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Morning Headlines 2/13/24

February 12, 2024 Headlines No Comments

HHS Expands TEFCA by Adding Two Additional QHINs

ONC and The Sequoia Project designate Kno2 and CommonWell Health Alliance as Qualified Health Information Networks.

Air Force Confirms Medical Disqualifications Doubled after New Med-Records System Implemented

Air Force officials confirm that the switch to MHS Genesis has lengthened the amount of time it takes to medically clear recruits due to an increase in initial, potentially disqualifying conditions that require further investigation.

Headlight Launches With $18 Million in Funding and the Addition of Amazon Pharmacy Executives to Support Their Mission of Simplifying Patients’ Mental Health Journey

Hybrid mental health practice SokyaHealth rebrands to Headlight, announces $18 million in funding, and names former PillPack executive Geoff Swindle CEO.

Curbside Consult with Dr. Jayne 2/12/24

February 12, 2024 Dr. Jayne 2 Comments

Several of good friends from medical school hold significant physician leadership roles. I always enjoy catching up with them and hearing what is going on at their hospitals, as well as trading ideas for solving the different kinds of challenges our organizations are facing. Sometimes one of us has already been through an issue and there’s no sense in reinventing the proverbial wheel when you don’t have to.

Although my colleagues are knowledgeable about their own departments as well as those that they have to work with closely, they don’t always have the broad view of hospital operations that I have as an informatics leader. I think that when working with large enterprise EHR implementations, clinical informatics leaders are just conditioned to make sure that we are thinking about every part of the hospital as well as systems that aren’t even under our roofs, such as emergency medical services, transfer infrastructure, and more.

Regardless of region or state, everyone is facing hospital overcrowding. When there aren’t enough inpatient beds available, patients start backing up into the emergency department. The root cause of the inpatient bed shortage is multifactorial. Sometimes physical beds are lacking, and sometimes there are actual beds open but the shortage is one of staffed beds. There just aren’t enough personnel to keep a unit open.

Although many disciplines are in short supply, including respiratory therapy, the major issue I see in my region is still a nursing shortage. Hospitals in our area are still playing games with nurse compensation and have instituted staffing policies that negatively impact nurses and their families. Of my friends who are nurses, all have left hospital care except one, and I guarantee if she worked on a medical/surgical unit, she would leave, too.

Unless people are actually impacted by these shortages, they don’t tend to get engaged around the policy work that is needed to solve the problems. I was excited to see NBC News bring some of these issues to light this week, as it reported on the potential end of funding for Hospital at Home programs at the end of this year and how that end might worsen already tragic emergency department (ED) overcrowding.

CMS created the program, which is officially called Acute Hospital Care at Home, in 2020. The program allows hospitals to deliver high-acuity care to patients in their homes, where they receive visits from community paramedics and are connected via technologies such as video visits and home-based monitoring systems. The programs can help boost ED throughput by admitting patients back to their homes rather than potentially having to board them in the ED while they wait for a physical hospital bed.

Although more than 130 health systems have been approved to participate, it’s difficult to understand how many are truly bought in or what level of resources are being dedicated to program initiatives. Even if they are participating, hospitals may be left dangling at the end of the year unless Congress votes to extend funding for the program. Although some private payers are participating, CMS still provides the majority of funding for programs.

Even for those organizations that have embraced Hospital at Home programs, their impact is incremental. Atrium Health, for example, is treating 60 patients per day in its program in North Carolina and hopes to ramp that up to 100 patients per day by the end of 2024, which is a fraction of its total count of inpatients. If Hospital at Home programs are sunset, patients who might have been referred to them are instead going to need regular inpatient beds, which will further worsen the situation in systems where those programs had been successfully making a difference.

Policymakers need to look at other causes of ED overcrowding. In addition to the shortage of staffed beds on medical/surgical units, there are fewer beds available in nursing homes, psychiatric units, and rehabilitation facilities. Mental health services are in short supply everywhere, with families sometimes bringing loved ones to the emergency department because they feel they have nowhere else to turn. Telehealth solutions can help mitigate this to some degree, identifying patients who might qualify for outpatient management or who need help navigating the system, such as obtaining medication refills or finding a new provider for ongoing care. Progressive states are looking at the upstream causes of the mental health crisis and are allocating money to community programs, but other states seem to be just looking the other way.

The report also mentioned other pitfalls of our state-by-state patchwork of healthcare solutions. It looked at data from Massachusetts hospitals, including data on patients who are boarded in the emergency department while they wait for beds in the hospital. It profiled the venerable Massachusetts General Hospital, which has been boarding at least 45 patients at a time for more than a year, and in January of this year hit a count of 103 boarders with 220 people across the state in the same situation. The hospital considers this to be a “capacity disaster” and has asked the state to approve additional beds to help the situation.

They have also instituted a Hospital at Home program and have created a Discharge Lounge to help speed patient departures from the hospital building. Patients can wait there for their caregivers to pick them up, rather than remaining in a standard hospital room. That intervention helps 125 patients per month leave more than 60 minutes earlier, which will add up over time and as the program is expanded. The hospital is also providing transportation services to help patients leave when they don’t have reliable transportation.

Other solutions that can help make beds more available include virtual nursing care, where offsite nurses can work with patients and families to deliver patient education and discharge teaching, freeing up bedside nurses to deliver care that must be rendered by an in-person nurse. Virtual nursing programs in my community are keeping nurses that have been placed on light-duty restrictions active in patient care, rather than sidelining them. The technologies can also be used as a “phone-a-friend” solution for early career nurses to bring in a second set of nursing eyes to evaluate a particular patient. Having been a newly minted intern, I appreciate the idea of using technology to consult dedicated virtual resources rather than having to interrupt colleagues who are already knee-deep in patient care of their own.

The NBC News report goes on to note that Massachusetts is “unique” in the way that it keeps statistics on emergency department boarding, and that many states are lacking high-quality data on the problem. I know my own state doesn’t do a good job of tracking it, let alone communicating it, which means that citizens in our communities have no idea there’s as big of a problem as there actually is. The majority of my neighbors and friends in the community think that because COVID is “over” and there aren’t daily stories on the news about how bad things are at the hospitals, that everything is fine. That is, until a loved one sits for 17 hours in the waiting room before they see a physician. But it’s unclear if those experiences translate to actions, such as lobbying one’s legislators.

Demographics are shifting in the US, with increasing numbers of elderly patients and more of us who are living with chronic conditions. We are not spending enough money on preventive care, health promotion, or disease prevention, so the problem is likely to get worse before it gets better. Let’s hope that stories like this help to raise awareness and generate change so that we don’t continue in the downward spiral in which many of us feel trapped.

Does your organization support Hospital at Home activities, and how are they going? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 2/12/24

February 11, 2024 Headlines No Comments

Staggering Rise in Medicare Bills Suggests Medicare Scam

The National Association of Accountable Care Organizations analyzes Medicare’s claims database to alert the federal government that 450,000 of its beneficiaries were billed for urinary catheters in 2023 versus the usual 50,000 in previous years, running up $2 billion in suspicious charges.

Virgin Pulse and HealthComp Introduce Combined Company as Personify Health

Virgin Pulse and HealthComp, which merged in November 2023, name the $3 billion business Personify Health.

AI cannot be used to deny health care coverage, feds clarify to insurers

CMS tells Medicare Advantage insurers that they can use AI and algorithms to assist them in making coverage determinations, but they must make sure that the tools use complete information and they can’t use technology alone to deny hospital admission or downgrade to observation stay.

Monday Morning Update 2/12/24

February 11, 2024 News 9 Comments

Top News

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The National Association of Accountable Care Organizations analyzes Medicare’s claims database to alert the federal government that 450,000 of its beneficiaries were billed for urinary catheters in 2023 versus the usual 50,000 in previous years, running up  $2 billion in suspicious charges.

Pretty in Pink Boutique — whose Medicare registration is for a house address in El Paso, TX and whose phone rings to an auto body shop — billed Medicare for at least $267 million in just over a year for catheters.

Patients and doctors who reported suspicious activity to CMS say they never got a response. Dozens of NYT commenters said the same, that the CMS person either expressed resignation with the status quo or lack of motivation to add to their workload.


Reader Comments

From Jerry Aldini: “Re: Oracle Health. Interesting comments on the Cerner Reddit.” Examples, all unverified:

  • “Oracle thought Cerner was worth buying for Larry’s little healthcare data hobby, but once everything is converted to OCI, nobody would ever want to buy what Cerner was ever again. So when Larry is no more or gets bored, it’s the end of the story.”
  • [On the company’s pledge to rewrite Millennium using AI] From everyone I’ve talked with, it is vaporware, and even then demos went to crap pretty quickly. I’m just riding this out until all clients abandon ship.”
  • “Maybe Congress would like to know more about Larry’s new wonderful AI software engineer and how it means that they can maintain a multi-billion-dollar system for America’s service people and veterans with nothing even remotely resembling what would be considered a normal software engineering company. Like, why bury the lede, Larry? You’ve successfully removed the need for high-cost, hard-to-find employees to maintain software. This is a coup for the entire tech industry. Forget the EMR, let’s hear about the AI, that’s where the money is.”

HIStalk Announcements and Requests

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Most poll respondents think that the former Cerner business has become less competitive since Oracle acquired it.

New poll to your right or here: Do you own shares or equity in a health IT-related company? You can use the poll’s comment function to describe times when you made or lost big money from a health IT investment.

Help me out by signing up for spam-free updates and connecting on LinkedIn.

I am an India-phile, fascinated with the culture, food, and business and technology advances of the world’s largest democracy. I also enjoy regional English usage. I collected these examples from HIStalk-related emails with people from India that featured words and terms that are accurate, just not commonly used here:

  • Prepone – the opposite of postpone, to describe moving an event earlier.
  • Revert back – not a redundant expression, but rather to ask for a reply, as in “kindly revert back.”
  • Cent percent – 100%.
  • Full stop – Indians were using this term long before trendy Americans embraced it in referring to the period at the end of a sentence, or to some, the more emphatic break at the end of a paragraph that signals a new train of thought.
  • Mention not – this is a great alternative to the wishy washy “you’re welcome.” I might start using this with hopes of displacing the dreaded “no problem,” although saying “mention not” after the person has already “mentioned” doesn’t quite fit.

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Welcome to new HIStalk Platinum Sponsor TruBridge. The Mobile, AL-based company connects providers, patients, and communities with innovative solutions to support financial and clinical solutions, creating real value in healthcare delivery. By offering technology-first solutions that address diverse communities’ needs, it promotes equitable access to quality care and foster positive outcomes. Its industry-leading HFMA Peer Reviewed RCM suite provides visibility that enhances productivity and supports the financial health of organizations across care settings. It champions end-to-end, data-driven patient journeys that support value-based care and improve outcomes and patient satisfaction. It supports efficient patient care with EHR products that integrate data between care settings. TruBridge clears the way for care. Thanks to TruBridge for supporting HIStalk.


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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Omnicell announces Q4 results: revenue down 13%, EPS –$0.32 versus –$0.64, beating Wall Street expectations for both. OMCL shares have lost 49% in the past 12 months versus the S&P 500’s 26% gain, valuing the company at $1.4 billion. The CFO said in the earnings call that customers are cautious about implementing new workflows because of IT and nursing staff shortages, while the CEO said that big health systems aren’t ready to implement innovation until they develop strategies for dispensing medication across their broad footprints.

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Virgin Pulse and HealthComp, which merged in November 2023, name the $3 billion business Personify Health.

Marathon Health, which bought Cerner’s employer occupational health clinics in August 2023, acquires Everside Health, expanding its services to 680 health centers in 41 states.

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Aptar Digital Health, a division of Aptar Pharma, will take over the digital health solutions of Biogen, which address neurological and rare diseases.


Sales

  • England’s Torbay and South Devon NHS Foundation Trusts chooses Epic.

People

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University of Tennessee Medical Center names Lynnette Clinton, MBA (BayCare) as SVP/CIO.


Announcements and Implementations

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Amenities Health launches plug-and-play provider search and scheduling for a health system’s public-facing website, extending its mobile app experience.

AdventHealth brings the last five of its 48 hospitals live on Epic, completing its conversion from Cerner. AdventHealth announced that it would implement Epic in early 2020, displacing the Cerner system that it had installed in 2002.

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Sparked, Australia’s national FHIR accelerator, opens the draft of its Australian Core Data for Interoperability Release 1 for comments.


Government and Politics

CMS tells Medicare Advantage insurers that they can use AI and algorithms to assist them in making coverage determinations, but they must make sure that the tools use complete information and they can’t use technology alone to deny hospital admission or downgrade to observation stay. CMS also warns that MA insurers should make sure that their systems are free of bias.

A North Carolina health news site observes that Atrium Health wields its status as a “unit of local government” to get tax breaks, the power of eminent domain, and anti-trust immunity that allowed it to acquire 40 hospitals in four states, after which it merged with Advocate Aurora Health to form the country’s third-largest non-profit health system with $27 billion in revenue.


Other

In India, a review finds that 11 of 40 of Bangalore tele-ICUs in rural “spoke hospitals” are not functional due to lack of Internet connectivity, lost software copies, and clinician shortages.

