Monday Morning Update 4/11/22

Top News

All federal Cerner systems – DoD, VA, and Coast Guard – went down for two hours Wednesday due to a server problem.

The irony is that the server in question was running database software from Oracle, soon to be Cerner’s owner in giving CIOs their “one throat to choke.”

VA Deputy Secretary Donald Remy says that the VA and Cerner will conduct a root cause analysis of the downtime.

Meanwhile, the VA’s Walla Walla facilities went live as planned on March 26. Columbus is up next on April 30.

HIStalk Announcements and Requests

Two-thirds of poll respondents were laid off or fired more than five years ago, and two-thirds of those said it turned out to be a good thing career-wise.

New poll to your right or here: What is the most significant result of hospital mergers?

Listening: Pink Floyd’s first new recording since 1994 in “Hey, Hey, Rise Up!,” a fundraiser that protests Russia’s invasion of Ukraine. The song features Boombox singer Andriy Khlyvnyuk, who cancelled the band’s US tour and returned to Ukraine to take up arms to defend his country.

Webinars

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

Announcements and Implementations

• Inova Health System signs an eight-year, $24 million contract with Visage Imaging to replace two legacy PACS with Visage 7, implemented in the public cloud.

Other

A reader sent me a copy of the paywalled Axios piece whose author claims that $4 billion startup Olive “overpromises and underdelivers.” It’s not exactly a smoking gun or a showcase of investigative journalism technique, obsessing instead with the company’s being “buzzy,” richly valued by investors, and driving purple buses around conferences. The article’s click-baity headline seems equally prone to underdelivering:

• Axios interviewed 16 “former and current employees, health tech executives, and others,” but apparently no actual current or former Olive customers, which seems to be a glaring omission for an investigative piece that focuses on customers. It does not list any cancelled contracts, aborted sales, or litigation that would suggest that Olive’s users are unhappy with the value they are receiving.
• The company claims that it uses AI/ML to automate administrative tasks, but often actually uses old-fashioned screen scraping. It is hardly unique to Olive that a lot of mundane technology has been optimistically relabeled as AI/ML because that imprecise term arouses prospects and especially investors. If Olive delivers the results it promises, I’m not sure the customer cares how they do it anyway.
• Former employees say the company uses questionable calculations to estimate potential cost savings, with one claiming that customers who expect $10 million in value “ultimately got less than a fifth of that.” A specific example would have been nice, hopefully including the reaction of the actual customer rather than that of a single ex-employee whose previous role wasn’t stated.
• The company doesn’t track outcomes and cost savings, and in some cases, has no way to do so. I would think that the customer is in the best position to audit Olive’s performance, so I’m not sure I find this relevant.
• Epic asked Olive to remove its name from company materials, saying Olive was misrepresenting the relationship internally and externally. I seem to recall writing about this as a reader rumor.
• Several sources say Olive salespeople installed capabilities that customers didn’t necessarily request because they know that the solutions would be difficult to remove afterward.
• Olive said in its response to Axios that it serves 200 enterprise customers, but Axios says internal documents say the real number is 80.
• My conclusion is that the article is thin on sourcing, not especially authoritative or insightful, and chose an easy target in a company whose market valuation is high but whose level of innovation is murky.
• The article doesn’t really change the basic of being a smart customer of Olive or any other vendor – perform due diligence of reference sites, get promises and expectations in writing, and share risk with the vendor instead of just writing them checks.

Amazon lists another interesting healthcare job. The senior clinical informaticist will join a team that is building “a completely new healthcare experience” (quibblers such as myself might point out that the “completely” is redundant and “new” might be as well). The job involves Amazon Care’s clinical systems, specifically its EHR.

