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Readers Write: Project or Program: Why It’s Time to Rethink Your Approach to Cyber Risk Management

August 15, 2022 Readers Write 1 Comment

Project or Program: Why It’s Time to Rethink Your Approach to Cyber Risk Management
By Jon Moore

Jon Moore, MS, JD is chief risk officer and SVP of consulting services for Clearwater of Nashville, TN.

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The modern healthcare enterprise constantly expands with new technologies, services, and devices. Still, few have a reliable process to ensure that these new additions meet their cybersecurity standards or are added to their risk analysis. Most do a point-in-time risk analysis or conduct their risk analysis using only a sample of their information assets, or worse, both.

Point-in-time risk analysis in a complex healthcare organization will be outdated nearly as soon as it is completed. Sampling information assets is risky. Any number of assets outside the sample could threaten an organization.

A firewall is not enough to protect an asset, system, or network. Effective, compliant cyber risk management is not just about implementing and protecting the electronic health records (EHR) system.

Today’s cyber risk management should be comprehensive, including all aspects of daily operations and supporting systems, evaluating applications and systems both on-site and in the cloud. That can be challenging for even the best teams to manage and even more difficult for smaller organizations where access to skilled professionals, risk landscape intelligence, and financial re sources can be hard to come by. It’s further complicated in mid-size to larger healthcare organizations, where technologies, software, applications, and configurations can vary from location to location and sometimes from department to department.

Without accurate, up-to-date asset, software, and system inventories, a team can quickly fall into siloed risk management practices that focus on the known, leaving security gaps with the unknown.

Adding more challenges to the mix is the growing third-party risk that healthcare organizations face as their vendor and partner lists grow, especially in new applications or devices that streamline patient care. Owensboro Health CISO Jackie Mattingly recently spoke about the challenges in keeping up with vendors, systems, and programs that are brought into the organization by various departments. “Most of these major EHR systems have a pretty good grip on security for their systems. We use Epic, and they have things pretty well buckled up,” Mattingly said. “They’ll notify us if they detect an incident, but the many other ancillary systems we use pose a greater threat. You have to assess risk across the enterprise.”

A recently released Cyber Readiness Report found that some 74% of healthcare organizations haven’t yet implemented comprehensive software supply chain risk management policies. The report noted that more than 90% of respondents struggled to measure and implement software supply chain risk management policies in healthcare. That should be alarming considering the number of successful healthcare breaches recently resulting from vulnerabilities in third-party software solutions.

While forward-looking security teams are trying to keep pace with healthcare innovation and the adoption of new technologies, it’s important to remember that the data in legacy systems may also be at risk. Late last year, a healthcare organization in Canada discovered a breach that could have affected data dating back to 1996. Although its EHR appears unscathed, data was taken from legacy administrative systems like those used for reporting and patient satisfaction surveying. The breach affected 13 different but overlapping data categories, such as medical and other information, and impacted others, such as an affiliated non-profit that purchases IT services and file storage from the core agency.

If you’re still approaching cyber risk as an annual project or initiative, it’s time to rethink this approach. While nothing can guarantee that a cyberattack won’t become a breach, having a comprehensive ongoing program in place means that even in the worst-case scenario, you’ll be prepared to show that you did what was reasonable and appropriate to protect your systems and patient data. This goes a long way when the Office for Civil Rights investigates a breach or audits your organization. It can save you countless hours, resources, and money by resulting in a short investigation and more favorable determination.

Unsure of where to begin? Consider:

  • Adopting reasonable and appropriate security controls across all of your information assets. Be sure to account for the legacy data you may have in storage somewhere. It needs protection, too.
  • Employing identity and access management processes that limit access to patient data to only what is needed for an employee to perform their job.
  • Segmenting your network as appropriate to reduce the ability of threat actors to move laterally through networks and systems.
  • Using a risk management software solution to power an ongoing risk assessment and risk management program so you always know where your risks are and how to address them
  • Working with an expert to develop a comprehensive risk management program for your organization, including seeking out program weaknesses and making plans to mature it over time.

    Morning Headlines 8/15/22

    August 14, 2022 Headlines Comments Off on Morning Headlines 8/15/22

    Digital health unicorn Truepill conducts third round of layoffs in 2022

    Truepill, which offers white-labeled, API-connected virtual pharmacy and telehealth solutions as well as home diagnostic kits, reportedly conducts its third round of layoffs this year.

    Growth Report: Oracle Cerner continues to expand client relationships

    Oracle Cerner announces it executed 161 new, extended, or expanded contracts from April to June 2022, including 11 new clients.

    Signify Health to lay off 489 people, including 45 in Connecticut

    Signify Health, the value-based home health provider reportedly being pursued by CVS Health, notifies the State of Connecticut’s Department of Labor that it will lay off 489 people beginning October 1.

    Comments Off on Morning Headlines 8/15/22

    Monday Morning Update 8/15/22

    August 14, 2022 News Comments Off on Monday Morning Update 8/15/22

    Top News

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    Truepill reportedly conducts its third round of layoffs in 2022, this time involving 175 employees that represent about one-third of its workforce.

    The company, which offers white-labeled, API-connected virtual pharmacy and telehealth solutions as well as home diagnostic kits, claimed last year that it was bringing in $300 million in annual revenue. It was reported to have been valued at $1.6 billion after raising $255 million.

    CEO Sid Viswanathan says the company will focus on increasing revenue and cutting expenses.

    Truepill was the preferred pharmacy provider of virtual mental health provider Cerebral and had acquired competing virtual ADHD provider Ahead. It shut down Ahead in April 2022 as the Drug Enforcement Administration started investigating the prescribing practices of both of the online ADHD providers, leading Cerebral to stop issuing those prescriptions. 


    Reader Comments

    From Derek Smalls: “Re: new Oracle Cerner deals. Notice how small the new clients are?” The Cerner announcement lists six of the 11 new CommunityWorks hospital clients the company signed since April, ranging from 15 to 35 beds. I would say that it’s encouraging that these rural, community, and critical access hospitals can implement Cerner in a way that is affordable and technically feasible.


    HIStalk Announcements and Requests

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    Life’s lessons from poll respondents who have lived them: plan your financial future early, take more risks, stay healthy, and don’t ignore your family.

    New poll to your right or here: Has your employer conducted a layoff that you would consider significant in the past 12 months?


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    Epic’s UGM is coming up August 22-24. It never occurred to me that I could feature how HIStalk sponsors are participating in that and other events as I do with the HIMSS conference, but let’s give it a shot. Sponsors, complete an information form by Wednesday, August 17 and I’ll summarize the results later this week for those who are traveling to Verona. I’ll do this for other conferences if response is good.


    Webinars

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


    Acquisitions, Funding, Business, and Stock

    Shares in the Global X Telemedicine and Digital Health ETF health IT index were up 11% in the past 30 days versus the Nasdaq’s 13.5% rise. However, they are down 27% in the past year and 17% since their July 2020 inception, meaning that your money would have been better invested in Nasdaq index funds.

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    A business filing indicates that BD’s price to acquire hospital pharmacy software vendor MedKeeper was $93 million.

