Walgreens' Find Care, a Digital Marketplace for Health Services
One of the few positive aspects of the Covid19 pandemic is that healthcare consumers are increasing turning to their digital devices for access to health services such as virtual visits with their personal physicians or filling prescriptions. I have been blogging about lab test ordering on the web, direct access testing (DAT), for about 15 years (see:Reinventing Direct Access Testing (DAT)) The die now seems to be cast regarding far greater engagement by consumers in digital health initiatives (see:What Is Digital Health and How Does a Health System Get There?).Walgreens, as part of this digital healthcare movement, is try...
Source: Lab Soft News - May 1, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Source Type: blogs

Will the Effects of COVID-19 Be Mitigated by the Warm Spring Weather?
One of the best articles I have come across lately regarding COVID-19 with a strong scientific orientation is: Why the Coronavirus Has Been So Successful. I have personally been wondering whether our upcoming warmer weather will ameliorate the effects of the pandemic as we have seen with our yearly influenza outbreaks. Here is the answer to this question extracted from this Atlantic article:Coronaviruses, much like influenza, tend to be winter viruses.In cold and dry air, the thin layers of liquid that coat our lungs and airways become even thinner, and the beating hairs that rest in those layers struggle to evict vir...
Source: Lab Soft News - March 21, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Epidemiology Source Type: blogs

Drive-Through Collection of Samples for COVID-19 Testing in Cleveland
The notion of drive-through to collect nasal swabs for COVID-19 testing is a practical and efficient idea and, I think, will ultimately be used across the country. Here's an article about how such a collection process is being organized by two Cleveland hospitals (see:University Hospitals and Cleveland Clinic Partner to Provide Drive-Through COVID-19 Testing). Below is an excerpt from the article:Cleveland Clinic and University Hospitals (UH) have partnered to provide drive-through COVID-19 testing for patients with a doctor ’s order from UH or Cleveland Clinic....Patients without a doctor ’s order wil...
Source: Lab Soft News - March 17, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Testing Cost of Healthcare Diagnostics Food and Drug Administration Healthcare Innovations Lab Industry Trends Lab Processes and Procedures Preventive Medicine Source Type: blogs

AI Platform to Assist Hospital Physicians in Lab Test Ordering
I have blogged extensively about the deployment of AI in healthcare (see, for example:CMS Offers $1M Reward for AI to Predict Unplanned Hospitalizations). I have learned that the simplest AI applications may sometimes have the largest beneficial effects (see:Medical Community Braces for Algorithm to Reduce Unnecessary Imaging Orders). That was my reaction when I read a recentDark Daily article (see:Florida Hospital Utilizes Machine Learning Artificial Intelligence Platform to Reduce Clinical Variation in Its Healthcare...). Below is an excerpt from it:Variation in how individual physicians order, interpret, and act up...
Source: Lab Soft News - March 13, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: AI Clinical Lab Industry News Clinical Lab Testing Diagnostics Electronic Health Record (EHR) Healthcare Information Technology Lab Processes and Procedures Medical Research Predictive Analytics Source Type: blogs

Some Details about an Emerging Healthcare Service -- Hospital-at-Home (HaH)
One of the new services in healthcare, hospital-at-home (HaH), has caught my attention. I encountered an article providing more details about one company in this business (see:In-Home Healthcare Companies Bring High-Acuity Care, Including Clinical Laboratory Testing, to Patients at their Homes and Workplaces). Below is an excerpt from it:Whatever name it is given, the high cost of keeping a patient overnight in a hospital is motivating a range of healthcare players to develop innovative ways to provide care to patients —even patients with acute conditions—in their home....One such company isDispatchHealth...whi...
Source: Lab Soft News - March 11, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Testing Cost of Healthcare Healthcare Delivery Healthcare Information Technology Healthcare Innovations Source Type: blogs

An Attempt to Make EHRs More Physician Friendly with Virtual Assistants
It's recognized that EHRs are a major cause of physician burnout due to the demands on their time for dictating notes and documenting various types of patient interactions (see:Relationship Between Clerical Burden and Characteristics of the Electronic Environment With Physician Burnout and Professional Satisfaction). Solutions for this problem include hiring scribes to manage the keyboard work for a physician (see:Greater Adoption of the Scribe Model for EMR Data Input) and the deployment of AI-enabled virtual scribes (see:This AI Software Company Just Raised $20 Million To Help Prevent Physician Burnout;Why"Virtu...
Source: Lab Soft News - March 7, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Electronic Health Record (EHR) Healthcare Information Technology Healthcare Innovations Medical Research Quality of Care Source Type: blogs

