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Monday Morning Update 10/25/21

October 24, 2021 News 5 Comments

Top News

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Consumer DNA testing company 23andMe will acquire telemedicine and online pharmacy vendor Lemonaid for $400 million in cash and shares.

23andMe says the acquisition it will extend its ancestry foundation into information about health risks and treatment that will “transform the traditional primary care experience and make personalized healthcare a reality.”

23andMe went public in June 2021 via a SPAC merger that valued the company at more than $3 billion. Shares are up 2% since versus the Nasdaq’s 8% gain.


Reader Comments

From HLTH Watcher: “Re: HLTH and ViVE conferences. Does reader feedback encourage you to attend? I’m considering it for next year or the year after depending on how HIMSS22 goes.” Maybe. Below are the attendee comments I received. My personal challenges with attending to write up the proceeds for HIStalk are: (a) as an introvert, I don’t love attending conferences; (b) I pay my own way to conferences using a phony job title instead of requesting a media pass so that I get a true on-the-ground impression of exhibitors, so my cost would be significant; (c) ViVE ends five days before HIMSS starts, leaving me unsure how to get the most out of two back-to-back conferences in Florida without sensory overload; and (d) HLTH22 is in Las Vegas, a city I avoid whenever possible. I’m sure HIMSS is watching closely since the new competitive threats of HLTH and CHIME could siphon off some of the HIMSS decision-making audience that has kept exhibitors paying, although HLTH momentum could fade if the stock market takes a hit that deflates some high-flying digital health startups that it draws. Meanwhile, HIMSS updates its conference page to reflect HIMSS22, which will offer both an in-person and digital track. The exhibitor count is at 378.

From John Moore: “Re: HLTH. I attended and it’s mostly a conference for smaller VC-backed companies and their investment partners. Exhibit hall was quiet with exceedingly few end user buyers and customers. Small companies had the ability to meet with larger health IT incumbents for potential partnerships. The good part of HLTH is that no other event outside of JPMorgan brings in executives from all facets of healthcare, which provides a broader perspective. The not-so-good is that outside the love fest between startups and their investors, there’s not much for users or patients, it has excessive glamor and glitz, and it’s definitely not worth the expense of attending unless you have networking objectives.”

From Dan Nigrin: “Re: HLTH. I was again impressed. The content and exhibitors represent the future of our industry. At least 100 small startups had friendly people stationed in their small spaces ready to explain things intermingled with larger companies instead of being relegated to some faraway exhibition space. Equally interesting was the gradual entry of more traditional HIT vendors. Panel and keynote discussions were interesting and relevant, many of them with standing room only. Disclaimer – I’m on the CHIME board, which is putting on VIVE together with HLTH this spring.”

From Diligent Scribe: “Re: HLTH. The exhibit hall was never overwhelmingly crowded, but flow of folks was consistent. It felt about perfect since booths were spaced but the exhibit hall didn’t feel bare. As a first-time attendee, what struck me was the quality of attendees and the variety of titles they represented. such as lots of transformation and innovation folks. This led to deep, high-quality conversations in our booth as well as offering a tremendous opportunity to talk with existing and prospective partners. The educational sessions were informative and not a regurgitation of the same old, same old. I felt it was a worthwhile use of my time and the company’s expense, to the point that I’m considering skipping HIMSS next year and just doing CHIME, VIVE, and HLTH since all three together cost less than HIMSS and likely deliver better results due to their content and the audience.”

From Love Doctor: “Re: Surescripts medication histories. Our health system received a patient safety notification that medication histories from two pharmacies were missing the slash or hyphen in the dose, which could cause a dose of ‘take 1-2 tablets a day as needed’ to display as ‘take 1 2 tablets a day as needed’ in Epic. Surescripts has removed the dosage portion of the medication history and Epic has provided a list of patients whose reconciled histories were impacted and removed those that were uncreconciled.” 


HIStalk Announcements and Requests

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Two-thirds of providers failed to review the available medical records from other providers in the most recent encounter of poll respondents.

New poll to your right or here: Which healthcare organization provided the poorest customer service in your recent personal or family experience?

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Welcome to new HIStalk Platinum Sponsor Verato. The McLean, VA-based company — the identity experts for healthcare — enables better care everywhere by providing the single source of truth for identity to organizations across the care continuum, including providers, payers, healthcare technology, life sciences, public health, and HIE organizations. Over 70 of the most respected brands in healthcare rely on Verato’s next-generation cloud identity resolution platform for a complete and trusted 360-degree view of their patients, provider networks, and customers in their communities. Organizations can integrate with its HITRUST-certified platform at every step of the care journey across CRM, EHR, enterprise analytics, and digital health experiences quickly and at scale. Thanks to Verato for supporting HIStalk.

I found this explainer video for Verato’s MPI on YouTube.


Webinars

October 28 (Thursday) 1 ET. “A New Streamlined Approach to Documentation and Problem List Management in Cerner Millennium.” Sponsor: Intelligent Medical Objects. Presenters: Deepak Pillai, MD, physician informaticist, IMO; David Arco, product manager, IMO; Nicole Douglas, senior product marketing manager, IMO. IMO and Cerner announce the launch of the IMO Core CSmart app, an in-workflow offering to improve clinical documentation and problem list management in Cerner Millennium. The presenters will review the challenges and bottlenecks of clinical documentation and problem list management, discuss how streamlined workflows within Cerner Millennium can reduce clinician HIT burden, and demonstrate how IMO Core CSmart can help clinicians document with ease and specificity, improve HCC coding, and make problem lists more relevant. Additional sessions will be offered on November 17 and December 1.

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


Acquisitions, Funding, Business, and Stock

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Cerner President and CEO David Feinberg, MD, MBA confirms an anonymous employee’s Reddit comment that Cerner will lay off 150 workers in early November.

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Shares in London-based digital health tools vendor Babylon Health closed their first day of trading Friday up 18% following its SPAC merger, making founder and CEO Ali Parsadoust, PhD a billionaire. The company predicts 2022 revenue of $710 million and that its losses will turn into profit in 2024.

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Medicare primary care provider Oak Street Health acquires RubiconMD, which offers PCPs electronic patient consults with specialists.


Sales

  • Hendrix Medical Center (TX) goes live on a newly created TeleMFM (maternal-fetal medicine) service offered by SOC Telemed and Ob Hospitalist Group. SOC program allows 94% of women with high-risk pregnancies to receive prenatal care and delivery services in their own communities instead of seeing specialists in urban centers.

People

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KONZA National Network hires Jeff Messer (ToolWatch) as COO/CFO.

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David Finn, MA (CynergisTek) joins CHIME as VP over its affiliated professional groups.

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Hillrom promotes J. B. Leeming to area VP of digital health.


Announcements and Implementations

Ninety-one percent of surveyed healthcare professionals say that fixing broken administrative processes is healthcare’s most urgent need for improving patient care, while patients having their medication history readily available to any provider they see would do the most to improve their outcomes. Nearly all healthcare professionals in the Olive-sponsored survey predict that healthcare AI use will be widespread by 2026, but patients remain skeptical.


Government and Politics

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A Florida state audit finds that case managers of its compensation program for brain-damaged children didn’t consult experts and instead Googled medications, therapy, supplies, and surgeries to decide which were medically necessary. The organization amassed $1.5 billion in assets while sometimes arbitrarily denying or delaying care while offering no appeals process for parents. It did not use a system to track denials or complaints, leading the state’s CFO to observe, “Why is a program of this size doing record-keeping with CD-ROMs?” The program’s executive director resigned on September 21 ahead of the report’s release.


Other

The employee relations department of Phoenix Children’s Hospital (AZ) emails 370 unvaccinated employees using CC:, thus exposing the list of recipients to all. I was thinking as I was writing this that not many people have seen an actual “carbon copy,” just as many computer users know the “save” icon even though it depicts a floppy disk that they have never physically touched.


