VitalHub Announces Acquisition of Strata Health
Health and human services software vendor VitalHub acquires digital care navigation company Strata Health for $23 million.
Health Commons Project, which operates a public health accelerator program in Washington, acquires HIE and health data company OneHealthPort.
Health data and analytics company Health Catalyst acquires cybersecurity business Intraprise Health, its second acquisition in just over three months.
Adventist Health Rideout uses Viz.ai to reduce the time that is required to transfer suspected stroke patients to a hospital that offers specialty care from 202 minutes to 109. The system analyzes the CT scan and alerts the care team if it detects a potential stroke. The data is preliminary, as the hospital has used the technology on just 10 patients since it launched in May 2024.
OpenAI adds web searching capability to ChatGPT. It also collects up-to-date search results from news and data providers and displays them in visual categories such as weather, news, and maps. Results include source links. Unlike Google’s search results, it does not display promoted links, advertisements, or sources that are of questionable quality.
OpenNotes and Abridge partner to research the effectiveness of patient visit summaries that are generated from ambient listening by having those patients evaluate them.
Aignostics, which applies AI to digital pathology to support precision medicine, raises $34 million in a Series B funding round. Mayo Clinic participated in the round and will work with the company to develop foundation models and biopharma product offerings.
Snoop Dog-backed cannabis biotech Oxford Cannabinoid Technologies collaborates with Oxford University to use AI drug discovery to develop non-addictive, cannabinoid-based pain medications. The company also announced that its shares will be de-listed because they have lost 97% of their value, leaving it with a market cap of $3 million.
France-based insurance startup Alan, which allows customers to ask questions to doctors via a chat interface and receive an answer back in 15 minutes, adds a virtual assistant to the feature. The virtual assistant, which is called Mo, rephrases the question and then asks if the person would rather interact with a doctor or Mo. Conversations with Mo are checked within 15 minutes by a doctor who can correct its recommendations. The company says it will enhance the tool to provide personalized guidance based on context and the user’s health history.
The National Cancer Institute awards Pieces Technologies a $2 million grant to develop a conversational AI agent that will allow cancer patients the ability to ask questions about their care. The system, which will also collect social determinants of health information, will be co-developed by MetroHealth.
Penn State researchers find that patients are more satisfied with using a medical AI chatbot if the system remembers their social information and makes small talk about their job and hobbies.
Nvidia’s healthcare VP says that the next wave of AI will turn medical devices into robots. Kimberly Powell predicts that “This physical AI thing is coming where your whole hospital is going to turn into an AI.”
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Kyle Kiser is CEO of Arrive Health.
Tell me about yourself and the company.
I’m in Year 10 with Arrive Health, having been around since the beginning as part of the original team. My background has primarily been in payer-facing digital health. I was an early employee at a couple of digital startups. Before that, Principal had an internal startup called Principal Wellness Company, which was a corporate wellness business, and I was a part of that. That’s probably where I caught the entrepreneurial bug, because it was this group of a few dozen people inside this tens of thousands of employees financial services business. We got to work on really interesting problems, work directly with customers, and move fast. There were some great leaders in that organization. That was the start of this interest and curiosity.
Arrive Health was previously known as RxRevu through mid-2022. Our founding story involves one of our co-founders, Dr. Kevin O ‘Brien, who is a physician in Denver. His mom came to him about her high out-of-pocket spend on meds. Like any son who has the capability to do so, he helped her. There were simple things that he could impact. Take this brand, break it into its generic parts. There’s a therapeutic alternative that you could use for this one that saves you money. Maybe one that you can pill split.
He made a pretty significant impact on her monthly out-of-pocket cost for those meds. That inspired him to start doing this work in his clinic. Kevin wasn’t doing that because he was in a value-based agreement. He wasn’t doing that because he made more money for doing it. He just started to identify the real need that the only meds that work are the ones you can afford. He started tracking these things over time for his patients. That is the seed of what became the initial API, which then became a real-time benefit network that connects into the point of care.
But it all started with Kevin wanting to help his mom. We have a mantra in the company, “Lucy Up.” That’s our way to say, raise your eyes to the mission and really remember why we’re here. Kevin’s mom’s name is Lucy. Everybody has somebody in their life, like Kevin did, who has had an experience with the healthcare system that’s too expensive, confusing, hard to navigate, or hard to access. That’s a very personal problem when it happens. We use Lucy Up as a mantra to make sure that we continue to take that problem personally. That has been a huge part of our story and what motivates everybody on our team.
From a business perspective, we offer a market-leading real-time benefit network. We connect to the point of care into the e-prescribing systems and the EHRs that are used by providers. We provide real-time, patient-specific, moment in time, specific insight into the cost of medications.
That has evolved since we last spoke. We’ve built some interesting prior authorization tools. We bought a company from UPMC that was doing some interesting work around medication management and adherence in concert with the health system access team. We expanded beyond just the point-of-care price transparency piece, which is still a huge focus and important primary part of what we’re doing, but it also enables lots of other opportunities to solve new affordability problems and to solve access issues around prior auth. We’re pursuing those things with all of our might right now.
When a patient leaves their physician visit knowing that their prescription has been sent off to their preferred pharmacy, what unpleasant surprises might await them at the pharmacy counter?
The key point is that the primary cause of non-adherence is cost. Patient cost is a lot more complicated problem to solve than it used to be. Deductibles used to be hundreds of dollars, but now they are multiple thousands of dollars. Out-of -pocket costs around drugs went from $5, $10, or $20 to hundreds and thousands of dollars and even more in some rare cases. The consequences of the wrong choice are much higher for patients.
At the same time, the complexity that physicians have to manage is way higher. Think about biosimilars, which have great promise. A lot of the health plans and PBMs are making specific choices around the right biosimilar, so now you’re going to end up in an environment where there’s a branded med, there’s a biosimilar option, or there are multiple biosimilar options to choose from, and those choices are different based on payer, PBM, or the type of insurance.
It used to be that if you talked to a provider, they probably knew that this drug makes the most sense for Blue Cross patients and this other one makes sense for these other patients. Now the complexity of that is not something that providers can manage in their head. It’s a problem that requires a piece of technology to help manage, because the complexity is so high and the consequences of a choice that is not aligned appropriately with the patient’s insurance, or when a cash pay option is more important, or when a patient may need some type of other support, means hundreds and thousands of dollars to the patient.
When half of Americans can’t endure an unexpected thousand-dollar expense, the stakes are pretty high. That’s the way we are thinking about the problem. The stakes are higher for the patients, the complexity is higher for the provider, and we have to show up with both the right connectivity and the right type of technology that brings to the table the intelligence of a pharmacist in real time to be able to meet that need.
Does the problem flare up on January 1 when patients might change insurance or plans, meaning that their maintenance meds might require a new prior authorization, coverage for the med might change, and their deductible resets?
A lot of changes happen around the first of the year. October 1 is another important moment with a lot of anniversaries for insurance. Changes in plan design make a big impact. Those happen on certain intervals, and those intervals create spikes in those types of changes. That’s only going to get more complicated as the Inflation Reduction Act impacts Medicare and the plan provisions inside of Medicare.
