News 10/4/19

Top News

Not to be outdone by Amazon, Walmart announces it will pilot several programs across the country to connect its employees to healthcare services that it hopes will offer quality care at more affordable prices.

Featured Provider programs in Arkansas, Florida, and Texas will incentivize employees to use physicians in their areas that provide appropriate, high-quality care. Health data aggregator and analysis vendor Embold Health (the brainchild of former Walmart Care Clinics CMO Daniel Stein, MD) will provide Walmart with data it will use to create lists of physicians that the company will share with employees. Those who wind up seeing a provider not on the list will pay more for their benefits.

The company will try out a Personal Healthcare Assistant concierge service that will help employees in the Carolinas find providers, deal with billing, understand diagnoses, and find transportation and childcare.

Walmart has tapped Doctor on Demand, Grand Rounds, and HealthScope Benefits to offer employees in Colorado, Wisconsin, and Maryland expanded telemedicine visits at $4 a pop, as well as the option to access care coordination services.

Reader Comments

From PizzaSlinger: “Re: Adventist’s Cerner contract. Adventist Health West Coast is ending the contract with Cerner RevWorks after only 2 years on 11/4. Work will revert back to Adventist and employees have option to convert to Adventist at same pay rate. If employees do not convert they will lose employment on 12/1. Huron is taking over management functions as well. Around 300 employees are affected.” PizzaSlinger’s numbers line up with those of the Kansas City Business Journal, which reports that 360 Cerner staffers will be impacted by Adventist’s decision. At least half of those probably came over from Adventist when the health system started outsourcing jobs last year.

From SoftwareSavvyShrink: “Re: Appriss Health’s acquisition of OpenBeds. I found it interesting that you highlighted the Appriss Health acquisition of OpenBeds software aimed at helping connect behavioral health patients with inpatient and outpatient care. This is a prime example of a technological workaround to a system defect. No matter how good the software is, it’s unlikely to solve the underlying problems, which are:

• Insufficient numbers and erratic geographic distributions of beds for inpatient psychiatric and substance use disorder treatment.
• Insufficient supply (and erratic geographic distribution) of psychiatrists and other mental health professionals to provide outpatient care and even smaller numbers of treatment programs for substance use disorder treatment.
• Insurance reimbursements and utilization review practices that cause many of the existing mental health professionals to avoid taking insurance altogether (including Medicare and Medicaid, so don’t hold out hope for single payer).
• Fragmentation of mental health services and no mandated accountability so that no one is interested in treating individuals with the most severe disorders or the most complex comorbidities (and value-based care and other performance measures make challenging patients even more challenging to treat without losing money).

Even the best software won’t solve issues of inaccurate information on bed availability and a lack of ability to predict discharges.

Hospitals tend to keep a bed open for their own services (ED or transfers from medicine) and are more reluctant to accept transfers from other hospitals because you often don’t get the full story on the patient from the referring hospital. (The person who’s ‘totally straightforward, has great insurance and their own house’ has multiple medical issues, doesn’t want to take medications, has been filing false complaints to the police, has already reached the coverage limits of their great insurance, and has a home but it’s in foreclosure.)

We had a software system almost 30 years ago to track available inpatient beds in our county but it was never very helpful because we couldn’t get accurate data on bed availability. And getting data on outpatient appointment availability was even more challenging.

The best system that I’ve ever seen for mental health referrals was the one we used 35+ years ago. Our region was divided into catchment areas and every catchment area had a designated community mental health center, an affiliated primary psychiatric hospital, a backup hospital, and a corresponding state hospital. We didn’t need any complicated processes or insurance authorizations. The psych resident on call carried a 1/4 inch bound volume known as ‘the magic book.’ If a patient needed referral, you looked up their address in ‘the magic book’ and learned their catchment area. You either gave them the number of the outpatient service for that catchment area, which was obligated to provide mental health or substance use treatment. Or you called the hospitals in sequence. It was never more than three calls and if they had a bed, they took the patient. If the other one (or two) hospitals had no beds, the patient was automatically accepted at the state hospital.

Unrelated to OpenBeds but related to substance use treatment, the Google Doodle on October 1 honored Dr. Herb Kleber, a pioneer of evidenced-based treatment of substance use disorders and an all-around-incredible person.”

