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Morning Headlines 3/19/24

March 18, 2024 Headlines No Comments

Phreesia Announces Fourth Quarter Fiscal 2024 Results

Patient intake and engagement software vendor Phreesia reports a 24% increase in Q4 earnings and a similar bump in fiscal year revenue.

UnitedHealth Group Cyberattack Status Update

UnitedHealth Group reports in a March 18 status update that it has paid out $2 billion in financial aid to cash-strapped providers, and that it will begin releasing medical claims preparation software as a part of Change Healthcare’s system restoration process.

Thyme Care Unveils “Thyme Care Oncology Partners,” a Provider-Powered Value-Based Care Model in Partnership with More than 400 Oncologists Nationwide

Care collaboration company Thyme Care launches Thyme Care Oncology Partners to help oncology clinics transition to value-based care.

Curbside Consult with Dr. Jayne 3/18/24

March 18, 2024 Dr. Jayne 1 Comment

My inbox seemed to explode while I was at HIMSS. I’ll be trying to tunnel out for at least the next week, I would bet.

One of the interesting articles I found was about the clinicians at telehealth provider Bicycle Health and the fact that they have filed with the National Labor Relations Board to unionize. A press release from the Union of American Physicians & Dentists notes that physicians, physician assistants, and nurse practitioners have experienced “a shift in company culture where we as providers feel increasingly overworked, undervalued, and our feedback is regularly ignored. In order to continue providing the best care for our patients struggling with opioid addiction, we knew we needed to come together.”

I’ve worked as a telehealth clinician for several different companies. It’s more likely than not that they have treated their telehealth providers as expendable despite the fact that patients can’t be seen if there aren’t licensed providers to see them. Even working for organizations that also had a brick and mortar presence, it’s clear that administrators thought telehealth providers are replaceable.

That may be true, given that a lot of telehealth providers only work on an as needed basis and are paid accordingly. As such, they are treated more like Uber drivers than knowledgeable professionals. It will be interesting to see how this shakes out over the coming months.

I spent a fair amount of time at HIMSS contemplating the marketing efforts of various companies. Some have clear and well-reasoned strategies, while others are a little bit more of what we might describe as all over the place.

Nothing says marketing drama than NYU Langone Health System suing Northwell Health over allegations of trademark infringement. Earlier this month, a federal judge dismissed the suit, citing the variability of shades of purple, intermittent use of sentence case as well as all-capital phrases in white, and other factors in the failure to prove infringement. The judge dismissed some of the claims without prejudice, which will permit NYU Langone to amend its complaint in the future.

I love some of the quotes from Northwell Health’s chief marketing and communications officer, who stated that NYU Langone has “no filed claim to the color purple” and that “If it truly is a trademark right of theirs, then they should protect the asset.” He went on to say that Northwell uses 16 colored triangles in its main logo, representing the diversity of the health system, and that continued pursuit of action is a “waste of time and resources.”

Speaking of lawsuits, I also had a blurb in my inbox about New York City (including New York City School District and New York City Health and Hospitals Corporation) suing social media companies in relation to the growing youth mental health crisis. The lawsuit was filed in the Superior Court of California, with named defendants including Meta / Facebook / Instagram, Snap, TikTok, and Google / YouTube. The complaint is 311 pages long and parts of it are a truly fascinating read. It starts with factual allegations against all defendants and then moves to specifics. Among the general allegations:

  • Social media’s core market includes school-aged children, who are “uniquely susceptible” to harm from the platforms.
  • The platforms are designed to addict youth who use the platforms with minimal parental oversight.
  • Millions of children use the platforms compulsively, including during school hours.

Specific claims include algorithms that are designed to promote compulsive use, gambling-inspired features that create cravings for likes as a reward, and tailored advertisements. Plaintiffs are asking for an order that the defendants’ conduct “constitutes a public nuisance” that requires abatement along with funding for prevention efforts, mental health treatment, actual damages, and punitive damages. I see plenty of children, teens, and adults who are addicted to social media and who can barely function without a phone in their hand.

At the same time, Florida Governor Ron DeSantis vetoed legislation that included social media restrictions for minors. Politico noted that the governor had indicated well in advance that he wasn’t supportive of the measures. Legislators immediately scrambled to try to create replacement legislation. The vetoed legislation would have prohibited creation of accounts by those under age 16 and would have required third-party age verification and would have prevented parents from helping their children bypass the restrictions. Watered-down replacement language would allow parental consent.

During my career as a physician, I’ve seen plenty of parents make bad decisions on behalf of their children, most recently because they fear the peer pressure that might ensue if their children don’t get exactly what they want. Physicians saw an uptick in skin issues in January from parents who bought their children certain TikTok-promoted skincare products for Christmas, not understanding that powerful anti-aging chemicals would be harmful. As of the time of this writing, DeSantis plans to sign the revised bill.

Although I enjoyed the warmth of Orlando and being able to enjoy some sunshine, I certainly don’t miss the traffic or the cranky children and frustrated parents. It was 20 degrees cooler when I landed at home and that was followed by severe weather and a significant temperature drop that was accompanied by golf ball-sized hail. We’re headed back below freezing tonight, so it’s time to get out the fuzzy slippers and flannel lounge pants in preparation for a full day of conference calls tomorrow.

I must say that when I travel, it feels a little strange to wear dressy clothes on both top and bottom after several years of virtual work in a hybrid wardrobe. My clinical shifts don’t count as wearing real clothes since all of my scrubs are well worn and are softer than most of my pajamas.

I’m looking forward to slipping back into my usual routine and seeing what the healthcare IT universe throws at me next. What do you enjoy most about being away at a conference? And what are the best parts of coming home? Leave a comment or email me. 

Email Dr. Jayne.

Readers Write: The New Lifestyle Coach: How AI Can Support Adherence for People with Diabetes

March 18, 2024 Readers Write No Comments

The New Lifestyle Coach: How AI Can Support Adherence for People with Diabetes
By Richard Mackey

Richard Mackey, MBA is CTO of CCS of Dallas, TX.

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Living with diabetes is more than a full-time job. It’s a 24/7 commitment to monitoring thousands of tiny details related to diet, exercise, sleep, stress, and overall health.

People living with diabetes end up making nearly 200 extra decisions every day to keep on top of their condition, creating a near-constant risk that a split-second of inattention can snowball into a slide away from healthy habits and appropriate adherence to care.

While much of this conversation around diabetes adherence has historically focused on medications, the modern diabetes care plan now often includes devices such as insulin pumps and continuous glucose monitors (CGMs). These devices are supposed to make self-management of care decisions easier, but sometimes they cause unexpected issues when a patient doesn’t understand how to use their device or struggles with staying on top of their routine.

As the diabetes epidemic continues to grow, health plans and their partners cannot expect people living with diabetes to bear these constant burdens all alone. Instead, they need to surround each and every individual with predictive, data-driven support that accurately flags risks of non-adherence — including that involving medical devices — before they become unmanageable and lead to poor outcomes and higher healthcare spending.

Leveraging artificial intelligence (AI) and machine learning to assess members predictively and longitudinally can help health plans identify emerging risks of non-adherence and proactively reach out with support for members to keep them on the right track with their care.