We are only making things more complicated. In some cases, with good intent, not complicated for the sake of complicated. We’re trying to solve problems and there are only so many levers to do it, but it makes the job of the prescriber much harder, which is what we are focused on. How we clear the path for that provider to make a clinical choice that makes sense and focus on the clinical visit with that patient. Try to take the burden of this background web of complexity out of that equation, to the extent that we can, and just serve up what makes sense based on what we can see in our system.
You mentioned biosimilars, which hold promise to reduce the costs of big-ticket drugs such as Humira. Uptake seems to have been slow, maybe because the doctor needs to generate a new prescription since it’s not a simple generic substitution. What lessons has this process offered?
The lesson is that things really do take some time to work their way through the system. The primary regulatable insurance types, like Medicare, can be impacted broadly by a regulatory choice. Commercial insurance is an entirely different animal, and much of that is self-funded employers. That change has to be adopted employer by employer by employer by employer by employer. The web of decision-making there is that brokers and consultants are involved, the health plan is involved, and there’s the plan sponsor themselves. There’s a lot of different decision makers along that chain, so it takes a while for things to work their way through the system. That’s one thing, and then once they do work their way through the system, we have to communicate that to providers and care teams so that they can help guide patients through that newly formed maze.
Will 21st Century Cures and broader interoperability help with payer-provider-patient communication?
It’s a mix. There are some great success stories, with real-time benefit among them. We benefited from a CMS rule that caused some great adoption of real-time benefit technologies on the health plan and health IT side. That’s a good news story about positive impact.
There’s still a bit of adoption happening around Cures, but it not going to happen in abstract. The distinction is that real-time benefit had a discrete use case with a problem to solve. Docs want to know how much things cost and they want to do that so they can help patients. We could move into that space, which requires interoperability and requires providers, health plans, and technology companies working more closely together. That works well. The things that are important, infrastructure like Cures to change the way we operate, require useful use cases to then drive them forward.
Some of the prior authorization rules are good momentum in that direction. That’s where everybody stands to benefit from doing that better and differently. It costs health plans a ton of money to administer prior auths, but at the same time, they feel like they can’t really reduce the complexity of prior auth because it’s an important tool for them. Providers and patients bear the burden of how challenging that can be. They’re the ones completing the prior auth, reworking medication choices, and from a patient perspective, trying to figure out what’s going on. It’s one of those things where prior auth is a powerful use case to drive forward some of the interoperability ambition in a discrete use case that will benefit everybody.
What’s the balance between insurers using PA to reduce their costs while requiring clinicians to perform free work to send them PA documentation? Could that be done electronically, or will AI play a role and perhaps even result in the AI systems of both parties arguing with each other?
That seems to be happening now. The AI systems that are pitted against each other is probably current state in some cases. PA is definitely one of those universal things that everybody agrees needs to be different.
AI is a great opportunity to make that different. There will be a role for payers, EMRs, and providers to operate differently together. Doing things like indexing the clinical data in a form that allows you to autocomplete prior auth is a no-brainer. It should happen, it is happening, and I think it will be adopted quickly.
One of the things that we are focused on, which is a little bit different than that, is how to take some of those policies and turn them into decision support. Every prior auth has documentation associated, where the health plan says, “Here are the rules of the road” for prescribing whatever it is you want to prescribe. This is probably not totally fair, but my guess is that the last person who read that policy is the one who wrote it.
The way the world works today is that providers submit everything and see what happens. They’ve been trained to do that, because the decision-making seems invisible to them. We want to turn that policy into decision support. We integrate directly into decision-making workflows so that we can start much in the same way that we did with real-time benefit. Let’s get the answer right the first time and guide that to the appropriate path based on the criteria that the payer requires, because then patients are more adherent.
I’ve heard estimates that one-third of patients just walk away when they experience a prior auth. That’s not great. We’re going to do this in a way that’s less burdensome to the provider and less consequential to the patient.
We’re going to reduce the waste that is associated with the payer experience. They probably have to deny a majority of what’s submitted, which we can avoid if we get that criteria into the hands of the decision maker. That’s where we’re focused and that’s what I’m most excited about, because if we do that right, a system embedded in the EMR that’s a guidance system could be a scenario where prior auths are no longer required. If we can get adoption of that type of tool at a broad scale the way we have with real-time benefit, we can go to those payers and say, not only are they following these guidelines, they’re using this tool to do so, it’s auditable, and we can show you. Then we can start to ask for a gold carding scenario, where prescribers maybe won’t be subjected to prior auth because they are using these types of tools.
That’s where I want to go, because PA is one of those things that we all assume has always been a part of American healthcare. The first PAs were not even introduced until the late 1990s, maybe mid 1990s. It has not always been this way. It doesn’t have to always be this way. We just need the tools to behave differently, and that’s where we’re focused.
Big corporations operate drug stores, specialty pharmacies, health insurance plans, pharmacy benefit managers, and in the case of UnitedHealth Group, all of the above. Can technology improve transparency in a system that was built around the profit motive and vertical integration?
There’s still a lot of really good and important problems to solve for patients in the existing system and in the existing structure. The profit motive certainly informs a desire to build bigger organizations, more consolidated organizations. But at a plan sponsor level, they are still incentivized to try to control cost and get the best quality care at lowest cost. There’s plenty of room to run on making the experience better, on creating more consumer choice.
We’re seeing a ton of progress there on driving more consumer choice at the point of care and throughout the patient experience. There’s more acceptance of just “that’s the way that is.” Some of those things are not necessarily our business so this is me commenting on industry generally. There’s things like integrated cash card programs that are being adopted by some of those people that you’ve mentioned that take insurance benefits and cash pay and start to compare those things, which is kind of the way it should work.
Like inside the deductible, you’re more often than not having to pay out of pocket. The in-network negotiated price list was intended to do a calculation to come up with a co-insurance number, not intended as the cash price. That has created the opportunity for these cash card programs and discount card programs. The integration of the benefit design and cash options is happening. Some of the regulations that relieve the restrictions that some pharmacies have on guiding on that have been helpful.
There’s plenty of plenty of places to make progress. If I were president of the universe today and could make the consolidation different, would I? Maybe. But we have to stand to where we are and make progress in the environment in which we exist. There’s lots of problems to solve for patients and plan sponsors in today’s environment.
What is the company’s strategy for the next few years?
A lot of it is the prior auth story we were just talking about. There’s a ton of opportunity to take on that space in a new way. That can also be working closely with some of the incumbents.
Prior auth is a big part of the future strategy,and expanding our definition of affordability is how I would also characterize our other strategic focus. How do we make sure that we’re getting best price for patients? That might be alternative ways to pay, that might be pharmacy selection, that might be guidance within the plan design. All of those things are relevant.
It’s about that type of consumer choice at the point of care and throughout the patient experience. That’s a huge part of our future. In the three- to five-year time horizon, we’ve been in a point of care connected price transparency environment, a real-time benefit environment. We are moving to a point of care care team integrated environment. That’s a lot of the work that we’re doing today. Where I want it to go is a consumer-facing type of experience and enabling that experience to happen.
