Monday Morning Update 2/17/25
Top News
A JAMA commentary piece notes that patients don’t trust how health systems will use AI, but then again, they don’t trust health systems in general.
A cited study found a mean health system overall trust score of 5.23 on a 12-point scale. Only 40% of respondents expressed high trust, down from 72% pre-pandemic.
The author, Vanderbilt informatics professor Jessica Ancker, MD, MPH, recommends that health systems clearly disclose AI interactions, specify who can access AI-generated data, and inform patients when AI is used to influence clinical decisions.
She also notes that people tend to be wary of technology they haven’t personally experienced, such as self-driving cars, but usually warm up to it once they see it for themselves.
Reader Comments
From Peds MD: “Re: Epic’s Care Everywhere. Responding to the HIStalk post last fall where Care Everywhere failed to match a critical newborn, Epic relaxed its requirements to make matches if you have the patient’s Care Everywhere number (from the place you are querying) and two other matching demographics. Today we had a patient who had “some kind of heart surgery” as a child in 2001, and it was medically important to know exactly what was done. Because they had moved across the country, I couldn’t match the patient using regular demographics — everything had changed except their name, sex, and date of birth — but when I obtained and entered the Care Everywhere number from the other hospital’s HIM department, the match came back immediately. We are still working with Epic on improving matching, but I think it’s important to recognize progress, as it made a big difference in this patient’s care. Kudos to HIStalk for helping in this.” I posted the reader’s original problem description last year. Thanks for the update and thanks to Epic, which I can say always responds quickly and personally to address issues that readers have reported here.
From Silken: “Re: Epic and SaaS. I’ve seen online commentary about the benefit of Epic moving to SaaS model. What do you and your readers think?” For me, I see the possible customer advantages of running a SaaS versus on-premise and cloud-hosted products. However, technical punditry and wishful thinking aside, you have to assume that Epic is like all companies in being most likely to take whatever path benefits it most. Thoughts:
- Big, Epic-using health systems aren’t visibly demanding a SaaS model, at least when it comes to voting with their dollars, which is the only vote that counts. They have already invested in Epic-driven infrastructure, IT expertise, and long-term budgets. These are sunk costs that shouldn’t influence future decisions, but hospitals are generally risk-averse and don’t relish major disruptions like retraining and workflow changes, especially in the absence of a clear business benefit.
- Even though Epic’s maintenance costs are high, SaaS wouldn’t necessarily be cheaper over time since it’s still up to Epic to set prices.
- Many health systems already operate a de facto SaaS model by hosting Epic for affiliated hospitals and clinics. This may be more cost-effective than Epic offering SaaS directly to an ever-decreasing number of unaffiliated small hospitals and practices.
- SaaS benefits include scalability and faster onboarding of acquisitions, but drawbacks include a reduced ability for customization, forced upgrades on Epic’s schedule, and tighter vendor lock-in.
- The Change Healthcare breach heightened concerns about reliance on a single vendor, possibly making CIOs skeptical that Epic SaaS would be more secure or resilient than their own IT capabilities.
- SaaS would increase health system dependence on Epic, with unknowns about what a post-Judy Epic looks like.
- Oracle Health talks up cloud-native ambitions but lacks market momentum, industry focus, and credibility to provide much of a medium-term threat. Health systems care less about technology compared to business results, proven ROI, and vendor responsiveness and stability. Oracle’s commitment, performance, and retention of internal healthcare expertise remains unproven, and customers have been historically burned by big tech outsiders who barged into (and then out of) healthcare.
- A full Epic rewrite is unlikely unless the reward to Epic clearly outweighs the risk. Few vendors have pulled this off. Meditech did it seemingly effortlessly with Expanse and Cerner (as a publicly traded company) sweated through many bad years until Millennium was fully baked. Otherwise a lot of vendor-touted technology improvement is pig lipstickery, and sometimes that’s all customers care about anyway.
- Epic dominates the market and will eventually run out of deep-pockets health systems to sell to. It doesn’t need to chase new customers by teasing their CTOs into an advanced state of technical arousal.
- Potential drivers for change are Oracle Health rebounding as a serious competitor; a demand for cloud-native AI and analytics; and regulatory pressures around interoperability and cybersecurity (which seem to be lessening by the day).
HIStalk Announcements and Requests
Most poll respondents book their medical appointments by telephone or patient portal. Some say they do it at the check-out desk at the end of their visit, which I’ve seen almost universally with dentists but commonly with doctors, although that experience probably involves routine chronic condition management.
New poll to your right or here: How much of your job performance can be measured using objective metrics?This came to mind while reading an article about how much of a pay cut office employees would take to work fully remotely. The article noted that managers who oppose WFH often oversee employees whose performance isn’t easily quantified by output metrics, which forces them to rely on in-office proxies such as hours worked, enthusiasm, and the perceptions of colleagues and customers. Another question might be that if your job performance isn’t being mostly measured by metrics, then why not? Is your work inherently unquantifiable, or is it that managers haven’t created the right metrics and instead rely on direct observation?
HIStalk sponsors: fill out this form to tell me about your HIMSS25 plans by February 24 and I will include you in my guide, which will look like the one above from last year..