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Medical malpractice physician Jeff Willis, MD, MHA notes that 28 states give full practice authority to nurse practitioners and another 10 are considering it. He says that while the NP lobby was smart to take advantage of the primary care crisis to expand practice, he ponders that it’s a broken healthcare system that created the need and that it raises malpractice issues. A commenter says that several states also allow advanced practice chiropractors to do physician-like work, while another says that NPs are important in rural areas because doctors won’t work there given low volumes that drive RVU-based compensation. A physician commenter says that the rural idea sounds nice, except a lot of the NPs chase the money that comes from running IV bars, Botox shops, and med spas in urban areas.


Sponsor Updates

  • Kellum Medical Group (TX) leverages the Sunoh.ai AI medical scribe as part of its EClinicalWorks EHR implementation.
  • Amenities adds online patient scheduling to its Digital Front Door Platform.
  • Availity achieves the CAQH Committee on Operating Rules for Information Exchange (CORE) Eligibility & Benefits, Claim Status, Payment & Remittance, Prior Authorization & Referrals, and Health Care Claims Operating Certification seals.
  • Health Data Movers joins CHIME as a member.
  • QGenda and Spok will exhibit at the AHA Rural Health Care Leadership Conference February 11-14 in Orlando.
  • Waystar will exhibit at Nymbl.Con 2024 February 14-16 in Scottsdale, AZ.

Blog Posts


Contacts

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

HIStalk Interviews Russ Richmond, MD, CEO, Laudio

February 9, 2024 Interviews No Comments

Russ Richmond, MD is co-founder and CEO of Laudio of Boston, MA.

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Tell me about yourself and the company.

I’m a lifelong entrepreneur. I’m also a physician, and through that and other activities, I’ve walked the halls of over 100 hospitals and I understand how they run. I have focused my life on building solutions software for hospitals.

I’m the founder and CEO of Laudio, which is an AI-enhanced platform for the frontline leaders or frontline managers in health systems. We support these frontline leaders with workflow that saves them time and drives improved employee retention and engagement, operational efficiency, and improved patient experience.

How much health system employee burnout and turnover can be tied to manager-level behavior rather than organization-wide policies like compensation?

Our best guess is that 60% to 70% of the employee’s engagement, which is the proximal metric for turnover, is influenced or driven by their direct reporting relationship with their manager. Health systems assume that it is always compensation related. I’m not saying that compensation isn’t a very important thing, but we know that frontline workers attach much more to their managers than they do to the overall organization. We know that by improving the bond between a frontline worker and their manager, we can greatly influence their propensity to stay engaged and employed at that organization.

People often say that they love the company, but can’t stand the boss.

People don’t quit jobs, they quit managers. Managers have a tremendous amount of influence on the mental wellbeing of their employees, and anyone who has had a bad boss knows that well.

But what we have learned inside health systems is that they have a special issue, which is that the frontline managers have very large spans of control. It’s not uncommon to see team sizes of 50, 70, or 100 direct reports into a manager. That really stretches the bandwidth of that manager to do traditional management.

The biggest lever is to increase the frequency of timely, relevant connections between the managers and their teams in a way that feels personalized, in a way that makes a big team feel smaller. That in and of itself can drive a tremendous improvement in engagement and retention. If a manager takes the time to have a one-on-one interaction with their team member every month, the likelihood of that team member quitting falls by over 40%. It’s just that the managers sometimes don’t have time to do that.

Beyond that, it’s the intuitive things, and a few counterintuitive things, that make a difference. First, managers showing that they care about the wellbeing of their employee when they do interact with them. How is their schedule? Have they worked too many shifts in a row? Are they forming relationships on the unit and inside their teams? Celebrating or recognizing good work done? These are the types of actions that managers can take that can make a real difference. 

Then somewhat counterintuitively, even when managers interact with team members on accountability-related issues — like corrective action with a worker who is always coming in late — that actually drives an increase in retention. Because all of a sudden, the frontline worker knows that someone is paying attention to them, that someone cares about whether they are there on time.

It can be a wide array of interactions, but the key is that they have to happen, happen regularly, and happen in a way that’s not a bulk email, not pro forma, but in a caring, personalized way.

What is the disconnect between what executives expect and what managers do?

Many executives don’t appreciate the challenge these frontline managers are up against. Huge spans of control, extending to the number of systems that they need to interact with and operate, the administrative burden that they face, and just getting their regular work done in terms of documentation, getting data into the right place, and setting the schedule. Because they are disconnected from that everyday reality, it’s harder for them to support and coach these frontline leaders. It’s harder for them to connect their agenda, which may be system-wide performance improvement, with the everyday actions of the frontline leader.

Laudio solves for that. It connects the overall system wide agenda — say, improving retention of full -time employees, reducing contract labor, or improving HCAHPS scores — with specific daily actions that frontline managers can take that and that fit into their workflow in an efficient way. That’s where we have focused our efforts on solving that problem.

How does a health system define its goals and then package up individual tasks that frontline managers should be doing?

We have live API integrations into the systems around these managers. That includes the HR information systems, like Oracle or Workday. That includes the time and attendance systems, like UKG. That even includes Epic, where we get patient geolocation information. The data aggregation is handled through our platform. 

Once we have the data in one place, it’s just a matter of working with the senior leaders in the health system around their priorities. Some of them have priorities, especially in today’s day and age, around reducing turnover or reducing incremental overtime. In that case, we are pushing those types of actions through Laudio. Some of them have priorities in saving their frontline leaders time, because they can see that they are overburdened. In that case, we are working with the frontline leaders on automating their work and creating more operational efficiency. Some of them have priorities in patient experience or quality, and in those cases, we are emphasizing those workflows.

Because we are a platform that surrounds the frontline leader, it’s just a matter of, from an organizational level, determining what to emphasize first and foremost. Then once we are seeing good results there, we can move on to the next area.

I’m still thinking about a hospital manager having 100 direct reports covering a 24-hour schedule. Is healthcare unusual in that regard?

Yes, it is unusual. I have not seen another industry like it. Normal executive span of control is between six to maybe 12 people. Even when you get to 20 people, which is a low span of control inside an acute care facility, you are way beyond that. 

I think it comes from the guild-based practice of medicine, where practitioners were meant to be individual contributors in an era that wasn’t as team-based and wasn’t as technically challenged. We live with it today, and it has become a more or less a permanent part of the economics of health systems. They have a hard time affording span-breakers and hiring more managers, because most health systems are working to reduce their labor expenses. It becomes what can we do for our managers to give them more capacity to take on these larger team sizes and to still drive the results that we need in the system.

I would assume that a lot of those folks were promoted into management because of their own job performance among peers rather than having managerial aspirations or talents.

That’s correct. Managers in health systems are almost never hired horizontally from other organizations outside of healthcare, and very rarely are they hired horizontally inside a facility or organization. What you see almost all the time is individual frontline workers getting promoted into being a frontline manager when their manager leaves, which we call a battlefield promotion.

In the context of a battlefield promotion, it’s difficult to ensure that that new manager has acquired all of the management best practices, skills, and training that will be needed to be good at that job. It’s a very different job than the one they had been doing. This is where we believe that software can at least be part of the solution, and that we can hardwire a lot of the management best practices through our system and also introduce best practices as they are discovered so that they can become immediately diffused to the managers versus waiting for them to go to get a master’s in healthcare administration or to take some type of a training program that that health system may offer.

Software has a tremendous advantage in supporting especially new managers, but all managers, to quickly acquire some of the skills they need to do a great job.

Do managers get adequate employee feedback from hallway conversations, or is a formal feedback mechanism required?

It is very difficult for a manager in a hospital to get accurate feedback, because they are managing a unit that is working 24×7 while working 40 or 50 hours of the week. They are not regularly interfacing with the entire employee base. When they are, it’s often in the context of putting out a fire. I put that in quotes, such as handling on a patient issue, a physician complaint, or a near-term operational priority like a staffing gap. 

Employee voice tools effectively gather feedback regularly and efficiently. They help managers understand their unit better by highlighting only the key issues that require action. This saves time and enables quick responses to important matters. It’s a great use of technology.

What are early warning indicators for burnout that an overburdened manager can detect so they can at least take action to retain an employee?

Health systems are collecting a lot of employee-specific data continuously all the time. The problem is sorting the signal from the noise, figuring out what is relevant, and then in the context of a busy unit, finding the right way to connect on it. 

Our software helps prioritize and identify the individuals who need the manager’s attention most, using AI and risk models. Then we connect the manager to the evidence-based best next action with that frontline employee. That can vary dramatically, depending on the core issue. It could be helping them iron out their schedule if they have an unusual working pattern where they are always on weekends or something undesirable. It could include helping them think about their promotional pathway and clinical ladder to give them a longer-term view in the system. It could be reviewing complimentary feedback from their patients and recognizing them for a job well done. It really depends on the situation and the individual worker. 

Where Laudio has a real advantage is that since we are collecting all this information, we are understanding what the managers are doing with it and the actions that we are taking. We have created an evidence-based dataset of which actions can support the workers the most. We publish a new use of evidence every week in a part of our website called Laudio Insights, where in a non-commercial way, we are trying to promote the practice of what we call evidence-based leadership. Everyone can benefit from what we are learning around what makes the most difference for managers and how they can use this evidence to practice differently.

What are your company priorities over the next few years?

Continuing to focus on helping create management actions that will drive new levels of impact in health systems. We can handle the data aggregation and analysis that is done automatically in our machine. We are starting to turn our frontline managers into super-powered frontline managers and make them more efficient.

In the future, we want to continue to pull new and different data sources into our system to help them to achieve new horizons of impact. This could include things like the supplies that are used inside each unit. It could include all of the sensors that are in patient rooms around handwashing or whether the patients are being rotated on their beds. We see a future where more and more of this data and information is integrated into a single source of recommendation for the manager so that they can make the impact happen without having the analysis, risk modeling, and data aggregation get in the way.

Morning Headlines 2/9/24

February 8, 2024 Headlines No Comments

Unlearn Raises $50 Million Series C to Optimize Clinical Research With AI-Powered Digital Twin Technology

Unlearn, which creates digital twins that allow smaller and faster clinical trials, raises $50 million in a Series C funding round.

Lurie Children’s Hospital says a ‘criminal threat’ forced the shutdown of its network

Initially deemed a network outage, Lurie Children’s Hospital confirms that the January 31 cybersecurity incident that forced it to take its communications network offline was caused by a criminal threat actor.

Official: Idaho should consider withdrawing from Health Data Exchange

An Idaho Department of Health official tells state legislators that the state should withdraw from the bankrupt Idaho Health Data Exchange, given that it has no legal recourse for oversight.

HHS Finalizes New Provisions to Enhance Integrated Care and Confidentiality for Patients with Substance Use Conditions

HHS announces new provisions to the Confidentiality of Substance Use Disorder Patient Records that address one-time patient consent, redisclosure, accounting of disclosures, use of records in legal proceedings, and breach notification.

News 2/9/24

February 8, 2024 News No Comments

Top News

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CMS approves the use of HIPAA-compliant secure texting platforms for sending patient information and patient orders in hospitals and critical access hospitals.

Previous guidance from late 2017 allowed texting patient information if a secure platform was used, but prohibited texting of patient orders in all situations.

HHS separately announces new provisions to the Confidentiality of Substance Use Disorder Patient Records that address one-time patient consent, redisclosure, accounting of disclosures, use of records in legal proceedings, and breach notification.


Reader Comments

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From Moon Pie: “Re: Best in KLAS. Notice that Oracle Health finished last for overall software suite?” I did notice. I don’t know if Oracle cares, but $28 billion is a lot to have spent to buy the last-place finisher. Oracle Health also took the bottom spots in the health system-owned ambulatory EHR and practice management system categories. Scores for Oracle Health’s patient accounting and patient systems were even more abysmal, bottoming out at 48.6 for mid-sized hospitals, a full 30 points behind second-place finisher Meditech. This is like when GE Healthcare took quite a few top-performing companies from first to worst after buying them. At least Oracle Health’s EHR beat Altera Digital Health’s Sunrise by a lot for large hospital EHR, although it’s a hollow victory when neither are selling much to big hospitals.


HIStalk Announcements and Requests

I published “HIStalk’s Guide to ViVE 2024,” which includes information about my sponsors that are participating. I’ll leave the collection form for HIMSS24 open a bit longer.

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I haven’t run a Donors Choose teacher photo in a while, so here’s one from Ms. P in Kansas, a school librarian who was excited to receive 10 STEM books from a reader’s donation and matching funds from my Anonymous Vendor Executive. She reports, “We are a large elementary school in a rather poor area and so it was nice to get these new books and make them available to our students to check out. We have a lot of smart, curious students and so they will enjoy these books and the hands-on projects that they can create by following the directions. We are so grateful for Donors Choose contributors. Your investment in our library is an investment in the future. Thank you so much.”