An empowered consumer will make a huge difference. Over the last 20 years, e-prescribing actually reduced consumer choice. That’s the only time I can think of where we adopted a technology and the flexibility to choose and understand choice went down. You went from being able to take your paper prescription wherever you wanted to to being constrained by an e-prescribing system that just tells you to go to a pharmacy, then find out what it is when you get there. I want to help evolve our industry to be fully invested in empowering consumers in that process again. The technology is there.
The promise of things like LLMs and generative AI enable that even further, and to your point around interoperability, the framework that is required to accomplish that is in place. It’s really just about starting to execute on that.
Providers are important stewards. We will always be focused on that patient-provider relationship because it’s the most important leverage point for positive change. We have to continue to expand that to empower consumers to make choices around some of the things I’ve mentioned — how to navigate plan design, how to choose pharmacies, and how to understand their alternatives as it relates to payment. Those are all the places that we’re going.
Once-growing diabetes startup backed by Blue Cross files for bankruptcy
Automated insulin dosing software vendor Hygieia files for Chapter 7 bankruptcy protection.
R1 RCM Reports Third Quarter 2024 Results
R1 RCM sees its 14.7% uptick in Q3 revenue tempered by a $20 million loss it attributes to customer and vendor technology outages.
In latest interoperability expansion, Epic advances personalized care
Epic releases an expanded set of APIs that support USCDI v3, supporting tribal affiliation, disability status, caregiver relationships, preferred language, and Social Drivers of Health.
Online mental healthcare company Cerebral will pay $3.6 million as part of a 30-month non-prosecution agreement for encouraging the unauthorized distribution of controlled substances between 2019 and 2022.
The company agreed earlier this year to pay $5 million in consumer refunds and $2 million in civil penalties as part of additional settlements with the DoJ and FTC.
CEO Kyle Robertson left the company in December 2022 and immediately founded telehealth operator Zealthy, which offers virtual treatment of anxiety and depression, weight loss, hair loss, and erectile dysfunction.
From Eyeball: “Re: Oracle Health’s new EHR. It has no menus or drop-downs that would allow clinicians to find information other than by speaking. How is privacy and interference with ambient noise handled?“
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present or promote your own.
A Healthcare Growth Partners survey of private equity investment professionals finds that:
Agfa HealthCare names Eric Sumner (Samsung Healthcare) SVP of sales for North America.
Harris Data Integrity Solutions promotes Rachel Podczervinski, MS to SVP.
Clarify Health names Dan Olson (Pearl Health) chief commercial officer and Alejandro Reti, MD, MBA (UnitedHealth Group) chief product officer.
Integris hires Dan Magoc, MBA (Mercy) as CIO.
Jonathan D’Souza (MedArrive) joins HarmonyCares as chief product and technology officer.
Brook Health combines Linus Health’s digital cognitive assessment software with its remote care technology, offering providers and patients same-day assessment and treatment planning capabilities.
In Washington, primary care provider Palouse Medical will implement Epic through an arrangement with Pullman Regional Hospital.
Epic releases an expanded set of APIs that support USCDI v3, supporting tribal affiliation, disability status, caregiver relationships, preferred language, and Social Drivers of Health. The federal government requires developers to implement USCDI v3 by December 2025. Epic has already committed to supporting USCDI v4 and v5.
CMS publishes the 2025 Medicare Physician Fee Schedule Final Rule, which includes codes that will enable providers to bill Medicare for certain FDA-approved mental health apps and related services.
Canadian Forces Health Services announces plans to replace its proprietary health information system with an off-the-shelf EHR. CFHS hopes to have core systems replaced by 2028 and full system functionality by 2031.
Memorial Hospital & Manor, a hospital and nursing home in rural Georgia, deals with a ransomware attack that it discovered early Saturday morning.
Memorial Healthcare System launches a Care Coordination Center for its six acute care facilities that incorporates Epic and virtual nursing software from Artsight.
Epic’s latest “Hey Judy” describes how the company asked one of its developers – who had created a gaming tips website on his own time – to develop a way for doctors to review patient charts at home. The result was Epic Web, which was rolled out to health systems in 1997 and celebrated in a series of three comic books. Those systems asked if they could share Epic Web with their affiliate providers, which spurred development of EpicCare Link that allowed school nurses, skilled nursing facility staff, and small clinics to exchange information with health systems.
Only in America. An Oregon ambulance driver who was making a right turn hits a bicyclist who is riding in the same direction, then transports him to the hospital for treatment of a fractured nose, after which the ambulance company billed him $1,900 for the ride. He’s suing the the ambulance provider for $997,000.
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Mr. H, Lorre, Jenn, Dr. Jayne.
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Online mental healthcare company Cerebral will pay $3.6 million as part of a 30-month non-prosecution agreement for encouraging unauthorized distribution of controlled substances between 2019 and 2022.
Medicare finalized coverage for some mental health apps. Now what?
A new CMS rule will enable providers to bill Medicare for certain FDA-approved mental health apps and related services.
Memorial Hospital and Manor investigating cyber attack
Memorial Hospital & Manor (GA) deals with a ransomware attack discovered early Saturday morning.
Rethinking Specialty Care in the Shift to Value-Based Care: Getting the Orchestra in Tune
By Najib Jai, MD
Najib Jai, MD, MBA is co-founder and CEO of Conduce Health.
In a value-based care world, the healthcare system operates like an orchestra that is attempting to perform a symphony. Primary care has led this effort — taking on risk, coordinating care, and striving to keep patients healthier in a more efficient way. Specialty care, however, has historically been left to play its own tune, disconnected from the overarching melody that defines value-oriented models.
This paradigm leaves patients navigating a seemingly divided ecosystem that often struggles to align around what’s best for them. Most visibly, individuals who are living with complex chronic conditions — especially those who are from historically marginalized and underserved communities — are left deserted somewhere in the middle.
As these models mature and we enter into the next frontier of value-based care, specialty care must come into alignment, which will allow every part of the system to contribute to the same score.
One of the biggest challenges that I have experienced, both as a physician and through my work with value-based care organizations, is the misalignment between specialty care and the core value-based ethos that has increasingly guided primary care. Primary care physicians (PCPs) are rewarded for keeping patients healthier and out of the hospital, while specialists often remain in a fee-for-service model, incentivized by the volume of care provided rather than quality and patient outcomes. Akin to a talented violinist who performs a beautiful and isolated solo, this fragmented care may be technically impressive, but is ultimately disconnected from the collective performance.
This issue isn’t just about efficiency or cost control, it’s about equity. Patients from underserved communities, who often face the highest barriers to specialty care access, are disproportionately affected. These patients, who may be burdened by multiple chronic conditions such as kidney and heart disease, require coordinated efforts from primary and specialty care providers. They shouldn’t have to experience the vertigo of moving among different worlds when visiting various physicians. This disconnect can lead to conflicting advice, confusion, and missed opportunities for early and effective intervention.
If we truly want to begin addressing disparities in health outcomes, building bridges between primary and specialty care is a critical effort. Excellence in isolation, much like a disjointed symphony, is jarringly insufficient. Different components must work together seamlessly to create a beautiful melody.
To bring specialty care into the fold of value-based care, we must address the incentive structures that keep it siloed. Specialists need to be rewarded for their contributions to patient outcomes. Bundled payments, shared savings, and capitation agreements are all imperfect tools standalone, but can make a significant difference if implemented effectively.
