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Morning Headlines 1/17/22

January 16, 2022 Headlines No Comments

Digital Health Leader Verana Health Secures $150M Series E Funding Round

Verana Health, which sells real-world evidence data to life sciences companies, raises $150 million in a Series E funding round, increasing its total to $289 million.

MPulse Mobile Acquires HealthCrowd and Receives Growth Investment from PSG

Healthcare conversational AI vendor MPulse Mobile acquires healthcare communications vendor HealthCrowd and secures funding from PSG.

VA pushes back second EHR deployment, citing delays in training from COVID-19

The VA pushes back its second Cerner go-live from March 5 to April 30 at its Columbus, OH facility, which it says has experienced training delays because 200 of its 1,700 employees are absent.

Monday Morning Update 1/17/22

January 15, 2022 News No Comments

Top News

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Verana Health, which sells real-world evidence data to life sciences companies, raises $150 million in a Series E funding round, increasing its total to $289 million.

The San Francisco-based company offered a tele-ophthalmology triage app under the name DigiInsight Technologies until 2018, when it signed a deal to commercialize the patient dataset of the American Academy of Ophthalmologists and pivoted into life sciences data.

The company’s real-world data network has 20,000 medical society member providers in ophthalmology, urology, and neurology.


Reader Comments

From Veteran of the Psychic Wars: “Re: HIMSS show dropouts. Will you be reporting them again this year?” I will when I hear about them, which really happened only during HIMSS20, when a company that decided not to attend was noteworthy enough to warrant issuing a press release or tweet. It isn’t in the best interest of HIMSS to announce pullouts, so the only surefire way to track dropouts would be if HIMSS religiously updates their conference exhibitor floor plan, in which case (a) it could be screen-scraped with the “not really exhibiting” vendors  who haven’t booked a 10×10 booth or larger could be excluded; and (b) the result could be exported to a database and compared with previous versions. The exhibitor count is at 640, up from 603 a week ago. Let me know if your company had signed up to exhibit but has decided against it. Still, I’ll offer the same advice as I did in 2020 and 2021 – exhibit or not based on your own comfort level, not on what everybody else is doing.


HIStalk Announcements and Requests

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About 20% of poll respondents have tested positive for COVID-19 at some point, with about 4% of those requiring hospitalization and the others evenly split between no impact or having some degree of symptoms.

New poll to your right or here: Which social networks are you using much less now than two years ago? I admit that I don’t use most of them and I’m weaning myself off Facebook because I feel worse after looking at it instead of better. I probably waste more time in the rabbit hole of YouTube than the others.

HIMSS isn’t the only conference trying to figure out how to implement safety protocols in Florida. Less than 50 days from its start in Miami Beach, the inaugural ViVE conference — put on by CHIME and HLTH March 6-9 — hasn’t announced COVID protocols, saying only that it hasn’t decided about requiring vaccination and hopes that “masking and social distancing can become personal decisions.” The conference expects 3,500 attendees, 300 sponsors, and 250 speakers.


Webinars

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


Acquisitions, Funding, Business, and Stock

Healthcare conversational AI vendor MPulse Mobile acquires healthcare communications vendor HealthCrowd. MPulse Mobile has raised $42 million through a Series C round, including a new investment that makes growth equity firm PSG its majority shareholder.

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A federal court orders former drug company CEO Martin Shkreli to repay $65 million and bans him from participating in the drug industry for life for his role at Vyera Pharmaceuticals, formerly known as Turing Pharmaceuticals, which acquired the exclusive rights to old toxoplasmosis treatment drug Daraprim and immediately raised its price by 5,000%. The New York attorney general declared him “a pharma bro no more.” He will complete a seven-year federal prison sentence for securities fraud in November. Shkreli’s swaggering, obnoxious personality and declarations that his actions were simply “capitalism at work” got him in trouble for doing pretty much what all drug companies do in monopolizing markets by buying off would-be competitors or burying them in legal challenges – he should have worn a suit, spoken soaringly about human health while quietly stuffing cash in the mattress, and jacked Daraprim’s price up steadily over a few years like insulin manufacturers have learned to do to prevent an immediate uproar for profiting on the backs of desperately ill people.


Sales

  • In England, five NHS trusts in Surrey and Sussex will implement Sectra radiology imaging.

People

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Hartford HealthCare names Joel Vengco, MS, MA (Baystate Health) as SVP / chief information and digital officer. He replaces Richard Shirey, who is retiring.

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Optimum Healthcare IT Chief Marketing Officer Larry Kaiser takes on additional responsibility in the same role with related company Clearsense.

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David McSwain, MD, MPH (MUSC) joins UNC Health as CMIO.

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Laboratory information management system vendor Ovation.io hires Curt Medeiros, MBA (Ontrak) as CEO.

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Matthew Anderson, MD, MBA (Banner Health) joins HonorHealth Medical Group as CMIO.


Announcements and Implementations

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CHIME launches the degree-granting CHIME University for digital health professionals, which will begin classes on January 31 for the 45 credit hour Master of Digital Healthcare and 60 credit hour Doctor of Digital Healthcare degrees. The degrees are self-paced and offered digitally, with a rolling enrollment allowing learners to start at any time. Each degree costs a flat $12,000 with discounts offered to CHIME members, CHIME Foundation members, and CHIME-affiliated organizations. CHIME University, which has not earned accreditation but will seek it, will initially offer its programs to residents of 21 states.

Kaiser Permanente joins member-led, non-profit digital health company Graphite Health, joining SSM, Presbyterian Health Services, and Intermountain Healthcare. The company offers a marketplace for digital health solutions.


Government and Politics

The VA pushes back its second Cerner go-live from March 5 to April 30 at its Columbus, OH facility, which it says has experienced training delays because 200 of its 1,700 employees are absent.


Privacy and Security

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File transfer software vendor Accellion reaches an $8 million settlement for a December 2020 breach that affected 9 million people, 3.5 million of them patients with Centene, Kroger, Trinity Health, and others. Hackers sent extortion emails to at least 100 companies, threatening to publish their sensitive data online. The company says in its settlement proposal that it did not guarantee the security of its software, adding that its license agreement disclaims those guarantees and includes a limitation of liability for breach-related damages. New sales of the company’s 20-year-old File Transfer Appliance software ended in 2016, but customers were allowed to renew their licenses even though the software’s final security update was in February 2019. The company now markets its products under the name Kiteworks.


Other

NPR covers the month-old ransomware downtime of Kronos Private Cloud, which has affected 8 million employees, including those of many health systems. AHA says that hospitals have been hit especially hard with the manual payroll work that is required as they deal with heavy COVID-19 workload. AHA says that hackers are obviously to blame, but it is disappointed with Kronos for a lack of transparency and its failure to protect its systems. The company said Friday that it has restored access for 1,000 customers, putting it ahead of schedule for its target of a complete recovery by January 28. Kronos also says that “a relatively small volume of data” was exfiltrated by the hacker in the December 11 attack and it has notified affected customers.


Sponsor Updates

  • InterSystems publishes a report, “The High Cost of Bad Data and Analytics on Strategic Healthcare Decisions.”
  • Wolters Kluwer Health and Laerdal Medical release the next generation of VSim for Nursing, which provides real-world, evidence-based training scenarios for nursing students.
  • OptimizeRx names Ash Roozbehani (Delta Dental) as senior counsel.
  • PatientBond joins Olive’s marketplace, The Library.
  • Premier’s Contigo Health business expands its provider-sponsored health plan offerings through a new partnership with OhioHealthy.
  • Talkdesk is recognized by TrustRadius with 2022 Best of Awards for Feature Set, Value, and Relationship in the Contact Center category.

Blog Posts


Contacts

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Weekender 1/14/22

January 14, 2022 Weekender No Comments

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Weekly News Recap

  • Report says that a private equity firm is close to acquiring urgent care EHR vendor Experity for $1.2 billion.
  • Ambient patient-physician voice scribing solution vendor DeepScribe raises $30 million.
  • Data exchange platform vendor Avaneer Health raises $50 million in seed funding.
  • Hospital-at-home technology and services vendor Medically Home raises $110 million.
  • DexCare raises $50 million.
  • HIMSS announces that masks will be required throughout the HIMSS22 campus.
  • PerfectServe acquires AnesthesiaGo.
  • Transcarent raises $200 million in Series C funding.
  • Clinical collaboration platform vendor TigerConnect raises $300 million in funding.
  • Aledade acquires care planning solutions vendor Iris Healthcare.
  • R1 RCM signs an agreement to acquire competitor Cloudmed for $4.1 billion.
  • Qlik files for an IPO six years after being taken private for $3 billion.
  • Stryker will acquire Vocera for $3 billion.

