News 9/29/21

Top News

A Government Accountability Office investigation into the activities of President Trump’s trio of Mar-a-Lago associates finds they were involved in decision-making for no fewer than five VA programs, including its contract with Cerner, despite having no official ties to the agency.

A review of 223 email exchanges between the three men and VA officials found they also weighed in on personnel decisions, budgeting, and ideas around monetizing VA patient data.

One of the three, Bruce Moskowitz, MD, shopped the data-selling idea to Johnson & Johnson, Apple, and CVS after a consultant he employed said that “it can be leveraged into hundreds of millions in revenue.” No personal gain was implied in the proposal. Documents suggest that VA Secretary David Shulkin, MD liked the idea.

Another member of the group, former Marvel Entertainment chairman and CEO Ike Permutter, scolded Haley Van Dyck, then deputy administrator and co-founder of the White House’s US Digital Service, for communicating with Apple while excluding “our broader team of subject matter experts.” He accused her of exhibiting “clear disrespect for everyone involved” and “hijacking of this effort,” adding, “I will not allow this to happen while I am involved.”

Reader Comments

From Academic Doc: “Re: Teladoc. I found your commentary about its stock performance interesting. Our hospital started using Microsoft Teams for telehealth early in the pandemic. There were a number of glitches and problems with people downloading the app, but in general it has been pretty usable. We piloted Teladoc and it was horrible in performance and features, although a newer version helped. The main advantages seem to be that you don’t need an extra app installed and Teladoc has their own support to help patients (although we don’t yet know how responsive they really are). It allows patients to complete rating scales, consents, and other forms, which was a weakness with Teams and our patient portal, but it apparently won’t integrate with the EHR except as a PDF. It also doesn’t seem to accessibility features such as closed captioning and doesn’t support group sessions. It integrates with the EHR’s patient schedules but not Outlook, so you have to switch back and forth to see scheduled patients versus other meetings.” 

HIStalk Announcements and Requests

I analyzed the first 100 items in my LinkedIn feed this morning, excluding promoted items, which yielded just 13 possibly relevant and interesting items (13%) as LinkedIn becomes more like Facebook every day:

• Annoyingly flowery inspirational story written or liked: 20
• Company or product pitch: 14
• Interesting article link: 11
• Personal article (deaths, new puppy, new school): 8
• Congratulations to a company or person: 8
• Recruiter or job available pitch: 8
• Unrelated local event or link to unrelated article: 6
• Social issue, company complaint, or COVID arguing: 6
• Proud of employer or team: 6
• Preachy how-to business instruction: 3
• Excitement at attending a conference: 3
• Self-promotion: 3
• Need a job: 2
• Mildly interesting company update: 2
• Job update: 2
• Relevant poll: 1
• Irrelevant poll (what is the best chain chicken sandwich?): 1

Webinars

October 6 (Wednesday) 2 ET. “Solving Patient Experience Challenges Through a Strong Digital Front Door.” Sponsor: Avtex. Presenters: Mike Pietig, VP of healthcare experience, Avtex; Jamey Shiels, MBA, VP of consumer experience, Advocate Aurora Health; Chad Thorpe, care ambassador, DispatchHealth. Patients expect healthcare providers to offer them the same digital experience they get when banking, shopping, and traveling. This webinar will describe how two leading healthcare providers created digital front doors that exceed patient expectations, improve patient outcomes, drive loyalty and acquisition, and future-proof their growth strategies in competitive markets.

October 6 (Wednesday) 1 ET. “A New, Streamlined Approach to Documentation and Problem List Management in Cerner Millennium.” Sponsor: Intelligent Medical Objects. Presenters: Deepak Pillai, MD, physician informaticist, IMO; David Arco, product manager, IMO; Nicole Douglas, senior product marketing manager, IMO. The IMO Core CSmart app, which is available for Cerner Millennium in the Cerner code App Gallery, helps providers document with specificity, make problem lists more meaningful, and improve HCC coding. This webinar will review the challenges and bottlenecks of clinical documentation and problem list management and discuss how streamlined workflows within Cerner Millennium can help reduce clinician HIT burden.

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

Acquisitions, Funding, Business, and Stock

Healthcare Triangle will likely go public later this week in an anticipated $40 million IPO. The cloud, security, advisory, and implementation services company was formed in June 2020 through the merger of health IT firm Cornerstone Advisors and software company 8K Miles, now known as SecureKloud.

Former HHS Deputy Secretary Eric Hargan launches a healthcare consulting firm offering advisory services, investor guidance, and legislative and policy expertise.

Sales

• Walmart will implement Epic across all of its health and wellness business lines, beginning early next year with four new Health Centers in Florida. Some, if not all, of its clinics were using Athenahealth when they opened in 2019.
• IHealthHome will add VitalTech’s remote patient monitoring technology to its senior-focused care management software.
• The Marion County Health Department will implement Epic through a software sharing agreement with West Virginia University Medicine.
• Unity Health (AR) will implement Meditech Expanse across its three hospitals and long-term acute care facility.

People

MedeAnalytics names Steve Grieco (ConnectYourCare) CEO.

Chris Powell (Aspenti Health) joins clinical assessment and triage software vendor ThinkMD as CEO.

Lumeon hires Breht Feigh, MSc (Press Ganey) as CFO.

Announcements and Implementations

Southwestern Health Resources (TX) implements analytics and predictive modeling from ClosedLoop.

Carolina Pines Regional Medical Center (SC) rolls out Vocera’s Ease app, enabling care teams to securely send messages to a patient’s family members.

Mile Bluff Medical Center (WI) will convert from NextGen to Meditech Expanse on October 1.

A new KLAS segment insights report looks at how 27 health systems define the term “digital front door.” Click the graphic above to enlarge. Epic customers turn to Epic first for digital front door tools, while Cerner customers more likely look elsewhere to companies like Amwell, Kyruus, R1, and Well Health. Companies that have successfully carved out niches include Kyruus (provider search and match and self-scheduling), Krames (patient education delivered via existing platforms), and Zoom (video visits). Those health systems reported that a wide variety of their C-level executives oversee their digital front door programs, ranging from CEO, CIO, CMIO, chief digital officer, and chief experience officer. Only one-third of respondents sought outside help to create their program.

Sponsor Updates

• Imprivata has celebrated the achievements of customers from the UK and Ireland at its annual HealthCon user group meeting.
• Arcadia announces that its MSSP ACO customers generated $386 million in shared savings in 2020, averaging $10.7 million each.
• Azara Healthcare completes the NCQA HEDIS Health Plan Measure Certification Program for 35 measure year 2021 HEDIS measures.
• Central Logic congratulates Clinical Operations Regional Lead & Solutions Architect Charles Larson on being elected to the American Organization for Nursing Leadership Board of Directors.
• CHIME releases a new Digital Health Leaders Podcast, “A Conversation with Aaron Miri, CHCIO, FCHIME, SVP, CDIO, Baptist Health.”
• Dina will exhibit at the NAACOS Fall Conference September 29-October 1 in Washington, DC.

Blog Posts

• Celebrate Heart Awareness on World Heart Day with Ability CareWatch (Ability Network)
• Texting & Emojis in Patient Communications (AdvancedMD)
• Certifying Azara DRVS for HEDIS and CMS ECQMs (Azara Healthcare)
• Beyond Virtual Telemedicine: Discovering the Future of Virtual Care (Bluestream)
• COVID-19 and the nursing home staffing crisis (CarePort)
• Getting Electronic Medical Record Data Right: How Small Changes are Big Wins (CereCore)
• The future of connected care planning (Cerner)
• Patient Access to EHR Clinical Notes Linked to Better Chronic Condition Medication Adherence (ChartLogic)
• The Importance of Self-Care for Caregivers (Obix Perinatal Data System, developed by Clinical Computer Systems)
• Navigating Changes Along the Patient Journey (ConnectiveRx)
• How Technology Can Help Your Office Crisis-Proof Chronic Care (CoverMyMeds)
• A Better Front Office Could Be Just Minutes Away (EClinicalWorks)
• Patient self-scheduling as a competitive advantage – interview with the expert (Experian Health)

Contacts

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

Morning Headlines 9/28/21

Walmart Selects Epic To Help Customers Simplify Their Health Care

Walmart will implement Epic across all of its health and wellness business lines, beginning early next year with four new Health centers in Florida.

Trump’s Mar-a-Lago Buddies Tried to Get the VA to Sell Access to Veterans’ Medical Records

Congressional investigators determine that President Trump’s trio of Mar-a-Lago business associates attempted to monetize VA patient data.