It’s a slow news weekend, so I caught up on tweets from iconoclast Jay Parkinson, MD, MPH, who is about to launch a new venture, but meanwhile has some fresh thoughts that interest me (paraphrasing):

• The gold standard in healthcare is the status quo. If that is a procedure, we’re probably the best in the world. If it’s a service, near the worst, yet the worst is fiercely defended.
• Patient histories at Jay’s former company Sherpaa ended with the same last question – what do you think you have? Patients were right 95% of the time. That would be an interesting way to design a telehealth service.
• It’s interesting that one-condition companies pivot to add more to grow their bottom line, like Noom doing weight loss for 15 years and now they are adding stress and anxiety.
• Journalists covering digital health funding, rather than reporting milestones that justify company valuations, is like baseball news reporting only that a new batter is up.
• Medical is pills, procedures, and feeling fleeced. Health is fun, it feels good, and people are happy to pay for that. The most successful DTC brands in “digital health” are consistently “health” rather than medical.
• The evidence for a drug is at the population level, not at the individual level. Since most people aren’t doctors acting on populations, they only think at the “me” level. They don’t really realize that most drugs are a crapshoot at the “me” level.
• Teladoc transitioning from being known for 20 years as one of the many places to turn to for a quick prescription for a UTI or pink eye to now wanting to manage all things serious and branding it as the “whole health” of a population … well, that must be a real bear.
• The amount of money and time people will spend to see the same guys on different stages answering the same questions is astounding. It proves that there is insatiable demand for health conferences, and if you really want to make a buck, start a
  platform for health conferences powered by AI and schedule one every week with the same lineup. To scale up, develop Glen Tullman and Jonathan Bush robots who can appear on stage, and they themselves can invest in it so they can focus on being CEOs.

Sponsor Updates

• Applied Clinical Trials magazine features OptimizeRx VP of Data Product Mike Rousselle in a new episode, “A Passion for Predictions.”
• Olive will open a new office in Columbus, Ohio, adding 400 jobs.
• Symplr CEO BJ Schaknowski joins Susan G. Komen’s Board of Directors.
• Premier releases a new podcast, “How AI Can Drive Value in Healthcare.”
• The Highway to Health Podcast features Relatient VP of Marketing Josh Byrd in a new episode, “How Josh Byrd Uses Songwriting Experience to Tell the Patient Story.”
• TriNetX enabled researchers at Hospital Universitario 12 de Octubre to leverage European real-world data for a study that found that multiple myeloma patients were more likely to contract COVID-19 and suffer a higher risk of mortality than non-MM patients.
• Optum publishes a white paper titled “5 priorities to improve financial performance.”
• Wolters Kluwer Health publishes a new report, “Nursing’s Wake-up Call: Change is Now Non-Negotiable.”
• VisiQuate announces major enhancements to its Flo and Late Charges predictive analytics solutions that help healthcare organizations achieve peak business health.

Blog Posts

• Patient Engagement Strategies that Improve Health Outcomes (PatientBond)
• 4 Healthcare Trends from HIMSS22 (Pivot Point Consulting)
• PerfectServe’s Clinical Collaboration Solution Reduces Care Team Toil (PerfectServe)
• The Quest for Evidence in Value-Based Care (Symplr)
• Geisinger Implements EHR Alerts, Reduces Costly Lab Orders (Premier)
• Why you shouldn’t underestimate the importance and value of contact center technology (Spok)
• 3 Benefits of Advanced Clinical Workflows in Alarm Management (TigerConnect)
• The year ahead in cancer statistics: Why personalized risk assessment remains so important in cancer care (Volpara Health)
• Better Together: What Joining Forces with Clinicient and Keet Means for the Industry (WebPT)
• How Patient-Provider Communication Can Support Community Mental Health (Well Health)
• If you built it, people will come – when you build what matters (West Monroe)

Contacts

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

Morning Headlines 4/8/22

Viz.ai Raises $100 Million in Series D Funding, Led by Tiger Global and Insight Partners at $1.2 Billion Valuation

AI-powered diagnosis system vendor Viz.ai raises $100 million in a Series D funding round that values the company at $1.2 billion.

UnitedHealth, Change Healthcare extend closure of merger deal by 9 months

UnitedHealth Group and Change Healthcare extend their merger closing deadline to December 31.

Aspirion Health Resources Announces Combination with ARx

RCM provider Aspirion acquires health system RCM outsourcer ARx.

News 4/8/22

Top News

UnitedHealth Group and Change Healthcare extend their merger closing deadline to December 31.