Best Reader Comments

Algorithm-assisted decisions will reduce that systemic bias + noise and will lead to higher quality diagnosis (and do it with better predictive capabilities for more upstream care). Of course, nobody is denying that for this to happen at scale, data quality, transparency in algorithm development process, awareness of clinical applicability etc. will all need to improve and the industry will do well to stay clear of AI/ML snake oil peddlers. Thoughtful visionaries will create and own that future – just like they always have. (Vikas Chowdhry)

Thirty years in healthcare IT implementations has taught me that hospital ABC can implement BestEverSystem and have great outcomes and usage, and hospital XYZ installs same system, but is a colossal failure. Other countries have managed [COVID-19] testing quite well, according to family that has experience with it. I’m sad to see the missteps US has taken, but I don’t think it’s intentional, just lack of experience in true public / social health environment. It’s obvious when they say “every health insurer has to provide 8 tests per person per month” that they have no idea what they are doing. Insurers should have zero to do with it, in my opinion. (ABCs)

#America – where there is a need for a service that helps patients who have the audacity to try to not die from cancer a way to declare bankruptcy. (Dales Brian)

The “line of people” and the “something” in this statement are a generalization and assumption of context. The people may not have nor want a technology-based solution that delivers the “something” without participating in a line. If a technology has been applied already and that results in a line, is the line formed because of a new demand for the “something” that would not have otherwise been available without technology? It would be better to restate as a question; Does a physical line of people waiting for something present an opportunity for technology to meet a need? (Paul Klehn)

What gives us common cause? Why do we bond as human beings? Where does the impetus to cooperate come from? As long as the answers to those questions keeps coming back to “you have to,” “your employer says so,” and “your paycheque requires it,” there is an element of compulsion involved. It also encourages a transactional environment. You are now a replaceable (and optional) cog in a machine. Good teamwork is not based upon these elements. The odd bit is that, rationally speaking, almost any corporate life involves being replaceable. You are certainly performing a bunch of activities for money. However if that is all that you are, it’s demoralizing and dehumanizing. Most people perform better if they are not slotted into transactional boxes. (Brian Too)

It’s 2022. “Hallway interaction” happens via Teams, Slack, and other random interactions that didn’t exist even five years ago. Culture is built via action and example, and always has been – not dreary in-person meetings reciting corporate values. If you can’t manage without physically being able to walk to someone’s workspace to check up on your employees, you probably weren’t an effective manager. I may be biased as an under-40 executive, but the atmosphere and culture at a work from home-optional company has been way better than the billion dollar company that preached culture every day that I left a few years back when they couldn’t adapt.(Leonard Shelby)

Slack is a very poor substitute for hallways and water coolers. Social engagement between peers outside of a work context is very hard to nurture in a remote setting … The atmosphere and culture may be better in a remote company, but correlation is not causation. In my personal experience between an billion-dollar company and a remote company, confounding factors were that the remote-first company was younger, smaller, more modern, had a much smaller and easier to change product, and had an executive tier that was more accessible to the average Joe. Being remote may have positive impacts on culture directly also, as well as on equity. It may be harder to forge an old boys club when they can’t rendezvous at the golf course. (MoreNuancedRemoter)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. T, whose Buffalo, NY first-grade class of 15 dual-language students is split into eight who are doing in-person learning and seven who are learning remotely. She reports, “This document camera has been a great tool for me to teach my students without having to share books and having students sit next to each other on this difficult time we are living with the pandemic and social distancing. Students have improved drastically because I can show not only one student, but the whole class how to solve math problems, write words, read spelling words, and practice all together by sharing the document.”

A UK doctor loses his license for using a cauterization tool to burn his initials onto livers he had transplanted.

Thirteen people, including two physicians, are arrested for their involvement in a $100 million insurance fraud scam in which 911 operators and hospital employees were bribed to provide information about car accident victims, who were then referred to doctors who ordered unnecessary treatments. The defendants took advantage of New York and New Jersey laws require auto insurance companies to pay all medical bills under their no-fault laws.


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Morning Headlines 1/14/22

January 13, 2022 Headlines No Comments

Avaneer Health Announces $50 Million in Seed Funding from Healthcare Industry Leaders

Data exchange platform vendor Avaneer Health raises $50 million in seed funding.

Medically Home raises $110M to care for patients at home

Medically Home, which provides hospital-at-home support services and technology to health systems, raises $110 million.

DexCare Closes $50M Series B Funding Led by Transformation Capital to Advance Its Digital Care Operating System

Health system patient acquisition and capacity management software vendor DexCare, which was spun off by Providence, raises $50 million in a Series B funding round.

HeyRenee Raises Another $4.4M in Oversubscribed Seed II Funding Round Led by Quiet Capital; New Capital Accelerates Mission to Enable Effective Whole Person Healthcare

Heal co-founders Renee Dua, MD and Nick Desai raise $4.4 million for HeyRenee, their new, app-based care coordination and concierge service aimed at seniors.

News 1/14/22

January 13, 2022 News 1 Comment

Top News

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Axios reports that  private equity firm GTR is close to a signing a deal to acquire urgent care EHR vendor Experity for around $1.2 billion.

The company’s owner, private equity firm Warburg Pincus, formed Experity in May 2019 by merging DocuTAP and Practice Velocity.

Experity’s software is used by more than 50% of US urgent care clinics.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Ambient patient-physician voice scribing solution vendor DeepScribe raises $30 million in a Series A funding round. The company says it has 400 physician users and has integrated its system with Claimpower, Elation, AdvancedMD, Practice Fusion, Athenahealth, and DrChrono. It says doctors save an average of three hours per day at one-sixth the cost of human scribes. 

Telehealth system vendor Caregility raises $25 million in funding.

Mindfulness app vendor Headspace Health acquires Sayana, which offers an AI-powered self-help app.

Data exchange platform vendor Avaneer Health raises $50 million in seed funding.

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Medically Home, which provides hospital-at-home support services and technology to health systems, raises $110 million in funding from investors that include Baxter International, Cardinal Health, Mayo Clinic, and Kaiser Permanente. The company has raised $275 million. It says 7,000 patients have been treated using its offerings.

Health system patient acquisition and capacity management software vendor DexCare, which was spun off by Providence, raises $50 million in a Series B funding round.


Sales

  • Roche Diagnostics USA will offer Glytec’s Glucommander insulin dosing support system as the first software application to run on its just-announced Cobas Pulse point-of-care blood glucose system.
  • The VA signs a $13 million contract for Google Cloud’s Apigee API management platform.
  • Johnson & Johnson Medical Devices Companies chooses Microsoft as its preferred cloud provider for digital surgery solutions, which provide medical device insights about patients to surgeons to increase consistency.

People

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Patient engagement software vendor Tendo hires Bala Hota, MD, MPH (Rush University Medical Center) as SVP / chief informatics officer.

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Healthcare Triangle names Sanjay Dalwani, MBA (Capgemini) as chief revenue officer.

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Patient engagement software vendor Clearwave hires Saji Rajasekharan, MBA (Premier) as CTO.

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Mayur Yermaneni, MBA, MS (EQHealth Solutions) joins healthcare analytics and consulting form Blue Health Intelligence as chief strategy and growth officer.

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Memorial Sloan Kettering Cancer Center hires Rémy Evard, MS (Flagship Pioneering) as chief digital officer and head of technology.

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David Wright, MPH (Get Well) joins Vital Software as chief growth officer.


Announcements and Implementations

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A JAMIA perspective piece says that health systems that switch EHRs – because they are acquired or want to replace their existing system – should apply the principles of Requisite Imagination in visualizing the desired future state to identify what might go wrong, especially with regard to patient safety. The authors make six recommendations:

  • Choose a leadership structure that includes technical and operational experts who encourage users to speak up about problems. Pay clinicians for content development.
  • Conduct a self-assessment of risk using ONC’s SAFER Guides checklists.
  • Standardize features, functions, nomenclature, and workflows to avoid unwarranted variation.
  • Create a standard taxonomy to track performance indicators from multiple sources, such as adverse event reports, help desk tickets, audit logs, and operational performance and patient satisfaction measures.
  • Import as much coded and free-text as possible from the old EHR, then provide an easily understood summary of the old chart for reconciliation with the new system during the first visit.
  • Communicate clearly to users what changes are upcoming, how quality care will be maintained, and how they will be supported. Offer workflow-specific training, dedicated practice time, and one-to-one support for clinicians who are struggling and consider reducing patient loads where possible in the first few weeks after go-live.

Atlantic Health System (NJ) expands its use of Kyruus ProviderMatch to offer online scheduling on its website.

HIMSS updates its HIMSS22 Right of Entry Protocols with two options for attendees, exhibitors, and speakers: (a) voluntarily provide proof of COVID-19 vaccination (boosters are not required) before badge pick-up; or (b) present negative antigen or PCR test results no older than the day before badge pick-up. Masks must be worn at all times while on the campus. The next update will be January 26, which will presumably provide details about how vaccination proof can be submitted before arrival.


Other

Drug maker and COVID-19 vaccine manufacturer Pfizer will lay off several hundred sales reps in predicting that doctors will prefer drug company contact to be conducted virtually 50% of the time even after the pandemic ends. Competitor Amgen took the same action a year ago, eliminating 500 sales rep jobs as the pandemic limited in-person contact.

