March 31, 2020: For this week’s edition of Tuesday Newsday, Bill takes a look at some of the most interesting news breaking around the topic of COVID-19. We hear about a new test developed by Abbot Labs which delivers results within drastically reduced speeds. Next Bill gets into sweeping regulatory changes made by the Trump administration to help U.S. healthcare systems address COVID-19 patient surges. After that, we take a look at somewhat of a data-sharing revolution characterized by the Trump administration’s order that healthcare systems provide them with details about COVID-19 cases. We then cover an article about timeframes of the pandemic with the main point being that healthcare providers need to be mentally prepared for something longer than two weeks. Bill gets into the controversy around 3M mask prices next, and praises industry leaders for their local sourcing and foresight in making preparations to be equipped for scaling production rapidly. Finally, listeners will hear about some recent statistics relating to how many people below 55 years old are being infected with the virus. Bill ends off with a few notes for CIOs on preparedness before closing off for the day. Join us for all the biggest stories about Health IT and the fight against COVID-19 right here.
Key Points From This Episode:
News Day - Abbott, CMS Telehealth Expansion and More
Episode 213: Transcript - March 31, 2020
This transcription is provided by artificial intelligence. We believe in technology but understand that even the smartest robots can sometimes get speech recognition wrong.
[00:00:04] BR: Welcome to This Week in Health It News where we look at the news which will impact health IT. It’s Tuesday Newsday. My name is Bill Russell, healthcare, CIO, coach, and creator of This Week in Health IT, a set of podcast videos and collaboration events, dedicated to developing the next generation of health leaders.
I want to thank our channel sponsors and this week’s episode sponsors. Our channel sponsors have partnered with This Week in Health IT for a full year of content and other initiatives such as this Slack channel, which we opened up. I appreciate them for sharing the show’s passion to develop the next generation of health leaders. They are VMware, Starbridge Advisors, Galen Healthcare, Pro Talent Advisors, and Health Lyrics.
Over the last three weeks, Sirius Healthcare has stepped up to sponsor these shows that we've been producing, and they wanted to support the industry and highlight the great work of health IT during the crisis. I'm extremely grateful for them and their commitment to the show.
We’re going to be doing field reports over the next – Well, until this thing really slows down, and I'm really appreciative. I’ve got a great response from CIOs. If you’re a CIO and want to do a field report, just drop me a note at [email protected]. I will start dropping those starting probably this afternoon and into tomorrow. I am doing 10-minute interviews with some of these health systems just to find out what's going on in the ground, what they have done. We’ll probably just keep revisiting them over this time to see how things are progressing and what they're focused in on and working on.
It seems to be answering the number one question I get from people as I’m talking to them, which is what are you hearing from other health systems. I want to capture that and share that with the industry so that you have ideas on what others are doing. Okay, now on to the news.
I think one of the most exciting things is on the testing front, and President Trump talked about this yesterday in the Rose Garden, and I highlighted it on LinkedIn last week, and that is that there's a new COVID-19 test from Abbott Labs, which gives results in about five minutes. Then the other aspect of it is you can do it on the spot right at the point of care without requiring a round trip to the lab, which is huge. I really thought the most important part of this article is that the availability of the test is that the ID NOW hardware from Abbott Labs that this thing runs on, it holds the largest molecular point-of-care footprint in the US and is widely available across doctor offices, urgent care clinics, and emergency rooms and other medical facilities. That’s exciting in and of itself.
The next question I typically get is how fast are they going to be able to ramp this up. The company said it would launch some tests this week in select healthcare facilities that deliver urgent care. They also said that they will supply about 50,000 tests a day starting April 1st according to John Frels, Vice President of Research and Development at Abbott Diagnostics. If you have these devices, you probably need to get them repositioned, get the cartridges ordered, and get ready to use them. I think we will go from this 10-day timeframe and move it down a little bit. There’s still not going to be enough tests, but it will be a lot better than what I'm hearing across the board. I'm still hearing 7 to 10 days for a lot of these tests, except for the systems that have come up with their own test.
I know that Providence have come up with their own test. Some of the academic medical centers have come up with their own tests, so you're seeing different timeframes based on where you go for the testing. But anyway, this is an extremely promising step forward, so I wanted to make you aware of that.
