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Monday Morning Update 9/21/20

September 20, 2020 News 2 Comments

Top News

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Healthcare robotic process automation vendor Olive raises $106 million in an equity investment, increasing its total to $220 million.

The 360-employee company’s “AI workforce” has been adopted by 600 hospitals. One of its investors is Ascension Ventures.

The company, formerly known as CrossChx, offers AI-as-a-Service, in which an annual price covers scoping, implementation, support, and ongoing optimization. Its Deep Purple taps the collective data of its customers to model the network-wide impact of promising solutions.

Founder and CEO Sean Lane is a former US Air Force captain and National Security Agency intelligence officer who has founded several companies.


Reader Comments

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From Anti Autocorrect: “Re: Phil Ehr for Congress. Wonder how many times he has become Phil Her for Congress?” The Florida candidate invites supporters to join the “Ehr Force,” which suggests his name is pronounced “Air.” I’m sure we can all have fun thinking up punny ways like Phil’s to sound out “Ehr” as “Air,” such as calling a company an “Air Vendor.”

From Where My Testers At?: Re: Epic’s latest Rover update. Requires nurses to key in the full date and time on the MAR since the shortcuts ‘T’ for today and ‘N’ for now have been removed. One more straw on the back of already-burdened nurses. Amazing that the testing protocols aren’t robust enough to pick this up.”

From IT Analyst: “Re: Signature Healthcare (MA). Went live with Meditech Expanse for Ambulatory on 9/16, replacing Allscripts Touchworks, which had been in place for 10 years.”


HIStalk Announcements and Requests

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About 60% of poll respondents have participated in a virtual conference and just over half of those would recommend that others do so. Two-thirds of those who have not participated say they are unlikely to do so down the road. Those respondents who provided positive comments say that it’s nice to be able to work during the sessions and not lose travel time, organizers are getting better at mastering digital conferencing tools, and the format allows attendees and vendors to participate in conferences that would have been impossible previously due to cost and logistics. Those with less enthusiasm say they miss the feeling of connection, they don’t like presenters who sit at home in casual clothes delivering death by PowerPoint, technical glitches seem to occur frequently, and presenters have not always rehearsed using the actual delivery technology and fumble during their moment in the spotlight.

New poll to your right or here, in a related question suggested by a reader: For companies that have participated in a virtual conference’s exhibit hall, were you satisfied?

Listening: new from Declan McKenna, a startlingly good 21-year-old English singer-songwriter who turns out polished music that sounds like a combination of the Beatles, Neil Young, and David Bowie but with lyrics that often fall into the protest song category. People this young aren’t usually capable of writing wry words like this on climate change in what seems to be a shot at Elon Musk: “Everybody gets so tired of hearing what you said, When you think your money’s gonna stop you getting wet, So Noah, you best start building, You better have ten thousand children, Because everybody wants to be one.” His band mates look like kids who are awkwardly pretending to play after school in Mom’s garage, but ears are a better judge than eyes. You could play the new album “Zeros” and immediately get into it like I did, but I think it would remain interesting after several plays. I hope his handlers keep bad influences away so that he has a long, productive career onto which we can hitch a ride.

RIP Lee “Bear” Kerslake, former drummer for Uriah Heep and Ozzy Osbourne, who died Saturday of prostate cancer at 73.  For real deep-cut types, he played in the mid-1960s at age 20 with the somewhat obscure group The Gods, whose alumni eventually included Ken Hensley (Uriah Heep), Paul Newton (Uriah Heep), Greg Lake (ELP), Mick Taylor (The Rolling Stones), and John Taylor (Jethro Tull).


Webinars

September 30 (Wednesday) 11 ET. “The Hidden Threat: New Research on Security Vulnerabilities and Privacy Gaps in Healthcare Apps.” Sponsors: Verimatrix, NowSecure. Presenters: Neal Michie, MEng, director of product management, Verimatrix; Brian Lawrence, direction of solution engineering, NowSecure. The presenters will present research on the security risk profile of 1,000 healthcare apps in managing patient privacy, how they compare to those in other industries, and where the biggest vulnerabilities lie. Attendees will learn how to make their healthcare apps more secure in managing protected health information.

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


Sales

  • NYU Langone Health will replace several legacy PACS with Visage 7 Enterprise Imaging Platform in four hospitals, including all radiology and sub-specialty imaging departments. The organizations will also work together to develop new enterprise imaging products and Visage will establish an R&D hub in New York City.
  • Houston Methodist chooses patient scheduling and referral management from Blockit.

People

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Baptist Health South Florida hires Tony Ambrozie, MEng, MSIM, MBA (The Walt Disney Company) to the newly created position of SVP / chief digital officer.


COVID-19

HHS Secretary Alex Azar bars the FDA from signing any new rules, including those related to vaccines, ordering in a memorandum that such power is now “reserved to the Secretary.” Observers say the timing will raise concerns that Azar is muzzling FDA Commissioner Stephen Hahn, MD to prevent vaccine-related surprises or obstacles before the election.

A New York Times investigation finds that controversial new CDC guidance – which advises that symptom-free people shouldn’t be tested for COVID-19 even if they are known to have been exposed — was written by HHS and posted to CDC’s website over the objections of CDC scientists. HHS and the White House coronavirus task force wrote the policy, which reversed previous recommendations to test more people, then posted it to CDC’s website even though it contains errors and recommendations that are not consistent with CDC’s guidance. HHS did the same for school re-opening guidelines that were posted to CDC’s site without its involvement. The original recommendation was restored this weekend in what was listed as a “clarification” that clearly says the opposite of the guidance it replaced in urging for symptom-free people who have been exposed, “You need a test.”


Other

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William “Bill” Stead, MD, professor and chief strategy officer of Vanderbilt University Medical Center, will retire from the medical center’s senior leadership team after a 29-year career. He will remain on the faculty of the Department of Biomedical Informatics. Stead has directed the Informatics Center, served as CIO, was the founding chair of what was originally called the Division of Biomedical Informatics, directed the biomedical library, was chair of Vanderbilt Center for Better Health, and was chief information architect. He was the founding editor-in-chief of JAMIA, was president of the American College of Medical Informatics, and chaired the Board of Regents of the National Library of Medicine. He got his start as a work-study undergraduate student at Duke University, where he got himself assigned to a heart research project that included the university’s first minicomputer, then started medical school and research under fellow informatics pioneer Ed Hammond, PhD.


Sponsor Updates

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  • Waystar partners with Louisville-based Cafe9M and ElderServe to provide weekly meals to community members in need.
  • PMD releases a new video (filmed at 350 mph!), “A Day in the Life – Dave (The Company Pilot).
  • Pure Storage will acquire Portworx, a Kubernetes data services platform, for $370 million.
  • Redox releases a new episode of its Shift+6 podcast featuring the Broad Institute’s Danielle Ciofani.
  • CareSignal announces that its device-less remote patient monitoring system has supported 20,000 patient-years, a metric it follows as a Clinically Relevant Engagement Duration that focuses on the long-term engagement of patients.
  • Relatient publishes a new case study, “QualDerm Partners’ VP Talks Scaling a Physician Network, Leveraging Patient Engagement, and Responding to COVID-19.”
  • SOC Telemed recognizes health system customer Guthrie for outstanding results in its telestroke program.
  • Spirion develops a Global Alliance Partner Program to offer an ecosystem of best-in-class solutions.
  • InterSystems joins the CARIN Alliance, a collaborative working to advance consumer-directed exchange of health information.

Blog Posts

Sponsor Spotlight

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Bluetree’s integrated team approach helps healthcare providers realize higher returns from their Epic EHR. Since 2019, Bluetree operates as an independent subsidiary of Providence. It received Inc. Magazine’s Best Places to Work award in 2019 and has a client base of more than 155 health systems nationwide, including all 10 organizations listed in the 2020-21 US News and World Report Best Hospitals Honor Roll rankings.


Contacts

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

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Weekender 9/18/20

September 18, 2020 Weekender 3 Comments

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Weekly News Recap

  • Amwell raises $742 million in its IPO.
  • Provation acquires EPreop.
  • MDLive secures investment totalling $75 million.
  • Change Healthcare announces plans to permanently close its Nashville headquarters.
  • Amazon opens up its HIPAA-compliant Alexa skill program to interested app developers.
  • Apple adds a blood oxygen monitoring feature to the newest version of Apple Watch.
  • Kaiser Permanente launches Virtual Plus, a virtual-forward health plan for members in six Washington counties.