HIStalk Sponsors Named Best in KLAS

  • Agfa HealthCare – imaging universal viewer.
  • Arcadia – value-based care managed services (now Guidehealth).
  • Dimensional Insight – data and analytics platform.
  • EVisit – non-EHR virtual care platform.
  • Findhelp – social determinants of health networks.
  • FinThrive – insurance discovery.
  • Fortified Health Security – security and privacy managed services.
  • Healthwise – patient education.
  • Impact Advisors – overall IT services firm; ERP implementation leadership; financial improvement consulting
  • Meditech – acute EHR small; patient accounting and patient management small.
  • MRO – release of information.
  • Nuance – clinical documentation integrity; front-end EHR speech recognition; image exchange.
  • Optimum Healthcare IT – go-live support.
  • PerfectServe – physician scheduling.
  • Pivot Point Consulting, a Vaco Company – managed IT services; technical services.
  • QGenda – nurse and staff scheduling.
  • Rhapsody – integration engines.
  • Sectra – PACS large; PACS small.
  • Symplr – time and attendance.
  • Tegria – application hosting.
  • Waystar – patient financial engagement.
  • WellSky – personal care services and private duty nursing.

Let me know if I missed anyone or if you need sponsorship information.


Webinars

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


Acquisitions, Funding, Business, and Stock

Unlearn, which creates digital twins that allow smaller and faster clinical trials, raises $50 million in a Series C funding round.

Private Equity Stakeholder Project publishes a list of the 460 US hospitals that are owned by private equity firms. Texas is the state leader by far with 97.

Amazon will lay off several hundred people in its One Medical and Amazon Pharmacy businesses as part of a company cost-cutting campaign. Insiders say that Amazon executives want One Medical to save an additional $100 million this year. They also report tension between Amazon’s leadership and One Medical that is likely to lead to the departure of some of One Medical’s executives.

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Neura Health expands its direct-to-consumer virtual neurology clinic for headaches and and migraines to include sleep disorders, epilepsy, concussion/TBI, stroke recovery, and tremor. Members pay $300 per year for access to $189 video visits with a neurologist within two days, 24/7 care team access, and health coaching. Its clinicians can issue prescriptions in 22 states, and insurance is accepted.


People

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Ed Lee, MD, MPH (The Permanente Medical Group) joins Nabla as chief medical officer.

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Healthcare IT Leaders promotes Ben Hilmes, MHA to CEO. He replaces Bob Bailey, who will remain executive chairman.

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Mary Langowski, JD (Solera Health) joins Walgreens Boots Alliance as EVP and president of the company’s US healthcare business.

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Rob MacNaughton, MBA (Redesign Health) joins Calibrate as CEO.

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Erik Smith (Stanson Health) joins Sprinter Health as VP of enterprise partnerships. 


Announcements and Implementations

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Mile Bluff Medical Center (WI) goes live with Meditech’s AI-powered Expanse search and summarization, powered by Google Health.

DirectTrust creates a standards body for interoperable cloud fax to support identity assurance, standards-based exchange of metadata, and federated standards for security. It is looking for members from several sectors.

Companies designated as notable performers in “Best in KLAS Software & Services 2024”:

  • Epic – top overall software suite.
  • Athenahealth – overall physician practice vendor.
  • Impact Advisors – overall IT services firm.
  • Evergreen Healthcare Partners – overall implementation services firm.
  • Chartis – overall healthcare management consulting firm.
  • The population health management solution of Lightbeam Health Solutions was the most improved software product, AGS Health’s Extended Business Office Services had the most improved services solution, and EClinicalWorks was named as the most improved physician practice product.

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Elsevier launches Complete HeartX, an educational tool for Apple Vision Pro.

The National Library of Medicine posts a guest piece on AI from OHSU informatics professor William Hersh, MD, in which he calls for conducting randomized controlled trials or systematic reviews of RCTs.


Privacy and Security

Computers, telephones, and Internet remain down at Lurie Children’s Hospital after a January 31 cyberattack.

Montefiore Medical Center pays $4.75 million to settle HHS OCR charges that one of its employees stole and sold patient information over six months in 2015. That’s a lot of money and a lot of time between the event and the settlement.


Sponsor Updates

  • The Blue Bonnet Family Medicine Health and Wellness Clinic in Texas attributes a 10% increase in patients seen to its use of EHR and AI assistant technology from EClinicalWorks.
  • The Point-of-Care Partners Podcast features KONZA National Network, “TEFCA Chronicles – Konza’s Journey to Becoming a QHIN.”
  • Riverside Doctors’ Hospital Williamsburg successfully deploys Upfront Healthcare’s platform for orthopedic total joint care journeys, achieving positive results in a number of areas.
  • First Databank becomes a Silver Corporate Partner of AMIA.
  • FinThrive will present at the HFMA Revenue Cycle Conference February 28 in San Diego.
  • Health Data Movers joins the ServiceNow consulting and implementation partner program.
  • The NerdMDs Podcast features KeyCare CEO Lyle Berkowitz, MD.
  • Linus Health publishes a whitepaper, “Expanding Cognitive Screening & Assessment: A Practical Guide for PCPs.”

Blog Posts


Contacts

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

Health IT Market Review 2/8/24

February 8, 2024 News No Comments

Christopher McCord, MBA, CFA is managing director of Healthcare Growth Partners , an investment banking and strategic advisory firm in Houston, TX. I follow the company’s reports and invited Chris to contribute a summary of their latest analysis.

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We’ve been ardent followers of HIStalk since our inception in 2005, hanging on to every post of insightful and in-depth reporting on the health IT landscape. We can’t stress enough its value as a resource for anyone wanting to stay informed about the latest trends and developments in the industry.

To that end, we’re excited to share some highlights from our latest “Health IT Market Review.” This report delves into key areas like mergers and acquisitions, investment flows, and market valuations, offering data-driven insights gleaned from our own experience and research. We believe it’s a valuable resource for anyone looking to understand the current state of the health IT market and its future trajectory.


Key Takeaways

  • M&A activity rebounds. Deal volume surpasses pre-pandemic levels, up 50% in Q4 2023 as compared to Q4 2022 and trending up in January, but valuations remain below historical norms, ~25% lower than the pre-COVID average and 57% off their COVID peak (based on multiples of revenue).
  • Investment declines. Investment in health IT continues to decline, falling to $743 million in January 2024, levels not seen since 2017.
  • Public market struggles. The number of public health IT companies has contracted from 68 to 53, and 13 are at risk of de-listing due to non-compliance.
  • Future outlook. Despite the challenges faced in 2023, positive signals abound, mostly fueled by anticipated decreases in inflation and interest rates.

First, we’ll attempt to describe how we, the collective health IT enthusiasts, got here in a few sentences.

The past decade in health IT was shaped by a potent cocktail of regulatory and economic forces. Starting with the American Recovery and Reinvestment Act’s HITECH Act, which incentivized Electronic Medical Record (EMR) adoption, and followed by the Affordable Care Act, significant regulations fueled an initial boom. The 21st Century Cures Act later evolved Meaningful Use into a more dynamic data platform, now laying the groundwork for AI integration.

Simultaneously, a decade of near-zero interest rates and quantitative easing inflated the US money supply, creating an environment where a generation of professionals became accustomed to expansionary policy and rising valuations. The COVID-19 pandemic further amplified these trends, dramatically validating the investment thesis in digital health across sectors like telehealth, mental health, and drug discovery.

The pandemic’s vivid demonstration of health informatics’ value undoubtedly contributed to a period of heightened investor confidence in the sector. It’s no wonder investors felt invincible.

The current market presents a dynamic interplay of forces, largely a byproduct of the complex macroeconomic and interest rate environment. While health IT M&A activity has witnessed a surprising resurgence, now exceeding pre-pandemic levels in terms of volume (but not value), new investments still show a declining trend. Valuations remain below pre-COVID levels, but are rebounding after hitting a floor in the first half of 2023.

Where does it go from here? The following charts and commentary delve into this critical unknown, leveraging data and experience gleaned from our own journey, to help you piece together your own market mosaic.

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After hitting a Q4 2022 nadir, 2023 US health IT M&A and buyout volume rebounded to levels higher than pre-COVID. The last quarter of 2023, with 84 transactions, marked a 50% surge compared to Q4 2022. The upward trend was maintained in January, with 30 US health IT transactions during the month, annualizing to 360 deals versus 319 in 2023.

While M&A volume has rebounded, M&A deal value sits at the lowest levels since 2017. This is attributed to a confluence of factors: rising capital costs, broader macroeconomic concerns, a tech-specific valuation reset, and a more cautious approach by investors – all concerns that are showing signs of dissipating.

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The following is what we think is the most important piece of data – valuation trends of health IT M&A and buyout transactions. The HGP Health IT Transaction Index sits at 3.6x revenue, a 22% discount from its pre-pandemic 4.6x average and a 55% discount from the peak of 8.1x seen during the COVID hype cycle. Despite the valuation gap, there are positive signals in both the data and macroeconomic picture. Notably, the standard deviation of transaction valuations has widened over recent months, meaning that more transactions are trading at both higher and lower multiples than the average, which is a promising signal that the average has room to move up.

The recent wider band of valuations reflects healthier market activity and perhaps and revival of traditional SaaS transactions, while the lower band generally represents the sale of distressed assets and divestitures of prior acquisitions. For those unfamiliar with valuation multiples, we’ve added an explanation at the end of this piece.

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Enterprise SaaS (multi-industry, not pure health IT) currently trades at a discount to pre-COVID averages, trending down from 8.8x to 6.5x forward revenue. The current 26% discount is even more staggering compared to its COVID peak of 18.8x, representing a 66% discount. The overarching question weighing on the market is whether valuations will revert to the mean and the definition of that mean. Low interest rates raised valuations, high interest rates lowered them, and the general expectation is that valuations will find the reversion to the mean as interest rates return to the FOMC’s “Neutral Rate”, generally defined as 3-3.5% (compared to February 2024’s 5.25-5.5% rate).

Recent transactions signal that investors see opportunity at these valuations. For those looking for points of reference for health IT valuations, Thoma Bravo’s acquisition of Everbridge, a critical event and communications vendor, is a legitimate comp. On February 5, Thoma Bravo announced a $1.5 billion go-private of Everbridge. The purchase price implies a 3.2x and 15x multiple of forward (2024) revenue and EBITDA, respectively, for a company with a <5% growth rate, 73% gross margins, and a 22% EBITDA margin, noting that the business traded for over 20x revenue during the post-COVID euphoria and posted growth rates 30-40% at that time. While today’s investors may be valuing profitability more over growth, this valuation would indicate that growth matters.

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Going deeper into valuation, HGP keeps tabs on the distribution of revenue and EBITDA multiples for M&A and buyout transactions, summarized in the following charts since 2017. Notably, while the COVID period represents 25% of the period (which we define as Q3 2020 – Q1 2022), this period represents 37% of transaction multiples, a reflection of the outsized share of transaction activity that occurred during this time. HGP believes the exclusion of the COVID period best represents valuations in the current market environment, which is described in more detail in our full report.

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Investment in health IT continues to slide, falling to levels not seen since 2017. Activity fell further in January 2024, with $743 million ($8.9 billion annualized) invested in 21 companies (252 annualized) in the US. The median investment round declined from $20 million in 2021 to $11.5 million in 2023, still above a pre-COVID average of ~$8 million.

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Not surprisingly, the COVID cycle saw the rise and fall of $100 million+ investment rounds. Despite the decline, the number of mega-rounds is higher today than pre-COVID, likely a result of larger private equity funds that were raised during the COVID cycle.

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The health IT public market scene has undergone major transformations since the end of the almost three-year drought of health IT IPOs that ended in 2019. Following a surge of activity that was supercharged by the rise in SPAC popularity in 2021, the market reversed course, almost inversely mirroring the 2019-2021 flurry of new entrants with seven de-listed companies in 2022 and 10 in 2023. Of the remaining 53 constituents, 13 trade below or dangerously near $1, risking de-listing due to noncompliance.

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We believe many emerged from this year stronger and nimbler, and many are encumbered by challenging capital structures because of recent market dislocations. Inflation and interest rates are projected to fall, and valuations may benefit from money supply to risk assets. Private equity dry powder sits at all-time highs at $2.5 trillion globally, and money market funds are sitting on a record $6 trillion in assets. These funds will likely be drawn down as rates fall, stimulating demand and supporting valuations for both private and public equities, with further stimulation as the credit markets get back into swing. Despite stubborn inflation, a presidential election year, and uncertain geopolitical backdrop, the economic and overall picture in the US is more positive and stronger than this time last year, injecting a much-needed dose of confidence into the market for the year ahead.

About Valuation Multiples

Compared to complex discounted cash flow methods, the most common way to value a business relies on revenue and EBITDA multiples. These multiples offer a standardized way to compare companies based on their financial performance. They’re valuable for comparing businesses, assessing potential investments, understanding industry trends, and negotiating deals. Investors compare companies to multiples derived from market data of publicly traded companies and similar recent acquisitions in the same industry.

These “multiples” are essentially valuation benchmarks. They’re applied to a company’s revenue or EBITDA to estimate its value. While popular for its simplicity and market data reliance, this method requires finding truly comparable companies, which can be challenging due to differences in size, maturity, and market position. Additionally, several factors beyond these multiples, like revenue models, growth potential and customer retention, can influence valuation. By analyzing these factors and their impact on multiples, investors can gain valuable insights into a company’s relative value and make more informed decisions.

EPtalk by Dr. Jayne 2/8/24

February 8, 2024 Dr. Jayne 3 Comments

I appreciate the fact that my health system of choice promptly shares visit notes with its patients. I’m less appreciative, however, of the fact that some physicians continue to refuse to follow documentation best practices, which have been designed for patient safety and improved patient experience.

