Ascension diverts ambulances, reverts to downtime procedures, and urges business partners to disconnect from its systems after detecting suspicious activity on its network.
In-House Health announces GA of its scheduling and management software for nursing staff and $4 million in seed funding.
Ciba Health Raises $10M in Series A Funding
Ciba Health, which offers digital therapeutics and virtual care, raises $10 million in Series A funding.
The American Hospital Association asks Congress to employ flexibility in any decisions to regulate AI in healthcare, proposing use of a sliding scale that is based on risk and the level of human oversight that is involved. AHA says that a one-size-fits-all regulatory approach could stifle innovation, saying that a better model is that of the FDA’s guidelines for defining Software as a Medical Device.
Apple announces the 2024 IPad Pro, the company’s first product to feature the newly announced, AI-optimized M4 chip. Prices start at $999 before trade-in credit for the 11-inch, one-pound model with Ultra Retina XDR display, 256 GB, and 12 MP front and back cameras. The company is speculated to be preparing all of its hardware to run AI without further upgrades, and the Wall Street Journal reports that Apple is working on a chip to run AI software in data centers.
Karius, whose early warning system diagnoses infectious disease by using AI to analyze a form of DNA from blood samples, raises $100 million in Series C funding. The company will use the proceeds to expand beyond its 400 US hospital customers of Karius Test, which can detect 1,000 pathogens from a single blood sample.
Opmed.ai, which uses AI to optimize surgery scheduling and resource allocation, raises $15 million in a Series A round.
Expion Health, which offers pharmacy and medical cost management solutions for payers, develops an AI-driven tool for responding to RFPs, which increases efficiency and reduces errors in its contracts in which it accepts financial risk.
OpenAI is working on a search feature for ChatGPT that would perform real-time web searches and return detailed information with citations, competing with Google’s search that includes paid ads and SEO-optimized, low-quality sites. Google generates $200 billion in annual search engine revenue, which represents about 80% of its total.
Experts from drug maker Lilly say that AI will soon be able to design new drugs by using its own thinking instead of being trained on human-created datasets. They believe that even AI’s hallucinations will provide value by analyzing non-existent proteins within models.
Ohio State researchers train AI on de-identified medical claims data to predict the impact of available medical interventions on patient outcomes, which could supplement randomized clinical trials and explore new uses for existing drugs.
A UCSF study of emergency room visits finds that AI performed triage based on acuity as accurately as physicians. The authors note that since the commonly used Emergency Severity Index (ESI) is a rules-based triage scoring system that is straightforward for clinicians to calculate, AI might outperform them when making decisions that are based on both ESI score and patient details, such as answering difficult questions such as, “We have two patients and one available resuscitation bed – which one should get it?”
A Mother Jones article says that AI chatbots not only haven’t eliminated health misinformation, they have made it worse. It says that GPT can’t tell the difference between scientific information and the information it crawls from questionable websites, refers users to sites that sell scientifically unproven health products, and is easily fooled by information that sounds authoritative but isn’t. A science communication professor says that AI, unlike humans, doesn’t have the capacity for critical thinking, applying skepticism, and seeking out facts that disprove inaccurate information. I replicated the authors question to Microsoft Copilot about alternative cancer treatment programs, which included a link to the website of for-profit, cash-only Cancer Center for Healing, whose physician owner sells cancer treatments that have not been FDA approved.
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Russ Thomas, JD is CEO of Availity of Jacksonville, FL.
Tell me about yourself and the company.
Availity connects health plans and providers for their critical business workflows. Most people would call that a clearinghouse, but we think of it as a 21st century clearinghouse because we add a lot of intelligence around the workflows that we facilitate between providers and payers.
We’ve been doing that for almost 25 years. The company started in 2001. Today, we serve well over 3 million providers around the country. We will process $3.5 trillion of claims through our network this year.
We are big believers in what we call multi-modality. We take providers however we find them. If they are sophisticated providers working in their Epic environment, we love that. We are deeply integrated with Epic with our revenue cycle product. At the same time, we have literally millions of providers who access their payer information through Essentials, our real-time, multi-payer portal. That gives them the vast majority of the information that they need, day in day out, to run their business. It serves all types of providers, not just physicians, but anyone who’s providing healthcare to a patient and getting reimbursed by health plan. Think about Medicaid, which includes atypical providers — ramp builders, transportation companies, or somebody’s aunt or uncle or mom or dad who is getting reimbursed for providing care to them.
What are the most urgent opportunities in improving communication between providers and payers?
The most urgent opportunity is quality of information. We are very good at building and deploying technology to facilitate the exchange of information in a timely way to the right person with the right information that they need. The underlying quality of the content has to continue to improve. Authorization workflow is facilitated today between most health plans and providers. Trying to figure out that translation of provider-speak to payer-speak often involves phone calls and faxes, and wait times for authorization are still long.
In that example, we have found a way to automate that workflow. We acquired a company about a year ago called AuthAI and have implemented that with one payer, with others in process. We are literally creating a real-time exchange of authorization information, facilitating that authorization workflow in under 90 seconds, all the way through a medical necessity determination. It’s a huge provider satisfier and works great for the payers as well, bringing value to both sides of the equation.
Right or wrong, I assume good intent. I assume that providers only want to perform procedures that are appropriate, medically necessary, and good for patient care. I assume that payers want to pay the fair contracted rate for that care. If the administrative workflow is slowing that down, creating obstacles, or getting in the way of good medical practice and good reimbursement practice, it can be more trouble than it’s worth.
We focus on eliminating those administrative workflows that just get in the way and aren’t providing any value. They were put in place with good intentions at some point in the past, but now they are not helping to improve either patient quality or the relationship between providers and payers.
What impact will patients see from federally mandated payer-to-payer APIs?
We have launched that. We have our first cohort of payers implementing now. I think it’s three or four that we’re starting with and our second cohort is right behind it. Transparency, right? Interoperability.
Availity is in Jacksonville, FL. We have been a Florida Blue company for a long time for our health coverage. If we decide to move to somebody else, my data shouldn’t be siloed in the Florida Blue environment. There’s tons of opportunity to improve patient care, to improve transparency, and to make the provider’s job easier by mandating the exchange of that information between payers when either I individually or my company makes a decision to make a switch. It’s freeing up data, which is what I love about it.
What are your biggest takeaways from the Change Healthcare cyberattack?
I anticipated that question, but I still don’t know that I have the best answer to but a couple of things.
Security is paramount. We talk about it in terms of resiliency. Resiliency means that you have a you have a really good Plan A, which is to maintain the highest possible level of information security to protect your network. You’re going to see us advocating for this as a company.