Humana's Launches New Venture: Medicare-Centric Primary Care Clinics
Humana is expanding its primary care presence (see:Humana's Broussard calls latest primary care venture an'expensive, complicated deal'). Below is an excerpt from this article describing this new initiative:Humana's recently announced joint venture to launch senior-centric primary care clinics was far from easy or cheap....The clinics will be payer agnostic and operated by Humana ’s primary care subsidiary,Partners in Primary Care....[The company CEO] was addressing a question about the acquisition as well as Humana's deal to acquire home health care providerKindred at Home in 2018. It&#...
Source: Lab Soft News - March 4, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Business Healthcare Delivery Healthcare Insurance Hospital Executive Management Population Health Public Health Source Type: blogs

Six Health Systems Suffer Financial Losses Following EHR Deployments
I have been blogging for at least seven years about the"numbing costs" of installing a new EHR (see:Who Says a Hospital CIO Can't Get Fired for Picking the Epic EHR?). These costs and sometimes subsequent financial losses are due to the enormous cost of installing such a system, inability to collect on accounts receivable during and even after the transition, and the decreased productivity of physicians and nurses using the new system after system go-live.There is an inevitable decrease in productivity following the deployment of any new technology because of the unfamiliarity of personal with it. Ideally, th...
Source: Lab Soft News - March 3, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Electronic Health Record (EHR) Healthcare Information Technology Hospital Executive Management Source Type: blogs

Mayo Clinic's Web Site Contains a " Find Diseases and Conditions " Feature
Searching for reliable web sites that discuss the diagnosis of diseases can be a hit-or-miss proposition. The process is sometimes jokingly referred to as"consulting Dr. Google" (see:The precautions you should take before consulting ‘Dr. Google’). Regarding the use of lab tests for diagnosis, one of the best resources that I know is the ARUP LaboratoriesTest Directory. One word of caution here is that it's primarily designed to guide physicians in test ordering.The trend of providing information on the web about diseases for consumers continues. One example is the Mayo Clinic web site (see:Fi...
Source: Lab Soft News - February 28, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Testing Diagnostics Electronic Health Record (EHR) Healthcare Information Technology Healthcare Innovations Medical Consumerism Public Health Source Type: blogs

Hospital Outpatient Visits Drop for First Time; Long History of Similar Inpatient Declines
It is well documented that hospital inpatient admissions have been declining for the past thirty years (see:The Case of the"Disappearing Hospital Beds"; Implications for Pathologists;Inpatient Admissions Decreasing; Implications for Hospital-Based Labs). Now comes news of a decline in outpatient visits (see:Outpatient Visits to Hospitals Decline Year-to-Year for First Time in 35 Years) Below is an excerpt from the article:Thanks to the popularity of urgent care clinics and other non-hospital-based ambulatory care providers, the year-over-year growth in the number of hospital outpatient visits has been on the...
Source: Lab Soft News - February 25, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Health Wearable Healthcare Delivery Healthcare Innovations Medical Consumerism Quality of Care Telemedicine Source Type: blogs

Big Tech Initiatives in Healthcare Coming from Many Directions
I have posted a number of notes about the increasing role of Big Tech in healthcare. It's time to take a look at the big picture and helpful in this regard is a SWOT table that was included in a recent article about this topic (see:BIG TECH IN HEALTHCARE). It was compiled byBusiness Insider Intelligence and is presented below:After having reviewed the bulleted items in the four columns for Alphabet (Google), Amazon, Apple, and Microsoft, I was impressed by the breadth and complexity of the list. For me, all of this this distills into the following Big Tech initiatives in healthcare:Home monitoring with wearables f...
Source: Lab Soft News - February 21, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: AI Diagnostics Electronic Health Record (EHR) Health Wearable Healthcare Information Technology Healthcare Innovations Medical Consumerism Predictive Analytics Preventive Medicine Source Type: blogs

Health System YouTube Videos Fulfill an Important Educational Function
My understanding of the legality and propriety of hospital"advertising" in social media was rather vague but an article on this topic cleared away the cobwebs (see:Hospital Advertising). Below is an excerpt from it. It turns out to be legal but later in the post I will discuss why I think it's beneficial for healthcare consumers.While advertising by doctors and hospitals has been legal for 30 years, until recently, professional taboos discouraged the practice. Increasing economic pressures and changing cultural norms have led, however, to the demise of these informal proscriptions, and advertisements pro...
Source: Lab Soft News - February 19, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Business Healthcare Innovations Medical Consumerism Quality of Care Social Media Source Type: blogs

Analysis of the Failure of IBM's Watson; Vertical Integration Backfires
I have blogged periodically about IBM's Watson which has never lived up to its early expectations (see:Scandal at M.D. Anderson -- Operating Loss and Then Watson Deep-Sixed).Forbes recently published a piece about Watson with an analysis of this failure (see:IBM Watson And The Value Of Open) and below is an excerpt from it:...[W]ith the passage of more time, it must be said that IBM Watson has not delivered the results that IBM expected. One particular moment was the decision of MD Anderson ’s Cancer Center to withdraw from its partnership with IBM in 2017. An internal audit by the University of Texas f...
Source: Lab Soft News - February 18, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: AI Electronic Health Record (EHR) Healthcare Information Technology Healthcare Innovations Medical Research Quality of Care Source Type: blogs