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    Medicare Advantage primary care chain ChenMed is considering selling its majority stake in JenCare, a joint venture with Humana that runs 30 clinics in five states, at a company valuation of $4 billion. Family-owned parent company ChenMed also owns Dedicated Senior Medical Center and Chen Senior Medical Center. ChenMed CIO Hernando Celada runs two other ChenMed businesses, Curity (AI-powered care management) and IntuneHealth (primary care centers and telehealth).

    Dental software vendor Planet DDS acquires the QSIDental cloud-based dental practice management software platform from NextGen Healthcare.


    Sales

    • Oracle Cerner executed 161 new, extended, or expanded contracts from April to June 2022, including 11 new clients.

    People

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    Julie Schubert, RN, MS joins Well Health as VP of professional services.

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    Intermountain Healthcare President and CEO Marc Harrison, MD, MMM resigns to run an unnamed healthcare platform business for venture capital firm General Catalyst. He earned $6 million in 2020, according to Intermountain’s most recent tax filings, and like other former big-system CEOs, further blurs the already faint line between being a highly compensated non-profit executive and taking leadership roles in the most capitalistic organizations in American society.


    Government and Politics

    A security researcher tells a Defcon security conference audience that the decades-old encryption system that the VA’s VistA system uses could be easily defeated, allowing a hacker to perform clinician functions.


    Privacy and Security

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    An Oregon hospital becomes the latest in a list of those that overpaid their employees during several weeks of ransomware-caused Kronos payroll system downtime that are trying to get employees to return the extra money. St. Charles Health System says the average employee amount owed is $780. The Oregon Nurses Association says it will issue a cease-and-desist letter to the hospital because its demand for repayment is illegal and the health system has provided no evidence that anyone was actually overpaid.


    Other

    A Commonwealth Fund blog post whose authors include former National Coordinator David Blumenthal, MD says that Amazon’s acquisition of primary care chain One Medical won’t resolve the “international embarrassment” of the US healthcare system. Snips:

    • While Amazon shouldn’t be underestimated, its previous healthcare forays have largely failed, such as its Haven partnership and its minimally disruptive Amazon Pharmacy.
    • One Medical has always lost money because third-party payers pay little for primary care, leading the authors to predict that Amazon will need to pursue value-based care contracts with commercial insurers instead of the usual Medicare and Medicaid market.
    • The authors expect that Amazon will uncharacteristically need to restrict customer choice by negotiating preferred rates with local PCPs, which may not be acceptable in the employer-funded insurance model where the employees complain about being excluded from the big-brand medical centers.
    • Amazon must complete with Optum and CVS Health / Aetna, which already have scaled up provider employment and bring unparalleled expertise in managing risk.
    • The article concludes that the real question is whether profit-driven entrepreneurship and innovation can bring the US healthcare system up to the level of most other developed countries that do a better job of keeping people healthy at an affordable cost. 

    Sponsor Updates

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    • Diameter Health CEO Eric Rosow and CTO Harvard Pan raise money for the Dana-Farber Cancer Institute through their participation in the Pan-Mass Challenge.
    • The Hazelden Betty Ford Foundation integrates Xealth’s digital therapeutic content distribution capabilities with its Oracle Cerner EHR, making it easier for patients to access educational content through their patient portals.
    • PerfectServe adds more than 400 physician practices across 37 states in the first half of 2022.
    • Sphere will exhibit at Epic UGM August 22-24 in Verona, WI.
    • Spok announces that 18 of the 20 adult hospitals and all 10 children’s hospitals named to US News & World Report’s 2022-23 Best Hospitals Honor Roll use Spok secure healthcare communication solutions.
    • Vocera will exhibit at the 2022 Defense Health Information Technology Symposium August 16-18 in Orlando.
    • West Monroe publishes a new report, “2022 Be Digital Research.”

    Blog Posts


    Contacts

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

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    Comments Off on Monday Morning Update 8/15/22

    Morning Headlines 8/12/22

    August 11, 2022 Headlines Comments Off on Morning Headlines 8/12/22

    GHX Launches Lumere Consulting Services to Accelerate the Clinically Integrated Supply Chain

    Global Healthcare Exchange (GHX) Lumere launches a consulting service to help hospitals with their cost-saving and clinical variation programs.

    Abridge Secures $12.5M in Funding and Launches Enterprise Solution to Combat Physician Burnout in Healthcare and Help Patients Stay on Top of Their Health

    AI-powered medical documentation vendor Abridge raises $12.5 million in Series A funding.

    Peraton to Serve as Defense Health Agency’s Enterprise Information Technology Services Integrator

    The Defense Health Agency’s Military Health System awards a subsidiary of government contractor Peraton a 10-year, $2 billion contract for digital transformation services.

    Comments Off on Morning Headlines 8/12/22

    News 8/12/22

    August 11, 2022 News Comments Off on News 8/12/22

    Top News

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    Cerner will pay $1.9 million in back pay and interest to 1,870 job applicants after the Department of Labor compliance evaluation found that the company had discriminated against Asian and black job seekers.

    The affected applicants were seeking employment as medical billing specialists, system engineers, software interns, and technical solution analysts at the company’s Kansas City, MO and Kansas City, KS offices.

    The review found that Cerner violated an executive order that prohibits federal contractors from discriminating in employment based on race, color, religion, sex, sexual orientation, gender identity, and national origin.


    Reader Comments

    From Outsider Trading: “Re: Change Healthcare’s ClaimsXten. The rumored acquisition by Availity this spring didn’t end up happening – TPG signed a definitive agreement to acquire it if UnitedHealth Group’s acquisition of Change Healthcare is approved by the federal government.” The initial media reports named Availity as the buyer of the payment integrity business, but TPG Capital signed a deal in April to buy it or $2.2 billion in cash, contingent on the UHG-Change merger being cleared by regulators. I removed that mention from Tuesday’s news post about Availity acquiring Diameter Health.


    HIStalk Announcements and Requests

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    Welcome to new HIStalk Gold Sponsor Direct Recruiters, Inc. The Solon, OH-based company has been recognized since 1983 as the relationship-focused search firm specializing in building customized employment solutions. Our Healthcare IT and Digital Health teams partner with clients to help them strategically build high-performing teams from the C-Suite through the contributor level across each area of the organization. DRI offers contingency search, contract staffing and retained “Direct Retention” search to source, identify, acquire, and retain top-performing professionals to elevate the success of our client organizations. Recognized for over 17 national awards, DRI has a proven record of success in recruiting top talent for leading companies. Thanks to Direct Recruiters, Inc. 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

    Virtual care and digital medicine vendor Biofourmis adds additional funding from Intel that increases its Series D round to $320 million.

    Bloomberg reports that CVS offered $18 per share to acquire One Medical months before Amazon bought the primary care chain for the same price. The detailed timeline laid out in SEC filings is fascinating  — CVS is reportedly Party A in the document.

    TikTok’s parent company, China-based ByteDance, buys women and children’s hospital chain Amcare Healthcare for a reported $1.5 billion.


    People

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    Tower Health (PA) promotes CIO Michelle Trupp, RN, MSN to SVP and COO of Reading Hospital.

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    Motient hires Brian Miller, MBA (Signify Health) as VP of business development.

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    Digital Diagnostics hires Chris Meenan (Philips) as CTO.


