HIStalk’s Guide to ViVE 2024

Care.ai

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Top News

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

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

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

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.

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.

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

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.

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

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

Availity names Jennifer Irwin (Alegeus) chief marketing officer.

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

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

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.

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.

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.

Blog Posts

• 2024 CPT Code Set Overview (AGS Health)
• Risk adjustment software: Key concepts and top vendors (Arcadia)
• How are Aridhia Customers Syndicating with HDR UK? (Aridhia Informatics)
• Revolutionizing Wellness: Navigating the Future of Digital Health in 2024 (Direct Recruiters)
• The Evolution of Prior Authorizations (Availity)
• Protect Healthcare’s Greatest Asset: Your Staff (AvaSure)
• New HHS Cybersecurity Performance Goals Help to Prioritize Security Practices, But Truly Protecting Healthcare Organizations Takes Much More (Clearwater)
• Taming the Tsunami of Clinical Data for Better Patient Care (DrFirst)

Contacts

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

HIStalk Interviews Jonathan Rosenberg, CTO, Five9

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

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.

Morning Headlines 2/6/24

Inovalon Acquires VigiLanz; a Leading Clinical Surveillance and Patient Safety SaaS and Data Company

Health data and analytics company Inovalon acquires clinical surveillance and patient safety software and data vendor VigiLanz.

SAMHSA and ONC Launch the Behavioral Health Information Technology Initiative

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.

Bonfire Analytics Raises Oversubscribed $2M Venture Round to Accelerate Digital Health, Medical Device, & Biotech Adoption Across Healthcare Providers

Bonfire Analytics, which offers health tech sales software and analytics, raises $2 million.

Curbside Consult with Dr. Jayne 2/5/24

I was invited last week to an onsite meeting at the local office of a national company, where a “return to work” policy had recently been enacted. Employees are expected to be in the office at least three days per week if they live within a certain radius of an office, regardless of whether their teams are located in that office or not.

One of the attendees was grumbling about the fact that he is the only member of his team that works in this market, so he essentially drives to the office and sits in a cube, where he attends video conferences most of the day. He mentioned that despite the policy, he’s often the only person in his part of the office, which doesn’t do a lot for building employee morale or enabling the growth of the company’s culture.

I was interested to see all the amenities in the building, which included a nice-looking cafeteria and an area that could be configured with courts for indoor sports and lawn-style games. I suspect that they pre-date the era of remote work, when everyone was in the office and people weren’t coming back in a fragmented way.

Given the fact that for this company, proximity to an office determines the need to return to in-person work instead of being part of a specific team or holding a specific job role, it’s no wonder that people are not thrilled about the return to work policy. It will be interesting to follow up in a few months to see whether more people are embracing in-office culture or whether it’s just causing more bitterness. Expecting people to collaborate in an office where there aren’t any team members simply makes no sense.

Having worked in environments that are in-person, completely remote, and various combinations in between, I’ve seen how company culture is governed more by people’s behaviors than by whether they’re interacting in person or online. For example, in remote environments, particularly when people are working in multiple time zones, it can be easy to overlook people’s posted work hours and schedule meetings that are too early or too late for them. I’ve had to do that on occasion, but try to only do it when there’s an external constraint, like physician attendees who work from one of the coasts and need to accommodate clinic hours, or something like that. I always reach out to the impacted people rather than just sending the appointment, so that people know it’s coming and can let me know if they can attend the meeting or whether we need to make other arrangements. Using that approach, most people are willing to adjust their schedules to accommodate an early or late meeting, but it’s the fact that you discuss it that helps build rapport, teamwork, and by extension, company culture.

Whether in-person or remote, it’s also important to have a culture where people can put focus time or work blocks on their schedules and have those times be respected. Those blocks need to be created in a way that respects existing standing meetings or important team meetings, but no one should ever be made to feel bad that they want time during their scheduled workday during to actually do their work. Remote employees often struggle with failing to achieve work-life balance because they are always at their workplace, and creating an expectation for them to spend time after-work hours playing catch-up due to overly full schedules isn’t a culture builder.

It was interesting timing to have this meeting since several articles about the topic were published this week. Gizmodo had a headline offering “There’s More Proof That Return to Office is Pointless,” highlighting a study from the University of Pittsburgh that demonstrated that return to office policies don’t positively affect productivity. Researchers looked at a sample of S&P 500 companies and concluded that such policies were more about corporate control than stock performance. They found negative correlations between returning to the office and key indicators such as employee satisfaction, ratings of work-life balance, and opinions of senior management.

Companies allege that returning to the office builds trust, but I have found that trust is best built, regardless of work location, by doing things such as giving employees the resources they need, ensuring that employees have adequate time away from work (such as uninterrupted lunch breaks), not requiring employees to have their cameras on 100% of the time, and assuming positive intent when employees seem to be asking a lot of questions.

Another colleague I talked to is convinced that her company’s return to office policy is a play to make good on bad real estate decisions that were made when people failed to realize the impact of remote work during 2020, 2021, and 2022, when others modified their leases due to the impact of the COVID pandemic. One of the companies I worked with in 2020 saw the proverbial handwriting on the wall and made the decision to unload countless square feet of real estate. They made it clear that they wouldn’t be going back to in-person work, and unsurprisingly, employee satisfaction continues to be high and turnover numbers are smaller than they have ever been.

