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April 29, 2021 News 11 Comments

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Clinical communications and workflow platform vendor Vocera announced after Thursday’s stock market close that it will acquire PatientSafe Solutions, which offers a unified inbox of messages, alerts, and notifications that is integrated with EHR data.

Reader Comments


From Descension: “Re: Ascension. EHR is the latest to be outsourced, but not the last. Best part is that they told us they are doing it to help the poor and vulnerable, not to save money. Is it time for me to find another career since it’s tough all over and outsourced offshore health IT is the future?” I’ll invite readers to weigh in on that latter question. I honestly don’t know. While it seemed inevitable, absent major user pushback, that most technical support would be shifted to cheaper offshore providers, I wasn’t so sure about specialized areas such as EHR support. The pessimistic view is that the old saying was right – if your job doesn’t involve touching something, plenty of people outside the US would be thrilled to do it cheaper and maybe even better. Ascension is running a billion-dollar quarterly profit as its contribution to the US’s world-leading healthcare costs that make our workforce non-competitive in the first place. On the other hand, sometimes health systems that are looking for “one neck to wring” elect to indeed wring that neck by insourcing everything back in-house down the road.

From Cond-Ascension: “Re: Ascension. Has outsourced IT, starting a while back with contact center and desktop support, now all application and EHR support. EHR support is considered a non-strategic commodity to Ascension now. Folks are being asked to stay until August, where they will probably need to apply for jobs to earn severance. Ascension allows a 10% pay reduction as a suitable offer when a role is eliminated. Tons of great talent will be flooding the market.” Anyone who is looking for Epic people should pay attention.

From CIO: “Re: VisuWell firing their CEO. The actions of the former CEO were obviously atrocious on any number of levels, but VisuWell did everything a company could do. The acting CEO and board chair got on the phone with the CMIO and me to make sure we understood what they were doing, then followed up yesterday to make sure we had everything we need and were completely understanding about us taking any action we thought we needed to. I can’t think of anything else they could have done short of inventing a time machine. We aren’t changing our relationship with them, and in fact chose them initially because we felt they were a better fit in dealing with a diverse patient population than some other vendors.”

From We Aren’t the Champions: “Re: WaitButWhy. What do you think about its most recent post? It seems like an overly optimistic exercise to get something like this off the ground, especially in the US, much less to have it succeed for the long term. I’m in Canada and there’s no chance of provinces paying for comfy chairs or coffee in the waiting room.” The article, which is titled “Why going to the Doctor Sucks,” calls out limited appointment times, unfriendly front desk employees, making patients write the same information on the same clipboard forms every visit, and doctors running behind and shortchanging patients whose appointment is late in the day. It concludes that in the US healthcare non-system, patients aren’t treated like customers because they actually aren’t customers, so cold interactions and indifferent waiting areas echo the DMV or post office. The author’s wife and a friend (non-physicians) decided to start a $2,400 per year, no-insurance primary care club in which members are assigned a doctor, a wellness advisor, and a concierge coordinator. My thoughts:

  • I already have this concept covered in my direct primary care doctor’s practice. I pay $75 per month to have direct access to her at all times (phone, mail, text, video, etc.), appointments are quickly available and booked for 30 or 60 minutes of uninterrupted time, in-office lab testing is included, she can provide prescription medications at cost, and simple procedures carry no extra charge. These no-charge extras save enough of my deductible alone to more than cover her annual fee.
  • I keep my health insurance  to cover specialists, ED, hospitalization, etc. that might come up, of course, but I haven’t seen a PCP using my insurance for several years. 
  • I don’t know what my doctor’s waiting room looks like because I’ve never seen one. She meets me at her office’s front door, we walk to the exam room, and we talk face to face with no keyboard between us. I’m the customer, so she will provide advice on whatever I need – exercise, stress, and diet are listed on her website. But she won’t just prescribe something because I ask for it (I don’t ask because I don’t like taking meds unnecessarily, but she made that clear upfront).
  • Quite a few investor-backed companies are placing big bets on practices – both general primary care and specific to Medicare beneficiaries – that feature better creature comforts, a more customer-friendly environment, and more convenient access.
  • These models are better for the doctor, who doesn’t need to jam their schedule full, practice substandard but profitable medicine, bow to corporate overlords like health system executives and insurers, and get stuck with patients who just want drugs. You can do the math – if my doctor has 500 members, she takes in maybe $40,000 per month of all-recurring revenue (cost varies by age), has minimal overhead, and can use just the tiny portion of EHR functionality that actually benefits the patient and her. She has to be careful about patient mix since having all Medicare-aged patients could require too much work, but she is allowed to set her panel any way she wants.
  • Here’s the beauty of the screwed-up system we have. Neither patients nor doctors like it and it is so wastefully expensive that it it’s easy to find enough cost savings in a new model so that neither pays more. Those corporate overlord middlemen I mentioned are bureaucratically inclined and thus ripe for disruption, and while the cash-only membership system excludes those who don’t have the resources to pay on their own, it assures equal treatment among those who do (and leaves assistance programs for those who need them most). Our suits-to-scrubs ratio makes fat-trimming easy.


