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News 8/26/22

August 25, 2022 News 3 Comments

Top News

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Amazon will close Amazon Care on December 31. It says that despite high patient satisfaction, the three-year-old virtual care offering did not provide a complete solution for its target audience of employers, concluding in an internal email that the business “wasn’t going to work long term.”

Amazon says it knew the business was not likely to be successful before it decided to acquire primary care chain One Medical, which was announced July 21. Some observers speculate that Amazon decided to focus on One Medical, which also sells to employers and offers telemedicine services. That acquisition has not yet received regulatory clearance.

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Amazon had recently announced an expansion of Amazon Care locations and services for 2022.

A Washington Post article from last week quoted company nurses who questioned Amazon’s heavy-handed operation of the business despite its limited healthcare knowledge.

Shares in Medicare Advantage home care operator Signify Health, which is reported to be the target of acquisition interest by Amazon (along with UnitedHealth and others), jumped on the news.

Some of the online reactions:

  • The company may have concluded that it makes more sense to work with providers instead of self-insured employers since the most expensive patients aren’t usually covered by employer insurance.
  • Amazon Care may have hit a wall in hiring clinical employees.
  • One Medical offers telehealth services, but also runs in-person clinics.
  • Some speculate that Amazon is closing the business to ease any regulatory concerns that are related to its One Medical acquisition.
  • The implications of Amazon not finding a go-forward path in telehealth may spill over into traditional providers.
  • The failure of both Amazon Care and its Haven joint project may have caused Amazon to realize the challenges of building versus acquiring a healthcare business.

Webinars

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


Sales

  • Baptist Health South Florida will implement Innovaccer Health Cloud for population health analytics, provider engagement, and care management.
  • Northern Ireland’s Department of Health chooses Lyniate to connect health and social systems to Epic, which goes live nationally in 2023.
  • MedAllies will implement Lyniate EMPI by NextGate.

Announcements and Implementations

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Epic CEO Judy Faulkner says at the company’s UGM conference that the records of 162 million Americans are stored in its Cosmos research database, which was used to author an article with the CDC that progressed from first draft to publication in one month. The company also announced a Cosmos feature called “Look-alikes” that will allow physicians to submit symptoms of a puzzling diagnosis to identify patients who have similar issues and to share information with their doctors . An Epic developer took the stage to lay out the benefits that are accruing from moving to a web-based platform, including easier upgrades and the ability to improve usability.

Pacific Dental Services completes the implementation of Epic in its 900 practices, which it says will support the role of oral health in overall health. The company trained 14,000 employees in converted the records of 10 million patients in the transition from its previous practice management system.

In England, the Royal Orthopaedic Hospital NHS Foundation Trust goes live on GE Healthcare Edison True PACS on Amazon Web Services, which it says allows continuous cybersecurity patching and reduced carbon footprint.

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Cardiology virtual care vendor MediCardia Health and aging-related genomics company Human Longevity launch a platform that uses extracted EHR data for patient risk assessment and remote patient monitoring. MediCardia founder and CEO Indrajit Choudhuri, MD completed fellowships in nuclear medicine, cardiovascular disease, and cardiac electrophysiology before starting the company in 2020.

First Databank launches FDB Navigo, which provides retail pharmacists with the patient’s most important risks, as derived from the pharmacy’s computer system, to help determine the “next best step.” 

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Google announces the next generation of Fitbit wearables that includes the advanced, $300 Sense 2 smartwatch, which includes continuous heart rate monitoring and tracking of sleep and stress.

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A new KLAS report on security and privacy consulting services finds high customer satisfaction with First Health Advisory and Impact Advisors, lowest overall scores for Intraprise Health and Meditology Services, and high satisfaction with managed services firms Fortified Health Security and CynergisTek (which will be acquired by Clearwater).


Government and Politics

The White House eliminates the optional 12-month journal article paywall embargo for federally-funded research projects, requiring journal publishers to make the articles and their associated data promptly available at no charge starting in 2026.

The Federal Trade Commission files a complaint about advertising technology vendor Kochava, saying that the company’s tools potentially violate the health privacy of consumers whose location and time are logged and then sold. The company denies the allegations, but says it will stop collecting mobile device user locations that involve health.


Other

A study of Epic Cosmos data finds that while 50% of suspected overdose patients are tested for opiates in the ED, only 5% of them are also tested for fentanyl, which was involved in 56,000 overdose deaths in 2020. The authors speculate that fentanyl testing is uncommon because it is usually not included in ED toxicology screening panels.

The New Yorker takes an on-the-ground look at what it’s like for residents of a nursing home that is acquired by a private equity firm. Spoiler: executives care only about cutting costs, always painfully and sometimes dangerously, and using complex corporate structures to protect the parent organization from the inevitable lawsuits over lower care quality.


Sponsor Updates

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  • NTT Data staff serve children and families staying at The Children’s Inn at the National Institutes of Health.
  • Intelligent Medical Objects publishes a new case study featuring Piedmont Healthcare, “Optimizing OR scheduling and perioperative workflows.”
  • Juniper Networks announces key milestones that highlight the company’s growth in the wired and wireless access space, including gaining the largest US healthcare provider as a customer.
  • Nordic joins KLAS’s Arch Collaborative that looks at EHR best practices and clinician burnout.
  • Surescripts joins interoperability organization Civitas Networks for Health.

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 8/25/22

August 25, 2022 Dr. Jayne 2 Comments

This week has been a bit disjointed due to travel. I’m starting to wonder how I survived being a road warrior for so long earlier in my career. I traveled at least twice a month for a number of years and there was a predictable routine to it, unlike today. In the current state, it seems like delays and difficulties have become the norm and a smooth trip is a rarity. Whether it’s due to labor shortages, supply chain issues, or other factors, I’ve grown used to airports where restaurants are closed, amenities are limited, and rental cars are less than plentiful.

I’m working on a project right now to increase accessibility to behavioral therapy services, particularly for patients who are dealing with anxiety, depression, and overall stress. The need for these services far outstrips the supply in some areas, and patients are looking for solutions that they can access during non-traditional hours as they try to juggle responsibilities at work and home. There is a particular need for services targeted towards adolescents, who are experiencing mental health diagnoses in ever-growing numbers.

As I was looking for statistics, I came across this opinion piece from the spring that suggested “It May Be Time to Ban Kids From Social Media.” I certainly know plenty of adults that struggle with social media. Family physicians and pediatricians have been speaking for years about the amplifying effect it can have on already existing social issues in pre-teens and teens.

The author cites a study that was published in Nature Communications that looks at which specific time windows of development have the most sensitivity to social media’s influence. The study, which looked at data from the UK, found that there were distinct impact windows for both males (14-16 years old) and females (11-13 years old), where higher estimated social media user predicts a decrease in life satisfaction ratings one year later. Both sexes also experienced a dip at age 19. He notes that it’s difficult to study these phenomena because of challenges identifying correlation versus causality and that using the one-year lag is helpful in trying to “tease out causality.” The authors of the study noted a feedback loop where increased social media use led to decreased life satisfaction, which led to increased social media use, and so on. The study was unable to separate the different types of social media use or platforms used, which is also a limiting factor.

Mental health issues in adolescents have been on the rise long before the COVID pandemic, and social media seems to be a significant contributing factor for many of the youth I encounter regularly. Gossip that used to spread within a given class grade level over several days at school can now spread to the entire school in seconds. Legislation to prevent children under 13 from having social media accounts has been in place for more than two decades, but I’m constantly encountering parents (including physicians) who help their children subvert these protections due to perceived fear of missing out or frankly giving into peer pressure. It’s interesting and often appalling to listen to the explanations given for parents who know they’re doing something that could harm their children but who don’t feel empowered to say no. Only time will tell how much of a public health threat social media really is, but it seems like we’re already past the point where the genie could be put back in the bottle.