Fast Company also had an article on the topic that highlighted results from a recent survey that indicated that half of potential employees wouldn’t even apply to a job if it was entirely in-person. Flexible work can be a tremendous asset for neurodivergent employees or those with disabilities, chronic medical conditions, or high commuting costs. There’s also the issue of environmentalism and the potential to reduce carbon emissions when fewer people are driving to a physical office.

I’m not saying that allowing employees to work remotely is all sunshine and lollipops. I’m wondering if some of the movement towards return to office policies has to do with declining professionalism. I’m sure many of us working remotely have done the “business on the top, pajamas on the bottom” wardrobe look and that’s OK. The people I work with regularly either have tidy home offices or use electronic backgrounds, although I do get distracted by those that have animations such as rain or snow on the windows.

However, in attending meetings for professional organizations and committees, I see a lot of people whose home lives have become part of their work lives, including interruptions from children and pets. Life happens, but when your kids are wandering in and out of your call, there’s always the option to turn off your camera, make an apology for the disruption, or even step away.

There’s also evidence that virtual meetings aren’t being done optimally, causing employees to become fatigued and inattentive on calls. Researchers looked at employee engagement during calls, along with physiological measurements, over two working days, encompassing nearly 400 meetings. They cross-referenced their data with questionnaires about work attitude and engagement, finding that fatigue during calls is due to mental underload and boredom in the workplace. They found that disengaged employees have a harder time maintaining focus in meetings where cameras are off, leading to multitasking behaviors and further distraction. They mentioned that highly automated and non-cognitive tasks such as walking can be carried out during meetings, and I suspect that extends to the knitting and crochet that I see some of my physician co-workers doing during committee meetings.

I know of a number of hospitals and health systems that allow technology workers to live anywhere in the US, even though their patient care sites aren’t nationwide. It would be interesting to specifically compare their outcomes to those that require workers to do the same jobs in person that others do remotely. Only time will tell whether organizations will back off on their return to office mandates.

Have you recently been subject to a return to office policy? If so, how is it going? Leave a comment or email me.

Email Dr. Jayne.

Readers Write: Would We Do It All Again? Insights from a Designated QHIN Regarding the Application Process

Would We Do It All Again? Insights from a Designated QHIN Regarding the Application Process
By Jay Nakashima

Jay Nakashima, MBA is executive director of EHealth Exchange of Vienna, VA.

I was asked recently, “Would we do it all again?” Knowing what we know now, would we still have been among the first organizations to apply to become a Qualified Health Information Network (QHIN) under the Office of the National Coordinator for Health IT’s (ONC) Trusted Exchange Framework and Common Agreement (TEFCA)?

Honestly, the answer is yes. But I’m glad it’s behind us.

There’s no doubt the QHIN process was a necessary step toward achieving nationwide healthcare interoperability. As the nation’s first federally endorsed health information exchange that already exchanges 21 billion transactions annually and in all 50 states, there was never a question whether EHealth Exchange would participate in the process.

But it was not always an easy and straightforward process to becoming one of the first Designated QHINs. As anyone who has developed a new system or process knows, what makes perfect sense in planning doesn’t always work out as intended. Unforeseen challenges pop up, and things need to be tweaked and adapted. We expected that.

Now that we’ve had a chance to take a breath and regroup after achieving QHIN designation, it seemed like a good time to share some thoughts and perspective to help others going through the application process.

The healthcare industry is slow to adopt new technology. After all, we’ve been talking about nationwide interoperability for more than 15 years, and while we have made great strides, it is not ubiquitous. The QHIN application process, by comparison, is incredibly fast. The timeline to accomplish various tasks can be remarkably short, sometimes only a few days or weeks in between deadlines. To keep up, an applicant must be prepared to move quickly because once an application has been accepted for testing, Candidate QHINs have 12 months to achieve designation status.

One thing that helped EHealth Exchange was that our team got started well before we entered the official application process. We looked at the proposed language in the QHIN Technical Framework (QTF), which was published in 2022, and spent more than six months ensuring that we closed any gaps between EHealth Exchange’s technology platform and our policies to ensure compliance with TEFCA requirements, standard operating procedures, and protocols. By the time the application was released, we were ready.

This process — and more importantly, the responsibility of becoming a QHIN — is not for the faint of heart. It was a two-year process for EHealth Exchange, and the work doesn’t stop after designation. For those entering the application process now, it’s worthwhile to review the requirements and begin tackling initial tasks before the clock starts.

Although the applicant QHINs were market competitors, we also were all working to achieve the same thing, which gave us a compelling reason to collaborate. Many applicants turned to each other for assistance, and we even began early testing together, unprompted by the government. Candidly, I thought that competition might hinder our abilities to work effectively together, and I am happy to say that that never surfaced. We were all a team working together toward a collective goal.  As others go through the QHIN application process, we would encourage a similar level of appropriate and compliant cooperation with your fellow applicants and Designated QHINs. After all, we all win with national interoperability. 

It’s always easier to drive on a freshly paved road, and I like to think that, along with our future QHIN exchange partners, EHealth Exchange helped pave the way for the next applicants.  As I said before, any new process – particularly one with the level of technical complexity that health data exchange demands – is going to run into unforeseen problems. And boy, did we encounter a lot of them. Steps have been refined. Some requirements have been clarified or adjusted, and new ones have been added. 

For example, each Candidate QHIN had to create its own terms and conditions. In Common Agreement Version 2.0, the Recognized Coordinating Entity (RCE) is proposing a standard set of terms and conditions that each QHIN, and its participants and sub-participants, must adopt to participate in TEFCA, which is a simpler and more consistent approach. The process is now better documented and defined, and I am optimistic that those changes will make it easier for other applicants. 