The bar is higher for firms who do what we do. The bar for clearinghouses needs to be higher, for both the level of information security that we maintain and for the resiliency or redundancy of our networks, because the alternative to that is to try to figure out how to protect millions of endpoints. I don’t think that’s a fair burden to put on providers in particular, who are already stressed and trying to run businesses that are financially struggling in some cases.
We have been advocating aggressively in the last couple of months with CMS. Congress has gotten involved and should be focused on hardening the network itself, so that physicians and payers can continue to collaborate effectively.
Information security has to be your Plan A. You have to be world class at it, and it needs to be a culture within your organization. It certainly is for us.
Then, candidly, you need a redundancy plan. Your Plan B that assumes plan A fails at some point. When there is an attack, and when there is an impact from attack, you have to be able to bring the network back to full strength in time periods that are measured in days, if not hours, not in months or quarters.
The takeaway for us is that as good as we think we are from an information security perspective, we have to continue to get better, better, and better. Invest more and bring more resources to bear. Challenge ourselves to think differently about how to protect our network. We have to make sure that our redundancy plan remains strong. We’re doing things today to make sure that we are fully cloud migrated, so that when or if something happens, we are able to move environments really, really quickly and have as little impact on our clients as possible. Those are the key takeaways.
I’m at a large health system today where we extended the Availity Lifeline. Not to brag, but I think we’ve done a really nice job of helping providers get back in business. We’ve stood up 300,000 providers in the last 65 days and moved over $160 billion of claims that would have otherwise been stuck. As you can imagine, that has allowed us to make some really good relationships. One of the things that we are hearing from these providers is that we have to have a backup plan. Being on our own and having one system has worked for a long time, but we really need to think about how to create redundancy in our own network with a solid backup plan. That’s a takeaway not just for Availity, but for a lot of providers.
We were at our annual client conference in Arizona when the cyberattack started on February 21. We took the correct immediate step to disconnect from anything with a “U” in front of it, not just Change, but all of the Optum environments and all the UnitedHealth Group environments that we were connected to. We then said to ourselves, we don’t know how long this is going to last, but there will be providers and payers who need some help. We created this program called Availity Lifeline to bring claims and remits back up. We stripped down our revenue cycle product into a really simple, fundamental version of it that was just claims and remits, which are the lifeblood of the business relationship between a health plan and the provider.
We went out to the market and said, we’ll make this available to anyone who needs it, free and with no strings attached. You can terminate it with five days notice. You never pay us a nickel, but in the short term, this at least will help you as a health system to get claims and remittance flowing again so that you can continue to run your business while you figure out what you want to do. It’s been very successful, with 300,000 providers and 150 or 160 actual systems that have implemented Lifeline. As I mentioned, we have moved $160 billion of otherwise stuck claims between payers and providers.
UnitedHealth Group paid the hacker’s demanded ransom, but was still down for many weeks. Oracle’s Larry Ellison said that they could have come up quickly if they were running Oracle Cloud. Is it harder to recover a complex network than to restore a health system, and does cloud provide a lot of extra recovery benefit or just a head start?
Cloud gives you a ton of extra benefit. If you listen to UHG CEO Andrew Witty’s testimony to Congress, there was a lot of older technology behind the scenes of Change. That created some real challenges, based on what they have said, in terms how the bad guys got into the network and had the ability to root around for a week and half before they actually pulled the lever on the actual ransomware attack.
Being cloud-enabled absolutely is advantageous in getting networks back up faster when there’s an event. I don’t know whether Larry’s right that it would happen in minutes. From the Availity perspective, we are completing our cloud migration. We run two data centers, but we never have them both processing transactions at the same time for that very reason. One is primary and one is redundant. If we had to move from A to B, we can do that in three to six hours. We also do some other things to protect our core data with things like immutable backups that nobody can touch. It’s a journey, but we are absolutely counting on our cloud migration to give us even further redundancy and resiliency against a cyberattack.
You’ve acquired Diameter Health and the Olive’s utilization management business since we last spoke. How did those acquisition round out your portfolio?
The first thing that we do, even in due diligence, is cyber audits and cyber reviews. Before we close, what do we need to do to bring an acquisition up to our standards for information security? We don’t do anything to combine, from a technical perspective, those kinds of capabilities until we have brought them up to standard if needed.
Diameter was a great acquisition. The best analogy that I can give is that it’s a refinery for clinical data. Unlike administrative data, a lot of clinical data has no structure. There are no standard terminologies that everyone uses. You get a lot of data in, but aren’t able to use it and apply it to business workflows in an automated fashion. Diameter upcycles – we use that term – and refines clinical data from a lot of different sources into consumable data elements that can then be implemented in an automated workflow. We are very happy with that acquisition. It is really core to our broader clinical data, clinical interoperability standard today.
AuthAI, likewise, has been great. We bought it with one client. We’ve now sold it to multiple clients. It is a true delighter. The difference between AuthAI and Diameter is that Diameter is more of an internal technology, while AuthAI has a user experience. We can walk into provider’s office and say, “We we have automated your auth workflows for the vast majority of the ‘ologies’ that you work with. Now you can get a response in 90 seconds, all the way through medical necessity determination.” That’s a difference-maker to a provider.
How will AI affect your business?
AI is going to give us new capability. We are pretty committed to it at this point. AuthAI is built on the premise that analytic AI is a great tool to apply in complex healthcare workflows. We’ve certainly seen that with our AuthAI solution. Internally, we are leveraging AI to simplify both our own workflows and our relationship with our providers and health plans and other customers.
I’ll say one thing as an example. I got demos yesterday from two really cool companies, not startups, but sort of earlier stage. One that is on the provider side is leveraging AI in clinical documentation to help providers by essentially transcribing their clinical conversation into an application, then leveraging AI to create a true clinical note and applying what the AI believes are the proper billing codes, ICD codes, to that note. Great. That could be a real time saver for providers.
The other demo later in the day was an early-stage AI company that was building what you and I would call, from our experience, fraud, waste, and abuse capabilities for payers. They use AI to look at the pattern of how claims come in and the documentation behind a claim to make sure that the claims are appropriate and medically necessary and therefore should be paid.
If you think about those two conversations individually, on both sides, they are cool, save time, save energy, and drive efficiency. However, you have to make sure that you achieve true transparency and enhanced decision-making to get to the right result. I don’t want to arrive in a year or two at a scenario where payer AI and provider AI are arguing with each other over whether a claim should have been a denied or whether a code should have been paid.
To the extent that AI can be applied like we’ve applied it with AuthAI to automate a workflow, in the end, between a payer and provider, where everybody’s agreeing to the rules of the road and you are leveraging the AI to drive a more efficient, effective process, the promise of that is just spectacular. That gets me really excited.