Best Reader Comments

Over the last few years, I have seen a lot of fancy AI driven care coordination tools, I have seen commercials from payers and health systems on how they are taking better care of their members and patients. But personally (for myself and for my family), I have not seen any improvement in how care is delivered to me. I have never ever received an individualized outreach from my insurance company (AI-driven or not) or my provider regarding the risks that I may face. I still struggle on hard to navigate websites to find the right provider. I still fumble through five different patient portal accounts to keep track of my own data. Even during the last six months of COVID-19 crises, I have not received even a generic email of empathy from my current insurance provider. Is the root cause of this complete lack of consumer care the fact that in the employer-driven medical care insurance world, the only customer that insurers like UMR have to please is the benefits manager at the employer? And those benefits managers typically don’t seek feedback from employees on whether they are satisfied with the insurance options? (US_MedicalCare)


Watercooler Talk Tidbits

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Readers funded the Donors Choose grant request of first-year teacher Ms. A, who asked for STEM resource kits for her California kindergarten class. She reports, “My students and I want to thank you for your generosity to our project, STEM in Kinder. These supplies are being used every day during our science time. My students were very excited when they first saw the supplies arrive. Once again, I cannot thank you enough for your help with this project. Most importantly, thank you so much for supporting my students and me. Especially this year it will make a huge difference in the lives of my students while they are learning from home.”

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A veterinarian at an Illinois zoo asks a “human doctor” to perform a hysterectomy on a monkey with a rare form of uterine cancer. OB-GYN Justin Hinzman, MD performed the procedure, noting that it felt strange because the patient was the size of a human toddler.

The Philippines banned nurses from leaving the country to work elsewhere because of its own COVID-19 needs, but working conditions there are so bad that most of those whose travel was denied aren’t working as nurses anyway. The country previously encouraged them to seek overseas employment that paid multiples of what they could earn at home, allowing them to send money back to their families. They make up 4% of the US nurse total.

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A North Dakota doctor is arrested in a prostitution sting operation at Hong Kong Spa, a massage parlor he owns. An employee says he is a “false owner” who was paid by the real owners to put his name on the business license.

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A hospice nurse makes the wish of a 50-year-old terminal cancer patient happen when she gets a private pilot to fly him to his son’s first high school football game of the season, an away game that was too far for him to travel by car.


In Case You Missed It


Get Involved


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Morning Headlines 9/18/20

September 17, 2020 Headlines No Comments

Google-Backed American Well Stock Rises 28% in Market Debut

Boston-based telemedicine company Amwell raises $742 million in an IPO that saw shares hit a debut high of $25.90.

LifeSpeak Announces $42 Million Equity Investment To Accelerate Growth Of Digital Mental Health and Wellness Platform

Toronto-based employee mental health and wellness digital education vendor LifeSpeak raises a $42 million growth investment.

Forbes 400 2020: These Billionaires Have Gotten The Richest Over The Past Year

Epic founder and CEO Judy Faulkner is among the members of the Forbes 400 whose net worth increased the most in the past year, gaining $1.7 billion to hit $5.5 billion.

Washington and Oregon Join California in Pilot Project Using Google and Apple Exposure Notification Technology to Slow the Spread of COVID-19

Oregon and Washington join California in a pilot project that will test COVID-19 exposure notification technology developed by Apple and Google.

News 9/18/20

September 17, 2020 News 1 Comment

Top News

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Gastrointestinal procedure documentation vendor Provation acquires EPreop, which sells anesthesiology quality reporting and perioperative care solutions.


Reader Comments

From Count Chocula: “Re: women on executive teams. It seems you have a threshold, so what is the right number?” I don’t know, other than it isn’t zero, but I would question the culture of a company that doesn’t at least have 30% female executives listed on its “about us” page. They can hire whoever they want, but we on the provider side are also free to choose vendors whose practices align with our beliefs and expectations. The percentage of women executives in a few companies I checked: Meditech 43%, Cerner 36%, Allscripts 35%, Change Healthcare 25%, Cognizant 8%, Athenahealth 23%, Nuance 27%, and NextGen Healthcare 27%.

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From Frontliner: “Re: our continuing abysmal public health and Infectious disease management supply pipeline. Children’s Health in Dallas can’t get microbiology culture supplies due to national shortages, so they are sending stool samples for E. coli testing to a reference lab, which adds 2-3 days to the turnaround time.” I’m skeptical of just-in-time inventory practices — it has been many years since interest rates and thus inventory holding costs were high enough to make the faddish practice worthwhile. MBA consultants pushed holding inventory measured in days or even hours, a mostly pointless logistical exercise that stops being harmless when supply chains are disrupted or demand increases, as we saw with hospitals desperately bidding against each other for PPE. Similarly, aggressively managed hospital staffing practices created labor shortages and excessive traveling clinician costs when faced with similar resource supply challenges. Frontliner and I conclude that making healthcare a free-market system run by profiteers hasn’t proven to be in the best interest of its customers (which includes all of us at one time or another). Imagine a country whose healthcare non-system is so broken that the only way we can come  up with to reduce crippling drug prices is to import them on the sly from smarter countries (watch your prescription prices, Canada, because we’re going to drive them up), beg for help with medical expenses via crowdfunding sites, and leaving a large chunk of the population unable to afford either health insurance or health services costs, making bankruptcy a key component of most care plans.

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From Mark Edelstein: “Re: HIStalk. I finally retired after a 40-year career in health IT, which included time with GerberAlley, Initiate Systems, Phamis, SMS, GTE, and RelayHealth. Reading HIStalk each day these past several years has really been a pleasure and has kept me so informed and educated , well beyond what knowledge I was able to uncover on my own. You have great energy and offer a terrific product. Keep it going!” Thanks and happy retirement (a.k.a. not the rocking chair, but rather the next phase of doing interesting work) to Mark, who is co-founder and executive director of MedGift, which encourages folks to “skip the flowers” for someone who is starting a care journey and instead use its platform to offer financial and emotional support through their support page. I hear occasionally from readers who no longer work in health IT, having either moved on to other industries or to retirement, but who still follow the companies and people that were once important in their daily lives. 


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor SOC Telemed. The SOC in the name of the Reston, VA company stands for Specialists On Call. It’s the largest national provider of telemedicine technology and solutions to hospitals, health systems, post-acute providers, physician networks, and value-based care organizations. Its proven, scalable, enterprise-wide platform Telemed IQ – which powers 850 facilities and eight of the 10 largest US health systems an integrates with the Big Four inpatient EHRs – offers  rapid deployment of optimized, sustainable telemedicine programs using the health system’s own clinicians. The company also provides neurology, psychiatry, and ICU telemedicine solutions that are staffed by its 200 board-certified clinicians. SOC was the first provider of acute clinical telemedicine services to earn The Joint Commission’s Gold Seal of Approval and has maintained that accreditation every year since inception. It helps health systems be the provider of choice, improve the patient experience, obtain or maintain accreditation for stroke and other programs, improve operational and clinical performance, and maintain clinician work-life balance. Customers include AdventHealth, Banner Health, Beth Israel Deaconess Medical Center, and WellStar. Thanks to SOC Telemed for supporting HIStalk.


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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Toronto-based employee mental health and wellness digital education vendor LifeSpeak raises a $42 million growth investment.


Sales


People

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Nordic hires Jeff Buss, MS, MBA (EY) to the newly created position of CIO.

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B. Well Connected Health names John J. Ostlund, MBA (VRBO) as CTO and Imran Qureshi (Clarify Health Solutions) as CIO.

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Clinical decision support vendor EvidenceCare hires Bo Bartholomew, MBA (Shearwater Health) as CEO. He replaces co-founder Brian Fengler, MD, who will transition to chief medical officer.


Announcements and Implementations

Microsoft integrates Nuance’s Dragon Ambient Experience with Microsoft Teams to allow clinicians to conduct telehealth visits via Teams and have the conversation turned into EHR clinical documentation.

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Allscripts announces that its Allscripts Client Experience user group meeting will be held virtually October 6-8, 2020, with free attendee registration.

Meditech partners with AHIMA and hosting provider Sisu Healthcare Solutions to expand use of its Expense EHR as the flagship EHR in AHIMA’s online training environment for 16,000 students in 300 colleges and universities.


COVID-19

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Analysis by Epic Health Research Network and Kaiser Family Foundation finds that people of color are more likely to test positive for COVID-19 and to require a higher level of care compare to white patients. Black, Hispanic, and Asian people had higher rates of infection, hospitalization, and death.

President Trump says CDC Director Robert Redfield, MD was confused and mistaken when he told a Senate subcommittee that distribution of a COVID-19 vaccine will likely happen in late spring or early summer, a timeline that other federal health officials agree is reasonable. Vice-President Pence told Fox News on Wednesday that the administration’s goal is to have 100 million doses available by December 31. The President also disputed Redfield’s statement that wearing masks could be more effective than a vaccine in some cases.

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HHS spokesperson Michael Caputo takes a 60-day medical leave of absence after five months on the job following a Facebook Live video rant in which he claimed that CDC’s scientists “don’t want America to get well,” urged supporters of President Trump to arm themselves, and said that “my mental health has definitely failed.” Caputo previously admitted that he has never actually read CDC’s Morbidity and Mortality Weekly Report even though his team demanded to edit each issue to make sure that its scientific content does not conflict with White House statements.

In England, a leaked document shows that top leadership of NHS Test and Trace includes just one clinician or public health expert.

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WHO warns that COVID-19 cases are rising alarmingly in Europe, exceeding their previous March peak with 300,000 new cases reported last week. The US reported 261,000 new cases in the past week as deaths approached 200,000.