    Announcements and Implementations

    A study finds that patients who tested positive for COVID-19 and used Get Well’s remote patient monitoring technology to track their symptoms and vital signs had a 32% lower hospitalization rate, stays that were 2.7 days shorter, and fewer ICU days

    Global Healthcare Exchange (GHX) Lumere launches a consulting service to help hospitals with their cost-saving and clinical variation programs. GHX acquired Lumere, which helped health systems align their drug and device purchasing decisions with evidence, in January 2020.

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    UNC Health and partners Gozio Health and Well Health enhance the health systems mobile platform to include a map of closest urgent care centers and EDs, a link to download the UNC Health app directly from text-based appointment reminders, and the option to save appointments to the mobile device’s calendar with a link to way-finding instructions. I noticed that the app also allows visitors to save their parking location so the app can route them back to their cars.


    Government and Politics

    The VA publishes a Digital Healthcare Playbook that describes how it works with contractors to develop software and lays out the kinds of solutions it needs.

    VA OIG finds that the VA loaned IPads to 41,000 patients last year for use in virtual appointments, but only half of them completed an appointment. The VA also failed to collect 11,000 devices that had never been used for virtual appointments, which cost $6.3 million for devices and another $78,000 in cellular data fees.

    Connecticut spent $20 million of mostly federal money to fund a University of Connecticut project to build HIE software that was ultimately discarded in favor of buying a system from Maryland’s CRISP HIE for $1 million per year. The group that developed the system, UConn Analytics and Information Management Solutions, has shut down and dismissed its 20 employees.

    The Defense Health Agency’s Military Health System awards a subsidiary of government contractor Peraton a 10-year, $2 billion contract for digital transformation services.


    Sponsor Updates

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    • CoverMyMeds staff raise funds for cancer research organization Pelotonia during its annual live and silent auction, and by participating in Pelotonia’s ride weekend.
    • Biofourmis appoints former Trevor Fetter (The Hartford) and Sachin Jain, MD (Scan Group) to its board.
    • EClinicalWorks releases a new podcast, “How Payer Data in Healow Insights Can Help Improve Care.”
    • CloudWave reports that over 50 of its customers have been with the company for five years or more, and that 92 have been customers for three years or longer.
    • The Veterans Data Integration and Federation Enterprise Platform, which leverages technologies from InterSystems, receives the 2022 FedHealthIT Innovation Award.
    • Lyniate launches version 11.2 of its Lyniate EMPI by NextGate.
    • NTT Data announces the winners of the NTT Data AI Hackathon for innovations in healthcare.

    Blog Posts


    Contacts

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

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    Comments Off on News 8/12/22

    EPtalk by Dr. Jayne 8/11/22

    August 11, 2022 Dr. Jayne 2 Comments

    One of my clients reached out to me for assistance adding information on monkeypox and smallpox vaccines to their EHR. I no longer support systems for the vendor she’s on, but was happy to connect her with another consulting company who can assist.

    It brings up a good point, though. In cities across the US, patients who have been exposed are receiving these vaccines. Not only is there sometimes low clinician awareness about the diseases, but also organizations need to think through how to incorporate exposure and vaccine data into their workflows. Fortunately, my EHR has been sending regular updates as the outbreak evolves so I know what to do, but smaller organizations with fewer resources are likely to be struggling.

    Governmental organizations are also having to keep up. CMS just issued new CPT codes effective July 26 which will need to be updated in EHRs and billing systems across the country. Hopefully the COVID pandemic led to organizations creating policies and procedures for these kinds of quick changes. I wonder how vaccine registries are handling this and whether they’re keeping current or lagging. If anyone is involved in statewide registries, I’d love to hear your thoughts.

    News of the weird. Now that I’m back in the air doing a fair amount of travel, travel stories always catch my eye. I’m glad I wasn’t caught in the holdup at the Springfield, MO airport when a suspicious carry-on item triggered a TSA response. When scanned, the item appeared concerning in that it contained wires and liquid, which can be characteristic of explosive devices. It turns out that the item in question was a urine warmer, which is typically used when trying to falsify a urine drug test. Since my last urgent care role also included occupational health duties, I’ve heard plenty of stories about the things they do when they have “dirty” urine and need to pass a test, but flying with your accessories probably isn’t the best idea.

    I had a great lunchtime Zoom with a longstanding colleague yesterday. It’s always good to have those relationships where you can feel instantly connected even though it may have been years. We hit a number of topics about remote work during our chat that were timely. One was “the etiquette of eating on Zoom” and how people feel about eating on camera. Both of us come from backgrounds where we attended working lunches or lunch meetings all the time, and where no one ever questioned whether you should eat in front of others. There’s something about being on camera and watching yourself eating, though, that seems to have made people reluctant to do it.

    I noted that there’s also a difference between randomly eating on a call and it being advertised as a lunch meeting or “brown bag” session where people are encouraged to eat their lunches. We both agreed that ultimately each team needs to address the topic as part of a team operating agreement exercise to make sure that no one is surprised one way or another. I’m a big fan of team operating agreements in general, because they help set guidelines for productive work and may be even more important in the virtual world than they were when we were in-person.

    Another big topic was “Will you ever go back to in-person?” My colleague comes from an organization that actively terminated leases once they came to the conclusion that COVID was here to stay, and which has significantly reduced its office space expenditures. They have had some increases in stipends for home office – internet, phone, printers, and comfortable desk chairs – but overall, it’s a fraction of what they were spending on rent, utilities, and insurance. Her team has been informed that they will remain 100% virtual and they’re excited about it. Several employees have moved to locations they’ve always dreamed about because they’re no longer tethered to an office.

    We also talked about how we see relationships among teams and colleagues when you’re in a virtual company. She noted that she thinks relationships are deeper because there has to be increased communication for teams to be successful. I agreed and added that I think it’s easier to get to know people on a personal level when you get to meet their pets or children on conference calls and can get a sense of who they are in their own environment versus whether they’re adopting a certain kind of persona because they’re going to work in an office setting. It’s also easier and more accepted to share pictures of pets and outside activities, which helps deepen those relationships.

    Both of us agreed that remote workers can be more productive. There are also different levels of communication that happen when you’re remote including increased reliance on instant messaging and chat platforms. There is also increased speed of communication. Rather than having to leave my cube, walk around to a couple of people and get opinions, then make a decision, I can simultaneously ask everyone for an opinion and quickly hash out a scenario when it might have taken the better part of an afternoon to solve in person.

    Of course, there are challenges with remote work, including rampant multitasking which can lead to inattentiveness and lack of focus. For every person who is energized by the ability to take frequent productive breaks to do things like starting laundry or grabbing a package off the porch, there are also people who become distracted by household responsibilities and family members. Being a successful remote worker involves a certain level of compartmentalization and time management skills that not everyone has.

    We also talked about the perils of the hybrid workplace, where some employees are on site and others are either remote or commute intermittently. Not all organizations are good at this. I’ve had exposures to those who had developed a bit of a caste system where workers were treated differently based on the percentage of time in the office. Sometimes it is obvious, such as access to reduced-cost meals and free snacks and beverages for those who are in-person. One company I worked for had a keg of craft beer delivered on Fridays. Other times, hybrid workplace issues are subtle, including concerns about preferential access to mentoring and staff development resources based on work location. Being completely remote can help level this playing field, but companies vary in the strategies they use to mitigate this.