Sponsor Updates

  • Olive launches The Library, a marketplace offering key distribution channels for industry pioneers.
  • Ascom and Ellkay bolster their respective offerings with RingCentral’s message, video, phone, and call center capabilities.
  • RxRevu receives Cerner’s Partner of the Year Award.
  • Sectra publishes a case study, “One for all – native support for automated breast ultrasound in Sectra’s expanded breast imaging PACS.”
  • Spok publishes a new infographic, “Burnout in healthcare contact centers.”
  • Waystar will exhibit and present at the MGMA MPE21 Conference October 24-27 in San Diego.
  • West Monroe publishes a client story, “Demand for a seamless patient experience drove this health system to innovate – and led to 5X faster results.”
  • Vyne Medical plants hundreds of trees as part of its “Growing Vyne Day” environmental sustainability effort.

HIStalk sponsors exhibiting at the CHIME Fall Forum October 27-30 in San Diego include Bluetree, Clearwater, Meditech, Divurgent, Ellkay, Optimum Healthcare IT, Clearsense, Imprivata, Cerner, HCI Group, Spok, InterSystems, Infor, Quil, Experian Health, and Agfa HealthCare.

Blog Posts


Contacts

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Weekender 10/22/21

October 22, 2021 Weekender No Comments

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Weekly News Recap

  • Vanderbilt University Medical Center reports that patient-to-clinician messages doubled when it started posting lab results immediately to its patient portal as required by the Cures Act.
  • Virtual care company Babylon begins trading on the NYSE via a SPAC merger that values the company at $4 billion.
  • Microsoft enhances Cloud for Healthcare and Teams with expanded virtual visit capabilities.
  • General Catalyst and Jefferson Health form an innovation partnership in which the health system will use technologies from the venture capital firm’s Health Assurance Network of companies.
  • The merged Grand Rounds Health and Doctor on Demand rebrand as Included Health.
  • Transcarent announces that it will offer Walmart’s pharmacy services to its self-insured employer customers.

Best Reader Comments

Appreciate the shift in language from “follow the science” to “evidenced-based.” The latter may be less intimidating and widen the door for more shared decision making as the patient and provider collect and review the “evidence” together. (Quynh Tran)

Love it when someone relatively new to the industry has all the answers and calls out the “crooks in the room” who don’t have all the answers – or does have them but they don’t want to share them?! (Steve Ex Twitter)

Am I the only one who thinks that the ratio of “Innovation Conferences” to “actual implemented, at scale innovation” is probably the highest in our industry compared to other sectors? Somehow, other industries keep making my life better through innovation without needing to have some many innovation conferences :). What gives? (Ghost of Andromeda)

Can we talk about how pretty much all of the interoperability standards for healthcare are not secured? HL7 is not an inherently secure protocol. DICOM is not an inherently secure protocol. I don’t think X12 are inherently secure protocols either. The protocols don’t support any native encryption and have little to no authorization/authentication mechanisms. So our healthcare InfoSec friends basically have two overlapping options: 1) encapsulate these messages in a protocol that is secure; 2) Use network microsegmentation to limit which endpoints on your network are allowed to talk to your databases. The problem with #1 is that while it’s doable in theory, and there is even an RFC for doing this with X12, I haven’t seen any commercial products or solutions that implement it. (Elizabeth H. H. Holmes)

Correct that HL7 v2, DICOM, X12 etc. do not have security in the protocols themselves – they are routinely secured by microsegmentation as detailed. I’m not persuaded that it’s more mistake prone than the alternatives – and it’s at least easier to test (but does need testing). FHIR is different – it’s built on the the web stack in order to get web level security. But as the report shows, that requires actual commitment to security to get right. But #2: a commit to metasploit… sounds like a good idea for someone to do. (Grahame Grieve)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. K from Arizona, who asked for hands-on math learning tools for her special education class of fourth and fifth graders. She reports, “The materials have arrived, and my students have loved using them during virtual teaching and learning! Thank you for supporting education and helping students develop a love of math! These math materials are awesome at inspiring students to keep learning and to be able to visualize important math concepts.”

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TV show “The View” demotes its health and safety manager Nurse Wendy after two fully vaccinated hosts tested positive – apparently falsely –-for COVID-19 minutes before Vice-President Kamala Harris was scheduled to go on in late September. The hosts tested negative several times after the incident despite their original positive PCR test. Host Sunny Hostin was angered because her surgeon husband had to be pulled out of the OR because of her false positive and the incident required her medical information to be revealed without her authorization. The show had previously honored Wendy Livingston, RN with an extensive on-air tribute as a healthcare hero.

A Seattle man is indicted for impersonating a nurse for 10 years by stealing the identity of a former college classmate. He had been discovered and fired several times but kept finding new nurse jobs, most recently as a care home’s director of nursing.

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A hospital ED nurse wheels a stretcher to the helicopter ambulance only to see that the occupant is her boyfriend – who is also an ED nurse at the same hospital – who dropped to his knee to ask her to marry him. She said yes.


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Morning Headlines 10/22/21

October 21, 2021 Headlines No Comments

Association of Immediate Release of Test Results to Patients With Implications for Clinical Workflow

Vanderbilt University Medical Center finds that immediately releasing lab results to the patient portal, as required by the Cures Act, was associated with a doubling of the number of patient-to-clinician messages that were sent immediately afterward.

Chubb Can’t Sidestep Settlement For Canceled Trade Show

A federal court rules that the insurer for HIMSS20 has to cover the organization’s settlement with exhibitors of the cancelled conference.

Babylon, one of the world’s fastest-growing digital healthcare companies, to begin trading on the New York Stock Exchange under the ticker BBLN

Virtual care company Babylon combines with SPAC Alkuri Global Acquisition Corp. to begin trading on the NYSE.

Ann Arbor’s Workit Health raises $118M in Series C funding round

WorkitHealth, developer of a virtual care app for addiction treatment, raises $118 million in a Series C funding round.

News 10/22/21

October 21, 2021 News No Comments

Top News

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Vanderbilt University Medical Center finds that immediately releasing lab results to the patient portal, as required by the Cures Act, was associated with a doubling of the number of patient-to-clinician messages that were sent immediately afterward.

The percentage of patients that saw their results before their provider had reviewed them jumped from 10% to 40%.

The report didn’t investigate whether patient questions about their results drove the increased messaging.

VUMC delayed release of results to patients based on test sensitivity and complexity until January 2021, which it met Cures Act requirements.

The authors question whether the unintended consequences of immediately sending results to patients, such as patient wellbeing and clinician workload, outweigh the benefits. 


Reader Comments

From Dolla Bill: “Re: executive compensation. Obscene and pointless – you can only spend so much.” Business ambition is another ultimately pointless diversion in the continuum of birth to death since we all know that hearses don’t pull U-Hauls. We all strive in our own ways to earn “gone, but not forgotten” status even though the legacy we create – other than our children – usually fades away after one generation no matter what we leave behind.

From Periodically Panned: “Re: new health IT publications. Seen these? New HDM and something from Modern Healthcare.” Health Data Management has been resurrected as part of a South Carolina non-profit health collaborative, while Modern Healthcare owner Crain Communications has announced a “digital media brand” that rolls up some databases it bought via an acquisition this summer. I didn’t see anything on either website that hasn’t been amply covered elsewhere and most of their content would have been irrelevant to me personally, but it’s the opinion of a potential audience rather than mine that counts.

From HLTH on Wheels: “Re: HLTH21. What have readers said about the conference compared to HIMSS?” I haven’t heard from anyone who attended, but I’m interested as well, especially with regard to sponsors and the exhibit hall since those are what make or break a conference. Most of the social media comments I saw were from folks who focused on socializing or attending celebrity panel discussions for which in-person attendance seems to add little value over virtual viewing. Perhaps academically focused attendees could research the validity of the oft-repeated conference-goer claim that the networking alone makes in-person attendance worth it (they don’t usually add “to my employer, who is paying the cost.”)

From Rx Wrangler: “Re: Walmart and Surescripts. I heard that incorrectly barcoded medications caused medication reconciliation errors this past weekend, similar to incidents from 2014 in which special characters in a drug database caused prescriptions to be listed incorrectly. Have you heard anything?” I haven’t, but reports are welcome.