Former Deputy Secretary of the U.S. Department of Health and Human Services (HHS) Launches a New Healthcare Consulting Firm

Former HHS Deputy Secretary Eric Hargan launches a firm offering healthcare stakeholders advisory services, policy and legislative consulting, and investor guidance.

Med-Metrix Secures Capital Investments From A&M Capital Partners, Hackensack Meridian Health and Existing Management in Support of Growth Initiatives Including a Merger with Miller & Milone

RCM and business intelligence company Med-Metrix secures an undisclosed amount of funding and merges with RCM-focused law firm Miller & Milone.

Curbside Consult with Dr. Jayne 9/27/21

Last week’s biggest medical news was the approval of COVID-19 booster shots for certain groups who had previously received the Pfizer immunization. When the announcement was made, one of the first things I thought about was how my clients would handle the need for outreach to populations who are now eligible. Certainly there would need to be some reporting to identify eligible patients, followed by communication, self-scheduling, and all the workflows we mastered earlier in the year. I wondered how long it would be before one of them reached out to me for assistance.

In the meantime, since I plan to be doing some in-person clinical work next month, I decided to schedule a booster dose for myself. Word on the street is that local pharmacies are throwing away doses due to lack of eligible patients, and if they’re going to waste a dose, it might as well go directly into the arm of a frontline physician.

I hopped online to see what my options were. The first place I looked was Costco, since I had a great experience there with my flu shot. Their website walks you through your vaccination history, but doesn’t ask anything about whether you are immunocompromised (which would have made you eligible for a third dose for several weeks) or your age. Instead, it gave me a happy green banner at the bottom of the screen that said, “Congratulations! You have received the recommended number of COVID-19 vaccine doses. You are officially vaccinated and do not need to schedule another appointment.”

The next place I checked was CVS. After a question about current symptoms and exposure status, I was asked whether I need to start the series, schedule a second dose, or whether I need to schedule a booster dose under the new criteria. Kudos to their IT team for updating the system quickly – things were looking promising. They also asked if I wanted to add a flu shot to the appointment (if available), so kudos for co-administration as a way of promoting public health. After keying in my date of last vaccine and that I had received the Pfizer product, it took me to a scheduling screen, where I quickly learned that there were no timely or convenient appointments at any of the three locations closest to my house. There were also no appointments available after 6 p.m. at the 10 closest locations. If we really want people to be vaccinated, we ought to make it convenient.

I also tried Walgreens, just for fairness if I was going to go the retail pharmacy route. Walgreens also had an updated system where I could quickly document my eligibility for a third dose or a booster dose depending on which criteria applied. Walgreens had an excellent assortment of evening appointments, but interestingly, none during the day – 5:45 p.m. was the earliest available slot. The site also offered the opportunity to add multiple other vaccines to the appointment including those for flu, shingles, pneumococcus, and Tdap. It was looking like the best option so far.

Glancing up at the vaccine card that’s stuck on the bulletin board behind my desk, I was reminded to think about the hospital where I received my initial COVID vaccines. There weren’t any opportunities to schedule vaccines of any kind within MyChart, only office visits, video visits, or telephone checkups. Visiting the health system’s website, it did appear that they were offering third dose appointments, but through a completely separate scheduling system depending on your state. After a few quick questions, it was on to the scheduling menu which had dozens of open slots but only on Mondays, Wednesdays, and Fridays, which might make it difficult for some patients depending on their work schedules. At the moment, my schedule is pretty flexible, so I scheduled for later this week. At the point where I needed to confirm the appointment that I selected, it offered me the opportunity to log into MyChart so that the appointment would be put on my record.

In hindsight, that seems like the best option regardless of convenience, because then all three doses will be from the same entity and I can download them all on a single record. Interestingly, the hospital in question hasn’t been very proactive about scheduling booster dose clinics for its employees and staff physicians, so it feels a little strange to be in the first wave of boosters when I’m not as exposed as others at the moment, especially considering how it was last December when the same health system was vaccinating its attorneys and marketing people but wouldn’t share doses with frontline urgent care physicians actively seeing dozens of COVID-positive patients each day. It just goes to illustrate how topsy-turvy and often without direction our healthcare system has become since this all started.

At a hospital where I have a pending application to be on the medical staff, they haven’t even started scheduling influenza vaccine clinics for employees despite typically starting them in September. Even though it’s not contraindicated to receive both vaccines on the same day, many people prefer not to receive two if they don’t absolutely have to. I’m hopeful that we have enough people masking and still modifying their activities that we have a flu season that is as mild as last year’s, but I’m not going to hold my breath.

I’ve got my talking points ready for any clients who reach out asking for assistance with scheduling of booster doses and have started putting some thoughts together on best practices for vaccine clinics in the event that the Pfizer vaccine is approved for children under age 12 next month. Parents in our community are clamoring for it as a way to avoid quarantines for their children as well as it being a way to try to restore some level of normalcy to childhood. I’m hoping that schools offer in-building vaccine clinics to make it easy for parents and caregivers, but given the politics around vaccines in some communities, that might be easier said than done.

How is your institution handling COVID-19 booster shots? Are you running recall campaigns, making a plan, or just trying to figure out how you’re going to address it? Leave a comment or email me.

Email Dr. Jayne.

An HIT Moment With … Ajay Kapare

An HIT Moment With … is a quick interview with someone we find interesting. Ajay Kapare, MBA is chief strategy and marketing officer of Ellkay of Elmwood Park, NJ.

How was the HIMSS21 experience for Ellkay and what are your plans for HIMSS22?

The team at Ellkay had a very successful HIMSS21 and our overall experience was just fantastic. And of course we would also like to thank you for the special shout out during HIMSS. This year’s HIMSS was smaller than in years past, for obvious reasons. However our team found a way to make the most of the opportunity and finally meet with industry colleagues in person again. Although we have accomplished a lot through virtual experiences over the past 18 months, nothing beats making personal connections face to face. It was really great and exciting to see how all of our hard work and planning had such a big impact and result.

As for HIMSS22, our planning is very much underway as it just around the corner. At HIMSS21, we had the chance to start new relationships, rekindle old ones, and revisit other facets of previous partnerships. We want to build on this momentum. Our goal now is to ensure we keep our HIMSS presence strong and establish the most effective methods of engagement from our HIMSS21 experience.

How do you go about setting goals for a conference like HIMSS and then developing a plan to achieve them?

Like with any marketing initiative, the first step was to evaluate Ellkay’s purpose of presence at HIMSS. We researched whether our own attendance would increase the chances of achieving strategic objectives, based on who we anticipated attending. Once our executive team determined the HIMSS audience would be an asset, we knew we wanted to make valuable use of our time there.

We take on an integrated and holistic approach with our marketing. Team Ellkay does not take on a project unless we can do it well. It’s like “Moneyball “in healthcare. We believe that many small things, done well, add up to make a big difference. All of those small items from our efforts, whether it’s training or graphics or social media posts, add up to make the event the best that it can be.

To pull this off requires collaboration between all of our contributing teams. The marketing team was essential in planning a dynamite, functional booth and scheduling innovative activities for sales to invite attendees to enjoy. The sales team then collaborated with strategies that attracted customers, colleagues, and of course prospects to our booth. We couldn’t do it without our product and operations teams, which have given us the foundation for compelling conversations and solutions we can be proud to demonstrate.

What advice would you give to to a small health IT company about developing or expanding its marketing efforts?

Ellkay’s event strategy is proactive marketing and sales collaboration. We did not just set up a great booth, then sit and wait for people to show up and ask about our products and services. Instead, we had already taken valuable time to build relationships and a reputation. Our colleagues at HIMSS intentionally sought us out, knowing we were there. The sales team was also in full partnership with our marketing efforts.

Each team member from Ellkay that attended HIMSS knew the type of HIMSS attendees and who they should connect with at the conference. This involves extensive research and pre-work for our sales team to set meetings in advance.

Ellkay is known for its conference giveaway of honey from its own bees. How did that come about?

Our co-founder and president, Lior Hod, had a long-held dream of raising honeybees. In 2015, there was a lot going on in the news about the declining honeybee population, so Lior decided to act. He called his beekeeper friend, who set up the first 36,000 bees on Ellkay’s rooftop. Our honey is harvested right at headquarters for our friends, colleagues, and conference attendees. Today, we have more than 1 million bees on Ellkay’s rooftop from 22 active hives. Every event we attend, we find the honey to be both a great conversation starter that really reflects our culture, as well as a memorable takeaway. Year after year, we have people returning for our honey, and of course good conversation.