    I once consulted for a company that was excellent at this. They deliberately crafted a strategy for their remote workers to mirror what was happening in the office. When it was time for flu vaccines, those in the office could receive a free one over lunch. The remote workers received CVS or other pharmacy gift cards so they could have the same benefit. On days where there was an office party or celebration, remote workers were included with a meal delivery gift card so they could feel like they weren’t being left out. Rather than using the company gym, remote workers could receive stipends to subsidize memberships to their local YMCA or gym.

    Of course, there are organizations that don’t see a need to provide parity and will instead spin the office-based perks as something that rewards people who work in person. Especially for a hybrid workplace, a better stance might be defining what perks you think all your employees should have access to and coming up with creative solutions to ensure everyone feels like the company is looking after them.

    What do you think about the hybrid workplace? Does your company manage it well or are their opportunities for improvement? Leave a comment or email me.

    Email Dr. Jayne.

    Morning Headlines 8/11/22

    August 10, 2022 Headlines Comments Off on Morning Headlines 8/11/22

    Biofourmis Raises Additional Funding from Intel Capital in Series D Extension and Names Top Healthcare Leaders to its Board

    Intel Capital invests $20 million in analytics-powered virtual care company Biofourmis, extending its Series D round to a final $320 million.

    Kansas City Medical Information Technology Company Agrees to Pay $1.8M to Resolve Racial Discrimination Alleged by US Department of Labor

    Cerner will pay $1.86 million to 1,870 job applicants to resolve federal allegations that it discriminated in hiring black and Asian applicants between 2015 and 2019.

    VHA Launches New Playbook Outlining Digital Health Care Needs For Patients

    The Veterans Health Administration publishes a Digital Healthcare Playbook to help the private sector better understand what the VA wants in future healthcare technology systems and devices, and to serve as an internal review of its current software utilization.

    Comments Off on Morning Headlines 8/11/22

    Morning Headlines 8/10/22

    August 9, 2022 Headlines Comments Off on Morning Headlines 8/10/22

    Availity to Acquire Diameter Health, A Leader in Clinical Data Interoperability

    Health information network management company Availity will acquire Diameter Health, which specializes in data optimization and interoperability, marking its second acquisition of the year.

    CPSI Announces Second Quarter 2022 Results

    CPSI announces Q2 results: revenue up 21%, EPS $0.21 versus $0.42, with shares down 15% in the past 12 months.

    Tens of thousands of tablets VA distributed for telehealth appointments go unused

    An audit of the Veterans Health Administration’s video connect program – budgeted at $14.5 million – finds that 51% of the 41,000 patients who were loaned tablets for telehealth appointments in 2021 never used them for that purpose.

    Comments Off on Morning Headlines 8/10/22

    News 8/10/22

    August 9, 2022 News Comments Off on News 8/10/22

    Top News

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    Health information network management company Availity will acquire Diameter Health, which specializes in data optimization and interoperability, marking its second acquisition of the year.

    I interviewed Availity CEO Russ Thomas in January, and Diameter Health CEO Eric Rosow shortly thereafter.


    Reader Comments

    From Prime Mover: “Re: API fees. Here’s what I have seen in the industry.” Thanks for sending me this list in response to a previous reader’s comment:

    • EHR vendors. API fees are common, pricing models vary, and per-transaction fees are often assessed. Some vendors take a cut of revenue for publishing apps on their marketplace and this is usually on top of an annual membership fee. Vendors are more likely to make USCDI-compliant APIs available at little or no charge so as to not invite scrutiny over information blocking, but these come with a limited support.
    • Integration platforms, such as Redox, Ellkay, and self-service options like Jitterbit and MuleSoft. Their business model is exchanging data on behalf of a customer, so they charge for this, most often a fixed amount per connection (pulling demographics and appointment data from System A to System B is two connections). Per-user pricing is uncommon and volume-based pricing is quite rare. Some charge upfront platform fees.
    • Health data exchanges, such as Datavant, Moxe Health, and 1upHealth. Companies use APIs to digitize and automate manual workflows, with much of the focus on provider-to-payer connections such as Medicare risk adjustment and release of information. Usually the interoperability piece is included in the overall service provided.

    HIStalk Announcements and Requests

    HIMSS pulled out of Chicago years ago over customer-indifferent McCormick Place union members strong-arming exhibitors who dared plug in their own power strips or empty their own trash cans. I guess it got so bad that the convention center now provides a list of what exhibitors can do themselves, at least by full-time employees who have been on the job for six months (exhibiting company newbies and contractors apparently can’t be trusted). Exhibitor employees are allowed to set up and tear down booths, install signs and decorative items on the booth’s drapery and exhibitor table skirting, and to plug in and turn on AV equipment. HIMSS-specific exhibit hall rules include the usual prohibition on clowns, strolling through the hall wearing a sandwich board, and working a booth naked.


    Webinars

    None scheduled in the coming weeks. Previous webinars are on our YouTube channel. Contact Lorre to present your own.


    Acquisitions, Funding, Business, and Stock

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    Netsmart acquires Zimmet Healthcare’s Core claims data analytics offering for skilled nursing facilities. Netsmart will add Core to its CareFabric platform for post-acute care providers looking to improve their value-based care performance.

    CPSI announces Q2 results: revenue up 21%, EPS $0.21 versus $0.42. Shares are down 15% in the past 12 months versus the Nasdaq’s 16% drop, valuing the company at $447 million.


    People

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    Erik Johnson (Verato) joins PatientIQ as VP of marketing.

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    Lehigh Valley Health Network (PA) names Maulik Purohit, MD (University Hospitals) chief health information officer.

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    Arcadia hires Chris D’Arcy (Liaison International) as chief human resources officer.

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    Advata promotes Corinne Stroum to SVP / head of product and Jamie Snell to chief customer success officer.

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    Health Catalyst names Melissa Welch, MD (InnovAge) chief medical officer and Edward Sheen, MD (Lumeris) SVP/ chief population health officer.

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    Randy Fusco (TEKsystems) joins Clearsense as CTO.


    Sales

    • Magnolia Regional Health Center (MS) selects AMC Health’s remote patient monitoring and virtual care technology and services for its RPM program focused on congestive heart failure patients.

    Announcements and Implementations

    Adventist HealthCare (MD) implements Innovaccer’s cloud-based population health management technology.

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    Atrium Health (NC) wraps up its system-wide conversion from Cerner to Epic.

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    MarinHealth (CA) goes live on Epic through a partnership with University of California, San Francisco Health.


    Government and Politics

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    An audit of the Veterans Health Administration’s video connect program finds that 51% of the 41,000 patients who were loaned tablets for telehealth appointments in 2021 never used them for that purpose. VHA staff failed to collect 11,000 devices from patients who never scheduled a virtual appointment despite a requirement that devices be given back if appointments weren’t scheduled within 90 days of receipt. Auditors concluded that the program’s $14.5 million budget could have been used more effectively through better device monitoring, collection controls, and oversight.