From Cricket: “Re: high-cost patients. See this Twitter thread from Jay Parkinson, MD, MPH.” I like it. Jay postulates that nearly all VCs are seeking investments that address the 5% of Americans that consume 50% of healthcare costs, but the reality is that improving their situation won’t move the needle much on overall costs because those people in the 5% fall into three groups:

  • Those who are chronically sick whose situation can be improved with interventions. That might reduce overall cost 3% at best.
  • Those who have an unpredictable incident, such as an accident, who will go back to being low spenders the next year.
  • Those who are dying expensively. It’s easy to predict who they are, but there’s little ROI to intervene because the health system is geared to take advantage of heroic Western medicine by making huge profits from their final months.

Webinars

October 28 (Thursday) 1 ET. “A New Streamlined Approach to Documentation and Problem List Management in Cerner Millennium.” Sponsor: Intelligent Medical Objects. Presenters: Deepak Pillai, MD, physician informaticist, IMO; David Arco, product manager, IMO; Nicole Douglas, senior product marketing manager, IMO. IMO and Cerner announce the launch of the IMO Core CSmart app, an in-workflow offering to improve clinical documentation and problem list management in Cerner Millennium. The presenters will review the challenges and bottlenecks of clinical documentation and problem list management, discuss how streamlined workflows within Cerner Millennium can reduce clinician HIT burden, and demonstrate how IMO Core CSmart can help clinicians document with ease and specificity, improve HCC coding, and make problem lists more relevant. Additional sessions will be offered on November 17 and December 1.

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


Acquisitions, Funding, Business, and Stock

Hackensack Meridian Health becomes one of the first health systems to use Google Workspace and Chrome OS devices (3,000 Chromebooks and Chromeboxes running Citrix) across its clinical and business environment. The health system will also deploy Google Cloud’s AI/ML solutions for screening and disease detection.

AI Visualize sues Nuance and Mach7 Technologies, demanding royalties for what the company says is infringement on its image-sharing technology patents. AI Visualize has a minimal web presence and seems to employ mostly patent attorneys.

Venture funds operated by investment firm Carlyle invest $430 million to take a majority position in clinical trials management and analytics platform vendor Saama.

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Microsoft announces enhancements to Cloud for Healthcare:

  • Microsoft Forms has been integrated into Bookings so that schedulers can collecting patient information while scheduling virtual visits.
  • Microsoft Teams adds a Waiting Room so that virtual visit patients can receive messages and notifications providers can send from their queue view.
  • Providers using Cerner PowerChart can launch virtual visits from the patient portal or SMS with no patient app download required. Multi-participant virtual visits will also be supported.

Sales

  • In the UK, NHS Wales chooses Australia-based Citadel Health’s Evolution VLab software for pathology, replacing three separate systems that manage 35 million tests each year.
  • Blue Shield of California will move toward real-time provider payments using AI/ML tools from Google Cloud.
  • Pharmacy benefits management company Vivid Clear Rx chooses Banjo Health’s prior authorization management solution.

People

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Hospital medical equipment tracking system vendor Cohealo hires Tom Cady (Kareo) as SVP/COO.


Announcements and Implementations

An InterSystems-sponsored study finds that 80% of surveyed health system executives don’t trust the data they use to make decisions. Half of the respondents say that lack of data integration and interoperability is the biggest barrier to achieving their strategic data analytics priorities.

The Vaccine Credential Initiative and The Commons Project will hold a webinar next week on using SMART Health Cards as a digital vaccination certificate that includes well-known speakers such as Andy Slavitt, John Halamka, Micky Tripathi, and Aneesh Chopra, 


Government and Politics

A federal court rules that the insurer for HIMSS20 has to cover the organization’s settlement with exhibitors of the cancelled conference.

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The Department of Defense’s program to use smart watches and rings to predict COVID-19 infections ends, with its former program manager blaming DoD’s sluggish innovation processes. A team that included Philips Healthcare ported a previously developed algorithm that mined EHR data to predict illness to commercially available wearables as a “check engine light” indication that something unusual is happening. The program manager says the big problem was that DoD needs to categorize projects to determine which regulations apply (is it a weapon, a platform, or a system?) and it could not decide if the tool was a medical device.


Sponsor Updates

  • EVisit launches the Change Healthcare Podcast featuring co-founder and CEO Bret Larsen and co-founder and CTO Miles Romney.
  • The Surescripts White Coat Award recognizes a dozen healthcare leaders for improvements in e-prescription accuracy and patient safety.
  • Everbridge launches its Unlocking Resilience Podcast with an episode featuring William Shatner, “Resilience Makes the Leader.”
  • Vyne Medical publishes a podcast titled “Connecting with Today’s Consumer: A Closer Look into the State of Healthcare Consumerism.”
  • Jvion publishes a new whitepaper, “Smart Healthcare: The AI-Enabled Patient and Population Healthcare Journey.”
  • Lyniate names Shelley Wehmeyer (Cerner) director of product marketing.
  • Meditech congratulates customer Kingman Regional Medical Center (AZ) for on receiving Health Current’s 2021 Health IT Innovation Award.
  • Nuance will present at the CHIME Fall Forum October 27-30 in San Diego.

Blog Posts


Contacts

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

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EPtalk by Dr. Jayne 10/21/21

October 21, 2021 Dr. Jayne No Comments

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There has been lots of chatter with my IT friends around the Windows 11 rollout. Most of the large organizations I’ve worked with over the years would rather risk letting their operating systems become so dated that they’re almost not supported rather than consider being on the cutting edge of a new release. I worked with several people who I thought would need to have Windows XP pried out of their cold dead hands, but somehow everyone survived their upgrades. From a consumer standpoint, several of my physician friends have run the “compatibility check” from Windows and are concerned that they may not be able to support the new release, but it’s usually due to requirements that they can meet but that aren’t enabled.

Apple is preparing to move AirPods into the medical device space. Temperature and posture sensors are on the horizon, as well as the ability to use them to augment hearing. Using them to check temperature in the ear isn’t a tremendous leap, but I’m less convinced about the posture sensor’s proposed slouch-detecting capabilities. AirPods Pro already have the “conversation boost” functionality, but it’s not clear whether they’re going to expand on this or offer something else for hearing loss. Having been part of plenty of dinner table conversations where dead hearing aid batteries have been a factor, I’m not sure how that’s going to play for Apple either.

As technology becomes smaller and has the potential to bring new diagnostic modalities to the bedside, it becomes more important to evaluate whether they’re really better than the status quo. There are some big discussions going on regarding whether robotic-assisted surgeries really deliver better outcomes than non-assisted procedures, and I’ve seen some pretty heated debates on the matter in the physician lounge. I enjoyed reading this article in JAMA Internal Medicine regarding so-called point-of-care ultrasound (POCUS). The headline sums it up: “Visually Satisfying Medicine or Evidence-Based Medicine?” Over the last several years, primary care journals have had plenty of editorials and discussions about the technology. It’s pretty slick, whether you’re using a dedicated device or something that hooks into your phone. But it requires training to interpret the images and seems to be best used by people who have the opportunity to use it frequently, rather than by individuals who might use it sporadically. The authors note that although “it has become the standard of care for most common bedside procedures” that “its use for diagnostic purposes is not as firmly grounded in evidence demonstrating net benefit on patient outcomes.”

They point out some key challenges for POCUS – that its use is somewhat informal and that images may not be accessible for later review. There is also a lack of clinical trials that have looked at key clinical outcomes such as length of stay or complications from a missed diagnosis. The variability between users is also a concern. They authors call for additional studies as well as the ability to capture images for later review. This may be a field where artificial intelligence might come into play to help with those retrospective reviews, flagging studies with concerning findings for immediate review as well as creating a quality assurance model for overall use. I always enjoy a scholarly article that has a little flair, and the description of POCUS use as “viscerally satisfying” is on track both for accuracy and in making my inner reader smile.

I had virtual drinks with a friend who works in the accountable care organization space and asked her what she thought about this piece regarding the transition to eCQM reporting. She agreed that the process is painful and shared some of her own experiences with the process. CMS is apparently listening and has pushed back the timeline for the transition, but it sounds like some of the EHR vendors might not be as on top of things as they need to be for ACO leaders to feel comfortable. It’s important to remember that ACOs might be dealing with data from dozens of disparate EHR platforms and making sure that the measure specifications are consistent is a significant challenge.