A couple things from CMS. The Trump administration makes sweeping regulatory changes to help US healthcare systems address COVID-19 Payson patient search. CMS.gov, so you can hit [inaudible 00:04:06]. I’m going to hit the highlights and I’m going to talk about telehealth specifically, because it's probably the one that's most relevant to this audience. Increased hospital capacity is one of the parts of this initiative, and that's hospitals without walls. CMS will allow committees to take advantage of local inventory surgery centers and other facilities that they hadn't been able to. They just have to be approved by the state but then they will be able to utilize those facilities and get reimbursement from their rapidly expanding healthcare workforce, local private practice clinicians, and their trained staff may be available for temporary employment since nonessential medical and surgical services are postponed during these public health emergencies.
So you have some offices that have closed down as a result of this. They’re just not enough volume and things aren’t there. Those clinicians could be redeployed into other areas and they saw off the rules around there to help health systems redeploy those workers and put patients over paperwork. CMS is temporary eliminating paperwork requirements and allowing clinicians to spend more time with patients. You’re going to want to take a look at this because any opportunity we have to reduce the burden on the clinicians while they're trying to do this work is really going to be huge, so we should look at that.
Then the one that I think is the most important for us to further promote telehealth in Medicare. I’m just going to read this. Building on the prior action to expand reimbursement for telehealth services to Medicare beneficiaries. CMS will now allow for more than 80 additional services to be furnished via telehealth. During the public health emergencies, individuals can use interactive apps with audio and video capabilities to visit with their clinician for an even broader range of services. Providers can also evaluate beneficiaries who have audio phones only. All right. So that’s huge. These temporary changes will ensure that patients have access to physicians and other providers while remaining safely at home.
This goes on. Well, there's more good stuff here. Providers can bill for telehealth visits at the same rate as in-person visits. That’s huge. Telehealth visits, including emergency department visits, initial nursing facility and discharge visits, home visits, and therapy services, which must be provided by a clinician that is allowed to provide telehealth, as well as established patients now may stay at home and have a telehealth visit with their provider. CMS is allowing telehealth to fill many face-to-face visit requirements for clinicians to see their patients in inpatient rehab facilities, hospice, and home health.
CMS is making it clear that clinicians can provide remote patient monitoring services to patients with acute and chronic conditions. It can be provided for patients with only one disease. For example, remote patient monitoring can be used to monitor a patient's oxygen saturation levels using a pulse oximeter. I’m sorry, pulse oximetry. In addition, CMS is allowing physicians to supervise their clinical staff using virtual technologies when appropriate, instead of requiring in-person presence.
All right. So there’s an awful lot of stuff there. You can hit the CMS website. Get more detail around it. I know that these things are coming fast and furious to the health systems. It's hard to keep up. It's hard to make sure you have the right codes and everything that you need to do around this but it's important to stay current on it, because they’re really trying to lighten the load and lighten the burden around this and provide the resources, so it's good to keep an eye on that CMS website.
Another one from the CMS website. Trump administration engages America's hospitals in unprecedented data sharing. Generally speaking, what they're trying to do here is they’re getting good information from the national labs and other things but they're not getting enough good information from the health systems, so here's what they're saying. CMS sent a letter to the nation’s hospitals on behalf of the vice president, requesting they report data in connection with their efforts to fight the COVID-19.
Specifically, the Trump administration is requesting that hospitals report COVID-19 testing data to the US Department of Health and Human Services, HHS, in addition to daily reporting regarding bed capacity and supplies to the Centers for Disease Control and Prevention, CDC; National Health Safety Network, NHSN; COVID-19 patient impact in hospital capacity in module. CMS and the federal agency with oversight of America's Medicare participating healthcare providers including hospitals is helping the Trump administration to obtain this critical information to help identify supply and bed capacity needs, as well as to enhance COVID-19 surveillance efforts. Hospitals will report data without personally identifying information to ensure patient privacy. Then it goes on to the sake of more things.
Again, good to keep an eye on this stuff and know that this reporting requirement is coming down. A lot of you, I know your analytics teams are busy. I've been talking to some analytics people this week and I'm setting up some additional interviews this week with some other people around what health systems are doing around this analytic side. But this is something that your team is going to want to get on top of and get in front of.