    Sponsor Updates

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    • Clinical Architecture supports the ALS Association Indiana at the 10th Annual Bob Kravitz Golf Outing to Defeat ALS.
    • EClinicalWorks releases a new customer success story, “Transforming Care for Two Practices with Healow Insights.”
    • Wolters Kluwer Health and the American Journal of Nursing welcome Carl Kirton, DNP, RN as incoming editor-in-chief.
    • Sonifi Health will integrate Vitalchat’s telehealth software with its bedside patient engagement smart TV technology at a new pediatric hospital being built in Texas.
    • Ascom Americas expands its channel partner network in Canada with Canem Systems – National Technology and Services Group.
    • Azara Healthcare publishes a new customer success story, “MPCA Drives Clinical Quality Improvement Through DRVS Mapping & Data Validation Project.”
    • CarePort partners with The Hospital and Health system Association of Pennsylvania’s HAPevolve subsidiary to offer members access to its care coordination technology.
    • CHIME releases a new podcast, “CHIME 30th Anniversary Podcast: Change with Bill Spooner, 2006 Board Chair.”
    • Clearwater names Henry Gyambiby (KP Global IT Consulting) a consultant on its cybersecurity and risk consulting team.
    • Experity names Amy Amick (SPH Analytics) to its Board of Directors.
    • Wolters Kluwer Health publishes a new handbook, “Navigating the ICU: A Guide for Patients and Families.”

    Blog Posts


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    Mr. H, Lorre, Jenn, Dr. Jayne.
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    Comments Off on News 8/10/22

    Morning Headlines 8/9/22

    August 8, 2022 Headlines Comments Off on Morning Headlines 8/9/22

    Netsmart Announces the Skilled Nursing Industry’s Only Data Analytics Solution with a Complete View of Claims, MDS, and Staffing

    Netsmart acquires Zimmet Healthcare’s Core Analytics offering for skilled nursing facilities.

    HHS Awards Nearly $90 Million to Community Health Centers to Advance Health Equity through Better Data

    HHS awards nearly $90 million to 1,400 health centers across the country to help them improve data collection and reporting.

    EirSystems Announces Close of Seed Financing Round to Advance Software for Preventing Prescription Abuse

    Tennessee-based e-prescribing startup EirSystems secures seed funding in a round led by Solas BioVentures.

    Comments Off on Morning Headlines 8/9/22

    Curbside Consult with Dr. Jayne 8/8/22

    August 8, 2022 Dr. Jayne 6 Comments

    In my work with large health systems, some of the projects I most enjoy are those that involve patient-facing technology. In sophisticated organizations, this includes actually bringing patients and caregivers into the product management and development work so that you can ensure that you are developing a solution that meets their needs. A lot of great ideas don’t necessarily resonate in the real world and it’s important to find those disconnects earlier in the process so that the solution can be refined. Otherwise, there is a risk that it will flop when it’s released into the wild. I’ve certainly seen plenty of initiatives go that route.

    Healthcare delivery organizations have been in a state of transition for several years as they try to move more care out of the hospital and into the home or other care delivery facilities. Many of these efforts make sense. Getting patients out of the hospital quicker reduces the risk of hospital-acquired infections as well as costs. Patients may recover better in familiar surroundings than they might in an institutional setting. There are numerous other factors and these approaches have been successful for many same-day procedures such as orthopedic surgeries. However, when thinking about these types of programs there is a presumption that patients have family who are not only available to assist but who have adequate health literacy, appropriate physical capabilities (strength, dexterity, etc.) but also the emotional fortitude to assist in caring for a loved one at home.

    A friend sent over this piece that was published on LinkedIn, with which I have a love/hate relationship as far as content creation and dissemination. It’s great to be able to share information, but there are a lot of people out there who interpret what they see on social media as being authoritative without fully understanding the background of a given issue. There’s a danger in drawing conclusions from narrow write-ups without fully understanding them or their downstream impacts. I saw this behavior often when working with large health systems that would pounce on an idea that they saw float by regardless of whether it applied to their situation or not. Significant resources were spent researching, evaluating, and assessing before the executive who thought it was a great idea could be convinced otherwise.

    The LinkedIn piece is from The Health Management Academy and talks about five barriers to scaling the hospital-at-home concept. It draws in readers by leading with the phrase “digitally-enabled home-based care models” and quickly connects interest in the topic to both the COVID pandemic and to CMS reimbursement allowances. It notes that programs are often small, which makes them somewhat unsustainable, and questions whether programs will be able to continue beyond the pandemic. Below are the barriers the article cites, as well as my comments:

    • Low patient enrollment. No surprises here, as patients have to be appropriately referred to the program, which requires time, effort, and coordination. Some organizations only allow patients who are in the emergency department to be referred, and others restrict patients to those who are already in an inpatient unit. This prevents other referrals which might be useful, for example, as an urgent care physician I would love to have referred patients with blood clots to such a program if they weren’t quite candidates to just manage it on their own yet didn’t really need a hospital admission to get started on blood thinners.
    • Staffing challenges. This is the universal challenge of all industries right now, from fast food to construction to healthcare. In addition to having healthcare skills appropriate to inpatient care, frontline workers in hospital-at-home programs need other skills, such as managing remote technology and being able to self-support. In talking with several inpatient nurses, they’d be reluctant to give up their current level of predictability for increased volatility and personal risk.
    • Provider support. Hospital-at-home workers have to be comfortable going into patients’ home environments, which sometimes have unfriendly living conditions, pets, and people. The article refers to this as “an uncontrolled setting,” and anyone who has ever done home care or rode along with EMS or the fire department knows what we’re talking about. This can be an extremely scary situation and there’s not a good way for those referring a patient for a program to know that Cousin Doug with severe uncontrolled mental illness also lives in the house, or that Aunt Julie has a handgun that she likes to leave on the end table.
    • Coordination of services. The article sums this up as transporting providers and equipment along with care coordination. Given the fact that hospital-at-home is often related to a relatively acute situation such as an Emergency Department visit or an inpatient hospitalization, quick and efficient coordination is needed. Having shared the patient experience when a close friend couldn’t get the appropriate durable medical equipment delivered to her home when her surgery had a three-month lead time, I’m not convinced of some organizations’ ability to handle this rapidly. It’s not just equipment, but other medical supplies and services like imaging, phlebotomy, pharmacy, and the care itself that all have to be coordinated effectively.
    • Reimbursement uncertainty. To me, this is the largest area of concern. Healthcare delivery organizations aren’t going to invest the resources to build the infrastructure to do all the things listed above if they aren’t convinced that they will be paid for their efforts in the future. Given the state of healthcare spending in the US and the fact that many of these programs are operating under a CMS waiver that provides payment equivalent to inpatient care, it’s unclear how much programs are willing to invest to keep the lights on let alone expand.

    The piece the article missed, of course, is the patient piece. Do patients really want this service, or do they feel it’s just another way to get pushed out of the hospital before they are ready? Do they find value in the offering, or do they find it stressful? How do they feel about having outsiders in the home when there are stories every day of scams, theft, and abuse of patients by unscrupulous caretakers? Is the family ready to start delivering nursing and other care? Any health system administrator who is considering this needs to have firsthand exposure to what it’s like to help care for family at home, including assisting with feeding, mobility, toileting, managing surgical drains, and more. Unless a program is going to provide 24×7 support, these tasks will fall to family and friends, and some of them are not for the faint of heart.

