21 keynote stage photo.


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Welcome to new HIStalk Platinum Sponsor Ideawake. The Milwaukee-based company enables employers to unleash the entrepreneurial spirit of their workforce. Its industry-leading idea management software makes it easy to capture, evaluate, and implement targeted ideas from frontline employees. Support a culture of innovation by using its one-stop platform for facilitating innovation challenges, shark tanks, hackathons, and improvement symposiums from initial sourcing of ideas to measuring ROI. Customers such as Advocate Aurora, UnityPoint, OSF Healthcare, and Sanford Health use Ideawake to cost-effectively discover more solutions, prioritize the best ones faster, and transform more of them into impact. Engage hundreds to tens of thousands of employees to solve your biggest problems and break down entrenched silos and geographic barriers while fostering a global, company-wide culture of innovation. Thanks to Ideawake for supporting HIStalk.

Here’s an Ideawake intro video.


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Reader Tom Foley, chief growth officer of GenieMD, emailed to say that the company was busy during HIMSS21, still going strong with demos and meetings at 4:00 Thursday as the exhibit hall closed. I was intrigued and asked why his company did so well when others didn’t seem as thrilled. I appreciate his ideas:

  • GenieMD offers an integrated telehealth and remote patient monitoring solution, which is a growth area since providers are finding out that their EHRs aren’t robust in those areas and video-only platforms aren’t a long-term solution.
  • The majority of booth visitors were senior decision makers.
  • The company expected reduced conference attendance, so decided just four weeks out to upgrade from a Caesars Forum kiosk to a 10×10 space in the main hall.
  • They bought a full-page ad in the conference magazine.
  • They issued four press releases the week before and during the conference and posted those on LinkedIn and Twitter.
  • GenieMD has chosen an 20×20 booth for HIMSS22, expecting to have more information to share then.

Webinars

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


Acquisitions, Funding, Business, and Stock

Acute care telemedicine vendor SOC Telemed reports Q2 results: revenue up 84%, EPS –$0.16 versus –$0.30. Shares dropped 34% on Friday following the announcement, valuing the company at $414 million. TLMD shares are down 69% since early November 2020, when the company went public via a SPAC merger.

Customer experience software vendor Talkdesk completes a Series D funding round that values the company at $10 billion.

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Clinical workflow solutions provider Medstreaming and its acquired M2S clinical data registries company rename the combined entity to Fivos Health. Industry long-timer Jay Colfer is CEO.

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Labcorp acquires Ovia Health, which offers health plans, employers, and individuals services that include women’s health coaching and apps for fertility, pregnancy, and baby development tracking. The company whose annual revenue is $20 million, previously received an investment from Labcorp’s venture fund.


Sales

  • Oklahoma Heart Hospital chooses Health Catalyst’s Data Operating System and DOS Marts.
  • Stratum Med will offer its practices CareSignal’s Deviceless Remote Patient Monitoring.

People

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Jeannell Thomas (UnitedHealth Group) joins Protenus as VP of implementations and customer solutions.

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Industry long-timer Brian Gildea (Spok) joins NThrive as VP of new client acquisition.

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Divurgent hires Scott Freeman, MHA (Leidos) as VP of client service.


Announcements and Implementations

Intelligent Medical Objects launches IMO Core CSmart app, which allows Cerner users to more easily capture ICD-10 specificity and secondary codes, improve capture of HCCs, and organize problem lists in clinical categories.

Imprivata rolls out a new digital identity maturity assessment tool.

Everbridge announces new versions of its CareConverge and HipaaBridge secure clinical collaboration solutions.

Adventist Health joins Cerner Learning Health Network.


Government and Politics

UnitedHealthcare will pay $15.7 million to settle federal and state charges that it overcharged or denied coverage for patients with mental health and substance abuse issues using a software algorithm to trigger extra reviews.


COVID-19

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The federal government’s HHS Protect system shows that hospitals in Florida and Georgia are using more than 20% of their inpatient beds for COVID-19 patients.

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State officials in Mississippi warn that its hospital system is facing imminent failure and ask for federal government help with more than 1,500 COVID-19 patients hospitalized, 400 in the ICU, and University of Mississippi Medical Center turning a floor of its parking garage into a field hospital. Oregon is sending National Guard members to hospitals that are overwhelmed with COVID-19 patients.