How should a marketing team work effectively with the company’s executive team and its salespeople?

Events represent a significant investment of time and resources for every company. Before committing to an event, the executive team needs to evaluate whether it is a good fit for their strategic objectives. Once they determine if the event’s audience and message are advantageous to the business goals, the marketing team steps in. Marketing develops a strategy to provide the sales team members with the tools they need in order to achieve substantial relationships through the event.

All teams involved should be aware of the purpose in attending the event, the audience, the company messaging which best appeals to the specific audience, and the strategic targets all parties must try to achieve. We spend significant time internally strategizing and communicating to ensure everyone is on the same page and recognizes the significance of the event.

Additionally, no team should enter an event without a plan for evaluation afterwards. All teams must have metrics in order to assess how they performed at the event, and how event attendance helped the company achieve its overall objectives. The evaluation plan should be shared before attending so all teams know how their performance is to be graded.

After attending an event, our team always asks for feedback from all members of participating teams. This allows our colleagues to share their personal perspectives on areas they found that could use improvement, or methods that were particularly successful, for consideration on future event participation.

Readers Write: Curating Information to Reduce Physician Burnout

Curating Information to Reduce Physician Burnout
By Nele Jessel, MD

Nele Jessel, MD is chief medical officer of Athenahealth of Watertown, MA.

No one in healthcare would dispute that it’s an enormous job to manage and distill all the patient data and clinical notes that are available with modern-day technology. Of course, technology has delivered many innovations and improvements to both the physician and patient experience. Yet sometimes even the most well-intentioned technology tools end up creating more challenges, with the unintended consequence of greater administrative burden, leading to provider dissatisfaction and burnout. I don’t know of any physicians who wanted to devote their career to the practice of medicine and are happy that they instead find themselves spending much of their time on administrative tasks.

A decade ago, my frustration with EHR technology – which made my life harder, not smarter – inspired me to open my own practice with the aim of using technology to automate workflows wherever possible. My goal was to spend more time with my patients and practice old-fashioned medicine in a high-tech setting. Over the past several years, my passion for the use of technology to drive advancements in healthcare and patient access, while facilitating the physician-patient relationship, led me deeper into the technology realm, resulting in my recent transition to Athenahealth, where I was once a client.  

At Athenahealth, we fielded a survey in late 2020 to a broad sampling of physicians about technological challenges and physician wellbeing. More than half of the physicians surveyed agreed or strongly agreed that technology supports their ability to deliver high-quality care to patients. However, the physicians also said the more they feel information overload (i.e., poorly curated information), the more it causes them stress in day-to-day practice, and the more often they feel burned out.

The irony here is obvious. We need technology to address physician burnout that is caused by technology. From the physician responses, it’s clear that the legacy technology to help with this issue has some room to grow.

Additionally, EHR technology has sharpened the focus on provider documentation, and therefore electronic notes can be voluminous compared to paper notes. With nonsensical coding and billing requirements to count the number of bullets in sections of the documentation, a rampant use of copy and paste has resulted in bloated notes. New coding guidelines for 2021 have shifted the focus away from bullet points to managing the illness and/or making medical decisions. It remains to be seen whether this change will translate into shorter and more succinct notes that capture all the relevant clinical information and tell the patient’s story without any extraneous information. 

With so much patient data available, managing the information and distilling it into exactly what is necessary to make decisions is a job unto itself. These burdensome administrative tasks are a serious problem when they take a physician’s focus away from direct patient care.

Practices looking to help with information overload should identify technologies that not only capture and store information, but also curate and translate data back into clinically meaningful terms. The increasing use of artificial intelligence and machine learning has the potential to transform how physicians work and interact with their patients.

For example, voice and ambient solutions integrated into the EHR enable automated messaging and speech-enabled applications that offer human-like interactions designed to help clinicians quickly locate key patient information and execute clinical tasks like navigating the exam and entering orders. Implementing the right technologies can help curate both the quantity and quality of information that a clinician must process, as well as minimize the manual effort required to integrate information from multiple sources.

We can do better for physicians to get the quality information they need for superior patient care.

Readers Write: Achieving Health Equity through Improving Diversity in Nursing

Achieving Health Equity through Improving Diversity in Nursing
By Karen E. Innocent, DNP, RN, CRNP

Karen E. Innocent, DNP, RN, CRNP is executive director of CE-CME for Wolters Kluwer, Health.

In meetings among nurse leaders, one of them expressed pride in only hiring nurses who have played contact sports, because nurses who were involved in sports were good “team players.” As the group praised that nurse executive’s selection criteria, I thought back to when I was growing up and remembered that my sisters and I didn’t play team sports. It was not by choice, but that my parents emphasized academic study and college preparation.

I jumped into the discussion and said that only hiring athletes could result in lack of diversity because everyone is not able to participate in contact sports. Some families value academic achievement, some may have financial limitations, and others may discourage sports because of gender norms in their cultures. We should all consider that teamwork and leadership skills can be acquired from non-athletic activities including having a part-time job, community service, or scouts.

Diversity is often associated with race, ethnicity, religion, gender, sexual identification, or disability. In addition, diversity could be viewed more broadly as political views, interests, hobbies, or lifestyle. Nurse leaders and other hiring managers in healthcare have the human tendency to hire employees who have similar characteristics as themselves. When there is homogeneity among workers, the employees have similar perspectives, beliefs, and behaviors. While this is not inherently bad, it does present a serious concern in healthcare. Creating a diverse healthcare workforce is an essential strategy for improving the quality of patient care.

Unconscious bias and structural racism have been linked to healthcare disparities. Variability in patient care can result from a lack of representation between those patients and the healthcare organizations serving them. Overwhelming evidence points to the benefits of hiring healthcare workers in proportion to the diversity represented in the communities they serve. 

Since the Institute of Medicine report “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care” was published in 2003, healthcare leaders have recommended increasing the diversity among healthcare professionals. The landmark report synthesized decades of research and concluded that racism, discrimination, and lack of awareness of cultural needs of the patient population resulted in poor health outcomes among various underrepresented ethnicities and sexual orientations. Research in the same report demonstrated that physicians of similar ethnic groups as the population had better patient outcomes.

More recently, a United States study from 1992 to 2015 that controlled for socioeconomic status, age, education, and comorbidities found significantly higher mortality in black infants regardless of maternal risk factors (Greenwood,  Hardeman,  Huang, Sojourner, 2020). The authors recommend increasing diversity among nurses and physicians to reduce health disparities.  Patients experience better outcomes with healthcare professionals of the same race, and experience other benefits such as improved communication, empathy with the needs of the community, and development of appropriate interventions and care plans.

Achieving diversity is a process. In order to effect significant change, healthcare leaders must commit to addressing root causes that result in a lack of diversity, including outdated hiring practices and barriers to admission into schools of nursing.  Diversity experts recommend that employers target their recruitment efforts at networks including Black, Hispanic, and Asian & Pacific Islander nursing organizations, community organizations, and online social networks. They recommend improvements in the hiring process to avoid unconscious bias in the hiring decisions. 

Regarding nursing school admissions, many qualified nursing school applicants – including those of underrepresented groups – are turned away because of inadequate nursing faculty. Other barriers include inability to afford tuition and uninformed high school guidance counselors. According to the American Association of Colleges of Nursing, there are more than 80,000 qualified nursing school applicants turned away annually because of faculty shortages (AACN, 2021). As baby boomers are retiring, there are insufficient faculty to fill open positions. Low faculty salaries, lack of awareness of teaching opportunities, and lack of preparation in nursing education need to be resolved to fill this growing void.

Many students who meet academic requirements come from low-income households. They require scholarships and grants to attend nursing school. However, there is difficulty connecting these disadvantaged students with financial aid. Several research studies indicate that high school counselors are unaware of the demand for nurses, the academic requirements, and financial aid available to students. Lack of awareness and misinformation results in qualified students lacking guidance to pursue nursing as a career (Williams & Dickstein-Fischer, 2019).  More should be done to ensure that there is information and access in underrepresented communities to create a pipeline of diverse high school students to enter the healthcare profession. 

Perhaps the presence of healthcare workers who reflect the diversity of the community will not be enough. Therefore, all employees with patient interaction should have continuing professional development on diversity, equity, and inclusion principles and social determinants of health to facilitate delivery of equitable treatment. To build patient trust, there should be hotlines established to enable reporting of observed or suspected discrimination or inequitable care. Because we can’t fix what we don’t measure, health systems should track quality improvement metrics related to equitable delivery of care and implement action plans to help achieve their goals.

