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June 22, 2023 News 1 Comment

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Tennessee Attorney General Jonathan Skrmetti requests information from Vanderbilt University Medical Center that includes patient referrals, email records, and copies of W9 and 1099 forms that detail its payments to physicians. His office is investigating possible billing fraud related to VUMC providing gender-affirming services to people who are covered by state insurance.

Tennessee law does not require the attorney general to obtain a subpoena or court order to compel VUMC to provide the requested information, although HIPAA supersedes state law.

VUMC has already provided the medical records of a list of specific patients that the AG provided from unspecified sources. VUMC notified those patients months after the fact.

Skrmetti said last fall that he would investigate VUMC after a political commentator claimed on social media that the hospital had punished employees who don’t agree with its gender-related treatments, which VUMC denied. A new Tennessee law takes effect on July 1 that criminalizes the provision of gender-affirming services to minors.

An updated statement from the AG’s office says that it launched an investigation almost a year ago, when it says a VUMC doctor publicly stated that she was manipulating billing codes to bypass insurer coverage limitations on gender-related treatment.

The AG’s office says it was surprised that VUMC recently notified patients, adding that it has no desire to turn a fraud investigation into a “media circus.”


Reader Comments

From Sebum: “Re: NEJM article. Extraordinarily good piece.” A perspective article titled “Ellipsis” by CU Medicine hospitalist Samuel Porter, MD describes the disconnect of receiving texted questions and requests from other caregivers that he mostly doesn’t know, where pager messages that were a “faceless voice” have progressed to phone messages that are a “voiceless face” of avatars. He says, “My avatar stretches its influence across a vast complex of specialized structures to dictate care from its pixelated mouthpiece.” He says that hospital physical sprawl and time pressure don’t allow seeing the patient directly, so the only constant is his computer, and the measure of his day’s work is counting icons rather than seeing facial reactions. It’s interesting to think about practicing medicine without even the visual feedback of a video visit, and I’m picturing doctors sitting in dark rooms “processing” requests and orders like a video gamer shooting aliens for dopamine jolts.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Linus Health. The Boston-based digital health company is dedicated to transforming brain health for people across the world, with a focus on Alzheimer’s and other dementias. By advancing how we detect and address cognitive and brain disorders – leveraging cutting-edge neuroscience, clinical expertise, and artificial intelligence – the company’s goal is to enable a future where people can live longer, happier, and healthier lives with better brain health. Its digital cognitive assessment platform provides a proven, practical solution for early detection; empowers providers with actionable clinical insights; and supports individuals with personalized action plans. The company is proud to partner with leading healthcare delivery, life sciences, and research organizations to advance cognitive care. Visit its website to learn more about its practical solutions for proactive brain health. Thanks to Linus Health for supporting HIStalk.

Here’s a Linus Health explainer video that I found on YouTube.


Webinars

July 12 (Wednesday) 2 ET. “101: National Network Data Exchanges.” Sponsor: Particle Health. Presenter: Troy Bannister, founder and CEO, Particle Health. It’s highly likely that your most recent medical records were indexed by a national Health Information Network (HIN). Network participants can submit basic demographic information into an API and receive full, longitudinal medical records sourced from HINs. Records come in a parsed, standardized format, on demand, with a success rate above 90%. There’s so much more to learn and discover, which is why Troy Bannister is going to provide a 101 on all things HIN. You will learn what HINs are, see how the major HINS compare, and learn how networks will evolve due to TEFCA.

July 27 (Thursday) noon ET. “Why You Shouldn’t Wait to Use Generative AI.” Sponsor: Orbita. Presenter: Bill Rogers, co-founder, president, and chairman, Orbita. The advent of generative AI tools truly represents a paradigm shift. And while some healthcare leaders embrace the transformation, others are hesitant. Invest 20 minutes to learn why you shouldn’t wait. When combined with natural language processing, workflow automation and conversational dialogs, generative AI can help leaders address a raft of challenges: from over-extended staff, to the rising demand for self-service tools, to delivering secure information to key stakeholders. You will learn where AI delivers the greatest value for providers and life sciences, how it can solve critical challenges faved by healthcare leaders, and how Orbita has integrated generative AI into its conversational platform so healthcare leaders can leverage its full capabilities safely and securely.