Texas health officials admit that the method that has been used to report COVID-19 test positivity rate has understated the level of spread, encouraging officials to justify the re-opening of bars, restaurants, stores, and child care centers. The state now uses the date that a test was administered rather than the date it was reported, which means that the seven-day positivity rate was 8.4% instead of 5.84% when the re-opening decision was made. The governor ordered bars to be re-closed and masks to be worn on June 26, when the reported positivity rate was 13.7%, but it was actually 18.5%. Governor Greg Abbott announced Thursday that business in most regions will be permitted to operate at 75% capacity and nursing homes can accept visitors starting next week, but bars will remain closed.

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Moderna provides details of how it will conduct and evaluate clinical trials of its COVID-19 vaccine, responding to scientists who have called for more transparency. The document suggests that the company won’t really know whether the vaccine works until spring, but will seek emergency FDA approval if the first data review sometime in October through December proves its effectiveness. Later Thursday, Pfizer also released its vaccine protocol.


Other

Forbes says that Epic founder and CEO Judy Faulkner is among the members of its Forbes 400 whose net worth increased the most in the past year, estimating that she gained $1.7 billion to hit $5.5 billion.

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Amazon donates 99 Echo Show devices to Southeast Health (AL) to enable two-way audio and video conversations between COVID-19 patients and staff via Aiva Health’s Alexa-powered voice assistant. Amazon also donated 74 Fire tablets.


Sponsor Updates

  • Redox’s EHR Integration is now available in AWS Marketplace.
  • Health Data Movers publishes a new white paper, “Physiological Monitor Deployment.”
  • Epion adds OptimizeRx prescription cost-saving recommendations to its patient check-in solution.
  • Healthcare Growth Partners advises EPreop in its acquisition by Provation.
  • Health Data Movers Inc. (HDM) ranks No. 475 on the 2020 Inc. 500.

Blog Posts

Sponsor Spotlight

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Optimum Healthcare IT provides professional staffing services as well as consulting services that encompass advisory, EHR implementation, training and activation, EHR optimization, community connect, managed services, enterprise resource planning, security, and ancillary services – supporting our client’s needs through the continuum of care. Our organization is led by a leadership team with extensive experience in providing healthcare staffing and consulting solutions to all types of organizations.


Contacts

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

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EPtalk by Dr. Jayne 9/17/20

September 17, 2020 Dr. Jayne 2 Comments

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The Office of the National Coordinator for Health Information Technology, in partnership with the Office for Civil Rights, released an update on Wednesday for the HHS Security Risk Assessment (SRA) Tool. Performing the SRA is required under HIPAA, and in my experience, many small and medium sized healthcare organizations struggle with it. The revised tool includes some user interface and navigation tweaks, as well as options to export reports. There was a corresponding webinar to educate users on the tool, but since I received less than 48 hours notice, I couldn’t make it work with my schedule.

I’ve not been a fan of the tool in the past since it is really just an electronic way to store a lot of manual work. People like it because it’s free, though, although I’ve found you get what you pay for. ONC’s SRA Tool stores data locally, which creates problems when the person responsible for your SRA goes out on medical leave or is otherwise unavailable (ask me how I know). Commercial solutions that are available store data either with the SRA vendor or otherwise in the cloud, making it easier for continuity from year to year as well as making it easier to recover if something unforeseen should happen partway through the SRA process. My favorite commercial solution is the one from HIPAA One, which is kind of like TurboTax for the SRA.

For those of you in the value-based care trenches, the Core Quality Measures Collaborative has released four updated core measure sets. The updates are the product of collaboration among more than 70 members of the group. The impacted sets include pediatrics; obstetrics / gynecology; gastroenterology; and HIV / hepatitis C. Core measure sets are used to help align various payer and governmental programs, which theoretically should help healthcare delivery organizations meet goals consistently and not have to do different data gathering and manipulation for similar but subtly different measure sets. An additional four core measure sets will be updated in the coming months, including medical oncology; orthopedics; cardiology; and one addressing primary care / patient-centered medical homes / accountable care organizations. There are also plans to release two new core measure sets covering behavioral health and neurology.

A recent Viewpoint piece in the Journal of the American Medical Association looks at the idea of “Algorithmic Stewardship” for artificial intelligence and machine learning technologies. At least 50 AI/ML algorithms have been reviewed by the US Food and Drug Administration and have received approval for various medical use cases. They can also be used to predict patient behavior or identify risks for increased morbidity and/or mortality. The authors propose that in addition to the FDA’s oversight process, health systems should also “develop oversight frameworks to ensure that algorithms are used safely, effectively, and fairly.”

The stewards would be charged with ensuring predictive algorithms are used fairly and should receive input from informaticists, patients, bioethicists, scientists, and safety / regulatory personnel. They would also be tasked with monitoring the ongoing clinical use and performance of predictive algorithms. I’d be curious to hear which organizations at the forefront of AI and machine learning have begun to incorporate such a stewardship model.

I’ve seen more than my share of poorly-maintained patient problem lists over the years. One of the goals of electronic health records was that problem lists would be more accurate and complete, and we just haven’t arrived yet. An article published in the Journal of the American Medical Informatics Association this summer looks further at “Characterizing outpatient problem list completeness and duplications in the electronic health record.” The authors looked at records from Partners HealthCare and identified patients with eight common chronic diseases, then reviewed those problem lists. They found a wide variation in levels of completeness as well as levels of duplications. Better completeness seemed to correlate with disease severity. The authors conclude that “further studies are needed to investigate the effect of individual user behaviors and organizational policies on problem list utilization, which will aid the development of interventions that improve the utility of problem lists.”

My very first EHR consulting project, somewhere in the early 2000s, revolved around a problem list. The organization had initially deployed EHR only to primary care physicians, and when subspecialists were brought on board, some of them “cleaned up” patient problem lists by removing entries that they felt were “primary care stuff” that cluttered up their idea of the problem list. Due to poor training (or lack of listening), they didn’t understand the concept of a shared problem list. I had the pleasure of going through thousands of charts and trying to rectify the mess, returning those pesky primary care problems to life. Nearly two decades later, the issues I see are still rooted in governance (or lack thereof). We should know better by now, folks.

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I spent some quality time with a new optometrist this week and was blown away by the new contact lenses she suggested. Fortunately, the dramatic change in my vision was due to being a year older rather than anything COVID-related, which made me happy. I was not, however, blown away by the text I received later in the day pre-booking me for an appointment next year, at an inconvenient time on an inconvenient day. There was no way to respond or reschedule via text, which forced me to call, hold within the office phone tree for more than five minutes, than reschedule. This is a perfect example of a good idea that was poorly executed. I know the importance of patient retention and continuity and would have been happy to schedule an annual follow-up before I left, but their approach was inconvenient. I wonder how many patients just no-show the following year?

I also had a dental checkup, and while I was impressed with their in-office screening protocols, I was not impressed by their phone screener. When I truthfully answered “yes” to the “have you had contact in the last 14 days with anyone who has COVID” and noted that I’m a physician and have been wearing personal protective equipment during the contacts, he somehow assumed that I had tested positive for COVID in the past. I was recently flagged in Epic by another physician office as a “high risk contact” and it took a lot of explaining to get it handled. There really needs to be an accommodation for healthcare workers who have positive contacts but are wearing PPE. It’s no fun having your friends treat you like you’re Typhoid Mary, and other healthcare institutions should have a better understanding of and appreciation for our collective efforts.

Have you been denied service or treated differently during the pandemic because you work in healthcare? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 9/17/20

September 16, 2020 Headlines No Comments

On-demand Healthcare Service, Ready, Raises $54 Million in Series C Financing

House call company Ready will use a $54 million Series C funding round to help it expand into mental healthcare, point-of-care testing, and vaccination services.

Anthem to study whether Apple Watch could help people with asthma

U.C. Irvine, Anthem, and CareEvolution will conduct a two-year study to investigate the role consumer devices can play in managing asthma.

Clearlake Capital-Backed Provation Acquires ePreop

Clinical decision support and documentation vendor Provation acquires EPreop, a developer of anesthesia quality reporting and perioperative care coordination software.

Vibrent Health Wins NIH Contract to Develop Powerful New Digital Health Solutions for COVID-19 Contact Tracing to Reduce the Risk of Infection and Help Society Return to Normal Activities

NIH grants Vibrent Health a $4 million contract to develop contract-tracing software that will also enable users to differentiate COVID-19 from the flu.

Medigate completes $30M Series B

Partech leads a $30 million Series B funding round in medical device security company Medigate, bringing its total raised to $50 million.

Morning Headlines 9/16/20

September 15, 2020 Headlines 4 Comments

OnCall Health Raises $6M Series A to Enable Virtual Care Programs for Healthcare Brands

White-label telemedicine vendor OnCall Health raises $6 million in a Series A round led by Base10 Partners.

CareCentrix, backed by Summit, enlists Morgan Stanley to weigh options

Home and post-acute care technology company CareCentrix will assess its options after receiving interest from a potential buyer.

Here’s everything Apple just announced

Apple adds a blood oxygen monitoring feature to the newest version of Apple Watch, and will partner with three healthcare organizations to study the feature and its benefits.