As always, I dutifully completed the electronic check-in process well in advance, verifying my insurance coverage and ensuring that my pharmacy was up to date. When bringing me back to the exam room, the first thing the medical assistant asked for was my pharmacy information. She didn’t log into the EHR using the workstation in the room, but was instead working from a sheet of paper.

It would be one thing if the paper had my information printed and she was simply verifying, but this didn’t seem to be the case since she asked me to provide the address and phone number. I politely declined, stating that I had just updated them in the EHR the day prior.

I’ve been to this office many times before, and the physician has never used the EHR in the room. She uses a scribe and is good at verbalizing the exam so that the scribe can capture it. However, the practice continues to use templated documentation that doesn’t reflect the work that was done during the visit. My most current documented a “comprehensive Review of Systems” which was not performed and included a reference to “see scanned document completed by patient” which doesn’t exist, since I certainly didn’t complete one. I wonder if the physician understands that documenting work that wasn’t actually done is fraud.

As always, I noted my concerns when the inevitable Press Ganey survey arrived, so hopefully someone will see it and take action. In the mean time, I’ve decided to leave the practice, not only due to this, but due to poor appointment availability and annoyances with the billing processes, such as refusing to collect your co-pay at the time of service, leading to more work on my part down the road. This practice is crying out for process improvement work, but it’s unlikely that will commence any time soon.

From Public Health Nerd: “Re: the recent Senate hearing on social media’s impact on youth mental health. Here’s some data for your consideration.” The statistics provided included a dramatic increase in teens who report “persistent feelings of sadness or hopelessness,” especially among girls. There has also been an increase in diagnoses of depression and increased suicide rates among teens. Although rates of social media use correlate with these changes, it’s difficult to prove causation, especially considering all the other changes happening at the same time, including community violence, rising income disparities, racial tensions, global conflict, and high-conflict political processes. More studies are definitely needed.

From Coffee Klatch: “Re: return to office programs. Keep up the good work exposing them as the power grab that they are. If companies want people to come to the office without complaint, they need to make it a place people want to visit. Nearly all of my colleagues use travel mugs, which don’t fit into the new coffee makers that our company purchased. I tried to bring a ‘shortie’ travel mug, but it was too wide. We all end up using paper cups to transfer coffee to our mugs. So much for the company’s commitment to sustainability initiatives, since we’re creating more greenhouse gases driving to the office and now using a bunch of paper cups we didn’t need before.” I’m sure some people thing this is a small thing, but it’s just one more example of how decision makers who are out of touch with their workforce are contributing to employee resentment and potential turnover.

I’m sure no one was surprised to hear the news of Amazon’s planned job cuts at its One Medical and Amazon Pharmacy units announced earlier this week. Executives who may have had lesser degrees of healthcare experience prior to entering our industry often find out quickly that it’s much harder to get those big wins and revenue bumps than they were used to with their previous employers. Amazon promises to continue to hire providers for frontline care delivery, but it looks like they’re primarily focused on building their midlevel provider workforce rather than hiring physicians.

I’ve had several patients follow up with my practice in recent months after receiving interesting diagnoses from online practitioners who conducted asynchronous evaluations that resulted in what was ultimately a misdiagnosis. Sometimes a picture is worth a thousand words, but other times you really need to have a conversation with the patient to fully understand what is going on. Our society puts the responsibility of making sure their provider is high quality largely on the patient, which is hard to do when you’re placed in an anonymous queue and have no idea who you are going to see until they are actually participating in your care.

Last week was Groundhog Day, when many in the US traditionally look towards a rotund woodland mammal for predictions on upcoming weather. Since reaching a point in my career when I have the flexibility to provide behind-the-scenes medical support for events and gatherings, I tend to keep an eye out for how that plays into any large happening.

This year, officials predicted that up to 30,000 people might try to see the venerable Punxsutawney Phil, gathering in the cold dark morning at Gobbler’s Knob, Pennsylvania. Planners had approximately 20 professionals from five emergency response organizations standing by. In the past, problems have included hypothermia (not unexpected in years when the wind chill has been well below zero), cuts and scrapes, medical emergencies from patients who didn’t take their medications due to the early start of the event, falls, and even the occasional heart attack. There have also been issues with intoxication, even given the typical 4 a.m. arrival for some attendees. I guess it’s never too early to get the party started when groundhogs are involved. Props to Allegheny Health Network and Punxsutawney Area Hospital for their onsite support.

Does your area have a local groundhog, and what was its prediction? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Interviews Larry Kaiser, Chief Marketing Officer, Optimum Healthcare IT

February 8, 2024 Interviews No Comments

Larry Kaiser is chief marketing officer of Optimum Healthcare IT and its sister company Clearsense.

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Tell me about yourself and your work.

I have been in healthcare IT for just over 20 years now. I started with Keane, which was acquired by NTT Data in 2010. They sold two EHRs. I started as the RFP manager and then moved up to running the marketing department. In 2016, I shifted to Optimum Healthcare IT, where I launched the marketing function from the ground up, built that, and helped grow the organization to about $160 million in revenue. I left Optimum to go to our sister company Clearsense for a couple of years. Now I am back at Optimum as we look at the next level of growth in the organization that is not centered on core EHR services. That includes ServiceNow services, Workday staffing and implementation, and cloud migration and cloud services.

How would you describe a marketing organization to someone who doesn’t know much about it?

Marketing is something different every single day. That’s what makes marketing interesting. That’s what makes it exciting. 

In the case of Optimum, where I was building an organization, I could look back on my experience at Keane and NTT Data over 10 and a half years. I saw how things were done from a corporate perspective and from a divisional perspective, how different people did different things, and learned from that. When you’re building a marketing department from the ground up, you have lots of examples of what worked and what didn’t work. You need to start very basic.

When I joined Optimum, it had a logo and a website that was built on the 2012 version of Drupal and had never been updated. This was in 2016. The first thing we had to do was to look at our public-facing presence and determine what we wanted to be. That started all sorts of internal conversations with many subject matter experts on how we should portray ourselves, the services that we offer, and start molding those together in a fashion that had never been done.

We worked on the website and the website content, getting it to a modern platform. Then we focused on pieces of collateral and slowly worked our way through that. Then we worked on thought leadership and exploring different types of white papers and case studies to allow us to show that we know what we’re talking about and to promote the successes that we had as an organization. From there, it goes off into many different areas, such as partnerships with industry organizations such as CHIME and HIMSS.

It’s really just understanding and taking an inventory. The marketing plan I put in place focused on several things across the board, looking through all of those, understanding from an organizational perspective and having all of those conversations, and then taking all that knowledge and executing it. Every day, I was doing something different. Having never been on the services side versus the product side, every day was an education for me, and I would learn something every single day. That allowed me to work through this process methodically to strengthen the brand position, promote that thought leadership, fuel that demand and lead generation, and ultimately educate the employees on what we would be doing  to grow the organization.

Have shortened attention spans changed the way that you create content?

Analytics plays a big role in that. If you talk to any marketers, whether it’s healthcare or any space, it’s all about the analytics. If I’m producing articles for a blog that will be mentioned on LinkedIn, X, or HIStalk, I have the necessary coding within those URLs to understand how many times it’s being clicked and who is looking at it. That helps drive the kind of content that we create. If we create infographics and find that traffic to those pages, clicks, and downloads are high, we will shift our attention to that.

White papers have traditionally been that lone piece of gated content that an organization will put up on their website. The challenge with that is when people fill out a form to download it, they will put Mickey Mouse for a name or a fake email address, because probably nine times out of 10, the form doesn’t check the email address and just opens the PDF for any entry. Emails sent by your marketing automation bounces back, but that person has already obtained that piece of content. It’s a challenge, in this day and age of cybersecurity threats and people’s phones and emails being hacked.

Social platforms are doing different things. LinkedIn offers newsletter capability. At Optimum, we have found that over the last couple of years, fewer people are filling out a short form that asks for name, organization name, and email address to subscribe to our thought leadership in their inbox. People don’t want to give their personal information.

This week, we launched Optimum Pulse, our new newsletter. That goes out to our 55,000 followers, and we’re up to 4,200 subscribers. Our strategy on our website now is that instead of asking you for your personal information to subscribe, we will put a link out for people to subscribe to our content on LinkedIn. Each week, we will publish a newsletter with a little preview and a link to our website. That link will be appropriately tagged for tracking. That will give us insight into what pieces of content are working.

From a white paper perspective, we haven’t published one in several years, for similar reasons. We didn’t have the bandwidth, because we’ve been so busy. They really weren’t being downloaded too much. We shifted to more case studies, blog articles, and when we had the bandwidth to do it, more video. We did lots of spotlights on some of our Optimum CareerPath students, and that has resonated in the market. Our target market of CIOs for the Optimum CareerPath program likes to view those videos of the people who have gone through and have had success.

It’s a challenge and it’s a constant struggle. It’s a constant monitoring of all those analytics to figure out what content your audience is reading.

How do you differentiate between brand awareness versus lead generation?

First and foremost, I don’t think brand recognition ever really goes away. That’s always going on. I’m of the belief that your public-facing website should be touched at least once every 18 months to update the look and the feel of that website to keep it fresh. That’s something that we’re doing at Optimum right now.

From a lead generation perspective, or demand generation perspective, for our basic core EHR services, our brand is recognized so much that we don’t really have to do demand generation in that space. People come to us, and that’s fantastic. But in the new areas of growth — ServiceNow services, Workday implementation and staffing, and cloud migration services – we are having to start from the ground up and focus on demand generation programs and developing those, because we’re not known for those things right now. That has been ongoing for the last several months.

For our ServiceNow practice, we hired a specific firm that specializes in ServiceNow demand generation. They are helping us develop the necessary content to start doing that demand generation.We will learn from that and probably do a little duplication of what they’re doing for the other practices as well. It’s definitely a shift as the organization grows into new areas and needs to focus on demand generation for them.

I’ve noticed on LinkedIn some health tech folks whose title involves “growth marketing.” How is that different from marketing in general?

That’s a toughie right there. A growth marketing individual is someone who is 100% focused on doing the B2B strategic, data-driven approach to building a pipeline in conjunction with your sales team. I’ve seen that same title a lot out there as well.

At Optimum and Clearsense, we have not necessarily had that individual. The marketing department is working with sales to generate the pipeline, qualify the leads, and make sure that everybody is doing what they need to do to move that opportunity through the buying cycle of the pipeline. Every organization will have a different cycle it goes through. I think it’s an extension, similar to saying that you’re a social media marketer or an influencer. It’s a small piece of the overall picture. It’s probably more like an inside sales rep, ultimately.

How do companies plan their involvement with health tech conferences?

I’ve been doing HIMSS for 20 years. For 16 or 17 of those years, we had one conference in healthcare IT, and that was HIMSS. If you didn’t go to HIMSS, you really weren’t relevant in the space. 

Because of COVID and how some things were handled, CHIME and HIMSS were no longer associated, and they went off and did the ViVE conference. The second year was much better than the first year. Clearsense went into that conference in 2021 in a rented booth from them and we really didn’t know what to expect. As a young organization promoting our SaaS product, we didn’t know who was coming. It was a little bit smaller, but year over year, it grew. Having CHIME associated with it brought our target market to that.

HIMSS was really struggling. I think that had a lot to do with how they handled the 2020 show. It wasn’t until last year when, all of a sudden, HIMSS appeared to be relevant again. At Clearsense, we had no idea what to expect at HIMSS last year. We were very pleasantly surprised. Our booth traffic was just as robust as it was at ViVE, to the point that we had a wait list to get demos of our product.

Clearsense is a product company. We are heavily invested in ViVE from various sponsorships. We built our own booth because financially it made more sense to build it and store it than to rent a booth every year. HIMSS is less of an investment, but I could see that investment growing in the future if the trend of growth and recovery for HIMSS continues.

As to HLTH, I have never personally attended. We explored the possibility of exhibiting at HLTH this year. I sought the opinions of many people. The folks at HLTH and I are friendly. They shared the breakdown of attendees. It’s more tailored to provider and payer now, where the angel investors aren’t as prevalent. But then when I have conversations with people, they tell me the exact opposite from their attendance. We chose not to invest in HLTH.

We are a main sponsor of ViVE, but we don’t have a booth. We have a pretty hefty investment in ViVE. Several years ago, we were no longer a HIMSS sponsor, but with these new areas of growth, it’s an area that I think we need to start investing in again because all the players are at HIMSS, such as AWS, ServiceNow, and Workday.

For both of our organizations, ViVE is number one, HIMSS is number two, and HLTH is a distant third, just based on the attendance.

Have you received any early indication of how the HIMSS conference will change now that Informa Markets is running it?

It’s too early to tell. The running joke in the industry is that maybe the aisles will have carpeting again this year.

Most of the HIMSS people that I was friendly with have moved over to the new company. In the questions I’ve been asking and the conversations that I’ve been having, we won’t see major change in HIMSS until 2025. What that change is, I don’t know. They haven’t really said what it will look like. Apparently HIMSS is still dictating the education at the show and Informa is doing the show itself. We’re all sitting back and waiting to see how it’s going to change.

