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Monday Morning Update 12/5/22

December 4, 2022 News 4 Comments

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Healthcare consumer engagement company Carenet Health acquires Stericycle Communication Solutions, which offers online scheduling, automated messaging, and call center services.

HIStalk Announcements and Requests


I could be convinced to change my “most important winter holiday” order of importance after reading a poll comment from Cyrus about Yalda. Yalda celebrants, most of them in Iran and nearby countries, observe the winter solstice (December 21 this year), the last day of autumn and the longest night of the year, after which hours of daylight start increasing again. People stay up all night, eat watermelon and pomegranates (their glowing colors symbolize dawn and life), read poetry, and dance and play drums when the sun rises in a triumph of light over dark. Yalda means “birth.” I like it even beyond my personal obsession with changing hours of daylight — nobody is excluded or favored since the same sun shines down on us all, although I suppose folks in the Southern Hemisphere would need to buy their Yalda pomegranates in June. 

New poll to your right or here: As a patient, would you be OK with your provider billing you personally for the time they spend answering clinical questions via patient portal or email? My immediate response to my own question was that of course professionals should charge me for their time that I consume voluntarily, regardless of the modality by which it is provided, but healthcare is different – will they tell me in advance that the clock is running, aren’t they already charging me ridiculously high prices without having to nickel-and-dime me over portal messages, will they bill only for new clinical work and not administrative questions or follow-up inquiries triggered by their lack of clear explanations, and should I be paying cash when I have insurance?


Welcome to new HIStalk Platinum Sponsor Bardavon. The Overland Park, NS-based company partners with employers to optimize their employees’ musculoskeletal health with both preventative and post-injury solutions offered at work, in clinic and at home. Bardavon differentiates from digital-only players by combining a hybrid approach to MSK optimization that is bolstered by a nationwide network of 25,000 physical and occupational therapists who are focused on the holistic health of the American worker. Bardavon’s unique focus on an often-forgotten subset of the worker population, those who do the manual labor in America, positions them in a unique category as they launch into the commercial sector with a focus on a complete offering enabling both healthy and injured employees as they work to optimize their movement health resulting in positive, long-time health benefits for both the employees and the employer. Thanks to Bardavon for supporting HIStalk. Thanks also to the company and long-time HIStalk reader SVP/GM Alex Benson (who worked for Cerner for many years) for making a generous donation to my Donors Choose project this past April that fully funded 41 teacher grant requests.


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

Acquisitions, Funding, Business, and Stock


Atrium Health and Advocate Aurora Health complete their merger to form Advocate Health, now the country’s fifth-largest health system with 67 hospitals, 1,000 sites of care, 150,000 employees, 21,000 physicians, and 42,000 nurses.


Advanced primary care services and technology vendor UpStream Healthcare raises $140 million in a Series B funding round, increasing its total to $185 million.

Investor-backed mental health startups – some of which were formed to exploit COVID-relaxed prescribing rules — failed to disrupt mental healthcare, Business Insider concludes, because they spent too much on advertising to attract patients and found that the direct-to-consumer model doesn’t work well because patients aren’t willing to pay. A former provider for Cerebral, which is best known for generating many prescriptions for Adderall and Ritalin, says she was allowed to spend just 15 minutes every three months with each patient.


  • Dayton Children’s Hospital will implement VisiQuate’s Denials Management Analytics and Revenue Management Analytics solutions.

Announcements and Implementations

I rarely mention open positions, but CHIME has an interesting one for director of innovation that does not require relocation.



A Washington newspaper describes the chaos at St. Michael Medical Center during a weeks-long ransomware downtime that affected parent organization CommonSpirit Health:

  • Staff could not access Epic, so switching to paper – by many employees who have never charted manually — caused ED and ambulance backups and caused an overwhelmed ED nurse to call 911 for help.
  • Employee timekeeping system caused payroll problems that still haven’t been fully resolved.
  • Staff had to take the word of patients about their meds, allergies, and recent procedures, even those who were probably not reliable.
  • Medications were dispensed without pharmacist oversight.
  • Patients were found in the ED waiting room who weren’t on their list to be seen.
  • Staff treated “scoop and run” patients who were brought in after incidents in assisted living without knowing their code status, intubation preferences, or if they wanted their families to be called.
  • Complaints that have been filed with the Department of Health claim that the hospital didn’t provide safety checks while Epic was down, allowed ED capacity to be exceeded by not allowing diversion, and required two hours or longer to provide lab and imaging results. One complaint says that routine labs for ICU patients took longer than 13 hours and stat labs weren’t reported for up to five hours.