Speaking of the teenage years, I started my medical career in earnest as a Candy Striper in a local hospital. That designation is likely long gone, replaced by “teen volunteer” in the early 1990s in most hospitals where I’ve worked. In a post-HIPAA era, I’m sure there were privacy concerns with regard to underage volunteers, and in many institutions, volunteer roles were significantly impacted by the pandemic. I volunteered with my best friend who wanted to be a nurse and it was a great experience.

Especially if they are considering healthcare, it’s important for young people to take a closer look at the careers they are considering. Our local school district has a health careers program as part of its vocational education offerings, where students can learn formally and build experience while completing their normal high school course work. I enjoyed reading a recent article about what hospitals should consider when hiring teens. One of the executives noted the emotional toll of his own daughter’s employment in the hospital’s food and nutrition area, especially when working with sick patients.

The article notes that Ohio’s Mount Carmel Health System lowered its hiring age from 18 to 16 in September 2021. Initial teen hires are working in environmental services, nutrition services, and patient transportation roles. Earlier this year, the organization created a patient-facing student support associate position and is working to onboard those who are enrolled in nursing or pre-nursing programs. The associates assist with tasks that are normally assigned to patient care technicians, such as taking vital signs, assisting with bathing patients, and helping manage equipment and supplies.

It’s a smart move, especially given the nationwide nursing shortage, since young people who have a positive experience with a given hospital might be more likely to consider a long-term role there once they have completed their training. It’s challenging, however, due to the limited hours that students can work.

It’s nice to see students be paid for the work that we did for free as Candy Stripers. We did a lot of running between our assigned floors and the central supply department, refilled ice and water pitchers, prepared ice packs on the postpartum unit, ensured that linen carts were filled, and sometimes even delivered medications from the pharmacy to nursing units. One of my favorite jobs was working in the hospital gift shop, which was a nice break from using the addressograph machine to apply unique demographics to paper chart pages. Keeping the shelves stocked appealed to my sense of order and helping the adult volunteer who was intimidated by the brand-new electronic cash register might have been the beginning of my career in technology and end-user coaching as well.

Here’s to all of us in healthcare who started as Candy Stripers. If you have a favorite story to share, leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 8/25/22

August 24, 2022 Headlines No Comments

Amazon is shutting down its telehealth service, Amazon Care

Amazon decides to shut down Amazon Care, its employer-focused virtual care company, after determining that it is not a “complete enough offering for the large enterprise customers” the retail giant has been targeting.

Firmament Backs Healthcare Revenue Integrity Technology Platform Panacea Healthcare Solutions

Firmament makes an undisclosed investment in Panacea Healthcare Solutions, a revenue cycle software and services company that recently acquired competitors Holliday & Associates and First Healthcare Compliance.

Epic’s Judy Faulkner dresses as Amelia Earhart for global conference

Epic announces a new Cosmos “look-alikes” feature that will enable providers to diagnose rare diseases more quickly using its database of 149 million patients.

Morning Headlines 8/24/22

August 23, 2022 Headlines No Comments

Babylon Disrupted the UK’s Health System. Then It Left

Struggling Babylon Health cancels its last NHS contract eight years early, saying that the projects aren’t profitable enough to continue in a cost-cutting environment.

HITRUST Selected for TEFCA Security Certification

The Sequoia Project selects HITRUST as the certifying body for organizations looking to prove compliance with TEFCA security requirements for designation as Qualified Health Information Networks.

Sanford breaks ground on transformative Virtual Care Center

Sanford Health (SD) begins construction on a 60,000 square-foot Virtual Care Center that will serve as a hub for the health system’s virtual clinics and telemedicine services.

News 8/24/22

August 23, 2022 News 5 Comments

Top News

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Struggling Babylon Health cancels its last NHS contract eight years early, saying that the projects aren’t profitable enough to continue in a cost-cutting environment.

Babylon had offered an AI-based chatbot for triaging patients and a telehealth service.

The company will focus on the US market, where the for-profit healthcare system generates more potential funding.

BBLN shares are down more than 90% since the company went public in a SPAC merger in October 2021.


Reader Comments

From Long Island IT: “Re: Northwell. Word in metro New York is that it is talking to Epic now that its CIO, who was tied tightly to Allscripts, is gone and the product set has been sold to Harris.” Unverified. Northwell and Allscripts announced in October 2019 that they would co-develop a next-generation EHR (which never happened) and Northwell extended its Allscripts contracts through 2027.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Shares of Signify Health jump on the news that Amazon is reportedly interested in acquiring the home healthcare company, joining CVS Health and UnitedHealth. Final bids for Signify, which could achieve an $8 billion valuation, are due around Labor Day. UnitedHealth’s bid of $30 a share has made it the frontrunner thus far, followed by Amazon, which acquired membership-based primary care company One Medical last month for nearly $4 billion.

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Virtual care company Recuro Health acquires Competitive Health, which offers digital health programs to employers. Recuro, which was founded last year by Teladoc founder Michael Gorton, acquired virtual primary care company WellVia in April.

Shares of Zoom took a beating on Tuesday as the company reported mixed quarterly results and lowered its forecast after enterprise sales failed to offset the loss of consumer users. A huge growth in Microsoft Teams users isn’t helping. ZM shares peaked in October 2020 at $559. They are now at $81, having lost 75% of their value in the past 12 months.


Sales

  • Baptist Health chooses Censinet for vendor and product risk assessment.
  • BronxCare Health System will implement virtual physical therapy, care paths, and remote education from Force Therapeutics for its orthopedic patients.

People

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Suki names Belwadi Srikanth, MBA (Google) VP of product and design.

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Brittany Carter, MBA (Cboe Global Markets) joins ChartSpan as CFO.

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Todd Garlitz, MBA (LexisNexis Risk Solutions) joins virtual genomic services company Genome Medical as VP of growth marketing.

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David Wardlaw, MBA (MobileSmith Health) joins Avant-garde Health as SVP of sales.

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Tamara Elias, MD (Merck) joins Nuance / Microsoft as SVP of strategy and business incubation.


Announcements and Implementations

Cone Health’s payer subsidiary, HealthTeam Advantage, implements Bamboo Health’s Pings real-time care notification technology.

Brown & Toland Physicians makes e-consults with Stanford Health Care (CA) subspecialists available to its network of primary care physicians.

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The Sequoia Project selects HITRUST as the certifying body for organizations looking to prove compliance with TEFCA security requirements for designation as Qualified Health Information Networks.

Payments technology vendor Anomaly announces an AI-powered claims prediction engine that it says can identify likely actionable denials with 97% accuracy.

The National Cancer Institute awards a grant to Memorial Sloan Kettering Cancer Center to publish best practices for telehealth-enabled cancer care, which will include a study of its MSK@Home program for breast and prostate cancer.


Privacy and Security

Methodist McKinney Hospital (TX) refuses to pay hackers to retrieve 360 gigabytes of data that was stolen in a recent ransomware attack, which also affected two Methodist surgery centers. The attack occurred between May and July. The hackers have threatened to sell the data on the dark web.

In France, ransomware hackers demand $10 million to restore the systems of 1,000-bed CHSF Hospital Centre, which is sending patients to other hospitals.

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The federal government warns hospitals about voice phishing attacks, in which hackers use telephone calls to convince computer users to install malware. The targeted user receives an email indicating that a subscription that they never signed up for is ending or from what is claimed to be a government entity or technology company, with instructions to call a provided telephone number for more information.


Other

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The Verona paper profiles Epic’s artist-in-residence Manabu Ikeda, whose on-campus studio is open for visitors each Monday, Wednesday, and Friday from 2:30 to 3:30 p.m.