COVID-19 test positivity rate exceeded 50% in Oklahoma and Mississippi last week. Their percentage of fully vaccinated residents is 41.7% and 35.9%, respectively.

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Even more concerning is the percentage of ICU beds that are housing COVID-19 patients.

NIH Director Francis Collins said on a Sunday news program that he expects the daily case count to exceed 200,000 within two weeks – it’s at 140,000 now — because 90 million people still aren’t vaccinated, concluding that “we’re in a world of hurt.”

Eric Topol, MD says in an op-ed piece that CDC is making a mistake by ending its monitoring of post-vaccination COVID-19 infections that don’t involve hospitalization or death. He says we are “flying blind” since we don’t know how many breakthrough infections are occurring, the threshold cycle of positive PCR tests would provide an understanding of viral load, and we can’t perform genetic sequencing to see if the virus is continuing to mutate. Data collection would also help public health officials identify who is at risk for breakthrough infections, analyze vaccine effectiveness, and figure out the types of patients who need booster shots.

In another call for increased CDC data analysis, former FDA Commissioner Scott Gottlieb, MD says it should gather data on children who are hospitalized with COVID-19 to determine whether the big ramp-up in the South is the “top of a huge iceberg of dire infection” or a sign that the virus has become more pathogenic in children.

Politico’s “Inside America’s COVID-Reporting Breakdown” says that state surveillance systems aren’t capable of giving public health officials real-time data to determine where outbreaks are occurring. Labs are short on staff to process tests quickly, many results are reported manually, and the systems that are used by state health departments are not interoperable with each other. Newly opened labs that weren’t prepared to report results electronically forced health department volunteers to pull results off fax machines and re-enter them into spreadsheets. Data de-duplication to make sure each result was entered only once was hampered by misspelled names.

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CDC issues a recommendation that people whose immune systems are compromised get a booster dose of vaccine. Those conditions are listed in the slide above from CDC’s vaccine advisory committee. CDC is also now recommending that pregnant and breastfeeding women receive the vaccine.

The Atlantic science writer Ed Yong writes a new version of his influence March 2020 piece titled “How the Pandemic will End.” He makes these points in the newly published “How the Pandemic Now Ends”:

  • The goal is once again to buy time to keep hospitals and schools open and to get more people vaccinated.
  • Unvaccinated people are often clustered geographically and that allows the variant to spread. Vaccinated people can transmit the delta variant to an unknown degree.
  • Societies cannot use vaccines as their only defense, and unvaccinated pockets can still shut down schools, overwhelm hospitals, and create more changes for worse variants to emerge. Available tools include better ventilation, rapid tests, and social support such as paid sick leave, eviction moratoriums, and free isolation sites.
  • Universal vaccination mandates probably won’t fly, but vaccination should be required for employees of hospitals, long-term care facilities, and prisons, where vulnerable people don’t have a choice about being exposed. They may also be likely for university students, government employees, and the military.
  • The delta variant has made it unlikely that COVID-19 can be eliminated. The pandemic will eventually turn into an endemic like the common cold.

Sponsor Updates

  • Avtex publishes a Digital Front Door Toolkit.
  • OptimizeRx SVP & Principal of Agency Channels Angelo Campano joins The Curtis & Coulter Podcast to discuss “The ‘Tele’ Movement & Evolution of Point-of-Care.”
  • Nordic publishes a new whitepaper, “The new healthcare ecosystem: Preparing for decentralized care.”
  • TCS Healthcare Technologies will use Healthwise Care Management Solution in its care management platform.
  • Protenus co-founder and CEO Nick Culbertson joins the ReCon Labs Podcast.
  • University Medical Center Utrecht in the Netherlands signs a 10-year contract for digital pathology with Sectra.
  • Spirion appoints Billy VanCannon head of product management.
  • Well Health salutes five customers who made the US News Best Hospitals 2021-22 Honor Roll.
  • Frost & Sullivan honors Lumeon with the 2021 North American Customer Value Leadership Award.
  • Nordic Consulting partners with Fortified Health Security to offer its customers cybersecurity solutions.
  • Surescripts publishes a new data brief, “COVID-19 Heightens the Need to Improve Interoperability, Provide Price Transparency & Relieve Provider Burnout.”
  • Halo Health releases a new infographic, “Clinical Collaboration Platforms and EHRs – An Essential Partnership.”
  • Healthcare Growth Partners has advised Radix Health in its sale to Relatient.
  • Infor announces significant success and momentum for its cloud-based interoperability solutions.
  • Meditech releases a new infographic, “How NMC Health leverages data with BCA dashboards.”

