News 2/14/24

Top News

ONC and The Sequoia Project designate Kno2 and CommonWell Health Alliance as Qualified Health Information Networks under TEFCA. They join Konza National Network, EHealth Exchange, Epic Nexus, Health Gorilla, and MedAllies, which were designated in December.

Webinars

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

Sales

• Biofourmis signs four contracts with pharmaceutical companies for its digital health and decentralized clinical trial solutions.

People

NRC Health promotes Helen Hrdy to chief customer officer.

ClinicMind promotes Kathleen Casbarro to SVP of its new Institutional Platform as a Service division.

Tomer Levy (Change Healthcare) joins Augmedix as SVP of engineering.

Announcements and Implementations

Children’s Hospital of Los Angeles implements Vital’s ERAdvisor software as a part of its MyVisit app.

MercyOne rolls out its TogetherTeam Virtual Connected Care virtual nursing program at all five of its hospitals in Iowa.

UC Davis Health (CA) launches a remote patient monitoring program for patients who’ve undergone Percutaneous Coronary Interventions using text messaging software from Twilio and RPM technology from Clinii.

Government and Politics

Air Force officials confirm that the switch to MHS Genesis has, as with the Navy and Army, lengthened the amount of time it takes to medically clear recruits due to an increase in initial, potentially disqualifying conditions that require further investigation. DoD representatives told Senate Armed Services Committee members last September that the switch to the Oracle Health-based system had added three more days to the recruitment process, though the Navy reported that up to 60 additional days were sometimes necessary.

An Idaho Department of Health official tells state legislators that the state should withdraw from the Idaho Health Data Exchange, given that it has no legal recourse for management oversight. The HIE, which currently has 190 customers, emerged from Chapter 11 bankruptcy protection last summer after running up $4 million in debt.

Tension escalates between the Southern Ute Indian Tribe, Indian Health Service, and Colorado Department of Public Health and Environment due to a technological glitch that has, for more than a year, prevented the Southern Ute Health Clinic from sending daily immunization data to the state registry via the IHS Resource and Patient Management System. None of the affected parties has been able to identify the problem, though the tribe has offered to cover the cost of a solution.

Privacy and Security

The Health Sector Cybersecurity Coordination Center within HHS alerts organizations to the tactics and targets of the relatively new Akira ransomware group.

Other

Australia’s Northern Territory Health temporarily suspends use of InterSystems TrakCare software at the emergency departments of Palmerston Regional and Royal Darwin hospitals, citing concerns that the software, dubbed Acacia, is slowing down access to patient records. Staffing shortages and other unspecified operational pressures also contributed to suspension of the system, which NT Health has been rolling out across its facilities since 2017.

Black Book Research survey respondents rank Surgical Information Systems as the top vendor for ambulatory surgical center software.

Through word of mouth and dedicated facilities teams, an NHS clinician in London reunites a fellow clinician working 100 miles away with a diamond ring she’d accidentally left in her scrubs five days prior.

Sponsor Updates

• EClinicalWorks releases a new podcast, “Boosting Data Analysis in Healthcare.”
• CereCore releases a new podcast, “Rolling Out EHRs in the Rural Setting: An Expert Guide.”
• Availity adds automation and process mining capabilities from Janus to its Availity Essentials Pro software.
• Arrive Health Senior Software Engineer Edward Kerns joins Code for Good West Michigan’s board as sponsorship coordinator.
• Censinet releases a new Risk Never Sleeps Podcast, “Deepfakes, Identity, and Insider Threats, with Jason Elrod, Chief Information Security Officer at MultiCare Health System.”
• Clearwater and 1stResponder partner to expand cybersecurity incident response within Clearwater’s Managed Security Service Provider portfolio.
• New research from Linus Health determines that its Digital Clock and Recall assessment within its Core Cognitive Evaluation solution outperforms the most commonly used paper-based assessment in detecting early, mild cognitive impairment and dementia, and with less ethnic and racial bias.

Blog Posts

• Rural Health CIO Advice: Things to Prioritize for EHR Implementation (CereCore)
• Confronting Patient Access Challenges (AGS Health)
• Care management software: Key features and top providers (Arcadia)
• GenAI in Healthcare: Transforming the Patient Communications Space (Artera)
• Exchanging Health Plan Member Data May Be Closer Than We Think (Availity)
• Overrepresented and Overlooked: Behavioral Health Challenges for Incarcerated Individuals (Bamboo Health)
• From Athletics to Healthcare: How Academy Medtech Ventures Navigates Cybersecurity, Compliance, and Sustainable Growth in Digital Health (Clearwater)
• Why We’re Best in KLAS – Again! (Dimensional Insight)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

Monday Morning Update 2/12/24

Top News

The National Association of Accountable Care Organizations analyzes Medicare’s claims database to alert the federal government that 450,000 of its beneficiaries were billed for urinary catheters in 2023 versus the usual 50,000 in previous years, running up  $2 billion in suspicious charges.

Pretty in Pink Boutique — whose Medicare registration is for a house address in El Paso, TX and whose phone rings to an auto body shop — billed Medicare for at least $267 million in just over a year for catheters.

Patients and doctors who reported suspicious activity to CMS say they never got a response. Dozens of NYT commenters said the same, that the CMS person either expressed resignation with the status quo or lack of motivation to add to their workload.

Reader Comments

From Jerry Aldini: “Re: Oracle Health. Interesting comments on the Cerner Reddit.” Examples, all unverified:

• “Oracle thought Cerner was worth buying for Larry’s little healthcare data hobby, but once everything is converted to OCI, nobody would ever want to buy what Cerner was ever again. So when Larry is no more or gets bored, it’s the end of the story.”
• [On the company’s pledge to rewrite Millennium using AI] From everyone I’ve talked with, it is vaporware, and even then demos went to crap pretty quickly. I’m just riding this out until all clients abandon ship.”
• “Maybe Congress would like to know more about Larry’s new wonderful AI software engineer and how it means that they can maintain a multi-billion-dollar system for America’s service people and veterans with nothing even remotely resembling what would be considered a normal software engineering company. Like, why bury the lede, Larry? You’ve successfully removed the need for high-cost, hard-to-find employees to maintain software. This is a coup for the entire tech industry. Forget the EMR, let’s hear about the AI, that’s where the money is.”

HIStalk Announcements and Requests

Most poll respondents think that the former Cerner business has become less competitive since Oracle acquired it.

New poll to your right or here: Do you own shares or equity in a health IT-related company? You can use the poll’s comment function to describe times when you made or lost big money from a health IT investment.

Help me out by signing up for spam-free updates and connecting on LinkedIn.

I am an India-phile, fascinated with the culture, food, and business and technology advances of the world’s largest democracy. I also enjoy regional English usage. I collected these examples from HIStalk-related emails with people from India that featured words and terms that are accurate, just not commonly used here:

• Prepone – the opposite of postpone, to describe moving an event earlier.
• Revert back – not a redundant expression, but rather to ask for a reply, as in “kindly revert back.”
• Cent percent – 100%.
• Full stop – Indians were using this term long before trendy Americans embraced it in referring to the period at the end of a sentence, or to some, the more emphatic break at the end of a paragraph that signals a new train of thought.
• Mention not – this is a great alternative to the wishy washy “you’re welcome.” I might start using this with hopes of displacing the dreaded “no problem,” although saying “mention not” after the person has already “mentioned” doesn’t quite fit.

Welcome to new HIStalk Platinum Sponsor TruBridge. The Mobile, AL-based company connects providers, patients, and communities with innovative solutions to support financial and clinical solutions, creating real value in healthcare delivery. By offering technology-first solutions that address diverse communities’ needs, it promotes equitable access to quality care and foster positive outcomes. Its industry-leading HFMA Peer Reviewed RCM suite provides visibility that enhances productivity and supports the financial health of organizations across care settings. It champions end-to-end, data-driven patient journeys that support value-based care and improve outcomes and patient satisfaction. It supports efficient patient care with EHR products that integrate data between care settings. TruBridge clears the way for care. Thanks to TruBridge for supporting HIStalk.

Webinars

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

Acquisitions, Funding, Business, and Stock

Omnicell announces Q4 results: revenue down 13%, EPS –$0.32 versus –$0.64, beating Wall Street expectations for both. OMCL shares have lost 49% in the past 12 months versus the S&P 500’s 26% gain, valuing the company at $1.4 billion. The CFO said in the earnings call that customers are cautious about implementing new workflows because of IT and nursing staff shortages, while the CEO said that big health systems aren’t ready to implement innovation until they develop strategies for dispensing medication across their broad footprints.

Virgin Pulse and HealthComp, which merged in November 2023, name the $3 billion business Personify Health.

Marathon Health, which bought Cerner’s employer occupational health clinics in August 2023, acquires Everside Health, expanding its services to 680 health centers in 41 states.

Aptar Digital Health, a division of Aptar Pharma, will take over the digital health solutions of Biogen, which address neurological and rare diseases.

Sales

• England’s Torbay and South Devon NHS Foundation Trusts chooses Epic.

People

University of Tennessee Medical Center names Lynnette Clinton, MBA (BayCare) as SVP/CIO.

Announcements and Implementations

Amenities Health launches plug-and-play provider search and scheduling for a health system’s public-facing website, extending its mobile app experience.

AdventHealth brings the last five of its 48 hospitals live on Epic, completing its conversion from Cerner. AdventHealth announced that it would implement Epic in early 2020, displacing the Cerner system that it had installed in 2002.

Sparked, Australia’s national FHIR accelerator, opens the draft of its Australian Core Data for Interoperability Release 1 for comments.

Government and Politics

CMS tells Medicare Advantage insurers that they can use AI and algorithms to assist them in making coverage determinations, but they must make sure that the tools use complete information and they can’t use technology alone to deny hospital admission or downgrade to observation stay. CMS also warns that MA insurers should make sure that their systems are free of bias.

A North Carolina health news site observes that Atrium Health wields its status as a “unit of local government” to get tax breaks, the power of eminent domain, and anti-trust immunity that allowed it to acquire 40 hospitals in four states, after which it merged with Advocate Aurora Health to form the country’s third-largest non-profit health system with $27 billion in revenue.

Other

In India, a review finds that 11 of 40 of Bangalore tele-ICUs in rural “spoke hospitals” are not functional due to lack of Internet connectivity, lost software copies, and clinician shortages.

Medical malpractice physician Jeff Willis, MD, MHA notes that 28 states give full practice authority to nurse practitioners and another 10 are considering it. He says that while the NP lobby was smart to take advantage of the primary care crisis to expand practice, he ponders that it’s a broken healthcare system that created the need and that it raises malpractice issues. A commenter says that several states also allow advanced practice chiropractors to do physician-like work, while another says that NPs are important in rural areas because doctors won’t work there given low volumes that drive RVU-based compensation. A physician commenter says that the rural idea sounds nice, except a lot of the NPs chase the money that comes from running IV bars, Botox shops, and med spas in urban areas.

Sponsor Updates

• Kellum Medical Group (TX) leverages the Sunoh.ai AI medical scribe as part of its EClinicalWorks EHR implementation.
• Amenities adds online patient scheduling to its Digital Front Door Platform.
• Availity achieves the CAQH Committee on Operating Rules for Information Exchange (CORE) Eligibility & Benefits, Claim Status, Payment & Remittance, Prior Authorization & Referrals, and Health Care Claims Operating Certification seals.
• Health Data Movers joins CHIME as a member.
• QGenda and Spok will exhibit at the AHA Rural Health Care Leadership Conference February 11-14 in Orlando.
• Waystar will exhibit at Nymbl.Con 2024 February 14-16 in Scottsdale, AZ.

Blog Posts

• Don’t Just Replace Cortext – Upgrade to Real-Time Care Team Collaboration with PerfectServe (PerfectServe)
• Your GPS for Multiple Prescription Benefit Coverages (Surescripts)
• Maximizing ROI in Healthcare: How Workforce Management Technology Transforms Patient Care (Symplr)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

News 2/9/24

Top News

CMS approves the use of HIPAA-compliant secure texting platforms for sending patient information and patient orders in hospitals and critical access hospitals.

Previous guidance from late 2017 allowed texting patient information if a secure platform was used, but prohibited texting of patient orders in all situations.

HHS separately announces new provisions to the Confidentiality of Substance Use Disorder Patient Records that address one-time patient consent, redisclosure, accounting of disclosures, use of records in legal proceedings, and breach notification.

Reader Comments

From Moon Pie: “Re: Best in KLAS. Notice that Oracle Health finished last for overall software suite?” I did notice. I don’t know if Oracle cares, but $28 billion is a lot to have spent to buy the last-place finisher. Oracle Health also took the bottom spots in the health system-owned ambulatory EHR and practice management system categories. Scores for Oracle Health’s patient accounting and patient systems were even more abysmal, bottoming out at 48.6 for mid-sized hospitals, a full 30 points behind second-place finisher Meditech. This is like when GE Healthcare took quite a few top-performing companies from first to worst after buying them. At least Oracle Health’s EHR beat Altera Digital Health’s Sunrise by a lot for large hospital EHR, although it’s a hollow victory when neither are selling much to big hospitals.

HIStalk Announcements and Requests

I published “HIStalk’s Guide to ViVE 2024,” which includes information about my sponsors that are participating. I’ll leave the collection form for HIMSS24 open a bit longer.

I haven’t run a Donors Choose teacher photo in a while, so here’s one from Ms. P in Kansas, a school librarian who was excited to receive 10 STEM books from a reader’s donation and matching funds from my Anonymous Vendor Executive. She reports, “We are a large elementary school in a rather poor area and so it was nice to get these new books and make them available to our students to check out. We have a lot of smart, curious students and so they will enjoy these books and the hands-on projects that they can create by following the directions. We are so grateful for Donors Choose contributors. Your investment in our library is an investment in the future. Thank you so much.”

HIStalk Sponsors Named Best in KLAS

• Agfa HealthCare – imaging universal viewer.
• Arcadia – value-based care managed services (now Guidehealth).
• Dimensional Insight – data and analytics platform.
• EVisit – non-EHR virtual care platform.
• Findhelp – social determinants of health networks.
• FinThrive – insurance discovery.
• Fortified Health Security – security and privacy managed services.
• Healthwise – patient education.
• Impact Advisors – overall IT services firm; ERP implementation leadership; financial improvement consulting
• Meditech – acute EHR small; patient accounting and patient management small.
• MRO – release of information.
• Nuance – clinical documentation integrity; front-end EHR speech recognition; image exchange.
• Optimum Healthcare IT – go-live support.
• PerfectServe – physician scheduling.
• Pivot Point Consulting, a Vaco Company – managed IT services; technical services.
• QGenda – nurse and staff scheduling.
• Rhapsody – integration engines.
• Sectra – PACS large; PACS small.
• Symplr – time and attendance.
• Tegria – application hosting.
• Waystar – patient financial engagement.
• WellSky – personal care services and private duty nursing.

Let me know if I missed anyone or if you need sponsorship information.

Webinars

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

Acquisitions, Funding, Business, and Stock

Unlearn, which creates digital twins that allow smaller and faster clinical trials, raises $50 million in a Series C funding round.

Private Equity Stakeholder Project publishes a list of the 460 US hospitals that are owned by private equity firms. Texas is the state leader by far with 97.

Amazon will lay off several hundred people in its One Medical and Amazon Pharmacy businesses as part of a company cost-cutting campaign. Insiders say that Amazon executives want One Medical to save an additional $100 million this year. They also report tension between Amazon’s leadership and One Medical that is likely to lead to the departure of some of One Medical’s executives.

Neura Health expands its direct-to-consumer virtual neurology clinic for headaches and and migraines to include sleep disorders, epilepsy, concussion/TBI, stroke recovery, and tremor. Members pay $300 per year for access to $189 video visits with a neurologist within two days, 24/7 care team access, and health coaching. Its clinicians can issue prescriptions in 22 states, and insurance is accepted.

People

Ed Lee, MD, MPH (The Permanente Medical Group) joins Nabla as chief medical officer.

Healthcare IT Leaders promotes Ben Hilmes, MHA to CEO. He replaces Bob Bailey, who will remain executive chairman.

Mary Langowski, JD (Solera Health) joins Walgreens Boots Alliance as EVP and president of the company’s US healthcare business.

Rob MacNaughton, MBA (Redesign Health) joins Calibrate as CEO.

Erik Smith (Stanson Health) joins Sprinter Health as VP of enterprise partnerships. 

Announcements and Implementations

Mile Bluff Medical Center (WI) goes live with Meditech’s AI-powered Expanse search and summarization, powered by Google Health.

DirectTrust creates a standards body for interoperable cloud fax to support identity assurance, standards-based exchange of metadata, and federated standards for security. It is looking for members from several sectors.

