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Monday Morning Update 1/29/24

January 28, 2024 News 6 Comments

Top News

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UK doctors warn that patient care will suffer under new laws that would limit their use of messaging apps such as WhatsApp and Signal for clinical use.

A journalist’s BMJ article says that a law requires that encrypted messages be placed under government surveillance by the national communications regulator to look for harmful or illegal content, rendering patient data insecure.

A law also requires that messaging app security upgrades be approved, which could take months, leading major tech providers such as Meta, Apple, and Signal to threaten to withdraw services to the UK. Wikipedia has already said it will not be able to operate under a law that tracks user identities, actions, and content submissions.

Clinical informatician Marcus Baw, MBChB says that NHS should have built its own encrypted app that connects to its email system.


Reader Comments

From Industry Recruiter: “Re: LinkedIn an ageism. Here are my thoughts.” A summary of this recruiter’s list, sent in response to my comments last week:

  • It’s ideal to include a headshot on LinkedIn, taken professionally within the past 10 years, but lack of a photo doesn’t dissuade them.
  • List all relevant work experience, even if it goes back more than 10 years, if it adds credibility to the industry or job you are seeking.
  • Listing more credentials never hurts unless you can show no real work experience with them.
  • Include at least one bullet for each job in your summary that highlights a specific accomplishment.
  • Don’t make the write-up so wordy that people can’t get a good review in a minute or two. Save descriptions of skills, such as teamwork or mentoring, for the resume.
  • Ask for LinkedIn recommendations.
  • It doesn’t hurt to publish LinkedIn articles, but that isn’t going to shift their view from the work experience.

From Unleaded: “Re: Epic Showroom. It brings together legacy partner programs such as App Orchard, Connection Hub, and Partners & Pals. It has four key parts: (a) Supply Shot for people support; (b) Health Grid, for providers connecting to the broader ecosystem such as payers, labs, and telehealth networks; (c) Products, a three-tiered partnership list that includes a list of all third-party apps, Toolbox for specific apps like Nuance DAX that follow Epic’s integration guidelines, and Workshop for companies like Abridge that are co-developing with Epic; and (d) Cornerstone Partners, companies like InterSystems and Microsoft whose software is used significantly by Epic.”


HIStalk Announcements and Requests

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Poll respondents say that General Catalyst’s biggest challenge as a venture capital firm that is buying a non-profit health system is to either swing it to long-elusive profitability or hope that its losses are made up elsewhere in its portfolio.

New poll to your right or here: Which of the following forms of discrimination do you suspect had the strongest negative influence on your career in the past five years? It’s your best guess, of course, since companies and managers who discriminate aren’t usually stupid enough to brag about it.

How to support HIStalk with practically no effort:

  • Sign up for spam-free email updates that I send when I post something new.
  • Connect and follow on LinkedIn and join Dann’s HIStalk Fan Club. The first thing I do if someone wants a favor is to see if we are connected or if they are among the 4,195 fan club crew.
  • Mention HIStalk to your colleagues and vendors.
  • Share news, rumors, and intriguing insights.

Sponsors: complete my information form for ViVE and/or HIMSS if you are participating and I’ll include you in my online guide. In the immortal words of John Blutarsky, don’t cost nothin’.


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Reader comments about Medicare’s conclusion that telehealth use has dropped of to nearly pre-pandemic levels led me to look beyond the headlines:

  • The Medicare Telehealth Trends Report looked at the percentage of eligible Medicare beneficiaries who had at least one Part B claim for a telehealth encounter between January 1, 2020 and June 30, 2023, suggesting that the yearly percentage has dropped from 48% in 2020 to 34% in 2021 and 29% in 2022.
  • The quarterly percentage jumped from 7% in Q1 2020 to 47% in Q2 2020, then settled into a 15% or so level from Q2 2022 until now.
  • Medicare didn’t report pre-COVID numbers to provide a true baseline, but a previously reported GAO review said that 0.3% of Part B beneficiaries used telehealth services in 2016, so basically nobody used it until the pandemic shut down many practices and CMS started paying providers equally for in-person and telehealth visits.
  • Medicare’s numbers cover only Medicare beneficiaries who signed up for the optional, extra cost Part B that covers physician visits and outpatient care, although most people enroll in both. I’m assuming that the report also covered traditional Medicare only and not Medicare Advantage, which jumped from 39% of all beneficiaries in 2019 to 51% in 2023, but that’s a guess on my part.
  • We don’t know the percentage of providers who offered telehealth services from 2020 until now, or how many beneficiaries would choose a telehealth encounter if their regular provider offered it.
  • We don’t know how many Medicare beneficiaries received telehealth services that weren’t billed to Medicare.
  • The recently noted surge in Medicare-covered services such as procedures – which is tanking the share price of Medicare Advantage insurers – may have temporarily or permanently reduced the demand for telehealth services as patients returned for deferred office visits.
  • We don’t know how many providers discourage telehealth visits for their patients, either because they don’t like doing them or they prefer an in-person visit where additional services can be offered and billed.

Webinars

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


Acquisitions, Funding, Business, and Stock

A Boston Globe article says that while CVS Health is generating record revenue and executing a healthcare center strategy that includes its Aetna insurance, CVS Caremark pharmacy benefits management, and Oak Street/Signify provider businesses, profits are down because its core business of drugstores suffers from lower payments, a shortage of pharmacists, general labor shortages that create customer lines, widespread store closings, and the perception of dirty and poorly managed locations. The company blames PBMs for their efforts to reduce prescription costs, one of which is its own CVS Caremark, which controls 33% of that market.


Announcements and Implementations

JAMA Network publishes an interview with UCSF’s Atul Butte, MD, PhD, who is chief data scientist over the entire University of California Health System:

  • UC’s 11-year repository of Epic data covers 9.1 million patients across 10 hospitals, 1.5 billion drug orders, 40,000 cancer genomes, and 50 million medical devices.
  • He says that health systems will want to undertake similar work to develop standard medical practices that reduce care variation.
  • UC uses “leave one medical center out” cross-validation, where they leave out one medical center when performing analysis and then see if the conclusions from the rest pan out for that remaining hospital.
  • The organization will work with drug and AI companies only if its own patients benefit.
  • He foresees a day when EHR-trained AI can be deployed to doctors via order sets and decision support tools and even to patients, who might have their own decision support tool on their smartphone. He says that big health systems will probably developed their own branded AI assistant, but their data could be used to help hospitals that don’t have those resources.
  • Butte says he personally uses AI to write letters of recommendation, emails, and programming code.

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In England, surveyed NHS doctors report that physician associates, who are being used to replace doctors despite having completed only a two-year post-graduate program, are prescribing drugs illegally and missing critical diagnoses. Physicians object to the plan to regulate PAs alongside physicians, and doctors report that PAs – who are renaming themselves from “physician assistant” to “physician associate” — are introducing themselves as doctors to patients. Meanwhile, a physician X user doctor calls PAs “noctors” (not a doctor), with screen shots showing a Royal London Hospital PA who brags on signing DNR forms and conducting an Instagram poll to decide how to perform an exam.

Cardiologists recommend in JAMA Cardiology that clinicians be mandated to capture SOGIE data (sexual orientation and gender identity and expression) in EHRs to help researchers understand the cardiovascular health of LGBTQ+ adults.


Privacy and Security

Ontario’s Bluewater Health restores its hospital systems that have been down since an October 23 cyberattack that affected five hospitals that had formed an IT shared services group. The hospital says legal implications prevent it from saying which parts of Meditech remain down, but confirms that it will be replacing the 20-year-old system with Oracle Cerner by the end of the year.

In the UK, former prime minister Tony Blair and former Conservative Party leader William Hague call on NHS to sell de-identified patient data to AI companies to use for training to develop patient monitoring tools. They also envision an NHS app that would give patients access to their own information and capture more data to sell. They call for NHS to set up a new data trust company that would oversee privacy in commercializing access to the information.


Other

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An NHS doctor who was flying to a skiing vacation responds to the flight crew’s call for a doctor to assess a 70-year-old passenger’s health problems. The plane wasn’t equipped with a pulse oximeter, so he used a crew member’s Apple Watch to determine that the woman had low blood oxygen levels, which he successfully treated with oxygen. He praised the Ryanair staff afterwards, adding a recommendation that all plans carry emergency physician kits that include tools for basic measurement, diabetes, blood pressure, and oxygen saturation. He luckily borrowed an older watch since a patent dispute has forced Apple to disable the pulse oximetry function that he used in recently sold Apple Watch models.


Sponsor Updates

  • SnapCare will provide contract staff transparency in its workforce marketplace, where it will itemize pay rates, travel costs, a standard rate that covers benefits and payroll taxes, and the company’s fee, saving clients an estimated 15%.
  • NeuroFlow publishes a two-part case study featuring the success EvolvedMD found using NeuroFlow’s technology as a part of its efforts to integrate behavioral and physical healthcare services for its customers.
  • Frost & Sullivan recognizes Wolters Kluwer Health as an “Innovation & Growth Leader” in clinical decision support systems.
  • Centerpoint Health leverages data from the EClinicalWorks EHR and its Healow no-show prediction AI model to improve its clinical workflows.
  • Vyne Medical releases a new customer success story, “Streamlining Fax Operations: A Growing Medical Center’s Success Story.”
  • Revuud shares its key highlights of its 2023 performance, including 16 new customers.
  • Symplr publishes its “Provider Credentialing 2024 Guide.”
  • Waystar will exhibit at the HFMA Minnesota Winter Conference January 30-31 in Minneapolis.

Blog Posts


Contacts

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

News 1/26/24

January 25, 2024 News No Comments

Top News

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Humana shares dropped 16% on Thursday as the health insurer issued full-year earnings guidance that was half of Wall Street’s expectations.

The company, which primarily sells Medicare Advantage insurance, said that its medical expenses have soared as patients return to hospitals to undergo pandemic-delayed procedures such as hip replacements. It warned that the trend is not related to respiratory conditions and thus is likely to continue.

Shares in other insurers such as UnitedHealth Group and CVS Health also slid on the news as investors became concerned about increased medical costs in their Medicare Advantage business.

The company reports Q4 results: revenue up 18%, adjusted EPS –$0.11 versus $1.97, beating revenue estimates but falling short on earnings.

HUM shares are down 29% in the past 12 months versus the S&P 500’s 22% gain, valuing the company at $44 billion.


Reader Comments

From Copy Cat: “Re: Dana-Farber research cheating. When did it become OK to replace ‘cheating, plagiarism, and lying’ with ‘data falsification’ or ‘inadequate citation?’ Any chance us non-academic elites would get a similar reprieve after falsifying resumes or dissertations?” I’m far from an expert since I’ve co-authored only a few articles in peer-reviewed journals and my contribution was incidental, but I’m guessing it relates to intent and extent (did they do it intentionally for some personal benefit and did it affect the article’s conclusions). Sometimes it’s a gray area, such as when authors publish on a topic without citing the seminal work of a pioneering researcher that they most certainly have read even if not used directly. The Dana-Farber researchers appear to have faked scientific graphics, although whether they did so to prove an incorrect conclusion or because of some logistical reason wasn’t stated (but is being investigated). The conclusion is that it’s better to do your own double-checking of citations instead of letting some cheap seats observer catch your misbehavior, whether inappropriate or not and even if it sneaks by peer reviewers.

From Conference Escalator: “Re: HIMSS24. The exhibitor count seems pretty low.” My interest level isn’t high, but since you asked, I scrolled and counted about 650 exhibitors, compared to maybe 1,200 to 1,500 before COVID and the emergence of competing conferences. But on the bright side, the exhibit hall will probably have carpeted aisles this year.


HIStalk Announcements and Requests

A reader asked about expressing years of work experience on LinkedIn while avoiding ageism. My initial reaction is that LinkedIn content doesn’t matter since at best it will get you an interview where you might face age discrimination anyway. Still, you have to avoid being shut out by recruiters and HR people who perform the initial screening, and there’s little effort required to make a better first impression. My conclusions (and it would be great to hear from recruiters who use LinkedIn to find or vet job candidates):

  1. Use a professional, contemporary headshot from years ago, or doctor your photo to look younger. Nobody will feel offended or duped. You could omit the headshot entirely like a resume, but I assume most employers are like me in finding it creepy if someone intentionally leaves out a photo.
  2. List only work experience going back a few years or a couple of jobs. Nobody cares before then.
  3. Highlight (or obtain, if necessary) technical skills that prove that you keep up as well as younger people. Take a quick course in ChatGPT, Excel, Python, or sales prospecting software to prove that you stay current. Likewise, remove obsolete credentials and irrelevant accomplishments, especially those that go back to the college years.
  4. Punch up the summary to emphasize accomplishment rather than elapsed time, especially if you can back up your achievements with numbers.
  5. Emphasize your ability to work with a team, mentor, and expend extra effort.
  6. Have a younger executive review your profile and resume to make sure that you are using modern terms and aren’t listing experience that is actually detrimental to finding a job.
  7. Ask for LinkedIn recommendations.
  8. Publish occasional LinkedIn articles ongoing, not just when you are suddenly facing a job search.

Webinars

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


Acquisitions, Funding, Business, and Stock

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Mercy Hospital – Iowa City and Altera Digital Health settle their contract dispute that stood in the way of the bankrupt hospital’s acquisition by University of Iowa Hospitals & Clinics. The hospital’s contract with Altera will be dissolved and Mercy won’t pay any amount owed, although it will pay $6 million as unsecured debt. Altera will sign a new contract with UIHC so that the hospital can keep using Sunrise with vendor support as required by the acquisition.