CMS’s pay-and-chase policies and perhaps its lack of sophisticated technology allow seemingly obvious fraud to take place over years before someone might be brought to justice. Couldn’t technology detect outliers more quickly?
I think there’s a great opportunity there, 100%. We sell our Advanced Editing Services product into Medicare through the MACS. It is built in with as a real-time editing capability so that you can continue to learn where games are being played or where there’s potential for fraud, waste, or abuse. You can build new edits in real time and deploy those prospectively. Why are you paying this and going after it? What you should be doing is applying the rules prospectively to deny the activity or to prevent the activity in the first place. That is 100% where we are focused as a company.
I don’t think that’s just to protect from bad activity. We are focused on it in terms of shifting left. Availity serves as the gateway for payers that are representing well over 100 million covered lives in the US. Generally, all claims and all activity flow through Availity. We believe that through the application of technology, including AI, we can make our gateway smarter, so that by the time we pass a claim onto the payer, It can be screened for nefarious activity, but it can also be screened for clinical appropriateness, proper documentation, and all the things that are required to pay a claim accurately and in a timely fashion.
What are the key points of the company’s strategy over the next five years?
We have a good thing going at Availity. We have a pretty unusual capital structure in that some of my largest customers in our health plans are investors in the company. We have a really good culture at the organization, with people who really believe in our mission. In the next five years, we will continue to do what we’re doing today to drive better collaboration, better partnership, and more transparency of information between payers and providers.
Then, to eliminate some of these lagging, complex, administrative problems that drive hundreds of billions of dollars of inefficiency in healthcare and just piss everybody off. No patient wants to stand at the MRI counter waiting an hour for their auth to be approved or to be told that even though you have a scheduled appointment, you have to come back tomorrow because I can’t get your auth approved.
Good, bad, or otherwise, we have just scratched the surface on some of these super complex challenges in healthcare. Availity has in important role to play over the next five or 10 years in simplifying the process of healthcare.
Rad AI Closes $50 Million to Empower Physicians with AI
Rad AI, which offers AI-powered radiology reporting workflow software, raises $50 million in Series B financing.
Healthcare cybersecurity solutions vendor Blackwell Security raises $13 million in additional funding and hires Geyer Jones (Cylera) as its first CEO.
OptMyCare Secures $3 Million in Series A Funding from Investor Group Led by LiveOak Ventures
AI-powered risk stratification software startup OptMyCare announces $3 million in Series A funding.
Palomar Health Medical Group phones, patient portal offline after ‘suspicious activity’ detected
Palomar Health Medical Group (CA) reverts to downtime procedures after detecting suspicious activity on its computer network.
Multi-state hospital operator Steward Health Care files for Chapter 11 bankruptcy protection and seeks up to $300 million in financing to keep the doors of its 31 remaining hospitals open.
The company blames declining reimbursements from government payers, rising labor costs, and inflation for its current financial state.
The private equity sharks who looted the business and walked away with hundreds of millions of dollars weren’t mentioned.
Today I learned (by experimentation) that I can project photos on my phone to the Roku device and thus to our non-smart TV using AirPlay. Flipping through vacation and family pictures on the big screen is a lot more interesting than squinting at them in my palm.
Happy 60th birthday to BASIC. Kudos to those keyboard warriors from the sepia-toned tech trenches of yesteryear who paid the bills or found new careers after mastering DIM, INSTR, and SHELL.
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present or promote your own.
Tech-enabled musculoskeletal care management company Livara Health raises $15 million in Series B funding. The company, formerly known as SpineZone, has raised $27 million since it was launched in 2014 by brothers and orthopedic surgeons Kian and Kamshad Raiszadeh.
Rad AI raises $50 million in Series B financing. The company, which has raised a total of $79 million, offers AI-powered radiology reporting workflow software.
Healthcare cybersecurity solutions vendor Blackwell Security raises $13 million in additional funding and hires Geyer Jones (Cylera) as its first CEO.
Nworah Ayogu, MD, MBA, general manager and chief medical officer of Amazon Clinic, has left the company to join healthcare-focused venture capital firm Thrive Capital.
Cone Health (NC) promotes Keith Jones, MHA to CIO.
Kyle Armbrester, MBA (CVS Health’s Signify Health) joins Datavant as CEO.
Dean Dalili, MD, MHCM (DispatchHealth) joins DeepScribe as chief medical officer.
Manifold hires industry long-timer Alex Akers (Health Catalyst) as VP of growth.
Nick Raup, MS (Optum) joins E4health as SVP of AI and automation solutions.
WVU Medicine Thomas Hospitals goes live on Epic.
Arrowhead Regional Medical Center (CA) works with Tegria to redesign its clinical decision-making governance structure.
MetroHealth (OH) implements Ovatient’s virtual care services. MetroHealth and MUSC Health (SC) created Ovatient in 2022.
NHS National Services Scotland goes live on Rhapsody’s EMPI, hosted in Microsoft Azure.
NeuroFlow, which offers behavioral health technology and analytics, launches perinatal and postpartum care pathways to support behavioral health after pregnancy.
A new KLAS report on virtual care platforms finds that those that are offered by Teladoc Health and Caregility have seen broad adoption, with Teladoc Health’s InTouch seen as a critical tool for expanding specialty coverage. Customers of Amwell report problems with slow development, inadequate support, and high costs, with Epic clients in particular considering replacing it with Epic’s outpatient virtual care offering. Andor Health was noted as being especially flexible, while Best in KLAS 2024 winner for virtual care platforms EVisit is seen as solid for outpatient use cases.
A health insurance broker sues several companies over a scheme in which a data marketing company gave consumers low-cost health insurance in return for allowing their internet and cellphone usage to be electronically tracked and sold to marketing companies. Customers complained after finding that their “junk” insurance plans offered little coverage.
Blog Posts
Mr. H, Lorre, Jenn, Dr. Jayne.
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Livara Health Raises $15 Million to Expand Value-Based Musculoskeletal Care Delivery Model
Tech-enabled musculoskeletal care management company Livara Health raises $15 million in Series B funding, bringing its total raised to $27 million.
Opmed.ai Secures $15M in Series A Funding
Operating room management software startup Opmed.ai raises $15 million in a Series A funding round.
US hospital network Steward files for bankruptcy, aims for new loan
Multi-state hospital operator Steward Health Care files for Chapter 11 bankruptcy protection and seeks up to $300 million in financing to keep the doors of its 31 remaining hospitals open.