While I wouldn’t volunteer to repeat the journey we took, for new applicants, you should have no qualms undertaking the application process. Not only because it has been tried and refined, but also because I believe deeply in its value. I’m excited to see TEFCA come to life and to bring our experience to bear in support of our future QHIN exchange partners, the RCE, and most importantly, the American health system and the patients whose care depends on nationwide exchange.

Readers Write: More Technology is Not Always Better in Specialty Medication Workflows

More Technology is Not Always Better in Specialty Medication Workflows
By Julia Regan

Julia Regan, MBA is founder and CEO of RxLightning of New Albany, IN.

Over the past decade, there has been a consistent promise made that technology would make provider and care team lives easier. However, the proliferation of EHRs, point solutions, manufacturer and vendor portals, and digital devices have made various processes not only more cumbersome, but more confusing and frustrating.

In specialty medication onboarding specifically, an HCP may need to visit upwards of 40 portals or websites throughout their day to check patient benefits, submit prior authorization, find and complete enrollment forms from various manufacturers, collect patient consent, and track enrollment statuses. It’s no wonder that healthcare is facing a burnout crisis.

As technology has become ubiquitous, it has created an additional challenge for biologic coordinators and medication access teams, especially those that work to support patients with complex treatment plans or work across therapeutic specialties. This, in turn, increases cognitive load, screen time, and clicks, slowing the completion of the necessary steps in a patient’s care journey and decreasing overall speed-to-therapy.

As an example of portal fatigue, a medication access team member at a large health system may need to support an oncology patient who is prescribed multiple brand name specialty medications, each of which requires portal access to obtain assistance. One of the drugs may have a manufacturer-sponsored co-pay assistance program, another may be eligible for foundation assistance, while another may need additional approvals via prior authorization. In order to effectively support this patient through their medication access journey, multiple portals and logins are required.

Instead of the common perspective that “more technology = better,” we must shift to a new perspective that says that “unified, purpose-built – even less – technology = better.” Instead of forcing teams to scour the web for up-to-date manufacturer forms, why not house all forms, and enable submission and delivery of those forms, in one solution? Instead of routing a form for patient and provider signatures via a distinct process, why not enable seamless signature collection at the point of care? Instead of manually researching affordability options — foundations, PAP, co-pay, etc. — on a variety of sites, why not integrate those options into the same portal where the forms and signatures live? Creating a uniform, digital entry point that leverages a repeatable process for any drug, any manufacturer, and any patient can significantly reduce cognitive load and burnout.

As I’ve had conversations with providers, care teams, and medication access specialists over the past few years, the more I’ve realized that “more technology ≠ better.” As patients enter and exit their offices, they wish for integrated, intuitive, secure technologies that minimize work and accelerate the speed at which they can deliver quality care. While the specialty medication onboarding process includes a variety of steps to help support patient access  — benefit verification, PA, consent, financial assistance, and fulfillment — there is no reason that these steps cannot be automated, integrated, and fast. An HCP should not have to worry about which manufacturers may or may not have sponsored a program, or if the technology will work for a specific patient. To reduce burnout and create consistency, technology should work the same way every time.

It is up to clinical leads, IT teams, and other leaders to sound the alarm and support the launch of solutions that reduce burden and burnout for their teams, instead of those that create more work. A single digital entry point for any patient and any medication is a reality that is within reach. We just need to drive provider adoption of these tools. The only way we can ensure better, faster, more affordable care for patients is to help providers with the work they do every day.

HIStalk Interviews Jonathan Davis, CEO, Trualta

Jonathan Davis is founder and CEO of Trualta of Ottawa, ON.

Tell me about yourself and the company.

I started Trualta about six years ago. I was investing in healthcare education companies that provided training, continuing education, and certification for healthcare professionals. It dawned on me that there were so many great best practices for caring for loved ones, especially aging loved ones, that families didn’t have access to. For example, why did an aide in a nursing home know how to manage a particular symptom of cognitive decline, but a family member didn’t?

That inspired me to think about how we could adapt professional-level training to the families who need it most. That was the start of Trualta. We built a caregiver education platform with articles, videos, and modules to help families build skills and establish confidence to provide care at home.

Right away, we started working to demonstrate that trained, confident family members can provide better care at home. By proving those outcomes, we could partner with governments, payers, and providers to offer Trualta for free to caregivers. We always believed that the caregiver shouldn’t pay for support. We know caregivers are often already facing unexpected costs.

Since then, the business has grown to offer not just caregiver training and support, but also community and coaching.

People don’t always know in advance that the caregiver role is about to be placed on them. What is the most common training and support they need?

That’s very true. Many caregivers don’t even self-identify as caregivers. The training and support that is most effective is a mix of topics related to the caregiver’s own wellness and how to manage this often unexpected, challenging care situation. We personalize our content to the caregiver’s unique care situation and the conditions they manage at home for their loved one. At the end of the day, all caregiving journeys are different. We anchor on the training outcome. We want our caregivers to feel more confident and less alone, which we know leads to better care for the patient, the loved one they are caring for.

What is the blend of people, technology, and support that makes it possible to successfully send patients home for care?

On the technology side, we’re all about finding the right support for the right caregiver at the right time. Maybe it is post-surgery. Let’s say Mom or Dad got a hip replacement. We know that individual care situation and can target the caregiver with specific content. For example, a common reason for readmission might be a UTI or a bed sore.