Sales

  • The State of Pennsylvania launches PA Navigate, a Findhelp-powered online tool that connects state residents with community-based organizations, county and state agencies, and healthcare providers to address basic needs.
  • NorthStar Care Community and Hospice of Michigan will expand their use of Netsmart’s CareFabric platform, including the MyUnity EHR for hospice, home care, and palliative care.

People

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Clearsense hires Jason Rose, MHSA (AdhereHealth) as CEO and board member. He replaces founder Gene Scheurer, who will remain on the board.

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Ochsner Health promotes Amy Trainor, RN, MHSA to SVP/CIO.

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Emory Healthcare names Nitu Kashyap, MD (Yale New Haven Health) as chief health informatics officer.

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Stacy Sand, MS (Healthwise) joins Get Well as VP of marketing communications.


Announcements and Implementations

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Blue Spark Technologies, which offers the TempTraq Bluetooth-enabled temperature monitoring patch, launches VitalTraq, which uses a “selfie scan” that is taken with a smart phone’s camera to report heart rate, heart rate variability, blood pressure, and respiratory rate.

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Black Book Research publishes the 2024 “State of the Global Health Information Technology Industry” report, which analyzes the response of 19,000 global health IT customers to rate 109 vendors on 18 key performance indicators. The 655-page research report can be downloaded instantly at no cost.

Fortified Health Security publishes its “2024 Horizon Report” on cybersecurity.


Government and Politics

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A federal court denies the motion of Erlanger Health to dismiss a lawsuit that accuses the hospital of allowing surgeons to bill for overlapping surgeries that they didn’t perform and allowing residents and interns to perform procedures without proper oversight if patients lacked insurance. The lawsuit was brought by two orthopedic surgeons and Erlanger’s former CIO, Stephen Adams, MD. It claims that the health system allowed surgeons to share their Epic login information with unlicensed staff to make entries under their names, and when the privacy offer was overwhelmed with lists of inappropriate chart access, Erlanger limited the number of events that would be reported because of the risk involved. The lawsuit also claims that the death of a child who was placed under anesthesia for a MRI was initially blamed on an Epic flaw, but audit logs indicated that the CRNA left the room to complete charts and the CRNA student who remained then made a fatal medication ordering error.

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U.S. News & World Report sues the city attorney of San Francisco, who has issued two subpoenas seeking information about the criteria it uses to create its “Best Hospitals” list, the possibility that high-ranking hospitals pay for the privilege, and that its rankings encourage hospitals to invest in specialties instead of primary care. The publication says the attorney is harassing it because he doesn’t agree with its rankings.

HHS publishes voluntary Cybersecurity Performance Goals for healthcare.


Sponsor Updates

  • MRO earns Validated Data Stream designation in NCQA’s Data Aggregator Validation program.
  • Healthcare IT Leaders adds health industry veteran Mary Mirabelli to its board.
  • Surescripts customer Elation Health adopts the Surescripts Real-Time Prescription Benefit tool.
  • Florida Digestive Health Specialists adds Sunoh.ai virtual scribing capabilities to its EClinicalWorks EHR.
  • Health Data Movers releases a new episode of its “Quick Hits” podcast featuring Kunjan Divatia.
  • Emanate Health (CA) adds to its suite of Meditech solutions, implementing the company’s Smart Pump Infusion Integration with the Baxter Spectrum IQ infusion system.

Blog Posts


Contacts

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

News 1/24/24

January 23, 2024 News 9 Comments

Top News

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Top researchers at Harvard-affiliated Dana-Farber Cancer Institute, including its CEO and COO, are accused of falsifying published research articles by Photoshopping scientific graphics.

Research integrity experts identified 57 studies that appear to have been manipulated, with the organization acknowledging 37 of them and moving to retract six of those studies.

Some journals are using AI tools that can identify image tampering, which is apparently common among researchers.


Reader Comments

From Summa Cum Lotta: “Re: Summa. I am surprised how loss-making hospitals with high debt are still making huge investments in technology. How long would it have taken money-losing Summa to break even on an $850 million implementation of Epic? Executives making such decisions should be let go.” The cost seemed high to me, even though I got that number directly from Summa’s website in a transcript of an interview with the CIO and CMIO. Replaying the audio, CIO Elbridge Locklear, MBA actually said “eight fifty million dollars,” which sounds more like a verbal stumble rather than an odd way of intentionally saying “$850 million,” so I’m sure he misspoke. I went through Summa’s federal tax filings, which say they spent $50 million overall on the project. They paid Epic $12 million in 2022 versus paying their Epic host Mercy Health $13 million the year before, when they also paid Cerner $5 million. I’m surprised that Summa hasn’t corrected their own podcast transcription.

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From GR_Buckeye: “Re: Epic. Has publicly published their Clarity data dictionary. Do you know why? They closely guard their IP and I can only assume that this was done as the result of some type of legal matter.” Epic published its EHI expert schema on its Open Epic interoperability information website. It was crawled by Internet Archive in February 2023, so it has apparently been there for some time.

From Watching Wins: “Re: learning from videos. You concluded that it shouldn’t be an either-or option between text and video since each have their audience. Why not use AI to create an HIStalk video of daily or weekly health tech news summary that you are already posting as text?” I could certainly do that pretty easily since I’ve researched available tools, but would anyone really watch or listen to a daily or weekly talking (AI) head video news digest?


HIStalk Announcements and Requests

A reminder to HIStalk sponsors: complete my information form for ViVE and/or HIMSS if you are participating and I’ll include you in my online guide

Dear everyone: please stop expressing your work history as “over” X years of experience. If you say “over eight,” then we know it’s not nine, and every person’s tenure is “over” the exact number, even if just by minutes. Trust me that nobody cares about your fractional years, but if your vanity requires, simply round up after the six-month mark to nine years. Related to that is expressing numbers in general — instead of “over 400 hospitals,” either give the actual number or just go with 400 since the distinction is not important.


Webinars

January 24 (Wednesday) noon ET. “Medication Management Redefined.” Sponsor: DrFirst. Presenters: Nick Barger, PharmD, VP of product, DrFirst; Caleb Dunn, PharmD, MS, senior product manager, DrFirst. Clinical workflow experts will paint a reimagined vision for e-prescribing that offers enhanced patient adherence, customizable clinical support, intelligent pharmacy logic, and data integrity and safety. Join this first chapter of an ongoing conversation about what medication management should be, how to deliver greater benefits today, and how to prepare for the future. Elevating your solution and customer benefits isn’t as hard, scary, or economically challenging as you may think.

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


Acquisitions, Funding, Business, and Stock

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Healthcare pricing transparency company Turquoise Health raises $30 million in a Series B funding round, bringing its total raised to $55 million since launching in 2021.

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The annual health IT market review of Healthcare Growth Partners finds that:

  • M&A and buyout deal volume returned to pre-COVID levels in 2023 from their low in Q4 2022.
  • Although valuations did not catch up, EBITDA-based valuations have held steady throughout
  • Investment activity continued to fall through 2023, dropping to $9 billion from its all-time high of $29 billion in 2021.
  • HGP’s HIT Index gained 3% last year versus 25% for the S&P 500 and 45% for the Nasdaq.
  • HIT Index stocks whose returns were worse than negative 60% for the year include Streamline Health, Invitae, Pear Therapeutics, GeneDx Holding, NantHealth, Bright Health Group, Cue Health, and UpHealth.

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In Wisconsin’s Chippewa Valley, HSHS Sacred Heart, St. Joseph’s, and Prevea clinics will close, with HSHS blaming “a mismatch in the supply of and demand for local healthcare services” and its failure to find a partner.


Sales

  • The CDC will use de-identified EHR data from health system collective Truveta for respiratory virus surveillance and research projects involving maternal and pediatric healthcare.
  • South Carolina-based specialty pharmacy Palmetto Pharm selects Inovalon’s ScriptMed Specialty pharmacy management software.
  • Innovaccer incorporates Wolters Kluwer Health’s Health Language terminology software into its data-based offerings.

People

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Ryan Royal (Interviewstream) joins Upfront Healthcare as CTO.

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Definitive Healthcare names founder, former CEO, and current Executive Chairman Jason Krantz, MBA as interim CEO upon the departure of Robert Musselwhite.

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AMC Health names Zebadiah Kimmel, MD, MBA (Medically Home) chief product officer and promotes Jon Shankman, MBA, MPH to chief analytics officer.

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Anatomy IT names Patrik Vagenius (Flywire) chief commercial officer.

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Mount Sinai Health System (NY) names Bruce Darrow, MD, PhD interim chief digital and information officer upon the departure of Kristin Myers, MPH, who has joined Northwell Health (NY) as chief digital officer.

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1upHealth hires Andrea Kowalski, MBA (Tebra) as chief product officer.

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Kyruus hires Harshit Shah, MS (Spring Health) as CTO.


Announcements and Implementations

Amazon reportedly offers One Medical providers access to virtual consults with Amazon Pharmacy pharmacists as part of a pilot project geared towards improving outcomes for high-risk patients, particularly seniors.

The Liver Cancer Collaborative in Australia uses Aridhia’s Digital Research Environment technology to help researchers share data and collaborate on projects.

UCSD Health researchers find that a real-time alert that is powered by the Composer deep learning training library accurately predicted patient sepsis in the ED and reduced mortality significantly. The nursing alert was presented as an Epic Best Practice Advisory, but the authors note that the Epic’s own Sepsis Score has not demonstrated comparable results.

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A new KLAS report finds that physician and nurse burnout has stabilized, but remain higher than pre-pandemic levels. Both groups suggest improving staffing and getting executives to listen to the concerns of clinicians and patients. Coming in at #3 for doctors is improving EHR efficiency, while for nurses, it is increasing pay.


Government and Politics

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A federal appeals court upholds Martin Shkreli’s lifetime ban from the drug industry and a requirement that he pay $65 million in restitution. His company bought a decades-old drug for treating a rare condition, immediately raised the price 4,000%, and prevented other companies from obtaining samples of the drug that would have allowed them to sell generics. His lawyer had argued that while the “pharma bro” has since served prison time for financial crimes, those weren’t related to the drug industry, suggesting that the courts “should encourage real geniuses like Mr. Shkreli to work in the industry.” Shrekli responded via X that he is the only person in the US to ever be sued as a monopolist, says he followed the same playbook as AbbVie and many other drug manufacturers, and warned every executive that they can be held jointly and severally liable for antitrust actions that are levied against their companies.


Other

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CMS reports that telehealth usage by Medicare users has dropped nearly back to pre-pandemic levels through mid-2023.

In Bangladesh, a private hospital director is arrested after demanding that parents of a newborn pay their $365 bill, and upon hearing that they didn’t have the money, sold the baby.


Sponsor Updates

  • Pinnacle Family Care (NC) improves efficiency using the EClinicalWorks AI assistant for Prisma.
  • Censinet releases a new Risk Never Sleeps Podcast, “Future-Forward Healthcare with Sherri Douville, CEO & Board, Medigram.”
  • CloudWave will sponsor the MUSE Social (Southern California) Community Peer Group Event February 1 in Covina.

Blog Posts


Contacts

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

Monday Morning Update 1/22/24

January 21, 2024 News 2 Comments

Top News

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Massachusetts regulators worry that Steward Health Care’s financial problems may force it to close hospitals, with the resulting loss of jobs and access to care.

Steward operates 33 hospitals in nine states, nine of them in Massachusetts. It is one of the top employers and taxpayers in towns where it operates hospitals. It has 30,000 employees nationally and operates 25 urgent care centers and 107 skilled nursing facilities.

The real estate company that bought and then leased back some of Steward’s hospital buildings says that the company is $50 million behind in rent payments.

Steward, which gets 70% of its revenue from Medicare and Medicaid, says that community hospitals in Massachusetts are paid less than academic medical centers. It has asked for state help with the cost of caring for Medicaid patients and undocumented immigrants.


Reader Comments

From Industry CEO: “Re: HIStalk. The first thing my earliest investors advised me to do as a founder was to read HIStalk every day. So I have, for many years. My team and I think really highly of HIStalk.” Thanks. These comments give me a push since I sit alone at keyboard each day, and even when I emerge into the wild, I decline to divulge my HIStalk identity because who cares anyway. I’m happy to leave it as a blank screen in an empty room with someone occasionally reading over my shoulder.


HIStalk Announcements and Requests

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Attention HIStalk sponsors: complete my information form for ViVE and/or HIMSS if you are participating and I’ll include you in my online guide. Also attention non-sponsors, because it’s not to late to get signed up for exposure for the other 359 days of the year when the exhibit halls go dark and attention is more focused.

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Twice as many provider decision-makers would rather learn about companies by reading a document or web page instead of watching a video, which is about the same percentage of those who aren’t provider decision-makers. I agree with commenter B. Efficient, who says that it shouldn’t be either-or — they won’t even look at video alone because it’s inefficient and often ends up being an advertisement, but a text-based overview with video detail such as screenshots is the way to go.

New poll to your right or here: what will be General Catalyst’s biggest challenge in its plan to buy Summa Health?


Thoughts About General Catalyst Acquiring Summa Health

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Venture capital firm General Catalyst promised to buy a non-profit health system when it formed Health Assurance Transformation Corporation (HATCo) in October 2023. The firm says that it evaluated several acquisition candidates, but it said last week that it has been talking to Summa for nine months, so perhaps that was always its choice.

Summa’s Advantages to GC

  • It is relatively small and can be acquired at a reasonable price.
  • Its market is geographically compact.
  • Its size allows changes to be implemented faster.
  • Summa has acute care hospitals, a rehab hospital, a physician network, and a small health insurance business.
  • It has been successful as an early participant in value-based care.

GC’s Health Assurance Network

GC had already formed its Health Assurance Network of health systems – their “partnership” terms have not been announced — that includes HCA, Jefferson, Intermountain, WellSpan, Banner, UC Davis, UCI Health, UHS, and others. Its goals:

  • Pair startups with health systems to develop and scale products.
  • Share best practices.
  • Move from sick care to wellness via population health.
  • Explore new care models.