I volunteer as an instructor at an outdoor school every few months, but I ended up missing a full year of sessions due to schedule conflicts. This weekend, I was back at it. It was a welcome detour from my usual days of back-to-back conference calls and endless client-related fire drills.
There was a threat of rain for the weekend, but all of our participants were reminded of the need to be prepared for anything that nature might throw at them. Part of my responsibility for the weekend was monitoring the weather, and when you consider what can happen during spring in the Midwest, that can be its own challenge.
I usually keep my camping gear packed so that I can be ready for adventure at a moment’s notice, but I apparently moved some items from one backpack to another without replacing them. I ended up arriving without a headlamp and had to make use of my backup flashlight, which was truly terrible. Fortunately, the daylight hours are longer and I wasn’t called out of bed in the middle of the night for a medical emergency or a facilities crisis, so I was OK.
I’ll admit that I was also counting on the fact that if someone had to find me for an emergency in the middle of the night, they would likely have a better flashlight than my backup. It’s always nice when you’re surrounded by people that you trust and that you know will have your back if you need help.
I also forgot a key piece of my outdoor school wardrobe. I was pleasantly surprised that no one gave me grief about not having it. The people with whom I serve on staff know that I have my stuff together greater than 95% of the time, so maybe that had something to do with it. I’m grateful to be able to work with people who trust me and know that if I’m not running at my usual level of performance, there’s probably a good reason for it, and I’ll make up for it if I can.
I admit that I was running around crazy on Friday with some work in the morning that took longer than it needed to. I was dealing with a sex discrimination situation and needed to make sure it was escalated as far as I could take it before I left town, trusting that others would pick it up and continue to act on it in my absence.
It’s disheartening to know that this kind of thing continues to happen in 2024. This particular situation is particularly egregious, with various regional teams deliberately violating a nationwide company’s policy in their attempts to keep women from participating in certain activities, citing “safety” as the reason. The roots of this issue go back several years, and those of us who have been working for decades to have women included in technical or other typically male-oriented fields are simply tired of it.
I wasn’t about to stand by while women were bullied because they are new to the organization and others were afraid to advocate for them for fear of retaliation. That’s when it’s nice to be a consultant, because other than my own work, I have nothing to lose in this situation. Fortunately, the individuals who I escalated to were in agreement that what had been going on was inappropriate, so I doubt I’m going to get kicked off the project any time soon.
We’ve all been the new person on a team, and it can be difficult. It’s important that existing members of the team are willing to support new members and make sure that they are treated fairly. I’ve been on teams where leadership does more bullying than leading, and in those situations, it’s tempting to just keep your head down and try not to become a target yourself. Unfortunately, that approach sometimes emboldens the bully, and it certainly doesn’t help the situation go away.
If we look out for each other, it strengthens the team. Eventually we can arrive at that magical place where the team is fully tuned in to each other and can really start to achieve its goals. It’s not always easy to be an upstander, but as we’re working to build workplace culture, it’s a necessity.
I enjoyed working with my assigned teams this weekend, which included a hospital pharmacist, several paramedics, a chaplain, and more than a couple of IT folks. It was interesting to see people leave their typical roles and focus on new challenges, such as lighting cooking fires in the middle of a rainstorm and figuring out how to safely use axes, saws, and other things they aren’t exposed to in their daily lives. I think our students learned a lot about how they react to new situations, how they can better work with people who may not be like them, and how to “embrace the suck” when things don’t remotely go as planned.
As many times as I’ve done this, I even learned a thing or two. One such lesson was that I shouldn’t have bothered to bring my laptop, because despite the work that needed to be done, I wasn’t going to have time to even power it up. The small amount of free time that I did have was taken up by a delightful power nap under a gazebo while the students were with another instructor.
Another lesson was that even though I was executing a plan I had done dozens of times in the past, I probably needed to check my preparations more thoroughly than I did. One could argue that the corollary to that one is “never take anything out of your go-bag,” and I think I learned that one as well. Last, I was reminded of the fact that even in challenging situations, sometimes you just have to make an attempt to do your best and be OK with that.
I have the dates for the next two outdoor school sessions on my calendar, so barring any urgent work travel or family emergencies, I should be able to stay in the groove. My backpack is restocked and my headlamp has fresh batteries. I’m ready for whatever gets thrown at me next. In the mean time, I’ve learned how to make campfire cannoli with crescent rolls, a stick, and pudding – and let me tell you, when it’s 90% humidity and you’re tired and your feet hurt, one of those is a great pick-me-up.
What’s your favorite dessert for camping? Leave a comment or email me.
Email Dr. Jayne.
It’s Time to Rethink Healthcare’s Reliance on Legacy Tech Amid Cyberattacks
By Tom Furr
Tom Furr is founder and CEO of PatientPay of Durham, NC.
One of the biggest questions surrounding a large-scale cyberattack in healthcare this spring is one that healthcare is hesitant to confront. Why did it take more than a month to get these systems up and running again?
We would never hear of a financial institution being unable to restore operations for such a long period of time, despite the fact that financial data, just like healthcare data, is an attractive target for cyberattack, with losses totaling more than $12 billion over the past 20 years.
But as financial institutions take a hard look at ways to de-risk technologies to bolster their defense against cyberattack — including by investing in cloud and edge computing and implementing zero-trust architecture to protect legacy tools from threats, partnering with technology hosting companies for their security solutions such as AWS’s Cloud Security, Oracle Cloud Security and Azure Cloud Security —healthcare has been slower to make the move to the cloud.
One study found that while 86% of healthcare organizations have experienced data theft of some type, just 47% of sensitive data in healthcare is stored in the public cloud, compared with 61% across industries, according to research by Skyhigh Security. While 56% of healthcare organizations surveyed by Forrester increased cloud spending between 2022 and 2023, most are focusing on moving electronic medical record (EMR) systems to the cloud. While it makes sense to start with the EMR, leaders shouldn’t overlook the need to move other on-premises systems and applications to the cloud, too, including legacy systems.
A few years ago, a HIMSS survey quantified healthcare’s reliance on legacy systems. It found that 73% of organizations still operate legacy systems even though leaders say that these systems also present the third-biggest security risk to organizations. Insiders refer to these systems as “basement tech.” They have been around so long that few members of the IT team know how to operate them, yet they’re expensive to retire, so they keep chugging along, often in the basement of a facility. I guess now that costs from the most recent breach are starting to become public, it appears retiring old systems might not be that expensive after all.
If a system were hosted in the cloud, it would have access to all the latest security protections as they are released. Even better, there would be multiple layers of security surrounding a system in the cloud. If one layer were penetrated during a cyberattack, there would still be security wrapped around the root code for the system. Even if cyberthieves were to penetrate the root area of the system, the nature of the cloud means access to the system is still possible. The vulnerable system could be shut down, with the same functions spun up in another area of the cloud within minutes, limiting downtime.