The article calls out a key challenge of electronic quality reporting, that users have to enter the data in the fields where the reports are looking for the reports to work. If there is a lot of dictation or speech recognition documentation being performed at the expense of discrete data entry, numbers aren’t going to look very good. Early in my consulting career, I worked with a number of health systems on their Meaningful Use efforts and it’s more difficult to change end user behavior than you might expect. My more successful clients baked discrete data entry into their physician compensation programs, which as you might expect led to a rapid transition.

JD Power released the results of its 2021 US Telehealth Satisfaction Study. Of the 4,600 patients surveyed, Teladoc was ranked number one for the time period from June 2020 to July 2021. The survey ranked providers based on customer satisfaction, consultation, enrollment, and billing / payment categories. Some interesting tidbits: although telehealth usage was consistent across generations, the highest use was among Generation Y (born 1977 to 1994) and the “Pre-Boomers” born before 1946. Top reasons for use include convenience, timeliness of care, and safety. Top concerns noted include difficulty accessing care and inconsistent service, which given the pandemic and its impact, I’m not surprised. Rounding out the top five, in order: Teladoc, MDLive, MyTelemedicine, Doctor on Demand, and LiveHealth.

Researchers at Stanford and UNC are looking at a wearable medical device that can deliver vaccines. The hope is that it will make it easier to distribute vaccines in underserved areas, but I’m sure there are plenty of people that will still see it as a product of a vast conspiracy. The 3D-printed vaccine patch works without the traditional injection and is said to also work more effectively than current delivery techniques. Using microneedles, the vaccine is delivered intradermally (into skin) rather than into muscle, creating a significant immune response. Part of the magic is that the 3D printing method allows creation of microneedles of controlled geometries which are difficult to manufacture via other means, which leads to greater retention of the vaccine within the skin. I’m a huge fan of prevention, so I can’t wait to see what they come up with next.

Fall is here in my world, with daily temperatures swinging 50 degrees during the course of a 24-hour period. I’m heading south for a little bit of sunshine before I have to deal with freezing temperatures and the potential of increasing COVID-19 transmission as people move their activities indoors. It will be good to get a little break because my latest project has me spinning in circles, but in a good way.

What are you doing to prepare for fall and ultimately winter? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 10/21/21

October 20, 2021 Headlines No Comments

GoCheck Raises $10 Million in New Funding to Protect More Children from Vision Impairment and Blindness

Digital vision screening technology vendor GoCheck raises $10 million in a funding round led by Hatteras Venture Partners and Pisgah Fund.

Bardavon Health Innovations Secures $90 Million in Series C Funding to Advance True MSK Technology Platform Beyond Workers’ Compensation Care

Worker compensation technology company Bardavon Health Innovations raises $90 million in a Series C funding round.

Marathon Health Unveils First-of-its-Kind Virtual Primary Healthcare

Occupational healthcare company Marathon Health launches a virtual primary care service for employees that includes telemedicine, remote patient monitoring, and care navigation and coordination.

Morning Headlines 10/20/21

October 19, 2021 Headlines No Comments

General Catalyst and Jefferson Health Announce Innovation Partnership

General Catalyst and Jefferson Health form an innovation partnership in which the health system will use technologies from the venture capital firm’s Health Assurance Network of companies.

Insiteflow Raises $2.3M to Accelerate Electronic Healthcare Record (EHR) Workflow Interoperability

Insiteflow will use a $2.3 million investment to further develop integration software that enhances the interoperability between third-party apps and EHRs.

TripleBlind Lands $24 Million in Series A Funding Led by General Catalyst and Mayo Clinic, in an Oversubscribed Round

Privacy-enforcing data sharing platform vendor TripleBlind raises $24 million in a Series A funding round that includes the participation of Mayo Clinic.

News 10/20/21

October 19, 2021 News No Comments

Top News

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General Catalyst and Jefferson Health form an innovation partnership in which the health system will use technologies from the venture capital firm’s Health Assurance Network of companies.

GC’s Health Assurance Network portfolio includes Commure, Tendo, Transcarent, and Olive.

The announcement suggests that Jefferson will de-emphasize the “hundreds of technology solutions who are vying for a piece of the hospital system’s growing technology budget” and instead will give preference to the General Catalyst-backed vendors.

Retiring Jefferson Health CEO Stephen Klasko, MD, MBA co-wrote “Unhealthcare: A Health Assurance Manifesto” with General Catalyst managing partner and billionaire Hemant Taneja last year.


Reader Comments

From Yuma Dew: “Re: having a PCP who knows you. It seems more important that they know your data.” I agree that “knowing about me” is a lot more important and achievable than “knowing me.” One of the most important clinician functions should be contributing and consuming patient data across providers, even though patients have low expectations and payers don’t seem to care. Thoughts:

  • My direct primary care doctor “knows me” because of the nature of that kind of relationship, but I doubt that has much impact on my health. She still documents the elements she needs to remember.
  • I don’t have records from other providers to review, but if I did, I should expect (and prepare to be disappointed) that they will be available if needed.
  • The provider should review my documentation before my visit, whether in-person or virtual, so they aren’t wasting our limited time together. Taking a 10-second glance at a printout before knocking on the exam room door is not ideal.
  • EHRs aren’t always ideal at allowing providers to tag those parts of a patient’s record that they find especially important or relevant.
  • The provider should document whatever is important to both of us even if it is in narrative form. My perception of symptoms her to-do items for down the road are as important as recording conveniently numeric lab or vital signs data. For that reason, Microsoft Word with speech-to-text might be a better documentation platform than an EHR if it didn’t have to generate bills.
  • We should all choose providers who value our data, maintain it rigorously, and share it with us so we can verify its accuracy and understand their thought process. That data should paint a concise picture for another provider who receives our records via interoperability.
  • Every provider who is being paid to work on the patient’s behalf — specialist, telehealth, therapist, pharmacy, urgent care, etc. — should be held accountable for documenting their work into the patient’s “permanent record” that at this stage of interoperability is mostly a pipe dream. By definition, they are documenting what is important to them, so that same information would likely be important to other providers and thus to the patient. Why should we expect less?

Webinars

October 28 (Thursday) 1 ET. “A New Streamlined Approach to Documentation and Problem List Management in Cerner Millennium.” Sponsor: Intelligent Medical Objects. Presenters: Deepak Pillai, MD, physician informaticist, IMO; David Arco, product manager, IMO; Nicole Douglas, senior product marketing manager, IMO. IMO and Cerner announce the launch of the IMO Core CSmart app, an in-workflow offering to improve clinical documentation and problem list management in Cerner Millennium. The presenters will review the challenges and bottlenecks of clinical documentation and problem list management, discuss how streamlined workflows within Cerner Millennium can reduce clinician HIT burden, and demonstrate how IMO Core CSmart can help clinicians document with ease and specificity, improve HCC coding, and make problem lists more relevant. Additional sessions will be offered on November 17 and December 1.

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


Acquisitions, Funding, Business, and Stock

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Israel-based Navina, whose AI model turns point-of-care data into a “Patient Portrait” for PCPs, raises $15 million in a Series A funding round. The co-founders worked in Israel’s military intelligence AI labs.

Privacy-enforcing data sharing platform vendor TripleBlind raises $24 million in a Series A funding round that includes the participation of Mayo Clinic.

Trinity Health (MI) invests $1 million in digital prescription referral vendor Xealth, increasing its Series B funding round to $25 million.

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Redi.Health raises $1.3 million in seed funding to develop technologies and services for chronic disease management. Offerings currently include a patient-facing app with medication management, symptom tracker, educational content, and PHR. The startup offers pharma support companies the ability to integrate their services with the app. Co-founder and CEO Luke Buchanan was previously with CoverMyMeds, as was co-founder and Head of Business Development Nate Rehm.

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Insiteflow raises $2.3 million. The company has developed integration software to enhance the interoperability between third-party apps and EHRs.