HIMSS24 is too close to the acquisition to make changes for this year. It will be interesting to see what it becomes and whether they can return it to its glory of many years ago. I’m not going to say that it’s not relevant now, but they are playing second fiddle to ViVe now, unfortunately.

Companies reduced their spending to weather the investment and economic downturn. How will they restore the marketing function as conditions improve and companies have to reestablish their competitive position?

2023 was a tough year in general for healthcare IT companies, whether you sell services or products. Historically, marketing is usually the first to go and the last to get rehired. Organizations that had a strong financial footing may have done some some RIFs, some layoffs, but they didn’t eliminate the department across the board. I have seen some organizations cut their entire marketing department, which Is interesting to me because you still need to maintain your brand. You still need to maintain the marketing activities that you were doing in order to grow pipeline. Marketing and sales go hand in hand.

This year and going into 2025, I think you will see a slow reinvestment in marketing. A number of articles from well-known publications have said that from their research and conversations, providers are opening their purses up again. When providers start buying again, an organization has to have marketing to successfully engage with them. Probably by the middle of this year, I think you’ll see an uptick in healthcare IT marketing expenditure to bring teams back in. It will happen methodically. An organization that cut everybody will probably bring in a leader first and have that person assess where they were before, where they are now, what needs to be addressed, and what roles need to be brought in. Then you’ll see a trickle down effect of them slowly ramping up their marketing departments again.

I’m very much plugged into the healthcare IT marketing organizations. I can open up my my browser to X and I have a chat with about 15 other healthcare IT marketing folks from various organizations. We have a chat every day, and just this morning, someone said their entire team was let go. We are seeing that a little bit, but by mid-year, you will see a real push to reestablish those teams.

Morning Headlines 2/8/24

February 7, 2024 Headlines No Comments

Amazon to cut a few hundred jobs at healthcare units

Amazon will reportedly lay off several hundred workers within its One Medical primary care and Amazon Pharmacy businesses.

AI-Contextual Care Laguna Health Nabs $16 Million Series A to Reduce Recovery Time and Readmissions

Laguna Health, which uses AI to create personalized care plans that incorporate social, emotional, and cultural factors, raises $15 million in a Series A funding round.

Lurie Children’s Hospital Systems Have Been Down a Week Over ‘Cybersecurity Matter’

Computer systems at Lurie Children’s Hospital in Chicago remain offline as the hospital works to recover from a “cybersecurity matter” that occurred January 31.

Healthcare AI News 2/7/24

February 7, 2024 Healthcare AI News No Comments

News

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Amazon announces Rufus, an AI tool that is trained on the company’s product catalog and on web information to answer customer questions about products, comparisons, and recommendations.

Google will reportedly rename its Bard AI tool to Gemini this week.

Attorneys say that the legal liability frameworks of the US and the EU are not equipped to determine who will be responsible for medical injuries that are caused by black box AI systems.


Business

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UC Davis Health chooses Viz.ai to help diagnose strokes from CT scans for quick intervention.

Radiology AI marketplace CARPL raises $6 million in seed funding.

Laguna Health, which uses AI to create personalized care plans that incorporate social, emotional, and cultural factors, raises $15 million in a Series A funding round.

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Ambience Health raises $70 million in a Series B funding round that was led by Kleiner Perkins and OpenAI Startup Fund.


Research

Researchers find that their AI model that predicts how well schizophrenia patients will respond to antipsychotic medications performed well, but didn’t work when used in other studies. Experts warn that AI’s ability to advance medicine is limited by the methods that are used to collect, process, store, and analyze data. A co-author of the study predicts that it will be more than 10 years until AI will be able to analyze patient questionnaire results well enough for clinical use in psychiatry.

The VA is using smart rings and AI to collect the health data of veterans who were exposed to open-air burn pits during wars in Iraq and Afghanistan in a study that is being conducted through Northwell Health. Researchers hope to correlate vague symptoms with monitored data and screening questionnaires.


Other

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AHIMA launches AI Resource Hub, which will provide health information professionals with information about non-clinical use of AI in healthcare.

A New York lawyer faces disciplinary action for citing non-existent cases in medical malpractice lawsuit documents, as provided by and hallucinated by ChatGPT without being checked by the lawyer.


Contacts

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

HIStalk’s Guide to ViVE 2024

February 7, 2024 News No Comments

Care.ai

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Booth 1402

Contact: Lexi Lutz, marketing manager
lexi.lutz@care.ai
407.800.1937

Care.ai is revolutionizing healthcare with the world’s first and most advanced AI-powered Smart Care Facility Platform and healthcare’s leading Always-Aware Ambient Intelligent Sensors. Care.ai transforms physical environments into self-aware smart care spaces, increasing safety, efficiency, and quality of care in acute and post-acute settings while at the same time autonomously improving clinical and operational workflows and enabling new virtual models of care for Smart Care Teams, including Smart-From-The-Start Virtual Nursing solutions.


CereCore

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Contact: Jillian Whitefield, business development manager
Jillian.Whitefield@CereCore.net
248.891.5557

CereCore is a proud sponsor of Club CHIME, so drop by the Club CHIME Lounge for some refreshment, swag, and to connect with our experts. Schedule a meeting with us on Feb 26 or Feb 27 from 8 a.m. – 6 p.m.

CereCore works behind the scenes to empower hospitals and health systems with IT services around the nation and globe. Looking for IT and application support, technical professional and managed services, strategic IT consulting and advisory services, or EHR consulting? We should meet if you are interested in EHR experts, technical and support teams to supplement yours, looking for the right talent so you can better manage IT operations, or searching for support desk solutions that will result in happier users and providers. Find meaningful change with CereCore’s healthcare IT managed services. Let’s connect at ViVE 2024.


Clearsense

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Booth 1702

Contact: Larry Kaiser, chief marketing officer
lkaiser@clearsense.com
516.978.5487

Get ready to rock at ViVE 2024! This exclusive event is where digital health execs connect with our 1Clearsense healthcare data analytics and interoperability platform. At ViVE, you will find us at booth #1702, in the Hosted Buyer Meeting program, and rocking Industry Night as a proud co-sponsor of an exclusive concert with legendary punk rocker Billy Idol.


Clearwater

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Booth 1549 in the Cybersecurity Pavilion

Contact: Julie Catron, director, product and content marketing
julie.catron@clearwatersecurity.com
217.620.0874

Healthcare’s largest pure-play cybersecurity and compliance firm, the Clearwater team is excited to meet you at ViVE 2024! Regardless of where you are in the healthcare ecosystem, we’re committed to helping you move to a more secure, compliant, and resilient state. Whether you’re looking for ideas, help with a stand-alone initiative, 24/7 SOC services and incident response, or someone to partner with you through a true managed services program, we’d love to talk with you. 

As a title sponsor of the Cybersecurity Pavilion, share some exciting things we’ve been working on. Here are a few of the things you won’t want to miss at our booth:

  • Monday, 2/26, 10:40 in the Cyber Pavilion – Chasing a Cyber Attacker: A play-by-play recount of threat detection and response and lessons learns about improving cyber resiliency.
  • Monday, 2/26: 1:30-2, Tuesday, 2/27: 10-10:30 2-2:30 – How Academy Medtech Ventures Navigates Cybersecurity, Compliance, and Sustainable Growth in Digital Health: Come meet AMV President JJ Mosolf as he demonstrates their cutting-edge Operating System of Cognition and shares how cybersecurity has been critical to scaling this digital health company quickly.
  • Information and giveaways at booth 1549.

Clinical Architecture

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Booth V2537

Contact: Jaime Lira, VP of marketing
jaime_lira@clinicalarchitecture.com
317.580.8400

Please join us on Tuesday, February 27 at 10:45 a.m. PST for a 30-minute case study presentation “Where Data Quality and Master Data Meet” featuring Will Lloyd, System Director Clinical Data Governance at CommonSpirit Health and Charlie Harp, CEO at Clinical Architecture in the InteropNOW! pavilion.

Clinical Architecture delivers data quality solutions for healthcare enterprises focused on managing vast amounts of disparate data to succeed with analytics, population health, and value-based care. Our industry-leading software provides semantic interoperability of data through robust content authoring, mapping and distribution architecture at speed and scale.


DrFirst

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Booth 1830

Contact: Erin Lease Hall, senior manager of events
eleasehall@drfirst.com
216.650.7687

Visit DrFirst at ViVE! Where Digital Health Execs Go to Redefine Medication Management What if less work – with up to 80% fewer clicks and keystrokes – is the key to getting your clinicians the clean, complete medication data they need? If that sounds implausible, it may be time to redefine medication management. And we can help. Heading to ViVE 2024 in Los Angeles? Stop by booth 1830 and learn how redefining medication management with better patient data can boost patient safety and outcomes to transform your business. Not heading to ViVE? Not to worry. We can still talk redefining medication management. Schedule a meeting with us.


ELLKAY

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Booth 1336

Contact: Auna Emery, VP of marketing
Auna.Emery@ELLKAY.com
201.808.9504

ELLKAY’s innovative, cloud-based solutions address the challenges that our partners across all healthcare environments face. ELLKAY delivers bi-directional, standards-based connectivity to hundreds of sources with access to discrete and actionable data, and provides tailored solutions to achieve your unique connectivity goals. Don’t miss our InteropNow! sessions with CommonWell Health Alliance at the InteropNow! Pavillion:

  • “Behind the Curtain of the 226M+ Persons National Network – CommonWell Health Alliance – powered by ELLKAY.” Get a glimpse of the interworking’s of CommonWell’s national network powered by ELLKAY, serving over 34,000 provider organizations to enable seamless health data exchange across member organizations, nearing close to 226 million+ individuals impacted through this network. The CommonWell Health Alliance chose ELLKAY to serve as the Technical Service Provider to enable clinical data exchange at scale and serve as a critical partner to achieve QHIN designation under TEFCA.
  • “CommonWell Health Alliance- powered by ELLKAY.” Understand how CommonWell Health Alliance is using ELLKAY to fuel the connectivity for its network. Get to know more about the updates to the CommonWell platform and how ELLKAY is providing the technical infrastructure to deliver a seamless patient data exchange to participating providers. Come learn who the CommonWell Health Alliance members are and the impact of participation in this national network.

Visit Team ELLKAY at booth #1336 – Mimosa Bar, Monday, February 26, 3:30-6:00 p.m., Ice Cream Bar, Tuesday, February 27, 3:30-6:00 p.m., Donut Bar, Wednesday, February 28, 8:30-10:30 a.m.


Five9

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Booth V946

Contact: Roni Jamesmeyer, senior healthcare marketing director
roni.jamesmeyer@five9.com
972.768.6554

Five9 offers a HIPAA-compliant healthcare cloud contact center solution that empowers you to seamlessly monitor and report call volumes in real-time across critical areas such as patient access, scheduling, prescription refills, and revenue cycle management, enhancing your staff’s efficiency. The Five9 Intelligent Cloud Contact Center seamlessly integrates with various back-end systems, including electronic health records, serving as a central hub to facilitate digital engagement, provide comprehensive analytics, optimize workforce performance, and leverage AI for improved outcomes and measurable business success.


Fortified Health Security

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Booth 1850

Contact:Robert Pullins, growth marketing manager
rpullins@fortifiedhealthsecurity.com
615.600.4002

A two-time Best in KLAS award winner, Fortified works with healthcare organizations to construct client-centric, customized programs leveraging both new and existing solutions. We are committed to building a stronger cybersecurity landscape for both our client ecosystem and the healthcare industry as a whole.

We are Healthcare’s Cybersecurity Partner and we’re coming to ViVE with a schedule full of collaboration and socializing! We hope you can join us for one of these events:

  • 3-track Tasting at the Figueroa: From 5-8 p.m. on Monday, February 26, CISOs and CIOs are invited to join us in hotel Figueroa and select a tasting track of spirits, wines or mocktails led by Blackfin Experiences sommelier Michael Stefanakos. Contact us to RSVP at connect@fortifiedhealthsecurity.com.
  • CHIME members only: Focus group titled “Future-proofing healthcare IT: A collaborative discussion on HHS’s new cybersecurity strategy” held Sunday, February 25 at 10 a.m.
  • Daily drawings at booth #1850 for travel JBL speakers.

Get-to-Market Health

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Contact: Steve Shihadeh, CEO
Steve@gettomarkethealth.net
610.613.4074

Get-to-Market Health is a specialized consultancy focused exclusively on accelerating sales and driving revenue growth for our healthcare technology clients. We work with business leaders to simplify the complexity and unique buying patterns of the healthcare technology market.


Healthcare IT Leaders

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Booth 3123

Contact: George Major, RVP of sales
george.major@healthcareitleaders.com
484.682.3614

Healthcare IT Leaders is a national leader in IT staffing, managed services, and consulting for healthcare systems. We provide strategy and talent for healthcare transformation across clinical, business, and operational systems. Areas of focus include EHR, ERP, HCM, WFM, RCM, Cloud, and Data where our consultants implement and optimize enterprise software solutions from leading vendors including Epic, Oracle Health, Workday, UKG, Oracle, Infor, SAP, Snowflake, AWS, Azure, GCP, and more.


