I read about that last week and it was really one of the most evil-on-a-personal-level things I've seen in a…
Monday Morning Update 11/18/24
Top News
Södra Älvsborg Hospital in Sweden pauses its use of the recently implemented Oracle Health Millennium. The regional director apologized, acknowledging that “the introduction has not gone according to plan.”
Specific user complaints include system slowness as well as displaying incorrect diagnoses, such as changing “no bleeding” to “bleeding.”
Hundreds of employees staged a demonstration to return to the old system, citing decreased efficiency and patient safety. Västra Götalands Medical Association is considering taking legal action over patient safety risks.
The previous system has been reactivated and some functions have been moved back to paper while Millennium problems are being addressed.
According to one chief physician, “It’s a lousy system that’s completely impossible to work in. These days, I’ve basically been unable to produce any healthcare.”
Reader Comments
From Lanman: “Re: AblePay. Do any readers know anything about it? My big health system says that those who can’t pay will get assistance, while those who can ‘may’ save up to 13%. Anyone know if it is legit / good idea?” The company’s website says that it contracts with providers at higher rates, provides members with cards with AblePay as the secondary payer, and guarantees that providers will be paid within two weeks of billing. Online member reviews are mixed, with one saying that it’s better to ask the hospital for a cash discount from rack rates or use the hospital’s no-interest payment plan instead of giving AblePay a credit card number that they will charge immediately. Your comments are welcome, especially if you have AblePay experience as a patient or provider.
HIStalk Announcements and Requests
Poll respondents like Madison as the US’s health tech capital. A couple of folks questioned why a Cerner-less KCMO or Minneapolis weren’t listed as choices.
New poll to your right or here: Have you taken a consumer DNA test such as Ancestry or 23andMe? Several of my acquaintances, especially older ones who were raised in different cultural times, have been shocked to find evidence of previously unknown siblings, learned that they were raised by someone who wasn’t their biological parent, or saw strong indications of being the result of incest.
I funded some new Donors Choose teacher grant requests using money that was provided by my Anonymous Vendor Executive, who is happy to offer a 1:1 match on your donation that you can submit as below. Companies that donate a matchable $1,000 will receive a couple of sentences in an HIStalk news post to convey any message they choose (a company pitch, for example).
- Purchase a gift card in the amount you’d like to donate.
- Send the gift card by the email option to mr_histalk@histalk.com (that’s my Donors Choose account).
- I’ll be notified of your donation and you can print your own receipt from Donors Choose for tax purposes.
- I’ll pool the money, apply all matching funds I can get, and publicly report here the projects I funded, including occasional teacher follow-up messages and photos.
These are the new, fully funded projects, all of which involved historically underfunded schools in which at least 50% of students come from low-income households:
- Weeding tools for the ecology club garden of Ms. M’s middle school class in Hawthorne, CA.
- Headphones for Mr. G’s elementary school class in Pasadena, TX.
- STEM kits for Ms. M’s middle school class in Moreno Valley, CA.
- Microphones and speaker for Ms. B’s elementary school math and science class in Kinston, NC.
- STEM supplies for Ms. M’s elementary school class in Seguin, TX.
- Electric car microcontrollers for Mr. P’s high school physicians and robotics classes in Brooklyn, NY.
- Math manipulatives for Ms. A’s kindergarten class in Sussex, VA.
- A voice amplifier for Mr. M’s preschool class in Dallas , TX.
- Flexible seating for Ms. H’s elementary school class in Port Saint Lucie, FL.
- An LED aquarium hit for Ms. G’s high school AP biology and environmental science classes in Savanna, GA.
A Reader’s Notes from the CommonWell Fall Summit, November 4-5, Nashville
General Overview
- Thirteen new CommonWell members in the past year (several appear to be general members rather than service adopters). The network now consists of 37,000+ providers, 248+ million individuals (primarily adults), and 9 billion health records retrieved. Currently seeing about 0.5 billion records (documents) exchanged each month.