Morning Headlines 9/27/21

Morgan Stanley Expansion Capital and Ally Bridge Group Lead $135 Million Investment in Elligo

Clinical research network vendor Elligo Health Research raises $135 million in a Series E funding round.

New health record data standard adoption remains stagnant, ONC finds

ONC has found that third-party apps have been slow to adopt the HL7 FHIR standard as mandated by the Cures Act, with adoption remaining close to 20% between 2019 and 2020.

Epic Systems develops tech to verify COVID-19 vaccine status, test results

Through its work with the Vaccination Credential Initiative, Epic has developed technology that enables organizations to verify COVID-19 test results and vaccination status.

Monday Morning Update 9/27/21

Top News

Clinical research network vendor Elligo Health Research raises $135 million in a Series E funding round.

The company recently acquired research practice management organization ClinEdge.

Existing investor Cerner, which returned for this round, also acquired life sciences analytics vendor Kantar Health for $375 million early this year and created the Cerner Learning Health Network EHR-powered clinical trials service for participating health systems in 2019.

HIStalk Announcements and Requests

Poll respondents expect remote patient monitoring and telehealth to affect healthcare more than any other technologies.

New poll to your right or here: Should physicians and other healthcare providers be licensed nationally rather than state by state?

Webinars

October 6 (Wednesday) 2 ET. “Solving Patient Experience Challenges Through a Strong Digital Front Door.” Sponsor: Avtex. Presenters: Mike Pietig, VP of healthcare experience, Avtex; Jamey Shiels, MBA, VP of consumer experience, Advocate Aurora Health; Chad Thorpe, care ambassador, DispatchHealth. Patients expect healthcare providers to offer them the same digital experience they get when banking, shopping, and traveling. This webinar will describe how two leading healthcare providers created digital front doors that exceed patient expectations, improve patient outcomes, drive loyalty and acquisition, and future-proof their growth strategies in competitive markets.

October 6 (Wednesday) 1 ET. “A New, Streamlined Approach to Documentation and Problem List Management in Cerner Millennium.” Sponsor: Intelligent Medical Objects. Presenters: Deepak Pillai, MD, physician informaticist, IMO; David Arco, product manager, IMO; Nicole Douglas, senior product marketing manager, IMO. The IMO Core CSmart app, which is available for Cerner Millennium in the Cerner code App Gallery, helps providers document with specificity, make problem lists more meaningful, and improve HCC coding. This webinar will review the challenges and bottlenecks of clinical documentation and problem list management and discuss how streamlined workflows within Cerner Millennium can help reduce clinician HIT burden.

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

Acquisitions, Funding, Business, and Stock

I was curious about the performance of Teladoc Health stock since announced its acquisition of Livongo for $18.5 billion in August 2020. Shares are down 30% versus the Dow’s 27% increase, with the company’s market capitalization now being barely more than the acquisition price of what was touted to be a $37 billion merger (the company is now worth $21 billion). TDOC shares are 56% off their 52-week high. The company lost $134 million in Q2.

Definitive Healthcare’s IPO performance and its resulting multi-billion dollar valuation has piqued curiosity about what the company does. Check out an analysis of its IPO filings by Redpoint Ventures principal Jacob Effron, MBA, who describes how the company has succeeded in offering prospect analytics to support healthcare sales for life sciences and healthcare IT companies as well as provider analytics for health systems.

People

Insurer technology vendor HealthEdge hires Anshul Pande, MS (Stanford Children’s Health) as SVP of R&D and Angelo Devita, MPH (Avalon Healthcare Solutions) as VP of enterprise account management.

Dennis Sutterfield, MS (Temple Health) joins SUNY Downstate Medical Center as VP/CIO.

RCM services vendor Savista (formerly NThrive’s Services Division)  hires Jan Grimm (Butterfly Network) as CEO and board member. He replaces Brenda Cline, who has retired and joined the company’s board.

COVID-19

US COVID-19 numbers continue to improve, with cases, test positivity rate, and hospitalizations all down significantly in the past week, although deaths remain at nearly 2,000 per day.

CDC recommends boosters for some people who have received the Pfizer-BioNTech COVID-19 vaccine – those over 65, people who live in institutional settings, those with underlying medical conditions, and frontline workers. CDC did not follow its vaccine advisory’s recommendation to exclude at-risk workers. The advisory panel has not yet been tasked with reviewing the need for boosters for the Moderna and J&J vaccines, but some panel members urged a mix-and-match strategy in which those recipients could receive a Pfizer-BioNTech booster.

Anti-vaccine Facebook groups are urging people to remove their relatives with COVID-19 out of hospital ICUs, which they say are blocking the use of “miracle cures” such as ivermectin. Groups whose members have realized that ivermectin is not effective are now touting a “protocol” that includes gargling with iodine and inhaling hydrogen peroxide. A Harvard professor calls it “vigilante medicine” that is “being practiced by laypeople who are reading groups created by other laypeople in echo chambers and silos that, likely, someone in the anti-vax movement is profiting from.” Meanwhile, horse owners can’t get ivermectin paste for de-worming because it is being bought up from feed stores for human use.

A startup launched in October 2020 that runs a dozen COVID-19 testing sites is charging $380 for the same at-home rapid test that drugstores sell over the counter for $20 and for which Medicare pays $41. Omaha-based GS Labs, which has performed 500,000 of the tests, is using a CARES Act requirement that insurers pay a provider’s cash price. The company says it prices are high because it offers premium service, such as fast appointments and a nursing hotline. It is owned by a real estate and investment firm. UPMC Health Plan noticed that 91% of patient claims that included both an antigen and an antibody test came from GS Labs, insurance payment for which is also guaranteed by CARES Act.

Other

I don’t usually post job openings, but this one sounds good. CVS Health is recruiting for a physician to serve as senior medical director of health informatics.

Sponsor Updates

• Nuance announces that it has again ranked highest in customer satisfaction by Black Book Research for AI-powered CDI, speech recognition, and clinical intelligence solutions.
• The HCI Group releases a new DGTL Voices Podcast, “Future of Music in this DGTL Age.”
• The Stevie Awards names Quil Health CEO Carina Edwards a Gold Winner for Most Innovative Woman of the Year in Healthcare.
• RCxRules partners with Athenahealth’s Marketplace Program.
• Spirion marks its 15th anniversary with a Great Place to Work Certification.
• The Patient Safety & Quality Healthcare Podcast features Talkdesk VP of Strategy Greg Miller, “The Digital Front Door of Healthcare.”
• Vyne Medical releases a new podcast, “Connecting with Today’s Consumer: A Closer Look into the State of Healthcare Consumerism.”

Blog Posts

• Access and Affordability Trends in Rare and Orphan Disease (OptimizeRx)
• Keeping Us Productive, Safe, and Supported: Netsmart Facilities Team (Netsmart)
• Everything old is new again (Nordic)
• CRO Recruitment: 3 Steps to Attracting Patients to Clinical Trials (PatientBond)
• Biller’s Corner: Top 5 Avoidable Denials in Medical Billing (PMD)
• Reducing Alert Fatigue in Healthcare (Premier)
• Medical Coding Automation: A Coding Team’s Secret Weapon (RCxRules)
• Meet Dina at NAACOS! (Dina)
• Staying True to Your Values Through Massive Growth (RxRevu)
• Scans in vans, 5G, AI, COVID … are we set for a quantum leap in taking diagnostics to patients? (Sectra)
• Credentialing by Proxy for Telemedicine: 7 Things to Know (SOC Telemed)
• HL7: What it is and why it’s important to understand (Spok)
• Improve Patient Care and Check the CMS “Box” with Tailored Clinical Intelligence (Surescripts)
• 5 Ways Telehealth is Transforming the Patient Experience (Twistle)
• Is It Time to Update Your PT Clinic’s Software System? (WebPT)
• Multilingual Patient Communication Serves Kheir’s Diverse Community (Well Health)
• Finding the keys to your digital front door and building better patient experiences (West Monroe)
• What can $2.1 billion do for infection control in the wake of COVID-19? (Wolters Kluwer Health)

Contacts

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

Weekender 9/24/21

Weekly News Recap

• Athenahealth is reportedly considering a sale of the company or an IPO at a $20 billion valuation.
• Clearsense acquires AI-powered predictive modeling company Compellon.
• AGS Health acquires EZDI.
• Former Teladoc executive David Sides joins NextGen Healthcare as president and CEO.
• Apple’s latest operating system gives IPhone users the ability to share health data with their providers via EHRs.
• Shares in Definitive Healthcare jump 81% in their first week of trading following last Wednesday’s IPO, valuing the company at $7 billion.