Commonwealth Fund President and former National Coordinator David Blumenthal, MD says in a Harvard Business Review piece that big corporations – CVS-Aetna, Walgreens, Walmart, Amazon, Optum – are hiring PCPs and buying primary care practices, which will have an unknown effect on the US’s failing primary care system, where many people don’t see the value of PCPs or can’t find one. He says those big corporations need to figure out how to pay PCPs, who make much less than their procedure-driven counterparts, more without burning them out, with three options: (a) treat primary care as a lost leader to draw customers in who will buy greeting cards or lawn chairs; (b) use physician extenders to increase productivity and therefore profit under the fee-for-service system, with the risk that corporations will create provider and patient discontent or add on billable services to the detriment of the healthcare system; or (c) allow health insurers to manage chronic conditions for which they already bear financial risk for unnecessary hospitalizations and ED visits, which can allow both lowered premiums and higher profits. Blumenthal says Option C is the most promising.

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Zus Health Product Manager Brendan Keeler provides an concise Twitter summary of the Big Three healthcare interoperability networks (Epic’s Care Everywhere, Carequality, and CommonWell):

  • Care Everywhere is CDA-based (not FHIR) and allows both querying and pushing patient-level summaries, encounter-level summaries, specialty CDAs, and non-discrete data such as PDFs. Epic turns it on by default so all Epic hospitals can share data with each other, but some of its customers block that exchange by turning it off.
  • Carequality is a distributed exchange (not a centralized HIE) and is roughly equivalent to Care Everywhere.
  • CommonWell uses a centralized record locator service and stores only the demographics that are needed to match patients. It is primarily based on CDA, but uses some FHIR APIs.
  • Carequality and CommonWell connected in 2018 to form a “somewhat comprehensive” national network for obtaining patient summaries, but it does not support pushing data like Care Everywhere does.
  • Epic’s EHR exposes more data via these networks than other vendor EHRs, which mostly provide just a patient summary and possibly encounter summaries.

I always enjoy scouring the exhibit hall rules of the HIMSS conference for nuggets like these, each of which must have been triggered by real-life violation:

  • Exhibitors cannot enter the booth of another exhibitor without permission. This is expressed in a badly worded rule that says, “Exhibitors are required to remain in their own booth space during exhibit hours and non-exhibit hours,” suggesting incarceration and the use of adult diapers.
  • “Sideshow tactics” such as using megaphones, clowns, flash mobs, dancing, body painting, and bungee jumpers aren’t allowed. In addition, “clothing must be worn at all times (including tops and bottoms).” I’m curious how the bungee jumping worked and who was guilty of exhibiting topless or bottomless.
  • “Special talent” is not allowed to walk the show floor, although the term was not defined.
  • Soliciting isn’t allowed in the convention center lobby, outside, or within any HIMSS block hotel.
  • Exhibitors can’t give away or sell marijuana or other controlled substances on the show floor.

Sponsor Updates

  • Everbridge appoints former Citrix president and CEO David Henshall to its board.
  • Redox doubled its network reach in 2021.
  • The HCI Group releases a new DGTL Voices Podcast, “How Cancer Transformed Us.”
  • Nordic achieves Select Partner and Public Sector Partner within the Amazon Web Services Partner Network.
  • Tidelands Health sees a 52% drop in inappropriate telemetry orders using Meditech’s professional services.

Blog Posts


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EPtalk by Dr. Jayne 1/13/22

January 13, 2022 Dr. Jayne 3 Comments

Mr. H recently threw out a challenge: “Discuss: a physical line of people waiting for something indicates a failure of technology to meet a need.” I’ll certainly take the bait on this one.

I recently needed to do three transactions at my state’s motor vehicle agency. The first involved renewing my car’s annual registration, and it was very straightforward online. Typically when you do this in person, you have to show at least four paper documents. For online renewals, though, the system is hooked up with the motor vehicle inspection sites as well as the taxation agency, to make sure everything is current. For the mere price of a $3 convenience fee, I had it completed in less than five minutes. The sticker that I needed to apply to my plates arrived in the mail less than a week later, and the emotional labor to complete the entire process was zero.

Contrast that with the other two transactions, which had to be done in person. Due to the explosion of COVID in my state, the office only allows a handful of people in the building at the time. The last time I had to go there in person was in August, and at that time I waited nearly 45 minutes outside before being able to enter the building and wait in line some more. Although they had appointments during the height of the first COVID peak, they no longer offer it, despite our current peak being significantly higher than the original.

Enter the emotional labor component of the exercise. I had to look at my work schedule, figure out when I could take off during normal business hours, and marry that up with the weather forecast to try to avoid being outside in sub-zero temperatures or freezing rain. I also had to move a couple of meetings and checked three different websites to make sure I had the correct paperwork for both transactions, because having to come back would be exasperating. On the appointed day, I dug out my heavy boots and heavy coat and decided to give it a go.

Usually there are two lines, one for vehicle-related transactions and one for driver licenses and ID cards. Likely due to the online vehicle process, there was no line for those transactions. Once I made it into the building, I found the vehicle side of the office, where three agents sat waiting. Everyone who walked in was handled in real time. When the vehicle agents had nothing to do, they would start a “pre-check” process for the people waiting in the driver license line, making sure they had all their paperwork in order to try to keep the process from bogging down. Several people were turned away from the line, which was for a while the only thing that made it appear to move. The office has two workstations that can take pictures, but one was unstaffed.

Once you got to the licensing workstation, you had to present the little paper slip that you received from the pre-check station, and the worker would key in the particulars and collect payment. Then you had to do a vision test followed by multiple computer screens that you had to validate and sign before the photo was taken. Finally, the worker printed a temporary license, punched a “void” marker on your old license, and you were done. The worker then sanitized the station and called the next person over. There were multiple delays for things like people removing coats, fluffing hair, reapplying lipstick that was smeared by masks, etc. In the time that a single patron was taken care of, the pre-check worker had reviewed at least the documents of at least four people.

I got to go through the whole scenario twice since I had two different renewals and there was no sharing of data from one transaction to another. I had to write two paper checks to pay for them. (This is sounding a lot more like healthcare, isn’t it?) In one photo, I look great, and in the other, I look like I’m on a wanted poster, so it didn’t work out too well for me (although if the process was more streamlined, I might have looked like a suspect on both).

I’m a serious process improvement nerd, so I’ll offer a couple of potential solutions. These processes have the same challenges that we have in the healthcare space, including patient / client registration, managing wait times, identify verification, demographic verification, payment collections and processing, photo acquisition, history gathering, and more. What if there were people who had dedicated their careers to improving processes like these? It’s a good thing I’ve worked with a couple of people like that. When you start thinking about solutions to these problems, they’re not always novel. Some are low tech and others are high tech, but to eliminate all the defects in the process, you could use a combination of solutions.

Let’s take a shot at it, shall we? Assuming a low staffing situation, if workers were cross-trained, they could have used the second camera workstation. Since agents on the other side had capacity, if they were able to run the slow process, it could have doubled throughput. Or, they could have used the available agents to add some additional flair to the pre-check process, asking people to remove their coats, organize their belongings, pre-write their payment checks, etc. so they would be ready for the next step in the process. If they really wanted to get fancy, they could have had the trained person run both camera stations (they were literally next to each other) and used the excess staff to assist by sanitizing the stations in between rather than it becoming a bottleneck. That person could also have voided the licenses and handed out receipts after they printed. I feel like just telling people what to expect and encouraging them to get their ducks in a row before they approached the station would have helped a lot.

On the technology side, they could dust off their appointment system since it worked during the early stages of the pandemic. Second, they could have a simple texting system that would allow people to check in and wait in their cars until they received a message that they were third in line or something like that, and to come in. If they wanted to get fancy, the state could develop an online portal where registrants could pre-submit their paperwork and have it approved remotely, verify all the information they would normally verify on the screens, and receive a confirmation ticket that they could bring to the office, eliminating the majority of the process for a subset of customers willing to start the process online (except for the vision test and photo, that is). Or, they could have a separate photo kiosk where customers could do their own photo, or have it taken by a less-trained person, so that it was already in the system and the staffer would just have to marry it up with the appropriate demographics.

Alas, though, my state is one of the last in the union to adopt such cutting-edge technologies as Real ID, immunization registries, and prescription drug monitoring programs, so I have little hope. I’m definitely keeping my eye out for consulting postings on the state procurement agency website. I might be able to monetize what feels pretty obvious.

What are your thoughts on other processes where lines of people are a failure of technology to meet a need? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 1/13/22

January 12, 2022 Headlines No Comments

DeepScribe Raises $30M To Become First Widely Accepted Application of Voice + AI in Healthcare

DeepScribe, an automated medical transcription startup based in San Francisco, raises $30 million.

Caregility Secures $25 Million in Additional Funding

Virtual care company Caregility will use a new $25 million investment from Star Mountain to scale its team and develop a new inpatient offering.

GTCR nears $1.3 billion deal for electronic health records company Experity

Private equity firm GTCR is reportedly close to acquiring urgent care health IT vendor Experity in a deal that could value the company at up to $1.3 billion.

U.S. Department of Veterans Affairs Partners with Google Cloud to Improve Veteran Access to Benefits and Services

The VA will leverage Google’s Apigee API management platform as part of a $13 million contract to help its developers create new digital health tools and services for veterans.

HIStalk Interviews Guillaume Castel, CEO, PerfectServe

January 12, 2022 Interviews No Comments

Guillaume Castel, MBA is CEO of PerfectServe of Knoxville, TN.