We never hear someone say, “I couldn’t access my bank account for a month because of that cyberattack.” So why do we accept that this can happen in healthcare?
The truth is, we shouldn’t. Not when providers’ livelihoods are at stake, with many physicians digging into their personal savings to keep their practices afloat. And let’s not forget the patient impact, with the most recent large-scale cyberattack forcing consumers to pay cash for expensive drugs or endure long waits for needed prescriptions, among other impacts.
The impact of the latest healthcare cyberattack will likely be felt for months, going beyond claim processing and payment to impact functions such as real-time eligibility checks and more. As the industry assesses the damage, providers must also double down on prevention.
Now is the time to take a hard look at what’s holding your organization back from cloud investment, the level of expertise needed to chart a path forward, and the types of investments that will best protect your organization from a breach in an era of increased cyber risk. Your organization’s reputation and its ability to maintain continuity in care depend on these actions.
Collusion in Health Care Pricing? Regulators Are Asked to Investigate
Senator Amy Klobuchar (D-MN) asks the Department of Justice’s Antitrust Division to investigate the pricing algorithms that are used by MultiPlan to reduce insurer payments to providers for out-of-network claims.
University Hospitals in Ohio attributes its nearly half billion dollars in operating losses over the last two years to inflation, rising employee costs, and expenses associated with its Epic implementation last fall.
FDA Qualifies Apple Atrial Fibrillation History Feature as an MDDT
FDA qualifies the Apple Watch as the first digital health tool to monitor atrial fibrillation during clinical studies.
Senator Amy Klobuchar (D-MN) asks the Department of Justice’s Antitrust Division to investigate the pricing algorithms that are used by MultiPlan to reduce insurer payments to providers for out-of-network claims.
The senator questions whether the practice constitutes price-fixing.
Just under half of poll respondents who are covered by a non-compete agreement say they’ll be more open to changing jobs once those are gone.
New poll to your right or here: What is the single biggest reason that Walmart Health failed? The “all of the above” option is compelling but intentionally absent. Most interesting to me is why the company so quickly about-faced from “we’re expanding to 75 locations by the end of 2024” to “we’re shutting the whole thing down because it’s not profitable.” I would guess that finding and paying staff was harder than Walmart expected. I also questioned from the beginning whether the “doc in the big box” strategy of Walmart and its equally struggling drugstore competitors is sound when most of us are surrounded by the offices of providers who work for health systems, themselves, or giant corporations such as Optum. There’s just not much opportunity for scale and brand recognition for offering primary care, which is financially challenging even without trying to carve out the financial returns that investors in publicly traded companies expect.
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Spok announces Q1 results: revenue up 5%, EPS $0.21 versus $0.16. SPOK shares are up 11% over the past 12 months, valuing the company at $291 million.
FDA qualifies the Apple Watch as the first digital health tool to monitor atrial fibrillation during clinical studies.
A Wall Street Journal article on AI-created digital twins profiles Unlearn, which uses the health data of a clinical trials participant to forecast how they would progress in the placebo group without denying them the potentially beneficial treatment. The CEO says that a top reason that people don’t participate in clinical trials is that they don’t want to be randomized into the control group that receives placebo rather than the therapy that motivated them to sign up in the first place.
John Seguin (PT Solutions Physical Therapy) joins RevSpring as VP of business development, West Coast.
Industry long-timer Peter Witonsky (Arctevity) joins Innovative Consulting Group as chief revenue officer.
Sectra and Leica Biosystems earn FDA 510(k) clearance to use DICOM images for pathology diagnostics, which allows replacing proprietary formats and technologies.
Bardavon, which offers workers’ compensation and musculoskeletal health technology, launches Recovery+, a health coaching platform for recovery and return-to-work.
Kentucky becomes the first state to decriminalize medical errors that are due to mistakes rather than gross negligence or intentional misconduct.
Atlanta-based staffing company Insight Global will pay $2.7 million to resolve federal False Claims Act charges that it failed to protect the health information of COVID-19 contract tracing subjects under its CDC-funded contract.
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Transcarent Raises $126 Million Series D
Transcarent raises $126 million in a Series D funding round that values the company at $2.2 billion.
Avel eCare Acquires Hospitalist Telemedicine Provider ‘Horizon Virtual’
Telemedicine provider Avel ECare acquires Horizon Virtual, which offers virtual hospitalists.
Pfizer plans direct-to-consumer platform for Covid and migraine treatments
Pfizer will follow the lead of competitor Lilly in rolling out an online platform where patients can order the company’s drugs directly, connecting US customers with independent telehealth consultants who will send prescriptions to a drug dispensing partner.
Contexture and Quality Health Network Announce Affiliation
Contexture, which manages HIEs in Arizona and Colorado, acquires Colorado-based HIE Quality Health Network.
UnitedHealth Group CEO Sir Andrew Witty tells the Senate Finance Committee – which was questioning him about the Change Healthcare cyberattack – that the half-trillion dollar market cap UHG isn’t all that big. He commented that the company doesn’t own hospitals or drug companies and employs just 10,000 physicians, although he acknowledged that another 80,000 doctors choose to work with the company.
He blamed the ransomware attack on the outdated cybersecurity tools of Change Healthcare, which he says UHG was in the process of upgrading following its October 2022 acquisition of the company. He admitted that two-factor authentication was not implemented.
Witty also admits that he personally made the difficult decision to pay the $22 million ransom that the hackers demanded in hopes of keeping patient information private.
Committee Chair Ron Wyden (D-OR) went after Witty hard over lax cybersecurity and monopolistic practices. When Witty touted the company’s offer of credit monitoring to those who were affected by the breach, Wyden chastised him that “credit monitoring is the thoughts and prayers of data breaches.”
From MizzuPharmD: “Re: Liberty Hospital. Will be acquired by University of Kansas Health System. May drive antitrust scrutiny.” The two organizations have consummated their mating as was originally announced in November. Lawmakers considered blocking the deal in expressing territorial indignation that a Kansas health system would take over a Missouri hospital. The acquirer runs Epic, while the acquiree runs (or at least did at some point) Altera Digital Health / Allscripts Sunrise.
From Oh the Irony: “Re: Epic. Interesting comment considering the company’s usual take on non-competes, ha!” Judy Faulkner says in a “Hey Judy” post that early-days Epic decided not to challenge a competitor’s theft of Epic’s internal information, concluding that, “Even if someone copies everything in our filing cabinets, it won’t make much of a difference. The corporate culture can’t be easily copied.”