    What is your organization doing as far as hospital-at-home? How do you feel about it as a patient, and as a family member? Leave a comment or email me.

    Email Dr. Jayne.

    Morning Headlines 8/8/22

    August 7, 2022 News 5 Comments

    CVS Plans to Bid for Signify Health

    CVS Health will reportedly make a bid to acquire value-based home care provider Signify Health, which has been exploring strategic alternatives.

    Definitive Healthcare Reports Financial Results for Second Quarter Fiscal Year 2022

    Healthcare commercial intelligence vendor Definitive Healthcare reports Q2 results: revenue up 37%, EPS –$0.05, beating expectations for both.

    ScanSTAT Technologies expands health information management services with acquisition of Georgia-based ResolveROI

    Health information management vendor ScanSTAT acquires release-of-information company Resolve ROI for an undisclosed amount.

    VA Cerner EHR system goes down for over 4 hours due to patient database corruption issue

    The VA’s Cerner system goes down for several hours due to database corruption.

    Monday Morning Update 8/8/22

    August 7, 2022 News 1 Comment

    Top News

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    From the Allscripts earnings call:

    • CEO Richard Poulton says the company’s potential acquisitions will be chosen to avoid past accusations of the company being “Frankenstein, because things didn’t really work together very well.”
    • Acquisitions will focus more on payer and life sciences than providers, but Allscripts is interested in revenue cycle and getting providers paid faster.
    • Asked by an analyst about a publicly traded competitor that is predicting a higher growth rate in the provider space, Poulton responded that “talk is cheap” and it’s laughable when someone predicts that their margins will double.
    • Asked about existing clients whose contracts cover products that were sold to Constellation as well as some that stayed with Allscripts, Poulton says overlap exists FollowMyHealth and with practice management systems used by large physician practices. He says that the contracts stayed with whichever business owns the products, and where a contract covers multiple solutions that were split between the companies, they will be served by both companies until the contract expires. He added that FollowMyHealth “is not a big piece of the provider business at all.”

    Reader Comments

    From Jimbo: “Re: API fees. People used to talk a lot about how vendors who send or receive data on behalf of clients would charge for that service. I’m wondering from your readers which ones do?” That was a big deal early on, as some vendors were using a “how much can we make from it” approach to interoperability. Anyone care to weigh in on API-related charges?


    HIStalk Announcements and Requests

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    Inconclusiveness is evident among poll respondents who weighed in on how Oracle’s acquisition of Cerner will impact the VA’s implementation.

    New poll to your right or here, repeating a poll question I asked three years ago:  For those over 50, what is the #1 thing you wish you had done differently?

    I’m interested in the dynamic of being laid off via a Zoom call from your home office. I think I would rather accept the corporate coup de grace remotely and in private versus being marched out of the office under the shocked but relieved gaze of co-workers. Those affected are surely stunned by the impersonal, scripted process regardless of its service location, but in my experience from being on both sides of layoffs, it’s best to get it done quickly and consistently and then send the person home so they can react in their own way elsewhere. I recall asking hospital security to be unobtrusively nearby when we were telling a bunch of our IT folks that their services were no longer needed, which seemed kind of slimy when it involves people you’ve known for years, but you never know how people will react. Then comes the classic Kubler-Ross stages of grief: (a) it surely was a mistake that will be fixed or customers and co-workers will rise in protest to override my dismissal; (b) management is clueless in failing to value my contribution to this train wreck of a company; (c) maybe I should have seen it coming, changed teams, or changed behavior less-valuable people got to keep their jobs; (d) realizing that the “please come back” call isn’t coming and the team and/or company is running fine; and finally (e) accepting what happened as unchangeable and figuring out how to move on. It’s dangerous deriving so much of your identity from a job that someone else can end with an Excel formula.


    Thanks to the following companies that recently supported HIStalk. Click a logo for more information.

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    Webinars

    August 10 (Wednesday) 12:30 ET. “Navigating healthcare’s data quality challenge: An actionable discussion.” Sponsor: Intelligent Medical Objects. Presenters: Alastair Allen, CTO, Better; Dale Sanders, chief strategy officer, IMO. Achieving a consolidated patient record is challenging in an environment of hospital M&A, where EHR rip-and-replace projects are expensive and HIEs and FHIR connectivity haven’t significantly accelerated progress. The underlying problem is that systems don’t speak the same language due to a lack of comprehensive, persistent clinical terminology and data standards adoption. UK-based Better offers a unique, FHIR-based approach to integrating disparate EHR data. The presenters will explore how to improve clinical data quality and how interoperable information can be used to support patient safety, reimbursement, and population health management.

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


    Acquisitions, Funding, Business, and Stock

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    The Wall Street Journal reports that value-based home care provider Signify Health, which has been exploring strategic alternatives, will likely receive an acquisition bid from CVS Health. The company’s NYSE share price values it at $4.7 billion.

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    Healthcare commercial intelligence vendor Definitive Healthcare reports Q2 results: revenue up 37%, EPS –$0.05, beating expectations for both. The company says it will continue to make acquisitions, expecting to close one or two per year. DH shares dropped 16% Friday following the announcement. They jumped 40% on their first day of trading in September 2021, but have since lost 43% of their value versus the Nasdaq’s 16% loss, valuing the company at $2.4 billion.


    People

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    Spok promotes Mike Wallace to president / COO and Calvin Rice, CPA to CFO.


    Government and Politics

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    The federal government posts an earlier-than-expected RFP for implementation of an EHR for the Indian Health Service.

    The VA’s Cerner system goes down for several hours due to database corruption. The outage reportedly also affected DoD and Coast Guard sites.


    Privacy and Security

    The UK’s NHS 111 non-emergency call line is affected by a cyberattack on its systems, causing delays in dispatching ambulances, booking appointments, obtaining referrals, and having emergency prescriptions filled. The affected patient management, electronic patient record, and care management are operated by vendor Advanced.


    Other

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    Customers of NC-based eye care practice EHR/PM vendor Eye Care Leaders accuse the company of concealing its ransomware attacks in 2021 that included a week-long outage, claiming that the vendor ignored IT requests, threatened them legally, was unable to restore current practice data because it backed its systems up only weekly, and may have failed to file the required breach notice with OCR. They also claim that the company didn’t reduce their next month’s subscription fee despite failing to meet their uptime service level agreement. Several practices have signed on to a proposed class action lawsuit to break their contracts, get their data, and seek payment for damages. CEO Roni Amiel’s experience includes stints as CIO / CISO of NYC Department of Health and Mental Hygiene and Blythedale Children’s Hospital.


    Sponsor Updates

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    • West Monroe staff volunteer with Boys Hope Girls Hope of Colorado to offer students career pathways insight, interview tips, and college internships.
    • EClinicalWorks releases a new podcast, “Improving Patient Safety by Avoiding Medical Abbreviations.”
    • Pivot Point Consulting promotes Kelly Robinson to senior operations specialist.
    • Relatient releases a new Dash Talk Podcast, “Activating Patients Through Targeted Messaging and Segmentation: A One Pediatrics Case Study.”
    • Surescripts releases a new podcast, “There’s a Better Way: Smart Talk on Healthcare and Technology, “The Nightmare & Silver Lining: Walgreens’ Tasha Polster on the Impact of COVID-19.”
    • Talkdesk CEO Tiago Paiva is recognized as the UC Leader of the Year during the UC Awards presented by UC Today.
    • Zynx Health partners with clinical data and intelligence company LogicStream Health to deliver advanced performance improvement capabilities to health systems.