Best Reader Comments

The state medical boards don’t really care about patient safety or good physician practice. What they do care about is maintaining their cash flow from physician and other professionals licensing fees … There needs to be a national licensing organization. The NBME already deals with the licensing exam and they could just as easily have everyone do the background checks and other licensing paperwork when submitting your Step 3 application. States could maintain some of their revenue by collecting a nominal standard fee ($25-35) for every state where you want a license with automatic approval with a valid federal license. Disciplinary actions would be more consistent if centralized and unscrupulous health professionals couldn’t move from state to state and fly under the radar. Telehealth would be facilitated and continuity of care would be better as well. (State Board Skeptic)

Re: Feds charge 138, including doctors, with $1.4 billion in health-care fraud involving telemedicine, Covid, opioids. This includes 42 healthcare professionals and 23 physicians! 23 PHYSICIANS! That’s why we cannot have nice things in healthcare. Those who complain about too much coding related documentation in healthcare, go and read the history of Medicare and why all those guardrails needed to be put in place over time. (Ghost of Andromeda)

When you wrote “I can only guess that the physician didn’t know how to contact the vendor”, it reminded me of hearing years ago that for many hospital/health organizations, the staff often have to channel their queries through one or two people who are the liaison to the vendor. I (sorta) get the intent here, but this makes no sense. (JT)

Epic sells to two groups within healthcare organizations: administrators and high value doctors. Epic is not going to tell the rank and file to go badger the people that cut Epic checks or the doctors who pull in a few million a year for the org. (IANAL)

Watercooler Talk Tidbits

Readers funded the Donors Choose teacher grant request of Ms. D in Arkansas, who asked for educational resources from the Teachers Pay Teachers program for her middle school class. She reports, “I cannot thank you enough for your generosity! With your donation I was able to purchase an online science curriculum that has helped me reach and engage my students this year. My students are so excited about the ‘scientist of the week’ package that I purchased, which includes information about a specific scientist that students get to explore and learn about for the whole week. This is just one of many resources that I was able to purchase that I can now use in my classroom moving forward. I was also able to purchase science stations and task cards which will help students use real world scenarios to learn science skills. Through this donation students have been able to engage in scientific thinking as well as see themselves as scientists, which has been very exciting for me to facilitate! Thank you!!!”

A North Carolina deputy is injured when a group of people who were fighting at a bingo hall resumed where they had left off in the hospital ED waiting room. The deputy was attempting to handcuff an armed participant when he was attacked by a juvenile female who charged him from behind. The deputy explains, “I hit her with my pepper spray, and I pepper-sprayed the gentleman that I’m fighting with. The gun falls out of his pocket onto the floor.” The melee started when one of those involved drove a car into the bingo hall, injuring several people.

A federal court convicts a Michigan doctor of running a $100 million healthcare fraud scheme in which prescribed opioids for patients who agreed to falsely claim that he gave them expensive spinal injections instead. Frank Patino billed Medicare for more of the spinal injections than any US doctor from 2012 to 2017. He was also Michigan’s #1 prescriber of oxycodone in 2016 and 2017. He took kickbacks from labs to which he sent patient samples, then used the money to promote his diet, lifestyle, and wellness books and programs.

In Canada, police are seeking a man who punched a nurse in the face repeatedly for administering COVID-19 vaccine to his wife without his permission.

New Hampshire’s health commissioner calls out the state’s highest-ranking lawmaker for spreading COVID-19 disinformation and placing federal vaccination funds on hold. Republican Rep. Ken Weyler claims without evidence that most NH COVID-related hospitalizations involve vaccinated people (when pressed, he cited his source as a talk radio show), federal government is being paid off by drug companies, the vaccine contains “something in the shot that’s going to help them control us,” and that he won’t receive the vaccine because his 25 years of flu shots – he’s 80 years old — make him immune from COVID-19. He adds that he gets his COVID-19 information from the Internet because “I don’t consider the CDC a credible source.”

A former concert pianist who completed her nursing degree when her father was diagnosed with liver cancer plays the piano in Mayo Clinic’s atrium as a volunteer after her shift as a Mayo non-vascular radiology nurse. The father of Genaida Benson, RN, who is cancer-free eight years after his first visit to Mayo, is among her audience when he returns for follow-up visits.   

In Case You Missed It

• News 9/24/21
• EPtalk by Dr. Jayne 9/23/21
• News 9/22/21
• Curbside Consult with Dr. Jayne 9/20/21
• Monday Morning Update 9/20/21

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Morning Headlines 9/24/21

Veritas, Elliott Consider $20 Billion-Plus Athenahealth Sale

Bloomberg reports that Veritas Capital and Elliott Management are considering a sale or IPO of Athenahealth at a $20 billion valuation.

Astarte Medical raises $7.6M to advance technology platform that aids premature infants

NICU clinical decision support software vendor Astarte Medical raises $7.6 million in a Series A funding round.

Toward a smarter electronic health record

Researchers at MIT and Beth Israel Deaconess Medical Center develop MedKnowts, a problem-oriented EHR side panel that displays a patient information card and offers a note-taking editor with auto-complete for clinical terms.

Alphabet life-sciences unit Verily is pursuing a secret plan to untangle itself from Google as it readies for a potential IPO

Verily, the life sciences unit of Alphabet, is reportedly planning to separate from Google’s technology in preparation for an eventual IPO.

News 9/24/21

Top News

Bloomberg reports that Veritas Capital and Elliott Management are considering a sale or IPO of Athenahealth at a $20 billion valuation.

Veritas and Evergreen Coast Capital – a subsidiary of hedge fund operator Elliott — acquired the company for $5.7 billion in cash in late 2018, Veritas had previously acquired GE Healthcare’s value-based care solutions group for $1 billion and named it Virence Health, which was then merged with newly acquired Athenahealth, retiring the Virence Health name.  

Former Athenahealth CEO Jonathan Bush is among several CEOs who have lost their jobs following campaigns by activist investor Elliott. He reportedly received $142 million when the company was acquired five months after his departure.

Reader Comments

From Adjudicator: “Re: conference poll. Was it a surprise that HIMSS was the preferred conference of readers over HLTH by a two-to-one margin?” Not really. My thoughts:

• Limited sample size (353 respondents) and a self-selected HIStalk poll audience probably favors the longstanding HIMSS conference, particularly among HIMSS exhibitors who have not attended HLTH.
• HLTH is the venture-funded new kid on the block, but it has convened only a few conferences (I think it has offered just two in-person events). It made a shockingly ill-advised mistake in convening its first conference right after HIMSS18 in the same city (Las Vegas), then skipped to the fall of 2019 in hopes of avoiding the competition. It draws big-name presenters outside the usual HIMSS focus on health systems.
• The direct competitor to HIMSS will be the VIVE conference, which is being co-developed by HLTH and CHIME. Its first conference will be in March 2022. Its model is a bit different, however, in offering a “Hosted Buyer Program” that corrals suppliers and prospects together in a matchmaking program in which buyers attend free if they agree to attend at least eight assigned vendor meetings. HIMSS is an unabashedly commercial boat show, but VIVE takes it to the next level in a way that I’ve seen work fairly well in other healthcare-focused conferences. The question there is scalability – how many health IT decision-makers will attend and buy product to draw exhibitor dollars? Does it really need to be a national, big-attendee blowout to support that format? CIOs switching their allegiance from HIMSS to VIVE and the CHIME Fall Forum would be tough on the HIMSS conference.
• Nobody knows how the forced trend of virtual conferences will affect in-person attendance. Will those formerly large in-person audiences seek to reconnect in person, or will they reconsider the value of spending time and money to attend an in-person conference to sit in front of speakers who un-ironically extol the virtues of virtual healthcare?
• We also don’t know how the cancellation of HIMSS20 and the underwhelming HIMSS21 will affect future HIMSS conferences. I can’t say I have a lot of enthusiasm for doing it all over again in March, I get zero value from being a HIMSS member, and their high executive salaries and purely revenue-seeking actions seem a bit tone deaf (although to be fair, I feel the same way about most healthcare systems). I wouldn’t attend if I weren’t covering it for HIStalk.
• It’s not hard to see the appeal or value of user group meetings. All they are missing is the opportunity for broader networking with users of other systems.

HIStalk Announcements and Requests

The HIMSS22 exhibit hall floor plan shows just over 500 vendors signed up so far, with the big-booth exhibitors being Optum, Epic, and Cerner. I’ll probably ask companies about their HIMSS22 plans in the next few weeks since the conference kicks off in 171 days.