When incentives align, specialists are more likely to collaborate with primary care teams, contributing holistically to patient outcomes. Much like a symphony, physicians are a part of one group that has the single aim of taking care of patients. Aligned incentive structures solidify this implied connectivity.
Lack of integrated data has become a ubiquitous healthcare challenge and impediment to the symphony of value-based care. Too often, specialists must make decisions without access to the full picture of a patient’s longitudinal medical history and lived experiences. These data silos make it difficult for well-intended physicians to deliver coordinated care. Interoperability remains a buzzword, but true integration is paramount for specialists and PCPs to operate from the same “sheet music.” A cardiologist who is treating a patient without seeing their recent visit notes from their PCP is like playing a solo without knowing the key of the piece. At best, it creates dissonance, and at worst, it causes harm.
While data may present a challenge, it also represents an opportunity. Leveraging data-driven insights to personalize specialty care can ensure that patients are connected with the right specialist at the right time. Instead of generic referrals, predictive models and frictionless workflows can help identify which specialists are best suited for each patient’s nuanced needs while maintaining the clinical autonomy of providers.
Understanding performance through the lens of a patient’s’ comorbidities, social drivers, care preferences, and the specialist’s experience with similar patients unlocks a novel, personalized approach to integrated specialty care. Analogous to an esteemed flutist not playing the cello, specialists have skills and training that positions them to serve certain patient populations better than others. This approach ensures that referrals are not only timely, but also meaningful, leading to better outcomes and a more efficient care journey.
The cultural shift that is required to bring specialists into value-based care is perhaps the most challenging part of this transition. Specialists are highly trained and adroit experts who are focused on their specific area of practice. However, creating a value-driven system means that all physicians must think beyond their individual role and understand how they fit into the broader picture of a population’s health.
This requires fostering a culture of collaboration, where specialists are enabled to see themselves as part of a broader healthcare orchestra rather than isolated soloists. It’s about creating an infrastructure in which their expertise is more clearly seen as one critical component of a larger effort to provide patient-centered care.
If we get this right, the potential for positive change is immense. By aligning incentives, improving data access, and fostering a culture of integration, we can create a coordinated and cohesive healthcare chassis. While simple in theory and challenging in practice, a meaningful opportunity remains – ameliorating a system of incongruous care that so many patients experience, particularly those who are already struggling due to systemic inequities.
It’s time to do away with the solos and grow towards a unified symphony, one that prioritizes the patient’s experience and ensures that every provider is working from the same score. It’s time for “value-based care 2.0” where specialists have a seat in the orchestra.
Every year when the leaves begin their fall color change, I wonder if this will be the year that my healthcare system will get its act together to synchronize patient reminders with care that is already scheduled. Unfortunately, this year was the same as all the others, when I received a formal letter that reminded me to schedule my mammogram that has actually been scheduled at their flagship imaging facility for more than 365 days.
Because I’m a concerned patient who doesn’t want to delay her screening, and because I’m trying to run my own business and have already blocked my calendar for that day, I have to take the time to log in to my patient portal, confirm that the scheduled appointment is still there, and become generally aggravated by the process.
What bothers me the most is that among all the problems that healthcare organizations are coping with, this is a relatively easy one to fix. It also has a direct cost savings when paper mailings are eliminated, and depending on how the organization handles those mailings, the savings can be significant. It’s also better patient care, but no one at this organization seems terribly motivated to fix the issue.
While I was still feeling the low-level aggravation of the situation, I ran into a catchy headline: “Why Medicine is Bad at Customer Service – And How to Fix It.” The article starts with a recitation of the conveniences that many of us use on a daily basis – online shopping, streaming entertainment, and rapid delivery of food and consumer goods. It contrasts those with the struggles that people face trying to conveniently access medical services.
It offers good reminders of the relevant statistics, including that healthcare constitutes more than 17% of the US economy, with per capita spending averaging over $13K. It summarizes the hassles of individuals who are trying to access care, ranging from inefficient phone calls to provider offices to the complexities of insurance referrals, appointment scheduling, and time-sucking office processes. It asks the question, “What other business treats its customers so poorly, so frequently, and so predictably?”
As is typically seen in these kinds of articles, the author mentions other industries and how they compare with healthcare. Although airlines have low consumer rankings, they at least have price transparency and collect payment up front, which allows comparison shopping. The article also mentions cable TV as an example of a service that executives didn’t feel that consumers could do without, yet where there has been a revolution where customers opted for other services based on convenience.
The author says, “It’s time for the medical business to view customers as people with busy lives, not just a collection of body parts that periodically breaks down and generates revenue.” Having worked with multiple health systems in my career, I found that statement telling, but also that it leaves out part of the story. Health systems bank on the income from revenue-generating procedures in their communities and even seek it out. It seems like almost everyone has an orthopedic “Center of Excellence,” and those that I’ve seen have a higher advertising budget than any primary care or preventive service lines combined.
The article calls for healthcare organizations to embrace customer service and access by investing in telemedicine and neighborhood-based health services. It advocates for expansion of home-based treatment options. As someone who spent some time in a non-US healthcare environment it sounds a lot like what other developed nations have been doing for decades.
It also mentions the horrific appointment lead times that patients are experiencing for basic healthcare services. In my area, even with good insurance that has a wide network, the wait for a new primary care physician is up to 12 months. With Medicaid, the wait for certain subspecialties is approaching infinity because providers have stopped seeing those patients due to low payments. The article addresses this by calling for realignment of financial incentives, which isn’t a new topic. It notes that the shift to value-based care should drive greater attention to consumer desires.
Those of us who have worked on the care delivery side know that healthcare is a lot more complex than the processes that are needed to order an Uber to take you to the airport or to set up a recurring delivery of household products and groceries to your house. One of the elements that adds to complexity is our fragmented multi-payer system, where a patient’s access to care (as well as the cost of that care) can change every time they encounter a so-called life event, whether it’s a job change or a change in marital status. Even with stable insurance coverage, providers are constantly opting in or out of different plans as reimbursements change and they seek to cultivate an optimal payer mix for their practices. Budgeting for services also changes depending on where patients stand with respect to meeting their annual deductibles.
Another element is the for-profit system that adds rebates and kickbacks into pharmaceutical purchasing, sometimes making it so that patients can buy drugs cheaper without using their insurance than they can with it.
Speaking of being for-profit, another level of complexity includes providers that are hawking cash-pay procedures that may not be indicated for a particular patient based on established guidelines, further eroding patient trust in the medical system. One of my relatives recently ran into this with an optometrist who was pushing digital retina photographs for an otherwise healthy 18-year-old patient. Guess what? That procedure is not covered by insurance because its hasn’t been proven to be beneficial in patients. When the patient said no, they were treated like they were failing to follow medical advice, despite the fact that the person telling them that they needed the service was a receptionist with no medical credentials. In my opinion, trying to do that kind of retail-style upsell on patients who are seeking medical services is simply unconscionable. But it’s just another day in healthcare, apparently.
There is also an incredible amount of inertia present among healthcare organizations. Just try to talk about opening up patient self-scheduling with a care delivery organization that isn’t already allowing it and you’ll hear dozens of arguments against it even though countless organizations have implemented it successfully. I guess when a health system controls a certain percentage of the market due to choice-limiting payer contracts, they have less incentive to make things more convenient for patients because they know they have a captive audience.