Data-driven risk stratification has become a core component of chronic disease management in recent years, but health plans still face challenges with identifying when and why certain individuals move up and down the risk ladder. Many plans primarily work with claims data, which can be incomplete from an analytics perspective and offers little insight into why members are straying from their care plans. With limited scope and up to several months of lag time, this claims dataset alone is not sufficient to get ahead of the exact moment a person starts to show potential issues that are likely to lead to non-adherence with recommended care best practices.

Instead of relying too heavily on claims data alone, health plans need to integrate datasets that give a more comprehensive and current view of member activities: socioeconomic data to identify non-clinical barriers; pharmacy data to show medication access and adherence patterns; diabetes supply ordering records to indicate therapy adherence; and device data to highlight continual usage of management tools and control of clinical factors, like blood glucose levels.

Together, these and other datasets paint a powerful, holistic, and timely portrait of a member’s ability to participate in their own care from a clinical and nonclinical perspective, enabling health plans and providers to pinpoint potential trouble spots and dynamically predict rising or falling risks of non-adherence.

AI has quickly become an essential tool for making sense of rich and varied healthcare datasets, but it must be deployed intentionally to maximize its impact. That means developing bundled algorithms and services that can identify accessible patient data while also spotlighting what data is actually missing in a patient’s longitudinal record.

For example, the sudden absence of a monthly diabetes supply order or prescription refill or a sporadic tapering off of data reports from a CGM over time are major red flags on the adherence front. AI tools must be sophisticated enough to know when missing data is a sign of an impending problem, which means designing models and corresponding patient outreach and education strategies that support prevention.

After examining these patterns at scale and over time, AI models can accurately assist health plans with identifying the clinical and socioeconomic factors that most directly correlate with these adherence gaps in their unique populations, allowing care management teams to move closer and closer to the non-adherence trigger point for individuals, and ideally, to also be able to predict likely non-adherence events for members before they occur.

For example, some members are providing care for children and aging parents while working full time and may have more limited opportunities to invest in their own care. Offering these members insights and best practices specific to maintaining therapy under a tight schedule can prove helpful. In other cases, financial uncertainty may be impacting a member. Providing these members with education and coaching on tools that allow for flexibility in out-of-pocket costs for medications and/or medical devices so that they can continue therapy without disruption can mean the difference between adherence and non-adherence.

Considering that the costs of caring for people with diabetes consumes more than 20% of the nation’s annual $4.5 trillion healthcare budget, investing in next-generation tools and partnerships to get ahead of non-adherence and negative member outcomes is essential for altering the trajectory of the ongoing diabetes epidemic.

However, identifying impending problems is only half the battle. Plans must be ready and able to conduct meaningful, individualized outreach to members who show signs of non-adherence as soon as possible. Direct engagement and education with members can often uncover the true obstacles, both tangible and emotional, behind non-adherence issues, including underlying issues of trust in the health system that may stem from personal or community experiences. These conversations with extended care teams can shift that narrative for individuals and become an opportunity for plans to provide compassionate, actionable problem solving for members that help build relationships and prevent future issues.

Information that is gathered during these outreach interactions can be structured and folded back into analytics efforts to enrich future insights and enable health plans to become even more predictive, personalized, and prepared to support their members with community-based resources, tailored diabetes education, and specialized training on how to best use their devices and adhere to a recommended care regimen.

Ultimately, AI can help identify non-adherence issues in people living with diabetes before it becomes a full-blown, costly problem. By diving deeper into holistic datasets and member care patterns, AI tools will soon be able to identify the underlying challenges facing members, empowering health plans to address these issues earlier while fostering meaningful outreach activities that surround people living with diabetes with the support and guidance they need to thrive.

Morning Headlines 3/18/24

March 17, 2024 Headlines No Comments

Veradigm Announces Initial Financial Guidance for Fiscal 2024

Veradigm reports that, despite having its shares delisted, its fundamentals are healthy and that it anticipates a small growth in GAAP revenue and a small decrease in earnings.

Lurie Children’s Hospital reactivating patient portal after network outage

Lurie Children’s Hospital in Chicago begins bringing its MyChart patient portal back online after a ransomware attack took it and other systems offline six weeks ago.

AHA Urges More Congressional Action to Help Providers Affected By Change Healthcare Cyberattack

The American Hospital Association tells the Senate Finance Committee that it cannot support budget proposals that call for the federal government to impose financial penalties on hospitals that have been the victim of cyberattacks.

Monday Morning Update 3/18/24

March 17, 2024 News 4 Comments

Top News

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Veradigm’s presentation to an investor conference last week includes these items:

  • The company sees itself as “a new leader in healthcare data intelligence.”
  • MDRX shares have been delisted, but the company hopes to regain listing and notes that its fundamentals are healthy, which is rare for a delisted company.
  • Growth initiatives include provider EHR modernization and cloud hosting, payer gap closure, and data and AI products. (click the graphic above to enlarge)
  • Guidance for 2024 is a small growth in GAAP revenue and a small decrease in earnings.

Reader Comments

From Selfie Sticker: “Re: HIMSS24. We have exceeded the 50% threshold of photos in which the taker themselves is featured.” I estimate that 75% of the conference photos that were posted on X and LinkedIn involve combinations of the same 10 people, most of them mugging for selfies or a series of smiley group shots that show little about the actual event, which is apparently less important than their presence there. Still, I’ll take that over yet another cliche photo – HIMSS ran a lot of these — in which someone does the Taylor Swift heart-hand thing.


HIStalk Announcements and Requests

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I might not have been specific enough in last week’s poll question since I’m wondering if the nearly three-fourth of respondents who said they scheduled an in-person visit using online technology alone (no phone call, email exchange, etc.) really did. Or maybe providers are further along in their self-scheduling rollouts that other reports indicate.

New poll to your right or here: In the past 12 months, has an in-person provider used conversational audio from the visit to create documentation? I’ve only seen my direct primary care doc and she types notes directly into the EHR, but she (and I) have the luxury of relaxed, one-hour visits that don’t need to feed billing or insurance, so she’s doing the listening rather than an app. 

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HIMSS24 attendees, tell me anonymously about what you liked or didn’t like about the conference and I’ll summarize later this week.


Possible to-do items for supporting HIStalk:

  1. Sign up for spam-free email updates.
  2. Share news, rumors, and intriguing insights with me.
  3. Get a perk or two as a former sponsor for returning to the fold by contacting Lorre. Not sure if you’ve sponsored before? Let me know and I’ll look it up.

Webinars

March 27 (Wednesday) 3 ET. “Houston Methodist: Deploying clinical AI at scale for improved outcomes.” Sponsor: Health Data Analytics Institute. Presenters: Khurram Nasir, MD, MPH, chief of cardiovascular disease prevention and wellness, Houston Methodist DeBakey Heart & Vascular Center; Brenda Campbell, RN, senior consultant, HM Health System Innovations; Nassib Chamoun, MS, founder and CEO, HDAI. The presenters  will share how an interdisciplinary team collaborated to successfully use predictive models and a novel AI-driven approach to address post-discharge mortality. They will also describe how they expanded use of the platform to reduce clinician time spent digging through the EHR with a one-page risk profile, including codes extracted from notes using generative AI, and targeting their highest risk patients for extra attention. They will speak to how they overcame barriers to bringing AI at scale to support clinicians across the care continuum.