A ProPublica investigation finds that publicly traded hospital operator Universal Health Services has pocketed $38 million in Washington state taxpayer funds over five years for running special education day schools in which underpaid, poorly trained employees taught students without a published curriculum and sometimes isolated and restrained them. The state paid annual tuition of $68,000 to $115,000 per enrolled student. Experts say that UHS, which earned $1 billion in profit last year, is one of several investor-funded companies that have targeted private special education and autism services because the revenue is steady and publicly funded.

Cardiologist Eric Topol, MD covers “medical selfies” in which he used a smartphone-based ultrasound device whose instructions came from YouTube. He says that US healthcare provides no incentive for using the devices because providers make money from traditional sonographer studies, but the technology is being used in other countries. He also notes the recent contribution of AI that allows anyone to perform a screening echocardiogram as guided by the app.

Police arrest a 72-year-old hospital inpatient in Germany who turned off the “noisy” oxygen machine of her room’s other occupant several times, requiring that patient to be resuscitated and moved to ICU.

Sponsor Updates

  • Premier’s Pinc AI Applied Sciences Division publishes a new study in Wolters Kluwer’s Journal of Wound, Ostomy, and Continence Nursing, “Characteristics, Hospital Length of Stay, and Readmissions Among Individuals Undergoing Abdominal Ostomy Surgery: Review of a Large Healthcare Database.”
  • Sectra publishes a new case study featuring St. Maria General Hospital, “How to save time on implementation while creating brilliant workflows.”
  • Volpara Health customer Virginia Mason Medical Center presents the results of the largest mammographic image quality evaluation to date, “Reduction in technical repeat and recall rate after implementation of [Volpara Health’s] artificial intelligence-driven quality improvement software.”
  • TigerConnect appoints former Cooper University Health Care CEO Adrienne Kirby to its board.
  • Wolters Kluwer Health adds a medication tray management solution to its Simplifi+ Compliance Suite.
  • Vyne Medical publishes a case study, “Refyne Connected Care Supports Virtual Collaboration among Montana Pediatricians.”

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Currently there are "4 comments" on this Article:

  1. I live in NE Ohio and have had mixed thoughts on Cleveland Clinic’s announcement that they will start charging for patient portal messages. On the one hand, of course I think that people should be paid for the time they work. But are providers really paid hourly? If they’re paid salary like me then you get a salary based on the work you’re expected to do, and it’s up to you to identify when to complete the work. Of course, we hear constantly about physician burnout and how charting and responding to patient messages adds to this burnout.

    On the other hand, as Mr. H outlines above, what type of transparency will be provided to the patient about the costs for the patient portal messages? Given the lack of transparency I experience as a patient today, I can’t imagine that there will be a level of satisfactory transparency or give the patient options to pay directly for a quick message instead of billing my insurance.

    On the other other hand (my foot I guess?), I am currently a healthy person, my PCP isn’t affiliated with Cleveland Clinic, and I’ve only gone there for some lab work and a mammogram. But their announcement was enough for me to start considering using one of the other two big hospitals in the area in the future. Of course those hospitals will also start charging for patient portal messages, so I’ll be back to square one. I have found Dr. Jayne’s articles talking about the physician experience and patient portal messages to be thoughtful and thorough, covering the nuance that I don’t get to see as the patient. So while I don’t have a satisfactory answer yet, I feel that I’ve at least had some solid education on all that’s involved in responding to these messages and the importance of placing a value on the physician’s time.

    • I may have missed it, but did the Cleveland Clinic announcement make it clear that they plan to bill patients directly? I think the announcement was vague enough so that it could mean that CC will be negotiating with insurance providers to get paid for patient portal messages.

      • “Drop charge, submit claim, see who pays, write off anything that would otherwise reach patient financial responsibility,” is not a stable equilibrium. No payer will for long be the chump who pays for a service that would be offered to its membership without charge if the payer declines coverage.

      • No, their message talks about billing the insurance company. Actually, they say that most messages will be free, but responses that take more than 5 minutes to respond to will be billed to the insurance company. But that will eventually just come back to me as the “owner” of a high-deductible plan and next year in higher premiums.

        But I think back to Dr. Jayne’s write-ups on what’s actually involved in answering those messages and surely some level of reimbursement should be expected? Paying directly instead of via insurance for a few one-off messages might be easier.

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  1. Part of my attitude relates to an experience I had. And this was within a single HIS. I wanted to…

  2. For what it's worth, the VA currently releases C-CDA (or HITSP C-32...my memory fails me) via eHealth Exchange and has…

  3. Unfortunately, I can't disagree with anything you wrote. It is important that they get this right for so many reasons,…

  4. Going out on a limb here. Wouldn't Oracle's (apparent) interoperability strategy, have a better chance of success, than the VA's?…

  5. Dr Jayne is noticing one of the more egregious but trivial instance of bad behavior by allegedly non-profit organizations. I…

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