    Blog Posts


    Contacts

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

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    Morning Headlines 8/5/22

    August 4, 2022 Headlines Comments Off on Morning Headlines 8/5/22

    WVU Medicine’s partnership with DHS is ending

    Davis Health System (WV) and WVU Health will end their partnership due to Davis Health’s decision to implement Cerner, rather than adopt WVU Health’s cost-prohibitive Epic system.

    Allscripts Announces Second Quarter of 2022 Results

    Allscripts announces Q2 results: revenue up 7%, adjusted EPS $0.18 versus $0.18, beat revenue expectations, but falling short on earnings.

    Atropos Health Announces $14M Series A, Taps Co-founder as CEO

    Atropos Health, which offers a digital consultation service for providers, raises $14 million in a Series A funding round.

    Veritas completes merger of RCM firms Coronis and MiraMed

    Veritas Capital merges recently acquired RCM vendors Coronis and MiraMed Global Services to offer providers end-to-end RCM software and services.

    Comments Off on Morning Headlines 8/5/22

    News 8/5/22

    August 4, 2022 News Comments Off on News 8/5/22

    Top News

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    Davis Health System (WV) and WVU Health will end their partnership due to a planned change in EHR vendors.

    DHS announced in February 2022 that it will implement Cerner under the CommunityWorks model, saying that while Epic and Cerner have similar functionality, Epic is unaffordable even when provided through WVU.

    DHS says WVU notified it immediately after it announced its EHR decision that it was ending the clinical affiliation due to lack of an integrated system.

    A DHS VP says, “It was a substantial difference of millions of dollars … we made the decision to go with Cerner, which will still speak to doctors at WVU or anywhere else in the state, it may just take an extra click … We went back to them and told them we would consider canceling our contract with Cerner if they could give us a new price that was more acceptable to our administration and the board. They said no.”


    Reader Comments

    From Allaboutlabs: “Re: Epic. Are they searching for a lab ordering partner? There has been some recent activity on genetic testing and EMR integration (Epic and Myriad, Meditech).”

    From Bonhomme Richard: “Re: Senior Helpers. I ran across this wild podcast from the spring.” The CEO of home care franchise operator Senior Helpers, which was acquired last year by Advocate Aurora Enterprises, says that home care and personal care companies aren’t data driven because they aren’t paid by Medicare and therefore don’t have outcomes or claims information, placing them at a disadvantage now that Medicare Advantage insurers are starting to pay for such services. The company has developed an “autonomy score” that predicts readmissions and ED visits and is developing ways to prove the cost savings that they provide in preventing falls, encouraging medication adherence, and preventing hospital encounters.


    HIStalk Announcements and Requests

    Carequality Executive Director Alan Swenson clarified some points from my Monday news of updates to its Carequality Connected Agreement that will allow federal agencies to participate: (a) the updated language was in its general CCA, not anything specific to EHealth Exchange; (b) Carequality has “implementers” rather than “members”; and (c) Carequality is an independent non-profit organization that operates under a management services agreement with The Sequoia Project, which created the initiative but is no longer its parent.

    My LinkedIn is awash in “I’ve been laid off and need a job” posts, but what’s interesting is how many of those users publicly thank their former employer for the opportunity they provided (until they didn’t). I understand the need to avoid communicating bitterness or despair while trying to land a new job, but that could be done equally graciously by not referencing the former employer at all, especially since it’s plain to see on the job history. I would find it hard to thank my corporate executioner unless they dispatched me with atypical grace or empathy, but I’ll side with the job-seekers who would gain little from publicly torching a company they didn’t leave until forced.


    Webinars

    August 10 (Wednesday) 12:30 ET. “Navigating healthcare’s data quality challenge: An actionable discussion.” Sponsor: Intelligent Medical Objects. Presenters: Alastair Allen, CTO, Better; Dale Sanders, chief strategy officer, IMO. Achieving a consolidated patient record is challenging in an environment of hospital M&A, where EHR rip-and-replace projects are expensive and HIEs and FHIR connectivity haven’t significantly accelerated progress. The underlying problem is that systems don’t speak the same language due to a lack of comprehensive, persistent clinical terminology and data standards adoption. UK-based Better offers a unique, FHIR-based approach to integrating disparate EHR data. The presenters will explore how to improve clinical data quality and how interoperable information can be used to support patient safety, reimbursement, and population health management.

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


    Acquisitions, Funding, Business, and Stock

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    Allscripts announces Q2 results: revenue up 7%, adjusted EPS $0.18 versus $0.18, nearly all of those numbers attributed to its Veradigm business since it has sold everything else. Revenue beat Wall Street expectations, but earnings fell short.

    CVS Health says in its earnings call that it will expand its services in primary, care, provider enablement, and home health, adding that it is already the country’s largest provider of retail health services with its MinuteClinics. CVS adds that “we can’t be in primary care without M&A” that will involve companies with a strong management team, strong technology, and the ability to scale, with a deal expected by the end of the year. It will emphasize value and consumer experience in offering virtual care and using its MinuteClinics and pharmacists as local access points. CVS passed on the chance to acquire primary care chain One Medical, which then accepted a $3.9 billion offer from Amazon. CVS has previously told investors that it hopes to own or manage up to 350 primary care clinics by the end of 2024, with a preference for practices that have experience in value-based care.

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    London-based Cera – which offers remote patient monitoring, homecare visits, and telehealth — raises a $320 million funding round.

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    Atropos Health, which offers a digital consultation service for providers, raises $14 million in a Series A funding round and names Brigham Hyde, PhD as CEO. The company says it solves the “evidence gap” via a publication-grade, just-in-time summary of real-world evidence that is extracted from millions of de-identified patient encounters.


    Sales

    • Stanford Medicine will study COVID-19 health outcomes using Komodo Health’s Sentinel application, AI analytics, and de-identified patient data.
    • The Iowa Board of Pharmacy uses Bamboo Health’s PMP Gateway solution to integrated the state’s prescription monitoring program with provider EHRs.

    People

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    The VA names David Massaro, MD, MBA, MS as the functional champion of its Oracle Cerner implementation, on detail from the VHA’s Office of Health Informatics.

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    Therapy Brands hires Jeff Shoreman (Magnitude Software) as CEO.

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    Bravado Health promotes Mallory Taylor to CEO.

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    Edifecs hires Raymond Bonnett, MBA (NextGen Healthcare) as VP of professional services, Mark Filiault (Diagnostic Robotics) as VP of payer sales, Chip Acton (Zipari) as VP of solution consulting, and Brian Hanley, MPAff (Nava) as VP of public sector sales.

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    Kyle Swarts (Curation Health) joins AiHealth as SVP of growth and marketing.

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    Megan Schmidt (Monarch Medical Technologies) joins Ellkay as VP of product management.


    Announcements and Implementations

    The Q3 trends report by Pivot Point Consulting, a Vaco Company finds that venture funding is down 40% so far this year versus last year; no digital health IPOs have occurred; and easing of virtual care red tape such as interstate provider credentialing is scheduled to end in February.


