EPtalk by Dr. Jayne 7/3/25

I’m not a superfan of The Joint Commission, but I was interested to see their press release about partnering with the Coalition for Health AI (CHAI) to create AI best practices for the US healthcare system. The partnership plans to develop AI tools, playbooks, and it wouldn’t be The Joint Commission without a certification program as one of the offerings.

If anyone wants to lay odds on the cost of such a program, I’m happy to run the betting pool. Initial guidance will be issued in the fall, with AI certification to follow. I’ve done consulting work around patient-centered medical home recognition, EHR certification, and other compliance-type efforts, so I’ll be looking for the devil in the details as they are released.

As a primary care physician at heart, I’m sensitive to the multitude of recommendations that we give to our patients, often all at one time. For example, a patient who is newly diagnosed with diabetes may need to have labs drawn, see a diabetic educator, visit an ophthalmologist, consult with a podiatrist, and manage prescriptions from a retail pharmacy and a mail order pharmacy. Health systems are investing in solutions to reach patients via patient portal, text, interactive voice calls, paper mail, and email, which has resulted in patients being overwhelmed. I’m intrigued by Lirio’s concept of “Precision Nudging” (they have trademarked the term) to help manage this problem.

AI is involved via their large behavior model that aims to use elements of behavioral science along the way. It pulls together engagement and outcomes data with consumer understanding to identify the most appropriate channel to reach a given patient. Interventions are modified based on patient response and are tweaked along the way.

I have followed other companies like this over time, but Lirio seems to get it better than others, going beyond vague concepts like “wellness” and “engagement” to actually talk about specific screening programs and revenue-generating interventions that can boost patient quality and deliver a solid return on investment. They do have a bit of a revenue cycle background, so I’m sure that helps.

I was also geeked to learn that the company’s name actually has meaning rather than being something that either just sounded good or hadn’t been registered yet, as one commonly sees in younger companies. It’s actually named after Liriodendron tulipifera (the tulip tree), which apparently is the state tree of Tennessee. Props to the marketing team for its use of the phrase “lustrous branchlets” to describe the company’s strengths. This wordsmith salutes you.

Mr. H already mentioned this, but I wasn’t surprised to see that Best Buy has sold Current Health, returning the company to its former CEO and co-founder. A Best Buy executive said that growing its home care business has “been harder and taken longer to develop than we initially thought.”

I can understand that given the performance of their booth team at HIMSS25. On one of my booth crawls, my companions and I stood in their large booth for probably 5-7 minutes chatting before anyone approached us, despite there being multiple employees in the booth staring at their phones. I didn’t mind it too much because we were enjoying their extra-thick carpet, but if they were looking to capture leads, they were falling down on the job. Once a rep finally approached, the conversation was passable, but negative first impressions are hard to undo.

As much as I think I’m with it as far as keeping up with healthcare IT news and trends, I still rely on HIStalk for information on a regular basis. There’s always some tidbit that I haven’t gotten to yet, which is not surprising given the calamitous state of my inbox these days. HIStalk was the first place I learned about the new CMS prior authorization program for traditional Medicare. I’m all for catching bad actors, such as the durable medical equipment companies that cold-call patients offering knee braces and other questionable interventions, then rely on relatively clueless physicians who have rented out their medical licenses to enable a high-volume prescription mill situation.

However, I feel like the majority of physicians caring for our nation’s seniors aren’t committing fraud. They are negotiating the complex interplay between evidence-based medicine, the costs of various treatments, and patient beliefs and preferences. Sometimes the “best” treatment is unaffordable for a given patient, or you’re working with patients who can barely afford food, let alone their medications.

They’re going after specific procedures, including knee arthroscopy for arthritis, along with skin and tissue substitutes and nerve stimulator implants. You know what else would help reduce these unneeded procedures? Greater health literacy and patient education campaigns, which are parts of public health that we continue to neglect in this country. Hopefully the program will remain with these high-dollar, low-benefit procedures and won’t creep into primary care on the whole.

Given the amount of data that CMS has on every prescriber’s habits, they should be able to hire some clinical informatics folks to find those who are practicing inappropriately and go after them rather than putting processes in place that annoy those who are trying to do the right thing.

I recently had a rough travel day with significant delays. As I was waiting for my inbound aircraft to arrive, I noticed two fire trucks pull up on the tarmac. They did a quick test that I recognized as preparing to deliver a water salute. I’ve seen it for Honor Flights that were returning to the airport and for a pilot retirement.

Since the airport was small, I could see my inbound plane taxiing at a slow speed, which was unusual given the airline’s propensity to get planes to the gate quickly, especially after delays. A few minutes later, a Marine Corps Honor Guard arrived and I realized this flight was carrying a deceased service member. The waiting passengers in the terminal gradually fell silent and stood to show their respect, with hardly anyone moving until the transfer was complete. It was a sobering reminder that no matter how bad I felt my day was, steps away from me was a family that was having one of the worst days of their lives.

As we approach the Independence Day holiday, I’m grateful for everyone who has put on a uniform and sworn an oath to protect and defend our country. Freedom comes at a high price. Thank you to all current and former service members and their families for being willing to make that sacrifice.

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