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Tell me about yourself and the company.

I’ve been with PerfectServe two and a half years. We offer clinical communication collaboration software. We have put three main assets together covering optimized scheduling, clinical communication, and patient engagement. We believe that putting the three capabilities together three years ago is what the market needed to provide collaboration at scale the right way. Prior to PerfectServe. I spent time as an executive in a health system and then a few years with The Advisory Board Company, which was an amazing experience. I grew up in IBM and Cisco Systems.

How are health systems using your platform creatively to address clinician burnout?

This is a bit of an overused term that has lost a bit of its integrity, but we have been in a number of discussions with clients of all sizes about helping with the most important issue that health systems face today, which is to find good talent, retain them, and help them provide care for their patients. We help in a number of ways, but the most practical is probably through our scheduling capabilities. A fair, balanced schedule leads to a better work-life balance and a better disposition for clinicians to provide good care to patients.

We allow administrators and practice leaders to understand who has been on call more than others and who hasn’t received the schedule they wanted in the last 3-4 weeks and therefore is likely to be disappointed and at a high risk of burnout. We allow for that data and analytics piece to be available to the majority of our clients. We also do spot surveys for users of our technologies to say, are you happy or not happy today? We try to balance that in contrast that with the reality that is showing up in the data. We’ve been involved in not just diagnosing burnout, but also predicting it.

Your competitors Voalte and Vocera have ended up being owned by huge medical equipment companies. What drove that?

First, I have congratulated the Vocera team for their news last week. Vocera is a high-quality company, and I’m happy to be collaborating with them on a number of contracts, clients, and locations. 

A great deal of consolidation is happening. You’ve seen it in our space, and it’s happening in other spaces. Clients want to deal with enterprise-grade vendors. There’s this connectivity around patient care that stays in place and goes occasionally past the communication lens. What some are trying to do is connecting medical device with clinical workflow, which makes good sense. People have wanted to do that with beds for a long time. I suppose they are trying to connect it with other areas of the care continuum.

We believed that we had the right thesis three years ago. We believed and continue to be a strong proponent of the fact that collaboration at scale, no matter the care setting, is what is going to win the day. For that to be successful, you have to have intelligent scheduling. You have to have cloud-based, rules-based clinical communications. You have to have the ability to engage with patients wherever they are. We know that care has moved from mostly being inside the hospital to being in the outpatient setting, the ambulatory network, to now increasingly the physician’s office. More and more we are seeing that care is going to be done at home. We’re focused on ensuring that we equip and help all of our clients with the ability to seamlessly deliver good collaboration and good communication among their care teams, regardless of the care setting.

You told me last time we talked that your goal was to make acquisitions where the whole is greater than the sum of its parts. As someone who has done that, how hard is it to find complementary offerings, figure out how they fit, and then actually acquire a company? [note: PerfectServe announced the day after this conversation that it had acquired anesthesia staff case assignment software vendor AnesthesiaGo].

The hardest part by far is to have the right pieces. I can tell you that I’m grateful for the thoughtfulness we put into thinking about what pieces to put together. The second piece is integration, which is something that people don’t want to talk about a lot. It’s a lot more exciting to talk about deal terms and multiples, but the reality is you get true value by integrating the pieces properly.

In our case, it has taken us at least 18 months to get to a place where we could start to see the equation equal or exceed “one plus one equals two.” Now we are far in excess of that, and I think our clients see it. We are continuing to be focused on messages getting to the right person, care going faster, care providers finding happiness again, and being an element at the disposal of large health systems all the way down to small physician groups to allow them to gain productivity and anticipate the next phase of care delivery changes. We’re very happy that we made the acquisitions three years ago. It has taken real work to get them to work in a way that made a difference for our clients.

How do you see the company responding to market demand for remote patient monitoring and chronic condition management?

The way your platforms are architected will either help you be flexible and go beyond where you shine — either inside the hospital or in the ambulatory network — into the patient’s home, or not. In our case, our premise was to be present across the continuum. We had that ability to have a technology that was flexible enough to branch into areas that we weren’t known for. Our PFC, Patient and Family Communication offering, was put in a bright light during the early stages of COVID, where we engaged with patients wherever they were. We helped health systems deal with an onslaught of patients who were in the parking lots waiting to be seen because they thought they had COVID. I’m simplifying a situation that was dire, confused, and tricky for health systems to manage.

What we believe now is that it was easy for folks to say that telehealth really jumped through that period. Yes, virtual care visits increased. They’ve come back down a little bit, but we’ve made a lot of progress, all of us, in allowing care providers to do virtual visits and care delivery with patients wherever they are. That is good progress for our clients and good progress for society.

What we believe is happening now is that virtual care is just one aspect of changing the way care is being provided. Increasingly sophisticated and innovative health systems will want to actually touch patients in their homes to the extent possible. If there isn’t a reason for someone who is not well to get in the car and go back into the emergency room, the person should stay home. The health system and the care provider should be able to serve them and care for them in the safety and quality of their homes.

Remote patient monitoring — and it goes beyond that to the ability to do remote exams — is going to be core to the next level of delivery. We are deeply embedded in continuing to ensure that communications flow naturally with that new care model. It’s not just about engaging patients, it’s about ensuring that the engagement is routed properly, that care teams are aware of the feedback loop, and that actions are being triggered and taken. That’s what good care looks like. It’s much more than just a bunch of solutions that are solving very small problems.

How  do you see the industry and the company changing in the next 3-4 years?

We are committed to making certain that we have a very direct impact on accelerating speed to care. Everything we do at the end of the day is in a search to allow our clients to accelerate the way they provide care and improve the care they deliver to their patients. Full stop. There are adjacencies that we are very interested in that fit into that. We want collaboration among care teams to be increasingly more intuitive. We continue to believe that schedules and the routing of messages to the right person using the right channel in any care setting and at home is a differentiator.

We know that we’re having a good month when usage of our platforms is up. We track this religiously because it tends to be a good indicator. There are areas that we continue to track pretty closely. Extensions of our capabilities and our scheduling suite of products. Extension of our capabilities and our ability to engage with patients differently. Extension of our capabilities with our core clinical communication products, which could include the ability to track devices that are being delivered at patient’s homes so that we can enable this remote patient exam paradigm that is upon us. We are looking at a ton of stuff.

We are excited about where we are. We are grateful to have patient investors who like what we do and respect what we do, and we’ve done very well with it.

Morning Headlines 1/12/22

January 11, 2022 Headlines No Comments

PerfectServe Acquires AnesthesiaGo, a First-of-Its-Kind Solution for Auto-Generating Daily Case Assignments for Anesthesia Staff

Clinical communications, collaboration, and scheduling technology company PerfectServe acquires AnesthesiaGo, a developer of automated daily case assignment software for anesthesia staff.

Transcarent Raises $200 Million in Series C Funding Highlighting Growing Demand for a Different Health and Care Experience Aligned with the Needs of Self-Insured Employers

Transcarent, the employer health insurance cost management software company led by Glen Tullman, raises $200 million in a Series C funding round that values the company at a reported $1.6 billion.

Vista Equity invests $300 mln in telehealth software firm TigerConnect

Healthcare collaboration software vendor TigerConnect secures $300 million in funding from Vista Equity Partners, bringing its total raised to $400 million.

Aledade Acquires Advance Care Planning Company Iris Healthcare as Part of New Health Services Arm

Primary care enablement company Aledade acquires Iris Healthcare, which offers advance care planning solutions.

News 1/12/22

January 11, 2022 News 9 Comments

Top News

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Revenue cycle technology and services company R1 RCM will acquire competitor Cloudmed for $4.1 billion.

R1 has made a handful of acquisitions over the last several years, including VisitPay for $300 million, Cerner’s RevWorks business for $30 million, Intermedix for $460 million, and SCI Solutions for $190 million.

The company made a comeback after several widely reported missteps under its former name Accretive Health – settlement payouts for aggressive patient collection tactics and lapses in data security, followed by delisting of its shares from the New York Stock Exchange – and was renamed to R1 RCM in 2017.

RCM shares trade on the Nasdaq, with a market capitalization of $6.5 billion.

CloudMed Solutions – sold to Revint, then named Cloudmed — was founded by Jason Merck, now EVP of Cloudmed, in 2015.


HIStalk Announcements and Requests

I’ve long wished for IOS-type capability in Chrome to be able to send a web page’s link (nearly always to myself) via Gmail, but somehow I never thought to Google a solution until today, when I found an ancient Chrome extension called Send from Gmail (by Google). It hasn’t been updated since 2013, but it seems to work fine, much easier than copying the web address and composing a new email and pasting it in.

Discuss: a physical line of people waiting for something indicates a failure of technology to meet a need.


Webinars

January 13 (Thursday) 1 ET. “Cultivating gender equity in STEM.” Sponsor: Intelligent Medical Objects. Presenters: Laura Miller, CEO, TempDev; Amanda Heidemann, MD, CMIO, CMIO Services, LLC; Deidra Jackson, VP of IFP customer success, Bright Health; Sunita Tendulkar, VP of agile portfolio management, IMO. Despites strides that are being made, women make up only 27% of the STEM workforce. This panel discussion will cover mentorship, STEM education, pay gaps, and debunking stereotypes.