Laudio

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Meeting Pod 2852

Connect with Laudio on-site. Tuesday, 2/27 at 10am: Join UNC Health CHRO Scott Doak, and Laudio co-founder and CEO Russ Richmond, MD, as they share their Playbook for Nurse Retention. Discover how UNC Health’s approach with Laudio’s automation software improved nursing management and reduced nurse turnover, leading to $5.4 million in annual savings.

Laudio empowers healthcare leaders to drive large-scale change through everyday human actions. Our AI-enhanced platform streamlines workflows for frontline leaders, strengthens interpersonal connections, and aligns C-suite objectives with frontline efforts, boosting operational efficiency, employee engagement, and patient experience. Laudio makes it possible for patients, frontline workers, and health system leaders to thrive together. Discover how at www.laudio.com.


Linus Health

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Contact: Laura Kusek, event and partner marketing manager
events@linus.health
954.825.8389

Chief Growth Officer Curt Thornton and Chief Product Officer John Showalter, MD will be in attendance. Please email events@linus.health to request a meeting.

Linus Health is a digital health company focused on early detection of Alzheimer’s and other dementias. We combine rich clinical expertise with cutting-edge neuroscience and AI to help providers spot and intervene on early signs of cognitive impairment – even those invisible to the human eye. Our digital cognitive assessment platform puts specialist-level insights about a patient’s cognitive function at providers’ fingertips in a matter of minutes.


Medicomp Systems

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Booth V1337

Contact: James Aita, director of business development and strategy
jaita@medicomp.com
647.207.0080

Clinical AI has healthcare abuzz. But how can you harness it to help make clinicians’ lives easier? Large language models (LLMs) are great at generating text, but clinicians need solutions to help them navigate compliance and quality reporting and complex billing requirements. The Quippe Clinical Intelligence Engine leverages LLM output, converts it into actionable data, and makes sense of it to help clinicians find what they need at the point of care to make their jobs easier. Meet with at Vive booth V-1337 to learn more about Medicomp’s clinical-grade AI solutions and Smart-on-FHIR apps for CQM compliance, HCC coding and risk adjustment, bi-directional interoperability, CDI and audit-readiness, point-of-care decision-making and more.


MEDITECH

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Booth 1524

Contact: Rachel Wilkes, director of marketing
rwilkes@meditech.com
781.774.4555

From the deployment of the latest AI solutions to industry-leading efforts in precision medicine and interoperability, discover how MEDITECH is making its vision for healthcare transformation a reality at ViVE 2024. MEDITECH staff and executives will be available at booth #1524 to discuss new Expanse tools for addressing key industry issues including: mobility, precision medicine, innovative care models, efficiency of care teams, interoperability, and AI.

In addition to activities in the booth, MEDITECH executives will also be speaking as part of the ViVE agenda:

On Monday, February 26 at 3 p.m., LACC, Show Floor, Venice Beach Stage MEDITECH’s Executive Vice President and Chief Operating Officer Helen Waters will be joined by leaders from Oracle and Epic for the “Back to the Future of Healthcare: Tomorrow’s EHR Landscape” session. They will discuss the future of healthcare and the transformative impact technological advancements have on patient experience and healthcare delivery.

MEDITECH Senior Director of Interoperability Market and Product Strategy Mike Cordeiro will host a session on Intelligent Interoperability on Monday, February 26 at 2:15 p.m. at the Tech Talk Stage. His presentation will focus on how EHRs should operate as data platforms – collecting, integrating, managing, analyzing, and presenting data in meaningful and actionable ways. Cordeiro will also highlight MEDITECH’s strategy for supporting interoperability standards and open API approaches that enable healthcare organizations to share meaningful data.

MEDITECH customer leaders will also participate as panelists in ViVE sessions, including: On Monday, February 26 at 2:00 p.m., LACC, Show Floor, Sunset Strip Stage Emanate Health Chief Information Officer Daniel J. Nash, MBA, PMP, CHCIO, CDH-E will discuss healthcare’s post-pandemic financial and workforce challenges in the session “Inside Job: Operating with Lean Staff and Healthy Margins.” The healthcare leaders will share cost-control strategies including workforce optimization and utilization of technology to enhance operational efficiency. HCA Healthcare Senior Vice President and Chief Information Officer Marty Paslick will join other panelists in discussing the ethical considerations, possible biases, and other challenges with AI in medical decision-making in the session “Awakenings: The Perils of AI Success” on Monday, February 26 at 4 p.m., LACC, Show Floor, Hollywood Stage. Attendees will learn more about the importance of responsible implementation to ensure patient safety and privacy.


QGenda

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Booth 2112

Contact: Dan Kamyck, senior director of growth marketing
Dan.Kamyck@qgenda.com
770.399.9945

As a CHIME Foundation Member, QGenda executives will also be available for meetings at Club CHIME, located at Booth 2801.

Healthcare workforce optimization starts with the schedule. QGenda transforms healthcare workforce management with QGenda ProviderCloud, a single platform to activate, deploy, and optimize the entire care team. QGenda executives are on hand to help you manage change within your healthcare workforce. CHIME members – Be sure to sign up for QGenda’s Focus Group session, “Navigating Change: Digital Transformation to Optimize Your Workforce,” which will take place on Sunday, February 25 at 1:15 p.m. PST. To attend, please sign up with CHIME.


ReMedi Health Solutions

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Contact: GP Hyare, managing director

g.hyare@remedihs.com
281.413.8947

ReMedi Health Solutions is a nationally recognized, physician-led healthcare IT consulting firm specializing in peer-to-peer, physician-centric EHR implementation and training. We’re a clinically driven company committed to improving the future of healthcare. We’re passionate “Clinician Whisperers” that believe understanding the “why” behind each EHR decision is as important as the “what” or “how”. We listen to physicians, nurses, and healthcare leaders in order to understand their biggest challenges, and we leverage our decades of experience to develop efficient solutions that greatly impact the delivery of care.

ReMedi designs customized training solutions that incorporate clinical workflows, evidence-based content, financial performance, and patient experience. Our clinicians and management consultants work with clients to: Improve physician satisfaction and engagement by enhancement of workflow and enabling efficient use of available tools. Enable physicians to more easily and accurately document patient conditions, comorbidities and acuity. Improve financial performance by capturing patient complexity. Evaluate reporting capabilities which allow the tracking of provider documentation and implications for the revenue cycle. Improve intra- and interdepartmental workflows between registration, physicians, and coding.


Rhapsody

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Booth 2423

Contact: Michelle Blackmer, marketing
Michelle.Blackmer@Rhapsody.Health
312.520.1873

Visit Rhapsody at ViVE! Heading to ViVE 2024 in Los Angeles? Stop by booth 2423 and learn how health systems and digital health teams rely on Rhapsody to reduce the barriers to digital health innovation adoption by streamlining patient data access. Not heading to ViVE? Not to worry. We can still talk digital health enablement. Schedule a meeting with us.


Tegria

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Booth 1624

Contact: Kristin O’Neill, senior director of external relations
kristin.oneill@tegria.com
617.319.5516

Tegria is a global healthcare consulting and services company delivering end-to-end solutions that leverage technology to help provider and payer organizations transform healthcare. Let’s schedule time to connect at Tegria’s Transformation Hub, located at booth 1624! Tegria solution experts will be available throughout the event, so this would be a great opportunity for us to brainstorm about solutions to your latest challenges. Schedule time to connect with us.

  • Tech Talk: “Scoring Big on Patient and Provider Experiences.” Monday, February 26 at 2:30 p.m. PT Mark your calendar and join Tegria at the Tech Talk Stage as we discuss the importance of taking a team-based approach to patient experience. Join us for this must-attend session to explore how a collaborative approach can transform healthcare delivery.
  • Happy Hour at the Tegria Transformation Hub Monday, February 26 at 4 p.m. PT After a full day of sessions and networking, stop by our Transformation Hub at booth 1624 beginning at 4:00 p.m. where you’ll be able to swap stories from the show floor, share your thoughts about a particularly interesting session you attended, or just unwind with some of your favorite Tegria experts.

TrustCommerce, a Sphere Company

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Booth 1249

Contact: Ryne Natzke, chief revenue officer
rynen@spherecommerce.com

Visit TrustCommerce at Booth #1249! TrustCommerce provides comprehensive patient card payment solutions integrated with top EHRs that has earned the trust of many of the largest healthcare organizations in the US. Transform the way you process payments with TrustCommerce’s 20+ years of expertise in healthcare provider support. Experience secure and compliant payment processing, anytime and anywhere – all while being seamlessly connected to leading EHRs like Epic, Veradigm, and AthenaIDX. Meet our team, enter to win an Amazon Echo Show, catch a demo, and pick up some cool swag at booth #1249. See you there!


Upfront Healthcare

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Booth 2130

Contact: Margy Enright, VP brand strategy and experience
menright@upfronthealthcare.com
913.568.1520

Upfront is a mission-driven healthcare company delivering tangible outcomes to leading healthcare systems and provider groups. Its patient engagement platform makes each patient feel seen, guiding their care experience through personalized outreach. The backbone of the Upfront experience is its data engine, which analyzes clinical, sociodemographic, and patient-reported data. These insights, along with its advanced psychographic segmentation model, allow Upfront to individually activate patients to get the care they need while building a meaningful relationship between the patient and their health system. Upfront is rooted in partnership, leveraging best-in-class healthcare expertise to maximize the impact of technology and deliver a next-generation patient experience.


HIStalk Interviews Aasim Saeed, MD, CEO, Amenities Health

February 7, 2024 Interviews 1 Comment

Aasim Saeed, MD, MPA is founder and CEO of Amenities Health of Dallas, TX.

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Tell me about yourself and the company.

I’m a Texas native and I live in Dallas. I have a medicine and public policy degree background, but I never practiced clinically after medical school. Instead, I went the route of management consulting at McKinsey, where I was almost exclusively focused on US healthcare and US healthcare systems specifically. I wanted to make an impact on the healthcare provider side. That remains my passion today. I was at McKinsey for a few years and then started getting into technology and jumped out from my first startup, which was an early stage fintech company that was acquired by H&R Block.

For the last four years, prior to launching Amenities about two years ago, I led innovation at a large healthcare system here in Dallas, Baylor Scott & White Health. It was an interesting time to be there from 2017 to 2021, when I left. Obviously COVID happened, but we also made massive investments in digital health, and I think we were pretty much leaders in the field from a health system side. That has a loaded connotation onto itself, but I did a lot of cool things, part of which sparked the ideas and opportunities that I wanted to explore at Amenities.

At Amenities, we help large healthcare systems build a much better patient experience. Specifically, we think that the digital consumer is dramatically lacking in US healthcare, and that health systems have a huge opportunity to shift the market experience and then hopefully get rewarded for doing so by moving patient volume.

We call our platform a digital front door and patient loyalty platform. That last part is important, because our bet is that if you not only improve patient experience, but do so in a new business model that rewards you with loyalty, that could be game changing. That’s the idea behind Amazon Prime, where you went from occasionally shopping online to basically shopping online exclusively. I have hardly set foot in a Walmart again because two-day shipping and free returns solved all my concerns.

Part of what we are trying to do is help health systems figure out how to be more compelling and exciting to their patients. That’s why we’re called Amenities, literally.

Healthcare consumers have a high lifetime value. Why don’t providers compete on customer experience?

I don’t think there’s a single answer, if I’m being blunt, and I’m definitely not the smartest person in the room to have a perfect answer for you. They don’t compete on it because nothing changes your decision-making as a patient. If you’re in an ambulance, you’re not typically choosing where you’re going. If your doctor says go to Baylor, THR, or Medical City, you follow those instructions. You only find out what it costs afterwards. You are picking based on a vague idea – what’s a good doctor or good health system? There is an abundance of reasons that patients aren’t able to discriminate health systems.

If you’re being fair and say, why aren’t health systems more motivated? It is because to date, if they have done something, it hasn’t resulted in more volume. They might have experimented with doing something for the patient, but it didn’t move enough volume in a specialty that mattered financially. There is a massive missing ingredient, which is a business model that rewards them in a metric they care about. I think that is membership, loyalty, and lifetime value of a patient, instead of just saying that we offer this concierge primary care practice, we signed up 100 patients, and that’s it. It doesn’t result in downstream loyalty.

Patients want to know what it’s going to cost. I spent four years at Baylor trying to figure out how to do meaningful price transparency. Frankly, it’s not really a solvable problem right now, based on the infrastructure we have and the multitude of players. 

There have been both handicaps for health systems, as well as that they haven’t had a financial business model that gets them excited enough about doing game-changing things. It’s sometimes unfair, but I think accurate, to say that this industry is known for conservatism. They don’t take big risks. They don’t swing for the fences. They don’t do this. We are trying to show them an opportunity not to do things for incremental cost reduction or try to find a use case for AI for AI’s sake, but rather let’s swing for the fences and change how healthcare is delivered here. Incentives around a membership could be a big activator.

Do health systems that launch innovation and digital teams have specific ideas of what they want to accomplish and establish metrics to track results?

You will find, unfortunately, some variation of the Triple or Quadruple Aim as the mission, just reworded to sound fancier, like reduce cost, improve quality, provider satisfaction, patient experience. At Baylor, when I was there but I think it’s changed now, we had value-based care. We had operational excellence. There was cost reduction. We had consumer digital, which was  patient experience. 