From Dr. Bass: “Re: Walmart Health Centers. Wonder what they will do with all the patient records they need to maintain for years?” They will need to export them from Epic into some sort of retrievable archive, I assume, which is probably easy but not common since few Epic customers have replaced the system or closed their doors. Negotiating a contract cancellation with Epic might be harder, especially since they just signed it in 2021.
From Relayer: “Re: Change Healthcare breach. The portal and underlying systems that caused the problem – and that don’t have multifactor authentication – are the original RelayHealth products that McKesson acquired in 2006. McKesson then ‘merged’ the business with Change Healthcare even though McKesson kept a 70% stake and made billions when Change went public in mid-2019. Acquired companies lose intellectual capital and don’t focus on the stepchild products, so it’s not surprising that these products become vulnerable after being sold off and orphaned.” The breach, as well as the government’s unhappy scrutiny over Change’s lack of two-factor authentication, has raised the user access bar for all software vendors, and likely health systems as well. It’s a squirmy position to be in when members of Congress angrily ask you to defend why you didn’t implement two-factor authentication when other organizations have.
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The latest chapter in my quest to achieve grammar curmudgeonliness involves leaving in the word “that” to make sentences easier to read. I’ll show, not tell: the second sentenced is easier to read than the first:
Listening (and watching): 11-year-old Ellen Alaverdyan, aka EllenPlaysBass, whose little fingers have mastered the sheer complexity and energetic fret-hopping of Chris Wolstenholme’s bass line in Muse’s “Hysteria.” Her videos, which usually include her instructor-dad Hovak, are a treasure. Watch her smile break out toward the end when she realizes that she has nailed the piece. She did a fine, grinning version of Rush’s “Tom Sawyer” when just nine years old. Keep in mind that she not only has to play the songs, she must learn every single note and nuance before picking up the bass.
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CVS Health reports Q1 results: revenue up 4%, adjusted EPS $1.31 versus $2.20, sending shares down 17% on the news as the company also lowered full-year guidance. Shares have lost 24% in the past 12 months. From the earnings call:
Transcarent raises $126 million in a Series D funding round that values the company at $2.2 billion.
Telemedicine provider Avel ECare acquires Horizon Virtual, which offers virtual hospitalists.
Wearable cardiac monitoring vendor IRhythm Technologies announces Q1 results: revenue up 18%, adjusted EPS –$1.23 versus –$1.10. IRTC shares have lost 17% in the past 12 months, valuing the company at $3.5 billion.
Financial Times reports that drug maker Pfizer will follow the lead of competitor Lilly in rolling out an online platform where patients can order the company’s drugs directly, connecting US customers with independent telehealth consultants who will send prescriptions to a drug dispensing partner. According to a global health professor, drug companies have realized that “The best way to convert customers is through patient portals where they can act as a consumer in medicine. They can go to the website, they can get the information they need, they can be linked to a prescriber and then a pharmacy, and do all those things independent of a primary care provider.”
Following its acquisition of Cerner in June 2022, Oracle Health has reduced its employee count in Kansas City from a peak of 14,000 to 6,400.
Bloomberg declares that “Austin’s glow is fading,” with the latest blow being Oracle’s planned headquarters relocation to Nashville after just four years in the Texas city. The article says that companies are rethinking their big plans for Austin, 25% of its commercial real estate is vacant, and residential real estate prices have dropped more than in any other US city. It adds, “That Oracle went to archrival Nashville is particularly painful for Austinites. The two cities compete over which has the more vibrant live music scene and who plays the better host to bachelor and bachelorette parties. There are heated debates over where to find the best custom-made cowboy boots.”
Chris Durham (Medhost) joins HCTec as VP of service desk operations.
OpenAI CEO Sam Altman describes ChatGPT 4 as “incredibly dumb” as he looks to newer versions that will operate beyond the chat interface into deploying AI-driven agents that are capable of performing tasks with a deep understanding of the user’s specific needs.
Truveta expands its 800-hospital research database to include family history, medication details, complex concepts, and de-identified medical images.
Lucem Health announces Reveal for Lung Cancer, which applies an AI model to EHR data to flag patients who meet USPSTF criteria for lung cancer screening. The company says that a provider organization can expect to identify 60% more patients who have early-stage lung cancer.
Healthcare AI deployers, be careful out there. Catholic Answers defrocks its days-old, AI-powered “Father Justin” after it went rogue in telling users that it was a real priest, took confessions and granted penance, and told one user that it was OK to baptize a baby in Gatorade. The organization says the AI chatbot will be retooled as just plain old layperson Justin, noting, “We didn’t anticipate that someone might seek sacramental absolution from a computer graphic.”
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Black Book releases its 10th annual “State of the Healthcare Cybersecurity Industry” report. A corresponding ranking of top cybersecurity firms based on customer satisfaction ratings includes the following HIStalk sponsors:
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The hot topic in the virtual physician lounge this week was that another company has decided that delivering healthcare is more difficult than it thought.
Across the board, members of a primary care discussion group felt vindicated that Walmart plans to close all 51 of its Walmart Health centers as well as its Walmart Health Virtual Care telehealth offering, citing rising costs and “the challenging reimbursement environment.” These are the same struggles that physicians are facing, usually without any kind of corporate subsidy.
The health centers locations by state are Florida (23), Georgia (17), Texas (7), Arkansas (3), and Illinois (1). Non-provider associates are eligible to transfer to other Walmart or Sam’s Club locations, otherwise they’ll be paid for 90 days and then receive severance benefits. Providers will be paid “through their respective employers” for 90 days and then will receive transition payments. Walmart Health is an Epic client, making me curious as to what breaking that contract looks like.
I’m a fanatic about scheduling my next dental appointment before I leave my current appointment, so I was surprised recently when I started receiving reminder text messages that my appointment was due and I needed to schedule. I called the office and they confirmed that my appointment had disappeared from the system, but offered me the “recently opened spot” that was actually my original appointment. It turns out that they migrated their electronic dental record to a different system and apparently some appointments became casualties. I’ve done enough practice management system conversions in my career to know that sometimes things happen, but it sounds like they may not have had as rigorous of a QA plan as they needed since they said other appointments had disappeared as well.
On the Saturday morning prior to my appointment, I received a text message to fill out some forms. I was busy doing other things and didn’t do it, only remembering as I was in the car on the way to the appointment. I had some extra time in the parking lot and tried to fill them, out but discovered that the web app wasn’t really configured for a mobile device and the fonts were too small to read. I couldn’t figure out how to make the fonts any bigger, so gave up and went into the office. They tried to send me the text again to have me complete the forms on my phone. I explained the problem with the font size and they had no suggestions other than to hand me an old fashioned clipboard. They mentioned that “none of the information from the old system came into the new one,” which made my informaticist heart shudder.