Loblaw investing $75 million for minority stake in telemedicine firm Maple

In Canada, Loblaw Companies takes a minority stake in telemedicine vendor Maple through its Shoppers Drug Mart business.

News 9/16/20

September 15, 2020 News No Comments

Top News

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MDLive secures $75 million through a $50 million crossover equity investment from Sixth Street Growth and $25 million in debt expansion from other investors, bringing its total raised to nearly $175 million. The company plans to IPO early next year.


Webinars

September 17 (Thursday) 1 ET. “ICD-10-CM 2021 Updates and Regulatory Readiness.“ Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, VP of global clinical services, IMO; Theresa Rihanek, MHA, RHIA, mapping manager, IMO; Julie Glasgow, MD, clinical terminologist, IMO. IMO’s top coding professionals and thought leaders will review additions, deletions, and other revisions to the 2020 ICD-10-CM code set that will be critical in coding accurately for proper reimbursement.

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


Acquisitions, Funding, Business, and Stock

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Capsule Technologies receives FDA 510(k) clearance for its Vitals Plus monitoring solution with Masimo’s NomoLine ISA CO2 module, giving providers the ability to monitor patients for respiratory deterioration in addition to other vital signs.

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Change Healthcare will permanently close its headquarters in Nashville and transition as many as 700 employees to remote work.


Sales

  • In the UK, the Hampshire and Isle of Wight Integrated Care System will implement Cerner’s HealtheIntent population health management software and HealthEDW analytics.
  • The State of Utah selects HHS Technology Group’s MediBook software to be the backbone of record-sharing software patients, providers, and payers can access during natural disasters.
  • The Nebraska Health Information Initiative will leverage Collective Medical’s ADT-based care coordination software.

People

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Ray Wolski (Wolters Kluwer Health) joins Lumeon as chief revenue officer.

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Experity names Calibrater Health co-founder Tim Dybvig SVP of patient engagement following its acquisition of the company.

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Craig Bloom (Cancer Treatment Centers of America) joins Intercept Telemed as chief growth officer.

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Medication safety software vendor Tabula Rasa HealthCare hires Bob Sullivan (Corsis) as its first CTO.


Announcements and Implementations

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Adventist Health (CA) adds provider look-up and patient self-scheduling capabilities from Kyruus to its website, and embeds them within its Cerner-powered patient engagement software.

AHIMA will offer Meditech Expanse as part of its online VLab, which offers students access to multiple software programs and corresponding lab lessons.


COVID-19

New research from 23andMe finds that people in blood group O seem to test positive for COVID-19 less frequently than those with other blood types. The research, part of a forthcoming study still awaiting peer-review, also found that people who tested positive and had a specific variant of a certain gene seemed more likely to have serious respiratory symptoms. Analysts caution that these findings, while novel, won’t impact treatment decisions.


Other

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Former Kansas City Chiefs right guard Laurent Duvernay-Tardif, MD shares his experience working for nine weeks in a long-term care clinic in Montreal during the initial COVID-19 outbreak, and his reasons for opting out of the 2020 NFL season. He will instead study nutrition, biostatistics, and epidemiology at Harvard’s T.H. Chan School of Public Health via online classes.

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After launching as an invite-only program a year ago, Amazon opens up its HIPAA-compliant Alexa skill program to interested app developers. Atrium Health, Swedish, Livongo, and Cigna were among the program’s initial participants.

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Apple adds a blood oxygen monitoring feature to the newest version of Apple Watch, unveiled today at the company’s product event. It will partner with three healthcare organizations to study the feature and its benefits. Apple is also working with Mount Sinai Health System to study the impact of COVID-19 on front-line healthcare workers using the watch.


Sponsor Updates

  • Everbridge announces that the latest version of the Everbridge COVID-19 Shield: Contact Tracing app is available in the Apple and Google app stores.
  • The Over Quota podcast features Arcadia VP of People Operations Tammi Pirri.
  • An annual Black Book Market Research survey ranks North American Partners in Anesthesia as the top Anesthesia Management Services outsourcing vendor for the fourth consecutive year.
  • Ellkay will exhibit at the AHIP National Conference on Medicare, Medicaid & Dual Eligibles through September 17.
  • ESolutions exhibits at the virtual HBMA 2020 Conference through September 17.
  • Ingenious Med’s point-of-care solution is now available in the Epic App Orchard.
  • Nuance’s Dragon Ambient eXperience clinical documentation software is now available through Microsoft Teams for virtual consults.
  • OptimizeRx partners with Epion Health to give patients point-of-care access to savings programs sponsored by life sciences companies.
  • Saratoga Hospital staff recount how Vocera Badges worn under PPE helped them prepare for and manage surges of COVID-19 patients.
  • Google Cloud hires Hans Thalbauer (SAP) as managing director of global supply chain, logistics, and transportation solutions; and Paula Natoli (Blue Yonder) as director of supply chain, logistics, and transportation solutions for North America and Latin America.

Blog Posts


Contacts

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

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Morning Headlines 9/15/20

September 14, 2020 Headlines No Comments

MDLIVE Announces $50 Million Crossover Equity Investment from Sixth Street Growth

MDLive secures $75 million through a $50 million crossover equity investment from Sixth Street Growth and $25 million in debt expansion from other investors, bringing its total raised to nearly $175 million.

Industry Vet Ron Lattomus Named Director of Federal Programs at Cerner

Cerner hires Ron Lattomus (DRS Global Enterprise Solutions) to head its federal programs, including the VA’s EHR modernization project.

Carbon Health Partners with REEF to Launch 100 Pop-up COVID-19 Testing Clinics Nationwide, Expanding Access to Testing and Primary Care

Tech-heavy primary care company Carbon Health establishes 100 pop-up COVID-19 testing clinics that will eventually transition into permanent care facilities.

Curbside Consult with Dr. Jayne 9/14/20

September 14, 2020 Dr. Jayne 2 Comments

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Over the last decade, I’ve spent a good chunk of my professional time on the road, sometimes for weeks at a time. I’ve also done the “five cities in three days” shuffle, which isn’t my favorite but can be a fun challenge. I haven’t been on a plane since March 3rd of this year, which seems strange when you’re used to traveling all the time. I had over a dozen trips booked when COVID reared its ugly head, and until this week wasn’t sure when I’d fly again. COVID or not, I was called back into duty this week and traveled to help a friend in need. Now that I’ve dipped my toe in the travel waters, I’ll share what I learned for any healthcare IT road warriors who might be called back into service.

I’ll admit that as I got ready, I had forgotten some of my travel routines. I had to make a point of going through all of my things to make sure I had what I needed. Since I rarely go anywhere but work, I rarely have more than $20 in my wallet, so I had to restock that. I also had to find my airport parking card, which luckily was in the coffee mug on the kitchen counter where I left it, along with some random gift cards that I’m not sure I’ll ever use. I also realized I didn’t remember how to use my iPod, which was pretty embarrassing, although I did figure it out before I had to visit the Apple support website. (Yes, I still use an iPod for music, because I don’t want to drain my phone battery, and it fits in a shirt pocket on the plane so it’s one less thing to have in your hands.)

The parking shuttle had seats clearly marked with bright yellow “don’t sit here” signs, and the other folks on the bus with me were playing along. However, I failed to notice the sign on the parking garage’s lobby that said I’d have to call for a pickup when I arrived back, which came to haunt me later. Now I know, but it seems like they should have had that signage on the bus and not just on the building. The garage has eliminated valet parking and I’d estimate that less than 10% of spaces were in use.

The terminal lobby was fairly busy, with security looking pretty “normal” for the time of day I was traveling, although the TSA Precheck line was empty. The whole Precheck process at my departure airport was unchanged, except for the TSA agent making me lower my mask briefly while she checked my ID. I’m glad I didn’t have my N95 on at the time because that would have been a production. They did have a hand sanitizer dispenser at the end of the security screening area where people organize their things, but there was a group of people standing in front of it, which wasn’t ideal. Fortunately, I had three different kinds in my bag, so a quick spritz and I was on my way.

The volumes are low enough at my airport that Southwest Airlines was only using every other gate, and they had a funny stream of rotating messages at the empty ones. That allowed travelers to spread out in the gate areas, which were the only places to sit because the seating areas at the takeout restaurants had been removed in favor of stickers on the floor for people to stand in line. Only one of the bar/restaurants was open and it had reduced seating. Less than half of the newsstand/snack places were open, which led to some lines that were not very socially distanced, and only one of two Starbucks locations was open. Bottom line, if you’re going to travel, you should bring your own snacks just in case.

There seemed to be a lot of families traveling (even a few groups with shirts and accessories that marked them as obviously Disney-bound) along with a sports team, which was kind of surprising. I saw very few solo travelers, which tells me there weren’t a lot of business types, unless they were taking their family in tow. Very few people had roller bags or hand luggage, which was a change from what I usually see.