Again, they might call it something different, but we haven’t seen much that’s materially different than that in different innovation teams. That’s because we haven’t accomplished those goals. That’s not a knock on health systems. Those are the things that we are all trying to achieve.

The question is, how is it going to scale? Where health system innovation teams struggle is that everything feels like an experiment, with death by pilot or a dozen little pet projects. We very much started out that way. You have to get to the core of the health system and what’s it trying to do. You can’t experiment for experiment’s sake.

Unfortunately, we’re seeing a lot of that. We get asked a lot, what’s your AI strategy? What are you talking about? That’s such a weird thing in healthcare. It’s like, what’s your cloud? I mean, I understand why people care in the IT arena, but that’s not a business case. If McKinsey taught me anything, it was to start with a tangible outcome that is undeniably important to the overall business, and let your strategy, especially your technology strategy, stem from that. 

The time that we had the most clarity at Baylor, and the digital health office that I ran, was during COVID. It was like, oh my God, patients can’t access virtual appointments and we’re not serving our patients. There was immediacy. But even immediately after that, our strategy became specific, to double the number of Texans served. That was so helpful for the innovation team to focus. We stopped doing things that just came to us, and we said, is this going to move the needle?  

That’s a level of focus that I left with for Amenities, to say that we’re not an app for app’s sake. Building a prettier app is not going to fix healthcare. If the app helps a patient register in under 30 seconds, find a doctor, and book an appointment, now we’ve done something. If AI can help, great, but 90% of those problems do not require AI. We have refused to create the operational systems, the scheduling systems, or whatever it is. We fix those things. We don’t try to do big, shiny things. We’re trying to help the health system attract new patients, make it incredibly simple for them to become a patient, find a doctor, and book an appointment. 

The fun really starts when we think, what would keep them loyal that doesn’t exist in the market today? When we think about loyalty, you have to be better than One Medical. You have to be better than than what’s out there in virtual health like Teladoc or whatever they can find on the street. There are creative opportunities to do new services that patients don’t know to ask for, but that they really love, based on our research.

What is the current and future state of the digital front door and patient portals?

For me, it’s absolutely clear. If your digital front door doesn’t add new patients simply and immediately, what is the point? That’s where patient portals are good. It’s good to have a patient portal, but they are completely lacking in imagination of what a comprehensive consumer experience should look like. 

Starbucks doesn’t say, I would just like an app to review my history of orders. It is a transaction tool. Starbucks would never in a million years go to the Coffee.com app with Joe’s and Pete’s and everybody else all using the same app, that’s no big deal. Like it or not, health systems are competing. The fact that they defer their most valuable digital asset to another company is just beyond me. It is an acquisition tool. That’s what it is. That’s what it should be. The fact that it’s not viewed that way is a gross oversight, full stop. Are people getting into your system and are you adding new users?  If not, then it’s lacking in what it could be, and how it could be financially ROI-backed in all of your investment.

At Baylor Scott & White, during COVID for 2020 through 2022, we added half a million net new patients through the app. That number for most other health systems, nine out of 10 of them, is zero. That’s crazy. That’s like health systems just now realizing that they need a website. That’s the equivalent of the app. In five or 10 years, we’ll look back and be like, that was crazy. Why would we limit use of the app to current patients or current customers? 

I don’t know how that happened or why, but it’s a lack of imagination to say, this is a digital commerce acquisition and loyalty play. Once we earn a place on their phone, what are we doing to keep them using that? Why do they love that? Why are they coming back to us over and over again? That’s how every other business thinks. I don’t know why healthcare doesn’t think that way.

A simple healthcare problem is that someone can’t get in the app unless they are already a patient. We found that nine out of 10 people threw their hands up and said, “I guess I can’t get into the app.” Why can’t they register? Oh, we don’t want to create duplicate accounts. OK, great, then we need to ID verify them. How do you do that? There are only really crappy systems where you have to take a picture of your ID and wait for HIM to review it. We said no, we want to automate all of that, and that’s what we do. In 30 seconds, we can full ID verify someone better than literally Experian can, with no data entry required. 

We don’t create any duplicate accounts. If they don’t have an account already, we register them into Epic in MyChart. We don’t have to make these sacrifices. The tech can do this. You just have to build an experience. Start with the experience that you are trying to create and then get it there. We got the idea from fintech and built that experience. The other one is airlines, which are the king of loyalty programs. No airline would ever say, here’s our loyalty program app, and you have to download this other Sabre app to actually book flights. That’s where health systems are. They haven’t forced these things to be the same. They haven’t said, “This is our brand and this is how we interact with everyone.”

Lack of transparency on pricing from a patient standpoint is a massive problem. I spent four years trying to figure out how to create meaningful price transparency for consumers at Baylor Scott & White, and two things went wrong. One is after like four years, we could tell them if their co-pay was going be $20 or $25. No one cares about that. That’s not the thing that they are worried about. They are worried about bankruptcy. They are worried about a surprise bill. Somebody’s out of network. The doctor who is wearing your scrubs, who has your ID badge, who is located inside your building, somehow doesn’t work for you. That’s the surprise.

We tested this and came up with a feature called no surprise billing guarantee. It was the number one feature wherever we tested. It’s an example of a feature that consumers aren’t asking for, but when you test it and you put it in front of them, it goes off the charts. The No Surprises Act exists, but patients aren’t understanding that, so let’s build a product around no surprise billing guarantee. That’s one of the primary things that Amenities does.

Health systems struggle to show their true pricing everywhere within a system. Baylor would direct you towards ambulatory surgery centers and not the main hospitals, because we all know that the pricing is cheaper for the same procedure at an ASC, but health systems aren’t really incentivized to do that. There was always this internal struggle. But I believe that health systems should embrace that and say, get on the patient side. Get on the consumer side. Because once you become a consumer advocate like that, that’s how you think big, not playing these games of, is that good for our hospitals, and what will that hospital president think? My push is to be on the consumer side completely.

Customers like to feel that the business knows them. Health systems people can look in the EHR for your medical history, but do they use technology as customer relationship management way to accommodate preferences or non-medical lifestyle information?

I was there when we brought in Dynamics and evaluated Salesforce as a CRM. CRMs are fine and definitely a tool, like cloud, that any modern company and architecture should be built on. It always comes down to, have we started with a use case? I see so many health systems, including ours, saying that we can’t do anything until we have a modern CRM that connects the website to the contact center and to our data. That’s just not true. That will take like four years, and if you don’t start with the use case, you won’t have the funding by the end of it. Everybody would be like, why did we just spend $50 million to do this thing and nothing has changed on our website? 

You have to start with the basics. Can we register a new user? OK, great, and then to your point about preferences, what are all the different communications channels that they get, and how are we letting them set those preferences so that they are not getting a bunch of phone calls when they only want texts or other things? There’s a lot of little, immediate things. What often happens in healthcare is that once you start talking about CRM and big legacy platforms, it becomes a five-year journey, and you don’t know if you’ll make it with the same team by the end of it.

Amenities is keen to say, you can try to build what we built, but Baylor Scott & White spent north of $25 million trying to build the MyBSWHealth app. It was wildly successful, even at that number, but that’s insane. Why is every health system doing this? Part of why we left to do this is that we built this at scale. We can be live in a matter of weeks, if not months, whereas we’ve never seen a health system spend less than $5 million a year and take two to five years to build something custom. Why would you do that? It’s not a good idea. We have to do something with the health system industry experts, like what we’re trying to do, which is custom build. Not take a generalized platform like CRM in every other industry and then try to spend two years plugging it in to get value out of it.

I’m not saying that’s not going to be required for the long run. It’s just that any large infrastructure investments are going to take two to four years just to get implemented, let alone the payoff period. Why not do something immediately that differentiates your health system from the consumer experience tangibly in a matter of months? That’s what we’re trying to offer and say, it’s really not about the technology. What is top of mind for those patients? We’re finding that it’s cost. It’s the worry of financial ruin. It’s a lack of transparency on any sort of quality metrics. 

Patients ask us in our research for things like no surprise billing guarantee, satisfaction guarantee, transparent cash pay pricing, or things like best surgeons. I don’t know a health system that’s willing to show their own data on who’s the best surgeons, but I can tell you that patients would love it. Those are the types of things where we have to get out of a conservative mindset and start offering consumer-centric things that make us uncomfortable and take a bet that it is going to pay off. Because if we are really on the consumer’s side, they will pick us over any other system. 

I don’t think that’s a crazy bet, because what would you want as a patient? If you or your parents need a CABG surgery and you have no information on any doctor about how good they are or their mortality rate, what’s it like? You’re just out there in the blue hoping that’s a good doctor over there. I hope they treat me nice. I wonder if I can get in the patient portal to track the progress? Doing little things to be on their side could be massive and saying, that’s really differentiated.

People want to self-schedule appointments with a provider who accepts their insurance, is conveniently located, has a good background, has time slots available, and accepts new patients. How well have health systems met that expectation?

It’s paramount. We gave a hype factor around AI, big data, and intelligence. I want to know, how many doctors do you have? Which ones are accepting new patients? What’s the earliest I can get an appointment? So few health systems in the country can answer this question. 

Until you’ve done that, you haven’t earned the latitude to go build AI tools. If you couldn’t build a online scheduling platform correctly that is meaningfully used, if you aren’t doing 25% to 50% of your volume in online scheduling, what are you doing? What are you doing on the other stuff? Because that is such low-hanging fruit. It saves you money in contact center. It delights patients who don’t want to call for any of these things. It’s a massive opportunity to shift volume in the market share. There’s so many reasons to do it. 

The only reason we don’t is that we’re not eating our own dog food. I don’t know many health system executives that are having to go through their own online portal and their own online scheduling, because as healthcare administrators, we all have access to calling the office to get us in, or we know Dr. So and So and we text them to get us in. We get to cheat. If we had to use our tools to try to book an appointment, nine out of 10 of us would be pulling our hair out because it’s so, so bad. You wouldn’t accept that from a barber. You wouldn’t accept that from a restaurant where you are reserving a table. Yet we say, “Sorry, but Dr. So and So doesn’t agree to open schedules. They think it’s unsafe or want to screen all patients first.” Well, too bad. Are we going to be consumer centric or not?

The fact that that’s all locked up in the EHR is a problem. We’re one of the only platforms that we’ve ever seen that can aggregate 50 to hundreds of providers and show you all their schedules sorted by next available. But it’s really all of that for that last step, sorted by next available, because we fundamentally believe that patients are going to pick their doctor based on who is available the earliest. Baylor has had that up on their website for three or four years. We’re starting to see one or two other health systems do it, but that basic capability is so far lacking and something that Amenities can do in a matter of weeks and months for health systems.

Just start there. That’s not an AI problem. Just get the logistics out and make all of primary care available for online scheduling. No questions asked, no exceptions. It’s the first thing we tell every health system. We’re going to make an amazing digital experience. Great, do you have online scheduling? No, not yet, but we’re talking to our docs about it. Our first question is, would you download the Pizza Hut app if you couldn’t order a pizza in it? No one’s going to use that thing you’re building, no one’s thinking about adoption and usage, and what will promote this and why is it differentiated?

We’ve started to talk to various health systems about memberships. One thing that we hear repeatedly is, we would like to do a virtual concierge program. That’s been done. That was done four years ago. You have to be better than One Medical, because One Medical is being advertised now inside of the Amazon app. Everyone has access to it for $9 a month.  Are you going to be better than that and differentiated? Because if not, why even start? Would you use that? I feel like sometimes that we don’t want to ask this type of questions, and we need to, because that’s how we build something better.

What are the company’s goals over the next five years?

We would love to see a massive shift in the whole industry, ideally with us, Mission driven. We want to see the industry eliminate all of this friction. A lot of our products – provider scheduling, registration, and the digital front door – will help get the friction out of healthcare. Well within those five years, I hope we can start to demonstrate how market-making and how transformative memberships could be.

You’re seeing a ton of back and forth about too much MyChart message usage. “Well, I guess we have to to charge patients.” Let’s piss them off, because we’ve already pissed off the doctors. That is such an uncreative solution. Taking MyChart messaging away from patients is like now saying, “I’m sorry, it’s going to be 10 cents per text message” like when cell phones first came out. That’s literally where we are. The reality is that people want to use this.

This is a massive opportunity to create a new business model. I don’t know about you, but if I want to talk to my doctor exclusively, I would happily consider $9, $10, or $20 a month to say that I have unlimited messaging for them. They can actually create new services and capabilities. Now I would want more than that, but that’s the opportunity. That’s what I want to see us doing in the next five years, that we can point to a couple of core examples in the industry where they try something new and different, wrapped in a membership. We are seeing that mindset shift, where people are starting to say, that’s interesting. That could actually be transformative and move a ton of market share.Why don’t I try that first before my competitor does?

How do we massively change the dynamic? You have to go through health systems. Direct-to-consumer healthcare is nice, but health systems deliver the majority of care in this country. Two, you have to align incentives. We are not incentivized to compete on experience, but what if we were? Could that be a motivation to do a lot of new and different things?

Morning Headlines 2/7/24

February 6, 2024 Headlines No Comments

Ambience Healthcare Raises $70M to Scale the Most Comprehensive AI Operating System for Healthcare Organizations

Ambience Healthcare, which has developed an AI operating system, raises $70 million in a Series B funding round.