When inertia has been present in the past, US lawmakers have stepped in to force change. It will be interesting to see if some of the new legislators who may be coming in following this week’s election have an appetite to improve the patient experience, or if we can expect more of the same.
If you could wave a magic wand and improve one thing in healthcare, what would it be? Leave a comment or email me.
Email Dr. Jayne.
Women’s health unicorn Maven Clinic cuts 10% of its workforce weeks after raising $125M
Maven Clinic, which offers virtual women’s and family health services, reportedly lays off 10% of its headcount weeks after it raised a $125 million Series F funding round at a $1.7 billion valuation.
Providence Alaska introduces telenurses, but bedside nurses protest the change
Providence Alaska’s efforts to introduce virtual nursing in two of its units leave bedside nurses concerned that their workloads will increase, potentially compromising patient safety, despite initial promises to the contrary.
CoachCare acquires Dedica Health
Remote patient monitoring and virtual care business CoachCare acquires Dedica Health, which specializes in RPM and chronic care management.
Maven Clinic, which offers virtual women’s and family health services, reportedly lays off 10% of its headcount weeks after it raised a $125 million Series F funding round at a $1.7 billion valuation.
Employees say on online forums that the layoffs are in preparation for an upcoming company IPO.
Maven posted an article last year about “Workplace Survivor Syndrome” that wrapped up with “How Maven can help you support employees following layoffs.”
From Jerry Rigged: “Re: Oracle Health. Aren’t they just using a code generator to transform Millennium to new technology?” That was the original plan, but now it sounds like they are developing from scratch, or at least spiffing up the front end without changing the functionality and data schema. Competing with Epic will require more than just an improved UI with some AI thrown in – Epic could match that if it thinks that’s what the market wants. The “crumbling infrastructure” comment isn’t exactly confidence-inspiring to existing customers who Oracle expects to stick around while they create a replacement product like other big outsiders have previously failed to do.. Maybe someone can answer these questions:
From Robert D. Lafsky, MD: “Re: NEJM article. Good, although I would dispute how much AI can make the derp filling up most of my shared EMR any worse. Although several primary care colleagues are using AI assistants in the room, I stubbornly stick with dictating a narrative and some concluding clinical reasoning using Dragon. If only their AI geniuses could figure out how to get it to distinguish between the words ‘in’ and ‘and’ it would be nearly perfect.” The NEJM perspective piece makes these points:
HLTH attendance isn’t beneficial to patients and healthcare in general, according to 81% of poll respondents overall and two-thirds of those who actually attended. Steve says that the conference is more geared toward getting investors and CEOs in the same room, while UnHLTHy says that HLTH ends up being companies that are trying to sell stuff to each other – an exhibitor told them that just 270 providers were on the list of 9,000 attendees.
New poll to your right or here: What will be Oracle Health’s biggest challenge in developing a new EHR? Those of us who have been involved in designing or implementing a new clinical software product could have extended the choice list by dozens, but I tried to keep it high level.
Congrats to everyone who proudly sticks to always tagging times as “EST” — you have finally entered the 33% of the year when you are not wrong. Pro tip: switch to just “ET” and you’ll be right 100% of the time. Beyond the time change that affects all Americans except for those in Hawaii and most of Arizona, I wish you a belated happy Halloween, Diwali, and Día de Muertos.
I accidentally found some useful LinkedIn options given that I have never checked my profile settings. Click “Settings & Privacy” under your profile picture on the top toolbar, after which you can do several things:
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None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present or promote your own.
UK-based Definition Health, which offers surgical workflow software, raises $7.5 million in pre-seed funding.
Cigna reports a “non-cash investment loss” of $1 billion related to its $2.5 billion investment in VillageMD in November 2022. The company wrote off nearly $2 billion of that investment in May 2024 when VillageMD majority owner Walgreens started closing its clinics.
Oracle Health and Meharry Medical College announce plans to create a health technology education and research collaborative, a health innovation hub, and a community care and wellness center in Nashville.
In Ireland, whistleblowers report confidentiality concerns that employees of Children’s Health Ireland are using the GoToMyPC remote desktop software on personal phones and laptops to access confidential patient information on hospital systems.
The rapidly aging population of Hong Kong, combined with China’s goal to care for 97% of its elderly citizens at home, is driving digital health innovation. Biometric sensor companies have developed wearables that monitor heart rate and blood oxygen levels, diagnose sleep apnea at home, function as non-prescription hearing aids, and detect heat stress. The company Well Being Digital focuses on earbud sensors, citing studies showing that earbuds are more commonly worn than watches or rings and offer more stable, accurate measurements compared to wrist- or finger-based devices. Additionally, earbuds – which the company calls “hearables” – allow interactive and intervention features, such as direct clinician communication.
Mr. H, Lorre, Jenn, Dr. Jayne.
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Small-Hospital EHR (1–200 Beds) 2024
KLAS finds that 42% of under-200 bed hospitals use legacy systems, while most new considerations involve Epic Community Connect, Meditech Expanse, and Oracle Health.
What’s Going On With All The Empty Cerner Buildings?
Oracle has closed two of the former Cerner’s three campuses and is using the former Innovations Campus to house the limited number of employees who don’t work remotely.
Jennie Stuart Board hosts meeting concerning possible merger
The Kentucky health system confirms that its desire to be acquired involves a conversion from Altera Digital Health to Epic.
Global Payments will sell EHR/PM vendor AdvancedMD, which it acquired in 2018 for $700 million, to Francisco Partners for $1.1 billion.
AdvancedMD President Amanda Sharp, who has been with the company for 19 years starting as an accounts receivable clerk, will take on the title of CEO.
From Ralphie: “Re: Oracle Health. We are a long-time Cerner customer evaluating the potential of moving to Epic. The internal Epic champions are going to throw the ‘crumbling architecture’ comment at everything. How does Oracle Health justify the last few years of our expense implementing and enhancing their solutions? How does an organization do a cost analysis on OH vs Epic? Too many questions that will likely force more organizations in the midst of this analysis to pursue Epic.” That remarkably clueless comment came from Seema Verma, who as CMS administrator mostly took political shots against the very programs she was paid to oversee, and now she’s slamming the former Cerner with similar insider contempt. Imagine being an Oracle Health sales rep who is trying to stem the Epic tide who now has to explain why “crumbling architecture” shouldn’t be a concern. Maybe the plan is to admit an inability to compete with Epic and put all the marbles into the lucrative VA and DoD contracts, knowing that they are the only former Cerner customers who don’t care about the company’s longstanding revenue cycle struggles.
From Beelzebub: “Re: HLTH conference. The founder has started and sold several conferences and has already moved on to his next one.” Jonathan Weiner has not only sold a previous conference to HLTH acquirer Hyve, he also sold one to Informa, which recently bought the HIMSS annual conference. He’s now starting an AI conference while staying on with HLTH for whatever time the acquisition terms specify. Terms of the HLTH deal weren’t announced, but the number most often bandied about, based on the revenue of comparable events, is $100 million, continuing the string of startup-pitching conferences that are far more successful than the companies that they promote. As the old saying goes, the smartest person in a gold rush is the one who sells shovels.