I did notice that the Benefit makeup kiosk had been replaced by one selling personal hygiene products including hand sanitizer, antibacterial wipes, and masks. Speaking of masks, I saw entirely too many adults with masks off, most were eating and drinking coffee but were unmasked for an extended period of time. I saw no children with bad mask habits, and even the teenagers were doing pretty well. The boarding process was good with Southwest only boarding 10 people at a time and only on one side of their usual line-up area, so we were well-spaced. They are still serving snacks and water, but nothing else, and the seat back pockets are empty except for the safety information cards. Southwest is only booking 2/3 of the flight so that middle seats can remain open, and I had the emergency exit row to myself.

I landed at Dallas Love Field and was the only person on the rental car shuttle, and it took me a minute to realize that the shuttles had been combined for National, Enterprise, and Alamo, and that all three vendors were operating out of the same building. There were exactly three available cars on the giant (but empty) lot and with two of them I could smell smoke through my mask, so those were a big nope. The traffic on the Dallas North Tollway was every bit as wild as it usually is, so at least there was a small bit of the trip that was consistent with the “old normal.”

When it was time to head home, I was screened at the rental car drop off and asked if I or anyone I had been in contact with on the trip had been tested for COVID or had a positive result return. I wonder how many people actually say yes to that? Since I was on the ground for less than eight hours, it was a resounding no for me. The rental shuttle back to the terminal was also serving as a shuttle for airport staff, who weren’t great about masking until they actually stepped onto the bus. The shuttle was packed, which wasn’t great.

Security at Love Field was nearly empty for my return trip, although I did have one of the last flights of the day scheduled. The DAL TSA procedure was a little different, with the TSA agents in glass booths with louvered speaking openings (kind of like a movie theater ticket booth). They wanted the passenger to put their boarding pass on the scanner but wanted to personally handle the ID, which was different from my earlier flight. Also, all the TSA agents working the scanners and x-ray machines were wearing face shields.

I did see a few passengers with face shields in Dallas, and the mask wearing there was pretty solid. The terminal at Love Field was much busier than the one at home, and the food court was fully open although seating was reduced by about half. Many of the newsstands and carry outs were closed, including my favorite gelato one, but fortunately I still had trail mix. My flight was delayed by a medical issue on the incoming plane, which the folks from Dallas Fire and Rescue handled quickly. The flight only had 50 ticketed passengers on a plane that seats somewhere near 170, and they actually made people space out for weight and balance. Only two of six emergency rows had people in them, so once again I had all the legroom. Only about one passenger in five had luggage for the overhead bin.

Deplaning was another issue entirely, as people raced up the aisle as soon as the seatbelt sign turned off, crowding up in the front of the plane. It was easy to avoid by staying in my seat, and the flight attendants were pretty aggravated and made people back up right away. All services in the airport were closed by the time we arrived, and then my failure to notice the “call for pickup” sign at the parking garage bit me. It was a decent night to sit outside and wait for one to come, which fortunately happened sooner than later.

Knowing that I traveled, lots of people have asked whether I thought it was safe and whether I’d do it again. I was very comfortable with the spacing on the plane, but I know other airlines aren’t doing it as reliably as Southwest. In deciding to make this trip it was a calculated risk, and given the circumstances was worth making. I’m not sure I’d be as crazy about leisure travel though or having to do it under more crowded conditions. I’m scheduled for another flight next month, so we’ll have to see what things look like then.

Have you done any business travel recently? What did you think? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 9/14/20

September 13, 2020 Headlines No Comments

New Virtual Plus care plan in Washington

Kaiser Permanente launches Virtual Plus, a virtual-forward health plan for members in six Washington counties to get care for their non-urgent issues via phone, online chat, video, or email.

Tech Executive Pratap Sarker Joins Greenway Health as President

Greenway Health hires Pratap Sarker, MBA (Conduent) to the newly created position of president.

Exclusive: Change Healthcare shutters HQ, moves hundreds of employees virtual

Change Healthcare will close its headquarters in Nashville and transition as many as 700 employees to remote work.

Monday Morning Update 9/14/20

September 12, 2020 News 4 Comments

Top News

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Kaiser Permanente launches Virtual Plus, a virtual-forward health plan for members in six Washington counties to get care for their non-urgent issues via phone, online chat, video, or email.

KP says it is conducting 65% of appointments virtually versus 20% prior to the pandemic, which led it to create the plan.

Members will be attended to by the same doctors and clinicians that work in KP locations, who will have their EHR data available. The patient may be asked to complete an in-person visit for follow-up.

Members will also have access to KP’s pharmacists through online or video visits, with delivery of 30-day supplies of medications within 1-2 days.

Kaiser Permanente says Virtual Plus will be its most affordable health plan. Individual visits are covered at no charge.

Virtual visits are available only when the patient is within Washington due to laws that prevent doctors from providing care across state lines. Members can receive in-person care while traveling out of state at any KP location, in-network urgent care, or CVS MinuteClinic in states in which KP doesn’t operate. Referrals to the in-person option are not required, but patients will have a cost depending on their plan’s benefits.

Virtual Plus will be available beginning January 1, 2021 pending state approval.


Reader Comments

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From Publicly Anonymous: “Re: volunteering for COVID vaccine trials. I received a typo-laden email, ostensibly from AstraZeneca’s research partner, and dismissed it as spam. I was contact the next day by phone to set up an appointment. The consent forms seem legitimate and the study location is my former PCP. I’m not sure if this is spam or if the intentional typos are to recruit less-educated people.” Investor-backed, North Carolina-based research services vendor Javara Research (or is that “Reserach?”) is legit, but this is certainly an embarrassingly poorly edited email if it really did come from them. Information in the email seems the same as that of a Javara Facebook post that is recruiting volunteers for the same study, so I’m pretty sure it’s the real thing. Let’s hope that the rigor of their science exceeds that of their editing.


HIStalk Announcements and Requests

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Most poll respondents would not be comfortable working for a company that regularly fires adequate performers in seeking to replace them with stars.

New poll to your right or here: What is your recent experience with virtual conferences? They probably aren’t going away any time soon, so feel free to add your comments about the features you like or would recommend to make them more valuable.

I received only a few responses to hanging out your health IT marketing/PR shingle, so either few have done it or they’re reluctant to talk about their experience.

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Welcome (back) to HIStalk Platinum Sponsor Meditech, which took a short, understandable break while focusing on the COVID-19 needs of their clients and employees. The company has been an EHR leader for over 50 years, and I’ve never seen anything like the reinvention and reinvigoration that came from (or that led to) development of its web-based Expanse EHR, which also offers a mobile experience, virtual assistant, and virtual care, all with a no-capital subscription pricing model. The company’s leadership team (of which six of 14 members are women) have all worked their way up through the ranks, with a quick eyeballing of the exec team roster showing that those with the shortest company tenure have still been there for 30 years. Thanks to Meditech for supporting HIStalk since 2016.

I found a new YouTube video overview of Meditech Expanse.


Webinars

September 17 (Thursday) 1 ET. “ICD-10-CM 2021 Updates and Regulatory Readiness.“ Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, VP of global clinical services, IMO; Theresa Rihanek, MHA, RHIA, mapping manager, IMO; Julie Glasgow, MD, clinical terminologist, IMO. IMO’s top coding professionals and thought leaders will review additions, deletions, and other revisions to the 2020 ICD-10-CM code set that will be critical in coding accurately for proper reimbursement.

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


Acquisitions, Funding, Business, and Stock

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Venture-backed national radiology practice Radiology Partners will acquire competitor Mednax Radiology Solutions for $885 million, increasing its radiologist count to 2,400. The transaction includes Virtual Radiologic, which Mednax acquired for $500 million in 2015. Radiology Partners raised $700 million a year ago and said it would likely pursue acquisitions. It has raised $2.4 billion in total.


Sales

  • Atlantic Health System standardizes on storage-as-a-service supplier Pure Storage, which it originally selected as a scalable foundation for Epic.

People

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Greenway Health hires Pratap Sarker, MBA (Conduent) to the newly created position of president.


Announcements and Implementations

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Cerner will integrate AxiaMed’s patient payment solution with Millennium and other products.

Elsevier announces the US launch of PatientPass, a cloud-based personalized patient education platform that is listed in Epic App Orchard.

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Southern Ohio Medical Center goes live on Meditech.


COVID-19

A cardiac magnetic resonance imaging study of 26 Ohio State athletes who are recovering from COVID-19 infection finds that 15% seem to have myocarditis and another 31% have findings that suggest myocardial injury.

Contact tracing finds that 12 children who were infected with COVID-19 in Utah child care facilities spread it to at least 12 of 46 adult contacts outside the facility.

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UC San Diego and UC San Francisco will pilot the use of the Google/Apple Exposure Notification smartphone app to see if student volunteers who receive notifications will self-isolate more quickly.

Politico reports that politically connected, non-medical HHS communications employees have demanded to be given control over CDC’s weekly public health journal to “ensure it is fair and balanced and complete” in matching White House statements. HHS officials claimed that CDC’s reporting of coronavirus spread in a Georgia overnight camp was intended to undermine the President’s push to return children to schools, to the point that the officials considered shutting down the publication. HHS spokesperson and former Trump campaign official Michael Caputo responded to media inquiries by claiming that his oversight is required because of “ulterior deep state motives in the bowels of the CDC.”