Health insurer software vendor HealthEdge will acquire Wellframe, which offers digital health management solutions for health plans.


Sales

  • UnityPoint Health (IA) will work with B.well Connected Health to offer patients access to all of its digital health tools in a single app.

People

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Fivos hires Susan Andrise (Global Payments) as CFO.

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Availity names former US Navy SEAL Jim McNary (Consortium Health Plans) COO.

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Remote patient monitoring platform vendor Veta Health hires James Sutcliffe (DayToDay Health) as CEO.


Announcements and Implementations

InnovaQor subsidiary Health Technology Solutions announces GA of virtual CIO services focused on IT infrastructure security and management.

Grand Rounds Health and Doctor on Demand rebrand as Included Health, the name of the healthcare navigation and care concierge vendor the merged companies acquired several months ago.


Other

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A CHIME survey of member CISOs finds that nearly 50% have experienced a phishing email or compromising business email at their organizations within the last year, while nearly 30% have suffered through an EHR or system outage. Fifteen percent have experienced a patient safety incident related to a cyber event, and 10% have had to divert patients as a result. Top areas of needed cybersecurity assistance include grants and federal assistance, and on-site guidance and expertise from cybersecurity experts associated with regional extension centers.


Sponsor Updates

  • Change Healthcare releases a new podcast, “Cost Transparency: Driving Better, More Informed Care Decisions.”
  • CHIME releases a new Digital Health Leaders Podcast featuring John Kravitz, chairman of the CHIME Board of Trustees and CIO of Geisinger Health, and Marc Potash, founder and CEO of Certify Global.
  • Clearwater Chief Risk Officer and SVP of Consulting Services Jon Moore will present at The Healthcare MSO Conference October 22 in
  • Dimensional Insight announces it has been named a top performer in KLAS Research’s “Data and Analytics Platforms 2021” report.
  • Tegria publishes a new case study featuring Engage, “EHR Implementation Project Transcends Multiple Natural Disasters.”
  • EZDI will exhibit at the ACDIS Conference October 25-28 in Dallas.
  • Healthcare Triangle advances to Google Cloud Premier Partner status based on its success in building, deploying, and managing Google Cloud solutions for healthcare and life sciences organizations

Blog Posts


Contacts

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

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Morning Headlines 10/19/21

October 18, 2021 Headlines No Comments

Grand Rounds Health and Doctor On Demand Rebrand as Included Health

Grand Rounds Health and Doctor on Demand rebrand as Included Health, the name of the healthcare navigation and care concierge vendor the newly merged companies acquired several months ago.

West Monroe eyes platform expansion after MSD deal

A strategic investment from MSD Partners will enable digital consulting firm West Monroe to expand in the US and abroad, beginning with the opening of a new London office next year.

CoverMyMeds, Beam vets found startup taking on chronic disease management

Redi.Health raises $1.3 million in seed funding to develop technologies and services for chronic disease management.

Curbside Consult with Dr. Jayne 10/18/21

October 18, 2021 Dr. Jayne 5 Comments

I was feeling a bit bummed this weekend, as I couldn’t attend the HLTH conference due to a previous commitment. I do a little dabbling in amateur radio and had been asked by a local radio club to be a station operator for the World Scout Organization’s “Jamboree on the Air” event. It’s held the same weekend in October every year and is a chance for young people around the world to talk to each other via radio (an internet component was added in 1995). There is always a big contingent from Germany on the air and it’s fun to try to have your scouts reach someone from every state as well as reaching international scouts. Women are typically a small percentage of any amateur radio gathering and I think it’s important for girls to have role models in tech hobbies, so I packed my gear and headed out.

Usually there is a lot of time for chitchat as you’re assembling antennas, staking them out, running cable, and figuring out how things are going to work when you’re trying to operate from a location you’ve never been. My team for the event included a search and rescue specialist, a retired Navy signal operator, an Eagle Scout, and a retired electrical engineer. Whenever people find out I’m a physician, they always ask where I practice, which can be tricky to explain based on what I do. When I mentioned that I’m only practicing virtually right now, the electrical engineer’s ears perked up. It turns out he’s got a little broader experience than electrical engineering. After receiving his degree in the 1960s, he started doing work in the then relatively new arena of biomedical engineering, specializing in the design of technology for the practice of nuclear medicine, but also in expanding the use of computers in healthcare.

Based on that, I figured I could go a little further and tell him that I spend the majority of my time working with electronic health records and emerging technologies such as chatbots, artificial intelligence, etc. and he was very interested. He asked if I had ever heard of “a guy named Larry Weed” and I said of course. Apparently my new radio friend had done some collaboration with him on his problem-knowledge coupler software in the 1980s and had some great firsthand stories about how that technology was received by physicians (not as well as it might have been) and how it evolved. It’s always interesting to learn from people who worked with the founders of our specialty and what they were like not only as innovators but as people. Had I gone to the HLTH conference, I certainly would have missed out on my own healthcare IT oral history project.

The day ended up being a lot of fun and hopefully we were able to get some young people interested in the art of radio. They enjoyed hearing how amateur radio operators can help in natural disasters and other emergencies, and they really loved learning how to craft Morse Code messages using some vintage code keys. Fortunately, conditions were such that they were able to chat with scouts on the radio from coast to coast, but the parents’ eyes were widest when they saw our teenage radio operator having a live Morse Code conversation with someone 2,000 miles away.

Online, they connected with scouts from Iceland, Taiwan, Finland, Japan, Cyprus, the UK, Serbia, and more. One of the highlights of the day was a radio “fox hunt” where the scouts had to use a directional antenna to find a hidden transmitter more than a quarter of a mile away, especially since the reward for successfully finding the fox involved chocolate chip cookies.

In addition to learning about Dr. Weed and his efforts, I picked up a couple of other tidbits along the way. The best radio tip was how to make an easily assembled and effective antenna mast out of a fiberglass paint roller extension pole, and needless to say I have since added one to my collection. We’ll have to see if the Homeowners Association has anything to say when I test it on my front lawn.

Back to HLTH, I’ve been getting some reports from the field, and it sounds like there is some good networking going on. Telehealth seems to be a hot topic, along with remote patient monitoring. I haven’t heard any grumbling about HLTH’s health and safety protocols, which involve not only proof of COVID-19 vaccination, but also a negative test within 72 hours of picking up your attendee badge at the conference. For those unable to get a test at an approved provider, onsite testing is available. Reading through the documentation on the HLTH website, the conference is picking up the tab for the onsite pre-event testing. It notes that optional testing will be available at no cost for anyone who wants to test throughout the event.

In the details, however, it specifies that attendees must have active US health insurance coverage “to receive free onsite services,” which tells me they’re not actually free — there just isn’t a patient payment required. We’ll all be paying for those “free” COVID tests that everyone is getting so they can attend events through higher insurance premiums and increased cost-sharing to the patient. As of this weekend, one of my local sports teams is requiring proof of vaccination or a timely negative test prior to attending events, and local urgent cares are already feeling the pressure.

Tuesday night is the HLTH Foundation Gala, and I hope people will share reports about the evening as well as photos of any sassy shoes or bedazzled masks they may encounter. I’m sure a lot of people have missed being able to dress up and go to events like these, so I’m betting at least one person will go all-out. At $250 per ticket, I hope the dinner is good and the entertainment is engaging. If not, the cocktails will certainly help. Maybe I’ll bust out some high heels and a martini glass and attend in spirit from my living room.

Are you at HLTH, and what’s your take on the event? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 10/18/21

October 17, 2021 Headlines No Comments

Walmart Selects Transcarent To Provide Go-to-Market Solution for Self-Insured Employers

Transcarent will offer Walmart’s pharmacy services to its self-insured employer customers.

West Monroe announces strategic investment by MSD Partners

MSD Partners will make a strategic investment in digital consulting firm West Monroe.

Right on Cue: NBA finds high-tech option for virus testing

The NBA will allow its players to self-test for COVID-19 via Cue Health, which provides a smartphone-connected nasal swab reader to provide results in 20 minutes.

Monday Morning Update 10/18/21

October 17, 2021 News No Comments

Top News

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Transcarent will offer Walmart’s pharmacy services to its self-insured employer customers.