The paper forms were a sorry lot, with the first page having been printed without all the desired data elements on it, so someone had gone through and written “Emergency Contact Name and Number” blanks by hand. I zoomed through to the medical history form, and only after answering the first question did I realize that the format made no sense at all. I made my best interpretation at what they were wanting and handed back my clipboard as quickly as possible.
It’s embarrassing that professionals think these kinds of forms are OK. I secretly wanted to offer some clinical consulting services. I mentioned my confusion about the form to the dentist, who reassured me that my records had indeed been migrated into the new system, showing my chart on the in-room display. He said that he would follow up with the front desk to find out why they’re making people fill out a full history, so at least that’s something. I’m not sure who the vendor was on the electronic dental record, but if you work for one and are reading this, please check your mobile app to make sure it’s accessible to those of us who are experiencing the visual changes that come with age.
An ”Inside Story” feature in JAMA Internal Medicine tells the story of what resident physicians feel like when the EHR goes down unexpectedly. The resident describes an “unexpected fatal error to the system that the IT department was working to resolve.” There is no mention of a downtime solution, with the author stating that “samples for the morning laboratory tests could not be collected because the phlebotomy team did not know which patient needed which tests.”
The resident arrived at the “simple answer” of asking patients about their conditions and talking to the nurses who had most recently cared for them. They changed to a “minimum laboratory testing approach” after realizing that it was likely that patients had been undergoing tests that weren’t necessary, but rather were ordered simply as a result of order set use.
The author notes that “the EMR downtime made me realize that while the system seems to make our clinical routine convenient, it may not result in increased efficiency or better patient care.” Patients continue to receive daily labs that are part of an admission order set and those caring for them aren’t asking each day whether those orders are necessary or appropriate. They mention that “I look unprepared to my team when I do not know my patients’ latest basic metabolic panel and complete blood count values during rounds, but no one would ask me how much time I spent talking to my patients.” The author also enjoyed actually talking to members of the care team rather than communicating through the EHR, closing by saying that “our patient care on that day was the most patient-centered and most collaborative than ever in my 2 ½ years of residency.” Only one comment has been left on the piece so far, but I’ve got my popcorn and am sticking around.
It’s time to update those health maintenance settings in the EHR, now that the US Preventive Services Task Force (USPSTF) has issued an updated Recommendation Statement on breast cancer screening. Women aged 40 to 74 are recommended to have screening mammography every two years. The previous recommendation that was last updated in 2016 called for women to begin screening mammograms at age 50 and that women aged 40 to 49 should engage in individualized decision-making to determine a screening plan.
In a situation where we don’t have enough physicians who have the time to truly do health-related counseling during their visits, individualized decision-making can be problematic. Patients are reluctant to schedule a dedicated appointment to discuss screening, so it becomes one more thing that has to be crammed into a well woman or other preventive visit. I wonder how quickly people will be updating the recommendations in their EHRs and how organizations plan to educate physicians and care teams.
What is your organization’s plan to roll out the new USPSTF recommendation? Leave a comment or email me.
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CVS Health Corporation Reports First Quarter 2024 Results and Revises Full-Year 2024 Guidance
CVS Health shares plunge on the news of disappointing Q1 results and revised full-year 2024 guidance.
Aledade and Medical Advantage Team Up To Expand Value-Based Care in Michigan
Value-based care and physician practice optimization company Aledade acquires Medical Advantage, a subsidiary of The Doctor’s Company that provides value-based healthcare consulting to practices in Michigan.
Tiger Global-backed Innovaccer in talks to raise $250M in new funding, sources say
Health data and analytics company Innovaccer is reportedly in talks to raise $250 million at a valuation of between $2.5 billion and $3 billion.
Google highlights the medical capabilities of its unreleased Med-Gemini AI models. The four models can provide text, image, and video outputs and are integrated with web search.
CLEW announces GA of its FDA-cleared, AI-powered system for early detection of patient deterioration. The company introduced its first AI prediction models for virtual ICUs in 2018 and has since expanded to cover all inpatient settings. CLEW’s CEO is industry long-timer Paul Roscoe, who has held leadership roles with Sentillion, The Advisory Board Company, Visionware, and Docent Health.
Several hundred nurses picket Kaiser Permanente San Francisco Medical Center to express their concerns that KP, which promotes itself as a leader in healthcare AI, will use the technology to improve its margins rather than patient care.
HHS OCR and CMS publish a rule that prohibits the use of patient care decision support tools –- their new name for what they previously called “clinical algorithms” – to discriminate based on race, color, national origin, sex, age, or disability. It requires Covered Entities to identify and review their use of any tools that take those factors into account to make sure they do not discriminate. It lists areas such as prior authorization, medical necessity determination, screening, risk prediction, diagnosis, prognosis, clinical decision-making, treatment planning, healthcare operations, and resource allocation in which race or ethnicity inputs might create discrimination.
AI drug developer Xaira Therapeutics launches with $1 billion in capital. The company’s founding CEO is former Stanford University President Marc Tessier-Lavigne, PhD, who left that post in August 2023 when several of the research papers he published while working for Genentech were found to have used manipulated data.
Startup Dionysus Digital Health develops an AI-analyzed genetic test that it says can detect post-partum depression before symptoms appear. DoD has provided a $6 million grant for further study. The company hopes to earn FDA approval for the $250 test and have it covered by health insurance.
Quest Diagnostics will acquire PathAI’s Memphis-based digitized laboratory – the former Poplar Health, which it acquired in July 2021 — and convert it to Quest’s AI and digital R&D and solutions center to support its AmeriPath and Dermpath Diagnostics specialty pathology businesses. PathAI will continue to offer clinical trials services from its biopharma lab, which is a separate business.
Drug maker Moderna launches its own instance of ChatGPT that has been used by 80% of its employees. The company is using advanced analytics, image generation, and a library of 750 self-developed GPTs that help drive automation and productivity. One of the GPTs evaluates optimal vaccine doses based on standard criteria and principles, supporting its conclusions with rationale, references, and charts that illustrate key findings, all of which are then reviewed by humans. The company identified its top 100 AI users to serve as champions and created an active internal AI forum. Moderna says that 40% of its active users have created GPTs and each user averages 120 ChatGPT Enterprise conversations each week.
Researchers find that using AI to analyze the high-risk ECGs of hospitalized patients was associated with a 31% drop in all-cause mortality, the first randomized clinical trial to show that AI saves lives.