Courts will review DOJ’s lawsuit in August. If DOJ’s merger challenge is upheld, UHG’s Optum will pay a $650 million breakup fee to Change.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Orbita. Innovative healthcare, life sciences, and medical technology organizations rely on the Boston-based company to power high-value virtual assistants for digital front door applications, remote patient support, pre and post-visit outreach, and other critical interactions throughout the care journey. Orbita’s robust conversational platform is designed for both developers and business users to quickly build, deploy, and easily manage “Automation with Empathy” virtual assistants for smart speakers, web and mobile chat apps, text messaging applications, interactive voice systems, and custom devices. Orbita’s platform is HIPAA compliant and SOC2 certified. Its customers and partners include Medstar Health, Mayo Clinic, Philips Healthcare, Amwell, Janssen, Medtronic, Yale New Haven Hospital, Bristol Myers Squibb, Cancer Treatment Centers of America, and others. Thanks to Orbita for supporting HIStalk.

Webinars

On demand: “Cybersecurity Threats Facing Healthcare Today.” Sponsor: Net Health. Presenters: Jason James, MS, CIO, Net Health; Monique Hart, MBA, CISO, Piedmont Healthcare; Jeffrey Rosenthal, , MBA CIO, Reliant Rehabilitation; David Jollow, MBA, CISO, Healogics. The panel of CIO and CISO leaders will discuss the cyberthreats that healthcare faces today. They will review security priorities for the increasingly complex healthcare IT environment that includes cloud-based applications, an increased number of endpoints that include connected devices and patient wearables, and patient portals.

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

Here’s the video of this week’s webinar from Mend titled “19 Massive Best Practices We’ve Learned from 4 Million Telehealth Visits,” along with the accompanying ebook.

Acquisitions, Funding, Business, and Stock

RCM provider Aspirion acquires health system RCM outsourcer ARx.

Eon, which use computational linguistics to identify patients with incidental findings, raises a $16 million growth equity investment.

IntelyCare, whose platform matches freelance nurses with available shifts, raises $115 million in a Series C funding round that values the company at $1.1 billion.

Clarify Health, whose software performs “Moneyball”-type analytics to identify optimal care interventions and therapies, raises $150 million in a Series D funding round.

AI-powered diagnosis system vendor Viz.ai raises $100 million in a Series D funding round that values the company at $1.2 billion.

Walmart opens five Walmart Health centers in Florida, which offer primary care, labs, X-ray, EKG, behavioral health, dental, optical, hearing, and care navigation. The centers, the company’s first in Florida, will be open seven days per week, covering Sundays with telehealth only. The company’s announcement notes that its Florida locations will be the first to use Epic.

Sales

• DME/HME software provider Bonafide Medical Group chooses Clearwater’s ClearAdvantage cybersecurity and HIPAA compliance managed services program.

People

Cerner hires former US Army Major General Patrick Sargent, MS (OptumServe) as SVP/GM of Cerner Government Services and promotes Alaa Adel, MBA to SVP/President of Cerner Global.

Brent Michael (Eye Care Leaders) joins DrChrono as president.

Health data curation vendor Verinovum hires Mureen Allen, MD, MS, MA (UnitedHealth Group) as CMIO.

Announcements and Implementations

The EU clears the AI-powered chest X-ray analyzer of Lithuania-based Oxipit to be used autonomously without radiologist review to identify images as showing no abnormalities.

Surescripts enhances its the patient matching capabilities of its MPI to include additional demographic data, which identified 2.2% additional medications in last month’s use.

Other

An Axios investigative article (which I can’t read because it is paywalled) says that startup Olive, which is valued at $4 billion, doesn’t deliver on its promises to save money and caregiver time, sometimes generating only a fraction of the savings it promises.

Sponsor Updates

• Net Health announces that its rehabilitation outcomes management system is now available in Epic’s App Orchard.
• Lyniate has been selected for inclusion within Epic’s Garden Plot SaaS model for independent medical groups.
• PeriGen wins Best AI Product in Health for its PeriWatch Vigilance solution at the 2022 CogX Awards.
• EVisit publishes a new Insights Report, “The Cost of Expanding Telehealth; Future-proofing Healthcare; Telehealth and Disabilities, & More.”
• Healthcare Triangle will present at the Noble Capital Markets Investor Conference April 20-21 in Miami.
• Surescripts introduces new innovations in patient matching through its master patient index that will improve more patient and provider experiences across a number of its solutions.
• Nordic releases a new podcast, “The value of data infrastructure modernization for the health system.”