Reader Comments

From Slattery: “Re: digital health. Are prescription delivery services really digital health companies or technology disruptors?” Startup folks have been motivated by investors to declare that just about any healthcare business that has a website and app is “digital,” hoping to be anointed as the next high-valuation Facebook or Salesforce. Examples: mail order pharmacies, Medicare Advantage insurers, vanity prescription drug companies, weight loss companies, primary care chains that have developed a basic app, online counseling services, and fitness tracker manufacturers. Health IT websites and publications gush over their latest funding rounds and acquisitions without asking questions such as, (a) are they really doing anything new? (b) can they can improve outcomes or cost? (c) does their incidental use of technology really make them a tech company that can scale with low overhead? and, (d) do they offer a sustainable competitive advantage with a high barrier to entry over the companies that are already serving their potential customers? I also look hard at who is paying for their services and whether those buyers are likely to continue doing so given that companies live or die by recurring revenue that must be predictably extracted from fickle markets. There’s also the telehealth-highlighted tension between giving consumers what they want versus what the science says is best for them in a a transactional environment where they won’t likely see the patient again anyway. Healthcare is different because it’s horrendously expensive, notoriously consumer-indifferent, and loaded with bureaucratic paper-pushers, but odds are slim that a couple of kids and their slick app will take money away from the incumbents. Maybe worst of all is that companies will profit by catering to the most financially capable users while not only failing to make the underlying health system better, but quite possibly making it even worse than it already is for those without those means.

From Tubeless Tired: “Re: blood collection tubes. Our hospital has been told that we can get just half our normal supply of blue top, pink top, and light green top tubes over the next several months. We are asking providers to evaluate the clinical need for tests, evaluate and reduce when possible the frequency of standing orders such as PT/INR, and only draw a tube when actual testing has been ordered instead of as part of any hold request.” This is probably a useful heads-up for informatics teams that will probably need to make system changes to preserve blood tube supplies.


HIStalk Announcements and Requests

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It’s not EHR vendors that are making doctors unhappy, poll respondents say. Good comments: HITPM says doctors are trained and paid to treat acute illness reactively, so the high-earning specialists who swoop in and out of a patient’s life aren’t the ones complaining – it’s the lesser-compensated physicians who help keep people away from those specialists who aren’t happy. IANAL ponders whether doctors who envy their overseas counterparts do so selectively in forgetting that along with the absence of administrative overhead and price-gouging in those countries comes lifetime earnings that could be half or three-quarters less. IANAL also adds that doctors themselves spawned the role of insurers and their overhead by pushing to keep physician compensation private.

New poll to your right or here: In your most recent physician or hospital encounter, did your provider review your records from a different organization?


Webinars

October 28 (Thursday) 1 ET. “A New Streamlined Approach to Documentation and Problem List Management in Cerner Millennium.” Sponsor: Intelligent Medical Objects. Presenters: Deepak Pillai, MD, physician informaticist, IMO; David Arco, product manager, IMO; Nicole Douglas, senior product marketing manager, IMO. IMO and Cerner announce the launch of the IMO Core CSmart app, an in-workflow offering to improve clinical documentation and problem list management in Cerner Millennium. The presenters will review the challenges and bottlenecks of clinical documentation and problem list management, discuss how streamlined workflows within Cerner Millennium can reduce clinician HIT burden, and demonstrate how IMO Core CSmart can help clinicians document with ease and specificity, improve HCC coding, and make problem lists more relevant. Additional sessions will be offered on November 17 and December 1.

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


Acquisitions, Funding, Business, and Stock

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MSD Partners will make a strategic investment in digital consulting firm West Monroe.


Sales

  • Stillwater Medical Center (OK) will implement system integration from Summit Healthcare and patient identity modernization from NextGate to provide a simplified and interconnected health record.
  • Physicians Ambulance Service (OH) chooses Spok Go for communication between ambulance staff and hospitals during critical patient transports.
  • In Switzerland, University Hospital Basel will implement Sectra’s radiology module.

Announcements and Implementations

A Well Health survey of frontline clinical support staff finds that most are burned out by communicating with patients on the telephone, which has worsened during the pandemic as those employees try to coordinate complicated vaccination appointments and to support virtual care. 

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The NBA will allow its players to self-test for COVID-19 via Cue Health, which provides a smartphone-connected nasal swab reader to provide results in 20 minutes. Only unvaccinated players – about one player per team – will be required to take the test on practice, meeting, and travel days, while all players will still need to pass a PCR test right before a game.

In Abu Dhabi, all 59 public and private hospitals, 1,100 clinics, and 380 pharmacies have connected to the Malaffi HIE as mandated by the emirate’s Department of Health.

A Waystar survey of health system executives finds that 64% of organizations plan to implement robotic process automation and/or AI in their revenue cycle in the next three years, most often to improve financial performance.


Other

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A pharma article describes the benefits of using real-world data (such as from EHRs and claims) to develop drugs for rare diseases: (a) patients are dispersed geographically and can’t be easily found and studied otherwise; (b) FDA hasn’t developed study endpoints for conditions that have no approved treatments; and (c) small numbers of patients and doctors mean that symptoms, diagnosis, and progression are hard to understand. The author mentions AllStripes, which uses EHR data (including unstructured physician and encounter notes), imaging data, and genetic testing results. The company recruits individual patients to participate.

Virtual-first health insurance plans cost less and are convenient, but online visits aren’t ideal for first encounters or for detecting new problems. The KHN article also observer that telemedicine doctors are often work-from-home contractors who are paid based on patient volumes and who often don’t have access to medical records from other providers.

Fascinating testimony from the trial of Theranos founder Elizabeth Holmes: the company’s second lab director had zero lab experience or credentials – he was the dermatologist of COO Sunny Balwani. Sunil Dhawan, MD, who replaced the previous (and qualified) director who quit over the company’s questionable technology, testified that he was paid $5,000 per month to sign whatever Balwani sent him, having never met any company employee, patient, or clinician and without knowing anything about its technology.


Sponsor Updates

  • OneMedNet will provide imaging platform vendor Arterys with real-world data to aid in the development, validation, and regulatory approval of its solutions.
  • NetSmart will exhibit at the Fall Conference October 19-21 in Memphis, TN.
  • Pure Storage announces it has been positioned by Gartner as a Leader in the Magic Quadrant for Primary Storage.
  • The Philadelphia Business Journal names Quil Health CEO Carina Edwards a 2021 Woman of Distinction.
  • Redox adds former MuleSoft executive Simon Parmett to its Board of Directors.
  • Goldman Sachs recognizes Talkdesk founder and CEO Tiago Paiva as one of the 100 Most Intriguing Entrepreneurs of 2021 at its Builders + Innovators Summit.
  • Tegria partners with the Seattle Kraken’s One Roof Foundation to support South Park community health initiatives.
  • Vocera publishes a new case study, “MercyOne Elkader Medical Center – Unifying Staff Through COVID-19.”

Blog Posts


Contacts

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

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Weekender 10/15/21

October 15, 2021 Weekender 3 Comments

weekender 


Weekly News Recap

  • Intelerad acquires Ambra.
  • Healthcare Triangle shares drop after IPO.
  • GetWellNetwork renames itself to Get Well.
  • A security researcher documents widespread security vulnerabilities in FHIR APIs.
  • Best Buy announces its planned acquisition of Current Health.
  • Cerner President and CEO David Feinberg, MD, MBA kicks off the virtual Cerner Health Conference with a call to “eliminate the noise in healthcare.”
  • SSM Health outsources services, including digital transformation and RCM, to Optum and will send 2,000 employees to the company.
  • The VA contracts for a year-long cost review of its Cerner implementation.