Webinars

October 6 (Wednesday) 2 ET. “Solving Patient Experience Challenges Through a Strong Digital Front Door.” Sponsor: Avtex. Presenters: Mike Pietig, VP of healthcare experience, Avtex; Jamey Shiels, MBA, VP of consumer experience, Advocate Aurora Health; Chad Thorpe, care ambassador, DispatchHealth. Patients expect healthcare providers to offer them the same digital experience they get when banking, shopping, and traveling. This webinar will describe how two leading healthcare providers created digital front doors that exceed patient expectations, improve patient outcomes, drive loyalty and acquisition, and future-proof their growth strategies in competitive markets.

October 6 (Wednesday) 1 ET. “A New, Streamlined Approach to Documentation and Problem List Management in Cerner Millennium.” Sponsor: Intelligent Medical Objects. Presenters: Deepak Pillai, MD, physician informaticist, IMO; David Arco, product manager, IMO; Nicole Douglas, senior product marketing manager, IMO. The IMO Core CSmart app, which is available for Cerner Millennium in the Cerner code App Gallery, helps providers document with specificity, make problem lists more meaningful, and improve HCC coding. This webinar will review the challenges and bottlenecks of clinical documentation and problem list management and discuss how streamlined workflows within Cerner Millennium can help reduce clinician HIT burden.

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

Acquisitions, Funding, Business, and Stock

Analytics platform vendor Clearsense acquires Compellon, which offers a plug-and-play AI predictive modeling solution.

Users of Apple mobile devices can download and store their COVID-19 immunization and test results in Wallet with the just-released IOS 15.1 update.

Verily, the life sciences unit of Alphabet, is reportedly planning to separate from Google’s technology in preparation for an eventual IPO.

Ascension Technologies will outsource the jobs of 330 remote tech support employees in the areas of application and platforms, collaboration and end-user engineering, network and telecom, and field services.

Sales

• TransformativeMed and partner Red One Medical will provide the VA Puget Sound Health System – Seattle Division with the CORES Work Manager suite of clinical decision support tools and the CORES Diabetes Module.
• Cancer Treatment Centers of America connects to the MedAllies HISP platform to develop technology to meet CMS requirements to send patient event notifications to primary and post-acute care providers.
• UC San Diego Health chooses the Unifier platform of Dicom Systems for imaging interoperability.

People

St. Jude Children’s Research Hospital hires Shannon Dean, MD (UW Health) as CMIO.

Medical imaging AI vendor Mirada names Mark Crockett, MD (Verge Health) as chief medical officer.

Announcements and Implementations

Renown Health announces that it has answered 57,000 questions and completed 700 COVID-19 risk assessments via its rollout of Loyal’s AI healthcare chatbot and live chat solution on its website.

Researchers at MIT and Beth Israel Deaconess Medical Center develop MedKnowts, a problem-oriented EHR side panel that displays a patient information card and offers a note-taking editor with auto-complete for clinical terms.

Salesforce launches Health Cloud 2.0, which includes a COVID-19 management platform for in-person events, contact tracing, vaccine management, and virtual visits. The product is not specific to healthcare organizations and will be available to all businesses. I’m confused by the product name since Salesforce Health Cloud offers solutions for providers and other healthcare organizations. The announcement’s link to Health Cloud 2.0 refers to a Health Cloud page that doesn’t mention anything new. UPDATE: I reached out to the company, which explained that Health Cloud hasn’t changed, while Health Cloud 2.0 is a bundle that includes Health Cloud plus the new COVID-related functionality. My confusion remains.

Intrado adds SMS-based referral management, along with integration with Cerner and Meditech, to its HouseCalls Pro digital patient engagement platform.

Children’s Health of Orange County joins Cerner’s Learning Health Network research consortium.

Meditech will hold its Physician and CIO Forum September 29-30 as both an in-person and virtual event.

Canada-based Well Health Technologies will acquire specialty EHR vendor Aware MD for up to $8 million.

Bizmatics enhances its PrognoCIS EHR to support the correct scheduling of virtual visits based on the individual time zones of patient and provider.

Prescription discounter GoodRx rolls out GoodRx Health, which will answer the most commonly Googled questions about health. The company says the new site is a cross between NerdWallet and Wirecutter for healthcare.

A new KLAS report on data and analytics platforms finds that Cerner, Epic, and Health Catalyst have the deepest adoption among established analytics solutions, while Innovaccer has high adoption as a newcomer. Dimensional Insight customers report high satisfaction and see the company as a partner, while Cerner has a 40% overall dissatisfaction rate mostly due to overpromising. Click the graphic above to see KLAS’s data and analytics platform framework and the underlying components.

Government and Politics

A GAO review of the DoD’s Cerner implementation finds that the system is live in six of 24 planned waves, system performance has improved, and early issues have been addressed. However, testing and resolution of the issues it raises remain unresolved, users say the training system doesn’t match production, and system change information isn’t being disseminated well.

COVID-19

FDA approves booster shots of Pfizer’s COVID-19 vaccine for those 65 and over who received their second dose at least six months earlier and for high-risk people. CDC’s advisory committee is meeting this week to determine those high-risk criteria and to discuss how the new recommendation affects people who received the Moderna or J&J vaccines.

Other

University of Toledo Medical Center will use its $4 million fiscal year surplus to create a $21 million capital reserve that will help pay for its Epic implementation, among other projects.

Sponsor Updates

• Wolters Kluwer Health will combine its Medi-Span Clinical drug-screening solution with Ecaresoft’s Cirrus EHR to offer a fully integrated NPHIES-compliant solution to providers in the Middle East.
• The HCI Group will sponsor the CHIME Innovation Summit September 23-24 in Chicago.
• Everbridge CEO David Meredith wins the 2021 Globee CEO World Award in the visionary category.
• Health Catalyst CFO Bryan Hunt and SVP of Investor Relations Adam Brown will present during the Cantor Global Healthcare Conference September 30.
• Healthwise celebrates its staff in a new video, “Celebrating Healthwise Yesterday & Today.”
• Intrado offers new capabilities within its HouseCalls Pro digital patient engagement platform, including automated referral management.
• Kyruus opens registration for its Annual Thought Leadership on Access Symposium November 9-10.
• National Coordinator Micky Tripathi will keynote Meditech’s 2021 Physician and CIO Forum September 29-30.

Blog Posts

• Vaccine Hesitancy: Understanding Fears and Addressing Barriers to Access (GetWellNetwork)
• Improving Glycemic Management in the ICU with a Pharmacy-Led Initiative: Critical Insights from Texas Health Huguley Hospital (Glytec)
• Why You Need a Mobile Collaboration Strategy (Halo Health)
• Wheels Up on Healthcare Analytics Summit 2021 Virtual! Day One Recap (Health Catalyst)
• What is sepsis and how can clinical data help save lives? (Wolters Kluwer Health)
• What is Patient Experience? (Avtex)
• VA PDMP: Using the Power of Data to Improve Care for Our Nation’s Veterans (InterSystems)
• The Importance of Testing Technology (Optimum Healthcare IT)
• Improve Your Pre-Procedure Patient Communication (Intrado)
• Nordic Consulting ranked No. 37 of Best Places to Work in Healthcare in 2021 (Nordic)
• What’s in a variant? Part III – Linking sequence and patient data for clinical research (Intelligent Medical Objects)
• This Time, Interoperability is Real: Part 3 – Patient Access API (LexisNexis)
• Four Ways E-Prescribing Helps to Improve Medication Adherence and Reduce Errors (Medhost)

Contacts

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

EPtalk by Dr. Jayne 9/23/21

Hospitals in my city are in lockstep as far as requiring COVID-19 vaccinations for employees, with compliance upwards of 98% for most facilities. Employees who aren’t compliant and don’t qualify for a religious exemption are finding that there isn’t anywhere to work unless they want to relocate or leave healthcare, so difficult choices are being made. In that context, I was interested to read about the approach being taken by Conway Regional Health System in Arkansas.

The system asks that those employees claiming a religious exemption attest that they understand that the same fetal cell lines they object to being used during development of the vaccine were also used in the development of commonly accepted medications such as Benadryl, Sudafed, and Tylenol. They go further in asking employees to confirm that their “sincerely held religious belief” prevents them from taking those medications as well. Many of my physician colleagues and I have had ongoing conversations about the fact that so many of the world’s major (and often fractious) religious groups have found common ground on recognizing COVID-19 vaccines as permissible and often encouraged. If only they could find common ground on other topics as well. Kudos to the system’s leadership for making sure its employees understand the science behind their exemption requests and what it might mean for non-vaccine products.