Blog Posts


Contacts

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

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Dr. Jayne Goes to HIMSS Digital – Thursday

August 13, 2021 Dr. Jayne No Comments

Thursday is functionally the last day of HIMSS for many attendees, as they’re worn out from cocktail parties and walking the exhibit hall. By this point, I would typically be packing my suitcase and dropping it at the bell desk so I could pick it up on the way to the airport for my late evening flight. Historically I do an Exhibit Hall Crawl with one of my long-time HIMSS friends, as we see who is left standing at the end of the week and who has headed out early. This time I’ve been receiving photos of the mostly empty exhibit hall from people on the ground.

I decided to attend the “Encouraging Science of Happiness” keynote featuring Rainn Wilson, since it was one of the few in-person sessions that was to be live-streamed. Logging into HIMSS digital, there was no information on the session, but I remembered hearing it was going to be streamed through the Accelerate platform. After way too many clicks, I was able to access the session, which was to start at 8:30 a.m. Ten minutes into it, I was still watching people wander in and find seats, with no update from HIMSS about any delays other than a single instance where a voice said something about “Changemakers, take your seats, the program is about to start.” It’s not like they had a crush of people they had to fit into the room.

Things finally got going at 8:42, but instead of showing video of speaker Reid Oakes, we were treated to a static image, and then the slide deck moved onto the HIMSS Stage 7 award recipients. They finally cut to a speaker view, but then the same thing happened when the keynote speakers came out – we got the slide deck, but we never got to see the actual speakers again until nearly the end. I guess HIMSS couldn’t figure out how to do a split screen?

Still, it was a good presentation, and talked about some of the challenges of current times – specifically the challenge of loneliness (which several nations including Japan and the UK have appointed governmental ministers to address) which according to the speakers has the same negative health effects of smoking a pack of cigarettes each day. Despite being one of the most connected generations, 18- to 24-year-olds (even pre-COVID) report higher levels of loneliness than senior citizens. One of the main points of the speech was the idea that intentionally choosing joy is an act of rebellion – going against the status quo. There was a part where the audience wrote notes to people who had positively influenced them and some of them read their notes aloud. It would have been nice to see those interactions rather than just a static slide.

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Great Tweet from Jan Oldenburg @janoldenburg yesterday, pondering how we will identify the potential impact of COVID-19 spread from HIMSS21. Everyone will be going back to their homes and their day-to-day lives, not necessarily knowing where or when they might have come into contact with someone who was positive. This makes determining if and when to test somewhat problematic, since CDC recommends that even if you’re vaccinated, as all HIMSS21 attendees are, that you test on day 3-5 if you’re exposed. Since HIMSS keeps touting its Accelerate platform and the meeting app, having a COVID-19 tool as part of it would have been cool – even my alma mater has one for its on-campus students.

Although I can’t provide medical advice since I don’t want to run afoul of any laws, I can tell you what my own plan was going to be for post-HIMSS symptom surveillance: stay mostly in one part of the house, avoid the rest of my household, and have a test four days after coming off the plane. If negative, it’s highly likely that the virus has been dodged.

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From everyone who has corresponded with me, it sounded like the in-person conference still had value even though there were some 100% unstaffed booths today. People generally liked being able to conduct their business without having to navigate crowds and without having to rush from meeting to meeting, since some of the meetings had canceled. Vendor-side reps felt the conversations were high value and less rushed. We’ll have to see what things look like a few short months from now, when we (hopefully) gather in Orlando. Time to hit the end-of-summer sale rack for what will become my sassy spring sandals.

Will you be attending HIMSS22? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 8/13/21

August 12, 2021 Headlines 1 Comment

PracticeSuite Announces Entrance into Consumer Health Information Market with Acquisition of HelloHealth

Ambulatory health IT vendor PracticeSuite acquires competitor Hello Health for an undisclosed sum.

Another big company hit by a ransomware attack

Accenture, which sells cybersecurity services, is hit by a ransomware attack in which hackers have threatened to publicly release company data.

US Indian Health Service to replace health information system

The Indian Health Service issues an RFI to vendors interested in being considered for its 10-year Health IT Modernization program contract.

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