Companies designated as notable performers in “Best in KLAS Software & Services 2024”:

• Epic – top overall software suite.
• Athenahealth – overall physician practice vendor.
• Impact Advisors – overall IT services firm.
• Evergreen Healthcare Partners – overall implementation services firm.
• Chartis – overall healthcare management consulting firm.
• The population health management solution of Lightbeam Health Solutions was the most improved software product, AGS Health’s Extended Business Office Services had the most improved services solution, and EClinicalWorks was named as the most improved physician practice product.

Elsevier launches Complete HeartX, an educational tool for Apple Vision Pro.

The National Library of Medicine posts a guest piece on AI from OHSU informatics professor William Hersh, MD, in which he calls for conducting randomized controlled trials or systematic reviews of RCTs.

Privacy and Security

Computers, telephones, and Internet remain down at Lurie Children’s Hospital after a January 31 cyberattack.

Montefiore Medical Center pays $4.75 million to settle HHS OCR charges that one of its employees stole and sold patient information over six months in 2015. That’s a lot of money and a lot of time between the event and the settlement.

Sponsor Updates

• The Blue Bonnet Family Medicine Health and Wellness Clinic in Texas attributes a 10% increase in patients seen to its use of EHR and AI assistant technology from EClinicalWorks.
• The Point-of-Care Partners Podcast features KONZA National Network, “TEFCA Chronicles – Konza’s Journey to Becoming a QHIN.”
• Riverside Doctors’ Hospital Williamsburg successfully deploys Upfront Healthcare’s platform for orthopedic total joint care journeys, achieving positive results in a number of areas.
• First Databank becomes a Silver Corporate Partner of AMIA.
• FinThrive will present at the HFMA Revenue Cycle Conference February 28 in San Diego.
• Health Data Movers joins the ServiceNow consulting and implementation partner program.
• The NerdMDs Podcast features KeyCare CEO Lyle Berkowitz, MD.
• Linus Health publishes a whitepaper, “Expanding Cognitive Screening & Assessment: A Practical Guide for PCPs.”

Blog Posts

• Hospitals have their best operational year since the pandemic (Black Book Research)
• Priority One for 2024: Staying Focused on Patients (EClinicalWorks)
• How the University of Hawai’i Empowers Student Success (Findhelp)
• Healthcare cybersecurity threats: January 2024 (Fortified Health Security)
• What is TEFCA? Find out in Our TEFCA 101 Autocomplete Game Video! (HealthMark Group)
• CereCore Achieves Outstanding 2024 KLAS Rating in Managed IT Services (CereCore)
• Harnessing Generative AI in Healthcare: A Pragmatic Guide to Accelerate Impact (Impact Advisors)
• The Economics of AFib (Lucem Health)
• Best Practices for Reducing Waste in the OR (Medhost)
• San Luis Valley Health elevates patient access with Meditech’s Expanse EHR (Meditech)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

Health IT Market Review 2/8/24

Christopher McCord, MBA, CFA is managing director of Healthcare Growth Partners , an investment banking and strategic advisory firm in Houston, TX. I follow the company’s reports and invited Chris to contribute a summary of their latest analysis.

We’ve been ardent followers of HIStalk since our inception in 2005, hanging on to every post of insightful and in-depth reporting on the health IT landscape. We can’t stress enough its value as a resource for anyone wanting to stay informed about the latest trends and developments in the industry.

To that end, we’re excited to share some highlights from our latest “Health IT Market Review.” This report delves into key areas like mergers and acquisitions, investment flows, and market valuations, offering data-driven insights gleaned from our own experience and research. We believe it’s a valuable resource for anyone looking to understand the current state of the health IT market and its future trajectory.

Key Takeaways

• M&A activity rebounds. Deal volume surpasses pre-pandemic levels, up 50% in Q4 2023 as compared to Q4 2022 and trending up in January, but valuations remain below historical norms, ~25% lower than the pre-COVID average and 57% off their COVID peak (based on multiples of revenue).
• Investment declines. Investment in health IT continues to decline, falling to $743 million in January 2024, levels not seen since 2017.
• Public market struggles. The number of public health IT companies has contracted from 68 to 53, and 13 are at risk of de-listing due to non-compliance.
• Future outlook. Despite the challenges faced in 2023, positive signals abound, mostly fueled by anticipated decreases in inflation and interest rates.

First, we’ll attempt to describe how we, the collective health IT enthusiasts, got here in a few sentences.

The past decade in health IT was shaped by a potent cocktail of regulatory and economic forces. Starting with the American Recovery and Reinvestment Act’s HITECH Act, which incentivized Electronic Medical Record (EMR) adoption, and followed by the Affordable Care Act, significant regulations fueled an initial boom. The 21st Century Cures Act later evolved Meaningful Use into a more dynamic data platform, now laying the groundwork for AI integration.

Simultaneously, a decade of near-zero interest rates and quantitative easing inflated the US money supply, creating an environment where a generation of professionals became accustomed to expansionary policy and rising valuations. The COVID-19 pandemic further amplified these trends, dramatically validating the investment thesis in digital health across sectors like telehealth, mental health, and drug discovery.

The pandemic’s vivid demonstration of health informatics’ value undoubtedly contributed to a period of heightened investor confidence in the sector. It’s no wonder investors felt invincible.

The current market presents a dynamic interplay of forces, largely a byproduct of the complex macroeconomic and interest rate environment. While health IT M&A activity has witnessed a surprising resurgence, now exceeding pre-pandemic levels in terms of volume (but not value), new investments still show a declining trend. Valuations remain below pre-COVID levels, but are rebounding after hitting a floor in the first half of 2023.

Where does it go from here? The following charts and commentary delve into this critical unknown, leveraging data and experience gleaned from our own journey, to help you piece together your own market mosaic.

After hitting a Q4 2022 nadir, 2023 US health IT M&A and buyout volume rebounded to levels higher than pre-COVID. The last quarter of 2023, with 84 transactions, marked a 50% surge compared to Q4 2022. The upward trend was maintained in January, with 30 US health IT transactions during the month, annualizing to 360 deals versus 319 in 2023.

While M&A volume has rebounded, M&A deal value sits at the lowest levels since 2017. This is attributed to a confluence of factors: rising capital costs, broader macroeconomic concerns, a tech-specific valuation reset, and a more cautious approach by investors – all concerns that are showing signs of dissipating.

The following is what we think is the most important piece of data – valuation trends of health IT M&A and buyout transactions. The HGP Health IT Transaction Index sits at 3.6x revenue, a 22% discount from its pre-pandemic 4.6x average and a 55% discount from the peak of 8.1x seen during the COVID hype cycle. Despite the valuation gap, there are positive signals in both the data and macroeconomic picture. Notably, the standard deviation of transaction valuations has widened over recent months, meaning that more transactions are trading at both higher and lower multiples than the average, which is a promising signal that the average has room to move up.

The recent wider band of valuations reflects healthier market activity and perhaps and revival of traditional SaaS transactions, while the lower band generally represents the sale of distressed assets and divestitures of prior acquisitions. For those unfamiliar with valuation multiples, we’ve added an explanation at the end of this piece.

Enterprise SaaS (multi-industry, not pure health IT) currently trades at a discount to pre-COVID averages, trending down from 8.8x to 6.5x forward revenue. The current 26% discount is even more staggering compared to its COVID peak of 18.8x, representing a 66% discount. The overarching question weighing on the market is whether valuations will revert to the mean and the definition of that mean. Low interest rates raised valuations, high interest rates lowered them, and the general expectation is that valuations will find the reversion to the mean as interest rates return to the FOMC’s “Neutral Rate”, generally defined as 3-3.5% (compared to February 2024’s 5.25-5.5% rate).

Recent transactions signal that investors see opportunity at these valuations. For those looking for points of reference for health IT valuations, Thoma Bravo’s acquisition of Everbridge, a critical event and communications vendor, is a legitimate comp. On February 5, Thoma Bravo announced a $1.5 billion go-private of Everbridge. The purchase price implies a 3.2x and 15x multiple of forward (2024) revenue and EBITDA, respectively, for a company with a <5% growth rate, 73% gross margins, and a 22% EBITDA margin, noting that the business traded for over 20x revenue during the post-COVID euphoria and posted growth rates 30-40% at that time. While today’s investors may be valuing profitability more over growth, this valuation would indicate that growth matters.

Going deeper into valuation, HGP keeps tabs on the distribution of revenue and EBITDA multiples for M&A and buyout transactions, summarized in the following charts since 2017. Notably, while the COVID period represents 25% of the period (which we define as Q3 2020 – Q1 2022), this period represents 37% of transaction multiples, a reflection of the outsized share of transaction activity that occurred during this time. HGP believes the exclusion of the COVID period best represents valuations in the current market environment, which is described in more detail in our full report.

Investment in health IT continues to slide, falling to levels not seen since 2017. Activity fell further in January 2024, with $743 million ($8.9 billion annualized) invested in 21 companies (252 annualized) in the US. The median investment round declined from $20 million in 2021 to $11.5 million in 2023, still above a pre-COVID average of ~$8 million.

Not surprisingly, the COVID cycle saw the rise and fall of $100 million+ investment rounds. Despite the decline, the number of mega-rounds is higher today than pre-COVID, likely a result of larger private equity funds that were raised during the COVID cycle.

The health IT public market scene has undergone major transformations since the end of the almost three-year drought of health IT IPOs that ended in 2019. Following a surge of activity that was supercharged by the rise in SPAC popularity in 2021, the market reversed course, almost inversely mirroring the 2019-2021 flurry of new entrants with seven de-listed companies in 2022 and 10 in 2023. Of the remaining 53 constituents, 13 trade below or dangerously near $1, risking de-listing due to noncompliance.

We believe many emerged from this year stronger and nimbler, and many are encumbered by challenging capital structures because of recent market dislocations. Inflation and interest rates are projected to fall, and valuations may benefit from money supply to risk assets. Private equity dry powder sits at all-time highs at $2.5 trillion globally, and money market funds are sitting on a record $6 trillion in assets. These funds will likely be drawn down as rates fall, stimulating demand and supporting valuations for both private and public equities, with further stimulation as the credit markets get back into swing. Despite stubborn inflation, a presidential election year, and uncertain geopolitical backdrop, the economic and overall picture in the US is more positive and stronger than this time last year, injecting a much-needed dose of confidence into the market for the year ahead.

About Valuation Multiples

Compared to complex discounted cash flow methods, the most common way to value a business relies on revenue and EBITDA multiples. These multiples offer a standardized way to compare companies based on their financial performance. They’re valuable for comparing businesses, assessing potential investments, understanding industry trends, and negotiating deals. Investors compare companies to multiples derived from market data of publicly traded companies and similar recent acquisitions in the same industry.

These “multiples” are essentially valuation benchmarks. They’re applied to a company’s revenue or EBITDA to estimate its value. While popular for its simplicity and market data reliance, this method requires finding truly comparable companies, which can be challenging due to differences in size, maturity, and market position. Additionally, several factors beyond these multiples, like revenue models, growth potential and customer retention, can influence valuation. By analyzing these factors and their impact on multiples, investors can gain valuable insights into a company’s relative value and make more informed decisions.

HIStalk’s Guide to ViVE 2024

Care.ai

Booth 1402

Contact: Lexi Lutz, marketing manager
lexi.lutz@care.ai
407.800.1937

Care.ai is revolutionizing healthcare with the world’s first and most advanced AI-powered Smart Care Facility Platform and healthcare’s leading Always-Aware Ambient Intelligent Sensors. Care.ai transforms physical environments into self-aware smart care spaces, increasing safety, efficiency, and quality of care in acute and post-acute settings while at the same time autonomously improving clinical and operational workflows and enabling new virtual models of care for Smart Care Teams, including Smart-From-The-Start Virtual Nursing solutions.

CereCore

Contact: Jillian Whitefield, business development manager
Jillian.Whitefield@CereCore.net
248.891.5557

CereCore is a proud sponsor of Club CHIME, so drop by the Club CHIME Lounge for some refreshment, swag, and to connect with our experts. Schedule a meeting with us on Feb 26 or Feb 27 from 8 a.m. – 6 p.m.

CereCore works behind the scenes to empower hospitals and health systems with IT services around the nation and globe. Looking for IT and application support, technical professional and managed services, strategic IT consulting and advisory services, or EHR consulting? We should meet if you are interested in EHR experts, technical and support teams to supplement yours, looking for the right talent so you can better manage IT operations, or searching for support desk solutions that will result in happier users and providers. Find meaningful change with CereCore’s healthcare IT managed services. Let’s connect at ViVE 2024.

Clearsense

Booth 1702

Contact: Larry Kaiser, chief marketing officer
lkaiser@clearsense.com
516.978.5487

Get ready to rock at ViVE 2024! This exclusive event is where digital health execs connect with our 1Clearsense healthcare data analytics and interoperability platform. At ViVE, you will find us at booth #1702, in the Hosted Buyer Meeting program, and rocking Industry Night as a proud co-sponsor of an exclusive concert with legendary punk rocker Billy Idol.

Clearwater

Booth 1549 in the Cybersecurity Pavilion

Contact: Julie Catron, director, product and content marketing
julie.catron@clearwatersecurity.com
217.620.0874

Healthcare’s largest pure-play cybersecurity and compliance firm, the Clearwater team is excited to meet you at ViVE 2024! Regardless of where you are in the healthcare ecosystem, we’re committed to helping you move to a more secure, compliant, and resilient state. Whether you’re looking for ideas, help with a stand-alone initiative, 24/7 SOC services and incident response, or someone to partner with you through a true managed services program, we’d love to talk with you. 

As a title sponsor of the Cybersecurity Pavilion, share some exciting things we’ve been working on. Here are a few of the things you won’t want to miss at our booth:

• Monday, 2/26, 10:40 in the Cyber Pavilion – Chasing a Cyber Attacker: A play-by-play recount of threat detection and response and lessons learns about improving cyber resiliency.
• Monday, 2/26: 1:30-2, Tuesday, 2/27: 10-10:30 2-2:30 – How Academy Medtech Ventures Navigates Cybersecurity, Compliance, and Sustainable Growth in Digital Health: Come meet AMV President JJ Mosolf as he demonstrates their cutting-edge Operating System of Cognition and shares how cybersecurity has been critical to scaling this digital health company quickly.
• Information and giveaways at booth 1549.

Clinical Architecture

Booth V2537

Contact: Jaime Lira, VP of marketing
jaime_lira@clinicalarchitecture.com
317.580.8400

Please join us on Tuesday, February 27 at 10:45 a.m. PST for a 30-minute case study presentation “Where Data Quality and Master Data Meet” featuring Will Lloyd, System Director Clinical Data Governance at CommonSpirit Health and Charlie Harp, CEO at Clinical Architecture in the InteropNOW! pavilion.

Clinical Architecture delivers data quality solutions for healthcare enterprises focused on managing vast amounts of disparate data to succeed with analytics, population health, and value-based care. Our industry-leading software provides semantic interoperability of data through robust content authoring, mapping and distribution architecture at speed and scale.

DrFirst

Booth 1830

Contact: Erin Lease Hall, senior manager of events
eleasehall@drfirst.com
216.650.7687

Visit DrFirst at ViVE! Where Digital Health Execs Go to Redefine Medication Management What if less work – with up to 80% fewer clicks and keystrokes – is the key to getting your clinicians the clean, complete medication data they need? If that sounds implausible, it may be time to redefine medication management. And we can help. Heading to ViVE 2024 in Los Angeles? Stop by booth 1830 and learn how redefining medication management with better patient data can boost patient safety and outcomes to transform your business. Not heading to ViVE? Not to worry. We can still talk redefining medication management. Schedule a meeting with us.

ELLKAY

Booth 1336

Contact: Auna Emery, VP of marketing
Auna.Emery@ELLKAY.com
201.808.9504

ELLKAY’s innovative, cloud-based solutions address the challenges that our partners across all healthcare environments face. ELLKAY delivers bi-directional, standards-based connectivity to hundreds of sources with access to discrete and actionable data, and provides tailored solutions to achieve your unique connectivity goals. Don’t miss our InteropNow! sessions with CommonWell Health Alliance at the InteropNow! Pavillion:

• “Behind the Curtain of the 226M+ Persons National Network – CommonWell Health Alliance – powered by ELLKAY.” Get a glimpse of the interworking’s of CommonWell’s national network powered by ELLKAY, serving over 34,000 provider organizations to enable seamless health data exchange across member organizations, nearing close to 226 million+ individuals impacted through this network. The CommonWell Health Alliance chose ELLKAY to serve as the Technical Service Provider to enable clinical data exchange at scale and serve as a critical partner to achieve QHIN designation under TEFCA.
• “CommonWell Health Alliance- powered by ELLKAY.” Understand how CommonWell Health Alliance is using ELLKAY to fuel the connectivity for its network. Get to know more about the updates to the CommonWell platform and how ELLKAY is providing the technical infrastructure to deliver a seamless patient data exchange to participating providers. Come learn who the CommonWell Health Alliance members are and the impact of participation in this national network.

