Monday Morning Update 3/21/22

Top News

Senator Patty Murray (D-WA) demands that the VA delay its planned March 26 Cerner go-live at the Walla Walla VA following VA OIG reports of continuing problems at the first live site at Mann-Grandstaff VA Medical Center in Spokane.

VA OIG issued a report Thursday in which it substantiated several user complaints related to medication management at Mann-Grandstaff, along with deficiencies in migrating DoD patient information to Cerner.

OIG substantiated reports that Cerner was not configured to accept future clinic orders for subsequent outpatient visits, so it cancelled them without notifying the provider. They also noted that if RNs entered multiple medication orders, only the first one was held pending physician authorization.

Reader Comments

From RFT: “Re: ROI Healthcare Solutions. Jason Berry left as president in February and not replaced. Marketing VP Danielle Watson, Controller Don DeHaven, Sales VP Brent Prosser, VP Lane Tucker, and CFO Jimmy Haddad all gone.” I compared the leadership page to its year-ago cache to note that four of the eight listed executives are no longer there, and all of the folks that the reader named have indeed left. I’ve omitted some of the reader’s other comments because I have no way to verify them as factual or to ascertain what that person’s connection is to the company.

HIStalk Announcements and Requests

End-of-winter alert: it is officially spring as of yesterday (Sunday), it’s getting dark later, and the HIMSS conference is over. That’s two long, dark COVID winters down, hopefully none to come. Another noteworthy day from last week, in addition to St. Patrick’s Day and sporting events, was Friday’s Match Day, when medical students learn where they will be spending their next few years as residents (or begin their panic over not matching and thus being dumped into the last-chance maelstrom of The Scramble).

Dear vendors, as a “Start at Zero” zealot, I won’t publish your graph whose X axis doesn’t begin at zero. Otherwise, you are intentionally misrepresenting a trend as being more significant than it is. I also won’t run poll or survey results that don’t include the number and type of respondents, a description of how those respondents were chosen, and preferably the exact wording of the questions that were asked. It’s easy to turn science into marketing fiction via shaky statistical methods.

Most poll respondents, whether attending HIMSS22 or not, expected to be working harder last week.

New poll to your right or here: Do patients get their money’s worth for indirectly paying the cost of providers and vendors to attend conferences like ViVE and HIMSS? It’s easy to forget that all those expensive hotels, lavish parties, and eye-popping exhibits are funded on the backs of sick people and taxpayers. Those sumptuous trappings also serve as the unintentionally ironic backdrop for brow-furrowing discussions about why the underperforming US healthcare system is the world’s most expensive.

Speaking of those conferences, I’m interested to hear from people who attended both as either an exhibitor or attendee. What were their strengths and weaknesses? How did the first “real” HIMSS conference since 2019 deliver? How well did the CHIME program integrate with ViVE compared to when it was offered with HIMSS? Which one(s) will you attend in 2023? Email me.

I found little value in most of the HIMSS22-related tweets last week. Conference tweets would ideally recap educational sessions for the benefit of those not attending, but most of what I saw was (a) endless mugging “look at me with my pals” selfies; (b) party photos; (c) overtweeting from people who were running around making pointless videos or podcasts; and (d) exhibitor booth staff photos or announcements. I actually kind of enjoyed (d) anyway since those people who worked the booths deserve some recognition and sometimes the company announcements were useful.

Webinars

April 6 (Wednesday) 1 ET. “19 Massive Best Practices We’ve Learned from 4 Million Telehealth Visits.” Sponsor: Mend. Presenter: Matt McBride, MBA, founder, president, and CEO, Mend. Virtual visits have graduated from a quickly implemented technical novelty to a key healthcare strategy. The challenge now is to define how telehealth can work seamlessly with in-person visits. This webinar will address patient satisfaction, reducing no-show rates to single digits, and using technology to make telehealth easy to use and accessible for all patients. The presenter will share best practices that have been gleaned from millions of telehealth visits and how they have been incorporated into a leading telemedicine and AI-powered patient engagement platform.

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

Acquisitions, Funding, Business, and Stock

France-based Doctolib — which offers doctor search, scheduling, virtual visit booking, and document sharing — becomes the country’s highest-valued startup at $6 billion based on a new funding round. The 2,300-employee company plans to enhance its provider-only, subscription-based offerings, which start at $140, with physician-to-physician instant messaging.

Sales

• In the Netherlands, Erasmus University Medical Center will implement Sectra’s digital pathology solution.
• Legacy Health chooses Pivot Point Consulting, a Vaco Company to provide Epic help desk support.

People

Jonathan Lloyd (Epic) joins AccessOne as VP of implementation.

Announcements and Implementations

Data warehouse as a service vendor Snowflake launches Healthcare & Life Sciences Data Cloud, which it says will allow organizations to centralize, integrate, and exchange sensitive data. Customers include Anthem, IQVIA, Spectrum Health, and Siemens Healthineers. SNOW shares jumped 6% Friday following the announcement, valuing the Bozeman, MT company at $68 billion, although they’re down 45% since mid-November 2021. Director Carl Eschenbach of Sequoia Capital Operations holds shares worth $3.4 billion, while  CEO Frank Slootman’s stake is worth around $7 billion.

InterSystems announces HealthShare Health Connect Cloud, a platform as a service for interoperability and data integration among clinical applications.