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


Acquisitions, Funding, Business, and Stock

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Outbound AI, which sells virtual agent technology for healthcare revenue cycle management, raises $16 million in a seed funding round.

Real-world data company Verana Health launches a subscription-based tool to help ophthalmology-related clinical trial sponsors and contract research organizations find potential trial sites.


Sales

  • University Hospitals will implement Nuance’s patient engagement solutions, including virtual agents and AI-powered call routing.

People

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Chilmark Research founder and CEO John Moore died Wednesday after a long battle with cancer.


Government and Politics

VA officials say despite last week’s layoffs in Oracle’s Cerner business that may have been driven by the VA’s own stalled implementation, it expects the company to provide the talent and expertise that is needed to fulfill its contractual commitments.


Privacy and Security

UK physician groups urge NHS England to pause its tender for a $600 million contract for a federated data platform, predicting that nearly half of NHS patients will opt out if the government choose analytics firm Palantir – which has ties to US security agencies – as its vendor. They propose alternatives based around the open source platform Open Safely and OneLondon, which they say are more transparent. Meanwhile, Palantir – which the physician groups say spending big dollars on lobbying to win the bid – is awarded a 12-month, $32 million contract to transition existing NHS projects into the new platform, which critics say raises concerns about the procurement program’s transparency and scope.


Other

A NBC News investigation finds that publicly traded hospital operator HCA Healthcare used an algorithm to identify hospitalized inpatients who were likely to die, then pushed them into palliative or hospice care to improve hospital performance measures that are tied to executive bonuses.

ChatGPT passes a simulated clinical informatics board examination, raising questions about the future of unproctored, at-home certification testing.


Sponsor Updates

  • CereCore publishes an e-book titled “Technical Debt and the Patient.”
  • Nordic posts a podcast titled “Designing for Health: Interview with Denise Worrell.”
  • Roni Jamesmeyer, senior healthcare manager at Five9, authors an article titled “TLC, not A&E: Reducing Emergency Situations through Proactive Communications.”
  • Medhost’s Meadteam Solutions launches a security operations center for its community hospital customers.

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
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Currently there is "1 comment" on this Article:

  1. Re: NHS Palantir Contract.

    As a long-time observer of the FOSS world, I have to wonder about the UK physician groups recommending Open Safely and OneLondon.

    FOSS proponents tend to wield terms like ‘transparency’, ‘freedom’, and ‘open’ as talismans of Good. To the converts, those are unassailable merits. No argument can be made against them.

    Just witness the events in Munich, when the municipal government first adopted, and then abandoned FOSS software. The FOSS community lost it’s collective mind over that episode! Allegations of bribes were made, with absolutely zero evidence to back that up.

    FOSS is great, and I’ll happily recommend it when appropriate. Yet there are times when closed source systems are better. Likewise, for-profit companies (ie. Palantir) can make for better service & support ecosystems. Sometimes the money is exactly the issue and for-profit companies have better resources due to being better funded.

    Why darkly mention that Palantir “has ties to US security agencies”? What is the concern exactly? That Palantir will leak patient data to those US agencies? Or that doing business with Palantir is immoral?

    I’ll not suggest that such disclosures are impossible. Yet it seems to me that the NHS is a pretty responsibly run organization. They will take steps to keep their patient data safe.

    In the modern IT security environment, no one can guarantee perfect data security. It is actually unprofessional to suggest otherwise. Therefore, the data security argument is weak, precisely because it is unclear that Open Safely and OneLondon can do a better job at it than Palantir.

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