Visit Team ELLKAY at booth #1336 – Mimosa Bar, Monday, February 26, 3:30-6:00 p.m., Ice Cream Bar, Tuesday, February 27, 3:30-6:00 p.m., Donut Bar, Wednesday, February 28, 8:30-10:30 a.m.

Five9

Booth V946

Contact: Roni Jamesmeyer, senior healthcare marketing director
roni.jamesmeyer@five9.com
972.768.6554

Five9 offers a HIPAA-compliant healthcare cloud contact center solution that empowers you to seamlessly monitor and report call volumes in real-time across critical areas such as patient access, scheduling, prescription refills, and revenue cycle management, enhancing your staff’s efficiency. The Five9 Intelligent Cloud Contact Center seamlessly integrates with various back-end systems, including electronic health records, serving as a central hub to facilitate digital engagement, provide comprehensive analytics, optimize workforce performance, and leverage AI for improved outcomes and measurable business success.

Fortified Health Security

Booth 1850

Contact:Robert Pullins, growth marketing manager
rpullins@fortifiedhealthsecurity.com
615.600.4002

A two-time Best in KLAS award winner, Fortified works with healthcare organizations to construct client-centric, customized programs leveraging both new and existing solutions. We are committed to building a stronger cybersecurity landscape for both our client ecosystem and the healthcare industry as a whole.

We are Healthcare’s Cybersecurity Partner and we’re coming to ViVE with a schedule full of collaboration and socializing! We hope you can join us for one of these events:

• 3-track Tasting at the Figueroa: From 5-8 p.m. on Monday, February 26, CISOs and CIOs are invited to join us in hotel Figueroa and select a tasting track of spirits, wines or mocktails led by Blackfin Experiences sommelier Michael Stefanakos. Contact us to RSVP at connect@fortifiedhealthsecurity.com.
• CHIME members only: Focus group titled “Future-proofing healthcare IT: A collaborative discussion on HHS’s new cybersecurity strategy” held Sunday, February 25 at 10 a.m.
• Daily drawings at booth #1850 for travel JBL speakers.

Get-to-Market Health

Contact: Steve Shihadeh, CEO
Steve@gettomarkethealth.net
610.613.4074

Get-to-Market Health is a specialized consultancy focused exclusively on accelerating sales and driving revenue growth for our healthcare technology clients. We work with business leaders to simplify the complexity and unique buying patterns of the healthcare technology market.

Healthcare IT Leaders

Booth 3123

Contact: George Major, RVP of sales
george.major@healthcareitleaders.com
484.682.3614

Healthcare IT Leaders is a national leader in IT staffing, managed services, and consulting for healthcare systems. We provide strategy and talent for healthcare transformation across clinical, business, and operational systems. Areas of focus include EHR, ERP, HCM, WFM, RCM, Cloud, and Data where our consultants implement and optimize enterprise software solutions from leading vendors including Epic, Oracle Health, Workday, UKG, Oracle, Infor, SAP, Snowflake, AWS, Azure, GCP, and more.

Laudio

Meeting Pod 2852

Connect with Laudio on-site. Tuesday, 2/27 at 10am: Join UNC Health CHRO Scott Doak, and Laudio co-founder and CEO Russ Richmond, MD, as they share their Playbook for Nurse Retention. Discover how UNC Health’s approach with Laudio’s automation software improved nursing management and reduced nurse turnover, leading to $5.4 million in annual savings.

Laudio empowers healthcare leaders to drive large-scale change through everyday human actions. Our AI-enhanced platform streamlines workflows for frontline leaders, strengthens interpersonal connections, and aligns C-suite objectives with frontline efforts, boosting operational efficiency, employee engagement, and patient experience. Laudio makes it possible for patients, frontline workers, and health system leaders to thrive together. Discover how at www.laudio.com.

Linus Health

Contact: Laura Kusek, event and partner marketing manager
events@linus.health
954.825.8389

Chief Growth Officer Curt Thornton and Chief Product Officer John Showalter, MD will be in attendance. Please email events@linus.health to request a meeting.

Linus Health is a digital health company focused on early detection of Alzheimer’s and other dementias. We combine rich clinical expertise with cutting-edge neuroscience and AI to help providers spot and intervene on early signs of cognitive impairment – even those invisible to the human eye. Our digital cognitive assessment platform puts specialist-level insights about a patient’s cognitive function at providers’ fingertips in a matter of minutes.

Medicomp Systems

Booth V1337

Contact: James Aita, director of business development and strategy
jaita@medicomp.com
647.207.0080

Clinical AI has healthcare abuzz. But how can you harness it to help make clinicians’ lives easier? Large language models (LLMs) are great at generating text, but clinicians need solutions to help them navigate compliance and quality reporting and complex billing requirements. The Quippe Clinical Intelligence Engine leverages LLM output, converts it into actionable data, and makes sense of it to help clinicians find what they need at the point of care to make their jobs easier. Meet with at Vive booth V-1337 to learn more about Medicomp’s clinical-grade AI solutions and Smart-on-FHIR apps for CQM compliance, HCC coding and risk adjustment, bi-directional interoperability, CDI and audit-readiness, point-of-care decision-making and more.

MEDITECH

Booth 1524

Contact: Rachel Wilkes, director of marketing
rwilkes@meditech.com
781.774.4555

From the deployment of the latest AI solutions to industry-leading efforts in precision medicine and interoperability, discover how MEDITECH is making its vision for healthcare transformation a reality at ViVE 2024. MEDITECH staff and executives will be available at booth #1524 to discuss new Expanse tools for addressing key industry issues including: mobility, precision medicine, innovative care models, efficiency of care teams, interoperability, and AI.

In addition to activities in the booth, MEDITECH executives will also be speaking as part of the ViVE agenda:

On Monday, February 26 at 3 p.m., LACC, Show Floor, Venice Beach Stage MEDITECH’s Executive Vice President and Chief Operating Officer Helen Waters will be joined by leaders from Oracle and Epic for the “Back to the Future of Healthcare: Tomorrow’s EHR Landscape” session. They will discuss the future of healthcare and the transformative impact technological advancements have on patient experience and healthcare delivery.

MEDITECH Senior Director of Interoperability Market and Product Strategy Mike Cordeiro will host a session on Intelligent Interoperability on Monday, February 26 at 2:15 p.m. at the Tech Talk Stage. His presentation will focus on how EHRs should operate as data platforms – collecting, integrating, managing, analyzing, and presenting data in meaningful and actionable ways. Cordeiro will also highlight MEDITECH’s strategy for supporting interoperability standards and open API approaches that enable healthcare organizations to share meaningful data.

MEDITECH customer leaders will also participate as panelists in ViVE sessions, including: On Monday, February 26 at 2:00 p.m., LACC, Show Floor, Sunset Strip Stage Emanate Health Chief Information Officer Daniel J. Nash, MBA, PMP, CHCIO, CDH-E will discuss healthcare’s post-pandemic financial and workforce challenges in the session “Inside Job: Operating with Lean Staff and Healthy Margins.” The healthcare leaders will share cost-control strategies including workforce optimization and utilization of technology to enhance operational efficiency. HCA Healthcare Senior Vice President and Chief Information Officer Marty Paslick will join other panelists in discussing the ethical considerations, possible biases, and other challenges with AI in medical decision-making in the session “Awakenings: The Perils of AI Success” on Monday, February 26 at 4 p.m., LACC, Show Floor, Hollywood Stage. Attendees will learn more about the importance of responsible implementation to ensure patient safety and privacy.

QGenda

Booth 2112

Contact: Dan Kamyck, senior director of growth marketing
Dan.Kamyck@qgenda.com
770.399.9945

As a CHIME Foundation Member, QGenda executives will also be available for meetings at Club CHIME, located at Booth 2801.

Healthcare workforce optimization starts with the schedule. QGenda transforms healthcare workforce management with QGenda ProviderCloud, a single platform to activate, deploy, and optimize the entire care team. QGenda executives are on hand to help you manage change within your healthcare workforce. CHIME members – Be sure to sign up for QGenda’s Focus Group session, “Navigating Change: Digital Transformation to Optimize Your Workforce,” which will take place on Sunday, February 25 at 1:15 p.m. PST. To attend, please sign up with CHIME.

ReMedi Health Solutions

Contact: GP Hyare, managing director

g.hyare@remedihs.com
281.413.8947

ReMedi Health Solutions is a nationally recognized, physician-led healthcare IT consulting firm specializing in peer-to-peer, physician-centric EHR implementation and training. We’re a clinically driven company committed to improving the future of healthcare. We’re passionate “Clinician Whisperers” that believe understanding the “why” behind each EHR decision is as important as the “what” or “how”. We listen to physicians, nurses, and healthcare leaders in order to understand their biggest challenges, and we leverage our decades of experience to develop efficient solutions that greatly impact the delivery of care.

ReMedi designs customized training solutions that incorporate clinical workflows, evidence-based content, financial performance, and patient experience. Our clinicians and management consultants work with clients to: Improve physician satisfaction and engagement by enhancement of workflow and enabling efficient use of available tools. Enable physicians to more easily and accurately document patient conditions, comorbidities and acuity. Improve financial performance by capturing patient complexity. Evaluate reporting capabilities which allow the tracking of provider documentation and implications for the revenue cycle. Improve intra- and interdepartmental workflows between registration, physicians, and coding.

Rhapsody

Booth 2423

Contact: Michelle Blackmer, marketing
Michelle.Blackmer@Rhapsody.Health
312.520.1873

Visit Rhapsody at ViVE! Heading to ViVE 2024 in Los Angeles? Stop by booth 2423 and learn how health systems and digital health teams rely on Rhapsody to reduce the barriers to digital health innovation adoption by streamlining patient data access. Not heading to ViVE? Not to worry. We can still talk digital health enablement. Schedule a meeting with us.

Tegria

Booth 1624

Contact: Kristin O’Neill, senior director of external relations
kristin.oneill@tegria.com
617.319.5516

Tegria is a global healthcare consulting and services company delivering end-to-end solutions that leverage technology to help provider and payer organizations transform healthcare. Let’s schedule time to connect at Tegria’s Transformation Hub, located at booth 1624! Tegria solution experts will be available throughout the event, so this would be a great opportunity for us to brainstorm about solutions to your latest challenges. Schedule time to connect with us.

• Tech Talk: “Scoring Big on Patient and Provider Experiences.” Monday, February 26 at 2:30 p.m. PT Mark your calendar and join Tegria at the Tech Talk Stage as we discuss the importance of taking a team-based approach to patient experience. Join us for this must-attend session to explore how a collaborative approach can transform healthcare delivery.
• Happy Hour at the Tegria Transformation Hub Monday, February 26 at 4 p.m. PT After a full day of sessions and networking, stop by our Transformation Hub at booth 1624 beginning at 4:00 p.m. where you’ll be able to swap stories from the show floor, share your thoughts about a particularly interesting session you attended, or just unwind with some of your favorite Tegria experts.

TrustCommerce, a Sphere Company

Booth 1249

Contact: Ryne Natzke, chief revenue officer
rynen@spherecommerce.com

Visit TrustCommerce at Booth #1249! TrustCommerce provides comprehensive patient card payment solutions integrated with top EHRs that has earned the trust of many of the largest healthcare organizations in the US. Transform the way you process payments with TrustCommerce’s 20+ years of expertise in healthcare provider support. Experience secure and compliant payment processing, anytime and anywhere – all while being seamlessly connected to leading EHRs like Epic, Veradigm, and AthenaIDX. Meet our team, enter to win an Amazon Echo Show, catch a demo, and pick up some cool swag at booth #1249. See you there!

Upfront Healthcare

Booth 2130

Contact: Margy Enright, VP brand strategy and experience
menright@upfronthealthcare.com
913.568.1520

Upfront is a mission-driven healthcare company delivering tangible outcomes to leading healthcare systems and provider groups. Its patient engagement platform makes each patient feel seen, guiding their care experience through personalized outreach. The backbone of the Upfront experience is its data engine, which analyzes clinical, sociodemographic, and patient-reported data. These insights, along with its advanced psychographic segmentation model, allow Upfront to individually activate patients to get the care they need while building a meaningful relationship between the patient and their health system. Upfront is rooted in partnership, leveraging best-in-class healthcare expertise to maximize the impact of technology and deliver a next-generation patient experience.

News 2/7/24

Top News

Inovalon acquires clinical surveillance and patient safety software vendor VigiLanz.

The deal marks Inovalon’s fifth recent acquisition and the first since the company was acquired by a private equity consortium in 2021 at a $7 billion valuation.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Laudio. The Boston-based company empowers health system leaders to drive large-scale change through everyday human actions. Its platform streamlines workflows for frontline leaders, strengthens interpersonal connections, and aligns C-suite goals with frontline actions – helping health systems improve operational efficiency, employee engagement, and patient experience. Laudio makes it possible for patients, frontline workers, and health system leaders to thrive together. Thanks to Laudio for supporting HIStalk.

Webinars

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

Acquisitions, Funding, Business, and Stock

Healthcare tech sales and market intelligence startup Bonfire Analytics raises $2 million.

Ambience Healthcare, which has developed an AI operating system, raises $70 million in a Series B funding round, bringing its total raised to over $100 million. The co-leaders of the round are OpenAI’s Startup Fund and Kleiner Perkins.

Hamilton Beach Brands acquires Ireland-based HealthBeacon, which offers a digital health platform for patients who inject medications at home for chronic conditions. The company previously marketed HealthBeacon’s product in the US within its Hamilton Beach Health brand, which it plans to expand into remote monitoring systems.

Digital sleep therapy app vendor Stellar Sleep raises $6 million in seed funding.

Astarte Medical, which sells precision nutrition software for NICUs, will shut down and offer its intellectual property for sale. The eight-year-old company blames long hospital sales cycles that caused lower-than-expected sales that didn’t meet the expectations of investors, who suggested to co-founder and CEO Tracy Warren, MBA that she throw in some AI to capitalize on the funding boom. She said she would not be comfortable with AI-recommended therapy and instead chose to close the business.

Publicly traded value-based primary care provider Cano Health files for Chapter 11 bankruptcy and is looking for a buyer. Shares are down 99% since the company went public in June 2021 via a SPAC merger, valuing the company at $12 million.

Sales

• Yuma Regional Medical Center (AZ) selects NRC Health’s Human Understanding patient experience optimization software and programs.
• The Queen’s Health System (HI) chooses Medaptus Assign to assign patients to hospitalists with rules-based patient census integration with Epic.
• Bill & Melinda Gates Foundation licenses the NSights de-identified patient database that the company sources from several premier health systems.

People

HCA Healthcare promotes Chad Wasserman, MBA to SVP/CIO upon the retirement of Marty Paslick.

Availity names Jennifer Irwin (Alegeus) chief marketing officer.

Aaron Wootton, MBA (Henry Ford Health System) joins Huntzinger Management Group as chief digital officer.

Alphabet’s Verily hires Myoung Cha, JD, MBA (Carbon Health) as chief product officer.

Announcements and Implementations

Variety Care (OK) goes live with EVisit’s telehealth platform at three of its clinics and across its behavioral healthcare team.

Government and Politics

SAMHSA and ONC launch the Behavioral Health Information Technology Initiative, which will invest $20 million over the next three years to promote the use of health IT within behavioral healthcare and practice settings.

Privacy and Security

Northern Light Health, a 10-hospital system in Maine, brings its computer systems back online after a weekend cyberattack forced it to activate downtime procedures. Hospital officials say the attack was not the result of ransomware.

Other

San Diego-based Sharp HealthCare’s Spatial Computing Center of Excellence distributes 30 of the newly launched Apple Vision Pros to physicians, nurses, informaticists, software developers, and others to determine how the virtual reality headset can best used in healthcare settings. Sharp is working with Epic on possible uses.

Primary care physicians are spending an increasing amount of time working in their EHRs, according to a new report that looks at the usage data of 141 UW Health PCPs over a four-year period. The 28-minute increase was mainly driven by patient portal messaging, with patient medical advice requests being the biggest chunk of messaging volume.

The University of Rochester Medical Center (CT) installs Higi health stations at three community banks as part of an initiative to provide patients living in rural areas with better access to care.

Sponsor Updates

• Netsmart announces its support for the launch of the CMS Innovation in Behavioral Health model.
• AdvancedMD announces QBSolutioneers as its newest integration partner.
• Health Data Movers joins the ServiceNow Partner Program.
• Optimum Healthcare IT launches a new healthcare IT information and best practices newsletter called The Optimum Pulse.
• Artera receives Frost & Sullivan’s 2023 Customer Value Leadership Award.
• Censinet will present at the AHA Rural Health Care Leadership Conference February 11-14 in Orlando.