Why Some Hospital CEOs May Be Opposing Interoperability in Support of Epic
In a recent post, I discussed the opposition to the proposed HHS rule on EHR interoperability on the part of Judith Faulkner, founder and CEO of Epic, and the CEOs of some 60 health systems (see:Faulkner Opposes Proposed HHS Hospital Interoperability Rules; No One Surprised). In this note, I would like to discuss some possible reasons why the CEOs of health systems might oppose such a rule.Firstly and as I have long maintained (see: NYT Op-Ed on EHR Interoperability Blames Vendors and Greedy Hospitals), data portability enables healthcare consumers to"shop" hospitals. However, they may not always do so on a ...
Source: Lab Soft News - February 16, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: AI Cost of Healthcare Diagnostics Electronic Health Record (EHR) Healthcare Innovations Healthcare Insurance Medical Consumerism Predictive Analytics Public Health Source Type: blogs

Continuing Discussion about the Epic/Faulkner Opposition to Interoperability
In response to my note yesterday concerning Epic and Judith Faulkner's opposition to the proposed HHS rules about EHR interoperability, a reader of this blog, Ivan Miller, submitted the following comment:Faulkner replicated Steve Jobs business model. He made a proprietary, locked system that he guaranteed would work-- and consumers were willing to pay a huge price for his product. Healthcare providers were no different. There is one notable difference however -- Jobs focused passionately on his product, and the free market rewarded his innovation. Judy was placed as chair of the EHR oversight/ inter...
Source: Lab Soft News - February 14, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Electronic Health Record (EHR) Healthcare Business Healthcare Information Technology Medical Ethics Source Type: blogs

Faulkner Opposes Proposed HHS Hospital Interoperability Rules; No One Surprised
Much in the EHR news lately has been about Judith Faulkner and Epic's opposition to the proposed HHS interoperability rules (see:Epic may sue HHS over interoperability rules concerns, Judy Faulkner says). Almost 60 health system CEOs have stated that they are in agreement with Faulkner and Epic on this matter (see:Epic Leads Almost 60 Health Systems Against Interoperability Rule; ONC's Rucker calls out hospital leaders who signed Epic's opposition letter; Epic Founder Faulkner Gives Hospital Executives Exactly What They Want). Most EHR executives have stayed out of this dogfight but Jonathan Bush has ...
Source: Lab Soft News - February 13, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Electronic Health Record (EHR) Healthcare Information Technology Hospital Executive Management Medical Consumerism Quality of Care Source Type: blogs

Bundled Cash Pricing May Provide an Ideal " Transparency " Solution for Many Hospitals
Major changes are now underway in the healthcare industry including the impending CMS price transparency rules that are eliciting marked opposition from various segments of organized medicine (see:Ohio Healthcare Network Serving Amish and Anabaptist Communities Could Provide Blueprint for Hospital Price Transparency). Below is an excerpt from an article on this topic inDark Daily:.... [O]n Jan. 1, 2021, a new Centers for Medicare and Medicaid Services (CMS) final rule (CMS-1717-F2) on price transparency goes into effect. It requires hospitals to publish their standard chargemaster prices, as well as payer-negotiated p...
Source: Lab Soft News - February 11, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Healthcare Delivery Healthcare Innovations Hospital Executive Management Hospital Financial Medical Consumerism Source Type: blogs

Health Insurers and Retail Pharmacies Expand Primary Care Services
I have blogged extensively about how health insurers and retail pharmacies have been entering the primary care market.Market Watch recently published an article informing the investor community about this trend (see:Health insurers and retail pharmacies are making a play for primary care). Below is an excerpt from this article:CVS Health..., Humana..., Walgreens..., Walmart...and UnitedHealth Group now operate hundreds of clinics that directly market themselves as primary care providers or provide a majority of primary care services. And they all plan to open more clinics in 2020....As the U.S. health care system has ...
Source: Lab Soft News - February 6, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Business Healthcare Insurance Public Health Source Type: blogs

Express Scripts Throws Lifeline to Some Digital Health Startups
I have blogged extensively about pharmacy benefit managers (PBMs) in the past (see, for example:Pharmaceutical Companies and PBMs Helped to Create Our Opioid Crisis;CVS's Caremark Expands Its Diabetes Care Program with Analytics and Coaching;Amazon-PillPack Pushes Against CVS with Prescription Deliveries; Also Seeking PBM Status). Now comes news thatExpress Scripts is taking some measures to assist selected digital start-ups with apps and devices that can be used to optimize the use of prescription drugs (see:Express Scripts throws a lifeline to digital health start-ups). Below is an excerpt from the article:...
Source: Lab Soft News - February 4, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Innovations Healthcare Insurance Medical Consumerism Pharmaceutical Industry Quality of Care Source Type: blogs