I left my most recent in-person clinical employer for a variety of reasons, including such factors as inadequate personal protective equipment, hellacious hours, short staffing, and cultural issues. Regarding the latter, we had reached a point where the mentality of “the customer is always right” had come to interfere with patient care by creating an environment where physician judgment was being questioned, and where leadership was turning a blind eye to clinicians who were prescribing non-evidence-based therapies like hydroxychloroquine and ivermectin for COVID prevention. A recent MSN article brought back some negative memories. The headline “Entitled consumers have terrorized service and retail workers throughout the pandemic” also applies to healthcare.

In checking with my former colleagues, patients are still throwing fits that they can’t be accommodated quickly for pre-travel testing due to the extremely high demand for testing. Patients register at 6 a.m. and often aren’t able to be seen until 2 or 3 p.m., so they take their anger out on the staff when they arrive. Never mind the fact that my county has free drive-through testing at the county health department, where test turn-around time is about 4 hours – patients don’t want to drive to what they perceive as “the wrong side of the tracks” for testing for a variety of preconceived notions. When you do the math, it would be more efficient even with the crosstown drive, and it’s certainly cheaper since my former employer is requiring a full physician visit (and urgent care co-pay) even for testing. However, the perception of convenience or quality or service is everything, apparently.

The practice is still fighting the most basic of battles, including patients who refuse to wear their masks properly despite being in a healthcare facility where known COVID-19 positive patients are present, and clinicians aren’t permitted to refuse to see patients who refuse to mask up. Patients who haven’t planned adequate turnaround time for their pre-travel PCR testing are permitted to complain to leadership, who will allow them to take their specimen swabs and personally drive them to the lab vendor for expedited service. This adds extra steps for the already overburdened staff. The organization still has approximately 20% of its locations closed due to lack of staffing and has even started its own emergency medical technician training program in an effort to bolster reserves. However, they seem unwilling to look at evolving the practice culture as a way of improving staff retention and satisfaction.

Unfortunately, many healthcare organizations will continue to confront these types of scenarios (and others which may be even more challenging) as the pandemic continues to rage. Healthcare has changed so much in the last 18 months; I can’t even imagine what it might look like if we ever make it out the other side of this. The reality is that we are one vaccine-resistant variant away from going back to square zero, and it feels like clinical teams are constantly waiting for the other shoe to drop.

The IT arm of Ascension plans to outsource an additional 330 technology jobs in the next few months, according to a Missouri state filing. The organization had already planned to lay off over 600 workers during the bottom half of the year. It’s hard to understand the true economic impact of these cuts because Ascension had transitioned earlier this year to allowing all employees to work remotely, which makes it more challenging to understand where the impacted positions are based. Functions being outsourced include application support, end user engineering, network services, and telecom. I always enjoy looking at primary source materials and, in this case, nearly 30% of the text of the document was redacted, so I will have to use my imagination to conjure up what I might have missed.

Today ONC awarded more than $73 million in Public Health Informatics & Technology Workforce Development Program funding to 10 college and university consortia. The funding comes from the American Rescue Plan and is targeted to providing training in public health informatics and technology for over 4,000 individuals. Organizations receiving funds include Historically Black Colleges and Universities, Hispanic Serving Institutions, Asian American and Native American Pacific Islander-Serving Institutions, and other higher education organizations. I’m pleased to see the diversity of recipients as we move forward addressing social determinants of health, as there are many underrepresented demographics in the public health workforce.

The funds will help provide support for curriculum development, recruiting, training, paid internships, and career placement assistance for those seeking positions in public health organizations. Having come up through the informatics ranks in a large hospital system, I didn’t have a lot of exposure to public health informatics. As I studied for my clinical informatics board certification, I found it to be one of the more interesting domains of the subspecialty. I’m excited to see it receiving more focus and hope that the funding helps attract some of the best and brightest to the discipline.

News of the weird: The State Medical Board of Ohio has given a two-year renewal to a physician who claims that vaccines cause people to become magnetic. The board has the opportunity to discipline a physician for false statements by a vote of at least half its members, yet it has failed to act in this case. The article goes on to mention that another notorious physician, this one of ivermectin fame, has his license coming due October 1. He has openly admitted to clinical wrongdoing, and it will be a travesty if the board continues to allow him to practice.

One of the reasons that state licensing boards are fighting against national licensure is their claimed need to police their own physicians. I’d recommend that if they’re going to continue to make that claim, that perhaps they start stepping up surveillance of those spreading dangerous misinformation.

Do you think state medical boards are living up to their responsibilities for physician discipline? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 9/23/21

Clearsense Acquires Plug-and-Play AI Analytics Firm

Health data management and analytics vendor Clearsense acquires AI-powered predictive modeling company Compellon.

Unite Us acquires NowPow to address health and social needs nationwide

Care coordination and social services referral company Unite Us acquires NowPow, which offers similar community care and services referral technology.

Defense Logistics Agency Is Building an EHR to Track Occupational Health

The Defense Logistics Agency prepares an RFP to fulfill its need for enterprise occupational health services and corresponding EHR software.

A new cybersecurity center wants to protect medical devices against hacks

The University of Minnesota launches the Center for Medical Device Cybersecurity to help organizations involved with medical devices understand and manage their cybersecurity risks.

Morning Headlines 9/22/21

AGS Health acquires AI-based clinical documentation and medical coding technology provider, EZDI

RCM vendor AGS Health acquires EZDI, a clinical documentation improvement, computer-assisted coding, and auditing business based in Louisville, KY.

What Our Latest Fundraise Means to the eVisit Team

Enterprise virtual care vendor EVisit raises $45 million in a Series B funding round.

Pager Secures $70M in Funding to Drive Expansion of Virtual Care in United States, Latin America and Worldwide

Virtual care navigation and collaboration software vendor Pager raises $70 million in a Series C funding round.

News 9/22/21

Top News

Former Teladoc executive David Sides joins NextGen Healthcare as president and CEO. Sides spent 17 years as SVP of worldwide consulting at Cerner, and had a shorter, more recent stint as president and CEO of Streamline Health.

Webinars

October 6 (Wednesday) 2 ET. “Solving Patient Experience Challenges Through a Strong Digital Front Door.” Sponsor: Avtex. Presenters: Mike Pietig, VP of healthcare experience, Avtex; Jamey Shiels, MBA, VP of consumer experience, Advocate Aurora Health; Chad Thorpe, care ambassador, DispatchHealth. Patients expect healthcare providers to offer them the same digital experience they get when banking, shopping, and traveling. This webinar will describe how two leading healthcare providers created digital front doors that exceed patient expectations, improve patient outcomes, drive loyalty and acquisition, and future-proof their growth strategies in competitive markets.

October 6 (Wednesday) 1 ET.  “A New, Streamlined Approach to Documentation and Problem List Management in Cerner Millennium.” Sponsor: Intelligent Medical Objects. Presenters: Deepak Pillai, MD, physician informaticist, IMO; David Arco, product manager, IMO; Nicole Douglas, senior product marketing manager, IMO. The IMO Core CSmart app, which is available for Cerner Millennium in the Cerner code App Gallery, helps providers document with specificity, make problem lists more meaningful, and improve HCC coding. This webinar will review the challenges and bottlenecks of clinical documentation and problem list management and discuss how streamlined workflows within Cerner Millennium can help reduce clinician HIT burden.

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

Acquisitions, Funding, Business, and Stock

RCM vendor AGS Health acquires EZDI, a clinical documentation improvement, computer-assisted coding, and auditing business based in Louisville, KY.

Xealth raises $24 million in a Series B funding round led by Advocate Aurora Enterprises, bringing its total raised to $53 million. The Providence Health & Services spin-off has developed software to help providers find and prescribe digital health apps and programs.

Clearlake Capital Group launches the Vive Collective, a program to help foster and potentially invest in digital health companies. Clearlake’s portfolio includes Bamboo Health (the newly merged and rebranded PatientPing/Appriss Health), NThrive, and Symplr.

Pager secures $70 million in financing. The company has developed virtual care navigation and collaboration software that it markets to providers, payers, and employers.

Surgical data analytics vendor Caresyntax adds $30 million to its $100 million Series C investment round, bringing the company’s total funding to $208 million.

Flywheel, a medical research data management company, raises $22 million in a Series C funding round led by 8VC. It has also acquired Radiologics, an imaging research data management and analytics business based in St. Louis.

Enterprise virtual care vendor EVisit raises $45 million in a Series B funding round. The Arizona-based company plans to nearly double its workforce in the coming months.