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A reader sent this shot of the famous opening campfire of Epic UGM. They offered kudos to the Verona fire department for managing the actual campfires. Meanwhile, I’ve read quite a few horror stories about would-be attendees who are sitting home because the airlines couldn’t figure out how to get them to Verona.

I had a photo of Judy’s keynote at Epic UGM inserted here that I should have noticed (as a couple of readers did who told me) that it was actually from last year’s conference, when the hall seemed emptier with distancing in place. That’s what I get for just searching Twitter for “EpicUGM” and forgetting that I would get old results since I almost never do a Twitter hashtag search. Anyway, Deep Space was apparently packed this week with 11,000 people in the audience. Thanks for the folks who let me know I goofed, and thanks in advance to whomever sends me a photo from this year’s session.


Sponsor Updates

  • WebPT releases the Keet Remote Therapeutic Monitoring Dashboard and announces enhanced integrations with WebPT and Insight EHRs.
  • Ellkay adds CRM data archiving to its LKArchive platform.
  • CarePort will exhibit at the Chicago Care Coordination Summit August 30.
  • An OptimizeRx study finds that its Evidence-Based Physician Engagement solution successfully identified doctors whose patients have treatment plans that may lapse due to a loss of insurance coverage.
  • Biofourmis COO Jaydev Thakkar will present at the 2022 DPharm Idol Disrupt Event September 13 in Boston.
  • Diameter Health exhibits at the Civitas Networks for Health Conference through August 24 in San Antonio.
  • Bamboo Health makes its Crisis Management System available to support 988 Suicide and Crisis Lifeline regional call centers.

Blog Posts


Contacts

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

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Morning Headlines 8/23/22

August 22, 2022 Headlines No Comments

Signify Health stock surges 32% on reports Amazon is bidding for the company

The shares of home healthcare company Signify Health jump on the news that Amazon is reportedly interested in acquiring the company, along with CVS Health and UnitedHealth.

Recuro Health’s Acquisition of Competitive Health Adds End-to-End Integrated Benefits to its Digital Medical Home and Portfolio of Digital Health Solutions

Virtual care company Recuro Health acquires Competitive Health, which offers digital health programs to employers.

Akili wraps up $1B deal with Palihapitiya-led SPAC

Akili Interactive, which has developed an FDA-approved video game to treat children with ADHD, goes public via a merger with Social Capital Suvretta Holdings Corp.

Curbside Consult with Dr. Jayne 8/22/22

August 22, 2022 Dr. Jayne 3 Comments

In many ways, I’m still recovering from the years I spent as an in-person urgent care physician, especially during the COVID pandemic. The organization where I spent a good chunk of my career was a well-run practice when I joined, but a series of events led to an ongoing downward spiral that resulted in tremendous staff turnover and contributed at least in part to loss of more than one life.

An event that finally convinced me to leave was the acquisition of the organization by a private equity firm and the subsequent chaos that change introduced. My former partners and the PE firm are still suing each other years later and the practice is in shambles. Staff members who were relocated to other states to grow the business by developing new locations were stranded when those sites were put on pause.

I was gratified to learn that there is an organization that keeps an eye on these things. The Private Equity Stakeholder Project (PESP) released a recent report that looks at the impacts of PE firms acquiring urgent care facilities. To be honest, private equity is everywhere in frontline healthcare delivery these days. Ambulatory surgery centers, dermatology practices, OB/GYN practices, and ophthalmology practices are big targets due to their revenue streams.

The PESP issue brief notes how urgent care centers benefit from a lax regulatory environment that allows them to escape the level of scrutiny that is paid to hospitals and other healthcare providers. Only 10 states require facility licenses for urgent care clinics, while in the rest, they operate under an individual physician’s license or a hospital’s license. Not surprisingly, private equity was involved in approximately 50% of all urgent care transactions from 2012 to 2020.

Additionally, the report notes that recent surprise medical billing regulations may provide loopholes for urgent care centers that will negatively impact patients. It’s no surprise that patients are drawn to urgent care centers, which can treat a variety of non-life-threatening conditions more quickly and economically than the emergency department. The brief notes that as of 2019, it was estimated by the Urgent Care Association that urgent care visits counted for 23% of primary care visits and 12% of all ambulatory physician visits. That’s a significant amount of primary care that is potentially being delivered in environments that don’t have the same supports in place as a traditional primary care practice, or by those who are not actually trained in delivery of high-quality primary care. I’ve used several EHRs that are specifically marketed to urgent care practices and those systems lack the content that is needed to manage chronic conditions or to ensure that preventive care is being delivered.

It goes on to note the tactics used by PE firms to improve cash flow, including adding service lines, reduced staffing, expanding the use of unlicensed staff, and pushing unnecessary high-dollar procedures. I’ve had a front-row seat to all of these, and unfortunately, it’s often reinforced by patient perceptions of technology and its role in good care. For example, patients often place more value in a CT scan than they do in a physician’s clinical skill. They specifically ask for laboratory testing and x-rays when they’re not clinically indicated, and physicians who don’t order the studies anyway are often penalized with poor reviews. Technology has become a proxy for experience and skill. That approach not only raises costs, but can lead to worse outcomes when there are slightly abnormal incidental findings on the tests that weren’t needed in the first place, which in turn leads to more testing, patient anxiety, and costs.

Prescription medications and polypharmacy are also part of the equation, especially when clinics are running their own pharmacies and dispensing medications on a cash basis. One urgent care I consulted for actually maintained a metric on their providers, scoring them on how many prescriptions they issued per visit. Leadership dinged them if they sent scripts to an outside pharmacy where patients could use their insurance. This was all supported through elaborate “talk tracks” that the staff was forced to memorize and use.

The process went like this. First, all prescriptions were filled in-house without asking the patient their preference. When the clinical associate went into the room to discharge the patient, they carried the medications with them and walked the patient to the checkout counter with no mention of the fact that the prescriptions had been filled on a cash-pay basis. When the patient arrived at the checkout counter, they were asked to “please sign here to indicate you received your medications” without explanation that the sheet was approval to charge for the medications.

If the patient complained, the checkout team had a speech about “filling the medications here as a convenience” without mentioning that some of the commonly used generics were more than four times more expensive than pharmacies charge cash-paying patients. When you have providers giving four or five questionably-indicated medications per urgent care visit, that really adds up.

If patients still balked, there was a speech about how important it was for patients to be compliant with all the provider’s treatment recommendations, and that failing to do so could place their health at risk. While that’s  generally a true statement, using it to coerce patients into purchasing prescription versions of medications they can buy over the counter or might already have at home is quite a stretch. There were a couple of additional talk tracks that staff could use at that point. 

If the patient still refused, the staff would take the medications and the billing sheet and walk them back to the clinical area to try to find a provider who could send the prescriptions to the pharmacy. The practice refused to install the capabilities needed to legally prescribe controlled substances electronically, so  those had to be manually printed and signed. Patients who had been to the practice before and knew the game and knew their insurance coverage or how to get the cheapest medications in town were savvy enough to tell the provider to preemptively send the prescriptions to the pharmacy versus going through the whole in-house pharmacy charade.

There are times where having a prescription filled in-house is worth an upcharge for convenience. A couple of those situations might include treatment of an infection requiring antibiotics that is diagnosed at 7 p.m. when many pharmacies are closed, or filling a prescription for a harried parent with four children in tow who doesn’t want to deal with lines or delays at a short-staffed pharmacy. Still, it should be the patient’s choice, and for many of us, ethics dictates that they should understand their options before choosing. That takes more of someone’s time at the bedside, whether it’s a licensed individual or a clinical associate, and practices simply aren’t willing to expend those resources.

I’m not sure what the answer is, but the continued growth of for-profit care delivery organizations is only going to fuel more sticky situations. Patients will continue to be left holding the bag, and clinical care will continue to be diminished in the name of profits.