- Labcorp is a newer member and is pushing CommonWell towards more discrete data exchange via FHIR. Labcorp will be an exception in the network in that it will only respond in FHIR format.
Product roadmap
- Individual Access Services (patients requesting their records) through FHIR is currently in testing. Will still be document-based through the exchange of FHIR DocumentReferences and Binaries.
- They have implemented passive indexing, which tracks the locations that have attempted to find a patient’s records. This gives them a sense for where the patient has been treated and, therefore, where you could go look for treatment-related records later on.
- Expecting to support the Healthcare Operations Exchange Purposes under TEFCA by the end of the year. Additional Exchange Purposes will be supported in the first half of 2025.
- Replacing their legacy Event Notification System with a new ADT & Patient Alerts framework; the latter will allow consuming systems to subscribe to updates when a patient has certain activity, such as a new link to an organization in the network.
TEFCA
- Additions to the TEFCA directory have been paused for several weeks due to concerns around vetting of participants. There is a new Vetting Process SOP coming out very soon to define a process for vetting participants, and the hope is that directory additions can resume by the end of November. (Of course, as I draft this email, the SOP is published.)
- The SOP involves a series of steps to follow, which vary based on the kind of provider being onboarded. It governs how QHINs submit a participant for inclusion in TEFCA and how other QHINs can object.
- Anyone already in TEFCA must still go through the vetting process, though they can continue to query through TEFCA while that plays out.
- Through August 2024, TEFCA has seen 486 million patient searches (this is an inflated number since each patient search hits every QHIN and therefore is counted multiple times), 4.9 million document queries, and 2.5 million document retrievals.
- In September 2024, CommonWell specifically saw 30.6 million patient searches from Epic, 547,000 from KONZA, and 12 from Kno2.
- Average response time to patient searches by QHINs varies, from as little as 40 ms to as much as 6455 ms.
Webinars
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present or promote your own.
Acquisitions, Funding, Business, and Stock
WellSky releases SkySense, AI-powered tools for its EHR sollutions that extract key information, perform ambient scribing, and summarize chart data.
Upheal, which offers a clinical documentation personal assistant for mental health professionals, raises $10 million in a Series A funding round.
Urgent care telehealth provider HealthLynked reports Q3 results: revenue down 56%, EPS –$0.01 versus $0.00. HLYK shares have lost 12% in the past 12 months, valuing the company at $11 million.
People
UT Health San Antonio promotes Michael Schnabel, MBA to VP/CIO.
Pete D’Addio, MS (Moffit Cancer Center) joins LCMC Health as VP of technology.
Announcements and Implementations
Truveta Data says that its EHR-sourced database contains the de-identified records of 120 million patients.
Government and Politics
ProPublica calls out the lax enforcement of state regulations that require insurers to keep their provider directories current. A previous New York study of “ghost networks” found that 86% of the listed mental health professionals had incorrect contact information, weren’t actually in the stated network, or weren’t accepting new patients.
Sponsor Updates
- Five9 expands its partnership with ServiceNow to deliver a turnkey, AI-powered solution combining Five9’s Intelligent CX Platform with ServiceNow’s Customer Service Management.
- Rheumatology Associates of Oklahoma reports significant time savings using EClinicalWorks AI Assistant for Images.
- WellSky adds SkySense, a new suite of AI-powered tools designed to increase operational and clinician efficiencies, to its EHR systems.
- Nordic releases a new “Designing for Health” podcast, “Interview with Graham Walker, MD.”
- CHIME honors Optimum Healthcare IT with the 2024 CHIME Foundation Partner Award.
- RLDatix will sponsor and present at the ACHE Scottsdale Cluster November 18.
- Sectra receives a CSA STAR Level 2 security certificate, facilitating cloud adoption in healthcare.
- Visage Imaging is featured in a new video titled “The Imaging Wire Show – The Road to Cloud-Based PACS.”