" Deaths of Despair " in the U.S. Require Broad Federal Policy Initiatives
It seems to me that there has been relatively little written about the current major public heath crisis in the U.S., the opioid epidemic and deaths of despair. (see:Every American family basically pays an $8,000 ‘poll tax’ under the U.S. health system, top economists say)...[Princeton University economists Anne Case and Angus Deaton] have risen to prominence in recent years for their work on America ’s “deaths of despair.” They discovered Americans between the ages of 25 and 64 have been committing suicide, overdosing on opioids or dying from alcohol-related problems like liver disease at sky...
Source: Lab Soft News - January 30, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Medical Consumerism Medical Research Medicolegal Issues Pharmaceutical Industry Population Health Preventive Medicine Public Health Source Type: blogs

New Technology to Destroy Cancer Cells, Oncotripsy, May Offer Promise
Many of the readers of this blog will be familiar withlithotripsy which involves the use of shock waves to disintegrate stones in the kidneys, bladder, and ureter (see:Lithotripsy). Scientists are now experimenting with the use of ultrasound to selectively kill cancer cells (see:Ultrasound selectively damages cancer cells when tuned to correct frequencies). They have called this type of treatment oncotripsy. Below is an excerpt from the article:A solid mechanics lab at Caltech first developed the theory of oncotripsy, based on the idea that cells are vulnerable to ultrasound at specific frequencies —like ho...
Source: Lab Soft News - January 28, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Delivery Healthcare Innovations Medical Research Source Type: blogs

Companies Emerge Offering Remote Text-Based Primary Care Consultations
In a recent note, I explored the difference betweenvirtual care andtelemedicine (see:Understanding the Distinction between Virtual Care and Telemedicine). Here is the explanation copied from the note:Simply put, the term virtual care is a way of talking about all the ways patients and doctors can use digital tools to communicate....While telemedicine refers to long-distance [direct and visual] patient care, virtual care is a much broader term that refers to a variety of digital healthcare services.This made a lot of sense to me when I wrote the note but long-distance care is growing more complex. A recent article described...
Source: Lab Soft News - January 23, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Healthcare Information Technology Healthcare Innovations Medical Consumerism Public Health Telemedicine Source Type: blogs

What Part of the Wellness Economy Should Be Pursued by Health Systems?
I came across an article inForbes discussing beauty and wellness trends for 2020 (see:9 Beauty And Wellness Trend Predictions For 2020 And Beyond). Included in the article was the graphic shown below that categorizes the global wellness economy for 2017 into various segments. All of this raised the question in my mind about how health systems can pursue a portion of this huge wellness market without straying too far from their roots. First, take a look at the graph below.I believe that it would be relatively easy for health systems to become more engaged in three segments of the global wellness industry as shown above...
Source: Lab Soft News - January 21, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Health Wearable Healthcare Delivery Healthcare Innovations Medical Consumerism Population Health Public Health Quality of Care Source Type: blogs

Virtual Personal Assistants as a Key Factor in Wearable Health Ecosystems
I have posted a number of notes pertaining to wearables and wearable health ecosystems (see, for example:Sony Develops Health Wearable Providing Connectivity, Stipulating That It's Not a Smartwatch;The Evolution of"Wearable Health Ecosystems" and Associated Partnerships;Status Reports and Hospital Referrals from Wearable Health Ecosystems). I have not yet raised the issue of providing a virtual personal assistant (VPS) with these home-based health systems. This idea was discussed in a recent article (see:Wearables Hold the Key to Connected Health Monitoring) and below is an excerpt from it:As voice inter...
Source: Lab Soft News - January 16, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: AI Health Wearable Healthcare Delivery Healthcare Innovations Medical Consumerism Point-of-Care Testing Public Health Test Kits and Home Testing Source Type: blogs

Amazon and AWS Help Improve Hospital Efficiency and Reduce Costs
In a recent note, I discussed howCerner was turning to Amazon/AWS for help in providing assistance with AI technology that an be embedded in its EHR product. One example was the deployment of a chatbot that can be used to interrogate the EHR for critical information that can be difficult to extract, particularly in the form of natural language (see:EHR Vendor Cerner Turns to Amazon Web Services for AI Development). In a recent article about Amazon's healthcare strategy for 2020 (see:15 things to know about Amazon's healthcare strategy heading into 2020), I was reminded of the relationship between Amazon andBet...
Source: Lab Soft News - January 14, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: AI Cost of Healthcare Healthcare Business Healthcare Information Technology Healthcare Innovations Hospital Executive Management Quality of Care Source Type: blogs