I’m interested in what readers think about this situation. As a patient, how do you feel about being treated by for-profit entities? Are there any advantages? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Interviews Anders Brown, Managing Director, Tegria

August 22, 2022 Interviews 1 Comment

Anders Brown, MS is managing director of Tegria of Seattle, WA.

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Tell me about yourself and the company.

Tegria is a 4,000-person healthcare technology services business. We are focused almost exclusively on the healthcare provider market, but we also service the payer and insurance markets across both the US, Canada, and increasingly Europe, specifically the UK, where there’s a lot of activity happening. We were founded by Providence in October 2020. I’ve been with the organization for about four years since the inception after working most of my career in technology consulting services.

What is the strategy behind a health system acquiring and operating health IT companies?

It was quite exciting when I got the opportunity to talk to the Providence leadership team and join it. Providence is one of the largest healthcare systems in the nation, a 175-year-old organization with a mission-driven idea of creating healthcare for everybody, better healthcare systems for everyone.

The idea was, what if Providence took a lot of their learnings and a lot of the investment that they were going to make to transform their own systems and expressed that to the rest of the nation, to a certain extent, through an organization like Tegria to try to help everybody move forward in the current landscape and environment that we have? For me personally, it was a great opportunity to look at healthcare. I’ve been in many, many other industries and joined something at the very early stages that I thought could make a huge impact over time in the healthcare market.

How do Providence and Tegria work with each other?

The first important piece of context is that we have grown Tegria through both acquisition as well as organic, ongoing growth. We now count well over 400 customers in our active customer base, Providence of course being one of those. We are an independent organization, so we have to compete for work at Providence, like any other folks would compete. But certainly being close to them and having connections to them gives us some insight into how someone like Providence is trying to transform their healthcare system so that we can take those learnings out to the rest of the industry.

Does Tegria have Providence-created intellectual property?

We certainly have the idea that we would like to technology-enable many of the things that we take to market. Tegria is one of the commercial efforts that Providence has. You might have seen recently that Providence also spun out Advata, a software organization that is almost a sister company of ours, and we work together. But right now, Tegria is focused more on technology services and technology consulting.

Several big health systems have recently outsourced their IT services, revenue cycle management organization, or both. What is behind that trend and how will it impact Tegria’s strategy?

In some ways, that trend is exactly what our business strategy is and plays into. Our fundamental thesis over time is that many of the healthcare systems are better served by putting all of their capital into taking care of their communities and effectively building better healthcare for the nation. To the extent that Tegria can work with them to not only improve those on a project basis, but over time take over some of those operations so that we can essentially gain some efficiency and hopefully reduce costs for those healthcare organizations, that gives them more capacity and more capital to improve really their care delivery, which is the priority and the focus of many of them. We see the same headlines that your readers see and we are certainly are out there doing what we can to win our fair share of that work.

As big health systems get bigger and expand beyond a regional footprint, how will that change their use of technology to scale and become more efficient?

The scaling of healthcare, or the growth of some of these healthcare systems, provides an opportunity to standardize and modernize the platforms, which can now be at some scale and offer increased efficiency. That efficiency leads to reduction in costs and then an increase in capacity to deliver healthcare for people’s communities. The opportunity for smaller hospitals is to continue to look towards the larger healthcare systems for direction and for partnership. We talk to both of those kinds of organizations and are focused on delivering that kind of value across both of those segments.

How will digital transformation change the relationship between healthcare organizations and consumers?

Our position is that we are at a unique point coming out of the pandemic. On one hand, we have consumers asking for more and more convenience and are willing to change their healthcare provider for that convenience. On the other hand, we have the providers themselves, the clinicians and doctors, who are frustrated with burnout and trying to understand how technology will make their lives better. 

This idea of transformation comes up a lot in conversations that we have. The challenge with that word is that it means something different to everybody. Our perspective is that you have to meet people where they are. For some folks, transformation can mean simply moving some data to the cloud. For others, that could be full-blown EHR replacement and implementation. It’s important to move forward, but the pace and speed at which you do that will depend on exactly where our customer is in that journey.

Health systems that mostly competed only with each other are now facing big companies such as Optum and CVS Health that blur the line between insurer and provider in trying to attract the same consumers. What influence will those companies have?

You see a number of interesting trends, and you commented on a couple. One is this payer-provider connection. The idea of retail being a connection point for healthcare. The third, which just was announced, is big tech, in this case Amazon, entering these markets with their acquisition of One Medical.

Change is afoot. There are pressure points on these healthcare systems to respond to these external new entrants. Our viewpoint is that technology can help, but the idea is that people see the opportunity to create efficiency and see the opportunity to deliver better patient care. Our goal at Tegria is to help all of those organizations do that.

What is the future of deep-pockets technology companies like Microsoft and Oracle entering what seems to be an appealing healthcare IT market?

It goes back to what these large organizations, whether it’s Microsoft or Oracle or Amazon, see, which is the opportunity for technology to make a huge impact in healthcare. At the same time, the healthcare providers themselves will benefit, in theory, from some of the scale that these organizations can bring and take advantage of that technology. So again, they can focus on what they do best, which is the clinical care, having the doctors and clinicians that can take care of the patients and their communities.

Our view at Tegria is that we will continue to partner with these large organizations and help deliver some of the best solutions out there to these healthcare providers. But it’s certainly a trend that has started and that I believe will continue to move forward for a long time.

How will financial market conditions that have driven down company valuations impact Tegria’s participation in mergers and acquisitions?

Tegria is totally focused on continuing our growth. We have aspirations to continue to grow not only the service offerings that we provide, but also the geographies in which we provide them. To the extent that he macroeconomic environment changes valuations, we’ll just be there with everyone else looking for opportunities. We’ll continue to grow organically as well. But for us, it really doesn’t change our strategy as much as it continues to support where we want to take the organization.

Where you see the company in the next three or four years?

Tegria is founded on this idea of trying to bring the best technology solutions to our customers. We will continue on that trajectory. We are excited about the next decade of technology and transformation that we think this industry will go through. We want to be there arm-in-arm with our customer base to help them move forward. It’s exciting times in healthcare and will continue to be so for quite a while.

Morning Headlines 8/22/22

August 21, 2022 Headlines No Comments

VA data shows Oracle Cerner EHR hit with nearly 500 major incidents since initial rollout

VA data obtained by FedScoop under the Freedom of Information Act shows that the VA has had at least 45 days of Oracle Cerner downtime and 498 major incidents since its first rollout in September 2020.

Alpha II, LLC Accelerates Revenue Cycle Management Solutions with Acquisition of Health EFilings

RCM software vendor Alpha II acquires Health EFilings, which offers analytics and automated MIPS reporting.

Russian hackers plan to release data stolen from McKinney hospital onto dark web

Methodist McKinney Hospital (TX) refuses to pay hackers to retrieve 360 gigabytes of data stolen in a recent ransomware attack.

Monday Morning Update 8/22/22

August 21, 2022 News 1 Comment

Top News

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VA data obtained by FedScoop under the Freedom of Information Act shows that the VA has had a least 45 days of Oracle Cerner downtime and 498 major incidents since its first rollout in September 2020.

The VA itself was responsible for one-third of the incidents.

The system issues caused 930 hours of incomplete functionality, 103 hours of degraded performance, and 40 hours of compete downtime.

The VA lists five medical centers as being live on the Oracle Cerner system — Spokane, WA; Walla Walla, WA; Columbus, OH; Roseburg, OR; and White City, OR. It has paused deployments that were scheduled for 2022 until next year.

VA Secretary Denis McDonough said in response to the FedScoop report, “The bottom line is that my confidence in the EHR is badly shaken … the system is not meeting those goals and needs major improvement. We at VA could not be more frustrated on behalf of Veterans and providers, and we’re holding Cerner, Oracle, and ourselves accountable to get this right.”