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present or promote your own.
IRhythm Technologies reports Q3 results: revenue up 18%, adjusted EPS –$1.26 versus –$0.89, beating revenue expectations but falling short on earnings. IRTC shares have lost 11% in the past 12 months, valuing the company at $2.2 billion.
Amwell reports Q3 results: revenue down 1%, EPS –$2.87 versus –$9.54, beating analyst expectations for both. AMWL shares have lost 67% of their value in the past 12 months, valuing the company at $137 million.
A Kansas City publication questions “What’s Going On With All The Empty Cerner Buildings?” in noting that Oracle has closed two of the former Cerner’s three campuses and uses the former Innovations Campus to house a limited number of employees who don’t work remotely. The article concludes, “What’s scarier than the empty Northland headquarters building and its futuristic metal spire? The prominent Cerner street signage that remains at the campus entrance, suggesting a false promise of a place that once provided livelihoods for thousands but doesn’t exist anymore.”
1upHealth hires Andrew Boyd, PhD (Personify Health) as CEO.
Glynn Stanton is named CIO for Yale New Haven Health System, Yale Medicine, and Yale Health and will continue in his role as the health system’s CISO.
Oracle founder Larry Ellison says at the Oracle Health Summit that “Cerner took about 25 years to write their system. We have completely rewritten that system in 14 months.”
Athenahealth integrates ambient documentation from Suki and IScribe with AthenaOne.
A new KLAS report on EHRs for under-200 bed hospitals finds that 42% use legacy systems and most new considerations involve Epic Community Connect, Meditech Expanse, and Oracle Health. Most Oracle Health and TruBridge respondents say they wouldn’t buy the solution again. Meditech and Epic Community Connect customers are happiest with the value received.
Elon Musk asks his followers on X to submit their medical images to his AI platform Grok to be used for its training, raising significant privacy concerns. It would also give Grok free, immediate access to protected health information without requiring signed patient consent forms.
The board of Jennie Stuart Health (KY) confirms to the public that its decision to seek acquisition by Deaconess Health was driven by its desire to implement Epic, which the small hospital can’t afford on its own. The health system says that its 2022 implementation of Altera Digital Health caused problems, with the hospital’s medical staff president adding that Altera had not lived up to its promises. He says that the hospital could be live on Epic through Deaconess in six to nine months. A community member had previously cited the hospital’s $8 million purchase of an “artificial intelligence boondoggle” as a significant financial issue.
Mr. H, Lorre, Jenn, Dr. Jayne.
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It’s Halloween, and there’s nothing spookier to me than Oracle Health’s announcement of a new EHR that is coming in 2025.
Those of us who have been in the EHR space for a long time immediately had questions. How far along is the development? How much have they spent already? Who do they plan to have pilot it? What is their certification plan? Do they have physician informaticists working on it? And of course, the rhetorical but honest “Are you kidding me?” So many questions here.
I reached out to some Oracle (and former Cerner) pals as well as CMIOs of current systems that are using the product formerly known as Cerner. Their comments ranged from eye roll emojis to no comment. If you have the inside scoop, do let us know, we’ll be happy to preserve your anonymity.
The fact that Oracle thinks Millennium has a “crumbling infrastructure” is interesting. If I held the CMIO title at an institution that is using the product, I would probably be using it as an excuse to try to get funding for a rip and replace to Epic rather than listening to years of promises about an as yet unseen system. My experience in the industry is that the devil you know is better than the devil you don’t know about 80% of the time. I wouldn’t want to risk my career plunging into the abyss with Oracle.
My other thoughts on the Oracle announcement. Their mention that it’s largely voice driven isn’t reassuring to me, because sometimes menus or drop downs can be useful to remind a busy physician of something they should be thinking about. Taking those away means that we’re reliant on memory or having the right data framework in our head, which can be difficult to do at the end of a 24- or 36-hour shift or even after 12 hours in a busy urban emergency department. The article has examples of this – asking if the patient has had lung cancer screening is dependent on the clinician remembering that the patient was a smoker and other risk factors. There’s also the issue that many of us process faster through visual and motor pathways than we do through speech, so it will be interesting to see data on how fast these visits go.
I didn’t see any folks with clinical titles from Oracle speaking about the product in the major media reports. We had a senior vice president for product management and of course Seema Verma quoted in most of them. Do they even have a CMO or CMIO? I’d love to hear from the people in those roles, regardless of their actual titles, and understand how they think about this. It would be good to understand who the patient safety and regulatory experts are and how they’re contributing to the effort, as well as understanding who is approving the build requirements from a clinical standpoint.
From Booth Crawl Betty: “Re: HIStalk’s guides to the major shows like HIMSS and HLTH. Exhibitors should list what kind of food they are offering in their booths. At HLTH there were some good options including Twilio, which had espresso that could be ordered in advance using a QR code, as well as booths with snacks, ice cream, and liquor outside the all-show happy hour time frames.” Nothing beats the scones that used to be baked at HIMSS, so I’m fully in support of a foodie’s guide to the shows. Last year’s HIMSS also had some amazing chocolate chip cookies that weren’t baked in the booth, but were better than 90% of the cookies I’ve had, and that’s saying a lot.
From Optimize Prime: “Re: inboxologists. It’s an interesting term to describe taming patient message beast.” I’m not a fan of the term, but I’m a fan of the concept. In fact, most of us who do process improvement work with medical practices have been championing that idea for the last two decades. It’s the old “work at the top of your license” concept under a new name. For those of us who practiced in outpatient offices pre-EHR, this is similar to having a triage nurse who fielded the majority of phone calls, bringing patients onto the physician schedule if they needed more than could be appropriately managed over the phone. In many organizations, the rise of EHRs meant those messages could be routed directly to the physician, even though they probably shouldn’t be. Practices looked at it as a way to cut costs — most of the primary care offices in my area don’t have nurses, and some barely have trained medical assistants — without looking at the bigger picture of shifting that work onto higher-cost resources like physicians.
Another not-so-shocking finding using tech-enabled workflows: Patients who receive electronic communications that encourage them to get influenza vaccines are more likely to get a vaccine than those who get no communications. The six electronic letters used in the study varied in effectiveness, but all of them were better than no letter. These kinds of patient-facing campaigns are just about the easiest thing you can do with an EHR and a patient portal, so if you’re not doing it, please encourage your patients to get their flu vaccines.
As I see for-profit entities sucking the “care” out of healthcare, I enjoy a good skewering of those who are not acting in the patients’ best interests. A recent report from the US Senate Permanent Subcommittee on Investigations looked at how Medicare Advantage plans are gaming the system using prior authorizations to deny care and boost profits. Long story short: they’re counting on the fact that physicians and their office staff are exhausted and simply won’t appeal a certain percentage of those denials. Health plans claim they are doing this in the name of savings, but those savings are a big part of what creates profit for the plans. They’re certainly not giving any money back to patients, providers, or the taxpayers who fund Medicare.