Acquisition Financials

Three-hospital Summa recorded a $57 million loss on $1.5 billion in revenue in its most recent tax filing.

GC said with the original announcement that it would spend $1 billion to $3 billion for its acquisition. For-profit companies that buy non-profit health systems usually pay slightly less than 1x revenue, so GC will likely spend at least $1 billion. HCA paid $1.5 billion for North Carolina’s Mission Health, whose revenue and bed count were nearly identical.

Summa’s CEO says the health system’s financial challenges, which include $800 million of debt, didn’t give it a lot of options. He says that Summa has been seeking a partner for more than 10 years, Summa announced plans to sell itself to Beaumont Health in late 2019 until COVID caused both parties to change their minds.

GC will need to finance the deal. It has $25 billion of assets under management, but probably not $1 billion in cash sitting around. The financial details of the transaction will come out when they look for investors or lenders, or perhaps before then in the likely event that the information leaks out. The resulting leverage and carrying costs, not to mention extraction of resources to give the buyer immediate reward, often bring down acquired health systems that were already struggling.

GC Says It’s Not a Typical Private Equity Acquisition

GC makes it clear that as a venture capital firm, it won’t follow the model of a private equity acquisition, where the goal is to cut costs (often recklessly) to increase profits to allow a quick flip of the business. However, it could be argued that this transaction is more like PE than VC, other than GC’s assurance that it is in for the long haul:

  • GC is buying a mature business that has stable revenue, not a high-potential startup whose success is not assured.
  • It is acquiring a 100% share rather than partial ownership.
  • GC may or may not become actively involved in Summa’s management.

For-Profit versus Not-for-Profit

For-profit companies own a significant percentage of US hospitals, but as their core business rather than one of several business lines. GC is an investor with no experience running a health system. Regulators have grown wary of what happens after the deal is done, when the acquirer may close locations, let quality slide, sell real estate to generate cash, or shut down money-losing core community services such as obstetrics to move into high-profit ventures such as ambulatory surgery centers.

For-profit status could make it easier to raise capital, but with significant downsides:

  • They lose the tax benefits.
  • They lose the 340B drug discount program, which can be a big profit-booster.
  • They will need to renegotiate contracts.
  • They will need to retire or refinance Summa’s $800 million of debt, probably at higher interest rates as a for-profit.

Operational Challenge

GC has promised that Summa’s executive team, employee base, service lines, and name won’t change. That may be challenging if profits don’t materialize, especially when most Summa executives have no experience running a for-profit hospital. Continued losses might be hard to swallow even if Summa helps GC make money from its other investments. The business structure will be important for the availability and cost of financing.

Buying a Software Sandbox

GC is buying a sandbox for its health tech portfolio companies. The original participants in GC’s Health Assurance Network are:

  • Commure (interoperability and data).
  • Tendo (analytics).
  • Transcarent (connecting consumers with providers).
  • Olive (process automation, but the company has been shut down).

GC may also be eyeing the value of Summa’s data for AI training.

GC will need to track the value that Summa adds to its portfolio companies, especially if the health system keeps losing money, to determine if its investment is paying off.

Health System and Software Companies Sharing an Owner

GC portfolio companies benefit from bypassing the “death by pilot” process in being implemented and measured at a health system that is a fellow portfolio company. That could generate convincing proof-of-concept studies. It could also backfire if Summa’s core business struggles despite using corporate-mandated software.

Epic

Summa previously ran on Mercy Health’s shared instance of Epic, then spent $850 million in late 2022 to launch its own instance. UPDATE: That number came from a Summa interview in which CIO Elbridge Locklear, MBA says what sounds like $850 million and remains transcribed that way on Summa’s website, but tax filings say they spent $50 million, suggesting that he may have stumbled verbally.

GC companies will have a leg up on Epic integration. That assumes that GC doesn’t run into issues with Epic’s willingness to work with a health system whose parent company also owns many dozen health technology competitors. The health system cannot risk having Epic shut its system down over IP concerns or contract renegotiation, and walking away from an expensive Epic contract to self-develop software would be unprecedented and risky.

Your Thoughts

I’m interested in your opinion. Leave a comment or message me.


Webinars

January 24 (Wednesday) noon ET. “Medication Management Redefined.” Sponsor: DrFirst. Presenters: Nick Barger, PharmD, VP of product, DrFirst; Caleb Dunn, PharmD, MS, senior product manager, DrFirst. Clinical workflow experts will paint a reimagined vision for e-prescribing that offers enhanced patient adherence, customizable clinical support, intelligent pharmacy logic, and data integrity and safety. Join this first chapter of an ongoing conversation about what medication management should be, how to deliver greater benefits today, and how to prepare for the future. Elevating your solution and customer benefits isn’t as hard, scary, or economically challenging as you may think.

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


Acquisitions, Funding, Business, and Stock

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23andMe CEO Ann Wojcicki says that tech investors who understand its consumer genetics testing business don’t like the burn that is involved with its drug development side, while pharma investors don’t understand its consumer business. She declined to say if the company might split into two companies, but notes that it is selling customer genetics data to drug companies under non-exclusive relationships, one of which just yielded a $20 million, one-year contract. ME shares have lost 94% of their value since the company went public via a SPAC merger in June 2021 at a valuation of nearly $4 billion, now $340 million. 23andMe reported in January that hackers had exposed the information of 6.9 million people who had activated its DNA Relatives sharing feature.

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Today I learned from LinkedIn about Veritas Data Research, which appears to have solved the longstanding healthcare data problem of not knowing if a patient/consumer has died. The company’s Fact of Death captures over 90% of US deaths, usually within a month. Tuva Health is partnering with the company, saying that it’s surprisingly hard to know whether a patient survived or not because CDC’s data takes up to a year to published, is available only to researchers, and becomes less reliable as more people choose to die outside the hospital. The use cases for providers include creating better population health and risk models and eliminating the embarrassment of sending bills and marketing communications to people who have died. Veritas has just added Cause of Death, which allows researchers to identify whether deaths may not be related to their study topic. The two founders previously co-founded Universal Patient Key, a healthcare data de-identification service that was acquired by Datavant in 2018.


People

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Darcy Nett (Wellbe) joins HealthX Ventures as principal.


Announcements and Implementations

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FDA clears DermaSensor’s AI-powered handheld device for detecting skin cancer.

Optum seeks EHR/PM vendors to test its prior authorization inquiry API.


Government and Politics

HHS OIG bans Theranos founder and federal inmate Elizabeth Holmes from participating in federal healthcare programs for 90 years, the same exclusion it gave to former Theranos President Sunny Balwani.


Privacy and Security

The American Hospital Association warns that offshore hackers are impersonating hospital revenue cycle employees to have their passwords reset by the hospital IT help desk, using stolen information about the employee to answer security questions. They then ask to have a cell phone with a local area code enrolled, which allows them to defeat multi-factor authentication to log on to financial systems to send money to their offshore accounts.


Other

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Epic CEO Judy Faulkner tells a fun story about opening the first buildings of its new campus in Verona, only to find that the entrances to their underground parking lots were too short for fire trucks. They had to buy the Verona Fire Department a new truck, which Carl Dvorak drove over with the sirens and lights on. Judy sat in the back with her white Samoyed dog, to which they had affixed black spots made of construction paper to make him look like a Dalmatian.

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Unrelated, but bizarre. The founder and CEO of a large Chicago-based ERP software company dies and its president is seriously injured during a company celebration in India. The two executives were leading the audience in singing while hanging from a cage that was suspended above the stage when its chain broke, tumbling them 15 feet to the concrete stage.


Sponsor Updates

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  • Spok staff pack gift boxes for patients and gift bags for nurses at Inova L.J. Murphy Children’s Hospital in Virginia.
  • CereCore International hires Andrew Hine (Babylon) as managing director.
  • EClinicalWorks shares a new customer success story, “Boosting Wellness Visits & Incentive Revenue in Healthcare.”
  • Nordic releases a new Designing for Health Podcast, “Interview with David K. Butler, MD.”
  • Optimum Healthcare IT publishes a new case study, “ServiceNow Clinician Connect EMR Help.”
  • SBI’s Growth Advisory Podcast features Symplr CEO BJ Schaknowski and President Nicole Rogas.
  • The American Journal of Nursing awards Wolters Kluwer Health with eight Book of the Year awards.
  • Waystar will exhibit at ASA Advance 2024 January 26-28 in Las Vegas.

Blog Posts


Contacts

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

News 1/19/24

January 18, 2024 News 1 Comment

Top News

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Venture capital firm General Catalyst signs a letter of intent to acquire Akron-based non-profit health system Summa Health.

GC formed Health Assurance Transformation Corporation, HATCo, in October 2023 to lead a technology-driven transformation from “sick care” to health assurance, which focuses on helping people stay well, reducing cost, and increasing accessibility. General Catalyst said at that time that it planned to acquire a health system to demonstrate the value of its approach, which includes the involvement of some of its healthcare technology companies.

General Catalyst’s health assurance portfolio includes more than 100 companies.

The company says that the acquisition should not be considered as “another private equity deal” because it will not focus on cost reductions or a quick flip.

Summa Health has three hospitals, 1,027 licensed beds, and 8,500 employees. Its most recent financial report shows a loss of $57 million on revenue of $1.5 billion. It will convert to a for-profit system under its new owner.

Beaumont Health signed an agreement to acquire Summa in December 2019, but the organizations backed out in May 2020.

Summa executives expect the acquisition to close by mid-summer.


Webinars

January 19 (Friday) 1 ET. “Unlocking Reliable Clinical Data: Real-World Success Stories.” Sponsor: DrFirst. Presenters: Alistair Erskine, MD, MBA, CIO/CDO, Emory Healthcare; Jason Hill, MD, MMM, associate CMIO, Ochsner Health; Colin Banas, MD, MHA, chief medical officer, DrFirst. Health system leaders will describe how they are empowering clinicians with reliable patient data while minimizing workflow friction within Epic. They will offer real-world experience and tips on how to deliver the best possible medication history data to clinicians at the point of care, use clinical-grade AI to infer and normalize prescription instructions in Epic, and encourage patient adherence to medication therapies for optimal outcomes.

January 24 (Wednesday) noon ET. “Medication Management Redefined.” Sponsor: DrFirst. Presenters: Nick Barger, PharmD, VP of product, DrFirst; Caleb Dunn, PharmD, MS, senior product manager, DrFirst. Clinical workflow experts will paint a reimagined vision for e-prescribing that offers enhanced patient adherence, customizable clinical support, intelligent pharmacy logic, and data integrity and safety. Join this first chapter of an ongoing conversation about what medication management should be, how to deliver greater benefits today, and how to prepare for the future. Elevating your solution and customer benefits isn’t as hard, scary, or economically challenging as you may think.

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


Acquisitions, Funding, Business, and Stock

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Reuters reports that the private equity owners of Netsmart Technologies are planning to offer the company for sale, hoping to attract offers of more than $5 billion.

PointClickCare acquires CPSI subsidiary American HealthTech, which offers long-term care management software. CPSI had stopped development of the product after deciding to divest the business.

Online vision testing company Visibly acquires EyecareLive, which offers a similar test along with video visits with optometrists.

Health data interoperability platform vendor Hart will move its headquarters from California to Kansas City, MO.

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SeamlessMD co-founder and CEO Joshua Liu, MD raises interesting points (and creates a fun graphic) about General Catalyst’s planned acquisition of Summa Health and its use of the health system as an incubator for its many health tech businesses:

  • Will they try to build an EHR? (leading to my corollary question – how does Epic feel about one of its customers, which the CIO says spent $850 million to move from a shared instance of Epic to its own Epic system in 2022, being bought by a VC firm that has ownership in healthcare software vendors?)
  • Will Summa make its own technology decisions or will GC force them to use products that its portfolio companies sell?
  • How will staff react to having the health system’s goals set by a financial firm?
  • Will startups that aren’t part of General Catalyst avoid working with Summa out of intellectual property concerns?
  • Will GC bring in entrepreneurs in residence and incubate new companies?
  • Will Summa develop innovation fatigue given the focus of its new owners?

Sales

  • The Association of Community Mental Health Centers of Kansas will implement Netsmart Population Health Platform across 26 members that are transitioning to the Certified Community Behavioral Health Clinic model.

People

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Roswell Park Comprehensive Cancer Center hires George ”Buddy” Hickman, MS (First Health Advisory) as chief digital and information officer.

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Vasanth Balu (Excela Health) joins Bozeman Health as CIO.

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Kevin Shiotelis (CorTech) joins Healthcare IT Leaders as CFO.

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Consensus Cloud Solutions promotes Johnny Hecker to chief revenue officer and EVP of operations.


Announcements and Implementations

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Hospital-at-home technology vendor Biofourmis adds in-home services to its platform, allowing providers to order, schedule, confirm, and track in-home services and diagnostics.

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Epic launches Showroom, which lists products and services that can be used with Epic.

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Nuance announces GA of DAX Copilot embedded in Epic, which it says has a 150-hospital waitlist.

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NYC Health + Hospitals adds Findhelp’s social services referral platform to Epic. Completing Epic’s SDoH screening tool will trigger resource recommendations from Findhelp, which staff can also search directly for community-based resources and create closed-loop referrals.

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UCLA Health creates Medical Informatics Operating Room Vitals and Events Repository (MOVER), a de-identified database of 83,000 surgical outcomes from UCI Medical Center’s Epic and former SIS system that approved researchers can use at no cost to test AI algorithms.