HIStalk Announcements and Requests

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The employers of most poll respondents haven’t had big layoffs in the past year.

New poll to your right or here: Would you post a “looking for work” article on LinkedIn if you needed a job? I’ve seen a ton of those lately and I would do the same – there’s no shame in seeking the next gig and LinkedIn’s reach is broad, although of unknown effectiveness.

The weather looks good for this week’s Epic UGM, with daytime highs barely reaching 80 and nicely cool, campfire nights in the high 50s. A few HIStalk sponsors updated me on what they’ll be doing there, so check that out. Your photos and reports are welcome.


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Welcome to new HIStalk Platinum Sponsor KeyCare. The newly launched company offers health systems access to a network of independent virtual care providers via its Epic-based platform, avoiding the challenge of overwhelmed internal providers and third-party telehealth vendors that use poorly integrated technologies. Health systems can easily augment their care teams, optimize capacity, and enhance their digital front doors by partnering with a nationwide network of virtual care groups, while patients can schedule appointments with virtualists from the health system’s MyChart portal or call center. Encounters are then documented in KeyCare’s Epic system, ensuring a seamless experience. The company’s first customer is BHSH Spectrum Health West Michigan Division, which says the service provides patient convenience while ensuring robust data sharing and streamlined clinical workflows. KeyCare and Spectrum Health will present details of their work at Epic UGM this week. KeyCare’s founder and CEO is industry long-timer Lyle Berkowitz, MD, aka DrLyle. The company just announced a $24 million Series A funding round. Thanks to KeyCare for supporting HIStalk. 


Webinars

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


Acquisitions, Funding, Business, and Stock

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Idaho Health Data Exchange files Chapter 11 bankruptcy after federal and state funding dries up, leaving it $4 million in debt. IHDE, which was created in 2008, says it will reduce costs and move toward heavier use of subscription and user-based fees. 


Announcements and Implementations

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NHS will pilot the use of smart glasses by home care nurses, hoping to reduce nurse administrative work by sending visit transcription to the EHR and offering them a way to obtain instant second opinions virtually. The software was developed by physician-launched Concept Health, which offers virtual and augmented reality based programs for remote consultation, chronic condition recovery, pulmonary rehab, relaxation, pain relief, and fall prevention.


Government and Politics

The Federal Trade Commission says that hospital mergers that are approved by states under Certificates of Public Advantage – state laws that shield hospital mergers from federal antitrust enforcement – usually don’t improve quality, increase employee compensation, improve access, or lower costs. FTC notes that most of the hospitals that sought COPAs to accomplish a merger ended up creating a single-hospital monopoly and that competition is the best way to improve cost and quality.


Privacy and Security

Novant Health sends 1.3 million letters to patients whose information it shared with Facebook via the Meta Pixel website visitor tracking tool. Novant says it implemented the technology in May 2020 to track the effectiveness of its marketing campaign for the use of Epic MyChart to boost virtual visits, adding that Facebook received more information than the health system intended because Novant configured the tracking tool incorrectly. Novant says it may have sent email addresses, phone numbers, IP addresses, emergency contact lists, appointment types and dates, and button clicks and freetext entries. Website The Markup told several hospitals in May 2022 that they were sending PHI to Facebook, after which Novant and some other named health systems removed it. Novant says it asked Meta Facebook about removing the information of its patients, but the company never responded.


Other

Amazon Care nurses say they were surprised by some of the company’s decisions in running a health business virtually. Examples:

  • Home care nurses were asked to dispose of medical waste at home and to use blood centrifuge machines in their cars.
  • The company didn’t collect patient emergency contact information until clinical staff told them it was necessary.
  • Amazon chose a “bargain basement” off-the-shelf EHR instead of waiting for a vendor to develop a custom one and equipped nurses with wireless stethoscopes that didn’t always work.
  • Nurses were sent to see patients in hotel rooms and at street protests without tracking their locations or giving them emergency button software.
  • They struggled to keep up with state-specific telehealth regulations and worried about outcomes from the company’s use of untrained contract nurses.
  • They worried about the cultural divide between nurses and Amazon employees, one of whom reportedly told a telehealth nurse that they were considered “the warehouse workers of Amazon Care.”

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A Wall Street Journal report describes the drug overdose death of a pre-med student who obtained Adderal from online mental health provider Done. Points:

  • Companies such as Done generate prescriptions for stimulants such as Adderal after video calls that list as little as 10 minutes and pressure their contracted clinicians to issue prescriptions if patients seek them.
  • The patient, who lived in a sober-living house, didn’t disclose his drug addiction history to Done’s nurse practitioner. He relapsed shortly afterward and died of a drug overdose.
  • The nurse practitioner was new to the company and had little experience with ADHD. She says she checked California’s prescription drug monitoring database as required by law, but didn’t notice the patient was  prescribed Suboxone by a rehab center.
  • The company, which was started by a former Facebook executive who has no medical background, considered firing the nurse practitioner because she was supposed to name a supervising physician as state law requires and had failed to do so.
  • Done’s clinicians are paid $10 per month for each monthly renewal, with one of them saying that she made $20,000 per month cranking out refill prescriptions at 30 seconds each.
  • The company responded to complaints about its practices from the patient’s mother by saying that it offers only a technical platform that matches patients to medical professionals, with no responsibility for any prescriptions that result.

Sponsor Updates

  • Optum publishes a new success snapshot, “Regional One amplifies utilization review effectiveness with Optum Case Advisor.”
  • Surescripts releases a new episode of its There’s a Better Way: Smart Talk on Healthcare and Technology Podcast, “The Giant Sequoia as a Metaphor for Advancing Interoperability.”
  • Vocera publishes a new white paper, “Smart, connected hospital framework.”
  • Ragan honors Well Health VP of People Marissa Morrison with a Platinum HR Award in the Future Leaders category.
  • Verato will exhibit at the Civitas Networks for Health Annual Conference August 21-24 in San Antonio.

Blog Posts


Contacts

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

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Morning Headlines 8/19/22

August 18, 2022 Headlines No Comments

Upfront acquires PatientBond; expands capabilities for market-leading personalized patient access and engagement platform

Patient engagement and access platform vendor Upfront acquires PatientBond, which offers patient relationship solutions.

Idaho Health Data Exchange files for bankruptcy, with $4 million owed to creditors

The Idaho Health Data Exchange has filed for bankruptcy after accumulating $4 million in debt since launching in 2009, despite receiving an $8 million federal grant in May.

Impact Advisors Acquires Chicago-Based C2 Healthcare

Impact Advisors acquires business intelligence consulting firm C2 Healthcare.

Motivo Health closes $14M Series A to solve shortage of mental health therapists

Motivo Health, which has developed an online marketplace to help aspiring mental health therapists obtain licensure, has raised $14 million in a Series A funding round.

News 8/19/22

August 18, 2022 News 1 Comment

Top News

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KeyCare, which offers an virtual-first care platform that gives Epic-using health systems access to a network of independent virtual care providers, raises $24 million in a Series A funding round.

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KeyCare’s founder and CEO is industry long-timer Lyle Berkowitz, MD.

The company’s website says that patients can use the service directly to connect with clinicians starting later this year


Reader Comments

From Quiet Cacaphony: “Re: Epic. Posted a job for a medical biller who will work on RCM activities for clients. Is this the start of a tentative or aggressive entry into rev cycle outsourcing, which Epic has eschewed? The job is based at headquarters with full benefits, so the strategy certainly doesn’t involve leveraging squeezed labor costs.” The job listing is nearly identical from one from mid-2017, when Epic was first launching billing services for Resolute Professional Billing customers, so this doesn’t seem like something new.


HIStalk Announcements and Requests

UGM 2022 attendees: connect with HIStalk sponsors while you’re in Verona.