Blog Posts

• 2024 CPT Code Set Overview (AGS Health)
• Risk adjustment software: Key concepts and top vendors (Arcadia)
• How are Aridhia Customers Syndicating with HDR UK? (Aridhia Informatics)
• Revolutionizing Wellness: Navigating the Future of Digital Health in 2024 (Direct Recruiters)
• The Evolution of Prior Authorizations (Availity)
• Protect Healthcare’s Greatest Asset: Your Staff (AvaSure)
• New HHS Cybersecurity Performance Goals Help to Prioritize Security Practices, But Truly Protecting Healthcare Organizations Takes Much More (Clearwater)
• Taming the Tsunami of Clinical Data for Better Patient Care (DrFirst)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

Monday Morning Update 2/5/24

Top News

The National Institutes of Health seeks $200 million in funding to replace its Altera Digital Health Sunrise system that it calls CRIS.

NIH Clinical Center CIO Jon McKeeby says that 40 of his 120 IT employees are at retirement age, raising concerns about support for the complex, best-of-breed system that the hospital installed in 2004 when it was known as Eclipsys Sunrise Clinical Manager. 

Reader Comments

From Snowbound: “Re: Oracle Health. Laid off 124 Cerner employees in Springfield, MO after CoxHealth announced that it is moving to Epic.” Oracle filed a WARN act notice with the state on February 1, adding that the health system has already made offers of employment to all of the employees who were affected.

From Twin Cities Healthcare Watcher: “Re: Allina outsourcing RCM to Optum. This will be interesting considering the MN AG’s focus on Allina’s billing practices and the history of regulatory intervention in MN with outsourced billing services such as at Fairview in 2012-2013.” Fairview’s former RCM vendor Accretive Health, renamed in 2017 to R1 RCM, paid a fine and agreed to stop doing business in Minnesota in 2012 after being charged with lax security practices and sending high-pressure employees into the hospital ED to demand payment in advance from patients who were suffering from strokes and heart attacks. Accretive referred to the practice as “Accretive Secret Sauce” that it internally proclaimed “check out our ASS.” Accretive’s big customer Ascension partnered with a private equity firm to buy a 40% stake in the company for $200 million in late 2015, since increased to a 54% share.

From LinkedIn Park: “Re: interview. It seems like everyone in the industry I know reached out to me the day my interview with you ran, and I have quantified the HIStalk effect by observing that my LinkedIn profile views are up over 300%.” Thanks for letting me know. 

HIStalk Announcements and Requests

A majority of poll respondents say they have experienced discrimination that hurt their careers, most commonly related to age and sex.

New poll to your right or here: How has the market competitiveness of the former Cerner changed since Oracle acquired it in June 2022?

Thanks to these companies that recently supported HIStalk. Click a logo for more information. Also, extra thanks to long-time HIStalk Founding Sponsors Healthwise and Medicomp Systems. 

Webinars

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

Acquisitions, Funding, Business, and Stock

Allina Health will outsource IT and revenue cycle management services to Optum, which will rebadge 2,000 health system employees effective May 5.

HCA Healthcare says in its earnings call that a key area of investment will be advancing the company’s digital capabilities to “unlock the embedded value we see in our operations.”

A Boston Globe reporter tracks down the 190-foot, $40 million, Galapagos-docked yacht that is owned by Ralph de la Torre, MD, MS, the former heart surgeon who partnered with a private equity firm to create Steward Health Care Systems as CEO. The reporter notes that Steward, which is teetering on insolvency that may force a taxpayer bailout, quadrupled the private equity firm’s investment by selling the land under its hospitals, allowing the company to walk away with $800 million and de la Torre to award himself a $100 million bonus, after which he yachted up.

Announcements and Implementations

In Canada, a university IT professor says that the health system has squandered billions of dollars on proprietary software development that led to all 10 provinces having their own expensive IT systems that don’t work together. He advocates developing open source software for billing, labs, and diagnostic imaging instead using HermesAPI, which would mean “sending less money to prop up American software companies.”

Visage Imaging launches Visage Ease VP for Apple Vision Pro. It includes a cinematic rendering engine, 4K resolution on virtual screens, independence from room lighting, and natural input using hands, eyes, and voice.

Cedars-Sinai develops Xaia, a mental health support app for the Apple Vision Pro. It offers immersive therapy sessions that are led by a digital avatar that simulates a human therapist. The hospital has licensed the system to VRx Health for commercialization.

The Permanente Medical Group publishes its initial experience with Nabla’s smartphone-based ambient scribing system, which it says has been used by 3,400 of the 10,000 invited physicians, of which around 1,000 have used it for more than 100 encounters. Physicians report that it is saving them time, even though they are required to approve the AI’s draft version, and patient feedback has been positive. The most common reasons for not using the tool include the required activation steps, lack of familiarity, and lack of integration with other workflow solutions.

Government and Politics

Two Texas doctors are indicted in federal court for submitting phony medical bills to the insurers of student athletes that they had not treated. The doctors, who owned sports medicine practice management system vendor Vivature, used the patient information that had been entered by athletic trainers to submit fraudulent bills for other services. The indictment lists three universities, including Auburn University, that shared the payment that Vivature received. The defendants are also charged with fraudulently billing for COVID-19 testing in partnership with international resorts who tested Americans who were traveling aboard. The DoJ says the defendants obtained $70 million between the schemes.

Privacy and Security

Computer, phone, and email systems remain down at Lurie Children’s Hospital (IL) following a February 1 cyberattack.

The CEO of one of the five hospitals whose shared services organization was taken offline by cyberattack in October 23 says that some major systems remain down and he expects that it will take most of 2024 for the hospital to fully recover from the attack.

Other

Not (yet) healthcare related. A finance employee of a huge Hong Kong company makes a $26 million money transfer for a confidential corporate transaction, as instructed in a video call with the CFO and other executives. He learned afterward that the video call attendees were AI-generated deepfakes and the money recipients were scammers.

Sponsor Updates

• Waystar joins Meditech’s Alliance program
• EClinicalWorks announces that its Sunoh.ai AI-powered ambient listening technology now integrates with EClinicalMobile and EClinicalTouch apps on iOS and Android smartphones, iPads, and Microsoft Windows and macOS devices.
• NeuroFlow will exhibit at the AMSUS 2024 Annual Meeting February 12-15 in National Harbor, MD.
• RxLightning (Claritas Rx) names John Paulson senior director of business development.
• SnapCare will exhibit at the ACNL Conference February 4-7 in Monterey, CA.
• Symplr achieves milestone recognitions in 2023, garnering industry and employee acclaim as a leader in healthcare operations.
• Wolters Kluwer Health makes the NEJM AI journal available on its Ovid medical research platform.

Blog Posts

• Best practices for building an AI-powered digital front door in healthcare (Notable Health)
• Fireside Chat Highlight Reel: Medical Coding Automation Trends and Autonomous Coding (Nym)
• NAHC President Bill Dombi Gives His 2024 Outlook (Netsmart)
• 5 questions to ask when you’re at a crossroads in your EHR strategy (Nordic)
• Rachel Marano in Fast Company on Workaholism (Pivot Point Consulting)
• How to Determine When It’s Time to Optimize Your Epic EHR (CereCore)
• Maximizing Healthcare Revenue: 3 Practical Tips for Transforming Front-End Processes (Vyne Medical)
• Important Changes to MIPS Reporting in 2024 (RCxRules)
• Crystal Ball Chronicles: Reflecting on Out of Pocket Health’s 2024 Predictions (Redox)
• Leadership Spotlight: Jazmin Richardson, Nursing Executive (Sonifi Health)
• A Health Plan, an EHR, and a Health System Team Up, Eyeing a Win for Patient Care (Surescripts)
• 5 strategies to overcome patient payment complexities (Waystar)
• Strategies for Effective Revenue Cycle Automation – Start Small (VisiQuate)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

News 2/2/24

Top News

A Stat review says that digital therapeutics is stagnating in the US, as evidenced by vendor bankruptcies and lack of Medicare coverage for their products.

The authors note that Pear Therapeutics shut down less than a year after CMS denied the company’s request to consider its substance abuse order product (pictured above) as a billable medical device.

Few commercial payers cover digital therapeutics because of concerns about efficacy, which poorly designed vendor studies have failed to prove.

The article says that vendors who want their products covered like traditional drugs will need to perform similar studies that meet a comparable standard of evidence, which is risky because of high cost and the possibility that their products aren’t effective. They could also sell their products to providers who might be reimbursed by payers for achieving specific results.

HIStalk Announcements and Requests

Thanks to the folks at DrFirst, which booked the Top Spot banner (at the upper right of the HIStalk page) for the long term, initially to showcase their participation in the ViVE conference. I appreciate the support.

Repetitive, I know, but winding down – sponsors that are participating in ViVE and/or HIMSS should complete the respective forms so I can list you in my guides pro bono (does that word make you think of U2 or Cher?)

Webinars

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

Acquisitions, Funding, Business, and Stock

Cardinal Health acquires group purchasing company Specialty Networks for $1.2 billion in cash, calling out the strategic value of its AI-driven PPS Analytics product that analyzes data from EHR/PM, imaging, and dispensing systems for clinical decision-making and for purchase by drug companies.

Medical practice patient communication technology vendor Vital Interaction raises $15 million in Series A funding.

Fabric, a healthcare enablement startup that was formerly known as Florence, acquires Gyant, which offers health systems an AI-powered virtual assistant.

Prior authorization technology vendor Cohere Health raises $50 million in equity funding, increasing its total to $106 million. It has five health plan customers.

Hindenberg Research predicts a “breakdown” for private equity-backed mental health rollup LifeStance, which has 6,400 clinicians, 600 centers in 33 states, a market cap of $2 billion, and a mountain of debt. It says the company is running out of cash, employs mostly therapists who bill at low rates compared to psychiatrists, provides stock grants to its highest-performing prescribers of drugs that have a high abuse potential, and pushes clinicians to see up to 30 patients per day. Former employees say that the industry has such low barriers to entry that LifeStance provides no value or even negative value because “all you need to do to open up your own private practice is post a thing on Facebook and start seeing private, cash-only patients.”

Sales

• Smile Train will provide its partners and affiliates access to select medical journals via Wolters Kluwer Health.
• VNAcare expands its relationship with Netsmart to implement its MyUnity EHR.
• ACO Vytalize Health will use WellSky Next-Generation Provider Solution for care coordination between acute and post-acute providers.

People

Oracle expands the role of former CMS Administrator Seema Verma, MPH to EVP/GM of Oracle Health, the former Cerner business.

Workforce management solutions vendor Hallmark Health Care Solutions names industry long-timer Bruce Cerullo, MS as CEO. He replaces co-founder Isaac Ullatil, MBA, who will transition to strategic advisor.

JTG Consulting Group hires Jaimie Augustine (Copan Diagnostics) as chief growth officer. She replaces Lisa Potter, who was promoted to COO.

Announcements and Implementations

Atlantic Health will acquire Saint Peter’s Healthcare (NJ) and move it to Epic.

ECRI lists its top health tech hazards for 2024:

1. Usability of medical devices intended for in-home use.
2. Insufficient cleaning instructions for medical devices.
3. Drug compounding without technology safeguards.
4. Environmental harm from patient care.
5. Lack of AI governance in medical technologies.
6. Ransomware.
7. Burns from single-foil electrosurgical electrodes.
8. Medication errors caused by damaged infusion pumps.
9. Defects in orthopedic implantables.
10. Web analytics software and the misuse of patient data.

Publicly traded hospital operator Community Health Systems migrates to a FHIR-based clinical data platform on Google Cloud and is implementing the company’s AI technologies.

Government and Politics

A law firm says that an Epic case that was heard by the Supreme Court raises the legal issue of proving that employees actually signed arbitration agreements that include employment class action waivers. It notes that employees are arguing that they don’t remember signing the agreement, which places the burden on the employer to prove that their electronic signature wasn’t provided by someone else.

The Substance Abuse and Mental Health Services Administration makes some COVID-19 flexibilities permanent, including the ability for Opioid Treatment Programs to prescribe opioid use disorder medications via telehealth without an initial in-person evaluation.

England’s health regulator finds that IT systems at Newcastle upon Tyne Hospitals – a Global Digital Exemplar and HIMSS EMRAM Stage 6 designee – are not always integrated and don’t always promptly provide staff with information they need. Inspectors noted that OR information is documented on paper and then entered into electronic systems afterward because of slow systems, which was measured at 45 minutes from log-in to retrieval of a single patient’s vital signs and fluid balance. The inspectors also observed that maternity staff are required to document the same information in two systems due to lack of integration.

Regional West Medical Center settles its contract dispute with Oracle for $6 million versus the $15 million that the company wanted, freeing it to convert to Epic. The hospital blamed financial losses and the lowering of its bond ratings on the revenue cycle disruption that was caused by its 2018 implementation of Cerner Millennium.

Other

A data manipulation expert uses AI to determine that a Harvard Medical School neuroscientist included plagiarized images in 21 journal articles, including images that came from other papers and from vendor websites.

Sponsor Updates

• CereCore publishes a new case study, “Liverpool Women’s NHS Foundation Trust: Successful EPR Transition Journey.”
• Hyndman Area Health Center expands its use of EClinicalWorks technology with the addition of AI solutions including the Sunoh.ai virtual scribe.
• WellSky will use cloud, analytics, and AI technologies from Google Cloud.
• Impact Advisors joins Epic’s new Rev Cycle Partners program.
• Findhelp names Dallas Mudd (United Way of Northwest Arkansas) senior director of partnerships.
• Health Data Movers welcomes Eric Williams (Kaiser Permanente) to its board.
• Inovalon names Katie Smith (Inari Medical) senior manager of clinical analytics.
• The Lean HealthTech Podcast features KeyCare CEO Lyle Berkowitz, MD “Virtual Visionaries: KeyCare’s Revolutionary Approach to Telehealth.”
• Konza National Network appoints Jonathan Smith, MPH (Lawrence-Douglas County Public Health) to its Board of Directors.
• Broadlawns Medical Center (IA) maximizes efficiency with Meditech’s labor and delivery solution.

Blog Posts

• Three clinical information challenges for care teams (Wolters Kluwer Health)
• Benefits of Medical AI Scribe Integrated within the EHR (EClinicalWorks)
• FDB Salutes Heroes Unleashing Power of Medication Decision Support (First Databank)
• Why Paper-Based Processes are Costing Your Health System (Vyne Medical)
• Social Drivers of Health (SDoH) Analytics: Health Leaders Amplify Impact Through Insights (Findhelp)
• HFMA Western Region Symposium 2024 Recap (FinThrive)
• #FreeTheContent (Healthwise)
• Establishing an Effective Change Management Office for Organizational Evolution (Impact Advisors)
• Top Healthcare AI Conferences 2024 – Part 1 (Lucem Health)
• Mastering Patient Retention: 5 Strategies to Prevent Leakage (Medhost)
• Preparing home health agencies for value-based purchasing in 2025 (Meditech)
• The Future of Wound Care Starts with Clinical ROI (Net Health)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

News 1/31/24

Top News

A district attorney in New York charges a 21 year-old Florida man with stealing the prescribing credentials of hundreds of doctors, which he used to fill and sell tens of thousands of prescriptions for narcotics across pharmacies in multiple states. He faces 19 charges, including illegally selling controlled substances and diverting prescription medications.

Devin Magarian sold prescriptions that customers picked up themselves or would provide the actual drugs that his team of runners obtained from the pharmacies. He charged premium prices to customers, who he recruited via a Telegram advertisement board, because the drugs came directly from pharmacies with no chance of adulteration.

He was arrested while visiting New York to collect $14,000 from a customer who had bought 630 Oxycodone pills using one of the fake prescriptions.

The Nassau County, NY district attorney warns that drug dealers have turned into cybercriminals who know how to exploit e-prescribing systems, noting that the defendant issued 18,500 phony prescriptions to pharmacies in 18 states in a single five-hour period. Authorities have not provided details on which system he compromised or how he did it.

Reader Comments

From Force of Nature: “Re: Summa Health. I heard the podcast stumble that you mentioned about their cost of implementing Epic. Summa has corrected the transcript to $85 million.” Thanks.

HIStalk Announcements and Requests

Sponsors: you still have time to complete my information form for ViVE and/or HIMSS if you are participating.

Webinars

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

Sales

• HHS’s Advanced Research Projects Agency for Health selects IT support, design, development, and implementation services from Leidos.
• Torbay and South Devon NHS Foundation Trust in England will replace 25 systems with Epic.
• Vytalize Health will use WellSky’s Next Generation Provider technology to enable bi-directional communication and care coordination between Vytalize’s ACO members and acute and post-acute care providers.