A University of Michigan survey finds that 7.5% of people aged 50 to 80 have used an online-only provider and 60% of those received a prescription, but two-thirds of them didn’t tell their regular provider. The authors express concern that online providers don’t have access to the patient’s health history and medical records, making it challenging to screen for drug interactions. Respondents said they used online services because of convenience or lack of access to a regular provider, with only 10% saying they used an online service because of discomfort talking to their regular provider about topics such as mental health or sexual issues.


Privacy and Security

Bluewater Health, which is part of a five-hospital shared services group that remains down from an October 23 ransomware attack, will replace its 25-year-old Meditech system with Oracle Cerner by the end of 2024. The hospital has cancelled 8,000 diagnostic imaging appointments. It planned to move to Cerner in 2013, but delayed the project.


Other

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Patent troll SynKloud Technologies sues Epic, claiming that MyChart violates a 2005 patent that it bought in 2019 that describes a personal alarm system for seniors.


Sponsor Updates

  • EClinicalWorks customer DePaul Community Health Centers (LA) adds Sunoh.ai ambient listening technology from ECW to its V12 EHR.
  • CereCore offers revenue optimization assessments to help health systems maximize financial performance despite increased denials.
  • Meditech signs its 100th Expanse MaaS customer, with 37 hospitals signing on in 2023 alone.\
  • Experity will host its third annual Urgent Care Connect Conference February 13-14 in Austin.
  • Black Book Research survey-takers rank Verisma as the leading vendor for release of information, audit management, and revenue integrity solutions for the fourth consecutive year.
  • Fortified Health Security names Joan Edens (Vaco) documentation and quality assurance specialist.
  • ThoroughCare integrates Healthwise’s educational healthcare content with its care coordination software.
  • Inovalon releases a new podcast, “Data Insights and Impact Across Healthcare.”
  • Linus Health publishes the results of a new study, “Digital Clock and Recall is superior to the Mini-Mental State Examination for the detection of mild cognitive impairment and mild dementia,” in Alzheimer’s Research & Therapy.

Blog Posts


Contacts

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

News 1/17/24

January 16, 2024 News 4 Comments

Top News

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Apple will remove pulse oximetry technology from its Watch to avoid the possibility of having the product banned from importation into the US if Apple loses a pending patent appeal.

The US International Trade Commission ruled in late December that the technology, which is included in the Series 9 and Ultra 2 models, infringes on the patents of medical device manufacturer Masimo. The ban was temporarily paused when Apple appealed the ruling, allowing sales of the Watch to be restarted.

Bloomberg says that Apple has already shipped modified watches to the company’s retail stores, but has yet to approve their sale. Apple has not announced any plans about previously sold Watches that contain the pulse oximetry feature or whether it will be disabled via an update.


Reader Comments

From RIP Cerner: “Re: Oracle Health. Rumor is that former CMS Administrator Seema Verma will replace the departing Travis Dalton as GM/SVP of Oracle Health. She joined Oracle last year as head of Life Sciences and will reportedly add Oracle Health to her responsibilities, reporting to EVP Mike Sicilia.” Unverified, but rumored internally. She raised a lot of controversy during her CMS years, especially related to her taxpayer-funded personal self-promotion.


HIStalk Announcements and Requests

Listening: Jimmy Fallon, who I can’t stand to watch in his late-night hosting job, but who is amazing beyond belief in his dead-on (no pun intended) impersonation of Jim Morrison and the Doors doing “Reading Rainbow.” I’ve listened to a lot of Doors and he is spot on in capturing style and stage mannerisms of Mr. Mojo Risin’ (minus the indecent exposure). The faux Densmore, Manzarek, and Krieger aren’t actually playing – The Roots are skillfully channeling 1967. I’m sure that Fallon’s celebrity fawning and self-aware attempts at cleverness pay better than fronting a Doors tribute band, but I would vastly prefer watching the latter.


Webinars

January 19 (Friday) 1 ET. “Unlocking Reliable Clinical Data: Real-World Success Stories.” Sponsor: DrFirst. Presenters: Alistair Erskine, MD, MBA, CIO/CDO, Emory Healthcare; Jason Hill, MD, MMM, associate CMIO, Ochsner Health; Colin Banas, MD, MHA, chief medical officer, DrFirst. Health system leaders will describe how they are empowering clinicians with reliable patient data while minimizing workflow friction within Epic. They will offer real-world experience and tips on how to deliver the best possible medication history data to clinicians at the point of care, use clinical-grade AI to infer and normalize prescription instructions in Epic, and encourage patient adherence to medication therapies for optimal outcomes.

January 24 (Wednesday) noon ET. “Medication Management Redefined.” Sponsor: DrFirst. Presenters: Nick Barger, PharmD, VP of product, DrFirst; Caleb Dunn, PharmD, MS, senior product manager, DrFirst. Clinical workflow experts will paint a reimagined vision for e-prescribing that offers enhanced patient adherence, customizable clinical support, intelligent pharmacy logic, and data integrity and safety. Join this first chapter of an ongoing conversation about what medication management should be, how to deliver greater benefits today, and how to prepare for the future. Elevating your solution and customer benefits isn’t as hard, scary, or economically challenging as you may think.

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


Acquisitions, Funding, Business, and Stock

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98point6 acquires Bright.md’s 17 telehealth customers and hires six of its employees. 98point6 announced last year that it would pivot from being a virtual care provider to offering technology, after which it sold off its chatbot, self-insured employer business, and physician group to Transcarent for $100 million. Bright.md, meanwhile, sold its asynchronous virtual care technology to Cigna’s Evernorth Health Services subsidiary last October.

Healthcare analytics vendor Innovaccer acquires Cured, which offers healthcare digital marketing software. Cured’s three co-founders started their careers with Epic.

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Per diem staffing provider Aya Healthcare acquires UK-based workforce solutions provider ID Medical, which will make Aya’s platform available to NHS and UK-based clinicians.


Sales

  • Bluewater Health in Ontario will replace its Meditech system with Oracle Health by the end of this year. The health system made a similar announcement in 2019, along with several other local hospitals that went on to adopt the then-Cerner software.

People

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Sarah Bennight (Carenet Health) joins IKS Health as SVP of marketing.

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NCQA names Tricia Elliott, DHA, MBA (Northwestern Medicine) VP of quality implementation within its quality measurement and research group.


Announcements and Implementations

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Capital Region Medical Center (MO) will adopt Oracle Health as a part of its now-finalized integration with MU Health Care.

Midwest Cardiovascular Institute (IL) will implement real-time monitoring, AI-powered diagnostics, and other digital health technologies from Livemed Telehealth.

Baptist Memorial Health Care (MS) finalizes its acquisition of Anderson Regional Health System, which will share Baptist’s Epic system.

Luminis Health (MD) rolls out Teladoc Health virtual nursing technology across its acute care hospitals.

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Essentia Health-Mid Dakota Clinics in North Dakota will go live on Epic this month.

Hackensack Meridian Health (NJ) implements Volpara Health’s breast cancer risk assessment and clinical decision support software.

In Canada, Quebec’s implementation of Epic will cost $1.1 billion USD if it is approved for full implementations, with the first go-live expected at the end of 2025. Epic would replace the Quebec Health Record, whose completion ran 10 years late and triple the original budget at $1.3 billion USD. Quebec chose Epic over the other finalist Cerner in September 2023, estimating the project’s cost at up to $2.2 billion.

In vitro diagnostics vendor BioMérieux will acquire Lumed, which offers antibiotic and infection monitoring software to hospitals.


Privacy and Security

A radiology practice in Sydney, Australia, tells patients that a November data breach was caused by an unspecified IT issue, all the while dealing with harassing phone calls and texts from the breach’s perpetrators.

Liberty Hospital in Missouri declares it has “significantly recovered” from a December 19 cyberattack that forced it to temporarily divert ambulances and revert to downtime procedures for several weeks.


Other

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South Dakota Governor Kristi Noem presents Avel ECare physician Katie DeJong, DO and Casie Hunter, RN along with EMT Ed Konechne with the Governor’s Award for Heroism for their roles in saving the life of a rancher who was critically injured in a bison attack. Konechne used the state-funded ambulance telehealth system to get ED physician instructions from DeJong, who was 140 miles away, and to then alert the hospital that they were en route.


Sponsor Updates

  • Bamboo Health will exhibit at the Massachusetts Health & Hospital Association Annual Meeting January 25-26 in Boston.
  • CereCore honors innovation and collaboration amongst its employees at its annual Connection event.
  • Nordic publishes a new episode of its “Designing for Health” podcast titled “Interview with David Butler, MD.”
  • Divurgent releases a new episode of The Vurge Podcast, “Change Champions with Amy Horner: Strategies, Leadership, and Personal Growth.”

Blog Posts


Contacts

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

Monday Morning Update 1/15/24

January 14, 2024 News 4 Comments

Top News

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A Google-created AI system called AMIE that was optimized for diagnostic dialog outperforms primary care doctors in synchronous text chat with patient actors. The authors warn that while this isn’t representative of clinical practice and thus places clinicians at a disadvantage to AI, the accomplishment is still a milestone in developing conversational diagnostic AI.

The evaluation criteria included history-taking performance, diagnostic accuracy, management reasoning, communication skills, and empathy.

The authors observe that history-taking and diagnostic dialog is dependent on context and requires a high level of clinician skill.

The tool was trained on medical licensing exam questions, real-life medical summaries, and audio transcripts from 100,000 medical conversations. It was further trained and refined by using self-play, where AI improves its performance by playing against itself and analyzing which of its approaches were successful.


Reader Comments

From A Beautiful Mind: “Re: Amazon. Your post about Health Conditions got me thinking about previous Amazon healthcare forays such as HealthLake, One Medical, etc. Do you speculate that they are throwing a lot of darts to see which ones stick, or is there a John Nash-like team in Seattle piecing together the chaos for ultimate world domination, and oh yeah, improving care and lowering costs?” Amazon is smarter than I, but I don’t understand its healthcare plan. The company doesn’t always hit healthcare home runs (see: Amazon Care, Haven, and Halo) but it swings a mighty bat and learns from failure. It hasn’t done much with online pharmacy PillPack, and buzz about its “all the pills you take for $5 per month” RxPass died down pretty quickly after it was announced a year ago. It paid $4 billion for money-losing primary care concierge practice One Medical, with few changes except to offer Prime members a discount on joining One Medical, which still bills insurance traditionally and is now is exposed to Amazon-recruited members who are older and less affluent that One Medical’s former client base. Amazon’s recent offerings seem to focus on charging to advertise third-party healthcare businesses. Healthcare is a financially appealing vertical, but is notoriously hard for even big-name outsiders to penetrate due to billing complexity; a hellish regulatory environment; the local and trusted presence of big health systems and national drug chains where Amazon is to many just a website or app that often sells offshore-sourced junk using phony reviews, and the challenge of scaling without killing someone. I think of Amazon as a company that makes money from selling ads, fulfillment services, and AWS with zero personal touch, which doesn’t suggest a broadly disruptive role in healthcare.

From Y2K11 Maverick: “Re: HIStalk. I last said this 10 years ago, but it has remained true. Rarely does a week go by that 1) I don’t learn something new by reading HISTalk updates and/or 2) I pass along something from your posts that my colleagues hadn’t seen before. THANK YOU for all that you’ve done, do and (hopefully) continue to do for us schmoes who are just trying to keep up! Loyal listener since 2011!” Thanks.

From JD: “Re: Billy Idol at ViVE. Your mention reminded me of John Lydon, aka Johnny Rotten of the Sex Pistols, who was his wife’s caregiver.” The 67-year-old punker was a full-time caregiver of Nora Foster, his wife of 44 years, for nearly 15 years until she died of Alzheimer’s in April 2023 at 80 years old. He said in an interview just before she died, “We know that she’s going to slowly deteriorate into something catastrophic, and then death. But she will enjoy every step of it, and I’m here to make sure of that because she’d do the same for me.”

From JustScratchingMyHead: “Re: the Texas surgeon sharing gender-affirming care records.  While technically he did redact the information, it still seems procedurally not correct and I would think the hospital would have some type of policy about screenshots being taken and sent externally. What happens when the next provider sends the information without proper redaction or none at all?” Ethan Haim, MD graduated from his Baylor surgical residency the day that HHS knocked on his door. He was an anonymous whistleblower until June 2023  and has moved on to Hunt Regional Healthcare as a general surgeon. The hospital’s bigger beef with him beyond screenshots would have been his efforts to get them in trouble with the state. He likens transgender interventions for children to COVID, arguing that both involve scant peer-reviewed medical evidence and the institutional censorship of those who question it.


HIStalk Announcements and Requests

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Provider poll respondents aren’t confident that their employer-paid conference attendance generates ROI. However, commenters add that attendance has value beyond immediate ROI, such as gaining knowledge, networking, and recruiting.

New poll to your right or here, for provider employees: which is your preferred medium to learn what a vendor does? This is in response to user comments. I’ll admit that while I’m critical of TL;DR types who can’t read more than two consecutive sentences without blaming the author with indignation rather than embarrassment for their phone-stunted attention span, I’m similar with videos, however – people who host them and love themselves excessively sometimes can’t shut up and let their guests speak. I f a video can’t tell me something useful in the first 30 seconds (or a text article in three sentences), the situation isn’t likely to improve and I move on.

Your to-dos for supporting what I do:

  • Join my spam-free mailing list.
  • Connect on LinkedIn and join Dann’s HIStalk Fan Club so that I see your posts and job changes.
  • Tell my sponsors, or potential ones, that you value their support.
  • Share news, rumors, and intriguing insights.