Where the technology and the tech-enabled community and coaching come in is that we start to understand how the caregiver is feeling. They’re a bit lonely and isolated, providing care 24/7 for their partner who is recovering at home. We know that they would benefit from a support group, so we direct them to one. It is a virtual, tech-enabled support group, but it is facilitated. To us, that’s a healthy mix of technology and people. If the care situation escalates and we see a high risk of caregiver burnout, we can route that person to a one-on-one coach.

A national challenge is the large number of baby boomers who will eventually need care, but with fewer people to care for them. How will that play out?

This is such a tough problem on both the demand and supply sides. On the demand side, we have this aging population. Folks are also living longer, with a higher likelihood of certain chronic conditions or cognitive decline. We know that older adults prefer to age in place. Then we have government policy promoting home and community-based settings instead of the institutional setting.

Demand is way up, but there’s an acute workforce shortage, so supply is also down. That market dynamic is putting so much on the family members. It’s more important than ever that our healthcare stakeholders support families and people who care for loved ones at home with skills, community, support services, and coaching.

How do you work with partner organizations?

We are thought partners with the organizations we work with. Most of the payers and providers that approach us know that they could be doing more for caregivers, and intuitively understand it will lead to better outcomes for members and caregivers. But they don’t really know where to start. They don’t have a caregiver strategy. Often, they don’t really know who the caregiver is or have contact information for them.

We build that strategy with them. We provide the learning and support platform, and then make sure it’s integrated into the workflow and existing systems.

Do you roll it out broadly, or is it case by case?

Generally, our partners have specific populations in mind where we focus, but access to the program is usually available across the organization, because supporting caregivers is becoming an enterprise-wide priority.

We’ve always focused on high-need populations. We’ve helped a lot of folks in really challenging care situations, like parents of kids with intellectual and developmental disabilities, or caregivers for individuals with dementia, cognitive decline, or a recent stroke. These are areas of focus where a social worker, nurse, or discharge team might be more deeply ingrained with Trualta than in other service lines.

What are the company’s priorities over the next three or four years?

Our vision for Trualta is that caregiver support is as ubiquitous as patient education. At every point of care, any discharge, especially with our aging population and shift to value-based care, it is so important that families are supported.

Our vision is, let’s take caregiver support from being a “nice to have”, where a few teams are doing it with some populations, and make it a critical part of every point-of-care experience. If a caregiver is present, we need to identify them, engage them, and support them to ultimately improve outcomes for their loved ones. We need to make sure that they are not overwhelmed and burning out.

Morning Headlines 2/5/24

NIH looks for new EHR to replace its 20-year old legacy system

The National Institutes of Health seeks $200 million in funding to replace its Altera Digital Health Sunrise system that it calls CRIS.

VMG Health Acquires Compliance Risk Analyzer from DoctorsManagement

Consulting firm VMG Health acquires Compliance Risk Analyzer, auditing and predictive analytics software developed by DoctorsManagement.

Allina Health deal shifting 2,000 workers to Optum

Allina Health will outsource IT and revenue cycle management services to Optum, which will rebadge 2,000 health system employees effective May 5.

Rivia Health Raises $3.25 Million in Series Seed Funding with PHX Ventures

RCM vendor Rivia Health raises $3.25 million in seed funding.

Monday Morning Update 2/5/24

Top News

The National Institutes of Health seeks $200 million in funding to replace its Altera Digital Health Sunrise system that it calls CRIS.

NIH Clinical Center CIO Jon McKeeby says that 40 of his 120 IT employees are at retirement age, raising concerns about support for the complex, best-of-breed system that the hospital installed in 2004 when it was known as Eclipsys Sunrise Clinical Manager. 

Reader Comments

From Snowbound: “Re: Oracle Health. Laid off 124 Cerner employees in Springfield, MO after CoxHealth announced that it is moving to Epic.” Oracle filed a WARN act notice with the state on February 1, adding that the health system has already made offers of employment to all of the employees who were affected.

From Twin Cities Healthcare Watcher: “Re: Allina outsourcing RCM to Optum. This will be interesting considering the MN AG’s focus on Allina’s billing practices and the history of regulatory intervention in MN with outsourced billing services such as at Fairview in 2012-2013.” Fairview’s former RCM vendor Accretive Health, renamed in 2017 to R1 RCM, paid a fine and agreed to stop doing business in Minnesota in 2012 after being charged with lax security practices and sending high-pressure employees into the hospital ED to demand payment in advance from patients who were suffering from strokes and heart attacks. Accretive referred to the practice as “Accretive Secret Sauce” that it internally proclaimed “check out our ASS.” Accretive’s big customer Ascension partnered with a private equity firm to buy a 40% stake in the company for $200 million in late 2015, since increased to a 54% share.

From LinkedIn Park: “Re: interview. It seems like everyone in the industry I know reached out to me the day my interview with you ran, and I have quantified the HIStalk effect by observing that my LinkedIn profile views are up over 300%.” Thanks for letting me know. 

HIStalk Announcements and Requests

A majority of poll respondents say they have experienced discrimination that hurt their careers, most commonly related to age and sex.

New poll to your right or here: How has the market competitiveness of the former Cerner changed since Oracle acquired it in June 2022?

Thanks to these companies that recently supported HIStalk. Click a logo for more information. Also, extra thanks to long-time HIStalk Founding Sponsors Healthwise and Medicomp Systems. 

Webinars

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

Acquisitions, Funding, Business, and Stock

Allina Health will outsource IT and revenue cycle management services to Optum, which will rebadge 2,000 health system employees effective May 5.