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


Sales

  • In Canada, Halton Healthcare chooses Sectra One Cloud for imaging.

Announcements and Implementations

UnitedHealth Group hasn’t updated their Change Healthcare restoration status since March 14. Its target for restoring electronic payments was this past Friday and testing of claims submission was slated for Monday, March 18.

Meditech adds integration with Nuance DAX Copilot to Expanse.

The American Hospital Association tells the Senate Finance Committee that it cannot support budget proposals that call for the federal government to impose financial penalties on hospitals that have been the victim of cyberattacks. The White House has asked for hospital cybersecurity funding, but with penalties to those that don’t meet requirements. AHA also notes that HHS has limited authority to offer financial assistance to providers who have suffered from the Change Healthcare cyberattack, and without Congressional approval, can’t help with denials of claims that involve Medicare Advantage, commercial insurers, and state Medicaid programs.


Other

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A commercial real estate firm pitches its listing of a Collingwood, Australia office building that is home to anchor tenant Epic. It says that the building “has appealed to a younger generation who have ample building amenities plus access to Smith Street, which was voted by Timeout Readers as the coolest strip in the world. Sackville Street is all about working, living, and playing in the same area.”


Sponsor Updates

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  • Netsmart sponsors the Kansas Mental Health Advocacy Day.
  • Nordic Consulting debuts its Cloud Innovation Lab developed in partnership with Microsoft Azure and AWS.
  • RxLightning names Erin Townsend senior reimbursement specialist and Jason Roberts technical support engineer.
  • Homerton Healthcare NHS Foundation Trust in England becomes the first NHS organization to deploy Sectra’s enterprise imaging service using public cloud.
  • SmartSense by Digi shares why Vail Health chose SmartSense for condition and environmental monitoring.
  • Tegria publishes a new case study, “Strategic Revenue Integrity Improvements Generate $19.4 Million.”

Blog Posts


Contacts

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

Morning Headlines 3/15/24

March 14, 2024 Headlines No Comments

UnitedHealth unit Change Healthcare’s pharmacy network back online

UnitedHealth Group reports that Change Healthcare’s pharmacy network is up and running, with nearly all pre-incident claim volume flowing.

From Wait Times to Real-Time: Assort Health Secures $3.5 Million to Scale First Generative AI for Healthcare Call Centers

Assort Health, which has developed healthcare call center software powered by AI, announces $3.5 million in funding.

Zephyr AI Raises $111 Million in Series A Financing

Precision medicine software vendor Zephyr AI secures $111 million in a Series A funding round, bringing its total raised to $129.5 million.

News 3/15/24

March 14, 2024 News No Comments

Top News

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HHS OCR launches an investigation of the Change Healthcare cyberattack to determine if a PHI breach occurred and if owner UnitedHealth Group is in compliance with HIPAA.

HHS OCR also reminds the company’s partners to make sure they have business associate agreements in place and are prepared to file HHS breach notification if they are made aware of PHI exposure.

Senate Finance Committee Chairman Ron Wyden (D-OR) pressed HHS Secretary Xaviera Becerra in a hearing Thursday to hold hospital and insurer executives accountable for cybersecurity.

The company said in a Thursday update that it has reviewed and protected most of its infrastructure and brought prescription services online. It said previously that it expects electronic payments to be restored on Friday, March 15.


HIStalk Announcements and Requests

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The number of “that’s a wrap for HIMSS24” social media messages posted Thursday must be disconcerting to HIMSS given that two keynotes and some education sessions are scheduled for Friday all the way through 2:15 p.m., although many folks consider the boat show over once the exhibit hall doors close for the week. It was both relaxing and weird the one and only year I stuck around for the last day while most folks were back in their own beds. I notice that HIMSS25 in Las Vegas will be shortened a day to run from March 3-6, but will return to a five-day schedule for HIMSS26, which is also in Las Vegas.

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Welcome to new HIStalk Platinum Sponsor TruBridge. The Mobile, AL-based company has over four decades of experience in connecting providers, patients, and communities with innovative solutions that create real value by supporting both the financial and clinical side of healthcare delivery. It’s a trusted partner to healthcare organizations with a broad range of technology offerings that address the unique needs and challenges of diverse communities, promoting equitable access to quality care and fostering positive outcomes. The company’s industry leading HFMA Peer Reviewed suite of revenue cycle management (RCM) offerings combine unparalleled visibility and transparency to enhance productivity and support the financial health of healthcare organizations across all care settings. Its solutions champion end-to-end, data-driven patient journeys that support value-based care, improve outcomes, and increase patient satisfaction. It supports efficient patient care with electronic health record (EHR) product offerings that successfully integrate data between care settings. Above all, it believes in the power of community and encourages collaboration, connection, and empowerment with its customers. TruBridge helps clear the way for care.


Webinars

March 27 (Wednesday) 3 ET. “Houston Methodist: Deploying clinical AI at scale for improved outcomes.” Sponsor: Health Data Analytics Institute. Presenters: Khurram Nasir, MD, MPH, chief of cardiovascular disease prevention and wellness, Houston Methodist DeBakey Heart & Vascular Center; Brenda Campbell, RN, senior consultant, HM Health System Innovations; Nassib Chamoun, MS, founder and CEO, HDAI. The presenters  will share how an interdisciplinary team collaborated to successfully use predictive models and a novel AI-driven approach to address post-discharge mortality. They will also describe how they expanded use of the platform to reduce clinician time spent digging through the EHR with a one-page risk profile, including codes extracted from notes using generative AI, and targeting their highest risk patients for extra attention. They will speak to how they overcame barriers to bringing AI at scale to support clinicians across the care continuum.

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


Acquisitions, Funding, Business, and Stock

Innovaccer acquires Pharmacy Quality Solutions, which offers a medication quality management platform for payers.

Healthcare IT and cybersecurity vendor Anatomy IT acquires Manta HealthTech, which offers managed IT services to medical, dental, optometry, and veterinary care providers.

Massachusetts General Hospital and Brigham and Women’s Hospital will combine their clinical departments and academic programs, with a single chair overseeing each one.


Sales

  • In England, New Victoria Hospital chooses Meditech Expanse, hosted on Google Cloud Platform.
  • Arkansas Heart Hospital extends its use of Oracle Health EHR and patient accounting to its ambulatory clinics and two hospitals.

People

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Net Health hires John Gresham (ValueHealth) as president of its wound care division.

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Frank Jackson, MBA (Verinovum) joins MRO as SVP of clinical quality and payer solutions.


Announcements and Implementations

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A HIMSS session on Thursday covered the International Patient Summary, a standards-based method of giving clinicians access to a patient’s basic medical information by scanning a QR code.

Verato will incorporate Google Cloud technology in its enterprise identity management solutions.


Privacy and Security

Lurie Children’s Hospital is conducting an investigation into the claims by the hacker group that was responsible for its recent ransomware attack that it has sold the hospital’s data.