Cigna Unveils App to Monitor and Improve Medication Adherence
It's well known that non-adherence to prescribed drugs is a major problem in healthcare (see:Medication Adherence: The Elephant in the Room). A quote from this article places the problem in the proper context:According to the World Health Organization, medication adherence can have a more direct impact on patient outcomes than the specific treatment itself.1 Medication adherence can affect quality and length of life, health outcomes, and overall healthcare costs.Nonadherence can account for up to 50% of treatment failures, around 125,000 deaths, and up to 25% of hospitalizations each year in the United States.Putting a...
Source: Lab Soft News - January 10, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Diagnostics Electronic Health Record (EHR) Health Wearable Healthcare Information Technology Healthcare Innovations Medical Consumerism Pharmaceutical Industry Preventive Medicine Public Health Test Kits and Home Testing Source Type: blogs

A " Preventive " Genomics Clinic Opens Its Doors at the Brigham and Women's Hospital
There is a new vocabulary that is evolving in healthcare relating to genomic testing and treatment. The latest phase that I have come across ispreventive genomics and its corollary,preventive genomic clinic. Below is a description of a clinic by this name that has opened at the Brigham and Women's Hospital in Boston (see:Preventive Genomics Clinic):The Genetics and Genomic Medicine Service at Brigham and Women ’s Hospital...is pleased to announce [opening of] the Preventive Genomics Clinic. The Preventive Genomics Clinic...provides innovative screening and cutting edge genomic information for healthy adults ...
Source: Lab Soft News - January 8, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Diagnostics Genomic Testing Healthcare Innovations Lab Industry Trends Medical Research Preventive Medicine Source Type: blogs

Possible Funding Tension Between Wellness Programs and End-of-Life Care
It is a well known that a large percentage of the total U.S. healthcare spend is devoted to end-of-life care (EOLC) for a small number of patients (see:How We Spend $3,400,000,000,000). To quote the subtitle of the article:..."[M]ore than half of America's healthcare spending goes to five percent of patients."I think that we are approaching the time for an earnest discussion about this disproportionate allocation of healthcare resources and whether some of these resources could and should be reallocated to wellness programs. In my mind, it is out of the question about whether to increase spending for&nbs...
Source: Lab Soft News - January 6, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Health Wearable Healthcare Insurance Hospital Financial Medical Consumerism Public Health Source Type: blogs

EHR Vendor Cerner Turns to Amazon Web Services for AI Development
We have reached the point when one of our major EHR vendors,Cerner, has come to understand that it can no longer rely on its own internal resources for AI and predictive analytics development (see:Cerner builds machine learning platform on Amazon Web Services). AI has become so sophisticated that EHR vendors like Cerner can't hope to compete in the field without support from experts such as those working for EWS. An excerpt from this article is presented below: In July...[Cerner] named AWS its preferred cloud provider. Under the agreement, Cerner is transitioning its artificial intelligence and machine l...
Source: Lab Soft News - January 2, 2020 Category: Laboratory Medicine Authors: Bruce Friedman Tags: AI Diagnostics Electronic Health Record (EHR) Healthcare Information Technology Healthcare Innovations Pathology Informatics Predictive Analytics Source Type: blogs

Digitally Decentralized Pathology Departments; Creating a Value Added Network
Although digital pathology is being adopted by a relatively small number of pathology departments, we now seem to be approaching an inflection point for the broader deployment of this technology. Adoption will be driven by at least two factors: (1) for surgical pathology reference labs, the portability of WSI case images and other DP features loom large as a strategic business advantage; (2) for academic pathology departments, potential trainee applicants will increasingly favor departments that have deployed the technology in order to be prepared for the future.As pathology departments increasingly"go digital," ...
Source: Lab Soft News - December 31, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Testing Digital Pathology Healthcare Information Technology Healthcare Innovations Lab Industry Trends Medical Education Quality of Care Surgical Pathology Source Type: blogs

Competition Between CVS and Amazon's PillPack Extends in New Directions
I have gotten very interested in the competition between CVS and Amazon's PillPack for the retail drug market. CVS had more than 9,600 retail establishments in 2016 (see:CVS Pharmacy). It's original business model was the traditional one of"corner drug stores" where prescriptions were dropped off and drugs picked up. The PillPack fulfillment model is virtual -- prescriptions are submitted via a web site and the drugs are delivered back to one's door, often byAmazon Logistics. In response to this business model, CVS began to provide individualized dose packaging and home delivery withRx Delivery. CVS a...
Source: Lab Soft News - December 28, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Delivery Healthcare Information Technology Healthcare Insurance Medical Consumerism Public Health Quality of Care Source Type: blogs