From Put a Ring On It: “Re: your recent post about the Happy Ring that recently received FDA approval as a medical device. If no one has acted on your suggestion, I recommend you buy an Oura ring for yourself, because life is too short to not buy your own jewelry.” Although it’s also a cool looking wearable, I found this New York Times piece that talked about the device’s shortcomings. According to the author, the device and its accompanying app rated his sleep as “good” despite seven awakenings, noting that “this was a classic case of an algorithm failing to objectively measure the very subjective nature of how I was supposed to feel about my sleep.” He also cited inaccuracies in step count and a comment from the company that it plans to update its algorithm in 2025.
Are tech/wearable rings worth the money or should I stick with my preference for ethically sourced vintage jewelry? Leave a comment or email me.
Email Dr. Jayne.
Global Payments sharpens core focus with $1.1 billion medical software unit sale
Global Payments will sell AdvancedMD to Francisco Partners for $1.1 billion, which Global Payments acquired in 2018 for $700 million.
Cedars-Sinai Launches Health Sciences University
The health system’s new health university will offer a PhD in health artificial intelligence.
Elon Musk wants you to submit medical data to his AI chatbot
The billionaire asks his followers on X to submit their medical images to his AI platform Grok to be used for its training, raising significant privacy concerns.
Oracle announces new AI-powered electronic health record
Oracle Health will release a new EHR in 2025 that is not built on the architecture of Cerner Millennium.
Digital Hypertension Management Solutions
A new report by the Peterson Health Technology Institute finds that hypertension tools for blood pressure monitoring, medication management, and behavior change don’t reduce healthcare spending, especially those that try to encourage patient behavior change.
Oracle Health’s Clinical AI Agent Helps Doctors Spend More Time with Patients
Oracle Health announces a new version of its Clinical Digital Assistant and its name change to Clinical AI Agent.
The Department of Defense will invest $25 million to roll out a wearable version of a pre-symptomatic infection detection algorithm for active duty personnel.
Ashley Womack is CEO of Aptarro, the newly renamed Alpha II.
Tell me about yourself and the company.
I started my career about 25 years ago. I was originally in corporate restructuring. I did turnaround work for companies, both in and out of court. I’ve spent most of my career in finance leadership roles.
About a decade ago, I decided to make the jump to running high-growth businesses. There’s a surprising overlap between distressed businesses and high-growth businesses. You have to make fast decisions and execute with a maniacal focus on results, which is near and dear to my heart. The important thing for us is to look for unique opportunities that may not have already been fully realized, which can cause people to either fail or grow. I find the growing part more fun than failing parts and it has been a good move for me.
Aptarro is our new brand after we brought Alpha II and RCxRules together as a software company. We help healthcare organizations break through the complexity of billing and help make it easier for people to get paid for the care that they’ve already provided.
What are the advantages of your products over those of competitors?
Our core products are around claim scrubbing and claims accuracy. The legacy product is called Claim Staker. The RCx products are revenue cycle engine and we have an HCC coding platform.
From a competitive perspective, everybody has some kind of solution for claims accuracy. Some kind. Doesn’t mean they have a good kind. They just have a kind of solution. Because we are very clearly fully focused on that little slice of the midsection of revenue cycle, we’re really good at it. We have great accuracy in terms of content and staying up to speed hourly on content changes.
We have a workflow automation tool that helps billers and coders be more efficient. It autocorrects a lot of things that we know with certainty should be changed, and helps prioritize other problems that need to be worked by people so they can stay focused on the more interesting, complex stuff and that with the biggest ROI.
From a competitive perspective, we overlap with specific point solutions, but the biggest competitor is that people just use the thing that’s the freebie that comes with their PM or EHR. Because it’s like one of a list of things, it’s not necessarily as focused on accuracy or automation as we are.
What are the most significant recent or upcoming RCM technology developments?
The revenue cycle business is ripe for technology disruption. Everybody talks about AI and other kinds of advanced learning technology. Those work best when you have a lot of complexity and a lot of volatility, which is what revenue cycle is all about.
We are focused on thinking about ways to both improve the accuracy of content, which is important for what we do, and how to be more efficient. Staff efficiency and reducing repetitive or low-value work stresses out the people who do revenue cycle and makes that job less fun than it should be. We are thinking about how to use next-level technologies to target both of those areas.
Will we see more linking of provider and payer systems to address RCM-related workflows?
Why not? That’s the issue that is frustrating to all of us just as patients. I recently had ankle surgery, and I’ve had a lot of frustrations with the healthcare system as a patient. For providers, those of us who are in the revenue cycle, and maybe or maybe not on the payer side, is it just takes too long. It’s too complex. It’s too disjointed. People are not on a level playing field.
It would be a great end state if we could figure out how to make sure that everybody has the access to the same information and the same decision-making tools. If we create more clarity and transparency, things could move faster, people could get paid more quickly and fairly for the work that’s being done, and patients could get the treatment they deserve.
What were the lessons learned from the Change Healthcare cyberattack?
So many lessons. I have near and dear to my heart cybersecurity, governance, and thinking about making sure that we are safeguarding all of the information that we’re stewards of in this business. I’m sure that is top of mind for everybody. But if we step beyond that, it’s about making sure that you understand your technology ecosystem and avoid being too single threaded. As the buyer of these technology solutions, you have to understand what your choices are, how to make the right choices, and where you have opportunities and options.
Folks were forced to make big changes after Change. Those changes should be a little bit easier. Technologies should plug in with each other a little bit more easily and be a little bit more standardized. It goes back to the earlier point about should or shouldn’t we shouldn’t we connect providers and payers. There needs to be more standardization and a better understanding of what’s happening with the data and not relying so much on third parties.
One of the great things about our technology is that we are agnostic to which PMs or EHRs that our providers use. We can plug in anywhere. Our goal is to provide the best accuracy and the best staff efficiency regardless of what your other ecosystem choices have been.
Did it raise issues around switching costs, especially for smaller practices?
Doctors didn’t go to medical school to be IT guys or medical billers. It’s understandable that it has been a challenge. Even running a software business, making a big change like that is a challenge. To me, the lesson learned is maybe a bigger global thought about the industry. People maybe are not as forward thinking. Technology has obviously changed tremendously over the last 20 years. People have gone to more cloud -based systems. Things are a little bit easier to plug in, implement, and change.
Not all providers are quite there yet, and there are many reasons. Some of it is security reticence. Some is the cost of making the change, both the economic cost and the heartache, which is not to be discounted. But I think that folks are realizing that they need more flexibility, and with on-premise, highly complex, or highly unusual setups, it’s not as easy to make a change.
How are investor-owned provider groups using technology and doing RCM differently?
There’s not one way to do things. There are definitely pros to having a variety of types of providers in the community for different folks, but I think some lessons can be learned from those investor-backed practices. The whole reason that investors are rolling those practices up is to try to make them more efficient and make them more profitable. That’s how they ultimately make money on them. If people can leverage those same types of tactics to make their own independently owned business more efficient and more profitable, why not?
One of those is definitely around technology. How to simplify the tech stack, how to make it more efficient, and how to focus on ROI and think about making sure that you are making the right choices in vendor and choosing solutions that have a pretty clear ROI. Revenue cycle is obviously where all the money is moving back and forth. It’s important to think about you make that more accurate and faster so that your working capital cycle is shorter, you get paid more quickly, and you get paid for all of the work that you do. There are lessons to be learned there in choosing the right tech stack and getting the bang for your buck.