Other

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A study published by Epic Research finds that people who were prescribed Eli Lilly’s tirazepatide (Zepbound, Mounjaro) lost a median of 15% of their body weight in one year, the highest percentage loss among five GLP-1 drugs.

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Doctors and employees of Copley Hospital protest the termination of ED doctor Liam Gannon, MD, who says he was fired for warning hospital administration in 2020 that the EHR they were considering – and later bought – could compromise patient safety and care quality due to problems with reported delayed or missing orders.


Sponsor Updates

  • Wolters Kluwer Health announces enhancements its clinical decision support solutions including UpToDate, UpToDate Lexidrug, UpToDate Patient Engagement, and UpToDate Digital Architect.
  • Findhelp welcomes Essex Regional Educational Services Commission, Delta Population Health Institute, and Memorial Hermann Health System to its network.
  • Forbes names Impact Advisors to its list of America’s Best Management Consulting Firms for 2024.
  • FinThrive releases a new Healthcare Rethink Podcast, “Let’s Super Charge Care Management.”
  • The Point-of-Care Partners Podcast features First Databank President Bob Katter, “Empowering Pharmacists: How Health IT Can Facilitate Seamless Data Exchange & Ease Workloads.”
  • Healthcare IT Leaders names Shelley Simkins (ProNexus Advisory) Elite Advisor.

Blog Posts


Contacts

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

From HIMSS with Dr. Jayne 3/13/24

March 14, 2024 News 4 Comments

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It was nice enough for people to sit out on the lawn on Wednesday. The giant HIMSS letters of the past have been replaced by this globe that proudly sports the Informa Markets branding.

The exhibit hall remained crowded this morning, with plenty of people feeling free to stop and have conversations in the main aisle, which at times made navigating difficult. Absent are the transportation carts that used to be present at previous HIMSS conferences, which also served to keep people moving. The exhibit hall begins to get thin around the 6500 aisle, which brings back memories of having to look for booths up in the thousands.

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The public spaces were starting to show signs of wear by lunch time, with empty water coolers and overflowing trash bins as people took their lunches outside. I found a full water cooler over by the Government pavilion, which was in a separate exhibit hall that is unconnected to the rest of the show floor. The red, white, and blue ceiling décor was a nice touch.

Luggage storage areas began filling up in the morning, which is typically on a HIMSS Wednesday. As I visited my first booth, I noticed some weird orange spots on my name tag. It turns out that the bubbly fizzy drink of last night was responsible, leaving sticky dots as a reminder of the fun I had.

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Nabla had a cool retro typewriter in their booth, which was inundated when I went by. I’m looking forward to learning more about their solution and how systems are implementing it.

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This is the first time I’ve seen crepes at HIMSS.

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Intelligent Medical Objects (IMO) brought their A game for both shoes and socks.

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First Databank delivered with HIMSS-approved axe throwing to replace their carnival game. Attendees were really getting into it, and I saw a couple of serious contenders at the end of the day.

From Bill Spooner: “Re: HIMSS. It is 30 years since my first HIMSS and I’m happy to partaking vicariously. I’ll be interested in your assessment, particularly a good comparison with VIVE. Educational substance, provider attendance (especially senior leadership and docs), hyped vendor announcements, networking, extracurricular activity, etc. If you have to choose one, which will bring the greater value? If only one were to survive, which are you rooting for?” Vendor friends told me their numbers from HIMSS indicated that there were in excess of 8,000 provider-side attendees, but they weren’t feeling that during their interactions. Several said they felt that there was a lot of business-to-business activity going on, with people trying to sell solutions to each other or talking about partnerships. I didn’t attend ViVE this year, so my comparison is more than a year old, but people were certainly talking about the two events. ViVE leads in the hype department and there were plenty of comments about the fact that it has better food and that it is included in the price. ViVE also costs twice as much to attend, so I’m sure if HIMSS wanted to up their fees, they could do better with food choices. HIMSS has also put a main stage on the show floor similar to ViVE, plus smaller embedded theaters around the hall, so it is trying to adapt.

I saw few CMOs and CMIOs in my travels, with mostly director and VP-level folks from provider organizations. HIMSS has better Continuing Medical Education offerings, so it will probably win my vote since I pay out of pocket to come and have to see tangible value. My previous ViVE experience felt like it was a “see and be seen” situation versus trying to help providers meet their state and specialty-mandated educational needs. As far as keynote speakers, the last several years have been pretty meh, but there are so many talking heads in the industry that I’m not sure who it would take for me to find them exciting.

From International Women’s Day: “Re: HIMSS. I always appreciate your hot takes. Thought you might be interested in their nursing mother’s rooms. It’s sadly not surprising that the ‘wellness rooms’ in Orlando and pretty abysmal. I used the one in Lobby C – it has a chair, a table, and a plug in a dusty room that could use a good vacuuming. No sink or fridge (fridge is kind of understandable since I’m sure they don’t want to be liable for safe breast milk storage). I’m pleased that they at least have rooms and put them on the map, but it’s a bit ironic at a healthcare conference to not have better accommodations for nursing moms.” I had peeked into one of the rooms earlier in the week before the comment arrived and found it to be drab. The room is also a shared space that invites people for prayer and meditation, which from experience have slightly different vibes than those that are channeled while trying to pump breast milk. Anyone who needs to wash pump parts would have to go across the hall to the restrooms, which have been plus/minus this week as far as having adequate supplies of paper towels and general cleanliness. I haven’t been a nursing mother in recent years, but generally I think I would prefer one of the nursing pods that you see in airports to a dusty multi-purpose space.

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I spent some time at the Epic booth today, learning about new offerings and how they are helping their clients make the most of multi-million-dollar investments. There’s a staff room behind the Epic booth where workers can get drinks and recharge, since they are on-stage with clients a lot of the time. Epic also manages their own connectivity and tech behind the scenes, and I caught a peek at the team sequestered in the back of the booth making the magic happen. I hope they get some rest after this busy week.

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Shoes of the day are courtesy of Relatient’s always dapper Jonathan Shivers. The colored laces are the key.

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Edifecs featured ballet dancer Misty Copeland on their annual inspirational t-shirt. Past tributes have included Dolly Parton and Ruth Bader Ginsburg.

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As usual, the puppy park was hopping. Who doesn’t love a puppy?

Today, it was back to the virtual salt mines, and I started traveling at 6 a.m. Orlando is one of my least-favorite airports, and it didn’t do anything to redeem itself this morning. TSA lines appeared fairly short, but apparently I was there at shift change and they were moving slower than anticipated. Additionally, they have an uneven number of PreCheck lanes compared to the number of ID screeners, which resulted in some lines not being called and passengers becoming exasperated. They had clearly posted signage about putting your passport on the scanner, but I was yelled at for not putting my boarding pass on the scanner. I haven’t had to present a boarding pass at a US airport in more than a year, so who knows what’s going on with TSA and why they’re operating outside their clearly posted process.

How was your Orlando airport experience? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 3/14/24

March 13, 2024 Headlines No Comments

Anatomy IT Expands Healthcare Specialties Expertise with Acquisition of Managed IT Services Leader

Anatomy IT acquires Manta HealthTech, which offers managed IT services to medical, dental, optometry, and veterinary care providers.