Webinars

January 19 (Friday) 1 ET. “Unlocking Reliable Clinical Data: Real-World Success Stories.” Sponsor: DrFirst. Presenters: Alistair Erskine, MD, MBA, CIO/CDO, Emory Healthcare; Jason Hill, MD, MMM, associate CMIO, Ochsner Health; Colin Banas, MD, MHA, chief medical officer, DrFirst. Health system leaders will describe how they are empowering clinicians with reliable patient data while minimizing workflow friction within Epic. They will offer real-world experience and tips on how to deliver the best possible medication history data to clinicians at the point of care, use clinical-grade AI to infer and normalize prescription instructions in Epic, and encourage patient adherence to medication therapies for optimal outcomes.

January 24 (Wednesday) noon ET. “Medication Management Redefined.” Sponsor: DrFirst. Presenters: Nick Barger, PharmD, VP of product, DrFirst; Caleb Dunn, PharmD, MS, senior product manager, DrFirst. Clinical workflow experts will paint a reimagined vision for e-prescribing that offers enhanced patient adherence, customizable clinical support, intelligent pharmacy logic, and data integrity and safety. Join this first chapter of an ongoing conversation about what medication management should be, how to deliver greater benefits today, and how to prepare for the future. Elevating your solution and customer benefits isn’t as hard, scary, or economically challenging as you may think.

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


Sales

  • Outpatient rehab provider Ability KC choses Netsmart’s TheraOffice EHR/PM.

Announcements and Implementations

Oracle moves its Health Summit to Nashville and pushes it back from February to April. Tennessee offered Oracle $175 million in incentives to build a $1.4 billion campus in Nashville that will likely have a significant Oracle Health presence. The company’s Oracle Health Conference, the former Cerner Health Conference, was held in Las Vegas in September 2023.


Government and Politics

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The chairs of the Kansas senate commerce and house judiciary committees ask Governor Laura Kelly to explain why the Department for Children and Families awarded $7.7 million of a $18 million federal social services grant to software vendor Unite Us. They question why so much of the money will be sent to an out-of-state company instead of being used to support local social service programs.

A Bloomberg article on the effects of significant national relocation on elections highlights Epic, whose large headcount and 3,000 hires in 2023 are mostly young and college educated.

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A Senate subcommittee reviews finds that national drugstore chains don’t require a warrant to provide law enforcement with the patient records they request for whatever reason, with Sen. Ron Wyden (D-OR) calling for HHS to update HIPAA to require pharmacies to insist on a warrant before disclosure in response to regulatory and law enforcement records requests.


Privacy and Security

A law firm that specializes in business security incidents is itself hit by hackers, exposing the identity, medical, and insurance information of 637,000 people that it had collected from its security incident clients.


Other

Former Olympic gymnast Mary Lou Retton was uninsured for her month-long hospital stay for pneumonia, for which she blamed pre-existing conditions and lack of affordable premiums. Either she’s not telling the whole story or she is unaware of Affordable Care Act plans that are legally required to cover pre-existing conditions and extend premium subsidies based on income. The 55-year-old Retton says she has since obtained insurance, but didn’t say if she paid for it from the $460,000 her four daughters raised for her via social media. She declines to name the hospital.


Sponsor Updates

  • Meditech reports record international growth for its Expanse EHR in 2023.
  • Nym will exhibit at the HFMA Western Region Symposium January 21-24 in Las Vegas.
  • Optimum Healthcare IT announces that it has been named a Workday Staffing Partner.
  • Verato publishes a new e-book, “How to overcome HHS identity management challenges.”

Blog Posts


Contacts

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

Morning Headlines 1/12/24

January 11, 2024 Headlines, News No Comments

Artisight to Scale and Advance AI-driven Smart Hospital Platform with Oversubscribed $42 Million Series B Round

Artisight, which offers a smart hospital platform, raises $42 million in a Series B funding round.

New Veradigm Leadership Provides Outlook on Business and Strategy, and Refreshed Financial Estimates for Fiscal 2023

Veradigm lowers its FY2023 revenue and earnings guidance below consensus estimates, noting in an SEC filing that it doesn’t yet know when it will file overdue financial reports for the last three quarters and year-end of FY2023 or convene its annual meeting of shareholders.

Hewlett Packard Enterprise to buy Juniper Networks in $14 bln deal

Hewlett-Packard Enterprise will acquire AI-enabled enterprise networking and security technology company Juniper Networks for $14 billion.

Graphium Health Acquires The ABG Anesthesia Data Group Strengthening Anesthesia Quality and Safety Initiatives

Anesthesia healthcare technology vendor Graphium Health purchases The ABG Anesthesia Data Group, which specializes in qualified clinical data registries management.

News 1/12/24

January 11, 2024 News 3 Comments

Top News

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Artisight, which offers a smart hospital platform, raises $42 million in a Series B funding round.

Co-founder and CEO Andrew Gostine, MD, MBA formed the company while working in his anesthesiology residency.


Reader Comments

From Video Kills Brain Cells: “Re: vendor videos. I saw Dr. Jayne’s mention that she doesn’t watch them. You should conduct a poll.” I’m with Dr. Jayne in usually declining to spend time consuming vendor videos or podcasts. Skimming text visually is faster than watching even 3x speed video unless the graphics are uncharacteristically vital. My advice to those who create multimedia is to avoid making it an either-or situation – send your video or audio files to an AI-powered transcription service like I use, and for an incremental cost and time of just about zero, you can post the transcript along with the original and satisfy both audiences. Requiring people to sit through your precious AV meanderings is a vanity play that excludes some folks who might be interested. Perhaps my poll will ask whether respondents are decision-makers since I don’t picture many C-suite members using video as their preferred vehicle for gaining industry information.

From Letme Throw: “Re: AI. I”m curious to hear your thoughts about the 2024 strategies that were announced by Oracle Health and Epic.” Oracle’s Larry Ellison talked up AI and voice-powered user interfaces in announcing the Cerner acquisition in December 2021, saying that Oracle would jump-start the business converting to a primarily voice-based UI for Millennium using Oracle’s Digital Assistant (along with creating a national EHR database, rewriting Millennium, getting the VA’s implementation done, etc.) I haven’t seen examples of Oracle Health’s real-life use of AI, not to mention that it won’t really matter if they keep losing customers to Epic. Epic seems to be way ahead, with some of its clients testing or using ambient listening documentation, inbox management, scheduling automation, AI-enhanced Cosmos research inquiries, and enhanced patient communications. Epic’s user base of huge academic health systems also gives it access to on-the-ground innovators who have the resources to design, use, and even develop AI-related tools that have an actual use case that is free of Oracle’s vested interest as a tech company in selling technical products to Cerner users. I would have low expectations of the provider impact of a quick bolt-on of Digital Assistant. I would enjoy hearing directly from Cerner and Epic customers about how they are using, or hoping to use, AI with their respective products. Also note that Meditech has arguably done a lot more with AI in Expanse than Oracle Health in Millennium, and at a friendlier price point.


HIStalk Announcements and Requests

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Something reminded me of one-time high flyer Nant Health, which hit $21 per share on its first day of trading in mid-2016 drug billionaire Patrick Soon-Shiong, MD launched several Nant-named companies. Those shares are now at $0.06, valuing the company at $12 million. The company’s headquarters address is a UPS store in the tiny town of Winterville, NC, a few steps away from the notable Sam Jones BBQ.


Webinars

January 19 (Friday) 1 ET. “Unlocking Reliable Clinical Data: Real-World Success Stories.” Sponsor: DrFirst. Presenters: Alistair Erskine, MD, MBA, CIO/CDO, Emory Healthcare; Jason Hill, MD, MMM, associate CMIO, Ochsner Health; Colin Banas, MD, MHA, chief medical officer, DrFirst. Health system leaders will describe how they are empowering clinicians with reliable patient data while minimizing workflow friction within Epic. They will offer real-world experience and tips on how to deliver the best possible medication history data to clinicians at the point of care, use clinical-grade AI to infer and normalize prescription instructions in Epic, and encourage patient adherence to medication therapies for optimal outcomes.

January 24 (Wednesday) noon ET. “Medication Management Redefined.” Sponsor: DrFirst. Presenters: Nick Barger, PharmD, VP of product, DrFirst; Caleb Dunn, PharmD, MS, senior product manager, DrFirst. Clinical workflow experts will paint a reimagined vision for e-prescribing that offers enhanced patient adherence, customizable clinical support, intelligent pharmacy logic, and data integrity and safety. Join this first chapter of an ongoing conversation about what medication management should be, how to deliver greater benefits today, and how to prepare for the future. Elevating your solution and customer benefits isn’t as hard, scary, or economically challenging as you may think.

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


Acquisitions, Funding, Business, and Stock

Veradigm lowers its FY2023 revenue and earnings guidance below consensus estimates. MDRX shares have lost 47% of their value in the past 12 months, much of that in a big price drop in early December. The company said in an SEC filing Wednesday that it doesn’t yet know when it will file overdue financial reports for the last three quarters and year-end of FY2023 or convene its annual meeting of shareholders.

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Rune Labs, whose FDA-cleared software tracks symptoms of Parkinson’s disease via the Apple Watch, raises a $12 million funding round. CEO Brian Pepin, MSEE founded the company after leaving his senior hardware engineer job at Verily Life Sciences in late 2018.

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An Apple share price drop caused by demand doubts makes Microsoft the world’s most valuable company. Had you invested $10,000 in MSFT shares 10 years ago, you would have nearly $102,000 today, or if you are former CEO Steve Ballmer, you would be rolling in $128 billion worth of shares that throw off $1 billion per year in dividends.


Sales

  • Spectrum Healthcare (AZ) chooses NextGen Healthcare for EHR/PM.

People

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Industry long-timer Jeff Stern (Carium) joins Brado as VP of business development.


Announcements and Implementations

AI medical scribing technology vendor DeepScribe launches integration with Epic’s SmartData elements, allowing users to customize note preferences and standards that are mirrored in Epic.

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Clearsense will present Billy Idol live in concert at ViVE 2024 in Los Angeles next month. I saw him a few years ago and he puts on a good show that goes beyond sneering through “Rebel Yell.” I’m predictably skeptical about the relevance of celebrity entertainment to healthcare, but if you are spending your employer’s money to attend ViVE, you might as well happily pump your fist overhead along with the punk rocker, who has been Medicare-aged for several years.

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Amazon rolls out its Just Walk Out checkout-free technology to hospitals, allowing employees to pay for food by scanning their badges to create a payroll deduction.

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PerfectServe’s Lightning Bolt describes combinatorial optimization, a mathematical process that chooses the best possible solution given a finite set of possibilities. The interesting article describes, with some level of detail, how the company uses that process, rather than the more common heuristic method, to build the best physician schedules. The article wasn’t credited, but someone did a nice job of explaining a useful concept.

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Caregility announces its new telehealth edge devices for hospital-based telehealth such as e-sitting, virtual rounding, patient-family communication, and tele-ICU, with OhioHealth and UMass Memorial Health being early adopters.

Palantir and University of Colorado Anschutz Medical Campus establish the Center for Linkage and Acquisition of Data as part of the NIH’s All of Us research program. The project will integrate claims and mortality data and address the challenges of linking EHR data from health information networks to improve data completeness. The principal investigator of the 18-month, renewable project – which is funded by a $30 million NIH grant —  is Melissa Haendel, PhD, the chief research informatics officer of the medical campus.

Health insurer Elevance will offer people who are covered by its Medicaid health plans a free smartphone with unlimited data, talk, and texting to provide access to digital and virtual healthcare tools, supported by funding through the FCC’s Affordable Connectivity Program.


Privacy and Security

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HHS investigates a 33-year-old Texas surgeon for providing case lists of minors who were undergoing gender-affirming care at Texas Children’s Hospital to a conservative activist, which HHS deems to be a HIPAA violation. Eithan Haim, MD, who completed his residency in 2023, says that he is innocent because he redacted specific information from his Epic screen shots. The hospital said in March 2022 that it was halting provision of the services in response to the state’s interpretation that they constitute child abuse, but his records indicate that treatments continued. I’m thinking that at least from the redacted screenshot provided, he’s correct in that while he disclosed some of the 18 HIPAA identifiers (such as age and diagnosis), redacting patient-identifiable fields such as name or medical record number makes it de-identified PHI, which isn’t protected by HIPAA, although the question remains about whether he accessed and disclosed the data inappropriately if not illegally. I suppose HHS knows best.

Novant Health will pay $6.6 million to settle a lawsuit that was brought by 10 of its patients for the health system’s use of the Meta Pixel website user tracking tool.


Other

Two hospital EDs in Australia will revert to their previous IT system for six months after implementation of InterSystems TrakCare in mid-November caused long patient wait times and user frustration.

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Noetik co-founder and CEO Ron Alfa, MD, PhD shares his tab for a single bottle of water at the J.P. Morgan Health Care Conference in San Francisco, where the moneylenders fly private to sit at $100 per hour lobby tables while pondering the mystery of why US healthcare is so expensive.


Sponsor Updates

  • EClinicalWorks announces that McKenzie Health System (MI) is improving operations using its EHR, clinical rules engine, and robotic process automation.
  • Net Health launches the next phase of its digital musculoskeletal thought leadership program in partnership with the American Physical Therapy Association.
  • First Databank names Kara Zebrowski (Glytec) product manager, Hamman Eltareb (Hearst Health) health data analyst, and Christian Wong software engineer.
  • Findhelp launches season two of its American Compassion Podcast about the history of the social safety net in America.
  • Meditech recognizes international customers of its Expanse EHR, which include providers in East Africa, Ireland, Australia, UK, and Singapore.
  • FinThrive releases a new episode of its Healthy Rethink Podcast, “He’s Here, He’s There … Virtual Care Everywhere.”
  • Medicomp Systems releases a new episode of the Tell Me Where It Hurts Podcast featuring Juan Carlos Gallegos, RN senior director of product, Homecare Homebase.