Okay, now I picked up three more stories. I picked these up from backers. They’re actually from last week, but again I thought they were important enough to highlight. Those are the US government is preparing for the possibility of an 18-month pandemic as COVID-19 cases increased 40% in one day due to increased testing. I find these reports to be – It really depends on the news outlet. This comes from CNN. Also, there’s some US News & World Report stuff in here. I don't share this to say, “Hey! This is going on for 18 months.” I share this to say it’s going on more than two weeks. First, when we got here, people were saying, “Well, there’s going to be a surge, and it’s going to go away.” It’s probably going to be longer than what we think. I don't know what the dates are. I’m not even projecting what the dates are.
The reason I share this on This Week in Health IT is to prepare your teams for a little longer cycle than maybe they had been anticipating, and it’s important to get people in the right mindset. This is – It’s not quite a marathon but it's deftly not a sprint. It was a sprint to get to this point. We stood up. The numbers I’m hearing are just unbelievable. You have 30 times the number of telehealth visits as we had this time last year. It's incredible the amount of scaling and the amount of work that health IT has done. It’s – I can't wait to capture some of these stories and begin to really analyze the data of what we’ve been able to accomplish in the short period of time. Now, with that being said, you can't work your teams at this pace for too long of a period of time. Just keep in mind that this might go on for three, six months, so pace yourself, take care of your teams, do all the things that you need to do.
I came across this story and I thought it was really interesting. This is manufacturing companies 3M and Honeywell will increase the production of protective masks and will be allowed to sell directly to hospitals. Now, I know that I'm going to talk about this story, and some people are going to get very upset that the PPE and the unavailability of masks. But I thought it was really fascinating that the story I read about 3M to me was really fascinating in that they have production of masks I think on three continents, and in each one of the continents they produce masks, they locally source all the materials needed for production. That showed a lot of foresight on their part that there was not going to be this ability to move the raw materials from one area to another for this.
The second thing I thought that was really forward thinking was inside of their factories they had almost doubled the capacity idling because they look at how that the demand for masks has gone up based on wildfires and other things over the years, and they know that it ramps up very rapidly. So you see 3M being able to increase their capacity significantly. They’re going to be able to support 420 million masks over the course of this year.
Now, I know that, gosh, Mark Cuban took a hit at 3M saying they're charging more for the masks. Quite frankly, at this point, part of the problem with Mark's math is that, yeah, if they can source them all from China, they’re going to be 95s and masks. If they’re going to source them from North and South Dakota, they’re not going to be 95s and masks because we pay them more. You have to ramp up capacity. The cost per mask is going to be a little bit higher. I don't think they’re being a bad corporate citizen. That would be outside of the character of 3M in general. I wish they could produce double that amount. But the whole industry has to support it. Honeywell’s going to increase their capacity to 120 million masks, so you’re talking about 540 million masks now through the remainder of this year.
Anyway, the market is responding to that. I thought the 3M story was interesting to me that they had the foresight to locally source and to have that much capacity idling and ready to go in case of an emergency, so I thought I’d share that as well. It’s just almost from a management lesson to be thinking through things a little bit more forward.
Another story from backers. 52% of COVID-19 patients are younger than 55. I share this because, I mean, this is This Week in Health IT. I just share these numbers because I think these numbers are interesting. According to the CDC, researchers analyzed data on COVID-19 cases reported to the CDC from February 12th to March 16th in the US among the 2,500 patients with known age, 6% were 85 or older, 25% were 65 to 84 years, 18% were 55 to 64 years, 18% were 45 to 54 years, 29% were 20 to 44 years, and only 5% were 19 years of age or younger. Patients 65 and older accounted for 80% of the deaths, however.
I think those numbers are interesting. I really want to talk to somebody who’s looking at the numbers. I’m going to interview Dale Sanders, who has been – If you’re not following my LinkedIn or LinkedIn specifically, he’s been sharing a lot of – He’s just reading perpetually and sharing some great reports and really doing the work and trying to understand how we’re going to be able to handle this better in the future. I love the stuff he's posting. It’s really well thought out, and I appreciate his insight into these things.