- SmartSense by Digi achieves SOC 2 Type II compliance.
- Sonifi Health releases a new e-book, “Reimagining Patient TVs.”
- TrustCommerce, a Sphere Company, publishes a new e-book, “TrustCommerce Community Connect Program.”
- Tegria publishes a case study, “Azure Data Lakehouse Enables Higher-Visibility Reporting Across Data Sources.”
- Spain’s Health Ministry renews its agreement with Wolters Kluwer Health for UpToDate clinical decision support solution.
- Agfa HealthCare, Artera, Elsevier, QGenda, Sectra, Visage Imaging, and Wolters Kluwer Health will exhibit at RSNA December 1-5 in Chicago.
Blog Posts
- Healthcare Literacy: A Language of Care that Goes Beyond Technology (CereCore)
- Accelerating quality performance in the real world (Notable)
- 4 Ways a Strategic Collaboration Helps Maximize Public Health Funding (Netsmart)
- Oracle’s next-gen EHR: A new era of AI in healthcare (Nordic)
- Nurses of Note 2024: The Occupational Health RN (PerfectServe)
- Fostering Community and Environment: Morgan’s Dedicated Service with Cleanup Club Chicago (Prominence Advisors)
- Financial Benefits of Optimized Cardiology Scheduling: Reducing Costs with Efficient Utilization (QGenda)
- Expand Your Nursing Career With the Oregon Licensure Program (SnapCare)
- Waystar True North™ 2024: 3 tips for healthcare revenue cycle leaders (Waystar)
Contacts
Mr. H, Lorre, Jenn, Dr. Jayne.
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With this Oracle roll-out in Sweden, and the Epic roll-outs in Denmark, Finland, and Norway, I wonder if anyone has insight into why the Nordic countries hate these products so much? There is always push back when starting to use these big and complicated products, but the amount and scale of the complaints in the Nordics seems much higher than usual.
Do these Nordic Healthcare systems concentrate the risk of a new system more that would certainly happen in the more diverse US system?
This is speculation, but it’s informed speculation. There are trouble spots to look out for that are likely involved:
1). These are “international” customers and Oracle was built in, and mainly for, the United States. Even if it includes explicit international support, often there are gaps in the internationalization;
2). Excessive customization. This is a fiendishly difficult subject because I firmly believe that some customs are justified. OTOH, it’s not uncommon to find politically powerful user groups who push for customs that are not worth the time and effort. Look for language like, “that’s the we we’ve always done things” instead of, “clinical best practice says X, and the impact of not doing X is Y.”
3). This one is based upon the idea that these are all Nordic countries. What if there are consultants and consultant groups in common among all these implementations? If there are weaknesses and biases in these teams, you may find implementation errors and flaws stemming from this source;
4). These are really big implementations. I’ve not been keeping track, but I believe at least one of these systems is a single image system for an entire country, and maybe several are. It’s nearly a law of nature that the larger the system, the more challenged it will be upon implementation;
5). Now this really is speculation. But what if there was some nativism going on here? It’s not inconceivable that there might be some resentment from a European country, about having to go to a US vendor for a system. The notional home of SAP and Baan might think they ought to have a European solution to a European need. Further, if there actually is a European EHR that lost out to Oracle/Cerner, there might be some fallout from that;
My company is an international customer. We just finished an enormous implementation of a US-origin EHR. We did it completely vanilla AFAIK, following all the vendor’s recommendations. The reports I’m getting are that, despite some challenges at various points, it has gone well. I actually predicted a couple of trouble spots that were either patched or avoided.
Thanks, appreciate these insights. I’ve been contemplating VA’s Oracle / Cerner implementation and wondered if implementing the same systems across 175 Medical Centers was a bridge too far, and if maybe a mix of EHRs suitable for different size healthcare systems wouldn’t be a better approach. Afterall, these things are supposed to be interoperable and able to talk with one another. One system offers an economy of scale with support but VA’s blown that efficiency.