HHS Office for Civil Rights Issues Letter and Opens Investigation of Change Healthcare Cyberattack

The HHS Office of Civil rights launches an investigation into the Change Healthcare attack to determine if patient data was breached and what, if any, HIPAA violations have been committed by Change and parent company UnitedHealth Group.

Lurie Children’s Hospital investigating claims that stolen data was sold online

Lurie Children’s Hospital (IL) investigates claims made by the Rhysida ransomware group that it sold data stolen from the hospital.

Biden budget cuts funding for health record refresh amid ongoing program ‘reset’

Proposed fiscal year 2025 budgeting for the VA does not include any new funding for the continued roll out of the department’s stalled EHR modernization program.

Healthcare AI News 3/13/24

News

Sixteen large health systems and Microsoft form the Trustworthy and Responsible AI Network (TRAIN), which will share best practices, register the use of AI in clinical settings, provide AI outcomes measurements, and facilitate creation of a federated national AI outcomes registry. The group will work with OCHIN and TruBridge to make sure that all organizations, regardless of resources, can benefit from TRAIN’s work. The recently formed Coalition for Health AI (CHAI) is a partner and says that TRAIN will operationalize its principles in health systems.

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Google launches Google Cloud Vertex Search for Healthcare, a set of search-and-answer tools that integrate with its MedLM, Healthcare Data Engine and Cloud Healthcare FHIR APIs. It offers medically-tuned search of EHR data for clinician presentation, configurable cloud APIs, the ability to answer clinician questions while understanding medical terminology, and providing links to source data points to provide transparency.

The government of China is working with private companies to develop a medically focused AI chatbot based on Meta’s Llama 2.0. It is testing an AI assistant model for neurosurgeons at seven hospitals in Beijing. The CARES Copilot 1.0 was trained on medical literature and can process images, audio, text, MRI, ultrasounds, and CT scans.

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Microsoft previews healthcare-specific safeguards for Azure AI Health Bot services that integrate with Copilot Studio to allow healthcare organizations to develop their own copilots.


Business

Symplr announces SymplrAI, which will offer healthcare efficiency tools via Amazon Web Services AI/ML.

Peter Thiel-backed Cognition AI unveils Devin, an AI-powered software engineer that can generate, debug, and deploy code for websites and videos from a single command. It has its own command line, code editor, and browser.

Amazon Web Services lists the generative AI solutions that its healthcare customers have created:

  • Digital pathology (Philips).
  • Phone-based, voice-enabled progress note generation (Pieces Technologies).
  • Hospital operations efficiency (Symplr).
  • Enterprise imaging (Konica Minolta).

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Biotech startup Insilico Medicine describes how it used its AI platform to create a drug candidate for idiopathic pulmonary fibrosis that is undergoing Phase II clinical trials. The company says the process took 2.5 years versus the six years that would have been needed without AI. The company used biology AI to discover the drug, then generated the molecule using chemistry AI.


Research

In England, University of Oxford researchers warn clinicians that using ChatGPT and Bard to create care plans could compromise patient privacy or mislead users with incorrect information.

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In Israel, Sheba Medical Center researchers develop an AI platform to help mental health professionals diagnose and manage conditions efficiently, concluding that its diagnostic accuracy is comparable to that of experience psychiatrists.

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A study finds that large language models can translate discharge summaries into readable, patient-friendly language, which helps providers comply with requirements to give patients immediate access to their discharge notes. However, the authors found examples of key information being omitted, most often history of present illness and procedures, which they attribute to prompt engineering that optimized readability in the form of shorter documents.


Other

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CommonSpirit Health EVP/CIO Daniel Barchi, MS says that healthcare’s adoption of AI should follow the Maslow’s Hierarchy of Needs in first being applied to technical needs, then moved up the triangle to improve healthcare efficiency and safety. (click graphic to enlarge)


Contacts

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

From HIMSS with Dr. Jayne 3/12/24

March 13, 2024 News 2 Comments

Tuesday was a busy day at HIMSS. As much as I thought the humidity was absent yesterday, it returned in full force this morning as I walked the ¾ mile from my hotel to the convention center.

I didn’t hear much commentary on the keynote speaker, which was supposed to be about harnessing AI to improve the patient experience. I didn’t make it to the session due to some breakfast meetings I had scheduled, and it didn’t feel like too many people were enthusiastic about the speech. When I arrived at the convention center well before the keynote was scheduled to end, there were plenty of people milling around and not attending the session. From what I’ve heard, it was lightly attended.

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The exhibit hall opened at 10 a.m. and several people were killing time at the Slack vending machine outside the first entrance to the hall. Attendees could scan their badges for a chance to win prizes, including a reusable utensil kit, which is what I ended up with. I usually carry a set of utensils in my consulting bag because you never know when a take-out order will be missing them, so the set was much appreciated.

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The exhibit hall was hopping from the moment it opened until the moment it closed, which made it feel like the boat-show style HIMSS of old. Hornet Security (booth 1220) had an excellent spokesperson engaging passers-by with this crazy pull-out banner inside his jacket. He wasn’t just a speaker, though, he knew all about the product and was able to answer questions about cybersecurity threats without handing them off to colleagues.

In general, booth staffers were attentive and warm in greeting those walking by. Of course, that is likely to fade as the week wears on. After a brief session of stalking the lower numbered aisles in the exhibit hall, I headed to some educational sessions so that I could at least earn enough Continuing Medical Education credits to make this trip worthwhile.

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Connection (booth 1449) was filling bags for the Palm Beach VA hospital. I was glad to help, and they were good at gently redirecting people who just wanted to take a pack of tissues and didn’t understand that it was a “fill the backpack” event. They have a lofty goal of backpacks that they’d like filled before the end of the conference, so be sure to stop by and help them out.

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The best shoes of the day were spotted at First Databank (booth 1747). Kudos to the ladies who chose comfort and style.

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First Databank also wound up on the HIMSS naughty list with their carnival game. I arrived just as their sledgehammer prop was being hidden away, having been shut down by HIMSS officials because the noise of the bell exceeded HIMSS noise standards. Kudos to their rep who was tasked to run the game and but ended up with nothing to do, but who engaged the crowd nevertheless. I suggested a quick run to Costco for the indoor axe throwing set I saw there recently, so we’ll have to see if they have a replacement for tomorrow.

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I did my annual booth crawl with Nordic CMO Craig Joseph, which was fun as usual. We decided to award Tierpoint (booth 3075) with the “best swag” award for handing out Tide pens. The booth staff were also engaging and kept up the energy level throughout the day, which is an achievement in itself.

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Parlance (booth 5183) had wonderful chocolate chip cookies and promised another delivery for Wednesday and leftovers on Thursday, so be sure to check them out. I was grateful to have a snack at the end of the day, since the lunch promised by my noon focus group was never delivered.

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I saw this fantastic suit several times.

Several exhibitors had happy hours at the end of the day, including Cox Health, Intelligent Medical Objects, and the Patient Experience pavilion. From there I headed to events hosted by Evergreen Healthcare Partners and Clearsense, which were both fun and great for networking.