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Acquisitions, Funding, Business, and Stock


UK-based Halma acquires perinatal safety technology vendor PeriGen. Halma, which operates many brands in the safety, environmental, and medical sectors, acquired healthcare location services vendor CenTrak in early 2016 for $140 million.


Allscripts announces Q1 results: revenue down 3%, adjusted EPS $0.19 versus $0.02, beating earnings expectations but falling short on revenue.

Castlight Health announces Q1 results: revenue down 10%, adjusted EPS $0.01 versus –$0.01. CSLT shares are up 140% in the past 12 months versus the Dow’s 40% rise, valuing the company at $288 million.


Surgery analytics vendor Caresyntax raises $100 million in a Series C funding round.

CVS Health launches a $100 million venture fund that will invest in early-stage companies that are “focused on making healthcare more accessible, affordable, and simpler.” The company cites previous success in its direct investments, such as Unite Us and LumiraDx.


Shares of national medical group and practice support technology vendor Privia Health closed Thursday with an IPO-day share price jump of 51%, valuing the ownership stake of parent Brighton Health Group at $2.75 billion. CEO Shawn Morris holds shares worth $144 million.

Online pharmacy operator Capsule raises $300 million in a funding round that values the company at more than $1 billion. The pharmacy fills and delivers prescriptions in six cities.


  • Orange County, NC selects Everbridge’s vaccine distribution platform.
  • UK’s Guy’s and St. Thomas NHS Foundation Trust will use Nuance Dragon Medical One to support its Apollo service transformation project, integrated with Epic.
  • Cigna will offer virtual mental health services to its behavioral health members from Ginger, of which Cigna is an investor.
  • Seattle Children’s moves its Epic system to the healthcare cloud of Virtustream, which is owned by Dell Technologies.
  • American Health Communities will implement live video consults for residents of 28 skilled nursing facilities in Tennessee using videoconferencing, live bio-analytics, and instruments from Let’s Talk Interactive.



Tonya Hongsermeier, MD, MBA (Lahey Health) joins Elimu Informatics as VP / chief clinical innovation officer.


NTT Data hires Michael Petersen, MD (Accenture) as chief clinical innovation officer.

Announcements and Implementations


Omnicell’s EnlivenHealth division will use Twilio’s customer engagement platform to expand its retail pharmacy offerings that include personalized communication by IVR, texting, chatbots, email, and a mobile app.


AHIMA creates DHealth, a catalog of digital health products whose developers have attested that they meet security and privacy standards. 


The US Army’s General Leonard Wood Army Community Hospital (MO) goes live with MHS Genesis / Cerner, the first facility to use the system for in-processing of newly arrived trainees. Above is Major Cynthia Anderson, chief nursing information officer, overseeing use of the mass readiness module that was developed for military medicine and is used at GLWACH to process 100 trainees per hour.

A small interview-based study of VA facilities looks at why timely follow-up on abnormal test results doesn’t always happen:

  • Rotation of medical residents, who may be sent results after they have left.
  • Lack of ownership of secondary findings.
  • Providers ignoring or not seeing EHR alerts with no standardized follow-up defined.
  • Lack of current contact information on file for the patient.
  • Communications breakdown caused by referrals to another facility.
  • Providers covering for each other.
  • Uncertain responsibility for reviewing results that were pending on discharge.


A new, small study finds that COVID-19 vaccines manufactured by Pfizer and Moderna are 94% effective in reducing COVID-associated hospitalization of those who are over age 64.

California’s COVID-19 case rate is now the lowest in the country.

Some experts say that President Biden missed a chance to reduce vaccine hesitancy in his Wednesday address to a joint session of Congress, where audience members were spaced, masked, and asked not to make physical contact. A better approach, some say, would have been to allow only vaccinated attendees and then permit them to behave in a 2019-like manner to send the message that vaccination can end the pandemic and return life to normal.

Pfizer expects to release a protease inhibitor for experimental use in treating early-stage COVID-19 by the end of the year, potentially keeping people with early symptoms out of the hospital.


The Public Health Company — which will advise businesses, providers, and public health organizations on public health issues using data, containment best practices, and genomic epidemiology – launches with an $8 million seed funding round. Its scope includes, beyond COVID-19, healthcare-acquired infections, antimicrobial-resistant infections, and foodborne infections. The co-founders are a California public health physician executive and a former Goldman Sachs partner. The business case involves the cost of avoidable business interruption, including supply chain and labor issues.


A University of Missouri study finds that nurse workload is doubled when patients are seen in virtual visits rather than in-office appointments, as nurses have to review, document, and act on blood glucose and blood pressure readings multiple times each week instead of the average in-person visit frequency of every three months.

China’s government is considering allowing prescription drugs to be sold online, which a state-controlled magazine says is a warning shot to public hospitals that profitably overprescribe drugs, including IV drips and antibiotics. The article notes that the government tried to fix the problem in 2017 by mandating that doctors and hospitals sell drugs to patients at their cost, but the providers wormed around that requirement by manipulating cost data and retaining rebates. The country does not have a system to make prescriptions universally accessible and Internet-based sales raises issues of prescription authenticity and supply chain safety. 