" Porch Pirates " and the Theft of Home-Delivered Drugs
In response to my recent note about the increasing competition between Amazon-PillPack and CVS in terms of home delivery of drugs, Andrea Pitkus submitted the following comment:It'll be interesting to see how this evolves, especially with the increase of porch pirates.It would be disastrous to patient safety if porch pirates steal meds from these unsecure delivery mechanisms. It would harm patients who need vital medication and also the receivers of the stolen (black market) meds. Hopefully, narcotics and other important meds are not delivered in the pill packs.Although"preset" pills are valuable for patients...
Source: Lab Soft News - December 27, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Business Healthcare Innovations Medical Consumerism Pharmaceutical Industry Source Type: blogs

Apple's iPhone and Watch Function as Medical Research Tools
As someone who is currently participating in an Apple/University of Michigan research study, I have a front row seat to a project that combines an iPhone, Apple Watch, and a blood pressure monitor to gather data. I have referred to this home-based technology as awearable health ecosystem (WHE) (see:The Evolution of"Wearable Health Ecosystems" and Associated Partnerships). A recent article in the NYT delved into the emerging Apple role in medical research (see:Apple ’s Reach Reshapes Medical Research). Below is an excerpt from it: ....[The] Harvard school [recently] announced an...ambitious women ’s he...
Source: Lab Soft News - December 25, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Health Wearable Healthcare Information Technology Healthcare Innovations Medical Consumerism Medical Research Point-of-Care Testing Population Health Public Health Test Kits and Home Testing Source Type: blogs

Amazon-PillPack Pushes Against CVS with Prescription Deliveries; Also Seeking PBM Status
In a previous note, I discussed how CVS was fighting back against its retail drug competitor Amazon-PillPack by slow-walking its prescription transfers to PillPack when requested by customers (see:Resistance to PillPack's Requests for Prescription Transfers from Retail Drug Stores). Here's a quote from my blog note about CVS's response:CVS certainly can't be counted out of this battle yet on the basis of pressure from PillPack and its web competitors (ExactCare Pharmacy,Remedi SeniorCare,PharmaPoint,Blink Health andPipelineRx). For example, CVS has announced same-day home delivery of drugs (see:CVS to offer...
Source: Lab Soft News - December 21, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Business Healthcare Delivery Healthcare Innovations Healthcare Insurance Medical Consumerism Pharmaceutical Industry Source Type: blogs

Biometric Identification Linked to Patient EHR Records
This report seems very positive regarding Sentara's deployment of biometrics involving"palm prints." Unfortunately, the use of this term in the article is non-specific. Hand geometry does not provide high specificity (see:Hand geometry). However, Imprivata lists"palm vein recognition" as its key technology when accompanied with a patient's date-of-birth (see:Palm vein recognition scan). I will assume that this is the technology that is being deployed at Sentara. Here is some additional information from the Imprivata web site about palm vein recognition:A palm vein recognition technology sol...
Source: Lab Soft News - December 18, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Source Type: blogs

Morning Hypertension and Home Monitoring of Blood Pressure
Morning hypertension is a syndrome about which there is an increasing understanding but ambiguity remains (see:Management of morning hypertension: a consensus statement of an Asian expert panel). Below is a quote from an article on the topic:Morning hypertension refers to high BP in the morning period, regardless of BP during the rest of the hours of the day. Morning hypertension is defined as morning BP ≥135/85 mm Hg for both ABPM [ambulatory blood pressure monitoring] and home BP monitoring. Clinic BP measurement can be used for screening morning hypertension.The diagnostic threshold is a BP ≥140/90 mm Hg. Morning ...
Source: Lab Soft News - December 16, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Diagnostics Health Wearable Healthcare Delivery Healthcare Information Technology Lab Industry Trends Medical Consumerism Medical Research Point-of-Care Testing Preventive Medicine Public Health Test Kits and Home Testing Source Type: blogs

Diagnostics Versus Therapeutics; The Changing Role of Physicians
Prior to the 20th century, physicians themselves performed a small set of"lab tests" for their patients. One such example was tasting urine which was sweeter for diabetic patients (see:Urine flavor wheels helped doctors taste patients' pee centuries ago). Bedside diagnostic skills in these earlier days were more highly developed than today. Physicians of earlier generations thus performedall diagnostic and therapeutic functions for patients. This began to change in about the mid-20th century as the lab test menu expanded greatly and the sophistication of radiologic procedures increased. Commensurate with this...
Source: Lab Soft News - December 12, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: AI Clinical Lab Industry News Clinical Lab Testing Diagnostics Health Wearable Healthcare Information Technology Lab Information Pathology Informatics Predictive Analytics Public Health Test Kits and Home Testing Source Type: blogs

Another Candidate for the Micro-Sample Diagnostics Market; CBC Results in Minutes
The Theranos fiasco (see:The rise and fall of Theranos, the blood-testing startup that went from Silicon Valley darling to facing fraud charges) served to cast a pall over the micro-sample diagnostics market. Now comes news about an Israeli company with a similar strategy but this time with an instrument providing a complete blood count (CBC) and a green light from the FDA (see:Unlike Theranos, startup ’s blood test device ‘delivers on promise’ with FDA nod). Below is an excerpt from the article:Israeli startupSight Diagnostics has received US Food and Drug Administration clearance to market a blood ...
Source: Lab Soft News - December 11, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: AI Clinical Lab Testing Diagnostics Food and Drug Administration Healthcare Information Technology Healthcare Innovations Medical Research Point-of-Care Testing Source Type: blogs