Readers provided microphones and speakers for students in Ms. B’s elementary school classes in Kinston, NC. She reports:
You would not believe how student engagement has changed in our classroom!!! We faithfully use the devices during our math lessons. Students love when they are able to clearly share their thinking, using the microphone, as they give explanations while solving rigorous word problems. Being in the spotlight, they aren’t shy to speak out for all to hear. The Bluetooth speaker sits stationary in the center of the room so all voices are projected throughout. I love the range and how I’m able to walk around freely without even realizing that it’s still on. The students are able to hear me no matter if I’m in the front of the room or in the back of the room.
Sponsored Events and Resources
Instant Access Webinar: “How AI Addresses Resource Constraints Within Identity Data Management.” Sponsor: Rhapsody. Presenters: Lynn Stoltz, MS, director of product management, Rhapsody; Drew Ivan, MS, chief architect, Rhapsody; Michelle Blackmer, chief marketing officer, Rhapsody. Discover how to overcome the toughest challenge in identity data management: resource constraints. The presenters will cover how Rhapsody EMPI with Autopilot solves resource challenges like limitations in time, talent, and budget; Reduces costs and risks associated with inaccurate data; and boosts identity data accuracy through 98% decision-making precision.
Contact Lorre to have your resource listed
Acquisitions, Funding, Business, and Stock
ProPublica examines the history of Zolgensma, a taxpayer- and charity-funded gene therapy for a rare nerve disease in infants whose rights were acquired by a startup. The chief scientist gained partial ownership, the startup went public, and Novartis later bought it for $8.7 billion, netting the scientist $400 million, an investor $315 million, and the CEO $190 million. Novartis then priced the drug at a record $2 million per dose. Medicaid spent $309 million on it over four years, while Novartis made $6.4 billion. The article notes that 10 gene therapy products now cost more than $2 million per dose once Novartis set the price bar so high.
People
WellSpan Health SVP/CIO Hal Baker, MD announces that he will retire in July. He encourages those who might want to succeed him to apply for the York, PA-based job, telling me that “We have a fantastic team, are doing some very cool cutting edge stuff in AI, and I think my 30 years working for a single employer says about as much as one can about how good the opportunity is.”
Announcements and Implementations
Meditech signs its 100th Meditech as a Service client.
Epic integrates organ donation registration capabilities into MyChart in collaboration with the non-profit Donate Life America.
Mayo Clinic will pilot VoiceCare AI’s voice AI agent in three areas for pre-authorization and benefit confirmation.
Ukraine’s Ministry of Defence deploys the first batch of 200 tablets to Air Assault Forces medics, who will use them to document frontline care in the military’s self-developed Electronic Primary Medical Records system. The tablets were donated by the Come Back Alive foundation, which supports members of the Armed Forces of Ukraine.
Other
In England, a trade union raises concerns about a hospital’s plan to use license plate recognition software to impose fees and fines. The website of technology provider ParkingEye says that the advantages are to “increase parking revenue, reduce car park abuse, and improve customer satisfaction,” also noting that 30 NHS trusts already use its systems. Complaints abound, mostly about being erroneously told by someone on site that it was free to park or to get validated, having their credit card hit with a huge charge with no response to appeals, and angry excuses of the “I was only a little over the time limit and it wasn’t my fault” variety.
Sponsor Updates
- Health Data Movers hires Andrew O’Hara as a health IT recruiter.
- TruBridge announces its selection as a preferred partner to healthcare services company Cibolo Health.
- Visage Imaging General Manager, North America Brad Levin recaps the first Sharp HealthCare Spatial Computing Health Care Summit in San Diego.
- Contessa Health (TN) works with Netsmart to develop and configure the first application in a suite of tools that is its new population health management platform for palliative care at home.
- Nym publishes a new case study, “Transforming Medical Coding at Inova.”
- Optimum Healthcare IT publishes a new white paper, “Improving Efficiency & Meeting User Demand with ITSM Practices in Healthcare.”
- Praia Health announces it has been granted a second patent for its account and experience orchestration technology.
- QGenda offers a new case study, “North American Partners in Anesthesia Achieves Faster, More Accurate Payroll with QGenda’s Schedule-Driven Time and Attendance Solution.”
- Waystar earns top rankings for its payment solutions in eight categories, according to Black Book Research’s latest analysis of AI-powered RCM software platforms.
- WellSky publishes an EHR checklist for behavioral health facilities.
Blog Posts
- Best Practices for Collaborating with Payers (FinThrive)
- CMS TEAM is coming: Why CIOs must act now on EHR optimization (Nordic)
- Top Physician Communication Frustrations (PerfectServe)
- The Cost of Doing Nothing (Praia Health)
- How Redox and Databricks are transforming prior authorization through interoperability (Redox)
- Powering the Prior Authorization Transformation (Surescripts)
- How a Healthcare Platform Transforms Patient Care & Operations (Symplr)
- How to Align Operations + Technology to Improve Patient Access (Tegria)
- Value-based care requires creativity and technology partnerships (Wolters Kluwer Health)
Contacts
Mr. H, Lorre, Jenn, Dr. Jayne.
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Merry Christmas and a Happy New Year to the HIStalk crowd. I wish you the joys of the season!