Blog Posts

• Crossings Healthcare Solutions is better than ever, with some new faces! (Crossings Healthcare Solutions)
• Accessing Healthcare: Easing Digital Frictions in the Patient Journey (Experian Health)
• Deploying Digital Technology for Health Equity (Get Well)
• Change Management Metrics: Define Targets and Track Progress in Your Organization (Impact Advisors)
• Natural Language Processing 101: A guide to NLP in clinical documentation (Intelligent Medical Objects)
• Symptom Checker: Answering Health Questions in Real Time + Easing the ER Burden (Loyal Health)
• Analytics to Drive Hospital Performance Improvement (Medhost)
• A Quick Guide to HIPAA Physical Therapy Guidelines in 2022 (MWTherapy)
• Wound Care Clinics Could Really Benefit from Predictive Analytics (NetHealth)
• KLAS gives DAX an A in its Emerging Technology Spotlight Report (Nuance)

Contacts

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

EPtalk by Dr. Jayne 4/7/22

A bill introduced in the US House of Representatives last week would allow employers to offer separate telehealth plans to its employees, much like they offer separate dental, vision, and medical coverage now. The Telehealth Benefit Expansion for Workers Act bill is a bipartisan effort, and it would also modify HIPAA and the Affordable Care Act to allow all employers (including seasonal and part-time staff) to benefit. It would allow freestanding telehealth programs to be separate from traditional medical coverage.

I haven’t seen any commentary on this from hospitals and health systems, which are probably still digesting how it will impact them if it passes. I haven’t had time to dig into the specifics of the bill, but I suspect the devil is in the details as far as what constitutes a freestanding telehealth program. For organizations that are already offering services but want to be able to capture their piece of the standalone pie, I imagine there will be a need to customize platforms to allow for different types of billing as well as to comply with any other program-related definitions. We’ll see how this bill navigates through the committee process and other parts of the legislative journey. If you’ve got any insider scoop, do tell.

In other telehealth news, the Government Accountability Office urges Medicaid to assess how its beneficiaries are using telehealth and to ensure that they are receiving quality service. The call to action is based on data from five states that showed significant increases in the number of services delivered via telehealth as well as the number of Medicaid beneficiaries participating. There are certainly challenges in delivering high-quality telehealth visits to Medicaid patients, who often have difficulty accessing healthcare in general. Technology may pose additional barriers due to cost, particularly when video is required for telehealth services. It will be interesting to see what types of studies are designed and what the outcomes are. A well-managed telehealth program can delivery high quality care, so let’s hope the studies are completed quickly so we can build upon the findings.

Despite spending the majority of my time on clinical informatics these days, I’ll always be a family physician at heart. With that in mind, I was disheartened to see a recent report from The Commonwealth Fund that showed the US ranking last for women’s healthcare among wealthy nations. Specifically, we had the highest rate of preventable deaths for reproductive-age women, with 200 avoidable deaths per 100,000. The UK was next with 146, followed by 132 in Canada and 90 in Switzerland. The maternal mortality rate in the US was three times the rate of other countries in the report, with high death rates among black women. The US also posted high rates of chronic health conditions, mental health issues, and difficulty paying medical bills. Although many of the people in legislative roles in the US are neither women nor of reproductive age, hopefully they have some family members who might fit into those categories and will consider taking action.

Back when my state’s Board of Healing Arts used to send out a paper newsletter listing its disciplinary actions, I often marveled at the ignorance, recklessness, and sometimes downright stupidity of some of my peers. Now I have to settle for digital snippets depicting doctors behaving badly, and a recent article. The Office for Civil Rights, which is charged with enforcing HIPAA, recently announced findings in a few investigations. Two were particularly salacious: one was a dental practice who provided patients’ protected health information to those running a state senate election campaign and another was a dental practice who disclosed a patient’s information on a website while replying to a negative online review. Seems to me like specialty medical certification boards should consider dropping some of their exam questions that deal with esoteric disease processes and consider adding basics of HIPAA (and being a decent human being).