HCA Healthcare says in its earnings call that a key area of investment will be advancing the company’s digital capabilities to “unlock the embedded value we see in our operations.”

A Boston Globe reporter tracks down the 190-foot, $40 million, Galapagos-docked yacht that is owned by Ralph de la Torre, MD, MS, the former heart surgeon who partnered with a private equity firm to create Steward Health Care Systems as CEO. The reporter notes that Steward, which is teetering on insolvency that may force a taxpayer bailout, quadrupled the private equity firm’s investment by selling the land under its hospitals, allowing the company to walk away with $800 million and de la Torre to award himself a $100 million bonus, after which he yachted up.

Announcements and Implementations

In Canada, a university IT professor says that the health system has squandered billions of dollars on proprietary software development that led to all 10 provinces having their own expensive IT systems that don’t work together. He advocates developing open source software for billing, labs, and diagnostic imaging instead using HermesAPI, which would mean “sending less money to prop up American software companies.”

Visage Imaging launches Visage Ease VP for Apple Vision Pro. It includes a cinematic rendering engine, 4K resolution on virtual screens, independence from room lighting, and natural input using hands, eyes, and voice.

Cedars-Sinai develops Xaia, a mental health support app for the Apple Vision Pro. It offers immersive therapy sessions that are led by a digital avatar that simulates a human therapist. The hospital has licensed the system to VRx Health for commercialization.

The Permanente Medical Group publishes its initial experience with Nabla’s smartphone-based ambient scribing system, which it says has been used by 3,400 of the 10,000 invited physicians, of which around 1,000 have used it for more than 100 encounters. Physicians report that it is saving them time, even though they are required to approve the AI’s draft version, and patient feedback has been positive. The most common reasons for not using the tool include the required activation steps, lack of familiarity, and lack of integration with other workflow solutions.

Government and Politics

Two Texas doctors are indicted in federal court for submitting phony medical bills to the insurers of student athletes that they had not treated. The doctors, who owned sports medicine practice management system vendor Vivature, used the patient information that had been entered by athletic trainers to submit fraudulent bills for other services. The indictment lists three universities, including Auburn University, that shared the payment that Vivature received. The defendants are also charged with fraudulently billing for COVID-19 testing in partnership with international resorts who tested Americans who were traveling aboard. The DoJ says the defendants obtained $70 million between the schemes.

Privacy and Security

Computer, phone, and email systems remain down at Lurie Children’s Hospital (IL) following a February 1 cyberattack.

The CEO of one of the five hospitals whose shared services organization was taken offline by cyberattack in October 23 says that some major systems remain down and he expects that it will take most of 2024 for the hospital to fully recover from the attack.

Other

Not (yet) healthcare related. A finance employee of a huge Hong Kong company makes a $26 million money transfer for a confidential corporate transaction, as instructed in a video call with the CFO and other executives. He learned afterward that the video call attendees were AI-generated deepfakes and the money recipients were scammers.

Sponsor Updates

• Waystar joins Meditech’s Alliance program
• EClinicalWorks announces that its Sunoh.ai AI-powered ambient listening technology now integrates with EClinicalMobile and EClinicalTouch apps on iOS and Android smartphones, iPads, and Microsoft Windows and macOS devices.
• NeuroFlow will exhibit at the AMSUS 2024 Annual Meeting February 12-15 in National Harbor, MD.
• RxLightning (Claritas Rx) names John Paulson senior director of business development.
• SnapCare will exhibit at the ACNL Conference February 4-7 in Monterey, CA.
• Symplr achieves milestone recognitions in 2023, garnering industry and employee acclaim as a leader in healthcare operations.
• Wolters Kluwer Health makes the NEJM AI journal available on its Ovid medical research platform.

Blog Posts

• Best practices for building an AI-powered digital front door in healthcare (Notable Health)
• Fireside Chat Highlight Reel: Medical Coding Automation Trends and Autonomous Coding (Nym)
• NAHC President Bill Dombi Gives His 2024 Outlook (Netsmart)
• 5 questions to ask when you’re at a crossroads in your EHR strategy (Nordic)
• Rachel Marano in Fast Company on Workaholism (Pivot Point Consulting)
• How to Determine When It’s Time to Optimize Your Epic EHR (CereCore)
• Maximizing Healthcare Revenue: 3 Practical Tips for Transforming Front-End Processes (Vyne Medical)
• Important Changes to MIPS Reporting in 2024 (RCxRules)
• Crystal Ball Chronicles: Reflecting on Out of Pocket Health’s 2024 Predictions (Redox)
• Leadership Spotlight: Jazmin Richardson, Nursing Executive (Sonifi Health)
• A Health Plan, an EHR, and a Health System Team Up, Eyeing a Win for Patient Care (Surescripts)
• 5 strategies to overcome patient payment complexities (Waystar)
• Strategies for Effective Revenue Cycle Automation – Start Small (VisiQuate)

Contacts

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

Morning Headlines 2/2/24

Where do we go from here on digital therapeutics?

The digital therapeutics market is stagnating in the US, as evidenced by vendor bankruptcies and lack of Medicare coverage for the sector’s products.

Cohere Health Raises $50 Million in Equity to Meet Increased Demand for AI-Driven Transformation of Prior Authorization Process

Prior authorization technology vendor Cohere Health raises $50 million in equity funding, increasing its total to $106 million.

Carpl guides healthcare providers through the growing market of radiology AI apps

Carpl, a San Francisco-based startup that has developed a marketplace of vetted radiology AI apps, raises $6 million.