People

Jeff Gartland (Anthem) joins Relatient as CEO. He takes over from Michele Perry, who will become vice chairwoman.

Sales

• The VA Puget Sound Health System’s Seattle Division will implement TransformativeMed’s Core Work Manager clinical decision support tools and diabetes module.
• Dignity Health’s Yavapai Regional Medical Center (AZ) selects digital front door technology from Phunware.
• Nicklaus Children’s Health System (FL) will deploy wayfinding technology from Gozio Health.

Announcements and Implementations

InterSystems announces GA of its Iris FHIR Accelerator Service for storing and retrieving FHIR data.

Methodist Le Bonheur Healthcare (TN) develops a remote patient monitoring program for COVID-19 patients using MD Revolution’s clinical experts and RevUp technology.

SCL Health implements Nuance Dragon Ambient Experience automated clinical documentation software for its telehealth and in-person exams for cardiology, orthopedics, and primary care across its facilities in Colorado and Montana.

COVID-19

Ellkay resolves a software programming glitch that mistakenly inflated the state of Vermont’s COVID-19 case count by 109 and delayed the reporting of positive test results to 237 patients. Ellkay’s analysis also determined that the slow-down may have impacted reporting in several other states.

COVID-19 has overtaken the 1918 Spanish flu as the deadliest disease event in US history, with 675,400 Americans succumbing to the disease.

Pfizer reports favorable results in its trial of a COVID-19 vaccine for 5 to 11 year-old children.

Other

Apple’s latest operating system gives Health app users the ability to share health data with their providers through EHRs. Six vendors are participating in the initial launch of the feature, first announced this summer, including Cerner and Allscripts. Pilots with several provider groups have shown the data-sharing feature to be well received by patients monitoring their blood pressure from home. 

Sponsor Updates

• Arcadia CMO Rich Park, MD and VP of Enterprise Partnerships Anna Basevich will present at the NAACOS Fall 2021 Conference October 1.
• CereCore has been recognized by Securance Consulting as a Best Practice Meditech Infrastructure as a Service provider for more than five years running.
• Cerner releases a new podcast, “Moving from data connectivity to real provider usability.”
• CHIME releases a new Digital Health Leaders Podcast, “A Conversation with William Hudson, SVP and CIO, John Muir Health.”
• Bluetree, Cerner, Clearwater, Divurgent, Optimum Healthcare IT, Imprivata, Clearsense, and the HCI Group will sponsor CHIME Fall Forum October 27-30 in San Diego.
• CloudWave Director of Sales Engineering Mike Donahue will present at the Meditech Users Network Conference September 23.
• CEO Magazine features Meditech International CEO Charlotte Jackson.
• Chris O’Brien Lifehouse has become the first hospital in Australia to upgrade to Meditech Expanse.
• CarePort parent company WellSky announces that former CMS administrator Seema Verma has joined its Board of Directors.

Blog Posts

• Enterprise Imaging supports connected care in Moscow (AdvancedMD)
• Top Telemedicine Problems to Avoid (Bluestream)
• Ambulatory providers: Achieving TCM success (CarePort)
• 5 Ways to Use Epic Flowsheet SmartForms to Capture Regulatory Data (CereCore)
• Navigating Today’s Rapidly Evolving Cyber Insurance Market (Clearwater)
• Where Are They Now? An Update On 2020’s CoverMyQuest Winners (CoverMyMeds)
• What Healthcare C-Suite Leaders Need to Know About Analytics (Dimensional Insight)
• Innovating with Health Plans: Working Together to Drive Outcomes (Dina)
• The Power of Search in Healthcare and Beyond (EClinicalWorks)

Contacts

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

Morning Headlines 9/21/21

NextGen Healthcare Appoints David Sides President and Chief Executive Officer

NextGen Healthcare names David Sides (Teladoc Health) president and CEO.

Oncology Analytics Announces Rebrand to OncoHealth

Oncology analytics and benefits management vendor Oncology Analytics changes its name to OncoHealth.

iOS 15 will give doctors a window into Apple Health app data

Apple’s latest operating system gives Iphone users the ability to share health data with their providers via EHRs.

Curbside Consult with Dr. Jayne 9/20/21

I was recently invited to join a physician forum centered on EHR optimization. It sounded like a great opportunity to share what I know about getting the most out of your EHR and to help colleagues who might not have access to clinical informaticists.

I decided to familiarize myself with the group by going through old posts and was surprised at how many physicians had posted questions that didn’t receive any responses. I felt bad for those docs, sending their questions into the wind without anyone answering. I wish I would have been there for many of them because it would have been easy to point people in the right direction at the time. Here are some of the main themes that we as tech enablers should be aware of:

First, despite what we might think at times, physicians often want to learn more about what they can do with their EHRs and want to be better users. However, they might not understand the resources that are available to them, even if they are free or included in the cost of their system. There were a number of highly specific questions about a particular EHR, such as “How do I document XYZ procedure in my EHR?” Those were the types of questions that most frequently went unanswered by the forum. In my experience as an EHR champion, they would have been easy questions to answer had the physician contacted the EHR vendor’s help desk or online help mechanisms.

I’ve done consulting work for several of the vendors mentioned and they all have robust help desks and client support structures, and one has a lot of searchable hands-on videos that would have answered the questions. I can only guess that the physician didn’t know how to contact the vendor. Perhaps they are an employed physician and their organization’s internal help desk didn’t give them the assistance they needed, or maybe they’re part of a group where a managing partner or office manager tightly controls the information. I felt bad for them though, wondering if they ever found answers to their documentation questions.

Second, many of the physicians showed a high level of interest in ideas that went way beyond EHR optimization. One hot topic on the forum was that of bias in artificial intelligence. The discussion also covered ways that physicians could advocate to their institutions to try to minimize bias in their systems. Of course, this topic is likely much more relevant to those at academic medical centers rather than small primary care practices, but it certainly got a lot of conversation. Physicians care deeply about whether technical systems could be harming their patients and want to know more about predictive rules or algorithms that they might be presented with.

Third, the physicians were vocal about how vendors, including EHR and third-party vendors, might be using their patients’ data for profit. There was a near-universal lack of enthusiasm for cloud-based patient data being sold, whether it was for research or not. One particularly spirited discussion revolved around an EHR vendor who was alleged to have sold patient data to a nutrition and supplement vendor. Whether it’s explicitly allowed in a vendor contract or not, the physicians had negative feelings about anyone profiting off of their patients. There was particular opposition to the supplement vendor since supplements are not regulated by the US Food and Drug Administration. It’s also a $40 billion industry that causes a lot of confusion for patients and may require physicians to spend significant time on counseling and education, so I can see why they felt this way.

Overall, it looks like an interesting opportunity to be able to contribute, so I am looking forward to the next round of posts and seeing if I can be of assistance. Hopefully their moderators will be more flexible than those of a group I tried to participate in last year – I was kicked out of the group for “self-promotion” for mentioning that I worked for a chatbot vendor while answering a question about chatbots. Never mind the fact that I never mentioned the name of the company I was working for and didn’t try to solicit business, or that I was simply trying to establish credibility and provide transparency before giving a very specific answer to a question. It’s always interesting to see how these groups police themselves, so we’ll have to see how the new one runs.

Other than my foray into the physician forum, I spent most of the weekend heads-down on a big client project. They’re getting ready to go live with some new content this week and didn’t finish building it until Thursday afternoon. They had hired me to do their user acceptance testing so their crunch time became my crunch for the weekend.

Typically, I encourage organizations like theirs to have their actual end users participate in user acceptance testing, because only their end users know what their daily workflows look like. We all know that users are creative, and depending on the number of workarounds in a given system, they might not follow the prescribed workflows all the time if at all. I’m more than capable of testing the new content against the organization’s published best practice workflows, but even if everything passes my review, there is still a risk that they might have broken a workflow that they didn’t even know was in use.

“Document, document, document” is my middle name these days, so if things do go awry, I will have plenty of backup for the fact that I warned them that their plan was not ideal. So far, nearly everything I’ve tested has met the specifications although I’ve found some issues with the training materials and documentation that need to be addressed before go-live. They’re going to have the virtual equivalent of a fat stack of markups waiting for them when they arrive Monday morning, so I hope they had a restful weekend. I’m sure they’ll be throwing it back over the fence to me shortly thereafter, so I’m going to spend Monday resting up myself.

When’s the last time you had to work on a crunch time project? What’s your beverage of choice for all-nighters? Leave a comment or email me.

Email Dr. Jayne.