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


Acquisitions, Funding, Business, and Stock

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Clinical communications, collaboration, and scheduling technology company PerfectServe acquires AnesthesiaGo, a developer of automated daily case assignment software for anesthesia staff.

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Multi-vertical analytics and data services company Qlik files for an IPO, with date, number of shares, and pricing yet to be determined. Thoma Bravo acquired Qlik in 2016 in a $3 billion deal, taking it private after facing pressure from activist hedge fund Elliott Management.

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Healthcare collaboration software vendor TigerConnect secures $300 million in funding from Vista Equity Partners, bringing its total raised to $400 million. Competitors Voalte and Vocera were acquired by medical technology vendors in 2019 and 2022, respectively, for $180 million and $3 billion.

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Transcarent, the employer health insurance cost management software company led by Glen Tullman, raises $200 million in a Series C funding round that values the company at a reported $1.6 billion. It has raised $300 million in just over a year. Transcarent inked a deal with Walmart last October to offer the retailer’s pharmacy services to its self-insured employer customers.

OR block time management technology vendor Copient Health raises $3.2 million in a Series A funding round. The co-founder and CEO of the Atlanta-based company is industry long-timer Mike Burke, who previously founded Dialog Medical and Clockwise.MD.

ASC revenue cycle management company National Medical Billing Services acquires MdStrategies, which offers medical coding services to ASCs.

Primary care enablement company Aledade acquires Iris Healthcare, which offers advance care planning solutions. It is the first acquisition for Aledade, which was co-founded in 2014 by former National Coordinator Farzad Mostashari, MD, MSc, who serves as the company’s CEO.


Sales

  • Baptist Health (KY) and Prisma Health (SC) select Well Health’s patient communication software.
  • Pullman Regional Hospital (WA) will partner with Providence to replace its Meditech Magic system with Epic by March 2023.
  • Grail will use Premier’s PINC AI clinical decision support technology to better identify patients eligible for its Galleri multi-cancer early detection test.
  • Meditech will integrate SecureLink’s critical vendor access management software with its systems.

People

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Availity hires Bobbi Coluni (IBM Watson Health) as chief product officer.

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Niall Brennan (Health Care Cost Institute), a former CMS chief data officer, joins Clarify Health as chief analytics and privacy officer.

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Revenue cycle technology vendor MedEvolve hires Branden Barkema, MBA (North Florida Surgeons) as chief revenue cycle officer.

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Kerri-Lynn Morris (Microsoft) joins The SSI Group as CTO.


Announcements and Implementations

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Wolters Kluwer Health announces GA of its Ovid Synthesis application suite, which includes Clinical Evidence Manager, its first cloud-based workflow management module.

Pivot Point Consulting’s “Healthcare IT Directions Report” highlights four trends for 2022:

  1. Healthcare and health IT will be challenged in unknown ways by job resignations.
  2. Telehealth and remote patient monitoring will cover a wide scope based on patient demand, patient population characteristics, and access enablers / limiters.
  3. Spending on public health infrastructure will ease data access and reporting while creating career opportunities.
  4. Deployment of interoperable EHRs to retail sites – such as Walgreens, CVS, and Walmart rolling out Epic – will allow retailers to compete with traditional healthcare providers, with the latter needing to embrace a digital strategy to offer a frictionless patient experience as a differentiator to offset the convenience of retail healthcare.

Other

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Healthcare visionary and cardiac surgeon Devi Shetty, MBBS, MS — chairman and executive director of India-based hospital operator Narayana Health — says that 95% of illnesses will soon be treated via telemedicine since healthcare requires only data, with few patients needing hands-on services such as surgery. He also predicts that EHRs will diagnose conditions better than doctors within five years, and that shortly after, doctors will be required to obtain a second opinion from software before initiating treatment.

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A non-profit consumer group publishes Upsolve, a free app that allows consumers to file Chapter 7 bankruptcy – often necessitated in the US by medical debt — without an attorney, paying only a $338 federal court filing fee (which the app also applies to have waived). The company’s mission is to destigmatize bankruptcy for consumers as has already happened with businesses, for which it is just a smart financial strategy to avoid paying debt. The group warns, however, that people can file Chapter 7 only once every eight years, so they should consider when to file if they are undergoing long, expensive cycles of chemotherapy.


Sponsor Updates

  • Meditech will offer Expanse users access to role-based, interactive online training courses from MedPower.
  • Clearwater publishes a new white paper, “Technical Testing and the HIPAA Security Rule: What’s Needed to Protect Your Healthcare Organization.”
  • Appriss names Annie Edwards (Luma) chief people officer of its Bamboo Health and Appriss Retail businesses.
  • Azara Healthcare will host its annual user conference May 2-4 in Boston.
  • Fortified Health Security CEO Dan L. Dodson is elected to the AEHIS Board of Trustees.
  • Delaware’s DHSS Division of Substance Use and Mental Health surpasses a milestone of 100,000 referrals through the Delaware Treatment and Referral Network, which is built on Bamboo Health’s OpenBeds platform.
  • Frost & Sullivan recognizes About as a patient access and orchestration leader with its 2021 Best Practices Customer Value Leadership Award.
  • Divurgent publishes its “2022 IT Trends & Insights Report.”
  • Elsevier adds its most advanced 3D full female model to its Complete Anatomy 3D platform.

The following HIStalk sponsors have achieved top rankings in Black Book Market Research’s latest population health tools and solutions report:

  • Population health AI tools: Olive AI
  • Population health/value-based care consultants: hospitals & health systems: Change Healthcare

Blog Posts


Contacts

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

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Morning Headlines 1/11/22

January 10, 2022 Headlines No Comments

R1 RCM to Acquire Cloudmed, Creating the Strategic Revenue Partner for Healthcare Providers

R1 RCM will acquire competitor Cloudmed for $4.1 billion.

BayMark Poised To Innovate Addiction Telemedicine Services Via Technology Company Acquisition

Behavioral health provider BayMark Health Services (TX) has acquired online addiction treatment vendor Kaden Health.

Celo Health Announces Opening of U.S. Headquarters in Seattle

Celo Health, a healthcare messaging app developer based in New Zealand, opens its US headquarters in Seattle.

Curbside Consult with Dr. Jayne 1/10/22

January 10, 2022 Dr. Jayne 2 Comments

I started my HIMSS22 preparations in earnest today with the booking of my flights. I had looked at them a few weeks ago and then was sidetracked by a multitude of things, and based on the dramatic jump in price, I am glad I went back and got them today. I’ll be coming from an airport that isn’t a major hub, so there are some limitations, but I was surprised to see them jump over $300 in two weeks. Capitalism is alive and well, and who doesn’t love warm weather in March? As usual, I’m flying my favorite no-change-fee airline, so if HIMSS throws us a curve ball, I’ll be covered.

Mr. H pondered this weekend whether hospitals will allow their employees to attend. I would say that’s up in the air and all depends on what happens with new coronavirus variants. My local institution banned international travel at the end of December, but said people could travel domestically if they could be back at work within 24 hours. I questioned whether that was realistic based on the number of cancellations in the airline industry. Now they’ve ratcheted it up to the “don’t plan to go anywhere in the next two weeks” level. Many of my super-subspecialty friends are pretty much isolating except for going to work because there are limited numbers of them at each hospital and they can’t afford to both be sick at the same time. Hospitals are still restricting N95s, which I think is not only ridiculous, but counterproductive.

Our area hospitals are doing daily press conferences where they try to keep people calm and confident, but those on the inside wish they would do a little more to paint a picture of what’s really going on. At one hospital where a friend is an emergency department director, they’ve run out of portable oxygen tanks twice this weekend. When that happens, it’s a mad scramble to rearrange patients and get them connected to a wall unit. It also increases the time that patients have to be boarded in the emergency department because they can’t be transported to the inpatient floors if they’re on oxygen and there are no tanks.

One of them finally came out over the weekend and said they had halted all COVID testing for individuals without symptoms. That means no back-to-school or back-to-work testing and no tests prior to travel. I get it – they have to reserve the tests for patients where the result is going to make a difference in how they are managed – but it has pushed testing to the other facilities in town, which were already drowning. Most of the commercial testing vendors now have a three-day wait for testing, and turnaround times can be three or four days on top of that, which makes things challenging.

The same system had announced that it is freezing non-critical surgical procedures. The other players in town are functionally doing the same thing, but are soft-pedaling it to the public by saying that they are managing patients “on a case-by-case basis.” Everyone is nearly out of monoclonal antibodies and no one can get their hands on the new pill-based therapies, but no one is saying that publicly.

The state has dipped below 15% available intensive care beds, yet a number of people aren’t batting an eye. They’re going about their lives like they did pre-COVID, and any talk of flattening the curve to protect healthcare workers and preserve hospital capacity is met with scorn. I ran across someone today who insisted that there’s not a shortage of nurses due to sickness or being out to care for sick family or children whose schools have closed. They said it is because “all those nurses quit rather than taking that poisonous jab.” As someone who has seen the real stats (1.25% attrition rate for failure to vaccinate), I didn’t even engage in the conversation. It’s not worth it and there will be no changing of hearts or minds with that one.