News of the weird: a man in Germany received 90 COVID-19 vaccinations so that he could sell vaccination card forgeries that included actual vaccine batch numbers. Staff at a vaccination center became suspicious when he presented for immunizations two days in a row. He was found to have blank vaccine cards, and although he was not detained, criminal proceedings are under way. Forged documentation is a hot commodity in Germany, where vaccine passports are needed to enter public venues.

Insomnia is a big problem around the world right now. I attended a couple of presentations at HIMSS that discussed solutions. One looked a prescription digital therapeutics as a potential intervention, while the other discussed a smart pillow to gather data as part of an overall sleep management program. During a recent trip, I had four straight days of poor sleep and felt the effects. I couldn’t control the heating and cooling in my room the way I needed to, and of course there were random hotel noises in the hallway and loud pipes in the bathroom. I’m sure stress was also a contributor, but sometimes there’s not a lot you can do to mitigate that compared to the other factors. With that in mind, I ran across an article discussing a recent study of sleep data that revealed 16 distinct ways that people sleep.

The data was gathered from smart wristbands used by the United Kingdom Biobank. The bands tracked patterns of sleep and wakefulness by measuring arm movements. Clusters of sleep patterns were then divided into five categories with a number of subcategories to total 16. Groups ranged from those waking up mid-sleep to those sleeping well without naps, and everything in between. The researchers also identified disruption that was likely due to shift work as well as those with fragmented sleep. I don’t know where I fall on the continuum other than knowing that my recent sleep has been “a cluster,” but I hope I can get things to reset soon. I’ll be spending several nights in the upcoming weeks sleeping in a tent, which usually does the trick since I crash hard after being active in the outdoors.

Have you found your sleep suffering in the third year of the pandemic? What strategies have you taken to improve things? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 4/7/22

Evernow Raises $28.5M in Series A Funding to Redefine Menopause Treatment

Women’s telemedicine and online prescription startup Evernow raises $28.5 million in a Series A funding round.

Adam Boehler and Martin Ventures Invest in Healthcare Company for People with Disabilities

StationMD, a telemedicine company specializing in treatment for people with intellectual and developmental disabilities, raises $3.2 million.

Healthtech Leader Eon Announces $16MM Growth Equity Investment Led by Integrity Growth Partners

Patient capture, engagement, management, and tracking software vendor Eon raises $16 million.

Morning Headlines 4/6/22

Clarify Health Closes $150M Series D Funding to Unlock the Promise of Value-Based Care with End-to-End Intelligence on Every Patient Journey

Cloud-based analytics and value-based payments software vendor Clarify Health raises $150 million in a Series D funding round.

HealtheMed Secures Funding to Fuel Expansion of Digital Care Service

Home-based virtual care company HealtheMed, which focuses its services on Medicaid patients in Minnesota, raises $1.2 million in seed funding.

Mindtree Invests in COPE Health Solutions to Accelerate its Healthcare Business

Technology consulting firm Mindtree invests in consulting and analytics company Cope Health Solutions.

Eleos Health Raises $20M to Unlock In-Session Behavioral Health Voice Data

AI-powered, clinical documentation company Eleos Health raises $20 million in a Series A funding round led by F-Prime Capital and Eight Roads Ventures.

News 4/6/22

Top News

Private equity firm Patient Square Capital will acquire acute care telemedicine provider SOC Telemed for $3 per share, for a total of about $300 million.

SOC Telemed went public via a SPAC merger in November 2020 at $10 per share.

TLMD shares traded at a low of $0.58 in late January 2022.

HIStalk Announcements and Requests

A reader asked whether anyone visited the booth of First Line Software at HIMSS22, thinking that they operate in Russia. I received this response from Anatoly Postilnik, head of the company’s healthcare practice. First Line Software’s healthcare offerings include real-world evidence and data, health data management, AI/ML, systems development and integration, and clinical quality and safety systems. He clarifies:

First Line is a US consulting and custom software development company with a stellar reputation. We are headquartered in Cambridge, MA and have no affiliation with Russia or its government, which is currently waging a horrific war in Ukraine. We have offices on every continent and used to have a presence in Russia, but much like McDonald’s, Microsoft, and other respected US and International companies, we have aggressively pulled out of Russia and severed all ties with this country, relocating our employees to other countries and providing financial assistance to them to alleviate hardship.