Best Reader Comments

The NPfIT attempted to build a system rather than buy one. My pet theory is that this is part of why the NHS failed with NPfIT. Having an existing system to implement automatically puts all sorts of conceptual stakes in the ground. You not only get the What will this system do, you also get the How and the Why laid out for you. Ultimately, this is why purchasing third-party software eclipsed homegrown systems. Well, that and the ability to spread the development costs around. (Brian Too)

I believe this announcement [of the VA’s 12-month Cerner implementation cost review] still requires far more of an explanation than was given. I think an explanation can be given that protects the identities and dignity of VA employees, but also makes it clear that changes are underway. This organization still serves a gigantic public need for a very valued constituency. Our veterans really do deserve a lifetime of strong support from the VA. I want to recognize that there is a lot of good work the VA does in fulfilling that mission. This project sounds like a corner where the VA may not be living its values. (Accountabilibuddy)

UHC is amassing a huge presence in healthcare (data, contracted patient lives, POC resources, etc), where they can use their position to control cost and access, much in the same way people fear digital companies like Google having access to large amounts of healthcare data. Your CIO audience should be concerned about the motives of these vendors, short and long term. They are in it to make money, many times at the expense of patients. (Susanna Stevens)

I don’t want to diminish [Seve] Job’s legacy in tech, because it is truly massive. That said, I think his early death is a good parable for Apple (and others) attempts to break into healthcare technology. Steve Jobs died because he thought he was smarter than oncologists who had studied cancer for years, and appeared to think he was smarter than the healthcare delivery system as a whole. Had Jobs pursued traditional treatment as soon as his cancer was detected, he would very likely be alive. He should be a very real warning to every startup and VC that thinks they are smarter than the people who have actually been doing it for their whole career. (Elizabeth H. H. Holmes)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. R in Oklahoma, who asked for a tripod stand and microphone for conducting virtual classes. She reports, “I am beyond blessed to have people like you continue to believe in the importance in education even during difficult times. Teaching online is difficult as it is, but knowing I have wonderful people like you who are willing to go the extra mile warms my heart and gives me the energy to keep doing the best I can for my students. Thank you once again and may God bless you for your contribution to this wonderful project.”

In England, an NHS nurse is fired for refusing psychiatric help after losing her lawsuit against a hospital that she claimed was secretly hypnotizing her, which she says caused headaches, breathing difficulty, uncontrollable flatulence, and unspecified attacks on her private parts.

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Harborview Medical Center (WA) nurse Guy Maddison, RN launches a podcast that interviews hospital workers about the challenges of caring for COVID patients. Maddison is also the bass player for Seattle cult grunge band Mudhoney.

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England’s Leeds Teaching Hospitals responds good naturedly to a sign’s spelling error that was called out on Twitter.


In Case You Missed It


Get Involved

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Morning Headlines 10/15/21

October 14, 2021 Headlines No Comments

Intelerad and Ambra Health Combine to Form the Global Industry Leader in Cloud PACS and Enterprise Imaging

Imaging management platform vendor Intelerad acquires competitor Ambra Health for a reported $250 million.

Medsphere Systems Corporation Acquires Systeem Medical

Medsphere acquires Plano, TX-based Systeem Medical, which offers managed IT services to medical practices.

Digital health veterans launch virtual primary care clinic for patients with chronic disease

Marley Medical announces the launch of its membership-based virtual primary care clinic for patients with chronic conditions alongside a $9 million seed funding round.

News 10/15/21

October 14, 2021 News No Comments

Top News

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Imaging management platform vendor Intelerad acquires competitor Ambra Health, whose clients include Johns Hopkins Medicine, Memorial Hermann, and New York Presbyterian.

The reported price was $250 million, valuing the combined companies at nearly $2 billion.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor EVisit. The Mesa, AZ-based company simplifies healthcare delivery with its market-leading virtual care platform, which works seamlessly across enterprise service lines and departments to improve outcomes, reduce costs, and boost revenue by enabling healthcare organizations to deliver faster, more accessible virtual care using their own network of providers across any specialty. With its distinct and leading position in the telehealth marketplace as a business-to-business company supported by a team of expert virtual care consultants, the flexible, end-to-end technology platform can match and virtualize any clinical workflow. Its system does not come with a competing provider network. EVisit is helping HCOs, including the largest systems in the US, innovate and succeed in today’s changing healthcare market. The company is the leader in the “Forrester Wave: Virtual Care Platforms in Digital Health, Q1 2021” and is a representative vendor in the “Gartner 2020 Market Guide for Virtual Care Solutions.” See them at HLTH21 next week. Thanks to EVisit for supporting HIStalk.

I found a brand new EVisit overview video on YouTube.


Webinars

October 28 (Thursday) 1 ET. “A New Streamlined Approach to Documentation and Problem List Management in Cerner Millennium.” Sponsor: Intelligent Medical Objects. Presenters: Deepak Pillai, MD, physician informaticist, IMO; David Arco, product manager, IMO; Nicole Douglas, senior product marketing manager, IMO. IMO and Cerner announce the launch of the IMO Core CSmart app, an in-workflow offering to improve clinical documentation and problem list management in Cerner Millennium. The presenters will review the challenges and bottlenecks of clinical documentation and problem list management, discuss how streamlined workflows within Cerner Millennium can reduce clinician HIT burden, and demonstrate how IMO Core CSmart can help clinicians document with ease and specificity, improve HCC coding, and make problem lists more relevant. Additional sessions will be offered on November 17 and December 1.

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


Acquisitions, Funding, Business, and Stock

Shares in healthcare cloud and data technology vendor Healthcare Triangle closed down 10% on their first day of trading Wednesday. They shed another 2.5% at Thursday’s market close, valuing the company at $118 million.

Medsphere acquires Plano, TX-based Systeem Medical, which offers managed IT services to medical practices.

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Walgreens invests another $5.2 billion in value-based primary care center operator VillageMD, increasing its stake to 63% and supporting the opening of 1,000 in-store practices by 2027.

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GetWellNetwork renames itself to Get Well.


Sales

  • Atlantic Health System will implement Syft’s enterprise-wide supply chain management system.
  • In Netherlands, Amsterdam UMC chooses Infor CloudSuite Healthcare with the support of system integrator Avaap.
  • Virginia Cardiovascular Specialists selects HealthSnap’s remote patient monitoring platform for chronic condition management.

People

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Industry long-timer Matthew Tuck, MBA (IRIS) joins NextGen Healthcare as VP of account management.

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Medical equipment tracking software vendor Cohealo hires Tom Cady (Kareo) as COO.


Announcements and Implementations

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Several big-name health systems form the Advanced Care at Home Coalition advocacy group, which will seek to extend COVID-driven payment coverage for at-home care permanently.

Nordic opens a security operations center at its Madison, WI headquarters.

Sentara Martha Jefferson Hospital (VA) goes live on enterprise imaging from Mach7 Technologies. Twelve Sentara hospitals have migrated 22.5 million studies from multiple PACS into Mach7’s vendor-neutral archive.

Bluestream Health announces Care Navigator, which offers patients a personalizable page and link from which they can initiate a app-free visit in which a dropped connection will reconnect automatically.

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CHIME names Daniel Barchi, MEM, CIO of New York-Presbyterian Hospital, as its CIO of the Year.

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GE Healthcare and Apprise Health Insights launch an HHS-funded real-time hospital occupancy solution in Oregon that will be implemented statewide next year. The system will be expanded beyond beds and ventilators to include specialty bed, PPE ED, and ECMO capacity as extracted from hospital EHRs.

A small study of the Epic Signal event log activity finds that ambulatory care network physicians who spent less time working in the EHR, especially in managing their inbox, were more likely to quit. The authors speculate that the counterintuitive findings may have been caused by physicians who were planning to leave and thus were winding down their patient activities or that EHR-proficient doctors may have been more marketable for new jobs. They also think that EHR workload or burnout is perhaps less directly related to turnover than other studies have suggested.

A Kyruus survey finds that consumers are increasingly using and preferring digital access channels to research providers, services, and care sites. Health plan websites have a strong role that is growing. Consumers place high value on understanding insurance acceptance, clinical expertise, reputation, and appointment availability and 40% of them prefer booking appointments online. 

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KLAS looks at health systems that manage downside risk contracts, which make up just 10% of the average system’s revenue. Successful organizations say that contract management is crucial and that interoperability with systems and payers needs to improve to apply advanced analytics. Vendors that primarily serve ambulatory providers – such as Azara Healthcare, HealthEC, and Cedar Gate Technologies – earner higher functionality ratings, while Innovaccer scores well for integration in larger organizations. Allscripts customers report frustration with interface management.