Two more physician friends resigned this week, although they still have to remain in their respective hellscapes for another 90 days for contractual reasons. Hopefully, we’ll hit the peak soon and then come down the back side of it quickly so they can get some relief. Projections are that numbers will continue to be record-breaking for the next two weeks.

Both of them reached out to me for information about telehealth practice and other ways to use their degrees without caring for patients in person. They’re both great docs and I wish I could leverage their expertise on some of my teams, but unfortunately, they don’t have much non-patient-facing experience. I have plenty of other friends who want to leave their jobs but haven’t yet due to a sense of loyalty or altruism. Some have developed healthy coping strategies, but others not so much, so I’m keeping an eye on those that are in the latter cohort.

If you’ve got friends in the clinical trenches, please be aware that generally they are not OK. Although they may seem to be coping on the surface, I don’t know of anyone who isn’t struggling to some degree. Help how you can, whether it’s having a meal delivered or just leaving a bottle of wine on the porch. Physicians are finding creative ways to pitch in. A group of local subspecialists has been reaching out on physician social media groups offering to care for patients who might normally have been seen in primary care for dermatology, ear / nose / throat, and digestive issues. They’ve also offered parking lot space for drive-through testing, which would be great if people could get supplies. Some of our local primary care practices are running seven days a week due to demand, but others have had to close entirely due to lack of staff. Things are truly all over the place.

We’re only 10 days into the new year and I don’t think it’s going as anyone hoped. Regardless of where you work in the healthcare universe, keep an eye out for those who are struggling and offer a kind word or a sympathetic ear where you can. We’re all in this together and it’s going to continue to be bad for the next several weeks.

Email Dr. Jayne.

Readers Write: Five Ways to Increase the Value of Your EMR

January 10, 2022 Readers Write No Comments

Five Ways to Increase the Value of Your EMR
By Jason Friedman

Jason Friedman is VP of sales for EVideon of Grand Rapids, MI.

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In a 2021 survey by Stoltenberg Consulting, 59% of hospital CIOs said getting the most out of their IT purchases, such as their EMR, is the biggest financial goal for next year. EMRs and EHRs have given rise to digital transformation in healthcare, and there’s no denying that adopting these tools has forever changed the way clinicians and healthcare staff do their jobs.

Yet, our industry is at a tipping point. The field of nursing is in crisis. Clinicians are burned out. There is a widening gap in health inequity. Trends in healthcare consumerism are putting increased pressure on a strained system. Never has it been so clear that it is time to think differently about the future of healthcare technology.

How can we do this? 

Deliver patient-centered care by personalizing the patient journey

The first step is to shift the focus of the EMR back to the patient by presenting information in an understandable and meaningful manner.

A digital whiteboard, when integrated with your EMR, is a centralized information hub for patients, families, and care teams, providing real-time health information that will improve care coordination as well as the overall care experience. Integration with the EMR and other installed technologies allows hospitals to personalize the patient journey with tailor messaging and targeted patient education.

In a recent research study, Brigham and Women’s Hospital (BWH) in Boston, one of the top-ranked hospitals in the US, partnered with a consortium of companies to research the impact of in-room digital whiteboards on communication and patient satisfaction in the emergency department. The study showed that 96% of participants preferred a room with a digital whiteboard as it improved communication and helped them feel more informed throughout their stay and prior to discharge.

In addition, 70% said the digital whiteboard helped them better understand what was happening during their stay. Beyond keeping patients informed, the whiteboards display patient information seamlessly, leaving little room for human error and allowing clinicians to focus on providing quality care.

Automate clinical workflows to enhance the clinician experience

We all know how overloaded and stressed nurses are, especially during this pandemic. A study published in the Journal of the American Medical Informatics Association found that higher EMR usability scores are associated with lower odds of burnout, and those usability scores have sharply declined. Specifically, researchers found that among 1,285 nurses who responded to a November 2017 survey about usability and burnout, the mean nurse-rated EMR usability score was 57.6. A 2019 study by the Mayo Clinic also supported that finding.

It’s time to make technology work for both patients and the care team. By integrating nutrition services, real-time location systems (RTLS), room controls, and other technology elements, you can automate many administrative tasks. For example, when a digital whiteboard is integrated with the EMR, nurses no longer need to manually update dry erase boards (or chase down a working marker). Advanced technology can turn the patient room into an extension of the care team, enabling clinicians to better focus on direct patient care.

Increase patient satisfaction

Patients naturally feel a sense of unease in a hospital. They’re away from home and feeling a loss of control, all while being worried about their health. Giving patients the ability to control elements in their room such as room temperature, shades, and lights, through an integration with building control systems, is a small thing that can have a big impact.

Giving control and self service back to patients can positively impact their overall rating and likelihood to recommend the hospital on their HCAHPS survey. For example, letting patients order their meals from their TV or other device – through an integration with nutrition services solutions such as Computrition, CBORD, or Morrison – puts patients in control, reminding them of the concierge service they get at home from apps like DoorDash and GrubHub.

A personalized, end-to-end experience and environment can enhance satisfaction. A television that greets patients by name as they enter the room provides easily accessible entertainment (movies and streaming TV), enables video visits with loved ones, and displays relaxation content that helps with stress and sleep can all contribute to a supportive patient environment.

In addition, announcing care team members on the TV as they enter the room, via RTLS integration, provides patients with a sense of security that the person in the room should actually be there.

Hospitals can also automate non-clinical service requests. From their room, patients can request clean linens, a visit from the chaplain, or other available hospital services.

Lastly, hospitals can keep a pulse on patient sentiment using pop-up surveys that unobtrusively collect patient feedback while they enjoy entertainment or education. Real-time insights can be automatically routed to key departments for service recovery, ensuring dissatisfiers don’t turn into HCAHPS issues.

Inform and protect patients, staff and visitors

Technology innovation can have a major impact on patient safety and workforce safety initiatives. One way to reduce harm and avoid preventable errors is using the EMR as the single source of truth to keep team members informed and aware of critical patient information.

Digital door signs that are integrated with the EMR can display critical safety information just outside the patient room. Real-time access to accurate health information can not only save staff time by eliminating the need to log into the EMR, but it also keeps them informed of any and all precautions or life-saving steps they may need to take.

Digitizing broad communications is another great way to keep patients, staff, and visitors safe. Throughout the COVID-19 pandemic, hospitals have leveraged digital signage to automatically disseminate crucial information like hand washing protocols, visitation policies, and other urgent COVID-19 related information.

Automating and digitizing manual processes reduces human error and empowers care care teams by giving them instant access to accurate, reliable, and real-time patient information when they need it most.

Manage your digital front door strategy

Rising trends in healthcare consumerism continue to push hospitals to integrate new technologies and enhance existing technologies to do more. Collecting real-time patient feedback and creating meaningful connections with your patients wherever they are, whenever they need you will help to build brand loyalty and drive utilization.

A tech-enabled experience before, during, and after the hospital stay can not only yield better health outcomes, but also influence hospital choice. Let patients complete forms prior to admission, and help them prepare for a visit and care post-discharge by sending patient care guidelines and education directly to a personal device. Delivering a care experience that is more convenient, meaningful, and effective for patients and their families will make your organization the preferred choice for today’s consumer.

EMRs can work in concert with other technologies to elevate the care experience for patients, families, and clinicians, making it seamless in ways that other industries like travel and banking have already done. Leveraging the EMR and integrating surrounding technologies also future-proofs the technology investments hospitals and health systems have already made.

It’s time to stop thinking about systems in isolation, and instead think about how systems can work together to produce a better net effect. What else is possible now and how can we leverage our current IT investments to do better?

Readers Write: If It’s Not Easy, It’s Wrong: Why Easy Is the Answer for Healthcare

January 10, 2022 Readers Write 1 Comment

If It’s Not Easy, It’s Wrong: Why Easy Is the Answer for Healthcare
By Arun Mohan, MD, MBA

Arun Mohan, MD, MBA  is president of Relatient of Franklin, TN.

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Years ago, as a medical resident, I spent a lot of time in the cardiac stepdown unit. I was caring for patients who had suffered heart attacks or exacerbations of heart failure or had had various cardiac procedures. One of the patients was a 60-year-old woman I’ll call Mary who had hard-to-control heart failure. Due to a rare disease, Mary’s heart didn’t pump like it should.

After a recent hospitalization—her third in as many months—I was determined to break the cycle. I spent time reviewing everything about her case. We prescribed a diet that we thought would keep Mary healthy. We adjusted her medications, adding multiple doses of short-acting drugs to titrate for maximum effectiveness. She was eager to follow the new plan, and I thought this would be the last time I saw her in the hospital.

About a week later, Mary was readmitted, again with swollen legs, trouble breathing, and chest pain. In our desire to maximize benefit, we had created a treatment regimen so complicated that it was almost impossible to adhere to.

Optimizing personal behavior is the holy grail of healthcare. It represents the single greatest opportunity to improve health outcomes since unhealthy behaviors account for nearly 40% of all deaths in the United States. But as anyone who has tried to change behavior knows, it is hard.