People

Unlock Health names Kevin Thilborger, MHA (Huron) chief managed care officer and chief revenue strategy officer.

Kerry Armstrong (Care.ai) joins LookDeep Health as VP of sales.

Glytec names Patrick Cua (HealthStar Growth Partners) CEO; Erik Eaker, MHA (LetsGetChecked) COO; and Ashley Reynolds, PhD, RN, MSN (Vault Coaching and Consulting) chief product and experience officer.

Keith Eggert, MHA (University of Miami Health System) joins Abax Health as chief strategy officer.

Aaron Rucker, MBA (University Clinical Health) joins Murray-Calloway County Hospital as CIO.

Manhattan Surgical Hospital (KS) hires Joe DeSimone (Umbrella Managed Systems) as CIO.

Katie Peppler (Tegria) joins B.well Connected Health as VP of strategic accounts.

Retired industry long-timer Matt Atwood, MBA, MSHI, who was most recently global implementation leader of Philips Connected Care Informatics, died of colon cancer last week. He was 55.

Announcements and Implementations

Israel’s Health Ministry confirms that at least 20 hospitals have been affected by a software glitch within Elad Health’s Chameleon EHR that has led to dozens of patients being given incorrect medications. Ministry officials were first alerted to the problem 10 days ago, when hospitals began reporting that patient discharge letters contained the wrong prescriptions. Elad Health says the malfunction has been fixed. The EHR is used by 75% of Israel’s hospitals.

Atropos Health collaborates with Google Cloud to connect its de-identified patient database to Google Cloud’s tools.

Philips will stop selling its Respironics sleep apnea machines in the US to settle federal charges that the devices contained noise-reducing foam that the company knew could disintegrate and cause cancer in users. The company recalled the machines in mid-2021, several years after it was made aware of the problem. Users were advised to stop using the machine during the recall period that lasted more than a year. Philips, whose CPAP machines held a 37% market share in the US, could also face criminal charges.

Government and Politics

The Justice Department is reportedly issuing subpoenas to drug companies and EHR vendors to determine if AI is being used to influence prescribing in ways that breach anti-kickback and false claims violations. EHR vendor Practice Fusion, now owned by Veradigm, paid $145 million in 2020 for using EHR alerts to push the prescribing of opioids in a contract with drug maker Purdue Pharma. The lead investigator who pursued Practice Fusion and four other EHR vendors says that Practice Fusion made some attempt at compliance, AI-driven recommendations could be harder to track and could make more persuasive recommendations using personalization.

Texas Attorney General Ken Paxton requests medical records from a second out-of-state provider, seeking information from a Georgia telehealth clinic to verify that it does not offer gender-affirming care to Texas minors. The state requested extensive records from Seattle Children’s Hospital in November, and the Georgia clinic owner says she has seen similar letters that were sent to other organizations. The requests raise questions about the Texas AG’s authority over other states and HIPAA’s requirement to provide patient records only in response to a court order or subpoena after notifying the patient.

Other

Meritus Health (MD) credits its Epic system for helping it reduce opioid prescriptions by 55% over the last five years. The switch to Epic in 2018 allowed doctors to see facility-wide prescriptions in real time and yielded data that was used to create the policies of its new Pain Management and Opioid Stewardship Committee.

Sponsor Updates

• CereCore publishes a new e-book, “The Buyer’s Guide to IT Managed Services: Elevating Healthcare Excellence.”
• Agfa HealthCare celebrates a 20-year image management partnership with Amiri Hospital in Kuwait.
• Cardamom Health names Jennifer Riffle (Nordic) a senior consultant.
• Censinet will support healthcare organizations interested in assessing, managing, and improving coverage of and compliance with the Healthcare and Public Health Sector Cybersecurity Performance Goals recently released by HHS.

Blog Posts

• Underpayment Management: Strategies and Best Practices (AGS Health)
• Population Health Management Software: The Ultimate Guide (Arcadia)
• Facilitating Project Team Dynamics with a DRE (Arhidia Informatics)
• Ten Years Dedicated to Movement Health (Bardavon Health Innovations)
• Improving post-acute care and cost with technology (CarePort)
• Network Cybersecurity Starts with Network Maintenance (Clearwater)
• Navigating the Healthcare Technology Landscape: Embracing Digital Transformation for Long-Term Cost Savings (Direct Recruiters)

Black Book’s list of top, physician-rated ambulatory EHR vendors include the following HIStalk sponsors:

• Netsmart – behavioral and mental health / geriatrics / physical therapy and rehab / psychiatry
• Medhost – emergency medicine
• Experity – urgent care and occupational medicine

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

Monday Morning Update 1/29/24

Top News

UK doctors warn that patient care will suffer under new laws that would limit their use of messaging apps such as WhatsApp and Signal for clinical use.

A journalist’s BMJ article says that a law requires that encrypted messages be placed under government surveillance by the national communications regulator to look for harmful or illegal content, rendering patient data insecure.

A law also requires that messaging app security upgrades be approved, which could take months, leading major tech providers such as Meta, Apple, and Signal to threaten to withdraw services to the UK. Wikipedia has already said it will not be able to operate under a law that tracks user identities, actions, and content submissions.

Clinical informatician Marcus Baw, MBChB says that NHS should have built its own encrypted app that connects to its email system.

Reader Comments

From Industry Recruiter: “Re: LinkedIn an ageism. Here are my thoughts.” A summary of this recruiter’s list, sent in response to my comments last week:

• It’s ideal to include a headshot on LinkedIn, taken professionally within the past 10 years, but lack of a photo doesn’t dissuade them.
• List all relevant work experience, even if it goes back more than 10 years, if it adds credibility to the industry or job you are seeking.
• Listing more credentials never hurts unless you can show no real work experience with them.
• Include at least one bullet for each job in your summary that highlights a specific accomplishment.
• Don’t make the write-up so wordy that people can’t get a good review in a minute or two. Save descriptions of skills, such as teamwork or mentoring, for the resume.
• Ask for LinkedIn recommendations.
• It doesn’t hurt to publish LinkedIn articles, but that isn’t going to shift their view from the work experience.

From Unleaded: “Re: Epic Showroom. It brings together legacy partner programs such as App Orchard, Connection Hub, and Partners & Pals. It has four key parts: (a) Supply Shot for people support; (b) Health Grid, for providers connecting to the broader ecosystem such as payers, labs, and telehealth networks; (c) Products, a three-tiered partnership list that includes a list of all third-party apps, Toolbox for specific apps like Nuance DAX that follow Epic’s integration guidelines, and Workshop for companies like Abridge that are co-developing with Epic; and (d) Cornerstone Partners, companies like InterSystems and Microsoft whose software is used significantly by Epic.”

HIStalk Announcements and Requests

Poll respondents say that General Catalyst’s biggest challenge as a venture capital firm that is buying a non-profit health system is to either swing it to long-elusive profitability or hope that its losses are made up elsewhere in its portfolio.

New poll to your right or here: Which of the following forms of discrimination do you suspect had the strongest negative influence on your career in the past five years? It’s your best guess, of course, since companies and managers who discriminate aren’t usually stupid enough to brag about it.

How to support HIStalk with practically no effort:

• Sign up for spam-free email updates that I send when I post something new.
• Connect and follow on LinkedIn and join Dann’s HIStalk Fan Club. The first thing I do if someone wants a favor is to see if we are connected or if they are among the 4,195 fan club crew.
• Mention HIStalk to your colleagues and vendors.
• Share news, rumors, and intriguing insights.

Sponsors: complete my information form for ViVE and/or HIMSS if you are participating and I’ll include you in my online guide. In the immortal words of John Blutarsky, don’t cost nothin’.

Reader comments about Medicare’s conclusion that telehealth use has dropped of to nearly pre-pandemic levels led me to look beyond the headlines:

• The Medicare Telehealth Trends Report looked at the percentage of eligible Medicare beneficiaries who had at least one Part B claim for a telehealth encounter between January 1, 2020 and June 30, 2023, suggesting that the yearly percentage has dropped from 48% in 2020 to 34% in 2021 and 29% in 2022.
• The quarterly percentage jumped from 7% in Q1 2020 to 47% in Q2 2020, then settled into a 15% or so level from Q2 2022 until now.
• Medicare didn’t report pre-COVID numbers to provide a true baseline, but a previously reported GAO review said that 0.3% of Part B beneficiaries used telehealth services in 2016, so basically nobody used it until the pandemic shut down many practices and CMS started paying providers equally for in-person and telehealth visits.
• Medicare’s numbers cover only Medicare beneficiaries who signed up for the optional, extra cost Part B that covers physician visits and outpatient care, although most people enroll in both. I’m assuming that the report also covered traditional Medicare only and not Medicare Advantage, which jumped from 39% of all beneficiaries in 2019 to 51% in 2023, but that’s a guess on my part.
• We don’t know the percentage of providers who offered telehealth services from 2020 until now, or how many beneficiaries would choose a telehealth encounter if their regular provider offered it.
• We don’t know how many Medicare beneficiaries received telehealth services that weren’t billed to Medicare.
• The recently noted surge in Medicare-covered services such as procedures – which is tanking the share price of Medicare Advantage insurers – may have temporarily or permanently reduced the demand for telehealth services as patients returned for deferred office visits.
• We don’t know how many providers discourage telehealth visits for their patients, either because they don’t like doing them or they prefer an in-person visit where additional services can be offered and billed.

Webinars

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

Acquisitions, Funding, Business, and Stock

A Boston Globe article says that while CVS Health is generating record revenue and executing a healthcare center strategy that includes its Aetna insurance, CVS Caremark pharmacy benefits management, and Oak Street/Signify provider businesses, profits are down because its core business of drugstores suffers from lower payments, a shortage of pharmacists, general labor shortages that create customer lines, widespread store closings, and the perception of dirty and poorly managed locations. The company blames PBMs for their efforts to reduce prescription costs, one of which is its own CVS Caremark, which controls 33% of that market.

Announcements and Implementations

JAMA Network publishes an interview with UCSF’s Atul Butte, MD, PhD, who is chief data scientist over the entire University of California Health System:

• UC’s 11-year repository of Epic data covers 9.1 million patients across 10 hospitals, 1.5 billion drug orders, 40,000 cancer genomes, and 50 million medical devices.
• He says that health systems will want to undertake similar work to develop standard medical practices that reduce care variation.
• UC uses “leave one medical center out” cross-validation, where they leave out one medical center when performing analysis and then see if the conclusions from the rest pan out for that remaining hospital.
• The organization will work with drug and AI companies only if its own patients benefit.
• He foresees a day when EHR-trained AI can be deployed to doctors via order sets and decision support tools and even to patients, who might have their own decision support tool on their smartphone. He says that big health systems will probably developed their own branded AI assistant, but their data could be used to help hospitals that don’t have those resources.
• Butte says he personally uses AI to write letters of recommendation, emails, and programming code.

In England, surveyed NHS doctors report that physician associates, who are being used to replace doctors despite having completed only a two-year post-graduate program, are prescribing drugs illegally and missing critical diagnoses. Physicians object to the plan to regulate PAs alongside physicians, and doctors report that PAs – who are renaming themselves from “physician assistant” to “physician associate” — are introducing themselves as doctors to patients. Meanwhile, a physician X user doctor calls PAs “noctors” (not a doctor), with screen shots showing a Royal London Hospital PA who brags on signing DNR forms and conducting an Instagram poll to decide how to perform an exam.

Cardiologists recommend in JAMA Cardiology that clinicians be mandated to capture SOGIE data (sexual orientation and gender identity and expression) in EHRs to help researchers understand the cardiovascular health of LGBTQ+ adults.

Privacy and Security

Ontario’s Bluewater Health restores its hospital systems that have been down since an October 23 cyberattack that affected five hospitals that had formed an IT shared services group. The hospital says legal implications prevent it from saying which parts of Meditech remain down, but confirms that it will be replacing the 20-year-old system with Oracle Cerner by the end of the year.

In the UK, former prime minister Tony Blair and former Conservative Party leader William Hague call on NHS to sell de-identified patient data to AI companies to use for training to develop patient monitoring tools. They also envision an NHS app that would give patients access to their own information and capture more data to sell. They call for NHS to set up a new data trust company that would oversee privacy in commercializing access to the information.

Other

An NHS doctor who was flying to a skiing vacation responds to the flight crew’s call for a doctor to assess a 70-year-old passenger’s health problems. The plane wasn’t equipped with a pulse oximeter, so he used a crew member’s Apple Watch to determine that the woman had low blood oxygen levels, which he successfully treated with oxygen. He praised the Ryanair staff afterwards, adding a recommendation that all plans carry emergency physician kits that include tools for basic measurement, diabetes, blood pressure, and oxygen saturation. He luckily borrowed an older watch since a patent dispute has forced Apple to disable the pulse oximetry function that he used in recently sold Apple Watch models.

Sponsor Updates

• SnapCare will provide contract staff transparency in its workforce marketplace, where it will itemize pay rates, travel costs, a standard rate that covers benefits and payroll taxes, and the company’s fee, saving clients an estimated 15%.
• NeuroFlow publishes a two-part case study featuring the success EvolvedMD found using NeuroFlow’s technology as a part of its efforts to integrate behavioral and physical healthcare services for its customers.
• Frost & Sullivan recognizes Wolters Kluwer Health as an “Innovation & Growth Leader” in clinical decision support systems.
• Centerpoint Health leverages data from the EClinicalWorks EHR and its Healow no-show prediction AI model to improve its clinical workflows.
• Vyne Medical releases a new customer success story, “Streamlining Fax Operations: A Growing Medical Center’s Success Story.”
• Revuud shares its key highlights of its 2023 performance, including 16 new customers.
• Symplr publishes its “Provider Credentialing 2024 Guide.”
• Waystar will exhibit at the HFMA Minnesota Winter Conference January 30-31 in Minneapolis.

Blog Posts

• Modernizing your digital front door to serve both patients and staff (Notable)
• E-Cloud Automates Well-Architected Framework Reviews with MontyCloud (Optimum Healthcare IT)
• Five Best Practices for Using Credentialing Workflows – Part Two: Proactively Establish Ownership (QGenda)
• CMS prior authorization rule finally crosses the finish line (Redox)
• Best Practices for Upgrading Mirth Connect: A Zen Healthcare IT Discussion (Zen Healthcare IT)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

News 1/26/24

Top News

Humana shares dropped 16% on Thursday as the health insurer issued full-year earnings guidance that was half of Wall Street’s expectations.

The company, which primarily sells Medicare Advantage insurance, said that its medical expenses have soared as patients return to hospitals to undergo pandemic-delayed procedures such as hip replacements. It warned that the trend is not related to respiratory conditions and thus is likely to continue.

Shares in other insurers such as UnitedHealth Group and CVS Health also slid on the news as investors became concerned about increased medical costs in their Medicare Advantage business.

The company reports Q4 results: revenue up 18%, adjusted EPS –$0.11 versus $1.97, beating revenue estimates but falling short on earnings.

HUM shares are down 29% in the past 12 months versus the S&P 500’s 22% gain, valuing the company at $44 billion.

Reader Comments

From Copy Cat: “Re: Dana-Farber research cheating. When did it become OK to replace ‘cheating, plagiarism, and lying’ with ‘data falsification’ or ‘inadequate citation?’ Any chance us non-academic elites would get a similar reprieve after falsifying resumes or dissertations?” I’m far from an expert since I’ve co-authored only a few articles in peer-reviewed journals and my contribution was incidental, but I’m guessing it relates to intent and extent (did they do it intentionally for some personal benefit and did it affect the article’s conclusions). Sometimes it’s a gray area, such as when authors publish on a topic without citing the seminal work of a pioneering researcher that they most certainly have read even if not used directly. The Dana-Farber researchers appear to have faked scientific graphics, although whether they did so to prove an incorrect conclusion or because of some logistical reason wasn’t stated (but is being investigated). The conclusion is that it’s better to do your own double-checking of citations instead of letting some cheap seats observer catch your misbehavior, whether inappropriate or not and even if it sneaks by peer reviewers.

From Conference Escalator: “Re: HIMSS24. The exhibitor count seems pretty low.” My interest level isn’t high, but since you asked, I scrolled and counted about 650 exhibitors, compared to maybe 1,200 to 1,500 before COVID and the emergence of competing conferences. But on the bright side, the exhibit hall will probably have carpeted aisles this year.