SAMHSA releases final rule on opioid use disorder treatment

The Substance Abuse and Mental Health Services Administration makes some COVID-19 flexibilities permanent, including the ability for Opioid Treatment Programs to prescribe opioid use disorder medications via telehealth without an initial in-person evaluation.

Network outage affects phone, internet service at Chicago’s Lurie Children’s Hospital

Lurie Children’s Hospital in Chicago works to recover from a Wednesday network outage that has impacted its internet, email, phone lines, and MyChart access.

News 2/2/24

Top News

A Stat review says that digital therapeutics is stagnating in the US, as evidenced by vendor bankruptcies and lack of Medicare coverage for their products.

The authors note that Pear Therapeutics shut down less than a year after CMS denied the company’s request to consider its substance abuse order product (pictured above) as a billable medical device.

Few commercial payers cover digital therapeutics because of concerns about efficacy, which poorly designed vendor studies have failed to prove.

The article says that vendors who want their products covered like traditional drugs will need to perform similar studies that meet a comparable standard of evidence, which is risky because of high cost and the possibility that their products aren’t effective. They could also sell their products to providers who might be reimbursed by payers for achieving specific results.

HIStalk Announcements and Requests

Thanks to the folks at DrFirst, which booked the Top Spot banner (at the upper right of the HIStalk page) for the long term, initially to showcase their participation in the ViVE conference. I appreciate the support.

Repetitive, I know, but winding down – sponsors that are participating in ViVE and/or HIMSS should complete the respective forms so I can list you in my guides pro bono (does that word make you think of U2 or Cher?)

Webinars

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

Acquisitions, Funding, Business, and Stock

Cardinal Health acquires group purchasing company Specialty Networks for $1.2 billion in cash, calling out the strategic value of its AI-driven PPS Analytics product that analyzes data from EHR/PM, imaging, and dispensing systems for clinical decision-making and for purchase by drug companies.

Medical practice patient communication technology vendor Vital Interaction raises $15 million in Series A funding.

Fabric, a healthcare enablement startup that was formerly known as Florence, acquires Gyant, which offers health systems an AI-powered virtual assistant.

Prior authorization technology vendor Cohere Health raises $50 million in equity funding, increasing its total to $106 million. It has five health plan customers.

Hindenberg Research predicts a “breakdown” for private equity-backed mental health rollup LifeStance, which has 6,400 clinicians, 600 centers in 33 states, a market cap of $2 billion, and a mountain of debt. It says the company is running out of cash, employs mostly therapists who bill at low rates compared to psychiatrists, provides stock grants to its highest-performing prescribers of drugs that have a high abuse potential, and pushes clinicians to see up to 30 patients per day. Former employees say that the industry has such low barriers to entry that LifeStance provides no value or even negative value because “all you need to do to open up your own private practice is post a thing on Facebook and start seeing private, cash-only patients.”

Sales

• Smile Train will provide its partners and affiliates access to select medical journals via Wolters Kluwer Health.
• VNAcare expands its relationship with Netsmart to implement its MyUnity EHR.
• ACO Vytalize Health will use WellSky Next-Generation Provider Solution for care coordination between acute and post-acute providers.

People

Oracle expands the role of former CMS Administrator Seema Verma, MPH to EVP/GM of Oracle Health, the former Cerner business.

Workforce management solutions vendor Hallmark Health Care Solutions names industry long-timer Bruce Cerullo, MS as CEO. He replaces co-founder Isaac Ullatil, MBA, who will transition to strategic advisor.

JTG Consulting Group hires Jaimie Augustine (Copan Diagnostics) as chief growth officer. She replaces Lisa Potter, who was promoted to COO.

Announcements and Implementations

Atlantic Health will acquire Saint Peter’s Healthcare (NJ) and move it to Epic.

ECRI lists its top health tech hazards for 2024:

1. Usability of medical devices intended for in-home use.
2. Insufficient cleaning instructions for medical devices.
3. Drug compounding without technology safeguards.
4. Environmental harm from patient care.
5. Lack of AI governance in medical technologies.
6. Ransomware.
7. Burns from single-foil electrosurgical electrodes.
8. Medication errors caused by damaged infusion pumps.
9. Defects in orthopedic implantables.
10. Web analytics software and the misuse of patient data.

Publicly traded hospital operator Community Health Systems migrates to a FHIR-based clinical data platform on Google Cloud and is implementing the company’s AI technologies.

Government and Politics

A law firm says that an Epic case that was heard by the Supreme Court raises the legal issue of proving that employees actually signed arbitration agreements that include employment class action waivers. It notes that employees are arguing that they don’t remember signing the agreement, which places the burden on the employer to prove that their electronic signature wasn’t provided by someone else.

The Substance Abuse and Mental Health Services Administration makes some COVID-19 flexibilities permanent, including the ability for Opioid Treatment Programs to prescribe opioid use disorder medications via telehealth without an initial in-person evaluation.

England’s health regulator finds that IT systems at Newcastle upon Tyne Hospitals – a Global Digital Exemplar and HIMSS EMRAM Stage 6 designee – are not always integrated and don’t always promptly provide staff with information they need. Inspectors noted that OR information is documented on paper and then entered into electronic systems afterward because of slow systems, which was measured at 45 minutes from log-in to retrieval of a single patient’s vital signs and fluid balance. The inspectors also observed that maternity staff are required to document the same information in two systems due to lack of integration.