A study finds that ChatGPT-4 performed poorly in evaluating the data of chest pain patients to determine whether they should be admitted. Researchers noted particular concern that the model would give different risk estimates and test ordering recommendations for the same set of patient data that it reviewed more than once.
University of Texas Southwestern Medical Center researchers find that ChatGPT 3.5 can extract pathological classifications from lung cancer pathology reports with 89% accuracy, with most misclassifications being caused by lack of specialized pathology terminology and its faulty interpretation of TNM staging rules (tumor, number of affected nearby lymph nodes, and the presence of metastasis). The test was repeated using ChatGPT 4, which improved the model’s performance by 5% but at a higher cost.
A Colorado attorney is suspended from the bar for one year and is fired by his law firm employer after admitting that he used ChatGPT to create legal documents. He says that he was trying to save his client money by using AI to perform case load research. ChatGPT generated what he says were “seemingly impeccable case law and case citations” that he didn’t double check, and a judge noticed that some of the cases cited were either incorrect or non-existent.
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Walmart Health announces that it will close its clinics and virtual care service, noting that it can no longer sustain a business model that is beset by rising costs and declining reimbursements.
Deputy VA Secretary Tanya Bradsher says that the department is committed to rolling out Oracle Health during a recent visit to Mann-Grandstaff Medical Center (WA), which went live on the problematic software in 2020.
Trovo Health Announces $15 Million Seed Funding Round Led by Oak HC/FT
Trovo Health, which offers AI-powered assistants for specialty practices, raises $15 million in a seed funding round.
Walmart Health announces that it will close its clinics and virtual care service, noting that it can no longer sustain a business model that is beset by rising costs and declining reimbursements. The company had previously said that it would open 22 additional health centers this year.
Walmart Health grew to 51 locations in five states during its five-year run, implementing Epic across its clinics in 2022. The concept was piloted in Dallas, GA in 2019, where it offered $40 visits and physicals from standalone offices. Walmart simultaneously ran Care Clinics from inside its stores in three states. Walmart acquired multi-specialty telehealth provider MeMD in mid-2021 and renamed the business to Walmart Health Virtual Care a year later.
The retail giant will continue to focus on the development of its pharmacy and vision offerings, of which there are, respectively, 4,600 and 3,000 in-store sites.
The company launched Walmart Health Care Research Institute in October 2022 to pair members of underrepresented communities with clinical trials, which included digital tools for research participants to manage their health records and insurance information. Walmart says that business will continue.
From Wiggles: “Re: Walmart Health Centers. We’ve been patients since it opened. It was convenient, offered easy access, and was super affordable. I guess it was too good to be true. My only frustration with the numerous times they cancelled appointments because they didn’t have available clinicians.” The upside is that physicians might be realizing that they can (or could) control delivery since giants like Walmart can’t scale with them, much less without them. Healthcare still requires doctors who might be in short supply, who don’t enjoy offering care-by-wire encounters, or who don’t find that wearing a Walmart-logoed white coat carries the prestige they expected. This is the chance for doctors to wrest control back from the suits in a medical form of a rollback special.
From Spindrift: “Re: Walmart Health. They must have spent a fortune implementing Epic for the short time they used it.” Agreed.
Today I learned that Larry Ellison’s son David is founder and CEO of Skydance Media, which makes the “Mission: Impossible” and “Star Trek” films and is negotiating a multi-billion dollar merger with Paramount Pictures. David’s wife is Larry’s connection to Nashville – she’s a country singer (who I could find next to nothing about, which I assume that she’s still hoping to break out) who has a house there.
I’m thinking of all the ways that Epic could theoretically limit the career options of its employees even if non-compete agreements are banned. I found the above language in the Epic contract of Ardent Health, which was filed with the SEC and which I think I recall is Epic standard contract boilerplate. Lawyers, is this legal, or just unlikely to be found illegal because affected employees don’t have the time or money to challenge it?
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Oracle Chairman and CTO Larry Ellison’s headquarters relocation declaration likely won’t impact most of the company’s US employees, given that the majority — including Ellison, who spends most of his time on his Hawaiian island of Lanai — are remote. Seven thousand are still based in the company’s original home state of California, while 6,400 largely former Cerner employees reside in Missouri. Just 2,500 call the company’s current Austin, TX, headquarters home.
HCA reports Q1 results: revenue up 11%, EPS $5.93 versus $4.85, beating analyst expectations for both. HCA shares are up 23% in the past 12 months versus the S&P 500’s 12% gain, valuing the company at $82 billion.
Streamline Health reports Q4 results: revenue down 19%, EPS –$0.02 versus –$0.04. Shares dropped on the news, valuing the company at $17 million, down 82% in the past 12 months.
Penn Medicine promotes Mitchell Schnall, MD, PhD, to SVP of data and technology solutions.
Hackensack University Medical Center (NJ) implements AvaSure’s TeleSitter virtual care technology.
Researchers find that using AI to analyze the high-risk ECGs of hospitalized patients was associated with a 31% drop in all-cause mortality, the first randomized clinical trial to show that AI saves lives.
Noting that, “There is no Plan B,” Deputy VA Secretary Tanya Bradsher says that the department is committed to rolling out Oracle Health. She made that promise during her second visit to the Mann-Grandstaff Medical Center in Spokane, WA, which went live on the software in 2020. Resuming implementations at VA facilities will depend upon the readiness of the system and each medical center, which will be determined by analysis of a “readiness scorecard,” according to VA EHR Modernization program lead Neil Evans, MD. Restarts will likely begin in 2025 and go-lives a year later.
UnitedHealth Group CEO Andrew Witty confirms via written testimony that hackers used stolen credentials to remotely access a Change Healthcare Citrix portal, which did not have multifactor authentication. The criminals spent nine days nosing around Change systems before initiating the ransomware attack. Witty, who will present his testimony to a US House Committee May 1, adds that paying the ransom was “one of the hardest decisions I’ve ever had to make.”
In Ohio, Montgomery County officials will work with the Greater Dayton Area Hospital Association, Montgomery County Behavioral Task Force, and area providers to develop a behavioral health services referral portal. The project will be funded in part with nearly $2 million received by the county as part of an opioid settlement earlier this year.
Notes from Oracle’s Larry Ellison from his healthcare fireside chat last week:
A former Cigna medical director says that her bosses pushed her to speed up her review of cases that nurses had flagged for coverage denial, saying that she wasn’t given enough time to review the literature or review the patient’s medical records. She said that peers simply copied and pasted the company’s denial language, which company insiders called “click and close,” even though the company’s Philippines-based review nurses often make mistakes that would have led to inappropriate denial of coverage.
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