I dislike using “reimbursement” to refer to provider payments since the word means being repaid for expenses you incurred.  The correct but obsolete term is “imburse,” which simply means getting paid. It’s odd that hospitals and doctors try to hide the fact that they send bills, get paid, and make a profit from income that exceeds expense by calling it something else.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Patient engagement and access platform vendor Upfront acquires PatientBond, which offers patient relationship solutions. Upfront has raised $20 million through a Series B funding round.

Nurse job-matching website Incredible Health raises $80 million in a Series B funding round that values the company at $1.7 billion. Co-founder and CEO Iman Abuzeid, MBBS, MBA went directly from medical school into health consulting, worked in project management for AliveCor, and then started a healthcare customer retention software company with a colleague that they shut down to start their current venture.

ASG, which buys and runs vertical SaaS companies, acquires MediMatrix, which sells a solution for portable radiology imaging services.

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HIPAA-compliant email vendor Paubox raises $10 million in funding.

Impact Advisors acquires business intelligence consulting firm C2 Healthcare.


Sales

  • Warren General Hospital will implement Meditech Expanse in a $2.3 million project.
  • British Columbia’s Fraser Health Authority chooses Picis Preop Manager, Anesthesia Manager, and PACU Manager for 11 acute care hospitals, integrated with Meditech as the health system replaces Client / Server with Expanse in an agreement signed in April 2022.
  • Santa Cruz Health Information Organization chooses Verato’s master patient index and identity management platform.

People

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Vyne promotes Steve Roberts to CEO. He replaces Lindy Benton, MS, who will serve as executive chair of the company’s board.

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McLaren Health Care hires Derek Morkel, MHA (HealthTechS3) as SVP/CIO after serving as interim since late 2021.

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Adam Tallinger, RPh, MHA takes a new position with Divurgent as VP of delivery.


Announcements and Implementations

Nuance and diagnostic intelligence company Covera Health launch the Quality Care Collaborative, which brings together payers, providers, and self-insured employers to support radiology quality improvement initiatives. Walmart has already joined the AHRQ-certified Patient Safety Organization as its first large-employer member.

Medical software vendor Parker Health will integrate First Databank’s FDB Vela, a cloud-native e-prescribing network, with its EHR.


Government and Politics

The Wall Street Journal reports that HHS is formulating how to shift the cost of COVID-19 vaccines and treatments to the commercial market instead of the federal government paying for everything.


Other

A study finds that higher-level EHR use is associated with a reduction in operating costs of urban hospitals – driven mostly by general / ancillary and outpatient costs – but rural hospitals don’t see any cost savings from their use. The authors note that rural hospitals more often choose vendors such as CPSI, Healthland, Evident, and Medhost than their urban counterparts, making the effect of vendor support uncertain when comparing urban versus rural hospitals.


Sponsor Updates

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  • CloudWave sponsors The Foundations for Firelands “Caddyshack” Open Golf Outing in support of cancer patients treated at Firelands Health.
  • Get Well adds a new monkeypox digital care management plan to its library of over 250 digital care management plans.
  • HIMSS Oregon appoints Pivot Point Consulting SVP Laura Kreofsky secretary and VP Joe Clemons sponsorship chair.
  • Everbridge integrates its Travel Risk Management and Critical Event Management solutions into Everbridge Travel Protector for healthcare, businesses, and government organizations.
  • Fivos Health will exhibit at AMP 2022 through August 20 in Chicago.
  • Nordic posts a new episode in its “DocTalk” video series.
  • Intelligent Medical Objects will exhibit at the Civitas Networks for Health 2022 Annual Conference August 21-24 in San Antonio.
  • Lyniate releases the latest version of its Enterprise Master Patient Index by NextGate.
  • Medicomp Systems releases a new Tell Me Where It Hurts Podcast featuring MedAllies CEO John Blair, MD.
  • Meditech releases a new podcast, “Sparking Passion and Resilience: True Stories from Nurse Leaders.”
  • NTT Data Senior Director of Statewide Consulting Patti Garofalo receives a Medicaid Enterprise Systems Conference Collaboration Award at MESC 2022.

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 8/18/22

August 18, 2022 Dr. Jayne 1 Comment

I booked my hotel for HIMSS23 this week, and I think this might be on par with the earliest I’ve ever done it. Still, my preferred dates were already sold out for the hotels closest to the convention center, which means I’ll be doing more walking but that I’ll be better located for parties.

Chicago is one of my favorite places for HIMSS when you consider the after hours scene, with plenty of interesting restaurants in close proximity when you discover that you have three events booked on top of each other. I’ve also loved the ability to just step out into the street and grab a taxi, although that might be different now in post-COVID world and with the rise of ride share services. The last time HIMSS was in Chicago I had one of those “the world is my oyster” weeks, so I have high hopes for the 2023 edition.

Hospitals claim to be running on razor-thin margins, but I still see them waste money on paper processes when they have perfectly good technology offerings ready to assist them. This week I received a letter reminding me that it’s time to schedule a mammogram, apparently without any kind of crossmatch to the fact that not only do I already have a mammogram scheduled but that it’s been on the hospital’s books for more than 11 months, so it’s not like my scheduling process crossed paths with the letter. The letter didn’t mention anything about “if you have already scheduled your study, please disregard this letter,” which made me wonder if there had been some kind of glitch, forcing me to check my patient portal and confirm that my appointment was still there.

The hospital should know that I have opted in for patient portal communications, so that’s a great way to save not only on postage, but on the service contract that I’m sure they have for mailings. They could have sent me a reminder electronically, but even better, they could have crossmatched the “patients who need a mammogram” report with the “patients who have a mammogram scheduled” report, using the magic of the very expensive analytics suite that I know they have. If they’re trying to prevent no-shows, they could use outreach tools to ask me to confirm my appointment.

Especially as a patient who is enrolled in their high-risk program and whose anxiety around the procedure is likely higher than average, I didn’t need the extra annoyance of wondering if my appointment got lost. Due to the need for taking off work since a trip to the high-risk clinic takes a minimum of three hours out of my day, I’d have been seriously irritated if it turned out to be more than just a poorly managed, wasteful, and annoying outreach effort.

Mr. H mentioned an article by physician Danielle Ofri, MD, who describes her journey to telehealth advocacy. I was excited about reading it. Many of her statements resonated with me as a telehealth physician. However, I tripped over the wording a little when she mentioned that telehealth “offers some flexibility to overburdened clinicians, who can do telemedicine from home if they happen to get grounded by a sick child or a COVID quarantine.” Seeing this kind of statement from a fellow physician makes me wonder how much Dr. Ofri actually understands the thin line that many physicians are walking with so-called work-life balance, what burnout is doing to us, or what flexibility really means. Of course, there’s a chance she was misquoted or that her statements were taken out of context, but still I ran it past a couple of colleagues who are parents to determine if I was being overly sensitive. Based on their responses, I was the least riled of the bunch.

The consensus among my colleagues (many of whom are pediatricians and primary care physicians) is that when a physician parent is “grounded by a sick child,” what they need is the same level of sick leave time that many other workers in the US have, not an expectation that they’ll just keep working at home. It doesn’t appear that the author understands what it’s like to juggle a vomiting child, or one with diarrhea, or one who’s lethargic and clingy, with basic care tasks including pumping the child full of clear liquids, doing copious loads of laundry, always having a popsicle at the ready, or watching the thousandth episode of Bob the Builder or some other show because it’s the only thing your child wants to do.

As a family physician, I would like to advocate for a world where sick children are actually cared for by their parents, not pushed to the side and only checked-on in between their parent’s telehealth visits with patients. The myth that physicians are some kind of superhumans who can work through anything (let alone should be expected to do so) needs to go away, once and for all. Of course, this should apply to all working parents, not just physicians, and the fact that families struggle with this on a daily basis shows how far we need to go as a society.