Higher Quality Healthcare Correlates with Lower Blood Transfusion Rates
In a previous life in the 1970s, I was a blood banker at a large academic hospital. This may sound unbelievable to some of the currentLab Soft News readers but one of our cardiac surgeons in the 1970's would often transfuse six or more units of blood during a CABG (see: Variation in Use of Blood Transfusion in Coronary Artery Bypass Graft Surgery). Although modern blood transfusion can be life-saving, it can sometimes be a substitute for controlling hemorrhage by other and more appropriate means. In other words, less transfusion can often be equated with higher quality care. There is also a financial benefit when a hos...
Source: Lab Soft News - December 10, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Blood banking Clinical Lab Industry News Cost of Healthcare Lab Industry Trends Medical Research Quality of Care Source Type: blogs

Why Apple Won't Buy Epic, Contrary to the Recommendation of Jim Cramer
Jim Cramer, the financial analyst, recently suggested that Apple should buy Epic (see:Jim Cramer: Why Apple should buy Epic). Below is an excerpt from the article: The most obvious acquisition in the [healthcare] space, Mr. Cramer said, is of EHR provider Epic.He noted that Epic and its competitors often engage in information blocking, or the refusal to share data between networks, which can lead to issues with patients' and providers' ability to access health records.However, Mr. Cramer notes that Apple launched its Health Records service last year, which allows iPhone users to access their own medical r...
Source: Lab Soft News - December 8, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Diagnostics Electronic Health Record (EHR) Health Wearable Healthcare Information Technology Point-of-Care Testing Predictive Analytics Quality of Care Test Kits and Home Testing Source Type: blogs

Patient Photos Integrated into EHRs, Causing Reduction in Medication Errors
One of the key elements of healthcare is ensuring that patients receive the proper meds and not those ordered for others. Medication errors are not uncommon so various measures have been used to help prevent such errors (see:Medication Errors and Adverse Drug Events). A recent article discussed the simple idea of placing a photo of a patient in the EHR and discusses how this simple measure appears to have been effective in curtailing mistakes (see:Patient Photo on Health Record Curtails Medication Errors). Below is an excerpt from the article:The idea is simple — display a photo at the top of an electronic health rec...
Source: Lab Soft News - December 5, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Electronic Health Record (EHR) Healthcare Information Technology Medical Consumerism Public Health Quality of Care Source Type: blogs

Plasma Proteins Used to Monitor Health Status; Emerging Science for Lab Testing
A recent article proposed a new way of analyzing patient serum as a means to broadly assess health status (see:Plasma protein patterns as comprehensive indicators of health). Below is an excerpt from the abstract:Proteins are effector molecules that mediate the functions of genes and modulate comorbidities, behaviors and drug treatments.They represent an enormous potential resource for personalized, systemic and data-driven diagnosis, prevention, monitoring and treatment. However, the concept of using plasma proteins for individualized health assessment across many health conditions simultaneously has not been tested. Here...
Source: Lab Soft News - December 4, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: AI Clinical Lab Industry News Clinical Lab Testing Diagnostics Healthcare Innovations Lab Industry Trends Medical Ethics Population Health Preventive Medicine Source Type: blogs

Understanding the Distinction between Virtual Care and Telemedicine
I have been incorrectly using the term virtual care as being synonymous with physician/patient encounters via telemedicine. I was set straight by the following article:Telemedicine vs. Virtual Care: Defining the Difference. It's important to carefully distinguish between these two types of digital care as the field rapidly expands. Here's the difference as defined in this article:  Simply put, the term virtual care is a way of talking about all the ways patients and doctors can use digital tools to communicate....While telemedicine refers to long-distance [direct and visual] patient care, virtual care is a muc...
Source: Lab Soft News - December 2, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Information Technology Healthcare Innovations Medical Consumerism Telemedicine Source Type: blogs

Telemedicine Visits Increasingly Being Accompanied by Lab Testing Services
The continuing adoption of virtual care (i.e., telemedicine) is driving a number of related changes in healthcare. One of them will certainly be changes in outpatient lab testing which has been stable for decades. In the past, patients with appointments in an outpatient facility, and for whom lab tests were ordered, typically had their blood drawn and tests performed in the same facility. These same conditions to not apply for a televisit where the participating physician sets the conditions for lab testing. This topic was addressed in a recentDark Daily note (see:As Primary Care Providers and Health Insurers Embrace ...
Source: Lab Soft News - November 30, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Industry News Clinical Lab Testing Diagnostics Healthcare Innovations Healthcare Insurance Lab Industry Trends Medical Consumerism Point-of-Care Testing Telemedicine Test Kits and Home Testing Source Type: blogs