Regional West Medical Center settles its contract dispute with Oracle for $6 million versus the $15 million that the company wanted, freeing it to convert to Epic. The hospital blamed financial losses and the lowering of its bond ratings on the revenue cycle disruption that was caused by its 2018 implementation of Cerner Millennium.

Other

A data manipulation expert uses AI to determine that a Harvard Medical School neuroscientist included plagiarized images in 21 journal articles, including images that came from other papers and from vendor websites.

Sponsor Updates

• CereCore publishes a new case study, “Liverpool Women’s NHS Foundation Trust: Successful EPR Transition Journey.”
• Hyndman Area Health Center expands its use of EClinicalWorks technology with the addition of AI solutions including the Sunoh.ai virtual scribe.
• WellSky will use cloud, analytics, and AI technologies from Google Cloud.
• Impact Advisors joins Epic’s new Rev Cycle Partners program.
• Findhelp names Dallas Mudd (United Way of Northwest Arkansas) senior director of partnerships.
• Health Data Movers welcomes Eric Williams (Kaiser Permanente) to its board.
• Inovalon names Katie Smith (Inari Medical) senior manager of clinical analytics.
• The Lean HealthTech Podcast features KeyCare CEO Lyle Berkowitz, MD “Virtual Visionaries: KeyCare’s Revolutionary Approach to Telehealth.”
• Konza National Network appoints Jonathan Smith, MPH (Lawrence-Douglas County Public Health) to its Board of Directors.
• Broadlawns Medical Center (IA) maximizes efficiency with Meditech’s labor and delivery solution.

Blog Posts

• Three clinical information challenges for care teams (Wolters Kluwer Health)
• Benefits of Medical AI Scribe Integrated within the EHR (EClinicalWorks)
• FDB Salutes Heroes Unleashing Power of Medication Decision Support (First Databank)
• Why Paper-Based Processes are Costing Your Health System (Vyne Medical)
• Social Drivers of Health (SDoH) Analytics: Health Leaders Amplify Impact Through Insights (Findhelp)
• HFMA Western Region Symposium 2024 Recap (FinThrive)
• #FreeTheContent (Healthwise)
• Establishing an Effective Change Management Office for Organizational Evolution (Impact Advisors)
• Top Healthcare AI Conferences 2024 – Part 1 (Lucem Health)
• Mastering Patient Retention: 5 Strategies to Prevent Leakage (Medhost)
• Preparing home health agencies for value-based purchasing in 2025 (Meditech)
• The Future of Wound Care Starts with Clinical ROI (Net Health)

Contacts

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

EPtalk by Dr. Jayne 2/1/24

Physicians who care for children — including pediatricians, family medicine physicians, and psychiatrists — have been sounding the alarm for years with regard to the negative impacts of social media on the health of the world’s youth. I’ve been following the recent hearings in the US Senate Judiciary Committee this week on the topic of child sexual abuse. Executives from TikTok, X, Snap, Discord, and Meta were grilled by senators about the platforms’ role in child exploitation.

For those of you who might not be following the issue closely, abuse and exploitation of kids via social media platforms is more than cyberbullying and child pornography. The list of problems continues to expand, and includes not only the sharing of images and videos, but also predators grooming children for abuse and potential trafficking.

Drug use is also a serious concern. I’m sure a lot of parents don’t know that you can use Snapchat to buy fentanyl. As an urgent care physician, I’ve seen the faces of parents who can’t believe that the pricey TikTok-promoted cosmetic products they gave their pre-teen daughters for Christmas have caused the horrible rashes that resulted in a $100 co-pay and prescription medications.

I continue to encounter parents who are willing to help their children lie to gain access to social media even though they’re not old enough to meet the age restrictions, because they are terrified that their children will be ostracized if they’re not keeping up with their peers. I also see children who have zero parental limits on social media use, which can manifest with sleep disturbances, poor academic performance, and serious behavioral health issues.

One hot topic during the hearing was the Kids Online Safety Act, which only two of the five platform leaders were willing to support. Others claimed that the Act contains provisions which are too broad and may clash with free speech issues. The act includes language not only addressing abuse but also predatory marketing and would potentially reduce the power of notifications and auto-played videos that trigger users’ dopamine pathways and contribute to compulsive and addictive behaviors.

YouTube was notably absent from the hearing, despite the platform’s popularity among teen media consumers. Unfortunately, the hearing ended without consensus or clear solutions and those of us who have seen countless children harmed will have to continue to wait for yet another bill on Capitol Hill to finally get passed.

I received a message from the CDC’s V-safe program this week, inviting me to participate in health check-ins for the updated COVID vaccine. Unfortunately, one has to register within six weeks of receiving the vaccine. For those of us who are frontline physicians of a certain age who received the updated vaccine shortly after it became available, I guess we’re out of luck as far as participating in vaccine surveillance. Seems like that should have been something they coded and released to time appropriately with the vaccine’s arrival in retail locations.

Unfortunately, this is just the kind of food for thought that conspiracy theorists latch onto, since it can be used to try to support the assertion that that “government really doesn’t want us to know about how many people are harmed by these vaccines.” I serve on the health advisory board for our local school district, and most of us are still seeing COVID-deniers in practice. Many don’t want to seek medical care because they’re afraid they’ll be tested for COVID. Maybe someday health literacy in our country will improve to a place where clinicians can spend more time rendering care and less time refuting medical misinformation.