Blog Posts


Contacts

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

News 1/10/24

January 9, 2024 News 1 Comment

Top News

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Amazon adds Health Conditions Programs to its Health services to help Amazon account holders find and enroll in digital health programs that are covered by their insurance plans.

The online retailer has tapped Omada Health, which offers programs for diabetes prevention, and diabetes and hypertension management, as its launch partner.

The Amazon program will apparently advertise third-party digital health products. It will be interesting to see how insurers react to having their customers pitched to buy digital health services at the insurer’s expense.


Webinars

January 19 (Friday) 1 ET. “Unlocking Reliable Clinical Data: Real-World Success Stories.” Sponsor: DrFirst. Presenters: Alistair Erskine, MD, MBA, CIO/CDO, Emory Healthcare; Jason Hill, MD, MMM, associate CMIO, Ochsner Health; Colin Banas, MD, MHA, chief medical officer, DrFirst. Health system leaders will describe how they are empowering clinicians with reliable patient data while minimizing workflow friction within Epic. They will offer real-world experience and tips on how to deliver the best possible medication history data to clinicians at the point of care, use clinical-grade AI to infer and normalize prescription instructions in Epic, and encourage patient adherence to medication therapies for optimal outcomes.

January 24 (Wednesday) noon ET. “Medication Management Redefined.” Sponsor: DrFirst. Presenters: Nick Barger, PharmD, VP of product, DrFirst; Caleb Dunn, PharmD, MS, senior product manager, DrFirst. Clinical workflow experts will paint a reimagined vision for e-prescribing that offers enhanced patient adherence, customizable clinical support, intelligent pharmacy logic, and data integrity and safety. Join this first chapter of an ongoing conversation about what medication management should be, how to deliver greater benefits today, and how to prepare for the future. Elevating your solution and customer benefits isn’t as hard, scary, or economically challenging as you may think.

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


Acquisitions, Funding, Business, and Stock

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Patient navigation software and services vendor Care Continuity raises $10 million.

Impact Advisors acquires payer-focused First Quadrant Advisory.

GE HealthCare will acquire medical imaging analysis software vendor MIM Software.

Medical record retrieval and analysis software startup Credo Health raises $5.25 million. CEO Carm Huntress, founder and former CEO of RxRevu, launched the company nine months ago.

Food and environmental services outsourcer Aramark will offer the hospitalized patients of customers of its clinical nutrition service the ability to connect with its dietitians via the hospital’s preferred telehealth platform. 

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Harris acquires the Medstreaming vascular and cardiovascular reporting, practice management, and billing solution of Fivos, which Harris will offer under its Picis brand.


Sales

  • Tallahassee Memorial HealthCare selects Ensemble Health Partners for revenue cycle management.
  • Premier Orthopaedic and Hand Center (IL) selects EHR and patient engagement software from EClinicalWorks.
  • VHC Health in Washington, DC will implement RCM software and services from Med-Metrix. Two hundred VHC RCM staff will transition to employment with Med-Metrix as part of the 15-year contract.
  • California-based HIE SacValley MedShare selects Health Catalyst’s data and analytics technology and professional services.

People

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NextGen promotes Srinivas Velamoor, MBA to president and COO.

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Ingeborg “Inge” Garrison, RN, MSN (RLDatix) and Amanda Heidemann, MD (KeyCare) join EVisit as principals of clinical strategy.

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Deb Anderson, MBA (Advocate Health) joins Endeavor Health as CIO.

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Caleb Hartman (Gozio) joins Loyal as VP of sales.


Announcements and Implementations

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Hartford Healthcare (CT) begins offering virtual care at select retail and community locations via OnMed health stations.


Government and Politics

ONC’s HTI-1 final rule is published in the Federal Register with an effective date of February 8. The rule covers algorithm transparency, USCDI Version 3 as a baseline certification standard, enhanced information blocking requirements, and new interoperability-focused reporting metrics for Certified Health IT.


Privacy and Security

Refuah Health Center (NY) will pay $450,000 in penalties and costs and will invest $1.2 million in cybersecurity improvements to settle New York State charges that it failed to protect patient information in a May 2021 ransomware attack. The state says that the hackers gained access to the FQHC’s security cameras that was protected by a static, four-digit code; moved from there to its private network; then used the login credentials of one of its IT vendors that had been unused since 2014 to gain access to its systems.


Other

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Withings unveils its BeamO “multiscope.” Designed for use during home-based virtual visits, the device acts as a digital thermometer, electrocardiogram, oximeter, and stethoscope. The company anticipates launching the product and its accompanying app in at select retailers in July for $250.

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OhioHealth equips its new Pickerington Methodist Hospital with smart room technology from EVideon.

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Healthcare think tank The Lown Institute announces the winners of its 2023 Shkreli Awards:

  1. Columbia University, for failing to stop the sexual assaults of one of its OB-GYNs despite complaints from 250 patients, with the resulting lawsuit costing it $235 million to settle.
  2. Non-profit Catholic hospital operator CommonSpirit Health, which paid its CEO $36 million in 2021.
  3. Drug companies that are challenging a new law that allows Medicare to negotiate drug prices with manufacturers for the first time, which they claim violates their constitutional rights.
  4. Hospitals that have partnered with private equity firms to offer high-interest medical credit cards.
  5. A doctor who has been disciplined by 12 state medical boards and settled Medicare fraud allegations related to performing unnecessary procedures who failed a mandated ethics course twice and is still practicing medicine.
  6. Drugmaker GlaxoSmithKline, which hid evidence that its Zantac heartburn drug caused cancer.
  7. An Indiana cardiologist who catheterized a single patient 44 times to implant 41 stents.
  8. Hospitals who were caught dumping homeless patients onto the street.
  9. A surgeon who implanted two expensive, experimental Medtronic devices into a patient of a hospital that serves mostly low-income patients, after which the patient had a stroke that caused with long-term damage.
  10. A Pennsylvania hospital that gave the family of an undocumented immigrant 48 hours to pay $500 per day for at-home medical equipment, find a hospital that would accept her transfer, or consent to be medically deported to the Dominican Republic.

Sponsor Updates

  • Arcadia joins Atropos Health’s Evidence Network.
  • The Thriving Practice Podcast features Arrive Health CEO Kyle Kiser, “On a Mission for Affordable Medications.”
  • Clearwater Executive Chairman Bob Chaput releases a new book, “Enterprise Cyber Risk Management as a Value Creator.”

Blog Posts


Contacts

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

Morning Headlines 1/9/24

January 8, 2024 News No Comments

Amazon introduces new Health Condition Programs—here’s what you need to know and how to enroll

Amazon launches Health Conditions Programs, an online service that helps Amazon account holders find and enroll in digital health programs covered by their insurance plans.

Care Continuity Secures $10M in Funding to Fuel Growth in Patient Navigation

Patient navigation software and services vendor Care Continuity raises $10 million.

GE HealthCare announces agreement to acquire MIM Software

GE HealthCare will acquire medical imaging analysis and AI-enabled workflow software vendor MIM Software.

Ventra Health and Advocate RCM Combine Forces

RCM and advisory services company Ventra Health acquires Advocate RCM, which specializes in RCM software and services for certain specialties.

Monday Morning Update 1/8/24

January 7, 2024 News 5 Comments

Top News

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Walgreens Boots Alliance is struggling with the performance of primary care chain VillageMD, in which it is the majority shareholder.

Walgreens has closed 27 of the 60 underperforming locations that it previously announced and will focus on marketing the practices in hopes of boosting patient panels that are lower than expected.

Walgreens said in last week’s earnings call that it will take advantage of its strong neighborhood presence “to help payers, providers, and pharma achieve their goals.” The company is freeing up pharmacist time to allow more meaningful patient interaction via health screenings, immunizations, diagnostic testing, and treatment and has contracted with 25 drug companies to recruit clinical trials participants.

The CEO concludes, “We are going to be a major community-based, neighborhood point of engagement for patients with human beings touching human beings, which I believe in the long term is how how healthcare in this country is going to evolve.”


Reader Comments

From Conferencius: “Re: conferences. Is your skipping the HIMSS conference for the first time in years an early indicator of a trend? I find myself being less interested in attending conferences in general.” I’m not sure a trend exists, although the newer, glitzier conferences may spread the attendance and exhibitor wealth around. Attending conferences without employer expectations can be fun, but I question the ROI for the patients who foot the bill for days of socializing, expensive meals, and splashy entertainment under the guise of “networking” that at least in my experience, never paid off for my employer. However, I learned early as a health system IT executive to grudgingly approve the cost of sending high-value employees to conferences without expectation of ROI beyond stroking their egos and leaving them vaguely “inspired.”It’s funny that as an industry, we assure patients that we can deliver life-affecting health services via telehealth and remote patient monitoring, but we can’t do our paper-pushing jobs without expensively traveling with the herd to a publicly traded company’s equivalent of a destination wedding. The COVID-era failure of virtual conferences proves that it was never about education. Your question inspired a poll (below).

From KC Masterpiece: “Re: David Feinberg. Finally found another company who needs a selfie-taker.” Feinberg isn’t leaving Oracle Health as chairman, at least not at the moment. He has taken an additional paying job as an advisor to a VC firm. People still ponder how it came to be that he took over as Cerner president and CEO (but not board chair) on October 1, 2021 and the board agreed to sell the company to Oracle 80 days later, netting him dozens of millions for having done nothing except choose office furniture. We don’t know if the acquisition was sealed by his hiring and if he knew in advance that it would swell his pockets mightily. I’m not clear on what his day job as “chairman” of a company’s single operating division even means since as far as I know, Oracle Health doesn’t have its own board for Feinberg to chair and I’m not sure he even has direct reports.

From Rascule: “Re: HIMSS Accelerate. The HIMSS VP who ran it is now the head of marketing at HLTH.” Verified from LinkedIn. HIMSS launched the Accelerate online discussion platform in mid-2021, the seemingly ideal time to provide an alternative for COVID-halted conferences, but it never caught on. HIMSS also created the similarly timed and named HIMSS Accelerate Health, whose purpose wasn’t clear but seemed to involve conference tracks and a podcast, but that seems defunct as former links go to 404 pages or to HIMSS TV. I sure would like to see a current HIMSS 990 form that tax-exempts are required to post publicly to get a better idea of the business structure, but they haven’t filed one since FY2020.

From Pivoteer: “Re: consulting. You should do a poll on how many readers lost or quit jobs and tried to morph themselves into a consulting firm until finding a job.” I’ll do that poll next time. I try not to be cynical about folks whose career goes from a seat at the table in the board room to one in the dining room, with intentions ranging from lofty “this is my new passion and life’s work” to the more realistic “this will hopefully pay the bills while I try to get someone to hire me.” I’m only critical when corporate-fueled ego spills over into gig work (I’m thinking about my former boss, who fled back to a health system job before the paint on his consulting company shingle had dried) in the form of of prestigious-sounding company names, splashy websites, and a CEO title for their one-person contract work, and then when the contracts don’t materialize, redirect their unplanned free time into social media and podcast punditry. Still, we all have bills to pay and people to support, so if hanging out a consulting shingle for the short or long term does the job, then be proud of taking the shot with humility, which is required since the phone doesn’t ring nearly as often when you’re a seller instead of a buyer.


HIStalk Announcements and Requests

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I ran a similar poll to this one nearly a year ago and only the finishing order has changed – the top vote-getters then and now were AI, precision medicine, and remote patient monitoring. Respondents back then showed insight in ranking AI high long before ChatGPTback triggered a now-obvious AI ubiquity.

New poll to your right or here: Provider employees: did your employer see a hard-dollar ROI within a year of funding your attendance at a national conference?


Thanks to these companies for recently supporting HIStalk. Click a logo for more information.

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Webinars

January 19 (Friday) 1 ET. “Unlocking Reliable Clinical Data: Real-World Success Stories.” Sponsor: DrFirst. Presenters: Alistair Erskine, MD, MBA, CIO/CDO, Emory Healthcare; Jason Hill, MD, MMM, associate CMIO, Ochsner Health; Colin Banas, MD, MHA, chief medical officer, DrFirst. Health system leaders will describe how they are empowering clinicians with reliable patient data while minimizing workflow friction within Epic. They will offer real-world experience and tips on how to deliver the best possible medication history data to clinicians at the point of care, use clinical-grade AI to infer and normalize prescription instructions in Epic, and encourage patient adherence to medication therapies for optimal outcomes.

January 24 (Wednesday) noon ET. “Medication Management Redefined.” Sponsor: DrFirst. Presenters: Nick Barger, PharmD, VP of product, DrFirst; Caleb Dunn, PharmD, MS, senior product manager, DrFirst. Clinical workflow experts will paint a reimagined vision for e-prescribing that offers enhanced patient adherence, customizable clinical support, intelligent pharmacy logic, and data integrity and safety. Join this first chapter of an ongoing conversation about what medication management should be, how to deliver greater benefits today, and how to prepare for the future. Elevating your solution and customer benefits isn’t as hard, scary, or economically challenging as you may think.

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


Acquisitions, Funding, Business, and Stock

France-based GPT clinical note generator Nabla raises $24 million in a Series B funding round that values the company at $180 million.

Marshfield Clinic and Essentia Health cancel their planned merger.

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Doctors express wariness about drug maker Lilly’s announcement that it will sell some of its drugs directly to consumers using third-party providers of telehealth and pharmacy fulfillment services. The CEO says LillyDirect will make it easier for patients to obtain prescriptions without resorting to compounded or counterfeit versions of products such as its $1,000-per-month weight loss drug Zepbound, but an expert says that LillyDirect is the next step in direct-to-consumer advertising where patients may not learn about treatment options that don’t involve Lilly’s products, also predicting that other drug companies will follow Lilly’s lead. The American College of Physicians responded to the announcement on Friday, expressing its concerns about patients ordering drugs directly from their manufacturer and the approach of “primarily oriented around the use of telehealth services to prescribe a drugmaker’s products.”