The " Amazoning " of Health Care; What Exactly Does This Mean?
A recent blog note raised the topic of the"Amazoning" of healthcare (see:The ‘Amazoning’ of Healthcare Will Bring Challenges and Opportunities for Health Plans). In the article, the term"Amazoning" was defined in the following way:At a recent healthcare conference I attended, it sure sounded like it. I heard healthcare professionals using “Amazoning” as a verb referring to therapid delivery of products and services, relentless focus on customer experience and cost optimization, and threat to various industries like retail, computing and entertainment.There is no question tha...
Source: Lab Soft News - November 27, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Clinical Lab Testing Diagnostics Health Wearable Healthcare Information Technology Hospital Financial Medical Consumerism Point-of-Care Testing Population Health Test Kits and Home Testing Source Type: blogs

Outcomes-Based Pharmaceutical Contracts Can Shape the Future of Healthcare
I think that it would be a very good idea if drug costs, particularly for the most expensive ones, were based on outcomes for patients under treatment. This is to say, payment for the drug would be based on evidence that the drug is both efficacious and safe. Outcomes-based drug contracts were the basis for a recent article (see:Outcomes-Based Contracts Can Shape the Future of Health Care) and an excerpt is presented below: Over the past decade, much of the health care economy has shifted from rewarding quantity (fee-for-service) to instead rewarding quality (outcome- and value-based payments). And yet, pharmaceu...
Source: Lab Soft News - November 26, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Cost of Healthcare Electronic Health Record (EHR) Healthcare Information Technology Hospital Financial Pharmaceutical Industry Quality of Care Source Type: blogs

Digital Health Wearables Can Be Used to Detect Gait Disorders, Undiagnosed Diseases
Axial motor symptoms related to speech, swallowing, balance, and gait freezing, particularly in the elderly, can be diagnostic of a number of disorders but most physicians are not sufficiently trained to assess them. The notion that walking is a sensitive indicator of overall health status and that self-selected walking speed correlates with life expectancy in elderly persons was made in a recent medical article (see:Gait disorders in adults and the elderly). Below is an excerpt from it:...[S]low gait in elderly non-demented persons correlates more closely with the future emergence of dementia than subjective cognitiv...
Source: Lab Soft News - November 25, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Diagnostics Health Wearable Healthcare Information Technology Healthcare Innovations Medical Consumerism Medical Research Point-of-Care Testing Preventive Medicine Test Kits and Home Testing Source Type: blogs

Elizabeth Warren Vows to Conduct Antitrust Investigation of EHR Market
Veteran readers of this blog may recall that I have referred to the major EHR vendors, notably Epic and Cerner, as holding a"quasi-monopoly" in the large hospital market and are thus able to exercise substantial leverage over this sector of healthcare (see:Are You an Enterprise or Best-of-Breed CIO? Access to Cash May Make the Difference;Could Apple or Amazon Make a Dent in the Hospital EHR Market?;Consideration of the Organizational and Personal Digital Health Managers of the Future). However, their decisions about EHR design and functionalities may not always be in the best interests of physicians, nurses, and ...
Source: Lab Soft News - November 21, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Electronic Health Record (EHR) Healthcare Delivery Healthcare Information Technology Hospital Executive Management Medical Consumerism Public Health Source Type: blogs

Veritas Sets Price for WGS and Interpretation at $599; Implications for the Future
The price for whole genome sequencing continues to cascade downward -- Veritas Genetics recently announced a new price of $599 including analysis of test results for 200 conditions (see:Veritas Genetics Drops Its Price for Clinical-Grade Whole-Genome Sequencing to $599, as Gene Sequencing Costs Continue to Fall). Below is an excerpt from the article:By announcing an annotated whole-genome sequencing (WGS) service to consumers for just $599, Veritas Genetics is establishing a new price benchmark for medical laboratories and gene testing companies. Prior to this announcement in July, Veritas priced its standardmyGe...
Source: Lab Soft News - November 20, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: AI Clinical Lab Testing Diagnostics Genomic Testing Healthcare Information Technology Healthcare Innovations Lab Industry Trends Medical Consumerism Medical Research Pharmaceutical Industry Preventive Medicine Test Kits and Home Test Source Type: blogs

Addressing Some of the Social Determinants of Health
Discussions about the social determinants of health have been much in the news lately. Here's a definition of the term from the WHO (see:Social determinants of health)The social determinants of health are the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels.The social determinants of health are mostly responsible for health inequities - the unfair and avoidable differences in health status seen within and between countries.If you believe that a person's healthy life can be predicted by...
Source: Lab Soft News - November 15, 2019 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Medical Consumerism Medical Ethics Medical Research Population Health Public Health Source Type: blogs