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The CommonWell Health Alliance party at Icebar had drinks powered by dry ice in the indoor bar area, sponsored by Ellkay. Those electing to don jackets and gloves were treated to cocktails served in ice mugs. Thanks to both for sponsoring the coldest part of the night.

After that, I was ready to head to my hotel and crash. It’s been 14 years since my first HIMSS and I’m definitely less of a night owl than I used to be. Kudos to the next generation who is keeping the wild nightlife vibes alive.

What has been your favorite part of HIMSS so far? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 3/13/24

March 12, 2024 News No Comments

Oracle Stock Surges On Strong Earnings, AI Cloud Demand

Oracle reports Q3 results: revenue up 7%, adjusted EPS $1.41 versus $1.22, beating Wall Street expectations for earnings and meeting revenue expectations.

Frazier Healthcare Partners Announces Acquisition of RevSpring

Investment firm Frazier Healthcare Partners acquires patient engagement and payments technology firm RevSpring from its private equity owner.

CodaMetrix Announces $40M Series B Financing to Advance Medical Coding Quality and Clinically Enrich Claims Data Through AI

Automated medical coding software company CodaMetrix raises $40 million in Series B funding, bringing its total raised to $95 million.

News 3/13/24

March 12, 2024 News 4 Comments

Top News

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Oracle reports Q3 results: revenue up 7%, adjusted EPS $1.41 versus $1.22, beating Wall Street expectations for earnings and meeting revenue expectations. ORCL shares rose sharply to a 52-week high on the news as investors reacted to the company’s cloud and AI prospects. From the earnings call:

  • CEO Safra Catz once again recited the need to “drive Cerner profitability to Oracle standards,” as the growth in that business lagged the company’s overall growth.
  • Catz said that the Cerner business ”is a significant headwind this year,“ but she expects it to return to growth next year.
  • Board chair and CTO Larry Ellison says that the company is using its Apex application generator and autonomous database to develop new healthcare applications. He says that an ambulatory clinic system that includes a Clinical Digital Assistant voice interface will be released in Q4.
  • The Clinical Digital Assistant will include ambient encounter documentation and will create prescriptions, orders, and notes that automatically update the EHR.
  • Ellison predicts that Oracle’s AI-centric healthcare cloud applications will allow customers to rapidly modernize their systems and transform Oracle Health into a high-growth business.
  • Ellison says that running Cerner on Oracle Cloud Infrastructure is less expensive than using a Cerner-dedicated data center in Kansas City; is more secure against cyberattacks; and allows automatic updates every three months.

Oracle also announced enhancements to Oracle Health Data Intelligence, formerly Cerner HealthIntent, that include a generative AI service that summarizes patient histories for care managers.


Reader Comments

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From Mike: “Re: HIMSS24. Rocking my HIStalk 2014 pin for the 10-year anniversary. My awesome HIStalk mug has finally faded out, so sad. And I miss the HIStalkapalooza days — HIMSS just isn’t the same.” My ideas are often financially unsound, such as lugging boxes of pins and mugs to HIMSS14 and then trashing most of them afterward as attendees were too overwhelmed with booth swag to want more. Ditto HIStalkapalooza, which was was a financial nail-biter every year and would have wiped me out in 2020 had I not ended it with the 10th edition in 2017. Still, like many things in life, the good memories outlive the not-so-good ones. The flamingo with a stethoscope design was reasonably clever.

From Booth Crawler: “Re: HIMSS24. Twitter is lit up with ‘influencers’ who are charging vendors to promote their talks, moderate their panels, or pitch their booth presence.” I’ve noticed a lot of that this year. I started HIStalk forever ago because so-called news sites mostly ran paid vendor promos in which no discouraging word was ever heard. I’m glad that’s still the case since it gives me a reason to keep doing it my way. Everybody has to choose what works for them.


HIStalk Announcements and Requests

Attending HIMSS24? I’m anxious to hear your thoughts about the buzz, trends, surprises. Did you attend any HIMSS-owned educational sessions versus the Informa-owned exhibit hall? That also reminds me that SxSW’s healthcare track ended Tuesday and I haven’t heard a peep out of it even though it and CES at one time looked like potential HIMSS competitors.


Webinars

March 27 (Wednesday) 3 ET. “Houston Methodist: Deploying clinical AI at scale for improved outcomes.” Sponsor: Health Data Analytics Institute. Presenters: Khurram Nasir, MD, MPH, chief of cardiovascular disease prevention and wellness, Houston Methodist DeBakey Heart & Vascular Center; Brenda Campbell, RN, senior consultant, HM Health System Innovations; Nassib Chamoun, MS, founder and CEO, HDAI. The presenters  will share how an interdisciplinary team collaborated to successfully use predictive models and a novel AI-driven approach to address post-discharge mortality. They will also describe how they expanded use of the platform to reduce clinician time spent digging through the EHR with a one-page risk profile, including codes extracted from notes using generative AI, and targeting their highest risk patients for extra attention. They will speak to how they overcame barriers to bringing AI at scale to support clinicians across the care continuum.

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


Acquisitions, Funding, Business, and Stock

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Cognitive assessment software vendor Linus Health acquires clinical-grade speech analytics company Aural Analytics.

Access Information Management acquires Triyam, which specializes in healthcare data conversion, migration, and archiving.

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Investment firm Frazier Healthcare Partners acquires patient engagement and payments technology firm RevSpring from its private equity owner.

Trey Lauderdale, who founded and led Voalte and then sold it to Hill-Rom for $180 million in 2019, brings his new, healthcare-unrelated company Atomic Canyon out of stealth as founder and CEO. The company’s AI platform scans federal databases to help nuclear power plant operators obtain regulatory approvals

AI-enabled precision medicine technology vendor Tempus hires Morgan Stanley to take the company public.


Sales

  • Ferrell Hospital (IL) selects remote patient monitoring technology from CareSimple.
  • Foothold Technology will integrate Findhelp’s social services referral management software with its human services EHR and care coordination technology.
  • Children’s Wisconsin will implement Locus Health’s remote patient monitoring software.
  • University Hospitals Plymouth NHS Trust in England selects Epic.
  • Sentara Healthcare (VA) opts for virtual rheumatology care services from Remission Medical.
  • Halifax Health (FL) will implement Epic.

People

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Walmart Health names consultant and former ChristianaCare executive Ken Silverstein, MD, MBA as VP of clinical operations.

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Divurgent names Mike Nash, MBA (RPM Advisors) SVP of its new Divurgent Canada division.

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Cone Health (NC) promotes Jason Wright, MA to VP of enterprise business platforms and digital solutions.

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Former Cherokee Nation Health CIO Donnie Parish joins General Dynamics Information Technology as VP of strategic operations.

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Clinithink names former consultant Mark Johnston as CEO.


Announcements and Implementations

CommonSpirit Health (UT) goes live on Epic across 45 outpatient departments.

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Crook County Medical Services District (WY) implements Oracle Health.

Wolters Kluwer Health announces the availability of UpToDate Enterprise and UpToDate Pro digital clinical decision support solutions under the UpToDate brand.