HIStalk Announcements and Requests

A reader asked about expressing years of work experience on LinkedIn while avoiding ageism. My initial reaction is that LinkedIn content doesn’t matter since at best it will get you an interview where you might face age discrimination anyway. Still, you have to avoid being shut out by recruiters and HR people who perform the initial screening, and there’s little effort required to make a better first impression. My conclusions (and it would be great to hear from recruiters who use LinkedIn to find or vet job candidates):

1. Use a professional, contemporary headshot from years ago, or doctor your photo to look younger. Nobody will feel offended or duped. You could omit the headshot entirely like a resume, but I assume most employers are like me in finding it creepy if someone intentionally leaves out a photo.
2. List only work experience going back a few years or a couple of jobs. Nobody cares before then.
3. Highlight (or obtain, if necessary) technical skills that prove that you keep up as well as younger people. Take a quick course in ChatGPT, Excel, Python, or sales prospecting software to prove that you stay current. Likewise, remove obsolete credentials and irrelevant accomplishments, especially those that go back to the college years.
4. Punch up the summary to emphasize accomplishment rather than elapsed time, especially if you can back up your achievements with numbers.
5. Emphasize your ability to work with a team, mentor, and expend extra effort.
6. Have a younger executive review your profile and resume to make sure that you are using modern terms and aren’t listing experience that is actually detrimental to finding a job.
7. Ask for LinkedIn recommendations.
8. Publish occasional LinkedIn articles ongoing, not just when you are suddenly facing a job search.

Webinars

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

Acquisitions, Funding, Business, and Stock

Mercy Hospital – Iowa City and Altera Digital Health settle their contract dispute that stood in the way of the bankrupt hospital’s acquisition by University of Iowa Hospitals & Clinics. The hospital’s contract with Altera will be dissolved and Mercy won’t pay any amount owed, although it will pay $6 million as unsecured debt. Altera will sign a new contract with UIHC so that the hospital can keep using Sunrise with vendor support as required by the acquisition.

Sales

• The State of Pennsylvania launches PA Navigate, a Findhelp-powered online tool that connects state residents with community-based organizations, county and state agencies, and healthcare providers to address basic needs.
• NorthStar Care Community and Hospice of Michigan will expand their use of Netsmart’s CareFabric platform, including the MyUnity EHR for hospice, home care, and palliative care.

People

Clearsense hires Jason Rose, MHSA (AdhereHealth) as CEO and board member. He replaces founder Gene Scheurer, who will remain on the board.

Ochsner Health promotes Amy Trainor, RN, MHSA to SVP/CIO.

Emory Healthcare names Nitu Kashyap, MD (Yale New Haven Health) as chief health informatics officer.

Stacy Sand, MS (Healthwise) joins Get Well as VP of marketing communications.

Announcements and Implementations

Blue Spark Technologies, which offers the TempTraq Bluetooth-enabled temperature monitoring patch, launches VitalTraq, which uses a “selfie scan” that is taken with a smart phone’s camera to report heart rate, heart rate variability, blood pressure, and respiratory rate.

Black Book Research publishes the 2024 “State of the Global Health Information Technology Industry” report, which analyzes the response of 19,000 global health IT customers to rate 109 vendors on 18 key performance indicators. The 655-page research report can be downloaded instantly at no cost.

Fortified Health Security publishes its “2024 Horizon Report” on cybersecurity.

Government and Politics

A federal court denies the motion of Erlanger Health to dismiss a lawsuit that accuses the hospital of allowing surgeons to bill for overlapping surgeries that they didn’t perform and allowing residents and interns to perform procedures without proper oversight if patients lacked insurance. The lawsuit was brought by two orthopedic surgeons and Erlanger’s former CIO, Stephen Adams, MD. It claims that the health system allowed surgeons to share their Epic login information with unlicensed staff to make entries under their names, and when the privacy offer was overwhelmed with lists of inappropriate chart access, Erlanger limited the number of events that would be reported because of the risk involved. The lawsuit also claims that the death of a child who was placed under anesthesia for a MRI was initially blamed on an Epic flaw, but audit logs indicated that the CRNA left the room to complete charts and the CRNA student who remained then made a fatal medication ordering error.

U.S. News & World Report sues the city attorney of San Francisco, who has issued two subpoenas seeking information about the criteria it uses to create its “Best Hospitals” list, the possibility that high-ranking hospitals pay for the privilege, and that its rankings encourage hospitals to invest in specialties instead of primary care. The publication says the attorney is harassing it because he doesn’t agree with its rankings.

HHS publishes voluntary Cybersecurity Performance Goals for healthcare.

Sponsor Updates

• MRO earns Validated Data Stream designation in NCQA’s Data Aggregator Validation program.
• Healthcare IT Leaders adds health industry veteran Mary Mirabelli to its board.
• Surescripts customer Elation Health adopts the Surescripts Real-Time Prescription Benefit tool.
• Florida Digestive Health Specialists adds Sunoh.ai virtual scribing capabilities to its EClinicalWorks EHR.
• Health Data Movers releases a new episode of its “Quick Hits” podcast featuring Kunjan Divatia.
• Emanate Health (CA) adds to its suite of Meditech solutions, implementing the company’s Smart Pump Infusion Integration with the Baxter Spectrum IQ infusion system.

Blog Posts

• Streamlining Workflows and Improving Patient Outcomes with EHR Optimization (EClinicalWorks)
• Basic Needs Navigation to Help Families Thrive (Findhelp)
• How Outside In Thinking Can Drive Your Health Tech Company’s Top and Bottom Lines (Get-to-Market Health)
• On Justice Sandra Day O’Connor’s Important Message (HCTec)
• Time to Talk TEFCA: An Intro to the Interoperability Framework That’s Gaining Steam (HealthMark Group)
• Mastering excellence: A guide to effectively benchmarking your healthcare quality metrics with monthly benchmarking data (Inovalon)
• Increasing EMR Satisfaction Through Personalization (InterSystems)
• Exploring Primary Treatment Pathways for Atrial Fibrillation (Lucem Health)
• Are You Ready for HTI-1? (Medhost)
• Progressing complex pediatric care with Bethany Children’s Health Center and Meditech (Meditech)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

News 1/24/24

Top News

Top researchers at Harvard-affiliated Dana-Farber Cancer Institute, including its CEO and COO, are accused of falsifying published research articles by Photoshopping scientific graphics.

Research integrity experts identified 57 studies that appear to have been manipulated, with the organization acknowledging 37 of them and moving to retract six of those studies.

Some journals are using AI tools that can identify image tampering, which is apparently common among researchers.

Reader Comments

From Summa Cum Lotta: “Re: Summa. I am surprised how loss-making hospitals with high debt are still making huge investments in technology. How long would it have taken money-losing Summa to break even on an $850 million implementation of Epic? Executives making such decisions should be let go.” The cost seemed high to me, even though I got that number directly from Summa’s website in a transcript of an interview with the CIO and CMIO. Replaying the audio, CIO Elbridge Locklear, MBA actually said “eight fifty million dollars,” which sounds more like a verbal stumble rather than an odd way of intentionally saying “$850 million,” so I’m sure he misspoke. I went through Summa’s federal tax filings, which say they spent $50 million overall on the project. They paid Epic $12 million in 2022 versus paying their Epic host Mercy Health $13 million the year before, when they also paid Cerner $5 million. I’m surprised that Summa hasn’t corrected their own podcast transcription.

From GR_Buckeye: “Re: Epic. Has publicly published their Clarity data dictionary. Do you know why? They closely guard their IP and I can only assume that this was done as the result of some type of legal matter.” Epic published its EHI expert schema on its Open Epic interoperability information website. It was crawled by Internet Archive in February 2023, so it has apparently been there for some time.

From Watching Wins: “Re: learning from videos. You concluded that it shouldn’t be an either-or option between text and video since each have their audience. Why not use AI to create an HIStalk video of daily or weekly health tech news summary that you are already posting as text?” I could certainly do that pretty easily since I’ve researched available tools, but would anyone really watch or listen to a daily or weekly talking (AI) head video news digest?

HIStalk Announcements and Requests

A reminder to HIStalk sponsors: complete my information form for ViVE and/or HIMSS if you are participating and I’ll include you in my online guide

Dear everyone: please stop expressing your work history as “over” X years of experience. If you say “over eight,” then we know it’s not nine, and every person’s tenure is “over” the exact number, even if just by minutes. Trust me that nobody cares about your fractional years, but if your vanity requires, simply round up after the six-month mark to nine years. Related to that is expressing numbers in general — instead of “over 400 hospitals,” either give the actual number or just go with 400 since the distinction is not important.

Webinars

January 24 (Wednesday) noon ET. “Medication Management Redefined.” Sponsor: DrFirst. Presenters: Nick Barger, PharmD, VP of product, DrFirst; Caleb Dunn, PharmD, MS, senior product manager, DrFirst. Clinical workflow experts will paint a reimagined vision for e-prescribing that offers enhanced patient adherence, customizable clinical support, intelligent pharmacy logic, and data integrity and safety. Join this first chapter of an ongoing conversation about what medication management should be, how to deliver greater benefits today, and how to prepare for the future. Elevating your solution and customer benefits isn’t as hard, scary, or economically challenging as you may think.

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

Acquisitions, Funding, Business, and Stock

Healthcare pricing transparency company Turquoise Health raises $30 million in a Series B funding round, bringing its total raised to $55 million since launching in 2021.

The annual health IT market review of Healthcare Growth Partners finds that:

• M&A and buyout deal volume returned to pre-COVID levels in 2023 from their low in Q4 2022.
• Although valuations did not catch up, EBITDA-based valuations have held steady throughout
• Investment activity continued to fall through 2023, dropping to $9 billion from its all-time high of $29 billion in 2021.
• HGP’s HIT Index gained 3% last year versus 25% for the S&P 500 and 45% for the Nasdaq.
• HIT Index stocks whose returns were worse than negative 60% for the year include Streamline Health, Invitae, Pear Therapeutics, GeneDx Holding, NantHealth, Bright Health Group, Cue Health, and UpHealth.

In Wisconsin’s Chippewa Valley, HSHS Sacred Heart, St. Joseph’s, and Prevea clinics will close, with HSHS blaming “a mismatch in the supply of and demand for local healthcare services” and its failure to find a partner.

Sales

• The CDC will use de-identified EHR data from health system collective Truveta for respiratory virus surveillance and research projects involving maternal and pediatric healthcare.
• South Carolina-based specialty pharmacy Palmetto Pharm selects Inovalon’s ScriptMed Specialty pharmacy management software.
• Innovaccer incorporates Wolters Kluwer Health’s Health Language terminology software into its data-based offerings.

People

Ryan Royal (Interviewstream) joins Upfront Healthcare as CTO.

Definitive Healthcare names founder, former CEO, and current Executive Chairman Jason Krantz, MBA as interim CEO upon the departure of Robert Musselwhite.

AMC Health names Zebadiah Kimmel, MD, MBA (Medically Home) chief product officer and promotes Jon Shankman, MBA, MPH to chief analytics officer.

Anatomy IT names Patrik Vagenius (Flywire) chief commercial officer.

Mount Sinai Health System (NY) names Bruce Darrow, MD, PhD interim chief digital and information officer upon the departure of Kristin Myers, MPH, who has joined Northwell Health (NY) as chief digital officer.

1upHealth hires Andrea Kowalski, MBA (Tebra) as chief product officer.

Kyruus hires Harshit Shah, MS (Spring Health) as CTO.

Announcements and Implementations

Amazon reportedly offers One Medical providers access to virtual consults with Amazon Pharmacy pharmacists as part of a pilot project geared towards improving outcomes for high-risk patients, particularly seniors.

The Liver Cancer Collaborative in Australia uses Aridhia’s Digital Research Environment technology to help researchers share data and collaborate on projects.

UCSD Health researchers find that a real-time alert that is powered by the Composer deep learning training library accurately predicted patient sepsis in the ED and reduced mortality significantly. The nursing alert was presented as an Epic Best Practice Advisory, but the authors note that the Epic’s own Sepsis Score has not demonstrated comparable results.

A new KLAS report finds that physician and nurse burnout has stabilized, but remain higher than pre-pandemic levels. Both groups suggest improving staffing and getting executives to listen to the concerns of clinicians and patients. Coming in at #3 for doctors is improving EHR efficiency, while for nurses, it is increasing pay.

Government and Politics

A federal appeals court upholds Martin Shkreli’s lifetime ban from the drug industry and a requirement that he pay $65 million in restitution. His company bought a decades-old drug for treating a rare condition, immediately raised the price 4,000%, and prevented other companies from obtaining samples of the drug that would have allowed them to sell generics. His lawyer had argued that while the “pharma bro” has since served prison time for financial crimes, those weren’t related to the drug industry, suggesting that the courts “should encourage real geniuses like Mr. Shkreli to work in the industry.” Shrekli responded via X that he is the only person in the US to ever be sued as a monopolist, says he followed the same playbook as AbbVie and many other drug manufacturers, and warned every executive that they can be held jointly and severally liable for antitrust actions that are levied against their companies.

Other

CMS reports that telehealth usage by Medicare users has dropped nearly back to pre-pandemic levels through mid-2023.

In Bangladesh, a private hospital director is arrested after demanding that parents of a newborn pay their $365 bill, and upon hearing that they didn’t have the money, sold the baby.

Sponsor Updates

• Pinnacle Family Care (NC) improves efficiency using the EClinicalWorks AI assistant for Prisma.
• Censinet releases a new Risk Never Sleeps Podcast, “Future-Forward Healthcare with Sherri Douville, CEO & Board, Medigram.”
• CloudWave will sponsor the MUSE Social (Southern California) Community Peer Group Event February 1 in Covina.

Blog Posts

• Understanding Prospective, Concurrent, and Retrospective Reviews (AGS Health)
• Data-driven tools and strategies for self-service healthcare analytics (Arcadia)
• Building a Greener Healthcare System with Data Analytics (Dimensional Insight)
• Bridging Healthcare Data Gaps with Clinical-Grade AI (DrFirst)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

Monday Morning Update 1/22/24

Top News

Massachusetts regulators worry that Steward Health Care’s financial problems may force it to close hospitals, with the resulting loss of jobs and access to care.

Steward operates 33 hospitals in nine states, nine of them in Massachusetts. It is one of the top employers and taxpayers in towns where it operates hospitals. It has 30,000 employees nationally and operates 25 urgent care centers and 107 skilled nursing facilities.

The real estate company that bought and then leased back some of Steward’s hospital buildings says that the company is $50 million behind in rent payments.

Steward, which gets 70% of its revenue from Medicare and Medicaid, says that community hospitals in Massachusetts are paid less than academic medical centers. It has asked for state help with the cost of caring for Medicaid patients and undocumented immigrants.

Reader Comments

From Industry CEO: “Re: HIStalk. The first thing my earliest investors advised me to do as a founder was to read HIStalk every day. So I have, for many years. My team and I think really highly of HIStalk.” Thanks. These comments give me a push since I sit alone at keyboard each day, and even when I emerge into the wild, I decline to divulge my HIStalk identity because who cares anyway. I’m happy to leave it as a blank screen in an empty room with someone occasionally reading over my shoulder.

HIStalk Announcements and Requests

Attention HIStalk sponsors: complete my information form for ViVE and/or HIMSS if you are participating and I’ll include you in my online guide. Also attention non-sponsors, because it’s not to late to get signed up for exposure for the other 359 days of the year when the exhibit halls go dark and attention is more focused.

Twice as many provider decision-makers would rather learn about companies by reading a document or web page instead of watching a video, which is about the same percentage of those who aren’t provider decision-makers. I agree with commenter B. Efficient, who says that it shouldn’t be either-or — they won’t even look at video alone because it’s inefficient and often ends up being an advertisement, but a text-based overview with video detail such as screenshots is the way to go.

New poll to your right or here: what will be General Catalyst’s biggest challenge in its plan to buy Summa Health?

Thoughts About General Catalyst Acquiring Summa Health

Venture capital firm General Catalyst promised to buy a non-profit health system when it formed Health Assurance Transformation Corporation (HATCo) in October 2023. The firm says that it evaluated several acquisition candidates, but it said last week that it has been talking to Summa for nine months, so perhaps that was always its choice.

Summa’s Advantages to GC

• It is relatively small and can be acquired at a reasonable price.
• Its market is geographically compact.
• Its size allows changes to be implemented faster.
• Summa has acute care hospitals, a rehab hospital, a physician network, and a small health insurance business.
• It has been successful as an early participant in value-based care.

GC’s Health Assurance Network

GC had already formed its Health Assurance Network of health systems – their “partnership” terms have not been announced — that includes HCA, Jefferson, Intermountain, WellSpan, Banner, UC Davis, UCI Health, UHS, and others. Its goals:

• Pair startups with health systems to develop and scale products.
• Share best practices.
• Move from sick care to wellness via population health.
• Explore new care models.

Acquisition Financials

Three-hospital Summa recorded a $57 million loss on $1.5 billion in revenue in its most recent tax filing.