COVID-19

A highly anticipated study finds that it’s OK to mix and match initial vaccine doses and boosters, and in fact those people who initially received Johnson & Johnson’s vaccine initially mounted a stronger immune response when given a Moderna or Pfizer booster instead of another round of J&J.

FDA’s vaccine advisory committee unanimously recommends approving a half-dose booster for Moderna’s COVID-19 vaccine for the same high-risk groups for which Pfizer’s vaccine was cleared.

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Time magazine describes how a cobbled-together chain of acquired pharmacies took advantage of loosened telehealth rules, millions in PPP loans, and demand for unproven COVID-19 treatments to make millions selling ivermectin and hydroxychloroquine at exorbitant prices via telemedicine visits, sometimes failing to deliver the expected medication to the desperate families of unvaccinated patients. Ravkoo, a “digital pharmacy” whose predecessor organization had several executives charged with running various opioid and kickback schemes, has not drawn scrutiny from the federal government even though customers – most of them referred by partner America’s Frontline Doctors — complain of price-gouging, lack of responsiveness, and threats about negative reviews.


Other

A security researcher finds that FHIR APIs are vulnerable to hacking, noting that a single log-in provided access to 4 million patient and clinician records. Every FHIR app tested gave access to the information of other people. EHR security was strong, but third-party data aggregators and mobile apps were full of security holes. The report calls for use of API security shielding solutions such as that offered by study sponsor Approov.

An EpicShare report describes how Seattle Children’s involves its patient family advisory councils in technology decisions. Parents provided input on its initial Epic and MyChart configuration for scheduling complex appointments, requesting prescription refills, and providing access to multiple caregivers. The council also tested its virtual visit access instructions for patients early in the pandemic. 


Sponsor Updates

  • Everbridge announces that its CareConverge telemedicine solution has won a 2021 Stratus Award from the Business Intelligence Group.
  • Black Book Research recognizes Fortified Health Security as a top outsourcing vendor for cybersecurity.
  • Jvion CMO John Frownfelter, MD will present a Tech Talk on AI and health equity at HLTH October 18 in Boston.
  • Kyruus publishes its fifth annual “Patient Access Journey Report.”
  • University of Michigan Health-West expands its adoption of Nuance’s Dragon Ambient EXperience across its entire primary care group.

Blog Posts


Contacts

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

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EPtalk by Dr. Jayne 10/14/21

October 14, 2021 Dr. Jayne No Comments

As my readers know, I’m a big fan of prevention. I went this week for my regular dental visit and was interested to see a wireless headset sitting on a charger on the dental hygienist’s counter where she usually charts. She mentioned that they had installed a new system that would allow her to dictate her findings as she was performing my preliminary examination, so my informatics senses were tingling.

Looking closer as she was getting ready, I noticed that an Echo Dot had also been added to the exam room, so I figured it was part of the new solution. Unfortunately, the system failed to respond to the wake word after several tries. Since patient care was the priority and not troubleshooting the technology, she said she was going to go “old school” and key in the data manually as they had done in the past. It was disappointing not to be able to see their new toy in action, but I have to give them full credit in doing what was better for the patient (and likely for their schedule). As always, I scheduled my six-month follow up before I left, so hopefully the system will be better behaved in April.

Digital transformation has certainly impacted care delivery organizations, but it is also impacting those that support clinicians. The American Academy of Family Physicians announced last week that they are no longer requiring a certain number of live Continuing Medical Education (CME) hours for physicians to maintain membership. In the past, physicians had to report 25 hours of live CME every three years. Reductions in the availability of live meetings due to the COVID-19 pandemic impacted the ability of physicians to claim these credits, leading initially to the AAFP granting extensions on the time needed to obtain the hours.

However, AAFP also realized that the definition of “live” has become more fluid in the digital world. Rather than deal with the complexity of defining whether “live” means “in person” versus “virtual” versus “livestream” or something else, they’re eliminating the category altogether in the name of allowing active members “to pick the learning formats that best suit their needs and preferences.” Active members will still need to report 150 hours of CME every three years and half must have the AAFP Prescribed credit designation, so we’re not entirely to the point where we have total flexibility in how we obtain our CME. The response in the comments section was overwhelmingly positive, so kudos to AAFP for helping make physicians’ lives at least a tiny bit less complicated.

Speaking of blurred lines between in-person interactions and other modalities, I enjoyed learning more about what Cleveland Clinic is doing at its Indian River Hospital in Florida. As part of a new program, patients are being “seen” by mental health providers during emergency department visits, an approach that not only reduces the time for patients to receive services, but is improving quality. Psychiatric consultations are being seen in less than an hour versus the 24 hours that could occur previously. Often, treating psychiatric concerns in the emergency setting can be a challenge, and in my area, we recently opened a dedicated psychiatric emergency department to better serve patients in a more welcome environment. From the day it opened, though, it’s been at capacity, so maybe augmentation with telehealth resources – either there or within traditional emergency departments – is something to think about.

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JAMIA Open published an article last week looking at an AI-based system that can flag medication errors in the EHR by looking at clinician ordering behavior in context. Researchers looked at pharmacy orders over a two-week period in a major metropolitan hospital system. The goal was to identify orders requiring pharmacist intervention then to further refine it within a given clinical context. Contextual data included specialty, clinician type (attending, resident, midlevel provider), day of the week, time of day, and the therapeutic class of the medication. The data used was from two weeks in July 2017, which somewhat limits the study – July is when new interns start and residents typically advance, resulting in changing responsibilities. The authors note this, and also that the small sample wouldn’t account for seasonal variations. Still, it’s important work, and developing effective systems to help reduce medication errors is a good thing.

I’m prepping tonight for a community presentation about COVID-19 vaccines, as a local volunteer organization tries to push its vaccination rate beyond 90%. I expect quite a few questions about third doses versus boosters as well as the usual questions about vaccines in general. I’m on a couple of groups’ COVID advisory panels, so I have to keep up with a steady stream of news along with being able to play my own little version of “MythBusters” every time I do a public forum. Today provided some interesting material about long COVID, which now has been officially defined by the World Health Organization. The clinical case definition of “Post COVID-19 Condition” as it is called includes lingering fatigue, shortness of breath, and cognitive dysfunction (also referred to as “brain fog”). Symptoms may continue for months after the initial COVID infection and are often severe enough to prevent patients from completing daily activities. Additionally, other explanations for the symptoms must be excluded before a patient is considered to have the condition.

In parallel, the US Centers for Disease Control and Prevention formally added an ICD-19 code for long COVID: U09.9 Post COVID-19 Condition, Unspecified. Additional guidance from the US Department of Health and Human Services explains that the condition can be considered a disability under the Americans with Disabilities Act. For those who think that COVID-19 infection is not a big deal, I hope we can look back in a few decades and it’s actually true. In the short term, however, I have significant concerns about the overall cost of COVID care to our health system and ultimately to the global economy. Seems like the $20 vaccine is looking like more of a bargain every day compared to the potential of hospitalization, disability, and death.

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CMS announced that the Quality Payment Program website will no longer support Internet Explorer 11 after October 13, 2021. I was shocked by the fact that approximately 2% of users access the site through IE 11. If you’re still using it, you’re missing out on the features offered by other browsers, so hopefully those users will like what life is like on the other side of the fence.

What’s your favorite browser? Leave a comment or email me.

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Morning Headlines 10/14/21

October 13, 2021 Headlines No Comments

Healthcare Triangle, Inc. Announces Pricing of $13.0 Million Initial Public Offering

Healthcare Triangle debuts on the Nasdaq in an IPO of $4 per share, with a goal of raising $13 million.

Lark Health Raises $100 Million Series D Funding Round Led by Deerfield Management

Mental health coaching app company Lark Health raises $100 million in a Series D funding round, which it will use to advance virtual care integrations with payers.

ScienceIO leaves stealth with millions to structure health data

Health data aggregation and curation startup ScienceIO raises $8 million in a seed funding round.

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