How do you as a company determine how to use ever-changing AI to improve administrative functions?
We have started by thinking about defining our strategy, creating governance around it, and creating a high-level, principle -based strategy around what we think AI should be doing and what should it not be doing. With medical billing and coding, and certainly around patient care, some decisions need to be made by humans Even when it comes to stuff like claims processing, claims accuracy, changing codes, and things like that, we’ve taken a big step back and thought about what we want to outsource to the computer and what we think is important to leave to human judgment.
We started with those principles to then create a map of the biggest problems that we think exist in the universe that we’re operating in and how technology can support us in solving those problems, either with better answers or less expensive answers for our customers. That’s how we are laying out an AI roadmap around what we build and how we potentially partner with other businesses that we can go to market with.
How do you as a former CFO run a business differently than someone whose background is operations, sales, or technology?
I grew up working with businesses that were in some type of transformation. Not always in distress, but some kind of transformation. Every business leader, regardless of their discipline, needs a strong foundation in understanding the finances of the business. That’s what it’s all about. How do we solve a problem in a way that is valuable to the customer and is also valuable to the business?
If you can’t get a good handle on thinking through the numbers, it’s hard to make good business decisions, good strategic decisions, good decisions about how to invest, how to grow the business, how to build new technology, how to hire new folks, how to scale. I would hope that it’s not that different because a lot of executive leaders, and certainly the best ones, are well steeped in thinking about the numbers.
I think about building a business as building a team. I’m kind of a healthcare newbie, and certainly there are challenges to that. But I think it’s really important to surround ourselves with good people who are both industry experts and experts in their discipline. Coming up through finance is a little bit unusual, but it reinforces that it takes a team to win.
What does the next three or four years look like for the company?
We’re on the doorstep of the first big change. We’ve just done a significant rebranding and, changed the company’s name to Aptarro. The purpose there was to reposition ourselves and clarify our position in the market. The businesses that we brought together have all been around for quite some time, and there are pros and cons to that. But as we are approaching this next phase, we want to make sure that people understand the problems we’re solving, which are around breaking through the complexity of healthcare billing and making it easier for providers to get paid accurately and easily for the work that they are already doing to care for patients.
This rebranding is about being able to clarify that across a couple of different offerings. We’ve brought three businesses together over the last couple of years and expect that we’ll continue to buy businesses and grow. We’re focused on that mid segment of the revenue cycle and helping make sure that claims are right and people are getting paid. That’s going to be a combination of product innovation, some of what we talked about around AI and technology, and traditional product innovation. We will be building things and potentially buying businesses and buying new products that make sense to help our customers solve the problems that are out there.
I think it’s an enduring health care trend that it’s hard to get paid. Providers did not go to medical school to become billers or coders, and that’s why we have RCM businesses. We are thinking about how we can make that easier. How do we tackle the complexity for them? The rebranding is part of that. We will continue to scale, both in terms of products offered and the rest of our footprint.
Oracle Health will release a voice-powered, AI-enabled EHR in 2025.
The new system will be developed from scratch rather than being built on Cerner Millennium architecture, which will then require existing customers to migrate to the new one.
The company says that it discovered that Millennium has a “crumbling infrastructure” that was not suitable for enhancement.
From TooCuteByHalf: “Re: Oracle Health’s application to become a QHIN. This is great news for interoperability … eventually. The application process takes months at the earliest, and even at that, it won’t be till at least mid 2025 before the first Oracle Health hospital goes live. TEFCA is nearly a year old, with millions of documents being shared, and the founding QHIN’s have been in the game for literally years. What took Oracle so long, and why take a victory lap in a race you’re not winning?” I’m even more interested in how Oracle Health plans to release a from-scratch EHR in the next few months that does not use Millennium’s underpinnings. It seems challenging to develop, test, document, and install a brand new EHR that will require existing customers to migrate, which is probably why no company has succeeded in rolling out a competitive inpatient EHR in decades. It’s a high-wire act to put out a huge software platform that directly affects patient care, especially given significant loss of former Cerner subject matter experts, and it wouldn’t take many clinically unfortunate missteps to send Oracle Health’s remaining customers fleeing to Epic. Meanwhile, having thrown the only available product under the bus after what seems to have been poorly executed due diligence, Oracle won’t likely make many new sales until the replacement system goes GA, not that it is selling much anyway.
From Big Dog: “Re: Epic. Is the shared version (where multiple clients are on the same instance) of Epic a reduced functional version of Epic when it’s a standalone version? Was talking to a nurse at a local hospital the other day and they recently converted from Cerner Community Works and the nurse was stating they must have purchased the cheap version as it was no better than what they had been using.“
This week is a first, in that both Jenn and I are away on vacation at the same time. I’ll put in enough hours to not miss anything important, but will keep it simple otherwise.
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present or promote your own.
London-based events operator Hyve acquires HLTH, whose HLTH USA conference will become its largest event by revenue. Hyve will take over HLTH USA (Las Vegas), ViVE (Nashville), and HLTH Europe (Amsterdam). Hyve says it has targeted HLTH for years as the top conference in healthcare, noting a post-pandemic trend in which the largest conferences are growing at the expense of smaller ones. Hyve will bring over 80 HLTH employees and founder Jon Weiner. Hyve was taken private by two private equity firms in June 2023.
Alpha II, which acquired RCxRules in October 2023, changes its name to Aptarro.
A study by Peterson Health Technology Institute finds that digital hypertension management tools – which include blood pressure monitoring, medication management, and behavior change – don’t provide overall health spending value even though they can be effective. It concludes that solutions that send data to care teams for medication management are most effective, while those that focus on patient behavior change deliver substandard results compared to traditional care.
Lissy Hu, MD, MBA (WellSky) joins healthcare learning solutions vendor Ascend Learning as CEO.
Oracle Health will apply to become a Qualified Health Information Network. The company says that it will continue to support CommonWell Health Alliance as a founding member. Epic welcomed Oracle Health to TEFCA, noting that Epic already has 700 hospitals live on TEFCA as a founding member and adding, “Epic hopes that today’s Oracle Health announcement indicates that they are finally ready to take interoperability seriously—and to deliver the technology that patients and providers deserve instead of making distracting, untrue statements.”
Altera Digital Health announces GA of Paragon Denali, a cloud-native EHR that runs on Microsoft Azure and is targeted to rural, critical access, and community hospitals.
Medscape announces a free, AI-powered scribe solution that transcribes and summarizes encounters.
Emory University and Emory Healthcare will consolidate their IT operations into a single organization under Alistair Erskine, MD, MBA, who has been named to the newly created position of enterprise chief information and digital officer. He joined Emory Healthcare as chief information and digital officer in March 2023.
Inovalon announces new products for eligibility verification, network provider utilization, AI-powered record review, FHIR API connectivity for health plans, a research network, and expanded pharmacy functionality.
A new KLAS report on ambient speech solutions finds that Nuance is most often considered while Abridge is strong in affordability and physician acceptance,with both companies benefiting from their relationship and integration with Epic. Suki and Augmedix are often considered by Meditech users.
Mr. H, Lorre, Jenn, Dr. Jayne.
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