In one popular model, behavior is a function of one’s motivation, ability, and a prompt. In many industries, including healthcare, we pay a lot of attention to motivation (just consider the billions that go into advertising), but don’t think enough about ability. Put another way, it’s incredibly difficult to change someone’s motivation, but it’s often possible to make something easier to do.

You don’t have to look far to see how simplicity can drive positive action. Whether it’s retail, entertainment, finance, or travel, consumers are willing to pay more for simpler experiences and are more likely to recommend a brand because it is simple. So how does this look in healthcare?

24/7 Access Boosts Consumer Response

Given changes in how we work and live, consumers are increasingly looking for 24/7 access. Just think about the last time you made a purchase decision. Was it between the hours of 9 and 5? To what extent did lack of availability make you look elsewhere?

Consumer behavior applies just as much to medical appointments. Historically, appointments have been made over the phone when the doctor’s office is open, typically 9 to 5. But when practices offer 24/7 access, consumers follow. In our own data, nearly one-third of patients go online outside normal business hours to schedule appointments.

Consumers Prefer Mobile-First Communication

Each day, the average American spends 5.4 hours on a mobile phone. Mobile-first communication is the easiest way to get a patient’s attention and will elicit the fastest response or action time. Further, patients strongly prefer their mobile devices for communication; 67% of consumers say they prefer to text with organizations about appointments and scheduling and 75% say they are frustrated when they can’t respond to a text message from a business.

You can make things easy for patients by tying an action directly into a mobile workflow. For example, we recently worked with a large dermatology group that was struggling to get patients scheduled for their annual skin checks. With numerous patients missing appointments due to COVID in 2020, many hadn’t been scheduled for their visits in 2021. Calling, emailing, and even writing letters to patients had limited effect, with response rates under 10%. But simply sending patients a text message and offering them a personalized link to click and start the scheduling process boosted conversion to more than 60%.

To Simplify the Consumer Experience, Minimize Decision-Making

We know that business can increase conversion by minimizing choices. If a person is presented with too many choices, they are actually less likely to buy. In a clever experiment, psychologists Sheena Iyengar and Mark Lepper studied the impact of the number of jams on a display table on conversion. On a regular day at a local food market, customers would find a display table with 24 kinds of jams. On another day, at the same food market, people were given only six jam choices. Guess which display table yielded more sales? While the big table generated greater interest, people were much more likely to actually buy a jar of jam at the smaller table – about 10 times more likely.

We have seen similar results in healthcare, where patients like to be given concrete choices. For example, rather than asking people to schedule a vaccination, simply giving people a choice of one or two days for appointments improves conversion. In a recent COVID vaccination campaign, some patients were asked to schedule an appointment by clicking on a link that came through a text, while others were asked to choose between three appointments, also via text. The results? Patients asked to choose one of three appointments were twice as likely to schedule.

Start Simplifying by Eliminating Duplication

These actions may sound easy, but in healthcare, we make them hard. The good news is that consumers are eager for change that simplifies. If, as healthcare leaders, we reexamine how we’re engaging patients and delivering care, we can create quick wins.

“Easy” is one of the most powerful forces at play in human behavior. Making things easy for people doesn’t have to be a monumental undertaking. Healthcare leaders can start small by identifying where patients and staff are duplicating efforts for no benefit and eliminating those redundancies. Delivering ease and simplicity will improve health outcomes and the bottom line.

HIStalk Interviews Lisa Esch, SVP, NTT Data

January 10, 2022 Interviews No Comments

Lisa Esch is SVP/provider industry solutions leader of NTT Data of Tokyo, Japan.

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Tell me about yourself and the company.

I’ve been with the company for a little over a year. I get to work with our clients and our customers as we tackle the challenges of healthcare and how IT supports that with services and technology. I’ve always been in healthcare. I started out as a clinician. I’m a dietitian by training and I worked for non-profit and for-profit health systems. I worked in the space around healthcare systems for many years, then in startups as well as large IT global systems integrators.

How will health systems use technology differently as they grow in size and geographic scope?

We’re seeing a lot of the innovation come out of the nimble, small companies, the ideas that can be executed and how we problem solve. There’s a balance between the large and the small, what the large can accomplish at scale versus what the small can do in driving innovation. There’s this blending of both that we need in the marketplace to drive the change that’s happening and to keep the patient at the center of what we’re trying to accomplish in this healthcare transformation, this digitization of healthcare.

Are health systems more consistently using their corporate approach and brand so that patients feel known at any of the health system’s venues?

Having the health system know them is a conversation that we are having with many of our customers. There’s this balance between “creepy know” that you get from commercial businesses that we interact with online versus knowing you so we can improve outcomes, engagement, and personalization.

You shouldn’t have to repeat things in your healthcare experience. You shouldn’t have to have nine portals. Even though you’re accessing in multiple places, it’s a single system, so personalization needs to come together. There’s a lot of fear around information and being proactive because of some of the rules and laws we have about how you communicate with patients, and the difference between marketing versus education and those types of things. But convergence is coming together with commercial industry and healthcare, and we have to figure a good way to make that happen.

What are health systems considering when developing their digital health strategy?

A lot of it involves how to humanize the digital experience. How we bring in information and data around people that isn’t traditionally healthcare that can help us drive engagement, make it more personal, make it a better experience, and make it a better outcome for the clinician as well as the patient. We are having conversations around that. We are building into our digital accelerator things that are AI driven, next best actions, personas, and different things that help with that digital experience and make it more personal.

Some organizations are more ready to have those conversations than others. Some react with, “Amazon knows more about you and Google knows more about you than you know yourself.” That’s not what we’re trying to get to, but how do we leverage the good that’s coming out of those things to bring together the clunkiness that we have in healthcare today? Imagine having a unified patient experience for someone so that an organization’s brand can stay connected to a patient as they traverse this healthcare delivery system where more is happening outside the four walls of the healthcare system than inside. There’s risk with brand and with connection. Patients have a lot of choice.

Is anyone looking far enough down the road to connect a variety of services and tools together to create an Amazon-like experience?

We are working on that strategy now. We’re putting together a marketplace where we can make it easy for organizations to have a problem to solve. We have partners that are pre-built or pre-vetted to make that process easier. We also have the capability of the technologies that can bring those things together, to make them all work together and better to get more out of them. We’re tackling this with our customers right now. 

A lot of decisions were made a couple years ago early on in the pandemic in buying technology. I need this and I need that. Now organizations are sometimes stuck with a bag of rocks. We are beefing up our healthcare consulting chops and advising organizations on, maybe we pull the plug on this. Let’s have a strategy here, and put more of a strategy around this transformation versus having the world put all this pressure on organization and people just buy things because they need something. 

Who is in the best position among healthcare players in getting the consumer’s attention as an information source or service choice?

The organizations that create this unified personal experience are further ahead. What that unified experience is is key. When I talk about a unified experience, I’m not talking about a single EMR across an enterprise. It’s much more than that. Patients become engaged in many more ways than just that their portal, which they don’t use except when they need to pay their bills. There’s this much more enriching experience, and patients can sometimes get that more easily from outside their healthcare system in other industries. Those other industries are obviously looking at healthcare.

The term “provider” is being redefined. There’s lots of ways healthcare is being provided lately. So it’s going to require partnering with people that you haven’t thought about and doing things in new ways. We’re tackling hospital at home, health at home, and it’s really complex. It seems like it shouldn’t be that hard, but we know that it is. That’s going to require a new way of thinking about delivering healthcare, new partners, and non-traditional things to move to that space. The ones that will win are going to be driven by experience and those that will invest in that unified personal human experience. Health and wellbeing is going to be delivered outside of just healthcare systems.

Is it hard to segment the wide variety of patients that a health system would serve, such as by preferred communication channel or the desired depth of the ongoing relationship?

That ties to a healthcare persona. It really is an engagement persona — how frequently they access and what kind of communication. It still is an omni-channel strategy. Some people still want to be communicated with or educated on paper. Some people want pure digital. The omni-channel experience is key, but the persona is a big part of it. We’ve tackled a lot of what we do with, “Here’s the technology. Just plug everybody into it.” Beyond that, we have a lot of research around engagement that can be driven digitally. We probably need to look outside of healthcare a little bit more to bring those capabilities in, to drive that and have it become part of our digital strategy as we transform the healthcare system.

Will we have enough providers in the right locations to support the business models involved in offering services in new ways?

Telehealth fit a need. A lot of clinicians move to it that because, wherever they were in their careers or whatever they were doing, it worked for them. Telehealth is here to stay and we are going to have that capability. Health systems need to balance out how they will deliver it because telehealth is still going to drive a different demographic, and when you look at the lifetime value of a patient, that experience will be important as people move and age through the healthcare system.

The partners you have how telehealth is delivered needs to ensure availability, but a lot of the telehealth that was stood up was disconnected from the health system and from the records. It was disconnected for the patient. They got what they needed in that moment, but it wasn’t part of a connected healthcare journey or their healthcare experience. That’s the part that’s a little messy still, and we’re working on determining the best next going-forward strategy and how we  balance that out.

Banks deployed ATMs so they could get rid of tellers, but also addressed an unmet need of customers who ended up rarely needing to interact with a bank employee anyway. How will the rollout of technologies such as chat bots benefit patients rather than just limiting their access to clinicians?