Sales

  • Brant Community Healthcare System signs up as the first Canadian user of Meditech Expanse as a cloud-based subscription.

People

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Kidney testing app vendor Health.io hires Geoff Martin, MBA (Olive AI) as CEO. He takes over from founder and former CEO Yonatan Adiri, who will move to president.


Government and Politics

A home health agency pays $10 million to settle Department of Justice charges that it fraudulently billed the federal government for in-home nursing care that actually involved telephone calls. The cost was billed to a Department of Energy compensation program for people and their survivors who were exposed to radiation from the government’s building of nuclear weapons in the 1940s and 1950s, including employees and nearby residents, that caused long-undetected cancers and birth defects. The program, which was created in 2001, has paid out $23 billion to 137,000 people.

NHS England is reviewing the planned use of social media influencers by Palantir, to which it recently awarded a $415 million contract to develop and operate a national NHS data-sharing platform. The US company says it explored but didn’t actually launch a campaign with New Zealand-based digital agency Topham Guerin, which previously ran Conservative Party campaigns. Palantir’s contract prohibits using NHS’s name without approval. The company planned to pay for posting videos and tweets to correct what it thinks is misinformation about the project, with specific instructions to influencers to not mention Palantir by name or hashtag. The legal non-profit Good Law Project says Palantir is “possibly the dodgiest company ever to gain access to our medical records.”

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Online mental health provider Cerebral will pay $540,000 in refunds to New York patients in a settlement with the state’s attorney general, who says the company intentionally made it hard for patients to cancel the subscriptions and instructed its employees to submit fake positive reviews. The AG says the company told subscribers they could cancel via email, but required completion of a survey and then put the cancellation on a multi-day hold while sending them retention offers in hopes of changing their mind. The company also charged customers when it had no providers available to treat them.


Other

In England, a nurse’s hospital employer calls her in for emergency floor coverage, then writes her an $89 parking ticket because her car didn’t have a $50-per-month employee parking pass. She had applied for the sticker, but the hospital admits that it is backlogged on sending them and suggests that employees instead take public transportation.


Sponsor Updates

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  • Netsmart staff volunteer at the Cornerstones of Care gift gallery to help distribute and wrap gifts for children within the organization.
  • CereCore releases a new podcast, “Fostering a Culture of Innovation and Growth.”
  • Nym achieves excellent customer satisfaction scores for the second consecutive year.
  • Nordic releases a new podcast, “Designing for Health: Interview with Kevin Dufendach, MD and Andy Spooner, MD.”
  • The “That’s Derm Good!” podcast features RxLightning founder and CEO Julia Regan.
  • Symplr expands its golf sponsorship program with the addition of four-time PGA Tour winner Russell Henley.

Blog Posts


Contacts

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

News 1/5/24

January 4, 2024 News 2 Comments

Top News

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Oracle Health General Manager Travis Dalton will leave the company to join MultiPlan as president and CEO on March 1. Dalton was previously chief client and services officer of Cerner, as well as president of its government business, when Oracle acquired the company for $28 billion in June 2022.

MultiPlan offers payer cost management services that include analytics and revenue integrity.

MPLN shares have risen 26% in the past 12 months, slightly outperforming the S&P 500 and valuing the company at $850 million. They dropped 7% Thursday in a flat market following the announcement that Dalton will replace Dale White, who will move to executive board chair.

Dalton is the fifth of Cerner’s 10-member executive team to leave the company following its acquisition.

SEC filings indicate that Dalton will be paid a signing bonus of $500,000, a starting annual salary of $825,000, an annual bonus of $1 million, shares worth $8 million, and another $5 million in stock options.


Reader Comments

From Dowser: “Re: HIMSS and Informa. The takeover of the annual conference has been quiet. Wonder if the deal didn’t pan out.” HIMSS24 isn’t listed on the events page of Informa Markets and a search for HIMSS on Informa’s website turns up nothing. However, online conference materials now reference Informa, including headers and footers on the conference home page and an Informa copyright notice. The organizations were maddeningly vague about their business arrangement, with HIMSS calling it a partnership, while Informa characterized it as an acquisition. Still, it’s none of my business since my loyalty to HIMSS as a long-time member, chapter officer, and conference attendee has waned with its new leadership, to the point I rarely give the organization a thought. The boat show will likely improve with the addition of Informa and the subtraction of me.


Webinars

January 19 (Friday) 1 ET. “Unlocking Reliable Clinical Data: Real-World Success Stories.” Sponsor: DrFirst. Presenters: Alistair Erskine, MD, MBA, CIO/CDO, Emory Healthcare; Jason Hill, MD, MMM, associate CMIO, Ochsner Health; Colin Banas, MD, MHA, chief medical officer, DrFirst. Health system leaders will describe how they are empowering clinicians with reliable patient data while minimizing workflow friction within Epic. They will offer real-world experience and tips on how to deliver the best possible medication history data to clinicians at the point of care, use clinical-grade AI to infer and normalize prescription instructions in Epic, and encourage patient adherence to medication therapies for optimal outcomes.

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


Acquisitions, Funding, Business, and Stock

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Drug maker Lilly launches LillyDirect, which will offer home delivery of its drugs for obesity, migraine, and diabetes directly to patients via the Truepill pharmacy service. The service will offer a provider search tool and access to independent telehealth providers. The website indicates that Lilly will offer cash discounts on high-price drugs to patients whose insurance doesn’t cover them, such as weight loss drug Zepbound for $550 per month, about half its list price. The telehealth providers are 9amHealth (diabetes), Cove (migraine), and FORM (obesity). The interesting aspect is that Lilly is eliminating unrelated middlemen, such as pharmacies and pharmacy benefit managers, by creating its own package of independent virtual providers and a pharmacy and consolidating its patient discount programs under its own roof.

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Mercy completes its acquisition of SoutheastHealth (MO), whose CEO says the hospital needed help because of a big jump in spending on outside labor, the loss of several providers in money-making services, and the cost of upgrading its EHR. The hospital will replace Cerner with Epic.

Walgreens announces Q1 results: revenue up 10%, EPS –$0.08 versus –$4.31, beating Wall Street expectations for both. The company will cut its dividend by nearly 50% to increase cash flow.

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Newly formed Arbital Health, which offers technology and third-party adjudicator services to assess whether value-based care outcomes were received, acquires Santa Barbara Actuaries and completes a $10 million Series A funding round. The company also offers value assessments to vendors of healthcare point solutions.

Cigna is reportedly negotiating to sell its Medicare Advantage business to Health Care Service Corp, which operates BCBS plans in five states. for up to $4 billion. The move follows Cigna’s failed attempt to acquire Medicare Advantage insurer Humana less than four weeks ago.

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At-home remote diagnostics provider Nanowear receives FDA 510(k) clearance for SimpleSense-BP, a non-invasive, cuffless blood pressure monitor. SimpleSense is an AI-enabled wearable that captures 85 data points to monitor heart rate and sounds, respiration rate, lung volume, and physical activity.


People

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Patric Cua (HSG Partners) joins Glytec as president and CEO.

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Best Buy Health hires Benjamin Zaniello, MD, MPH (PointClickCare) as chief medical officer.

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Wisconsin Statewide Health Information Network promotes Steven Rottmann, Jr. to CEO.


Announcements and Implementations

DirectTrust publishes updated criteria for 19 of its accreditation programs.


Government and Politics

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National Coordinator Micky Tripathi, PhD, MPP explores the need for a FHIR API to allow patients to electronically request their insurer’s notes about denied claims.


Privacy and Security

23andMe blames its users for a breach of its systems that exposed the genetic and ancestry data of 6.9 million people. The company says that a hacker’s brute force password attack gave them access to 14,000 user accounts, but the breach expanded because users had activated the DNA Relatives feature that allows 23andMe users to share data with others to whom they appear to be related. The company also says the breach wasn’t its fault because users didn’t change their passwords after they were exposed in security incidents involving other sites.


Other

In the UK, the local paper questions why Princess Alexandra Hospital spent $75,000 to send employees to the Oracle Health Conference in Las Vegas. CIO Phil Holland says other NHS also attended using funding from NHS England’s digital strategy program. The hospital is implementing Oracle Health Millennium.


Sponsor Updates

  • Optimum Healthcare IT names Matt Divenere (Optum) director of content development.
  • Healthwise employees collect toys for 64 children through the Boys & Girls Club of Ada County in Idaho.
  • Healthcare IT Leaders releases a new Leader to Leader Podcast, “Innovation Through Simplification: Minimizing IT Complexity to Drive Results.”
  • Gartner recognizes InterSystems as a Challenger in its Magic Quadrant for cloud database management systems.
  • KONZA National Network reports that 333 KONZA-powered sites have earned and/or maintained validated data stream designation in NCQA’s Data Aggregator Validation program.
  • Meditech staff have contributed gifts to 35 local families over the holiday season through its Adopt-A-Family initiative.

Blog Posts


Contacts

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

News 1/3/24

January 2, 2024 News 4 Comments

Top News

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Veradigm acquires Koha Health, a full-service revenue cycle management company for orthopedic practices and ambulatory surgery centers.

Koha Health, which was known until mid-2022 as Physicians Resources Ltd, is a 40-year-old family business with headquarters in Merrimack, NH.


Reader Comments

From Ipanema: “Re: AI-powered chatbots and online tools. Will organizations gain strategic advantage by not using them?” They might. Oligopolies such as utility providers, banks, streamers, and Amazon can get away with barricading their knowledgeable and helpful employees behind walls of technology and offshore workers that add little except to prevent their “valued customer” from receiving valued service. Chasing scale unfortunately means removing humans from the process wherever possible, no different than companies of yore that programmed their phone trees to ignore desperate customers who pressed “0” or “#” trying to get out of endless loops and poorly designed options. The high-cost, low-service, tech-heavy business model doesn’t always work when you have competitors and low switching costs. I can call my direct primary care doctor directly on her cell, but otherwise I find the typical medical practice’s telephone and online options frustrating because they are often designed by the same cranky front desk people who post scolding signs about turning off cell phones, filling out forms, and not leaning on their precious glass.

From Todd Castor: “Re: podcasts. It has become so common among self appointed experts that they’re now interviewing each other.” I’ve seen a few recent examples among podcast pontificators who must believe that they’re smarter than the people doing actual frontlines work.


HIStalk Announcements and Requests

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Half of poll respondents received a holiday gift from their employer, although 40% of those say that it wasn’t memorable.

New poll to your right or here: Which technology will have the greatest impact on health outcomes and costs over the next five years?

You can support HIStalk by:

  • Signing up for email updates when I post something new.
  • Connecting and following on LinkedIn and joining Dann’s HIStalk Fan Club.
  • Mentioning HIStalk to your colleagues and vendors.
  • Sharing news, rumors, and intriguing insights.

Webinars

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


Acquisitions, Funding, Business, and Stock

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Cano Health receives a second de-listing warning from the NYSE, this time pertaining to its inability to sustain a $50 million total market capitalization over a 30-day trading period. The primary care company is in the midst of an overhaul, with plans to sell certain assets and lay off employees in an effort to cut costs by $290 million over the next 12 months.

CIOs say that they will control IT costs in 2024 to find room in flat budgets to work on new technologies such as generative AI. Tactics include reducing cloud usage, consolidating vendors, and negotiating discounts. Projects with high ROI will take priority, and global companies will cut back in their investment in startups unless they are likely to provide immediate benefit.


Sales

  • North Memorial Health (MN) will replace 14 business systems with Oracle’s Fusion Cloud Applications Suite.
  • RCM vendor Advantum Health selects AI-powered medical coding and billing software from Aidéo Technologies.
  • The VA awards Iron Bow Technologies a $1.4 billion contract for connected care technologies and support.

People

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Verily Chief Medical Officer and VP of product development Amy Abernethy, MD, PhD says in a LinkedIn post that she will leave the company to start a non-profit that will focus on the collection of health data.

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James Crawford, PhD, MA (AMI Expeditionary Healthcare) joins Nordic Consulting as president of Nordic Federal.

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Propeller Health co-founder Greg Tracy, MS (ResMed) joins Wondr Health as CTO.

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David Stewart (Gerent) joins Divurgent as VP of client services.


Announcements and Implementations

UCHealth’s Sterling Ranch Medical Center (CO) implements Epic.

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Trinity Health Grand Rapids (MI) launches virtual nursing care at its Lacks Cancer Center using technology from Teladoc Health. The health system has implemented Virtual Connected Care in 19 hospitals since launching the program in 2022.

An Artera Health survey finds that nearly half of patients experience communications issues with their providers, leading to unpaid bills, the inability to schedule appointments, and the willingness of 60% of them to switch providers because of poor communication. Eighty percent want to be able to initiate text-based conversations with providers on any topic, not just to reply to text messages with “Y” or “N.


Privacy and Security

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Anna Jaques Hospital, part of Beth Israel Lahey Health (MA), recovers from a Christmas Day cyberattack that forced it to divert ambulances and revert to downtime procedures.

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Liberty Hospital continues to rely on paper charts as it works to get IT systems up and running after a December 19 cyberattack.


Other

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BayCare SVP/CIO William Walders, MHA – whose healthcare experience includes a 22-year stint in the US Navy through 2018 – posts an insightful comment on LinkedIn:

The soundbite is that the old CIO role is dead. The role of SOLELY keeping the network secure and resilient, applications available and up to date, and support functions consumer centric is dead. However, the responsibility persists and is understood by your peers to be the bulk of the CIO’s role. While it varies by organization, the “new role of the CIO” is now, more than ever, a strategic business leader aiding in decision making on ALL healthcare decisions, many of which aren’t glamorous, innovative, or require digital evangelism. Looking back at 2023, my year was 70% being brilliant at the IT basics, 20% healthcare strategist and thought partner with the C-suite on non-IT specific topics, and 10% innovative.