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor StayWell. The Yardley, PA-based health empowerment company enables providers everywhere to improve health outcomes using the science of behavior change. Its patient education and marketing solutions inspire change, improve outcomes, and create loyalty. Providers use its digital, video, and print educational materials for 80 million patients each year, with outcomes that have been proven in 120 peer-reviewed studies. Its Krames On FHIR solution — available in Epic App Orchard and Cerner App Gallery – delivers personalizable patient education directly into the clinician’s EHR workflow for the specific patient’s profile and encounter, allowing users to tag their favorite tools, organize folders, search by keyword, and filter by age and gender. Thanks to StayWell for supporting HIStalk.

Webinars

None scheduled in the coming weeks. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

22C Capital joins Advent International and Spectrum Equity as an investor in health data marketing and research firm Definitive Healthcare’s recapitalization, first announced in June.

Defense lawyers for former Theranos CEO Elizabeth Holmes and former president and COO Sunny Balwani insist the prosecution is refusing to turn over documents that would clear the pair of any wrongdoing. The attorneys contend that documents from the FDA and CMS are vital to refuting allegations that the pair knew Theranos blood tests were inaccurate and that they lied to investors, partners, physicians, and patients. The Theranos saga will continue on November 4, when all parties are expected back in court.

Sales

• The Texas Health Services Authority selects Audacious Inquiry’s Emergency Department Encounter Notifications and Encounter Notification Service care coordination technology.

People

Mathew Gaug (Lima Memorial Hospital) joins Memorial Hospital and Health Care Center (IN) as VP and CIO.

Diameter Health names Terry Boch (Machinify) chief commercial officer.

Announcements and Implementations

In New Hampshire, GraniteOne Health system will leverage Dartmouth-Hitchcock Health’s Epic software and telemedicine expertise once their merger is approved.

The George Washington University Hospital in Washington, DC implements new software that combines care coordination and communication software from TransformativeMed with clinical decision support from Crossings Healthcare Solutions.

Meditech will offer EHR software on Google Public Cloud, starting with its Meditech-as-a-Service subscription model. Google Cloud will also work with the company to develop native cloud products and corresponding APIs.

North Memorial Health (MN) will connect its Epic system to the state’s AWARxE PDMP, developed and managed by Appriss Health, next month.

Porter Medical Center, part of the University of Vermont Health Network, will go live on Epic November 1.

Other

ProPublica digs into the steps Newark Beth Israel Medical Center (NJ) took to keep a heart transplant patient alive for one year in order to avoid being penalized by federal regulators who could potentially shut the transplant program down. A leaked recording of a meeting of hospital administrators found that some found the situation unethical given the patient’s vegetative state and a lack of communication about palliative care with his family; but most ended up agreeing that the patient would “take one for the team” to help the transplant program survive.

Sponsor Updates

• Engage and Gevity Consulting partner to expand their services across Canada.
• Elsevier Clinical Solutions, Ensocare, Healthwise, and Imprivata will exhibit at CHC 2019 October 7-9 in Kansas City, MO.
• EClinicalWorks will exhibit at the Georgia Primary Care Association conference October 9-11 in Alpharetta.
• Glytec congratulates customer Sentara Healthcare for achieving Magnet status at its Virginia Beach General Hospital.
• Phynd becomes a member of the CHIME Foundation.
• CoverMyMeds will sponsor and exhibit at the IPatientCare National User Conference October 18-19 in Cincinnati.
• CB Insights includes Kyruus, Redox, MDLive, PatientPing, and TriNetX on its list of 150 digital health startups redefining the healthcare industry.
• Experity launches a new website to serve as the one-stop-shop for urgent care businesses.
• Meditech announces its support for Health Records on iPhone.

Blog Posts

• CMS Issues Final Payment Rules for 2020 Payment Models: What You Need to Know (Ensocare)
• Insights from the Field: Delivering Value with FormFast (FormFast)
• 5 Keys to Ensuring the Success of Your Healthcare Technology Company (Get-to-Market Health
• Change Healthcare: Building an API marketplace for the healthcare industry (Google Cloud)
• Experiencing Healthcare Excellence When I Needed it the Most (Impact Advisors)
• “Expanding Boundaries. Removing Barriers.” – Six Takeaways from ATLAS 2019 (Kyruus)
• Planning for Successful EHR Training (Optimum Healthcare IT)
• Pause to Consider: Patch Management (Fortified Health Security)

Contacts

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