Symplr announces the GA of SymplrAI, a virtual workforce assistant designed to help streamline hospital operations.

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Sonifi Health debuts cloud-based smart room technology featuring patient engagement tools at the bedside.

Stanford Health Care (CA) deploys Nuance’s DAX Copilot automated clinical documentation software.

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Altera Digital Health announces Paragon Denali, an Azure-based EHR for rural, critical access, and community hospitals.

Clearwater announces an addition to its IRM|Pro platform that allows organizations to gauge their cybersecurity program performance against NIST’s framework.

Several Meditech sites are deploying ambient listening technology with its Expanse EHR using multiple voice assistant vendors.

InterSystems enhances the patient matching functionality of its HealthShare Patient Index by incorporating LexisNexis LexID.

ECRI publishes its Top 10 Patient Safety Concerns 2024, which includes these technology-related items:

  • Workarounds with barcode medication administration systems, such as administering meds whose barcodes won’t scan and charting after the fact.
  • Unintended consequences of technology adoption, such as clinician burnout, and the potential of making bad clinical decisions because of unreliable or poorly trained AI.

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Apple touts the development of health and wellness apps for Apple Vision Pro, noting currently available apps for visual surgical planning, medical equipment training, and Epic Spatial Computing Concept, which allows clinicians to interact with Epic to complete charting, review results, conduct secure chats, and complete in-basket workflows.


Other

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UnitedHealthcare asks Oregon regulators for emergency approval of its acquisition of The Corvallis Clinic, which it says is in imminent danger of closing because of financial challenges. It didn’t mention that those challenges were caused by the weeks-long claims and payment outage of Change Healthcare, which is owned by UnitedHealthcare. The excellent report by The American Prospect concludes that UHG-owned Optum, which is the largest employer of physicians in the US, “can add to its stable by securing purchases of companies put into a terrible position by its own ransomware hack.” The article also notes that UnitedHealth pays $662 million in medical claims each day, so it is piling up cash as its own systems prevent it from sending out the money it owes to providers.


Sponsor Updates

  • CereCore releases a new podcast, “Why EHR Optimization is Worth the Effort and Budget.”
  • Agfa HealthCare accelerates growth in enterprise imaging cloud business amidst strong market momentum.
  • Black Book’s latest user survey ranks Innovaccer’s Data Activation Platform as the top end-to-end population health solution.
  • CHIME’s Leader to Leader Podcast features Divurgent Chief of US Operations Joe Grinstead, “The Science of Organizational Change Management.”
  • FinThrive announces enhancements to its Analyze, Authorization Manager, and Real-Time Insurance Discover and Active Insurance Discover revenue cycle solutions.
  • First Databank adds CDS Hooks integration to its Targeted Medication Warnings solution.
  • Surescripts publishes its 2023 national progress report, “Tracking the Impact of Health Intelligence Sharing Across the United States.”
  • Linus Health adds Hearing Screener and Digital Trail Making Test Part B assessments to its comprehensive, AI-enhanced brain health platform.
  • TruBridge partners with the newly-created Trustworthy & Responsible AI Network, which aims to operationalize responsible AI principles to improve the quality, safety, and trustworthiness of AI in healthcare.
  • Wolters Kluwer Health announces key milestones for AI Labs, its Clinical Generative AI beta launched last year and powered by its UpToDate CDS solution.
  • EClinicalWorks offers a new customer success story, “Empowering Population Health & Revenue Growth.”

Blog Posts


Contacts

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

From HIMSS with Dr. Jayne 3/11/24

March 12, 2024 News 2 Comments

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Monday was my travel day since I couldn’t justify an extra hotel night and had other more exciting things to do. I was tempted to wear some mouse ears just so I could feel like I was fitting in with the rest of the crowd. Traveling to Orlando during spring break isn’t my favorite thing to do, although HIMSS seems to think it’s the best thing ever.

I was sad to receive a couple of emails and texts from people I had hoped to connect with at the conference but who wouldn’t be attending. One had become sick during travel last week and decided to keep his germs to himself, which I fully appreciate. Another had her travel withdrawn by her employer at the last minute. Seems like poor planning given the non-cancelable nature of most hotel and airline reservations, but there are plenty of poor decisions that happen in healthcare IT every day.

My home airport was a hot mess, with the TSA PreCheck line stretching about four times longer than I’ve ever seen it. Some of us were tempted to hop into the regular line, which was much shorter, but overly aggressive airport staff were turning away TSA PreCheck holders from that checkpoint and directing them to the back of our line. It turns out that before 6 a.m., there is only one person checking IDs on the PreCheck lane even though they were running three x-ray machines. Once 7 a.m. rolled around, another two ID agents were deployed and the backlog was quickly cleared. Still, there were plenty of people griping about it and one guy who claimed to have missed his flight, but it’s just one more thing to reassure those of us who are habitually early that we should continue our routines.

There were some badly behaved travelers on my flight, and they looked to be of the business traveler variety, so they should have known better. I was flying Southwest Airlines, where checked bags fly free, and the gate agent was very clear about the fact that there were 140 people ticketed on our flight and only 40 checked bags. She noted that a quick count of bags in the gate area made it look like they would have to do some last-minute gate checking and encouraged people to check their bags in advance. Of course, people didn’t comply, which made for chaos in the aisle as people couldn’t find places for their bags.

The cranky traveler in question was boarding position C20-something, which for those of you who don’t routinely fly Southwest, means he was one of the last people to board and of course that he had to check his roller bag. He was angry about that and then huffed about in the cabin because there was nowhere to put his backpack, lamenting that “this effing backpack never fits under the seat.” As a student of the English language, the “never” implies that he has experienced non-fitting of the bag multiple times previously but chooses to carry it anyway. First, there’s no reason to curse on a flight full of small children, and second, his discomfort seemed to be self-inflicted and I have little sympathy for that.

My flight was smoothed by my complimentary margarita, and after a nice nap, I emerged from my flight and found the HIMSS registration desk located in the airport baggage claim. I had printed my QR code, so badge pickup took about 60 seconds, which made me happy. The taxi line was nearly non-existent, but I had booked a last-minute discounted rental car, so I was quickly on my way. The hotel gods smiled on me with an early check-in, and from there I was on my way to take the long hike to the convention center. The weather was gorgeous with minimal humidity compared to what we usually experience in Orlando.

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The opening reception kicked off with a bang, or at least a rat-a-tat-tat, as a neon-adorned drum line played in the lobby. From there, they proceeded up the escalator to the now-open doors of the reception room. Initially, there was an overactive fog machine that was making me cough, but the mist dissipated quickly. There was entertainment with acrobats on neon-adorned hula hoops, some kind of robot-looking character in an LED costume, and a DJ with lots more neon on display. The drum line made another appearance partway through the reception.

Food lines and bar lines were reasonable and the room wasn’t too crowded, although as we were leaving it appeared that a lot of the party had shifted into the lobby, probably because of the volume in the room. Overall, the vibe seemed positive. Following the reception there were a number of private parties, but after a quick round of drinks with friends, I called it a night and headed back to plot tomorrow’s adventures.