Price transparency remains a significant issue for patients, so this research letter in JAMA Surgery caught my eye. The authors looked at National-Cancer Institute-Designated Cancer Centers and how compliant they were with the January 2021 requirements for price transparency. In addition to publishing their master charge lists, hospitals are required to publish the negotiated rates that they have obtained with health insurance companies. Since cancer care is a huge segment of spending ($200 billion annually), they looked at NCI-designated hospitals to see whether the information was provided and how useful it was.

By examining the websites of the 63 designated hospitals, they found that although two-thirds of them provided some information on negotiated rates, fewer than one-third were fully compliant. Failures in compliance included lack of inclusion of the required machine-readable format and lack of documentation for all of the required price parameters. The authors had some choice commentary about the data that was provided, including a note that one facility used the word “variable” over a hundred thousand times in its documentation. They found the data difficult to use with large files that “required advanced coding and statistical experience to open or analyze.” It just goes to show that some of our best efforts to help patients fall short, and it’s going to take a coordinated effort by experienced technologists to make this information useful.

How is your institution handling the price transparency rule? Do you think patients benefit or are you missing the mark? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Sponsors at Epic’s UGM 2022

August 18, 2022 News No Comments

Availity

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Booth #214. People interested in reaching out to Availity can contact Stephanie Hastings at stephanie.hastings@availity.com or Kim Kirincic at kimberly.kirincic@availity.com.

Availity is the place where healthcare finds the answers needed to shift focus back to patient care. We work to solve communication challenges in healthcare by creating a richer, more transparent exchange of information among health plans, providers, and technology partners. As one of the nation’s largest health information networks, Availity facilitates billions of clinical, administrative, and financial transactions annually. Our suite of dynamic products, built on a powerful, intelligent platform, enables real-time collaboration for success in a competitive, value-based care environment. 


Baker Tilly

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As Baker Tilly will not have a booth at UGM, we will be coordinating meetings with interested readers by emailing charlie.cook@bakertilly.com.

We have been providing Epic advisory services, end-to-end implementations, Refuels, upgrades, and staff augmentation resources since 2008. Our Epic Practice Director will also be at UGM and she is available for meetings from Monday – Thursday during UGM.


ELLKAY

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Booth #206. ELLKAY Attendees: Ajay Kapare (Ajay.Kapare@ELLKAY.com) and Leah Gorman (Leah.Marshall@ELLKAY.com).

ELLKAY empowers hospitals, health systems, diagnostic laboratories, healthcare IT vendors, payers, and healthcare organizations with cutting-edge solutions. Since 2002, ELLKAY’s system capability has grown to over 58,000 practices connected and 700+ EMR/PM systems across 1,100+ versions.

Join us for “ELLKAY’s Taste of Wisconsin” on Monday, August 22 from 7-9 p.m. Enjoy locally-sourced favorites from Cedar Grove Cheese Curds to beers from the top six breweries in Wisconsin. Come get whisked away by the flavors from farmers and producers in the state of Wisconsin which will be paired with great conversation! RSVP today! https://lnkd.in/gk3Zjyxn.


Elsevier

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Booth #201.

Since 2004, Elsevier has worked with Epic to deliver the highest quality content and solutions, ensuring you not only have the content necessary to support critical thinking and decision-making, but also seamless integration to optimize your IT investment. Elsevier can help you maintain consistent top performance, reduce variability in care, and ultimately improve patient outcomes. Come visit the Elsevier booth to learn more about all we are doing to support Epic customers for nursing and patient solutions (acute care plans, ambulatory care plans, patient education content and FHIR solutioning) reference (Skills, ClinicalKey Point of Care for Physician, Nurse, Pharmacy), provider pathways (ClinicalPath), and more.


FDB (First Databank)

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Booth #211.

FDB (First Databank) creates and delivers the world’s most powerful drug knowledge that ignites, inspires, and illuminates critical medication decisions. We collaborate with our partners to help improve patient safety, operational efficiency, and health outcomes. Our drug databases drive healthcare information systems that serve the majority of hospitals, physician practices, pharmacies, payers, and all other areas of healthcare and are used by millions of clinicians, business associates, and patients every day.

Major solutions we will be sharing with our Epic user colleagues at the Epic UGM:

  • CDS Analytics. An intuitive and powerful analytics tool to easily evaluate and improve the efficacy of clinical decision support for meds and beyond.
  • Targeted Medication Warnings. Actionable medication guidance from a patient-first perspective. Including hyperkalemia, QT prolongation, opioid use risk assessment, nephrotoxicity, bleeding risk and pharmacogenomics.
  • Pharmacogenomic CDS. Actionable drug-gene guidance within the workflow for appropriate drug therapy, to help prevent patient harm and ensure effective treatments.
  • AlertSpace. Enabling clinicians to collaboratively improve and customize alerts to make them more meaningful, intuitive, and actionable.
  • Meducation. Address patient medication adherence and understanding with personalized and simplified medication instructions, multilingual labeling support, and custom calendars in 30+ languages.
  • FDB Vela. A new cloud-native electronic prescribing network that enables the seamless flow of critical prescription information, real-time benefits verification, and decision support between prescribers, payers, and pharmacies.

KeyCare

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KeyCare and Spectrum Health will be presenting more details about their innovative use of the Epic platform and its Telehealth Anywhere technology.


Lyniate

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Booth #207. People interested in reaching out to Lyniate can contact Mike Barbour at mike.barbour@lyniate.com.

Lyniate partners with healthcare organizations around the globe delivering a flexible interoperability suite that reliably connects people and the quality data they need. The Lyniate interoperability suite includes:

  • Lyniate Corepoint Integration Engine
  • Lyniate Rhapsody Integration Engine
  • Lyniate Envoy Managed Service
  • Lyniate Rapid API Gateway
  • Lyniate EMPI
  • Lyniate HealthTerm Clinical Terminology Management

Earlier this year, Epic selected Lyniate for integration within its Garden Plot offering, Epic’s new hosted and supported Software as a Service (SaaS) model for independent medical groups.


Sphere

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Visit Sphere | TrustCommerce at Booth #200.

Sphere, powered by TrustCommerce, is trusted by the nation’s largest health systems to facilitate their integrated patient payments. Sphere helps clients process payments anytime, anywhere—securely, in compliance, and connected with core business software including EHRs. Stop by Booth #200 to learn about:

  • Sphere’s TrustCommerce patient payment platform and its new digital wallet support within MyChart.
  • How Sphere is now included in the Epic Garden Plot offering with integrated payments.

We’ll be giving away a set of Apple Airpod Pros. Visit us and enter to win.


Morning Headlines 8/18/22

August 17, 2022 Headlines No Comments

Eir Partners invests in ClaimLogiq, the Leader in Healthcare SaaS Payment Integrity Solutions

Eir Partners announces a growth recapitalization investment in ClaimLogiq, a payer-focused payments company that recently acquired natural language processing-enabled medical claims and coding vendor SyTrue.

AliveCor Announces Series F Financing to Help Expand Offerings to Key Healthcare Industry Stakeholders

Heart health technology vendor AliveCor secures an undisclosed amount of funding in a Series F round led by GE Healthcare.

KeyCare Expands Nation’s Only Virtual-First Care Platform Built with Epic via $24M Series A Investment

Epic-enabled virtual care startup KeyCare, launched by health IT veteran Lyle Berkowitz, MD raises $24 million in a Series A funding round.

HIStalk Interviews William Febbo, CEO, OptimizeRx

August 17, 2022 Interviews No Comments

William J. “Will” Febbo is CEO of OptimizeRx of Rochester, MI.

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Tell me about yourself and the company.