The Oxford COVID-19 vaccine trial of AstraZeneca resumes after one participant’s suspected adverse event was determined to present no risk to the others.

President Trump’s touting of convalescent plasma treatment for COVID-19 has stifled the expected spike in demand as people recall his previous erroneous claims about the efficacy and safety of hydroxychloroquine. The American Red Cross says that demand has not increased even as federal taxpayers paid for a $340 million public relations campaign to encourage plasma donation.


Other

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Insurance claims analysis by the Health Care Cost Institute finds that non-urgent care dropped tremendously in April, which isn’t surprising, but people aren’t catching up with deferred preventive care such as mammograms, vaccinations, and colonoscopies as many assumed would happen with re-opening.

Several medical journals publish the first clinical trials guidelines for AI protocols and publication.


Sponsor Updates

  • OpenText opens registration, and announces the agenda and speakers for OpenText World, which will be hosted virtually October 26-29.
  • Redox releases a new podcast, “The State of Interoperability in 2020 with Redox’s Brendan Keeler.”
  • CareSignal’s remote patient monitoring technology has supported tens of thousands of patients with heart failure, COPD, diabetes, depression, and dozens of other conditions for a duration of more than 20,000 patient years.
  • CoverMyMeds, Health Catalyst, InterSystems, Premier, RxRevu, and SailPoint will sponsor HLTH VRTL October 12-16.
  • Spok publishes a new infographic, “Ray Baum’s Act and Kari’s Law.”
  • SymphonyRM, Intermountain Healthcare, and MDClone significantly enhance care for chronic kidney disease patients in early identification and engagement.
  • Harlem Consolidated School District will use donated space at Experity’s headquarters to store furniture so that it can build out socially distant classrooms on its campus.
  • Visage Imaging will present at the Society for Imaging Informatics in Medicine’s virtual conference, CMIMI20, September 13-14.
  • Chung Shan Medical University Hospital in Taiwan joins the TriNetX research network to streamline research and accelerate data analysis.
  • The Royal National Orthopaedic Hospital NHS Trust in England reports an 84% improvement in care team response time after replacing pages with the Vocera smartphone app and hands-free communication badge.
  • WebPT becomes the Alliance for Physical Therapy Quality and Innovation’s first At-Large Member and strategic partner.
  • Wolters Kluwer Health publishes a new report, “Nurse Executives: Driving Change in the Era of COVID-19.”
  • Zen Healthcare IT launches an educational video series on national trusted exchange networks.

Blog Posts

Sponsor Spotlight

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Dina powers the future of home-based care. We are an AI-powered care coordination platform that can activate multiple home-based service providers, engage patients directly, and plug into remote monitoring devices. Dina helps professional and family caregivers capture rich data from the home, using artificial intelligence to recommend evidence-based, non-medical interventions. The platform creates a virtual experience for the healthcare team so they can communicate–and help patients and families stay connected–regardless of location.

(Sponsor Spotlight is free for HIStalk Platinum sponsors).


Contacts

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

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What I Wish I’d Known Before … Striking Out On My Own in Health IT Marketing/PR

I wish I had started freelancing sooner, especially in healthcare. It is so rewarding working in a field where the products or services you’re marketing can make a positive impact on someone’s health.


Don’t! The debacle of health insurance makes this an exercise in major frustration and heartache and massive risk. You can buy “insurance,” but since its not really insurance but rather a Costco membership to buy (maybe) at lower cost, you are left holding the bag and it just takes once medical issue and you are f$%#ed. Thinking about getting LTD insurance – good luck since you can only get coverage for whatever your current income is, and as you strike out, that will be low and maybe non-existent, so your previously viable LTD is nigh on useless Getting back in likely proves even harder once you discover your mistake. Suck it up and accept the crappy work environment and be grateful you have health insurance.


I started my own healthcare IT-specific product marketing business eight years ago, after 25 years in corporate product marketing in healthcare. Here is what I have learned:

  • Building a business takes three times longer than one expects.
  • In general, people have their own concept of product marketing, which (incorrectly) tends to revolve around advertising and sales sheet creation.
  • Everybody thinks they’re a marketer!
  • Business leaders don’t understand that marketing efforts take 6-10 months to have an impact. They expect an immediate impact on their sales.
  • Most healthcare IT business leaders are technical and believe that marketing is unnecessary. They frequently believe “if I build it, they will come,” which is never true.
  • Many healthcare IT business leaders under estimate the importance of collaborative reference sites and their role in marketing.

I did the solo thing for 20-plus years and it was great, yet came with a lot of headaches. Before leaving your current job, I have the following suggestions:

  • Assess your core competencies, focus on what you do best, then identify companies that need your services.
  • Survey colleagues to determine the fees you will charge. Simultaneously, create an initial business plan outlining how many hours you have to bill per month to pay yourself and pay for your business expenses (don’t forget to calculate taxes).
  • Line up a client or two and have them sign a simple contract committing to a minimum monthly fee for your services. Sample contracts are online for free or a minimal fee. Then, quit your current job.
  • At minimum, set up a sole proprietorship with your state. Preferably, set up an LLC or S corp to get some legal protection. All of this can be done online without paying someone to do it for you.
  • Set up company bank account. If you have some cash, you can self fund yourself for a while and place it into the account (essentially making a personal loan to your new business). The account will add accountability and tracking for your business expenses, which are deductible.
  • Determine office needs — what you have, what you need to purchase, including computers, phones, software, internet access, etc.
  • Set up website (free or low cost), and create your social media presence.
  • If you’ll need health insurance, get quotes to determine premium costs.
  • Evaluate other types of insurance you’ll need, e.g., workers comp, home office insurance policy rider, liability, errors and omissions, etc. Many large companies require contractors to have a $1 million liability policy and $1 million errors and omissions policy.
  • Consult with a CPA to learn what is deductible and how often you’ll have to file taxes (usually quarterly, at first), and what software they’ll want you to use to track everything (QuickBooks, Peachtree, etc.).

Most importantly, ask yourself: Will all of this be fun, or an even larger hassle than your current job? And, will you have a security net for situations when clients pay slowly or not at all?

I didn’t have all of these items in place when I quit my job and went solo, and things still worked out for me. I had a wonderful experience, and wouldn’t trade it for anything. After two decades of running a business, I decided that I wanted something different and took on a role at an amazing company. No regrets so far.

Lastly, Google is your friend. Search for lists and tutorials on starting your own business. Literally everything you need to know is out there if you search for it.

I wish you the best!


Weekender 9/11/20

September 11, 2020 Weekender 1 Comment

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Weekly News Recap

  • Hyland will acquire Alfresco.
  • Amwell’s IPO plan values the company at $3.6 billion.
  • Zocdoc’s former CEO sues the company, claiming his co-founders and the CFO ousted him in a coup.
  • A federal court dismisses a patient’s lawsuit against University of Chicago Medical Center and Google for using his data for machine language training.
  • HIMSS confirms that a HIMSS20 exhibitor has filed a class action lawsuit against it over refund policies for the cancelled conference.
  • VA accelerates its Cerner implementation plan for VISN10 in the Midwest.

Best Reader Comments

Inviting mediocrity to find an opportunity elsewhere sounds about right to me. Of course, some people may not be the right fit for a particular job, but if you can figure out where they excel, then you have keepers. On the flip side of that equation, if you can’t manage strong talent, then maybe you need to be a better manager. I have found that when I hire good people, they get stuff done, and the impossible becomes possible with a few more weeks of effort. Think about Mayo Clinic, their administrators are docs, they are about the mission, the mission is valid and impactful, and anything that falls outside the mission is ‘reviewed’ for relevancy. They swore an oath and the oath means something. I found that same commitment in the service — plenty of people who were mediocre, and plenty of team players who strove for excellence — you weeded the bad, encouraged the mediocre, and rewarded the excellent. (Brody Brodock)

Can’t imagine having a team full of All Stars! What a headache. Someone needs to do the work and keep the ship moving. Interesting that the bribe is top salary in the industry and keep looking over your shoulder. Can’t imagine what that does for balance and family life. And, take a vacation any time you want because no one is looking. Not so fast, when you get back you find out you lost the race for “who would you fight for competition?” Absolutely crazy. There will come a time when this generation will self destruct. (William Reay)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. W in South Carolina, who asked for civil rights books for her elementary school class. She reported in early March, “Thank you for supporting our students in reading! Through building our classroom library, you are helping to provide texts that the students can read at their own independent level and with texts that engage them. They love reading and learning about social studies topics. With a classroom as diverse as our the Civil Rights Movement is a topic that we all care about deeply. They were so excited and proud to check out and add these new texts to their individual book boxes to read this week! Thank you once again for your love and support of our students and their love of reading!”

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Criminal defense lawyers for former Theranos CEO Elizabeth Holmes will arrange a psychiatric evaluation that they hope to use to support a “mental disease” defense.

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Two COVID-19 field hospitals totalling 2,500 beds that were built in less than two weeks in Wuhan, China in early February were closed one month later, along with 14 other temporary hospitals, when President Xi Jinping declared that the outbreak had ended. The two big hospitals were sealed off on April 15, with state media saying they were both full at one point and that the 1,500-bed one had treated 2,000 patients.