Astarte Medical is shutting down. Here’s why the infant tech startup decided to close its doors.

Astarte Medical, which sells precision nutrition software for NICUs, will shut down and offer its intellectual property for sale.

HHS’ Office for Civil Rights Settles Malicious Insider Cybersecurity Investigation for $4.75 Million

Montefiore Medical Center (NY) will pay $4.75 million to settle HIPAA violation allegations stemming from a 2015 data breach perpetrated by a Montefiore employee who sold the PHI of 12,517 patients to an identity-theft ring.

Stellar Sleep Raises $6M to Help End Sleeplessness With the First Digital Sleep Therapy Platform for Chronic Insomnia

Digital sleep therapy app vendor Stellar Sleep raises $6 million in seed funding.

News 2/7/24

February 6, 2024 News No Comments

Top News

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Inovalon acquires clinical surveillance and patient safety software vendor VigiLanz.

The deal marks Inovalon’s fifth recent acquisition and the first since the company was acquired by a private equity consortium in 2021 at a $7 billion valuation.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Laudio. The Boston-based company empowers health system leaders to drive large-scale change through everyday human actions. Its platform streamlines workflows for frontline leaders, strengthens interpersonal connections, and aligns C-suite goals with frontline actions – helping health systems improve operational efficiency, employee engagement, and patient experience. Laudio makes it possible for patients, frontline workers, and health system leaders to thrive together. Thanks to Laudio for supporting HIStalk.


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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Healthcare tech sales and market intelligence startup Bonfire Analytics raises $2 million.

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Ambience Healthcare, which has developed an AI operating system, raises $70 million in a Series B funding round, bringing its total raised to over $100 million. The co-leaders of the round are OpenAI’s Startup Fund and Kleiner Perkins.

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Hamilton Beach Brands acquires Ireland-based HealthBeacon, which offers a digital health platform for patients who inject medications at home for chronic conditions. The company previously marketed HealthBeacon’s product in the US within its Hamilton Beach Health brand, which it plans to expand into remote monitoring systems.

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Digital sleep therapy app vendor Stellar Sleep raises $6 million in seed funding.

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Astarte Medical, which sells precision nutrition software for NICUs, will shut down and offer its intellectual property for sale. The eight-year-old company blames long hospital sales cycles that caused lower-than-expected sales that didn’t meet the expectations of investors, who suggested to co-founder and CEO Tracy Warren, MBA that she throw in some AI to capitalize on the funding boom. She said she would not be comfortable with AI-recommended therapy and instead chose to close the business.

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Publicly traded value-based primary care provider Cano Health files for Chapter 11 bankruptcy and is looking for a buyer. Shares are down 99% since the company went public in June 2021 via a SPAC merger, valuing the company at $12 million.


Sales

  • Yuma Regional Medical Center (AZ) selects NRC Health’s Human Understanding patient experience optimization software and programs.
  • The Queen’s Health System (HI) chooses Medaptus Assign to assign patients to hospitalists with rules-based patient census integration with Epic.
  • Bill & Melinda Gates Foundation licenses the NSights de-identified patient database that the company sources from several premier health systems.

People

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HCA Healthcare promotes Chad Wasserman, MBA to SVP/CIO upon the retirement of Marty Paslick.

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Availity names Jennifer Irwin (Alegeus) chief marketing officer.

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Aaron Wootton, MBA (Henry Ford Health System) joins Huntzinger Management Group as chief digital officer.

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Alphabet’s Verily hires Myoung Cha, JD, MBA (Carbon Health) as chief product officer.


Announcements and Implementations

Variety Care (OK) goes live with EVisit’s telehealth platform at three of its clinics and across its behavioral healthcare team.


Government and Politics

SAMHSA and ONC launch the Behavioral Health Information Technology Initiative, which will invest $20 million over the next three years to promote the use of health IT within behavioral healthcare and practice settings.


Privacy and Security

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Northern Light Health, a 10-hospital system in Maine, brings its computer systems back online after a weekend cyberattack forced it to activate downtime procedures. Hospital officials say the attack was not the result of ransomware.


Other

San Diego-based Sharp HealthCare’s Spatial Computing Center of Excellence distributes 30 of the newly launched Apple Vision Pros to physicians, nurses, informaticists, software developers, and others to determine how the virtual reality headset can best used in healthcare settings. Sharp is working with Epic on possible uses.

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Primary care physicians are spending an increasing amount of time working in their EHRs, according to a new report that looks at the usage data of 141 UW Health PCPs over a four-year period. The 28-minute increase was mainly driven by patient portal messaging, with patient medical advice requests being the biggest chunk of messaging volume.

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The University of Rochester Medical Center (CT) installs Higi health stations at three community banks as part of an initiative to provide patients living in rural areas with better access to care.


Sponsor Updates

  • Netsmart announces its support for the launch of the CMS Innovation in Behavioral Health model.
  • AdvancedMD announces QBSolutioneers as its newest integration partner.
  • Health Data Movers joins the ServiceNow Partner Program.
  • Optimum Healthcare IT launches a new healthcare IT information and best practices newsletter called The Optimum Pulse.
  • Artera receives Frost & Sullivan’s 2023 Customer Value Leadership Award.
  • Censinet will present at the AHA Rural Health Care Leadership Conference February 11-14 in Orlando.

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HIStalk Interviews Jonathan Rosenberg, CTO, Five9

February 6, 2024 Interviews No Comments

Jonathan Rosenberg, PhD is chief technology officer and head of AI at Five9 of San Ramon, CA.

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Tell me about yourself and the company.

My job is to direct our overall technology strategy, run our AI engineering teams, and figure out how to apply AI technologies to the evolution of contact center technology, which is a super interesting and exciting space. I’ve been in the IP communications industry for approaching 30 years. I was previously the chief technology officer for Webex and for Skype before that.

How has technology changed the way that inbound telephone calls are managed?

It’s having a huge impact, and that impact is going to get even bigger over time. Probably the biggest thing is that we have been able to dramatically improve self-service, not having to wait on hold to speak to a live agent for tasks that users would prefer to self-service anyway. 

There’s tons of examples in the healthcare space, things like appointment scheduling and rescheduling, looking up and getting information on prior authorizations, answering questions about hospital visits, benefits coordination, cost estimates, and insurance verification checks. The list goes on and on. All of these things are relatively easy to support with self service. We can get the call to the right person and understand what the caller wants, collect information, and direct them to the right place. We’ve all experienced way too much transferring. You get to the wrong person, then you transfer somewhere else and you have to repeat everything all over again.

But it isn’t just inbound, there’s outbound as well, communication from healthcare providers and payers to their patients and customers.

Are technologists surprised that many people still prefer making a phone call?

The death of voice in the contact center, which has been predicted for 20 years, is absolutely, positively false. We are seeing an increased amount of usage of communication of the technology. It’s not that people aren’t doing other things. They are, but it’s the total amount of interaction that’s happening between customers and the brands and companies they work with. That has increased as these additional tools, like chat, SMS, and website have gone up.

But at the end of the day, there’s a lot of stuff where people still want to call and talk. It’s faster. It’s interactive. You feel greater levels of trust, especially when you talk to a live person. And in many cases, you want to speak to a real person. We don’t think that everything will go to self-service. That is best done with voice, especially in high-emotion, high-stress situations like we see in healthcare. A voice of empathy — nothing beats that.

What is the role of AI-powered virtual agents?

It has two sides. People understand less about what we call agent assist. In agent assist, AI is involved, but it isn’t replacing the human agent, it is augmenting them. It provides lots of benefits to the agent that help them do a better job and provide a greater experience for the customer. That includes things like coaching the agent to make sure that they perform their checklist of required tasks to the patient or to the customer. Helping provide information at the agent’s fingertips so they don’t have to put the customer on hold and go look something up — the information can just be put right in front of them.

Another really good thing that we have seen is that our agent assist application provides a live, real-time transcript to the agent. If they didn’t quite hear what someone said, they can just glance back at the live transcript.

That is one half of agent assist. The other half is self-service use cases, where a customer or patient calls in and they are talking or chatting with a bot to provide these self-service kinds of use cases that I’ve described. Both of these are powerful in the contact center.

Are health systems assembling all of their interactions with patients – mailings, outbound calls, fundraising, billing – so that anyone who interacts with them has the full story?

One of the hardest problems to solve in the industry is breaking down these silos. It is becoming more important than ever for companies that are providing customer service to do that. 

One of the interesting drivers that will accelerate the collection of all this information together is this emergence of generative AI and large language models. These things are incredibly powerful and highly beneficial to a lot of the use cases that we are talking about. They need contextual data to work. They need to know about the caller and the customer to provide the experience they want.

The more of this information that you can collect and feed to that generative AI model, the better job it can do to provide superhuman experiences, something that you couldn’t even hope to get from a human alone. We are excited about that, and we think it will drive a lot of the collection of all this data together.

Healthcare is powered by fax machines, photocopies, and clipboard forms, yet consumers interact everywhere else with chatbots, smart search, and voice processing. Will healthcare embrace these technologies?

I hope so. Customers in general are seeing advances in technology and how they receive service in other industries, and that sets levels of expectation.

For the benefit of healthcare, a lot of the rest of the world is becoming more sensitized to the type of issues that have traditionally prevented or made it difficult for healthcare to do this, related to sensitivity of data and the protection of personal information. With all of this, especially with this genre of AI technology, those questions are top of mind now for buyers of these products and services. They were top of mind for healthcare before, and now they are top of mind for everybody else. That will drive increased attention to solving those problems so that we can deliver solutions that are broadly adaptable in the healthcare industry. That’s the optimist in me that thinks this way and hopes to see this technology penetrate quickly across healthcare.

Health systems have grown by acquisition into regional or even national organizations that have a large scale and an increased technology capability, but that may create more bureaucracy. How will this affect their use of technology?

In some sense, centralization helps a lot of these things. It consolidates the buying power and the deployment of these technologies. You can deliver it out to your regional hospitals and practices so that everyone gets it quickly. Instead of every single doctor’s office or hospital having to do this on their own, you get to do it just once. That could be helpful in accelerating adoption of this technology.

How does a software company incorporate AI into their product when it changes every day?

At Five9, we have adopted a strategy that we call engine-agnostic. That means that we have built our software platform so that we can consume third-party AI engines, as we call them. These engines are the raw ingredient that do the processing.

For example, the thing that takes an audio file and spits out a transcript. Or the thing that takes a sentence of text and delivers the intent. What was the thing that the customer said? Or you send it a paragraph and it produces the medication name, the doctor name, and the dosage off the information paragraph.

These are like raw engines. We have designed our system to allow those to be pluggable, so that we can adapt and evolve as these technologies improve. They are improving at a lightning, breathtaking pace, and that has definitely made it challenging. In fact, we have already switched our underlying LLM engines a few times for different use cases. We have only been able to do that because of this engine-agnostic strategy.

How will the market respond to companies that add the simplest AI wrapper to their product with few actual benefits, just to be able to use the marketing buzzword?

Especially in the contact center, tons of little startups said, “We can finally build the chatbot that the world has wanted.” Then they throw a UI wrapper in front of ChatGPT and call it a day. 

That’s not what the market wants. The market, especially in the contact center space, wants a platform that spans all of the interaction modes – voice, chat, email, SMS, and social channels. They want powerful reporting and analytics. They also want to make sure that humans and AI are integrated together so that calls and chats can bounce between them, and all of that just works. 

That’s hard. You realize that the value proposition is delivering all of that, and then plugging in the AI to make it better. The platform plays are the likely winners in the in the contact center technology space, and we are one of them.

AI allows companies to create closed models of their internal documentation and processes to help a frontline person who is in the middle of a call or chat session. Is that creating new possibilities?

This is another thing that has taken a generational leap forward. Prior to large language models and generative AI, we would have to train a custom model on the different intents, as we call it, different use cases and things that would be discussed in the conversation that need to be detected that would then trigger information to be shown to the agent. That all had to be done looking at their existing conversations to go collect all that data to train and fine tune the model. 

Generative AI has changed dramatically the way that we can think about that. We used to need to enumerate every single use case, what might be said and asked, and then handcraft the model to detect it and handcraft the response that should be shown to the agent. Now with gen AI, we can just ingest all of this knowledge, processes, and documentation the same way a human agent would go read those materials. Then we can give written direction to the agent assist functionality on what we want to do. It can start to provide this knowledge and guidance.

We are seeing great initial results with this, and this is what we are building towards. It will be transformational in this space in the coming years. It is incredibly powerful and amazing technology.

What does the company’s strategy look like over the next three or four years?

With generative AI, three to four years is like really far away [laughs]. But it’s that thing, generative AI. It’s going to be incredibly amazing in delivering superhuman experiences to customers and delivering the kind of customer experience that the contact center market has always dreamed of delivering to customers, but that in many cases, fell short of expectations. Now we have the tool to deliver the kind of experiences that we have really wanted to.

I talk about the end of call hold. I can’t wait for the day when you can call the contact center, you want to speak to someone live, and they never need to put you on hold ever again. Because anything that they need, anything that they have to say, anything that they need to do, is instantly at their fingertips. That will be a great day, and we are working towards that day in the next two to four years.

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