Salesforce announces enhancements to Customer 360 for Health to include Slack-powered patient care coordination, virtual care, unified health scoring, patient data platform, and a patient commerce portal.

Connecticut Children’s goes live on Nym Health’s autonomous medical coding system for RCM in its emergency department.

Secure transaction exchange among Surescripts network users increased 17% in 2021, with huge jumps in the use of Clinical Direct Messaging, Medication History, and Record Locator & Exchange. Electronic prescribing increased from 84% of all prescriptions to 94%.

A survey of 240 physicians, most of them PCPs, finds that most of them have used telehealth and expect to continue doing so. Most of them conducted telehealth visits by video or phone, with much smaller percentages using secure messaging, email, and text messaging. More than half or providers were frustrated by the quality of care they can provide via telehealth, the unrealistic expectations of patients of what can be accomplished virtually, and the quality of the technology.

Cerner will integrate Nuance’s DAX ambient clinical documentation with Millennium. It’s interesting that a company that is about to be acquired by Oracle – which made integration of Millennium with its own hands-free voice interface as the acquisition driver — would tout integration with Microsoft-owned Nuance and its Azure-hosted voice solution. Somehow I doubt that this latest announcement will come to fruition unless the acquisition deal falls apart since I don’t see Oracle playing all that nice with Microsoft, Google, or anyone else.

Government and Politics

Naval Medical Center Camp Lejeune is among several DoD locations in North Carolina that are going live on Cerner this week.

Other

Amazon CEO Andy Jassy said in leaked audio from a November all-hands company meeting that he considers Amazon Care primary care business as one of the company’s most innovative projects. He said that Amazon is a “significant disruptor” in healthcare and that the cumbersome process of seeing a doctor in a traditional visit would seem “crazy” 10 years from now. The company plans to integrate and expand its three major healthcare businesses – primary care, online pharmacy, and diagnostics – into a one-stop shop that will offer “a much better value” than the usual primary care experience. Amazon is reportedly considering an entry into the Medicare Advantage market, working with health plans such as BCBS to become an in-network benefit, and to partner with startups and health systems. It is also considering launching a brick-and-mortar pharmacy that uses its cashierless technology and also adding pharmacies to its Whole Foods locations.

Bloomberg Businessweek questions whether ADHD drugs are too easy to obtain online, focusing on investor-backed online mental health provider Cerebral. Snips:

• The growth-obsessed startup targets patients with social media ads. Google “buy Adderall” and a Cerebral-sponsored result is headlined with “ADHD Meds Prescribed Online – First Month $30.”
• The company’s revenue comes from subscriptions that cost up to $325 per month.
• Providers are assigned high numbers of daily patients and are required to prescribe medications such as Adderall, amphetamines, and Xanax to 95% of patients, but not 100% since that might make the service look like a pill mill.
• A former Cerebral coordinator says she was assigned 1,000 patients on her first day and received 100 messages from them each day, some of them in crisis.
• Patients who are angered by Cerebral providers who choose not to prescribe what they want are offered a “second opinion” from a more prescription-friendly company provider.
• Former nurse employees of the company say they fear that not only is Cerebral meeting demand, it is creating it and likely fueling a new addiction crisis.
• One former employer said of 30-year-old founder and CEO Kyle Robertson, “Whenever he talks about ‘providing quality mental health care,’ his eyes are dead. He does not care.”
• Cerebral’s biggest fear is that DEA will go back to stricter pre-pandemic rules for prescribing controlled substances. The company has joined 300 others in calling for Congress to extend telehealth waivers.

I didn’t know that UTHealth’s School of Biomedical Informatics offers the country’s first DHI (doctorate in health informatics) degree, which is a practice degree rather than a research doctorate like a PhD. Joe Bridges is its first graduate.

England’s chief nursing officer calls for every healthcare organization to employ a CNIO to give nurses a stronger voice in healthcare change.

Sponsor Updates

• PatientBond publishes a new case study, “Recovering Missed Patient and Insurance Payments.”
• Redox releases a new podcast, “The Return to HIMSS.”
• West Monroe promotes 13 employees to managing directors and appoints new office leaders to continue scaling its next stage of growth.

Blog Posts

• Guide to interoperability for healthcare leaders (Nordic)
• How automation can support caregivers and patients (Olive)
• The One-Stop Test to Treat Plan in Pharmacy (OmniSys)
• Develop a Clinical Communication Governance Strategy (PerfectServe)
• Three Ways to use Real-World Evidence to Improve Research and Outcomes (Premier)
• Healthcare Security’s Top Priority (Protenus)
• How to Manage Conversations About Caregiving Technology Supports (Quil Health)
• 3 challenges keeping nurses up at night (3 technology solutions to help) (Spok)
• How to use call center reporting and analytics to improve performance (Talkdesk)
• The CNO’s Guide to Alarm Management & Event Notification (TigerConnect)
• Improving Care for Rural Communities with Digital Health Tools (Twistle)
• New lung screening and coverage guidelines expand access to lung screening in America (Volpara Health)
• Enhancing the Front Desk Experience: How to Turn Patients’ First Impressions into Lasting Ones (WebPT)
• Patient Engagement is Top of Mind for Healthcare Leaders (Well Health)
• Embracing the right tools and opportunities to build health equity for resource-limited populations (Wolters Kluwer Health)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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