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A former EVP of struggling Wheeling Hospital (WV) will receive $10 million as his whistleblower share of the $50 million that the hospital will pay to the federal government to settle charges that it paid doctors based on the value of their patient referrals. The hospital had countersued, saying that Louis Longo was also a partner with Deloitte and did not report his concerns to the hospital’s compliance officer and instead, as a bitter former executive, decided to “extort a settlement.” 

The wife of a urologist who has pleaded guilty to Medicare fraud, who was also his office nurse, is sentenced to probation for ordering employees to re-use “certain anorectal devices.”

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Nephrology fellow Nyan Pyae, MD leaves the hospital after a 106-day COVID-19 stay, including 80 days in the ICU and 26 on ECMO. 

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Reebok’s ad campaign for a new shoe line that is tied to the upcoming movie “Wonder Woman 1984” features real-life Boston nurses.


In Case You Missed It


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Morning Headlines 9/11/20

September 10, 2020 Headlines No Comments

Hyland enters definitive agreement to acquire Alfresco

Hyland will acquire Alfresco, which offers cloud-native content services solutions.

Grand Rounds Secures $175 Million Investment, Led by The Carlyle Group, to Accelerate Clinical Navigation and Virtual Primary Care

Grand Rounds, which offers self-insured employers a health navigation app, telemedicine services, and medical opinions for their employees, raises $175 million.

Radiology Partners Signs Definitive Agreement to Acquire MEDNAX Radiology Solutions

Radiology Partners will acquire Mednax’s radiology solutions business, including teleradiology software used by 500 virtual radiologists, for $885 million.

News 9/11/20

September 10, 2020 News No Comments

Top News

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Telehealth vendor Amwell announces IPO details that include selling $525 million in shares that, along with a $100 million private placement with Google, will value the company at $3.6 billion.

The company’s SEC filing says that it lost $88 million on $149 million in revenue in 2019 and has lost $113 million on revenue of $122 million in the first half of 2020.

The filing also indicates that Amwell, working with its investor Google, will develop an app-free video visit platform called Amwell Now.

Founders, brothers, and Co-CEOs Ido Schoenberg, MD and Roy Schoenberg, MD, MPH each hold shares worth about $300 million at the IPO price. Their Class B shares give them 51% voting power at all times.


Reader Comments

From Non-Attendee: “Re: virtual conferences. I would not attend, even at no cost, since I don’t like watching video in real time.” Neither would I. I would rather watch recorded sessions afterward, where I’m free to fast-forward, bail out if it gets boring, or skim a transcript, which plays up the advantages of video compared to in-person sessions. Virtual conferences have significant challenges: (a) educational sessions weren’t the primary draw for most conference attendees, who were looking more for networking and self-celebration, and the overall quality of these sessions isn’t enough to carry the concept; (b) it already feels virtuous to attend an online session and being required to pay for it makes it even less of a draw (expensive universities have that same challenge); and (c) people are already sick of staring at on-screen video wearing sweatpants all day. I was leery of the value of conference educational sessions even pre-pandemic, having skipped them entirely at the last several HIMSS conferences after wasting time in sessions that were poorly done, boringly presented, and that contained increasing amounts of promotion of companies and the presenters themselves, so watching those same questionable presentations on video is about as compelling as an Adam Sandler movie marathon.


HIStalk Announcements and Requests

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A reader asked me to create a Meditech news history page like I did for Cerner, so that’s done and also added to the top menu in the “Company News History” category. News items that were significant enough to make the HIStalk news cut will be copied and pasted there, creating an easily referenced longitudinal view of “real” company news that will get longer and more valuable over time.

We always offer new sponsors a little sweetener this time of year. Sign up now and Lorre will make your renewal date 12/31/21, giving you the rest of this year free. Existing Platinum sponsors get a deal, too – I’ll run a Sponsor Spotlight if you fill out this form. Contact Lorre or Jenn. It will at least give you something to do while waiting out the long dry spell until HIMSS21. 


Webinars

September 17 (Thursday) 1 ET. “ICD-10-CM 2021 Updates and Regulatory Readiness.“ Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, VP of global clinical services, IMO; Theresa Rihanek, MHA, RHIA, mapping manager, IMO; Julie Glasgow, MD, clinical terminologist, IMO. IMO’s top coding professionals and thought leaders will review additions, deletions, and other revisions to the 2020 ICD-10-CM code set that will be critical in coding accurately for proper reimbursement.

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


Acquisitions, Funding, Business, and Stock

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Hyland will acquire Alfresco, which offers cloud-native content services solutions.

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Truepill, which just raised $75 million in a Series C funding round, says that its annual revenue will reach $200 million by the end of the year. The company offers API-connected, white-label pharmacy and lab services to sites such as Hims and Nurx that sell direct-to-patient prescriptions for hair loss, erectile dysfunction, and weight loss. Truepill is launching a third product line in which it will sell at-home lab tests. Co-founder Umar Afridi was working as a CVS pharmacist three years ago, while his co-founder is a biomedical engineer who came from LinkedIn.

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The co-founder and former CEO of one-time health IT high flyer Zocdoc, which offers consumer-facing provider search and scheduling, sues the company that was once valued at $1.8 billion, claiming that his two co-founders and the company’s CFO pushed him out in a 2015 coup. He wants his old job back.

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Grand Rounds, which offers self-insured employers a health navigation app, telemedicine services, and medical opinions for their employees, raises a $175 million investment that increases its total to $270 million.

Healthcare Growth Partners says in its August review that “M&A is back and the velocity of the rebound has outpaced all expectations” with summer deals that include recapitalizations of WellSky, QGenda, and Edifecs and M&A involving Teladoc-Livongo and Waystar-ESolutions. The health IT sector has delivered a 42% return year to date.


Sales

  • Tampa General Hospital and USF Health go live on CareMesh to deliver event notifications, referrals, and transitions of care from Epic to community providers and practices.
  • Monument Health will implement Nuance’s Dragon Ambient Experience conversational AI for capturing encounter information that then updates the EHR.
  • Four of Finland’s regions will work with Cerner to develop a digital platform to support moving municipal healthcare services under a regional authority.
  • Mount Sinai Health System chooses Artifact Health’s mobile physician query platform for clinical documentation improvement.
  • RWJBarnabas Health will implement Wellsheet’s EHR predictive workflow tool in seven of its hospitals. The health system is an investor in a fund that has a financial interest in Wellsheet.

People

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Uber Health GM Dan Trigub – who previously served in a similar role with Lyft — will leave the company after two years to launch a care access startup.

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Behavioral health data analytics vendor Evidation Health names Christine Lemke as co-CEO and appoints co-CEO Deb Kilpatrick, MS, PhD as executive chair of the board. The company has five co-founders on its executive team.


Announcements and Implementations

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Meditech launches Expanse Virtual Assistant, a voice navigation system powered by Nuance that can allows users to perform hands-free actions.

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East Alabama Medical Center goes live on the Enhanced Physician Documentation System of Crossings Healthcare Solutions, which provided virtual training and conversion support. The company offers Cerner Millennium enhancements that include solutions for documentation, order renewal, catheter management, physician notification, quality advisors, direct submission of professional billing from the chart, blood transfusion advisor, insulin management advisor, patient care dashboard, ED triage management, interdisciplinary rounding, a CCL smart template wizard, and tools to compare builds and perform change management. Demos are online.

B. Well Connected Health launches a COVID-19 return-to-work solution for employers that includes a self-screening questionnaire and recommendations.

The latest results of the Social Progress Index finds that only the US, Brazil, and Hungary have move down the list since it was first published in 2011. The US — which came in at #28 among 163 countries in areas that include nutrition, safety, freedom, the environment, and health – finished behind 96 countries in access to quality healthcare.

AMA adds two coronavirus-related CPT codes to cover time spent complying with safety protocols and running antibody tests.

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Virtual, site-less clinical trials vendor Science 37 adds EHR integration to its platform.

Strata Decision Technology completes the 50th virtual implementation of its StrataJazz financial planning, analytics, and performance applications since mid-March, including Duke University Health System, Christus Health, and Sharp HealthCare.


Government and Politics

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An investigation by House and Senate Democrats finds that CMS Administrator Seema Verma spent $6 million of taxpayer funds on GOP-connected consultants who billed up to $380 per hour to promote her personal brand by pitching her for magazine interviews and leadership awards. One consultant threatened to bar a Modern Healthcare reporter from CMS press calls after the magazine ran a story Verma didn’t like, while another scored her a photo shoot for a HealthLeaders puff piece. Taxpayers footed a consultant’s $3,000 bill to arrange a “girls’ night” that was thrown in Veema’s honor at the home of USA Today Washington Bureau Chief Susan Page, while another charged $1,000 to place an op-ed on Fox News to tout President Trump’s changes to the Affordable Care Act. She also disclosed details about her plan to overhaul the EHR market to the consultants three months before the new rules were released – after overriding the concerns of federal officials — in hopes of getting CNN’s Sanjay Gupta to run a story on her.