A USA Today opinion piece by Harvard’s Marie Plaisime, PhD, MPH describes her disappointment at receiving an Apple Watch for Christmas that, like many medical wearables, don’t work for people whose skin is dark. The author notes that soap dispensers, pulse oximeters, and forehead thermometers can’t register darker skin tones. She also bristles that the Apple Watch leaves the consumer to figure out how to use blood oxygen readings since the company has not earned FDA clearance to market the Watch for medical uses.

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Mayo Clinic’s new hospital in La Crosse, WI, which will open in September, will feature wireless remote patient monitoring technology across all of its 94 beds. Patient rooms will also feature infotainment systems that offer access to medical records and virtual consultations.


Sponsor Updates

  • Skin Solutions Dermatology (TN) reports a significant increase in monthly online appointments after implementing the Healow Open Access online appointment booking solution from EClinicalWorks.
  • Wolters Kluwer Health predicts the top four impact-drivers for generative AI in 2024.
  • Amenities Health announces that its digital front door platform is now available in the Panda Health Marketplace.
  • CereCore releases a new podcast, “Fostering a Culture of Innovation and Growth.”
  • Arrive Health sponsors holiday gifts for residents of one of WellPower’s resident treatment locations.
  • Clearwater releases a new podcast, “Navigating Information Blocking Regulations in Healthcare Transactions.”

Blog Posts


Contacts

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

News 12/29/23

December 28, 2023 News 1 Comment

Top News

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Apple restarts sales of the advanced models of its Watch Thursday after an appeals court temporarily pauses an import ban. The halt was related to Apple’s ongoing pulse oximetry patent dispute with Masimo and AliveCor.

Apple also says that it has submitted design changes to the Watch to the US International Trade Commission that could make the ban unnecessary.


Reader Comments

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From Upshot: “Re: Harris / Constellation acquisition of Medhost. What is Constellation’s business model and what health technology company will be next?” Company founder and billionaire Mark Leonard is like Warren Buffett, with a simple, steady, and ingenious formula that has worked consistently. Constellation has acquired several hundred companies and has sold only one (Leonard still kicks himself for that one exception). A $10,000 investment in CNSWF five years ago would be worth $40,000 today as the company’s market cap has reached $53 billion. Leonard – who is 6’5” tall and sports a ZZ Top-like gray beard — is either “intensely private” or “bizarrely reclusive,” depending on who you ask. He took a rare step into the public eye with a podcast interview in 2020 that I may transcribe and post here for posterity. The company’s acquisition strategy is based on these ideas:

  • Focus on companies that sell mission-critical software to a vertical market whose customers will keep paying recurring fees to avoid replacing the incumbent software. These are often in the public sector.
  • Choose from potential acquisitions using the First Chicago Method of valuation: set scenarios for best, worst, and average cases; set a valuation for each scenario using the net present value of future cash flows; and weight the likelihood of each scenario to arrive at a hurdle number.
  • Acquire companies that are profitable and that have consistent earnings and growth.
  • Acquire 100% of the company rather than a partial share.
  • Do not use hostile takeovers or unsolicited bids. Companies will often volunteer to be considered for acquisition for a variety of reasons.
  • Look for acquisitions that have a lower growth rate and thus command a modest price, reportedly 1 to 1.5 times revenue.
  • Leave the acquired company’s management and employees in place and let them run the business.
  • Improve the acquired company through coaching, sharing best practices with Constellation’s other companies, and management training and mentoring.
  • Use the cash flow to fund more acquisitions instead of trying to fuel growth.
  • Minimize corporate involvement except for data analysis.
  • Incent business unit leaders based on return on invested capital and organic revenue growth and treat them as owners.

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Aledade CEO and former National Coordinator Farzad Mostashari, MD, MSc observes that Constellation had a rare (and large) misfire in paying $700 million in 2022 for the hospital and large practice business of Allscripts that it renamed Altera, only to have its biggest customer Northwell announce soon afterward that it was moving to Epic. Constellation highlighted Altera’s dramatic revenue slide in its most recent quarterly report. Mostashari adds that healthcare software is a good fit for Constellation and the total addressable market is huge – he notes that the Allscripts business that they didn’t buy, which is ambulatory and Veradigm, is worth just $1.1 billion but will generate $100 million of free cash flow this year – but EHRs require more product development to keep up with regulatory changes.

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He also added an insightful HIStalk comment from a reader and Altera customer who expressed disbelief at another reader’s report that Altera declined to renew their health system’s maintenance contract (click the image to enlarge).


Webinars

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


Acquisitions, Funding, Business, and Stock

Stat reports that UnitedHealth Group has denied rehabilitation care for Medicare Advantage patients who live in nursing homes or have cognitive impairment by changing its guidelines for clinicians.

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Walgreens needs to rebuild its IT department to support the company’s business plan, The Wall Street Journal reports, following CIO and IT management turnover, cutbacks on the use of contractors, low employee morale, and the company’s plan to make big cuts in operating and capital expense. Walgreens is dealing with legacy systems and technologies used by its acquired companies even as it plans to implement AI and supply chain technology.

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Best Buy Health recaps its 2023 accomplishments that include partnering with providers, enhancing its cell phones and alerts for seniors, and launching its sale of continuous glucose monitoring systems.

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Sales of over-the-counter hearing aids are lower than expected, given that one in five US adults struggle with hearing and those problems often precede cognitive decline. Possible reasons for the lagging sales include physician inattention to adult hearing issues, lack of insurance coverage, and the stigma of wearing hearing aids. Experts also note that unlike vision problems, people who have hearing deficiencies often aren’t aware of their diminished hearing. FDA approved direct-to-consumer sales of hearing aids last year for mild to moderate hearing loss. Johns Hopkins researchers have developed a standard at-home hearing test for consumers that may spur awareness.


Sales

  • HSS Sports Medicine Institute will implement Kemtai’s computer vision exercise guidance technology for home training of athletes to avoid ACL injuries.

Announcements and Implementations

Preventable, serious medical complications increased significantly among Medicare patients after hospitals were acquired by private equity firms, a JAMA-published study finds. Staffing cutbacks, which have been anecdotally blamed for clinical quality issues, were not reviewed in the study.


Government and Politics

A chiropractic clinic wins a lawsuit that it brought against McKesson for faxing unsolicited ads for medical billing software to the practice. The court rejected McKesson’s defense that the clinic consented to receiving ads by listing its fax number on licensing forms, ruling that providing a fax number doesn’t imply consent to receive ads. The court denied class action status, however, citing a precedent that sending faxes through an online fax service falls outside the Telephone Consumer Protection Act.


Privacy and Security

Corewell Health (MI) reports its second patient data breach in a month to patients, both involving its vendors (HealthEC and Welltok).

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Poland’s data protection agency fines the health ministry for disclosing a doctor’s medical information on social media. The former health minister looked up the records of a doctor who had publicly criticized new regulations that limit doctors to issuing 300 electronic prescriptions each day, then posted on social media that the doctor had prescribed psychotropic drugs for himself. That health minister resigned in August after his actions came to light.


Contacts

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

Morning Headlines 12/27/23

December 26, 2023 News 2 Comments

Constellation Software’s Harris Operating Group Acquires MEDHOST, Inc.

Medhost will be operated as a standalone business within Constellation’s Harris software group.

Mercy medical record transition heats up in bankruptcy court

Mercy Iowa City and Harris-owned Altera Digital Health argue the terms of continued EHR support as the hospital awaits its acquisition by University of Iowa.

Apple files appeal after Biden administration allows U.S. ban on watch imports

Apple stops selling its smart watches that offer pulse oximetry after losing a patent infringement dispute with medical device maker Masimo.

Why do doctors still use pagers?

NPR talks to doctors whose project to replace ED pagers with smart devices failed.

News 12/27/23

December 26, 2023 News 5 Comments

Top News

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Constellation Software acquires EHR provider Medhost. Terms were not disclosed.

Medhost will be operated as a standalone business under Constellation’s Harris software group, where it joins Altera Digital Health, Amazing Charts, QuadraMed, Iatric Systems, Picis, and several other acquired health IT companies. 


Reader Comments

From Oracular Degeneration: “Re: Oracle Health. The former Cerner was blamed for missing revenue expectations. Expect license audits to follow.” Oracle is somewhat famous for turning innocent-sounding “license audits” into a sales channel, where the company collects customer usage information (voluntarily or otherwise) in coordination with a sales rep and then demands that the customer buy more licenses to avoid legal action. Palisade Compliance describes how the city of Denver was rushed into paying Oracle $4 million under an Oracle program that Palisade calls ABC audits (audit, bargain, cloud) in which the company forced the city to buy cloud services to avoid legal actions. NASA recently bought $15 million in unneeded Oracle software in fear that the company would find something amiss. Former clients of Cerner may be running under old contracts or those that weren’t prescriptive about M&A, hardware upgrades, virtualization, or moving services to the cloud, so it might be prudent – especially for any contracts that involve processor-based metrics – to assess your situation before Oracle does.

From Adapt or Die: “Re: changes at my primary care practice. They will now require holding a credit card on file, charge a $15 annual cash fee for services that insurance does not cover, and limit annual physicals to health screenings and risk management with no review of specific medical issues.” These changes seem entirely reasonable, although I would be nervous about leaving a credit card number on file given the unpredictable nature of the amounts and timing of physician billing. This practice says that the patient usually receives the EOB first and has time to resolve problems with their insurer. When the practice’s business office receives their copy of the EOB, the patient’s balance will be billed via InstaMed. Leaving a credit card on file is dangerous for the many or most Americans who can’t afford to pay unexpected (or even expected) medical bills, but patients who can’t afford to pay their legitimate healthcare expenses aren’t the practice’s problem. This state of affairs must be puzzling to the rest of the developed world that can’t understand how we allow every profitable aspect of healthcare to be milked financially by publicly traded companies, zillion-dollar health systems, and private equity firms. The status quo remains in place only because we peasants aren’t all sick at once and thus haven’t charged the healthcare castle carrying torches.

From VTViper: “Re: ModMed. Huge layoff last week. The entire podiatry team was let go.” Unverified.


HIStalk Announcements and Requests

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Only 10% of poll respondents expect Oracle Health to be the owner of an improved former Cerner business in five years, with more than half expecting the company to sell or close most of it. Commenters note that Oracle will milk the business solely to keep VA/DoD taxpayer dollars flowing and ponder why David Feinberg is still pocketing millions with few signs of serious job responsibilities.

New poll to your right or here: Did you receive a holiday gift from your employer? My theory is that big-employer gifts are rarely more than a check-the-box effort (company-branded merchandise, a low-value gift card, or a box of candy), although individual bosses may go above and beyond to recognize their employees more personally. My experience is almost entirely within health systems, where the number and diversity of employees ensured low-effort corporate swag like a mug or tote bag. I have mixed feelings about the alternative of department pizza parties, which are tacky on the surface but often slightly fun for those whose schedule and location allows them to attend.


Webinars

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


Acquisitions, Funding, Business, and Stock

Harris Healthcare-operated Altera Digital Health petitions the bankruptcy court of Mercy Iowa City over the hospital’s planned transition to a new EHR upon completion of its acquisition by University of Iowa. The hospital, which partly blames the former Allscripts software for its poor financial condition as its AR jumped 40% after implementation, told Altera that it will be cancelling its agreement but requires access to company support through early 2025. Altera wants the court to either force the hospital to honor its existing agreement that runs through 2031 or declare it void. The company says the $8 million “cure amount” of the existing contract is insufficient and wants $12 million plus damages that are accruing at $207,000 per week.

Apple stops selling its Series 9 and Ultra 2 smart watches due a US International Trade Commission decision that the Watch’s pulse oximetry technology infringes on patents held by medical device maker Masimo. Apple has filed an appeal.


People

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Baylor Scott & White Health promotes Nathan Winn, MPA to VP of IT.


Announcements and Implementations

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NPR addresses the “why do doctors still use pagers” question, with these observations from doctors who led a failed hospital project to replace them in the ED:

  • Pagers, as a 1980s relic from the Sir Mix-a-Lot days that even drug dealers have abandoned, should be easy to displace. Doctors don’t like receiving pages that contain only a phone number with no hint as to who they’re calling or what that person wants. Pages also can’t be verified as received. On-call residents are handed a pile of team-specific pagers for their “Rambo belt” and need to track down which one is beeping.
  • However, pagers are “the cockroaches of communication” because they are cheap, nearly impossible to damage, run forever on a single AA battery, and are more reliable with fewer dead spots since they don’t use cellular networks.
  • Doctors worry that patients will think they are screwing around if they look at their phones during a visit to read a message, but with a pager, “they know you’re doing doctor work.”
  • Smart apps make communication among doctors too easy, where the sender doesn’t worry about bothering a colleague or phrasing a request succinctly
  • Pagers provide control, or at least the illusion of it, as even junior residents can decide when and how to respond without the sender knowing if they have seen the message.
  • A management professor says that technology isn’t just about the tools and instead is a project that involves RHIP (pronounced “rip”) – risk, habit, identity, and power. Doctors were being asked to change their routines, the change made them feel differently about their jobs, and it shifted power.
  • The result was that the pager replacement system failed to reduce patient time in the ED, partly because the existing system was already efficient and also because many doctors had stopped using the new devices.

Other

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A small, single-hospital study finds that inpatient satisfaction scores increased if their room’s guest chair was placed near the patient’s bed to encourage doctors to sit while visiting, which the authors call a “chair nudge.”


Contacts

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