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Plenty of organizations are hosting happy hours on the exhibit hall floor, which always makes me happy to reach the end of the day. I’m hoping there will be some scones or other good treats as well, but as usual I’ll settle for wine. IMO (booth 2251) won the booth happy hour advertising game with their email offering wine pairings for various healthcare IT goals. In case you’re curious:

  • Simplified clinical documentation pairs best with chardonnay.
  • Standardized condition and treatment data goes well with pinot grigio.
  • Meaningful problem lists are better with merlot (and I would agree).
  • Streamlined OR scheduling is best with reisling (personally I’d put that with optimized patient education, but that’s just me).

I’ll offer some additional pairings for those of you who prefer spirits: lab crosswalk review goes best with vodka, marketing workshops definitely require beachy rum drinks, and the art of constructing governance documents most certainly pairs best with bourbon.

What are your favorite healthcare IT and beverage pairings? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 3/12/24

March 11, 2024 Headlines No Comments

Linus Health Acquires Aural Analytics

Cognitive assessment software vendor Linus Health acquires Aural Analytics, which offers clinical-grade speech analytics.

Access, a Leader in Information Management Services, to Significantly Accelerate Its Digital Solutions Strategy with Acquisition of Triyam, an Innovative Data and Software Business

Information management services company Access acquires healthcare data conversion, migration, and archiving vendor Triyam.

Divurgent Announces Formal Expansion into the Canadian Healthcare Market

Virginia Beach-based healthcare technology consulting firm Divurgent announces its expansion into Canada.

R1 RCM Forms Special Committee to Evaluate Strategic Alternatives

R1 forms an advisory committee to consider the acquisition offer made by majority shareholder New Mountain Capital, a deal that would value the technology and services company at $5.8 billion.

Curbside Consult with Dr. Jayne 3/11/24

March 11, 2024 Dr. Jayne 1 Comment

Mr. H reported on this last week, but I’m still struggling with the story about Guam Memorial Hospital spending $5 million on an EHR that isn’t fit for purpose. As someone who used to do consulting work to help healthcare organizations with EHR system selection needs, it’s just baffling that this hospital’s project has reached this point.

You can try to blame the fact that there was a pandemic that caused delays, but that feels like a convenient excuse to try to cover problems that range from incompetence to willful neglect. There’s also the question on who will profit from the $20 to $60 million that it will take to replace the current system with one that will actually get the job done.

The system has been in place since October 2022. An administrator has stated that leadership determined it “really wasn’t built for an acute care hospital landscape” and would be more suitable for a behavioral health application. Because there isn’t funding to address the issues, caregivers are essentially stuck with it for the time being.

It feels like the basic tasks involved in system selection were somehow skipped: demonstrations, reference checks, and site visits with peer organizations that were currently using the system. This isn’t a magical new process for buying an EHR. I’ve done it at least a dozen times in the last two decades, and it’s pretty straightforward. Even if you claimed that the pandemic prevented site visits, you could still address a number of needs through a virtual site visit. In my experience, physicians rarely lie about the capabilities of an EHR unless they are being bribed.

I can’t throw the vendor under the proverbial bus without all the facts. It’s not entirely clear with of the vendor’s modules were actually purchased and how they were implemented.

I’ve personally been involved with EHR implementations where health systems did some pretty silly things, such as “forgetting” to include laboratory interfaces in their original Request for Proposal document, and grossly underestimating the volume of patient data that would need to be converted in order for physicians to work efficiently and for patients to be safe.

On the other hand, it feels like the facility might have skimped out on certain implementation steps as well as system selection steps, including elements such as workflow design, inclusion of patient safety and quality reporting features, and a little thing called user acceptance testing. Maybe issues were raised and leadership just plowed on through, though – I’ve certainly seen that happen a number of times.

As for the complicity of the vendor in this situation, I did a quick glance at its website, which may not at all resemble what the hospital had access to as it was selecting the system. There are plenty of areas of the website that channel language specific to behavioral health inpatient applications. There are consistent mentions of using DSM 5 to capture diagnoses in the chart rather than using ICD-10. There are also several mentions of the ability to document group visit notes, which typically don’t occur in the standard medical / surgical inpatient setting. The vendor does list a number of component products, however, and it looks like there may have been some mergers or acquisitions along the way, so that might be part of the issue too.

The news article notes that management is busy preparing a new RFP and therefore couldn’t offer additional comments on the downstream operations and billing impacts caused by the situation. I suspect they can’t offer comments because they’re actually preparing updates to their resumes as they consider pursuing other opportunities. The hospital is tied into a subscription-based contract, so they’re stuck with it until they can get a replacement live.

Hospital IT projects don’t happen overnight, and if the same leadership team remains in place, I’m sure it won’t be an efficient rip-and-replace at all. Even in the best of situations, you’re looking at an 18-month lead time to install a hospital system, just due to the sheer number of decisions that have to be made, the workflows that have to be mapped, the clinical data that has to be converted, and of course the ever-hellish hospital contracting process. That’s not allowing additional time for lots of questions to be asked, since the facility has already bought a lemon and stakeholders probably don’t want to buy another one.

Reading through the article, the organization has dealt with a number of technology problems in the past, including concerns logged during site visits from the Centers for Medicare & Medicaid Services (CMS). Those citations focused blame on the hospital’s previous EHR, which has since been discontinued. CMS cited the facility for failure to systematically track medical errors.

The administrator speaking to the media for the article noted that the new system had been recommended by the previous vendor. That’s problematic in my book, because when I have a vendor that’s failing to meet expectations, the last thing I want to do is to take their recommendation for a replacement. Apparently the two vendors were somehow affiliated, but trying to figure that out is beyond the scope of my investigative reporting motivation at this point. Apparently it was a no-bid contract situation, and that’s enough information for me. I can’t help but feel concern for and outrage on behalf of the patients who are now stuck receiving care in this environment, and the clinicians who have to try to make do with something that is clearly incapable of supporting them.

There are only a handful of comments on the article, and I wonder if any of them are from clinicians. If I had inside knowledge of the situation, I’d certainly be spilling it. I’m curious if we have any readers who work with the vendor in question or who have inside knowledge on the situation and would be happy to help you share your thoughts anonymously. Inquiring minds want to know: How do situations like this happen? Is there more to this story than meets the eye? Or is it simply a case of rampant incompetence? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 3/11/24

March 10, 2024 Headlines No Comments

UnitedHealth Group Update on Change Healthcare Cyberattack

UnitedHealth Group hopes to restore Change Healthcare’s electronic payments systems by March 15 and its medical claims platform the week of March 18.

MPath Health Raises $1.1 Million to Improve Cancer Screening and Save Lives

MPath, an automated cancer screening technology startup that got its start at Wake Forest University School of Medicine, announces $1.1 million in new funding.

Emory Healthcare transforms clinician access to health records with Epic and MacBook Air

Emory Healthcare goes live on Epic on MacBook Air via Epic’s just-announced native Hyperspace app that is available in the Mac App Store.

VA, DoD launch new EHR at joint site — a major milestone for each agency’s rollout

DoD goes live on Oracle Health in the Lovell FHCC that it operates in conjunction with the VA.

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