When AI and chat reduce access, there are probably unintended consequences that aren’t so positive. It’s finding the right place to leverage that and to have it improve and enhance the experience and not be a way to block the experience. There are times where certain personas will engage with that and others won’t. That’s part of the strategy with AI —  how do you find those who will engage with that and those who will not?

An example where it worked great was putting together a SOAP note prior to a visit by having the patient chat with AI before they saw the physician. They found that patients shared more with this bot than with a human being, so they got a more robust background prior to that visit. That’s really cool technology. Sometimes AI can be a better experience than the human one, while at other times, it’s not. We  have to sort all that out as we build this strategy. There will be a place for it, and there will be a place where it’s not helpful.

Where do you see digital health and the company advancing in the next few years?

The digital health innovation that we’re going to see over the next two to three years will be similar to what we’re seeing now. The ideas, the startups being disruptive, and then elements of those things moving into mainstream. I’m also seeing the big transformations that have to happen in healthcare, the digital ecosystem and how we deliver healthcare, as that is also being transformed. We’re going to see AI and robotic process automation. We’re going to see all these small things find the right place in the bigger picture that will drive the transformation. We are excited about is helping with the roadmap, the strategy around that, and helping to find those partners and put those things together that are unique to a healthcare system.

It will be exciting to see what that transformation will going to be. We will see this transformation of, who and what is a provider? How is healthcare provided in the community? With COVID, everyone in the workplace is in healthcare. An employer is responsible for understanding and keeping their patients safe and healthy, so this definition of health and wellbeing is also being redefined and identifying who is responsible for that in our communities. This conversation is going much more broader than just healthcare providers. We’re in the middle of all of that, trying to bring that together and help communities deliver.

Digital healthcare and the digital ecosystem are patient driven. There’s a consumer aspect to it, there’s a technical aspect to it, it is driven by innovation, and it is driven by tradition. These things are coming together in a new way than we’ve seen before. It requires all of those different points of view to move forward, and that’s what I’m so excited about.

Morning Headlines 1/10/22

January 9, 2022 Headlines No Comments

Qlik files for IPO six years after being taken private for $3B

Thoma Bravo-owned analytics and data services company Qlik files for an IPO, with date, number of shares, and pricing yet to be determined.

Missouri’s CRMC brings network back online, 3 weeks after cyberattack

Capital Region Medical Center (MO) brings its systems back online after a December 17 cyberattack.

Maryland health workers, lawmakers want answers as problems persist a month after cyberattack

A December 4 cyberattack on the Maryland health department’s systems continues to impede staffers, including clinicians, from accessing several systems.

Monday Morning Update 1/10/22

January 9, 2022 News 9 Comments

Top News

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Medical technology vendor Stryker will acquire clinical communication and workflow platform company Vocera Communications for $3 billion.

Stryker says the acquisition will help it “significantly accelerate our digital aspirations to improve the lives of caregivers and patients.”

Stryker got its start as a manufacturer of hospital beds like its competitor Hillrom, as both companies expanded into technology. Hillrom, which acquired Vocera competitor Voalte in early 2019 for $180 million, was acquired by Baxter International last month for $10.5 billion.

Shares of Vocera, which went public on the New York Stock Exchange in early 2012, had risen 55% in the year prior to the acquisition announcement. The company has 1,900 hospitals and healthcare facilities as customers. Its Smartbadge was named to Time’s list of the “100 Best Inventions of 2020.”


HIStalk Announcements and Requests

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Only a small percentage of poll respondents believe they are less effective when working from home. I would expect that some jobs that involve heads-down individual work (programming, writing, etc.) or remote contact (customer service and support) can be performed as well or better at home. I wonder, though, whether companies are being damaged in ways that aren’t yet obvious with the lack of culture-building personal contact, reduction of serendipitous hallway interactions, and having managers in charge whose forte is visually monitoring piecework production.

New poll to your right or here: What is your personal experience with COVID-19? I’m not sure it’s a relevant question since I’m pretty sure we will all have tested positive soon, but I’m curious.

Meanwhile, HIMSS still hasn’t announced any changes to its Right of Entry Protocols for HIMSS22 that may be required by Florida laws. The conference is just over 60 days away. Exhibitor count is at 603, lower than HIMSS21 although the number will likely increase as the conference draws closer. HIMSS21 had 14 booths of 2,000 or more square feet while the HIMSS22 floor plan is showing 32, so that’s a positive sign of increased exhibitor interest. The big question now, assuming that the conference won’t be cancelled because HIMSS can’t afford a skipped year, is whether COVID-drowning hospitals will allow their employees to attend a conference.

The number of friends and family members who have tested positive for COVID-19 in the past few days is getting too hard for me to track, especially since it’s not the first go-round for some of them. Mrs. H went to a tiny-town Walgreens Thursday for hairspray or something and the clerk said they had already sold out of the 4,000 antigen tests they received that same morning, even with a purchase limit of four. PCR testing lines are impossibly long and results are taking 4-5 days to come back in many cases, rendering testing somewhere close to pointless. Home testing, no-testing, and other under-reporting probably means that we’re at 3 million or more cases per day, and many of those folks who will be sick and/or isolating (and/or spreading infection because they can’t afford to miss work) are critical workers and healthcare staff. Former FDA Commissioner Scott Gottlieb, MD estimates that up to 40% of Americans may end up becoming infected with Omicron, spreading the virus widely because their mild symptoms aren’t obviously COVID-19 and tests are too hard to get to verify. Let’s hope, probably unreasonably, that the supply chain for prescription drugs and medical supplies holds up since hospital beds and physician appointments are going to be scarce for a while.

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

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Webinars

January 13 (Thursday) 1 ET. “Cultivating gender equity in STEM.” Sponsor: Intelligent Medical Objects. Presenters: Laura Miller, CEO, TempDev; Amanda Heidemann, MD, CMIO, CMIO Services, LLC; Deidra Jackson, VP of IFP customer success, Bright Health; Sunita Tendulkar, VP of agile portfolio management, IMO. Despites strides that are being made, women make up only 27% of the STEM workforce. This panel discussion will cover mentorship, STEM education, pay gaps, and debunking stereotypes.

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


People

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Divurgent hires Joe Grinstead, MBA (Healthcare Triangle) as principal.

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Industry long-timer Amy Fuller-Heffernan (Verinovum) joins Interbit Data as VP of client strategy.

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Chris Apgar, president and CEO of security and privacy consulting firm Apgar & Associates, died last month at 60.


Announcements and Implementations

TriNetX announces Bring Your Own Model for applying machine learning capabilities to real-world research data.

HIMSS launches a new certification to its stable, Certified Professional in Digital Health Transformation Strategy. The cost is $1,299 plus a renewal fee. I would question whether someone passing the exam will suddenly find themselves more employable or whether the market really needs HIMSS to sort out the lesser-competent players in it, but I always underestimate the yearning of insecure industry folks to add new letters to their walls, business cards, and LinkedIn profiles. For them, HIMSS also offers CAHIMS (associate in healthcare information and management systems) and CPHIMS (professional in healthcare information and management systems). All require healthcare IT experience, so candidates must have been boldly working without certification for employers who didn’t seem to mind.

A study finds that in-hospital mortality at the former Lutheran Medical Center (NY) declined from 2.6% to 1.9% after it was acquired by NYU Langone Health and the hospital saw improvements in central line infections, catheter-associated UTIs, and patient recommendations. Three of the five post-acquisition focus areas were related to IT – implementing Epic, using real-time analytics and dashboards, and implementing EHR-embedded clinical decision support.


Government and Politics

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ONC releases final technical specifications for Project USA, which hopes to standardize the representation of patient addresses to support identity matching.


Other

A.O. Fox Hospital (NY) becomes the latest hospital to make local news for failing to pay its employees accurately because of the Kronos payroll system ransomware downtime. Most affected hospitals are paying hourly employees the same amounts as on their last system-issued paycheck in early December, meaning they aren’t being paid accurately for overtime, holiday pay, or COVID-19 coverage and instead are being promised that their money will be sent retroactively once Kronos comes back up (or, even less positively, that employees whose early December hours exceeded those afterward will need to return the overpayment).

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HHS reports that 18% of available US hospital beds were being occupied by COVID-19 patients this weekend as the COVID curve resists flattening (thank goodness for our US profit-driven overbedding). Brown School of Public Health Dean Ashish Jha, MD, MPH warns that the US healthcare system is in even more trouble than is obvious, as 1 million Americans could need hospitalization for COVID-19 over the next 4-6 weeks, far exceeding aggregate hospital capacity (note also that average length of stay times a million admissions is an unfathomable number of patient days, not to mention that hospital beds don’t sit on a grid so that total supply can meet local needs). The New York Times says that hospitals are being bombarded with punishing patient loads as they operate short-staffed because of employees who have quit or who have COVID-19 themselves.


Sponsor Updates

  • Availity partners with PriorAuthNow to deliver timely prior authorization services.
  • The Consulting Report includes Nordic CEO Jim Costanzo on its list of “Top 50 Consulting Firm CEOs of 2021.”
  • Olive appoints Credit Karma executive Nichole Mustard to its board.

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