Let’s see. How much time do we have left here? Well, it’s about 15 minutes. I would be sharing these reports. They’re the field reports. What I'm finding is a lot of the organizations are talking about telehealth and they’re talking about VDI and they’re talking about the ability to scale up, talking about the ability to stand up. These clinics were finding that everybody has a different point. I've talked to federal-qualified healthcare clinics, and they had to wait for the money to show up. It's not like they had a pool of money just sitting there ready to move forward, so they had to approach this a little differently.
That's one of things I wanted to really point out from these field reports is it's going to depend on your market. It’s going to depend on the surge and how it's happening. It's going to depend on your financial situation, how you approach this and where you're at currently in your digital journey, how you approach this. Some people were able to just turn a couple of knobs and increase their capacity. Others had to be very creative within financial constraints and very creative within technology constraints.
I think that I find that interesting and I think that's important to understand that you can't listen to a certain health system and say that’s what we’re going to do, because their market’s different, the size of their hospitals are different. There’s just too many variables that are a little different than yours. Now, obviously telehealth, VDI, work from home, remote testing facilities; these have all been pretty common things.
One of the things I will say is I'm hearing a lot about what we've done and I'm also talking to some health systems that are in pretty in the affected areas, the places that are starting to surge. What I would say to people right now is we do these things called tabletop exercises in disaster recovery where we sort of play this game where you have somebody come in and they sort of play the dungeon master if you will for the disaster and they just like flip cards and say, “Okay, your data center power just went out. Your generator doesn't work.” I mean, they just keep flipping cards and say this is what’s going to happen next.
I like that exercise. I think that exercise is probably – If you have any spare cycles right now, I would play that exercise. There's a lot of health systems right now that are in the – We sprinted. We’re in the – We’re prepared but we’re waiting for the search. Start playing that exercise. Say, “What if our surge gets to this point? What if it gets to this point? What if we need to – What’s the next group of things that the health system is going to ask health IT for?” I think there's an awful lot around analytics. I mean, I think we did a lot of the HR work. I think we did a lot of capacity work and those kind of things.
Think about telehealth into the rooms. Start limiting the amount of contact that your clinicians are having with the patient's, if you can do that to create safety. I don't know. I mean, just keep playing that game of your what's next. If it surges in your market, how do you get information across the entire market? Have you built the network of relationships across the other health systems? Do you have a way of sharing supplies and supply shortages across the market that you serve, across the region that you serve, across the state that you serve so that potentially there are ways to move resources around outside of your specific health system? I don't know.
I like the tabletop exercises because it causes you to be creative. Bring people in a room. Don’t bring them in a room. Bring them on to a Zoom meeting and start talking about, “Okay, guys. People in this room, what do you think is going to be next for IT,” and start playing out some scenarios and just see where it takes you.
That would be my encouragement right now if I am coaching CIOs, and it's one of the things I’ve started talking to them about this week if they have some cycles, and so we’ll have some cycles. It hasn’t surged yet in their markets. They are a well-prepared, they're doing a lot of great work, and now's the time to be thinking about what happens in certain cases and stereos.
All right. Well, that's all for this week. Special thanks to our sponsors once again; VMware, Starbridge Advisors, Galen Healthcare, Health Lyrics, and Pro Talent Advisors for choosing to invest in developing the next generation of health leaders. This show is in production in This Week in Health IT. For more great content, check out the website, thisweekhealth.com, or the YouTube channel. We’re now over I think 300 some odd subscribers to the YouTube channel, which we really just started promoting this year, so I’m excited about that growth.
If you want to support the show, the best way to do that is to share with a peer. I believe we are the fastest growing health IT podcast in the space, and that is due to you guys sharing with your peers, you guys promoting our content on social media, and I really want to thank you for that. We’re going to be back again with the field reports through the end of the week. I have a couple of great interviews coming up as well. We’re just going to keep dropping episodes until it seems like I shouldn’t be dropping an episode every day. I can't tell you when that’s going to be, so I'm in the same both as you guys are in. We’ll play this day-to-day and see what tomorrow brings. Thanks for listening and thank you for all that you're doing out there in the field. That's all for now.