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CMS launches Care Compare, a provider search website for consumers.


COVID-19

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President Trump says in audio recordings of interviews with journalist Bob Woodward that were made over several months that he knew, even before the first US COVID-19 death in early February, that the virus was deadly. He described to Woodward in significant detail how coronavirus spreads, its lethality, and that young people are infected, but says he intentionally kept that information from citizens because he didn’t want to create a panic. He said publicly for weeks afterward that COVID-19 was no worse than flu, that it would go away on its own, and that mask-wearing was unnecessary. The President tweeted Thursday afternoon that the recording shows his “good and proper answers,” and otherwise Woodward should have reported them at that time to save lives instead of holding them for a future book.

Florida’s state government orders counties to stop publishing infection details for individual schools, citing privacy concerns. The state has threatened to withhold funding for districts that did not open by August 31. WHO says that the infection rate should be under 5% for safe school re-opening, while Florida’s average is 14.5%. The state has seen more than 10,000 positive cases in children under 18 since school started.

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University of Wisconsin will move all classes online for two weeks and will quarantine students in two of its largest dorms after seeing 1,000 COVID-19 infections five days after it started classes under its “Smart Restart” program. At least 46 outbreaks are linked to the Madison campus and test positivity rates are at 20%. The university wisely won’t send students home to spread the infection further. The university’s interim president is former governor Tommy Thompson, who served as federal HHS secretary from 2001-2005.

Eighty percent of polled Americans don’t expect a COVID-19 vaccine to be widely available by Election Day, but if it does hit the market, 54% say they won’t take it.


Other

JP Morgan’s annual healthcare conference in San Francisco will move to a virtual format in January. The influential gathering is best known for creating a constellation of nearby meetings of moneyed folk who aren’t even attending the conference proper, a ticket that is mighty hard to come by. Zoom will likely not prove to be a good substitute for glad-handing and deal-making. Seema Verma is a keynote presenter, referred to in the program as “Dr. Seema Verma” even though I believe her highest degree is an MPH, not a doctorate.

UK Health Secretary Matt Hancock says NHS will receive $65 million to support several AI/ML projects.

A Health Affairs article lists five ways to integrate telehealth into primary care practices:

  1. Pay the same rate for telehealth and in-person visits.
  2. Create billing codes and payment models to cover the time that is required to address technology issues.
  3. Provide insurance coverage for home monitoring devices such as connected thermometers and blood pressure cuffs.
  4. Provide incentives for companies to develop telehealth technology that is more patient- and provider-friendly, including integrating interpreter services.
  5. Review malpractice issues such as delivering care across state lines, standards of care, and the possible propensity of patients to sue a provider they have never met in person.

Sponsor Updates

  • In England, Royal National Orthopaedic Hospital NHS Trust reports an 84% improvement in care team response time after replacing pagers with Vocera’s smartphone app and badge.
  • Saykara President and Chief Medical Officer Graham Hughes, MBBS writes ”The promise of conversational AI in helping restore the doctor-patient relationship.”
  • Jvion’s momentum continues in 2020 with initiatives to address COVID-19 disparities, expanded product offerings, and industry recognition.
  • Gartner includes CI Security as a Representative Vendor in the Managed Detection and Response category in its “Market Guide for Managed Detection and Response Services” report.

Blog Posts


Contacts

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

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EPtalk by Dr. Jayne 9/10/20

September 10, 2020 Dr. Jayne 1 Comment

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My organization uses a scheduling app to manage the work arrangements of our 500+ employees. We switched to it a couple of years ago, moving from one that we were starting to outgrow. The hope was that the new one would have more robust features, but in some ways, it was a step backwards because it didn’t have a mobile app at the time of the switch. They promised it would be available in a couple of months, but in reality it took almost a year to deliver.

When I logged in after the Labor Day holiday, I discovered that they had re-skinned the platform. My easily usable and well-ordered list was now represented as tiled buttons across the middle of the screen, forcing my eyes to track all the way across rather than just parsing down a list as I was used to. The vendor included a page on the re-skinning, bragging on their “fresh fonts” and removal of wasted space, although at least for my access level, the amount of white space is unchanged. Hopefully there are some big wins for the people preparing the schedules behind the scenes, but for the majority of us, it was unremarkable.

We’re in the middle of re-credentialing with some of our payers, and I’m shocked at how manual the process is. All the providers have to print, sign, and scan documents as part of the process. I threw a flag on one payer’s play because the document I was asked to sign said I consented to be bound by their Provider Participation Agreement and their Provider Administrative Manual as viewed on a portal I don’t have access to. When I pushed back on our in-house credentialing folks about wanting copies of the documents I was agreeing to, I received a phone call about ‘being difficult.’ Apparently, the majority of my physician colleagues signed it without reading all the terms, which is somewhat concerning. When I finally received the documents 10 days later, there were over 100 pages to read. There’s no mechanism for electronic signature on these either, so I didn’t bother to ask about that. Since I have to print and scan, they can wait a little longer.

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CMS will close the comment period for the 2021 Proposed Rule for the Quality Payment Program at 5 p.m. ET on October 5. Due to the pandemic, CMS is focusing primarily on “essential policies including Medicare payment to providers.” Key elements include: an increase in the complex patient bonus; postponing implementation of the MIPS Value Pathways until 2022; and removing the CMS Web Interface as collection and submission types for reporting MIPS quality measures beginning with the 2021 reporting period. Comments can be submitted via Regulations.gov as well as through snail mail or overnight mail.

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The American Medical Association announced new CPT codes this week, with one intended to help practices charge for the added supply and staff cost generated by operating in the COVID world:

99072 Additional supplies, materials, and clinical staff time over and above those usually included in an office visit or other non-facility service(s), when performed during a Public Health Emergency as defined by law, due to respiratory-transmitted infectious disease.

Don’t get too excited about billing for them just yet. At the same time as they created it, AMA also sent recommendations to the Centers for Medicare and Medicaid Services recommending coverage for them. It will take time for them to be approved by payers, and I suspect that some will try to bundle this code with other services and not pay it, despite its intent. Either way, it only works when we are subject to a declared public health emergency due to respiratory illness, so we’ll have to see how many people actually receive money by billing it. We’ll also see how long it takes EHR vendors to get the code loaded in their systems.

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A couple of friends of mine scored some kicky socks at the hospital blood drive. An opinion piece in JAMA Internal Medicine this week highlights the continued inability of many gay men to donate blood. Author Greg Zahner, MD summarizes the history of the restrictions on these donations. For younger physicians and healthcare folks who might not have been around in the pre-HIV world and don’t know the history, or for those who want us to have an adequate supply of blood products, it’s an interesting read.

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Lots of people have taken up new hobbies during the pandemic, and I admit to some pastry therapy as well as continuing to learn a new musical instrument. A family member double-dog-dared me to sit for the amateur radio licensing exam, which I completed this weekend. The Greater Los Angeles Amateur Radio Group VEC is one of 14 FCC-recognized Volunteer Exam Coordinators. Exams are usually administered in person, but GLAARG has delivered over 1,000 exams via Zoom since April 2020. I have to say the physical arrangements were as intense as some of the high-stakes examinations I’ve taken to further my medical career. Applicants have to be in a room without any potential reference materials and no chance for interruption and are monitored by a panel of three volunteer examiners while they take the online test. There’s nothing quite like welcoming three strangers into your hall bathroom, where you’re sitting with a laptop and a TV table. You have to show the entire room, including floor and ceiling, to make sure there is no contraband.

It was a well-organized process, with applicants first being oriented in a large Zoom waiting room until they were “teleported” to breakout rooms where they went through a pre-check process to ensure good audio and video, and where they made sure all browser extensions were disabled and popups were suspended before being migrated to the actual testing breakout session. Although I had an initial glitch where one of the panel members couldn’t see all of my shared screen, he was quickly replaced by another examiner. The exam went smoothly with instantaneous grading and electronic signatures on the FCC-required documentation. Even with taking the exam during a holiday weekend, the FCC processed my license quickly and I was ready to hit the airwaves on Tuesday morning.

It’s been fun learning something completely new, although there were some exam questions dealing with the effects of radio frequency emissions on the human body as well as those on how to avoid being electrocuted that overlapped with my previous studies. The amateur radio community is a welcoming bunch, and to any of you out there, I send you a hearty “73.”

Did you try new things or pick up a new hobby during the pandemic? Leave a comment or email me.

Email Dr. Jayne.

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Reader Comments

  • AnInteropGuy: I would hope that we have better medicine and science than we did 67 years ago. Our understanding of virus mechanisms ar...
  • Angela C. Witt: Most of the suggestions you have to improve order management in the EHR are features available in current vendor product...
  • masterblaster: I was intrigued by your statement of "Because they so tightly control access to the vendor’s documentation, I have no ...
  • IANAL: In spite of AMA lobbying, regulatory changes in the early 2000s allowed pharmacists to give flu shots. Costs fell, acces...
  • Brian Too: My theory is that telehealth is a bigger benefit for the patient than it is for the clinician (though there are clinical...

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