Sponsor Updates

  • Medicomp Systems releases a new “Tell Me Where It Hurts” podcast, “Reimaging Healthcare Through NLP.”
  • Meditech offers a new case study, “How Meditech and Interlace Health support integrated electronic patient consent.”
  • KLAS recognizes GetWellNetwork as a top-performing vendor for COVID-19 response.

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Currently there are "11 comments" on this Article:

  1. I have experience with Dell off-shored health IT staff. All I can say is that you get what you pay for. If you want to pay 1/4 for folks that really don’t understand what you are getting at, then re-do it, because of said lack of comprehension, then it’s a good model. Half my job is interpretation between clinicians that have needs but don’t really “get” the system, and the techies who can’t grasp why solution XYZ won’t fit the needs of that clinician. Add a foreign culture and language in the middle, and it’s complicated. I have given as black and white specs and directions to off-shored folks, only to find out they didn’t follow them and didn’t understand what they were to even do…and because they are off-hours, so have to wait another 24hrs to get it back. If I’m supposed to dumb down specs, or spend considerable time with them to get them to do the basic things (above what I would for an internal US employee), you are wasting my time and skills.

    Besides, I have personal distaste for any company that off-shores to save a buck, instead of investing in the USA and it’s workers. If I had power to control consulting dollars, I would find a local company.

    • My job involves taking this black&white spec to skilled IT staff and get it developed. A fucking whole army of useless Indian management who r paid heavily by usa management did not let me do my job correctly. I get wat u want but sadly ur employer pays my manager 5 times my salary to make it impossible for me to do my job.
      Don’t blame dell staff . Blame ur management who pays the Dell offshore managers big bucks.

      • Why not blame both? Shame on the client who mistreats their employees, and shame on the consultants who run away with the funds without providing quality work.

        • The same logic applies to most healthcare it vendors as well. Low quality work at a high price for poorly managed, fat pocketed customers. Actually applies to most US white collar workers now that I think about it.

    • The outsourcing thing has been going on since the 1990’s.

      At a certain point, I realized the following: The management doing the outsourcing, they are approaching this at a simplistic, finance-driven level. The thinking seems to be this: “Fine, the foreign outsourcer isn’t as good. Who cares? We are paying 1/4 the price! Just double up on the outsourcing analysts, and we are still only paying 1/2 the price.”

      Which is fine, I guess, except what if doubling up on the analytical talent still isn’t enough? What if tripling up, or quadrupling up isn’t enough? What if the foreign outsourcers never “get it”? What if they flatly don’t have the talent required, or the various barriers that exist, are too difficult to bridge?

      For any remaining staff on-shore, and particularly if you either have some responsibility for the outsourcing relationship, or if you simply care about the customers? It can be very hard to watch.

      • Very hard indeed. Local India management – says NAans want the job we got for u. NA employees may not support u in ur work but we support u. Just show up do some work. Rest we – India management will manage. U will get ur raise.
        So sick to experience. All top IIM /IIT graduates speaking like this.

      • How do these Mahindrans get their certs? Can they take Epic courses online? Or are they just trained by the PT/CTs and told to figure it out?

        Is this for all projects or just support? What happens at upgrade time? Are we talking no on-site visits? This seems short sighted but I’m sure it’s great for the bottom line.

      • The clearest example of this is from a friend who bought a washer and dryer set from Sears, about 10 years ago. He needed to change the delivery date. His call to Sears was sent to India. The person receiving the call could not quite comprehend what the buyer was trying to do. He used the word “cancel”, and the Sears person comprehended that, and canceled the entire order. Friend was livid, went to Sears store in person (when they existed) and ended up getting one of the items for free. So yeah…giving away a free appliance every day is still cheaper than paying American workers, is the corporate thinking. Although the savings did not help keep Sears alive, so there’s that lol.

        • I had a very interesting experience with outsourced support. This was 20+ years ago.

          We had a printer that was mangling print jobs. There was an AS/400 involved and I worked very hard to not discuss that fact (the complexity would have scuppered the whole support case).

          So I watched, as foreign tech support slowly, painfully worked through an obviously scripted support performance. Eventually they hit the end of the road and the problem wasn’t fixed.

          That was when I finally intervened. I told the tech, “what you have done was necessary, but it was not sufficient.”

          The tech got all defensive. “What have we not done Sir? Tell me! We’ve done everything!”

          “No”, I said, “You haven’t. How do you know it’s not the print driver?” This was the subject I had been waiting all along, to address. You see, the printer manual (which I had searched), didn’t list the various OTHER printers, that the printer in question could emulate.

          It was like a light bulb went on in tech support’s head. “Oh, print drivers!” Immediately, the tech started rattling off compatible drivers. The first alternate we tried worked perfectly.

          But I had to let the Tech work right through to the end of their script. It’s only when they hit a wall and can go no further, that they are ready to entertain off-script ideas.

      • Similar finance-driven decisions are made not only for support, but also for the building of software at your vendor. The more mature the product, the more likely that offshoring the build might actually result in cost savings. In the startup world, it never works because the instantaneous iterative nature of early-stage software development can’t survive the communication barriers.

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