GC said with the original announcement that it would spend $1 billion to $3 billion for its acquisition. For-profit companies that buy non-profit health systems usually pay slightly less than 1x revenue, so GC will likely spend at least $1 billion. HCA paid $1.5 billion for North Carolina’s Mission Health, whose revenue and bed count were nearly identical.

Summa’s CEO says the health system’s financial challenges, which include $800 million of debt, didn’t give it a lot of options. He says that Summa has been seeking a partner for more than 10 years, Summa announced plans to sell itself to Beaumont Health in late 2019 until COVID caused both parties to change their minds.

GC will need to finance the deal. It has $25 billion of assets under management, but probably not $1 billion in cash sitting around. The financial details of the transaction will come out when they look for investors or lenders, or perhaps before then in the likely event that the information leaks out. The resulting leverage and carrying costs, not to mention extraction of resources to give the buyer immediate reward, often bring down acquired health systems that were already struggling.

GC Says It’s Not a Typical Private Equity Acquisition

GC makes it clear that as a venture capital firm, it won’t follow the model of a private equity acquisition, where the goal is to cut costs (often recklessly) to increase profits to allow a quick flip of the business. However, it could be argued that this transaction is more like PE than VC, other than GC’s assurance that it is in for the long haul:

• GC is buying a mature business that has stable revenue, not a high-potential startup whose success is not assured.
• It is acquiring a 100% share rather than partial ownership.
• GC may or may not become actively involved in Summa’s management.

For-Profit versus Not-for-Profit

For-profit companies own a significant percentage of US hospitals, but as their core business rather than one of several business lines. GC is an investor with no experience running a health system. Regulators have grown wary of what happens after the deal is done, when the acquirer may close locations, let quality slide, sell real estate to generate cash, or shut down money-losing core community services such as obstetrics to move into high-profit ventures such as ambulatory surgery centers.

For-profit status could make it easier to raise capital, but with significant downsides:

• They lose the tax benefits.
• They lose the 340B drug discount program, which can be a big profit-booster.
• They will need to renegotiate contracts.
• They will need to retire or refinance Summa’s $800 million of debt, probably at higher interest rates as a for-profit.

Operational Challenge

GC has promised that Summa’s executive team, employee base, service lines, and name won’t change. That may be challenging if profits don’t materialize, especially when most Summa executives have no experience running a for-profit hospital. Continued losses might be hard to swallow even if Summa helps GC make money from its other investments. The business structure will be important for the availability and cost of financing.

Buying a Software Sandbox

GC is buying a sandbox for its health tech portfolio companies. The original participants in GC’s Health Assurance Network are:

• Commure (interoperability and data).
• Tendo (analytics).
• Transcarent (connecting consumers with providers).
• Olive (process automation, but the company has been shut down).

GC may also be eyeing the value of Summa’s data for AI training.

GC will need to track the value that Summa adds to its portfolio companies, especially if the health system keeps losing money, to determine if its investment is paying off.

Health System and Software Companies Sharing an Owner

GC portfolio companies benefit from bypassing the “death by pilot” process in being implemented and measured at a health system that is a fellow portfolio company. That could generate convincing proof-of-concept studies. It could also backfire if Summa’s core business struggles despite using corporate-mandated software.

Epic

Summa previously ran on Mercy Health’s shared instance of Epic, then spent $850 million in late 2022 to launch its own instance. UPDATE: That number came from a Summa interview in which CIO Elbridge Locklear, MBA says what sounds like $850 million and remains transcribed that way on Summa’s website, but tax filings say they spent $50 million, suggesting that he may have stumbled verbally.

GC companies will have a leg up on Epic integration. That assumes that GC doesn’t run into issues with Epic’s willingness to work with a health system whose parent company also owns many dozen health technology competitors. The health system cannot risk having Epic shut its system down over IP concerns or contract renegotiation, and walking away from an expensive Epic contract to self-develop software would be unprecedented and risky.

Your Thoughts

I’m interested in your opinion. Leave a comment or message me.

Webinars

January 24 (Wednesday) noon ET. “Medication Management Redefined.” Sponsor: DrFirst. Presenters: Nick Barger, PharmD, VP of product, DrFirst; Caleb Dunn, PharmD, MS, senior product manager, DrFirst. Clinical workflow experts will paint a reimagined vision for e-prescribing that offers enhanced patient adherence, customizable clinical support, intelligent pharmacy logic, and data integrity and safety. Join this first chapter of an ongoing conversation about what medication management should be, how to deliver greater benefits today, and how to prepare for the future. Elevating your solution and customer benefits isn’t as hard, scary, or economically challenging as you may think.

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

Acquisitions, Funding, Business, and Stock

23andMe CEO Ann Wojcicki says that tech investors who understand its consumer genetics testing business don’t like the burn that is involved with its drug development side, while pharma investors don’t understand its consumer business. She declined to say if the company might split into two companies, but notes that it is selling customer genetics data to drug companies under non-exclusive relationships, one of which just yielded a $20 million, one-year contract. ME shares have lost 94% of their value since the company went public via a SPAC merger in June 2021 at a valuation of nearly $4 billion, now $340 million. 23andMe reported in January that hackers had exposed the information of 6.9 million people who had activated its DNA Relatives sharing feature.

Today I learned from LinkedIn about Veritas Data Research, which appears to have solved the longstanding healthcare data problem of not knowing if a patient/consumer has died. The company’s Fact of Death captures over 90% of US deaths, usually within a month. Tuva Health is partnering with the company, saying that it’s surprisingly hard to know whether a patient survived or not because CDC’s data takes up to a year to published, is available only to researchers, and becomes less reliable as more people choose to die outside the hospital. The use cases for providers include creating better population health and risk models and eliminating the embarrassment of sending bills and marketing communications to people who have died. Veritas has just added Cause of Death, which allows researchers to identify whether deaths may not be related to their study topic. The two founders previously co-founded Universal Patient Key, a healthcare data de-identification service that was acquired by Datavant in 2018.

People

Darcy Nett (Wellbe) joins HealthX Ventures as principal.

Announcements and Implementations

FDA clears DermaSensor’s AI-powered handheld device for detecting skin cancer.

Optum seeks EHR/PM vendors to test its prior authorization inquiry API.

Government and Politics

HHS OIG bans Theranos founder and federal inmate Elizabeth Holmes from participating in federal healthcare programs for 90 years, the same exclusion it gave to former Theranos President Sunny Balwani.

Privacy and Security

The American Hospital Association warns that offshore hackers are impersonating hospital revenue cycle employees to have their passwords reset by the hospital IT help desk, using stolen information about the employee to answer security questions. They then ask to have a cell phone with a local area code enrolled, which allows them to defeat multi-factor authentication to log on to financial systems to send money to their offshore accounts.

Other

Epic CEO Judy Faulkner tells a fun story about opening the first buildings of its new campus in Verona, only to find that the entrances to their underground parking lots were too short for fire trucks. They had to buy the Verona Fire Department a new truck, which Carl Dvorak drove over with the sirens and lights on. Judy sat in the back with her white Samoyed dog, to which they had affixed black spots made of construction paper to make him look like a Dalmatian.

Unrelated, but bizarre. The founder and CEO of a large Chicago-based ERP software company dies and its president is seriously injured during a company celebration in India. The two executives were leading the audience in singing while hanging from a cage that was suspended above the stage when its chain broke, tumbling them 15 feet to the concrete stage.

Sponsor Updates

• Spok staff pack gift boxes for patients and gift bags for nurses at Inova L.J. Murphy Children’s Hospital in Virginia.
• CereCore International hires Andrew Hine (Babylon) as managing director.
• EClinicalWorks shares a new customer success story, “Boosting Wellness Visits & Incentive Revenue in Healthcare.”
• Nordic releases a new Designing for Health Podcast, “Interview with David K. Butler, MD.”
• Optimum Healthcare IT publishes a new case study, “ServiceNow Clinician Connect EMR Help.”
• SBI’s Growth Advisory Podcast features Symplr CEO BJ Schaknowski and President Nicole Rogas.
• The American Journal of Nursing awards Wolters Kluwer Health with eight Book of the Year awards.
• Waystar will exhibit at ASA Advance 2024 January 26-28 in Las Vegas.

Blog Posts

• Healthcare Revenue Cycle Management: What to Expect in 2024 (Nym)
• The Importance of Governance in Large-Scale On-Call Software Implementations (QGenda)
• Patient Care in 2045: Predicting the Singularity of Life-Changing Medications (and More) (Surescripts)
• Your Complete Guide to Meditech Expanse (Tegria)
• Pharmacist POV: Patient Safety with Meditech Expanse Pharmacy (CereCore)
• Strategies for Effective Revenue Cycle Automation – Start Small (VisiQuate)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

News 1/19/24

Top News

Venture capital firm General Catalyst signs a letter of intent to acquire Akron-based non-profit health system Summa Health.

GC formed Health Assurance Transformation Corporation, HATCo, in October 2023 to lead a technology-driven transformation from “sick care” to health assurance, which focuses on helping people stay well, reducing cost, and increasing accessibility. General Catalyst said at that time that it planned to acquire a health system to demonstrate the value of its approach, which includes the involvement of some of its healthcare technology companies.

General Catalyst’s health assurance portfolio includes more than 100 companies.

The company says that the acquisition should not be considered as “another private equity deal” because it will not focus on cost reductions or a quick flip.

Summa Health has three hospitals, 1,027 licensed beds, and 8,500 employees. Its most recent financial report shows a loss of $57 million on revenue of $1.5 billion. It will convert to a for-profit system under its new owner.

Beaumont Health signed an agreement to acquire Summa in December 2019, but the organizations backed out in May 2020.

Summa executives expect the acquisition to close by mid-summer.

Webinars

January 19 (Friday) 1 ET. “Unlocking Reliable Clinical Data: Real-World Success Stories.” Sponsor: DrFirst. Presenters: Alistair Erskine, MD, MBA, CIO/CDO, Emory Healthcare; Jason Hill, MD, MMM, associate CMIO, Ochsner Health; Colin Banas, MD, MHA, chief medical officer, DrFirst. Health system leaders will describe how they are empowering clinicians with reliable patient data while minimizing workflow friction within Epic. They will offer real-world experience and tips on how to deliver the best possible medication history data to clinicians at the point of care, use clinical-grade AI to infer and normalize prescription instructions in Epic, and encourage patient adherence to medication therapies for optimal outcomes.

January 24 (Wednesday) noon ET. “Medication Management Redefined.” Sponsor: DrFirst. Presenters: Nick Barger, PharmD, VP of product, DrFirst; Caleb Dunn, PharmD, MS, senior product manager, DrFirst. Clinical workflow experts will paint a reimagined vision for e-prescribing that offers enhanced patient adherence, customizable clinical support, intelligent pharmacy logic, and data integrity and safety. Join this first chapter of an ongoing conversation about what medication management should be, how to deliver greater benefits today, and how to prepare for the future. Elevating your solution and customer benefits isn’t as hard, scary, or economically challenging as you may think.

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

Acquisitions, Funding, Business, and Stock

Reuters reports that the private equity owners of Netsmart Technologies are planning to offer the company for sale, hoping to attract offers of more than $5 billion.

PointClickCare acquires CPSI subsidiary American HealthTech, which offers long-term care management software. CPSI had stopped development of the product after deciding to divest the business.

Online vision testing company Visibly acquires EyecareLive, which offers a similar test along with video visits with optometrists.

Health data interoperability platform vendor Hart will move its headquarters from California to Kansas City, MO.

SeamlessMD co-founder and CEO Joshua Liu, MD raises interesting points (and creates a fun graphic) about General Catalyst’s planned acquisition of Summa Health and its use of the health system as an incubator for its many health tech businesses:

• Will they try to build an EHR? (leading to my corollary question – how does Epic feel about one of its customers, which the CIO says spent $850 million to move from a shared instance of Epic to its own Epic system in 2022, being bought by a VC firm that has ownership in healthcare software vendors?)
• Will Summa make its own technology decisions or will GC force them to use products that its portfolio companies sell?
• How will staff react to having the health system’s goals set by a financial firm?
• Will startups that aren’t part of General Catalyst avoid working with Summa out of intellectual property concerns?
• Will GC bring in entrepreneurs in residence and incubate new companies?
• Will Summa develop innovation fatigue given the focus of its new owners?

Sales

• The Association of Community Mental Health Centers of Kansas will implement Netsmart Population Health Platform across 26 members that are transitioning to the Certified Community Behavioral Health Clinic model.

People

Roswell Park Comprehensive Cancer Center hires George ”Buddy” Hickman, MS (First Health Advisory) as chief digital and information officer.

Vasanth Balu (Excela Health) joins Bozeman Health as CIO.

Kevin Shiotelis (CorTech) joins Healthcare IT Leaders as CFO.

Consensus Cloud Solutions promotes Johnny Hecker to chief revenue officer and EVP of operations.

Announcements and Implementations

Hospital-at-home technology vendor Biofourmis adds in-home services to its platform, allowing providers to order, schedule, confirm, and track in-home services and diagnostics.

Epic launches Showroom, which lists products and services that can be used with Epic.

Nuance announces GA of DAX Copilot embedded in Epic, which it says has a 150-hospital waitlist.

NYC Health + Hospitals adds Findhelp’s social services referral platform to Epic. Completing Epic’s SDoH screening tool will trigger resource recommendations from Findhelp, which staff can also search directly for community-based resources and create closed-loop referrals.

UCLA Health creates Medical Informatics Operating Room Vitals and Events Repository (MOVER), a de-identified database of 83,000 surgical outcomes from UCI Medical Center’s Epic and former SIS system that approved researchers can use at no cost to test AI algorithms.

A University of Michigan survey finds that 7.5% of people aged 50 to 80 have used an online-only provider and 60% of those received a prescription, but two-thirds of them didn’t tell their regular provider. The authors express concern that online providers don’t have access to the patient’s health history and medical records, making it challenging to screen for drug interactions. Respondents said they used online services because of convenience or lack of access to a regular provider, with only 10% saying they used an online service because of discomfort talking to their regular provider about topics such as mental health or sexual issues.

Privacy and Security

Bluewater Health, which is part of a five-hospital shared services group that remains down from an October 23 ransomware attack, will replace its 25-year-old Meditech system with Oracle Cerner by the end of 2024. The hospital has cancelled 8,000 diagnostic imaging appointments. It planned to move to Cerner in 2013, but delayed the project.

Other

Patent troll SynKloud Technologies sues Epic, claiming that MyChart violates a 2005 patent that it bought in 2019 that describes a personal alarm system for seniors.

Sponsor Updates

• EClinicalWorks customer DePaul Community Health Centers (LA) adds Sunoh.ai ambient listening technology from ECW to its V12 EHR.
• CereCore offers revenue optimization assessments to help health systems maximize financial performance despite increased denials.
• Meditech signs its 100th Expanse MaaS customer, with 37 hospitals signing on in 2023 alone.\
• Experity will host its third annual Urgent Care Connect Conference February 13-14 in Austin.
• Black Book Research survey-takers rank Verisma as the leading vendor for release of information, audit management, and revenue integrity solutions for the fourth consecutive year.
• Fortified Health Security names Joan Edens (Vaco) documentation and quality assurance specialist.
• ThoroughCare integrates Healthwise’s educational healthcare content with its care coordination software.
• Inovalon releases a new podcast, “Data Insights and Impact Across Healthcare.”
• Linus Health publishes the results of a new study, “Digital Clock and Recall is superior to the Mini-Mental State Examination for the detection of mild cognitive impairment and mild dementia,” in Alzheimer’s Research & Therapy.

Blog Posts

• 7 Patient Engagement Solutions to Help Patients and Practices in 2024 (EClinicalWorks)
• 4 Ways to Maximize Government Reimbursements (FinThrive)
• AI in Contact Centers: What Makes it a Game-Changer? (Five9)
• The 5 Stages of Adopting Intelligent Virtual Care (AvaSure)
• Improving Clinician Workflows and Data Insights (InterSystems)
• Identifying Advanced Adenomas Helps to Prevent Colon Cancer (Lucem Health)
• Healthcare Trends 2024: Three Topics to Keep on Your Radar (Medhost)
• Responding to disaster at Brockton Hospital (Meditech)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

News 1/17/24

Top News

Apple will remove pulse oximetry technology from its Watch to avoid the possibility of having the product banned from importation into the US if Apple loses a pending patent appeal.

The US International Trade Commission ruled in late December that the technology, which is included in the Series 9 and Ultra 2 models, infringes on the patents of medical device manufacturer Masimo. The ban was temporarily paused when Apple appealed the ruling, allowing sales of the Watch to be restarted.