I’m CEO and director of OptimizeRx, going into my seventh year. I’ve been in healthcare technology for about 25 years. Early on, I decided to put myself between industry and healthcare providers and patients and try to use technology and data to make that relationship more seamless. That’s obviously a challenge, but both groups need each other. I’m excited to be part of OptimizeRx because It helps me down my personal journey to get those two groups communicating better with technology and data and doing it all compliantly.

OptimizeRx is a health technology platform that enables digital engagement among our clients, life science organizations, healthcare providers, and patients, particularly at critical junctures through the care journey. We reach about 60% of healthcare providers and millions of their patients through this platform that we’ve built over the years, which we call Digital Point of Care Network. We like to say, as a team and in our culture, that we are helping patients start and stay on their medication.

Pharma marketing used to involve aggressive sales reps and buying lunch for doctors. How has that changed?

Even before the pandemic, acts such as HITECH and Sunshine made it nearly impossible to continue the usual lunches, entertainment, connectivity, and building relationships. Then the pandemic hit and made that even harder. The industry is going through a pretty big change right now. Everyone woke up in January 2020 thinking pretty much the same strategy — we’ve got our reps, conferences, and speaker bureaus and we’re figuring out this digital thing to try to make it all smoother.

Then obviously we all had to stay home. What we saw as a company — and I think my peers did as well after talking to other CEOs and team members – was that all of a sudden there were a lot executives from our clients in meetings around digital enablement of connectivity. How to communicate, how to leverage call centers using technology, and how to communicate at the point of care, the point of dispense, and in the waiting room. Obviously digitally, because we were all staying home.

Then in 2021, we saw a lot of micro trying. Pharma tried, either through agencies or directly, lots of different solutions. OptimizeRx has been in the market for a while. This is our seventh year. We like to say we re-founded the business to have a broader platform to approaching communication between industry and doctors and patients. But the pandemic helped awareness and adoption happen. One of the challenges was that a lot of solutions stepped up. They all sound terrific when they’re presented. When you can’t talk to your clients, you’re going to try anything that’s compliant. 

What we have found lately is that pharma is seeing some terrific digital technology and now wants to see who can scale. They are looking at the whole country and then beyond the states as a way to communicate, and not just micro populations and pilot tests with different solutions. 

The pandemic helped pharma lean into digital more, to put continued pressure on the model of people and gatherings, but certainly didn’t kill it. There are lots of questions every day that doctors have for reps in their territories, especially as we’re seeing so many specialty medications come to market. If you think of how many medications people are on and the type of conflicts those can have, then there are questions. So that infrastructure is needed, but I think we’re going to see a wonderful hybrid of digital enablement and people working together and pharma helping that move as fast as possible.

In a perfect world, pharma marketing would benefit the patient, the prescriber, and the sponsor company more than just blasting ads to increase product use.

That’s right. We focused in on two solutions. TeleRep is a connectivity point in the workflow of EHR that the doctor can click on and connect to their local rep to either email or text a quick question. We found in a newly launched six-month case study, and this happened to be in the autoimmune area, that 89% of the brand reps were contacted. It’s a button in the workflow.

There’s not much hard about that, other than getting it there and making sure the doctors are aware of it, but we saw a 42% increase in the engagement over the baseline. It was relevant, timely engagement and support at a time where people had questions and the reps couldn’t be in the hospital. We think there’s some real benefit that’s coming out of the connectivity, but the key is being in that workflow and being present because doctors are on EHRs a big part of their day.

We also launched a real-world data evidence solution that addresses the lack of interoperability between EHRs. We gather data on a patient cohort from various sources. We then build an algorithm around a mechanism of action so that we can compare a patient in workflow to a set or cohort of patients and trigger the appropriate message to the physician at the right time. Targeted, data-driven, and highly relevant. For our clients, we uncovered a significant opportunity and saw an increase of their addressable physician audience of about 200%.

We hear a lot about the newfound effectiveness of inserting information into the clinician’s workflow. How will companies and organizations avoid the clinical decision support dilemma, where users get so frustrated with unwanted or unhelpful interruptive messages that they tune them out completely?

We work with our partners. Their clients are physicians. Through our Innovation Lab, we partner with these EHRs and hone in on the pain points or friction points that frustrate physicians when in the care journey.

Trying to come up with a platform that tells a doctor what to do clinically is not wise. They can do that. The key is giving them tools that help them get information that is highly relevant. Not tangentially relevant, but directly relevant is the key. We also heard from talking to physicians and our partners — no more clicks, no popups, don’t disrupt the workflow. That’s key to keeping the noise out of that care journey.

People with good intentions have come up with lots of solutions, but there’s always a sentence at the end that says, “They just need to go to this app or just need to go to this website.” That’s the hardest part of those models. Physicians aren’t looking for another app. They’re not looking for another website. They really don’t like working in the EHR, but they have to. The key is focusing in on reducing friction, actually reducing time on the tech, and bringing the right tools and information at the right time. That’s hard to do if you’re not integrated, because otherwise, you’re asking them to go somewhere else, and frankly, they don’t want to.

How can technology support the increasing use of specialty drugs and their associated information burden?

It’s a huge problem. You have awareness prior to prescribing, but then a whole host of problems post-prescribing. Pharma has used specialty pharmacy contracts and also hubs to try to make that better for the patient. We had a partnership with a company called EvinceMed last year, which built technology to give an alert about which specialty pharmacy should go with a prescription. They did some of the prior authorization work between the EHR and the specialty pharmacies and the hubs.

We ended up acquiring that company earlier this year because we saw such a friction point, so much frustration with the doctors and the patients and the hubs, and the whole ecosphere. This was a really elegant technology. A couple of other companies are doing it as well, but it’s a big space with so many new medications that have different distribution channels.

Specialty drugs are expensive and complex and involve a lot of questions. Just calling through the pharmacy is not going to do it 100% of the time. The technology that we acquired and that others have is trying to take that friction out, focused on specialty only, not the general meds or the volume meds through retail. We’re pretty excited about that space. And the same way we help agencies help pharma, we see an opportunity to help the hubs help their clients. Technology is going to be a friend to that problem.

Many digital health companies have taken a hard fall in share price along with layoffs. What factors will determine which ones succeed or even survive?

We and our peers have all taken it on the chin. There’s different reasons for different sectors, but what the pandemic did to the investor base was get them excited about solutions that can help with health. That’s happened in fintech and in the consumer world and it rushed into health. There really aren’t that many public companies that can scale.

You had a real rush of retail and institutional investment. In the exuberance, there were some mergers and acquisitions that frankly just either didn’t make sense or couldn’t sustain what was promised. The investor base, at least the one I talk to, is looking at who has a long-term, sustainable competitive advantage. Who’s your client? Is it pharma? Is it a payer? Is it the government? Is it providers? There’s just so much more awareness now.

As pharma leans more towards digital, they are going to look for clients that scale. That makes it a good opportunity for investors. They can look at companies that are public and private that have true connectivity to an HCP or patient and can improve care and not just be a website.

I’m excited about the space. Most of us get into healthcare to actually make a difference and don’t get too caught up in stock price. That’s what I tell my team. Our culture is not about the stock price. It’s about helping patients start and stay on therapy. If you just delight the client and focus there, you’ll build a great business. We’re all getting over the drop in valuation and are focused more on the clients, doctors, and patients.

What will be important to the company over the next three or four years?

We are focused on our clients being connected digitally to doctors and patients wherever they are. We want to help patients start and stay on therapy. We want to get rid of friction. We’ve made huge progress in the almost two years since you and I last spoke. We have enhanced the leadership team, won all sorts of really cool awards around that RWD solution, and added some great people in AI and just great team members. The issue of communication has only gotten more challenging. It’s still a fragmented way to get to people. We will not only have the platform to facilitate that, but it will be omnichannel as well. We’ll be able to get to them wherever they are, whether that’s in the hospital setting, at home, on their cell phone, or in the pharmacy.

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