As a telemedicine physician, I’m concerned about the conflicting priorities that our industry faces, including balancing patient satisfaction and perceived convenience with elements such as clinical quality and antibiotic stewardship. One of the challenges is the lack of telemedicine-specific metrics, which leads organizations to try to mold in-person clinical quality measures to virtual care. The Agency for Healthcare Research and Quality has created the AHRQ Safety Program for Telemedicine, which will help prescribers look at antibiotic usage over an 18-month period starting in June 2024. The program will provide educational sessions to providers, including scripts for navigating patient concerns about not having their wishes met when they request “a Z-Pack to nip things in the bud since we’re going into a weekend,” which universally makes physicians cringe. Providers are expected to perform better on antibiotic-related quality measures after participating in the program, and continuing education credits are available. There is no charge to providers to be part of the program, which is a welcome element for those of us already spending too much to maintain board certification and other recognitions.

Mr. H recently mentioned concerns by developers such as Microsoft and Google with regard to the cost of the computing power needed for AI projects. I’m a bona fide space nerd, having once wanted to be the first physician living permanently in space. Instead, I’m content to watch from the sidelines as scientists execute cool projects that I could only dream of. I’ve followed NASA’s Ingenuity helicopter, which nearly every journalist describes as “plucky,” especially since it was planned for less than a half dozen missions and eventually flew 72. Ingenuity weighs less than 4 pounds, but provided an amazing amount of data about the ability to achieve powered autonomous flight on another planet.

A headline about the craft caught my eye this week, noting that the craft “packed more computing power than all other NASA deep space missions combined.” This was a challenge given its small size, with engineers having to forego heavy components whose design would mitigate radiation damage and the extreme temperatures on Mars. Instead, designers specified off-the-shelf components, including the brain of the helicopter: the Qualcomm Snapdragon 801 processor, which was used in smartphones nearly a decade ago. Here’s to those IPhone 6, Blackberry Passport, and Google Nexus 6 users whose daily calls shared NASA-worth technology and they didn’t even know it. Photo credit: NASA/JPL.

What was your childhood dream? Are you working in a related field or would you give up your meeting-filled days for a ride into outer space? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 2/1/24

Cardinal Health to acquire Specialty Networks and its PPS Analytics platform, a technology enabled multi-specialty group purchasing and practice enhancement organization in urology, rheumatology and gastroenterology

Cardinal Health will acquire Specialty Networks and its PPS Analytics software for $1.2 billion.

Oracle Taps Former Trump Official Seema Verma to Lead Cerner Business

Confirming HIStalk reader rumors, Oracle taps former CMS Administrator and current Oracle Life Sciences lead Seema Verma to head up Oracle Health.

Austin-Based Vital Interaction Closes $15M Series A Funding Round to Revamp Patient Communication with Hyper-Personalization

Austin-based patient engagement and retention technology startup Vital Interaction raises $15 million in a Series A funding round.

Health care operations enabler Fabric pays cash for AI helper Gyant

Fabric, a healthcare enablement startup formerly known as Florence, acquires Gyant, which offers health systems an AI-powered virtual assistant.

Healthcare AI News 1/31/24

News

Oracle announces a generative AI service that supports text generation, text summarization, and LLM-contextualized search results. The company says it will release search, aggregation tools, and prebuilt agent actions across its SaaS applications, including those of Oracle Health.

Apple will reportedly release AI features with IOS 18 in June, reportedly including enhancing Messages to answer questions and auto-complete sentences.

The State of Illinois launches a Google AI-powered portal for families to access behavioral and mental health resources.

In UAE, Emirates Health Services launches an AI-powered virtual nurse that answers patient questions, provides medical advice, and helps with assessment and triage. EHS will also assess patient-reported symptoms to schedule appointments with the correct specialty. EHS is running a long list of AI projects, including those related to diagnosis, treatment, disease prediction, patient monitoring, and speech-powered clinical documentation.

Microsoft and Google warn investors that the arms race to develop AI products will be expensive due to the computing power it requires.

Business

The Justice Department is reportedly issuing subpoenas to drug companies and EHR vendors to determine if AI is being used to influence prescribing in ways that breach anti-kickback and false claims violations

Microsoft and OpenAI are reportedly in talks to invest up to $500 million in AI-powered robot developer Figure AI, which could value the 2022 startup at $2 billion. The latest autonomous model is 5’6” tall, can carry 44 pounds, walks at 1.2 meters per second, and operates for five hours when charged.

Research

Researchers apply AI and sophisticated analytics methods to test the detection of Medicare fraud, noting that traditional auditors only have enough time to look for specific suspicious patterns.

Other

Cleveland Clinic says in its annual meeting that it is piloting AI for answering the questions of patients with chronic disease, creating ambient clinical documentation, predicting patient volume, and creating draft responses to questions that are submitted via Epic’s MyChart.

The hottest job in corporate America is the executive in charge of AI, according to the New York Times. It notes that Mayo Clinic in Arizona has hired its first chief artificial intelligence officer. 

An AAMC story describes the experience of physicians who are using AI to create documentation from recordings of their patient encounters. Eric Poon, MD, MPH (Duke Primary Care) says he is finishing his clinical schedule on time for the first time in his life, also noting that he didn’t realize how his EHR typing was slowing down the visit. Matthew Anderson, MD (Atrium Health) says he has a summarydraft in his hand 15 seconds after the visit ends. However, users say that ambient listening tools aren’t perfect in deciding what parts of the conversation to include or exclude, and some of them report that they spend quite a bit of time editing out extraneous information. They also say that it works well for quick visits, but less so when visits involve multiple medical issues.

Contacts

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