    Sponsor Updates

    • Bluestream Health announces that its technology powers New York State’s COVID-19 “Test to Treat” program.
    • ChartSpan announces a partnership with group purchasing organization Health Resource Services.
    • Experity publishes a new e-book, “Learn How Successful Urgent Cares Make Business Decisions.”
    • Donations from FDB help fund National Council for Prescription Drug Programs Foundation grants of $295,000, which help to fund research dedicated to enhancing patient safety, expanding patient access to care, and expanding the role and value of the pharmacist.
    • Wolters Kluwer Health donates clinical decision support tools including UpToDate, Lexicomp, and Lippincott Procedures to Mercy Ships, a humanitarian organization that operates two floating hospitals for underprivileged populations.
    • HCTec supports Aspirus Health as a sponsor of its 2022 Golf Classic.
    • Loyal earns SOC 2 Type II certification.
    • Healthcare IT Leaders is ranked among the largest staffing firms in the US, according to Staffing Industry Analysts.
    • Intrado names Tyler Remund (Sanford Health) senior product manager.

    Blog Posts

    Resources: Consulting Engagement Request for Information, Sponsor Guide.


    Contacts

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

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    Comments Off on News 8/5/22

    EPtalk by Dr. Jayne 8/4/22

    August 4, 2022 Dr. Jayne 1 Comment

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    Some days are more challenging than others when it comes to finding healthcare IT topics worthy of blogging about, but this week brought plenty of interesting and/or entertaining content to my door. In the category of “hospitals behaving badly,” we have Nebraska’s Bryan, which recently updated its dress code policy. The purpose of the policy change was to remove restrictions on hair colors, but it was delivered with additional commentary regarding “messy buns,” including pictures of rogue hairstyles. Social media is now alive with the hashtag #showmeyourbuns along with plenty of comments about hospitals worrying about the wrong things while they’re struggling to retain staff members. I share my own messy bun pic in solidarity. And yes, those are cocktail picks holding it together.

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    Also on my list is HLTH, otherwise known as spammiest conference ever. I thought HIMSS was bad with the volume of email it generates, but since I registered for HLTH, it feels like I have something from them every day. Do I really care who the first 200 sponsors to register are, or how great HLTH thinks its hosted buyer program is? Why is every other email focused on topics related to women? What about other groups that are inequitably served by our healthcare delivery systems, such as minorities, children, or the elderly? To be honest, it feels like pandering, and I’ve started keeping track. I haven’t attended previously, but I’m already tired of the conference hyping itself. You already have my money (and a fair amount of it, at that), so dial it down, already.

    CMS is looking for public input on improving Medicare Advantage programs. The organization wants to understand how programs are working for Medicare beneficiaries as well as to understand whether the programs are improving outcomes and decreasing costs. For those not familiar with the programs, Medicare Advantage is also sometimes referred to as “Medicare Part C” and involves contracting with private insurance providers that typically offer not only the traditional Medicare benefits, but also coverage such as vision or dental. Most of them also offer prescription drug coverage (Medicare Part D). In general, they function similar to HMO programs with narrow networks in an effort to better control costs. Comments are encouraged from insurance plans, providers, beneficiaries, patient advocates, states, employers, unions, and others who are stakeholders.

    I ran across several articles about telehealth services for mental health, and nearly all of them mentioned the shortage of behavioral health therapists, counselors, social workers, and case managers. One article had a profound headline: “Want to Keep People Working in Mental Health? Pay Them More $$, Experts Say.” One expert cited in the piece stated it would take a $13 increase in hourly wages to keep people from leaving the field. She notes the challenges of the new 988 national suicide prevention hotline in that states have to figure out how to fund it. She’s been able to hire less than half the staff she needs and comments that her crisis center is competing with retail and entertainment employers for available workers who often gravitate to lower-stress, higher-paid positions.

    The article notes the wide disparity in access to psychiatrists as an example of the workforce challenges, with New York state having 612 psychiatrists per 100,000 people where Idaho might have one psychiatrist for the same population. Other factors causing workforce challenges include greater awareness of the need for mental health services as well as increased numbers of referrals for care. One of my colleagues recently referred an adolescent to the emergency department for suicidal thoughts, and after 16 hours, the patient still hadn’t received a psychiatric assessment. Ultimately the family left the emergency department without being seen after their primary care physician crowdsourced a same-day psychiatric referral on Facebook. It shouldn’t be that way, but it is, and most people are unaware how poorly our systems are running.

    There’s also the matter of escalating abuse and violence against hospital staff. The death of a South Carolina hospital mental health technician was recently ruled a homicide as the technician had been kicked by a patient while staff was trying to restrain her. The staffer, Kevin Robinson, had worked at the facility for 11 years and was only 40 years old. Incidents like this are truly tragic and when young people hear about them, it’s no surprise they’re not gravitating towards jobs in the field.

    Last but not least, I spent some time with my parents this week and received a crash course in “patient experience with the local Veterans Affairs health care clinic.” Due to flooding in the area, my dad called the clinic to make sure that the staff was able to make it in. The reply he received was “oh, we’re here, come on in, baby,” which made both him and my mom laugh. The staff at his local clinic is outstanding and the veterans are treated with the care they deserve. The information systems they work with are challenging at times, though, and apparently between his last visit and this one he somehow underwent a religious conversion in the EHR without requesting an update. He was surprised at how much time the staff spent with him going through a variety of screening instruments and taking a detailed history, a much longer duration than the staff at his non-VA primary care office has ever spent with him. I reassured him that it was a good thing they’re doing things like screening for suicide risk and fall risk.

    They made sure he had instructions for accessing the patient portal and encouraged him to sign up. He’s proficient with MyChart and other online services, so was surprised that it ended up taking several hours to get signed up for the VA’s portal. Part of that was due to authentication and identify proofing. It was interesting to hear a non-informaticist’s explanation of the process. When he was finally able to access the system, he immediately pulled up his visit note, which was a whopping 49 pages. He thought the view / download capabilities were cool and it was nice to see how a patient perceives something like View / Download / Transmit that most clinical informaticists take for granted. His VA has not yet implemented Cerner, so I’ll have to keep an eye out for when that transition occurs so I can see how it goes from the patient perspective.

    What topics in healthcare or healthcare IT caught your eye this week? How do you feel about messy buns in the workplace? Leave a comment or email me.

    Email Dr. Jayne.

    Morning Headlines 8/4/22

    August 3, 2022 Headlines Comments Off on Morning Headlines 8/4/22

    Homeward Secures $50 Million in Series B Funding to Improve Access to High-Quality Healthcare in Rural Communities

    Rural hybrid care company Homeward raises $50 million in a Series B funding round, bringing its total raised to $70 million.

    CareTrack Health Secures $2.5 Million Investment from Hybrid Capital Partners

    Patient adherence software vendor CareTrack secures $2.5 million from Hybrid Capital Partners.

    Athenahealth Implements DrFirst’s Digital Engagement Solution to Encourage Patients to Follow Prescribed Treatment Plans

    Athenahealth integrates DrFirst’s RxInform patient medication notification software with its EHR to improve medication adherence.

    Comments Off on Morning Headlines 8/4/22

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