Bloomberg says that Apple has already shipped modified watches to the company’s retail stores, but has yet to approve their sale. Apple has not announced any plans about previously sold Watches that contain the pulse oximetry feature or whether it will be disabled via an update.

Reader Comments

From RIP Cerner: “Re: Oracle Health. Rumor is that former CMS Administrator Seema Verma will replace the departing Travis Dalton as GM/SVP of Oracle Health. She joined Oracle last year as head of Life Sciences and will reportedly add Oracle Health to her responsibilities, reporting to EVP Mike Sicilia.” Unverified, but rumored internally. She raised a lot of controversy during her CMS years, especially related to her taxpayer-funded personal self-promotion.

HIStalk Announcements and Requests

Listening: Jimmy Fallon, who I can’t stand to watch in his late-night hosting job, but who is amazing beyond belief in his dead-on (no pun intended) impersonation of Jim Morrison and the Doors doing “Reading Rainbow.” I’ve listened to a lot of Doors and he is spot on in capturing style and stage mannerisms of Mr. Mojo Risin’ (minus the indecent exposure). The faux Densmore, Manzarek, and Krieger aren’t actually playing – The Roots are skillfully channeling 1967. I’m sure that Fallon’s celebrity fawning and self-aware attempts at cleverness pay better than fronting a Doors tribute band, but I would vastly prefer watching the latter.

Webinars

January 19 (Friday) 1 ET. “Unlocking Reliable Clinical Data: Real-World Success Stories.” Sponsor: DrFirst. Presenters: Alistair Erskine, MD, MBA, CIO/CDO, Emory Healthcare; Jason Hill, MD, MMM, associate CMIO, Ochsner Health; Colin Banas, MD, MHA, chief medical officer, DrFirst. Health system leaders will describe how they are empowering clinicians with reliable patient data while minimizing workflow friction within Epic. They will offer real-world experience and tips on how to deliver the best possible medication history data to clinicians at the point of care, use clinical-grade AI to infer and normalize prescription instructions in Epic, and encourage patient adherence to medication therapies for optimal outcomes.

January 24 (Wednesday) noon ET. “Medication Management Redefined.” Sponsor: DrFirst. Presenters: Nick Barger, PharmD, VP of product, DrFirst; Caleb Dunn, PharmD, MS, senior product manager, DrFirst. Clinical workflow experts will paint a reimagined vision for e-prescribing that offers enhanced patient adherence, customizable clinical support, intelligent pharmacy logic, and data integrity and safety. Join this first chapter of an ongoing conversation about what medication management should be, how to deliver greater benefits today, and how to prepare for the future. Elevating your solution and customer benefits isn’t as hard, scary, or economically challenging as you may think.

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

Acquisitions, Funding, Business, and Stock

98point6 acquires Bright.md’s 17 telehealth customers and hires six of its employees. 98point6 announced last year that it would pivot from being a virtual care provider to offering technology, after which it sold off its chatbot, self-insured employer business, and physician group to Transcarent for $100 million. Bright.md, meanwhile, sold its asynchronous virtual care technology to Cigna’s Evernorth Health Services subsidiary last October.

Healthcare analytics vendor Innovaccer acquires Cured, which offers healthcare digital marketing software. Cured’s three co-founders started their careers with Epic.

Per diem staffing provider Aya Healthcare acquires UK-based workforce solutions provider ID Medical, which will make Aya’s platform available to NHS and UK-based clinicians.

Sales

• Bluewater Health in Ontario will replace its Meditech system with Oracle Health by the end of this year. The health system made a similar announcement in 2019, along with several other local hospitals that went on to adopt the then-Cerner software.

People

Sarah Bennight (Carenet Health) joins IKS Health as SVP of marketing.

NCQA names Tricia Elliott, DHA, MBA (Northwestern Medicine) VP of quality implementation within its quality measurement and research group.

Announcements and Implementations

Capital Region Medical Center (MO) will adopt Oracle Health as a part of its now-finalized integration with MU Health Care.

Midwest Cardiovascular Institute (IL) will implement real-time monitoring, AI-powered diagnostics, and other digital health technologies from Livemed Telehealth.

Baptist Memorial Health Care (MS) finalizes its acquisition of Anderson Regional Health System, which will share Baptist’s Epic system.

Luminis Health (MD) rolls out Teladoc Health virtual nursing technology across its acute care hospitals.

Essentia Health-Mid Dakota Clinics in North Dakota will go live on Epic this month.

Hackensack Meridian Health (NJ) implements Volpara Health’s breast cancer risk assessment and clinical decision support software.

In Canada, Quebec’s implementation of Epic will cost $1.1 billion USD if it is approved for full implementations, with the first go-live expected at the end of 2025. Epic would replace the Quebec Health Record, whose completion ran 10 years late and triple the original budget at $1.3 billion USD. Quebec chose Epic over the other finalist Cerner in September 2023, estimating the project’s cost at up to $2.2 billion.

In vitro diagnostics vendor BioMérieux will acquire Lumed, which offers antibiotic and infection monitoring software to hospitals.

Privacy and Security

A radiology practice in Sydney, Australia, tells patients that a November data breach was caused by an unspecified IT issue, all the while dealing with harassing phone calls and texts from the breach’s perpetrators.

Liberty Hospital in Missouri declares it has “significantly recovered” from a December 19 cyberattack that forced it to temporarily divert ambulances and revert to downtime procedures for several weeks.

Other

South Dakota Governor Kristi Noem presents Avel ECare physician Katie DeJong, DO and Casie Hunter, RN along with EMT Ed Konechne with the Governor’s Award for Heroism for their roles in saving the life of a rancher who was critically injured in a bison attack. Konechne used the state-funded ambulance telehealth system to get ED physician instructions from DeJong, who was 140 miles away, and to then alert the hospital that they were en route.

Sponsor Updates

• Bamboo Health will exhibit at the Massachusetts Health & Hospital Association Annual Meeting January 25-26 in Boston.
• CereCore honors innovation and collaboration amongst its employees at its annual Connection event.
• Nordic publishes a new episode of its “Designing for Health” podcast titled “Interview with David Butler, MD.”
• Divurgent releases a new episode of The Vurge Podcast, “Change Champions with Amy Horner: Strategies, Leadership, and Personal Growth.”

Blog Posts

• How healthcare will evolve in the next decade (Arcadia)
• Enablement of hospital-based precision dosing with the DRE (Aridhia)
• Meet the Clinician – Calvin Janney (Ascom)
• The Future of Healthcare: AI in Prior Authorizations (Availity)
• The Privacy Impact Assessment: Identifying and Minimizing Risks of PII Exposure (Clearwater)
• CloudWave’s 2024 Predictions Part 2: How AI Will Transform Healthcare in 2024 (And What CIOs Must Do to Prepare) (CloudWave)
• Hospital Finance Predictions for 2024 (Dimensional Insight)
• How Clinical-Grade AI Streamlines Healthcare Workflows (DrFirst)
• Start the Year Off Right: Strategies for Enhancing Revenue Cycle Performance (Vyne Medical)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

Monday Morning Update 1/15/24

Top News

A Google-created AI system called AMIE that was optimized for diagnostic dialog outperforms primary care doctors in synchronous text chat with patient actors. The authors warn that while this isn’t representative of clinical practice and thus places clinicians at a disadvantage to AI, the accomplishment is still a milestone in developing conversational diagnostic AI.

The evaluation criteria included history-taking performance, diagnostic accuracy, management reasoning, communication skills, and empathy.

The authors observe that history-taking and diagnostic dialog is dependent on context and requires a high level of clinician skill.

The tool was trained on medical licensing exam questions, real-life medical summaries, and audio transcripts from 100,000 medical conversations. It was further trained and refined by using self-play, where AI improves its performance by playing against itself and analyzing which of its approaches were successful.

Reader Comments

From A Beautiful Mind: “Re: Amazon. Your post about Health Conditions got me thinking about previous Amazon healthcare forays such as HealthLake, One Medical, etc. Do you speculate that they are throwing a lot of darts to see which ones stick, or is there a John Nash-like team in Seattle piecing together the chaos for ultimate world domination, and oh yeah, improving care and lowering costs?” Amazon is smarter than I, but I don’t understand its healthcare plan. The company doesn’t always hit healthcare home runs (see: Amazon Care, Haven, and Halo) but it swings a mighty bat and learns from failure. It hasn’t done much with online pharmacy PillPack, and buzz about its “all the pills you take for $5 per month” RxPass died down pretty quickly after it was announced a year ago. It paid $4 billion for money-losing primary care concierge practice One Medical, with few changes except to offer Prime members a discount on joining One Medical, which still bills insurance traditionally and is now is exposed to Amazon-recruited members who are older and less affluent that One Medical’s former client base. Amazon’s recent offerings seem to focus on charging to advertise third-party healthcare businesses. Healthcare is a financially appealing vertical, but is notoriously hard for even big-name outsiders to penetrate due to billing complexity; a hellish regulatory environment; the local and trusted presence of big health systems and national drug chains where Amazon is to many just a website or app that often sells offshore-sourced junk using phony reviews, and the challenge of scaling without killing someone. I think of Amazon as a company that makes money from selling ads, fulfillment services, and AWS with zero personal touch, which doesn’t suggest a broadly disruptive role in healthcare.

From Y2K11 Maverick: “Re: HIStalk. I last said this 10 years ago, but it has remained true. Rarely does a week go by that 1) I don’t learn something new by reading HISTalk updates and/or 2) I pass along something from your posts that my colleagues hadn’t seen before. THANK YOU for all that you’ve done, do and (hopefully) continue to do for us schmoes who are just trying to keep up! Loyal listener since 2011!” Thanks.

From JD: “Re: Billy Idol at ViVE. Your mention reminded me of John Lydon, aka Johnny Rotten of the Sex Pistols, who was his wife’s caregiver.” The 67-year-old punker was a full-time caregiver of Nora Foster, his wife of 44 years, for nearly 15 years until she died of Alzheimer’s in April 2023 at 80 years old. He said in an interview just before she died, “We know that she’s going to slowly deteriorate into something catastrophic, and then death. But she will enjoy every step of it, and I’m here to make sure of that because she’d do the same for me.”

From JustScratchingMyHead: “Re: the Texas surgeon sharing gender-affirming care records.  While technically he did redact the information, it still seems procedurally not correct and I would think the hospital would have some type of policy about screenshots being taken and sent externally. What happens when the next provider sends the information without proper redaction or none at all?” Ethan Haim, MD graduated from his Baylor surgical residency the day that HHS knocked on his door. He was an anonymous whistleblower until June 2023  and has moved on to Hunt Regional Healthcare as a general surgeon. The hospital’s bigger beef with him beyond screenshots would have been his efforts to get them in trouble with the state. He likens transgender interventions for children to COVID, arguing that both involve scant peer-reviewed medical evidence and the institutional censorship of those who question it.

HIStalk Announcements and Requests

Provider poll respondents aren’t confident that their employer-paid conference attendance generates ROI. However, commenters add that attendance has value beyond immediate ROI, such as gaining knowledge, networking, and recruiting.

New poll to your right or here, for provider employees: which is your preferred medium to learn what a vendor does? This is in response to user comments. I’ll admit that while I’m critical of TL;DR types who can’t read more than two consecutive sentences without blaming the author with indignation rather than embarrassment for their phone-stunted attention span, I’m similar with videos, however – people who host them and love themselves excessively sometimes can’t shut up and let their guests speak. I f a video can’t tell me something useful in the first 30 seconds (or a text article in three sentences), the situation isn’t likely to improve and I move on.

Your to-dos for supporting what I do:

• Join my spam-free mailing list.
• Connect on LinkedIn and join Dann’s HIStalk Fan Club so that I see your posts and job changes.
• Tell my sponsors, or potential ones, that you value their support.
• Share news, rumors, and intriguing insights.

Webinars

January 19 (Friday) 1 ET. “Unlocking Reliable Clinical Data: Real-World Success Stories.” Sponsor: DrFirst. Presenters: Alistair Erskine, MD, MBA, CIO/CDO, Emory Healthcare; Jason Hill, MD, MMM, associate CMIO, Ochsner Health; Colin Banas, MD, MHA, chief medical officer, DrFirst. Health system leaders will describe how they are empowering clinicians with reliable patient data while minimizing workflow friction within Epic. They will offer real-world experience and tips on how to deliver the best possible medication history data to clinicians at the point of care, use clinical-grade AI to infer and normalize prescription instructions in Epic, and encourage patient adherence to medication therapies for optimal outcomes.

January 24 (Wednesday) noon ET. “Medication Management Redefined.” Sponsor: DrFirst. Presenters: Nick Barger, PharmD, VP of product, DrFirst; Caleb Dunn, PharmD, MS, senior product manager, DrFirst. Clinical workflow experts will paint a reimagined vision for e-prescribing that offers enhanced patient adherence, customizable clinical support, intelligent pharmacy logic, and data integrity and safety. Join this first chapter of an ongoing conversation about what medication management should be, how to deliver greater benefits today, and how to prepare for the future. Elevating your solution and customer benefits isn’t as hard, scary, or economically challenging as you may think.

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

Sales

• Outpatient rehab provider Ability KC choses Netsmart’s TheraOffice EHR/PM.

Announcements and Implementations

Oracle moves its Health Summit to Nashville and pushes it back from February to April. Tennessee offered Oracle $175 million in incentives to build a $1.4 billion campus in Nashville that will likely have a significant Oracle Health presence. The company’s Oracle Health Conference, the former Cerner Health Conference, was held in Las Vegas in September 2023.

Government and Politics

The chairs of the Kansas senate commerce and house judiciary committees ask Governor Laura Kelly to explain why the Department for Children and Families awarded $7.7 million of a $18 million federal social services grant to software vendor Unite Us. They question why so much of the money will be sent to an out-of-state company instead of being used to support local social service programs.

A Bloomberg article on the effects of significant national relocation on elections highlights Epic, whose large headcount and 3,000 hires in 2023 are mostly young and college educated.

A Senate subcommittee reviews finds that national drugstore chains don’t require a warrant to provide law enforcement with the patient records they request for whatever reason, with Sen. Ron Wyden (D-OR) calling for HHS to update HIPAA to require pharmacies to insist on a warrant before disclosure in response to regulatory and law enforcement records requests.

Privacy and Security

A law firm that specializes in business security incidents is itself hit by hackers, exposing the identity, medical, and insurance information of 637,000 people that it had collected from its security incident clients.

Other

Former Olympic gymnast Mary Lou Retton was uninsured for her month-long hospital stay for pneumonia, for which she blamed pre-existing conditions and lack of affordable premiums. Either she’s not telling the whole story or she is unaware of Affordable Care Act plans that are legally required to cover pre-existing conditions and extend premium subsidies based on income. The 55-year-old Retton says she has since obtained insurance, but didn’t say if she paid for it from the $460,000 her four daughters raised for her via social media. She declines to name the hospital.

Sponsor Updates

• Meditech reports record international growth for its Expanse EHR in 2023.
• Nym will exhibit at the HFMA Western Region Symposium January 21-24 in Las Vegas.
• Optimum Healthcare IT announces that it has been named a Workday Staffing Partner.
• Verato publishes a new e-book, “How to overcome HHS identity management challenges.”

Blog Posts

• To sit or not to sit: How a chair can affect patient satisfaction (Nordic)
• The Power of Listening: Three key components of an effective change management program – Part 1 (Qgenda)
• How to Simplify Affordability in the Specialty Medication Workflow (RxLightning)
• Not Exactly a Crystal Ball, but 8 Healthcare Trends to Watch for in 2024 (Symplr)
• Oklahoma Supports Family Caregivers with Groundbreaking “Caring for Caregivers Act” (Trualta)
• 5 most unproductive touches in the healthcare RCM process (Waystar)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.

Morning Headlines 1/12/24

Artisight to Scale and Advance AI-driven Smart Hospital Platform with Oversubscribed $42 Million Series B Round

Artisight, which offers a smart hospital platform, raises $42 million in a Series B funding round.

New Veradigm Leadership Provides Outlook on Business and Strategy, and Refreshed Financial Estimates for Fiscal 2023

Veradigm lowers its FY2023 revenue and earnings guidance below consensus estimates, noting in an SEC filing that it doesn’t yet know when it will file overdue financial reports for the last three quarters and year-end of FY2023 or convene its annual meeting of shareholders.

Hewlett Packard Enterprise to buy Juniper Networks in $14 bln deal

Hewlett-Packard Enterprise will acquire AI-enabled enterprise networking and security technology company Juniper Networks for $14 billion.

Graphium Health Acquires The ABG Anesthesia Data Group Strengthening Anesthesia Quality and Safety Initiatives

Anesthesia healthcare technology vendor Graphium Health purchases The ABG Anesthesia Data Group, which specializes in qualified clinical data registries management.