Listening: Gilbert Neal, whose tracks I found randomly on Spotify and then played most of the day Monday. It is genre-bending excellence in singing and songwriting, every track highly listenable with smart, clear lyrics (not the usual love-and-lust prattling trying to pass as profound) and musicality that might at any given moment suggest Billy Joel, Steely Dan, Moxy Fruvous, or a 1970s prog rock band. I haven’t heard music this emotionally engaging for a long time. Website. The best phrase I’ve heard lately is Gilbert’s term for a group of his friends that would make a smashing band name– “a cabal of ne’er-do-wells.”

Webinars

April 6 (Wednesday) 1 ET. “19 Massive Best Practices We’ve Learned from 4 Million Telehealth Visits.” Sponsor: Mend. Presenter: Matt McBride, MBA, founder, president, and CEO, Mend. Virtual visits have graduated from a quickly implemented technical novelty to a key healthcare strategy. The challenge now is to define how telehealth can work seamlessly with in-person visits. This webinar will address patient satisfaction, reducing no-show rates to single digits, and using technology to make telehealth easy to use and accessible for all patients. The presenter will share best practices that have been gleaned from millions of telehealth visits and how they have been incorporated into a leading telemedicine and AI-powered patient engagement platform.

On demand: “Cybersecurity Threats Facing Healthcare Today.” Sponsor: Net Health. Presenters: Jason James, MS, CIO, Net Health; Monique Hart, MBA, CISO, Piedmont Healthcare; Jeffrey Rosenthal, , MBA CIO, Reliant Rehabilitation; David Jollow, MBA, CISO, Healogics. The panel of CIO and CISO leaders will discuss the cyberthreats that healthcare faces today. They will review security priorities for the increasingly complex healthcare IT environment that includes cloud-based applications, an increased number of endpoints that include connected devices and patient wearables, and patient portals.

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

Acquisitions, Funding, Business, and Stock

Advocate Aurora Enterprises, the development and commercialization arm of the Illinois-based health system, acquires MobileHelp, which offers remote patient monitoring and personal emergency response systems.

Cloud-based analytics and value-based payments software vendor Clarify Health raises $150 million in a Series D funding round, bringing its total raised to $328 million. The company acquired analytics company Embedded Healthcare last month.

Nurse-1-1, a nurse chat software startup that works with digital health companies, raises $2.3 million in seed funding.

Home-based virtual care company HealtheMed, which focuses its services on Medicaid patients in Minnesota, raises $1.2 million in seed funding.

Sales

• Rady Children’s Hospital – San Diego will offer patients tech-enabled, home-based physical therapy services from Luna Care.
• Desert Oasis Healthcare (CA) will implement Lark Health’s digital cardiovascular coaching program.
• MemorialCare (CA) will integrate TytoCare’s AI-powered remote medical exam technologies with its telehealth services.
• HonorHealth goes live on Loyal’s Symptom Checker.

People

Protenus names Michael Baglio (Codametrix) CTO and Sonal Patel (DataBank) VP of professional services.

Konica Minolta Healthcare Americas promotes Fumihiko Hayashida to president and CEO.

Kelly Ostertag (Pivot Point Consulting) joins Continuum Health IT as VP of operations.

Kyruus hires Gail Airasian, MBA as GM of emerging markets.

Edward T. A. Fry, MD begins his term as president of the American College of Cardiology. He helped launch Ascension-owned data quality management company Navion Healthcare Solutions.

Orbita hires Sara Inman, MA (Press Ganey)  as SVP of sales and Elizabeth Glaser (2bPrecise) as SVP of marketing.

Madaket Health promotes Martin Cody to VP of sales.

Tiffani Misencik (Intelerad Medical Systems) joins Greenway Health as chief revenue officer.

Craig Richardville, MBA (SCL Health) becomes SVP/CIO of Intermountain Healthcare as it completes its acquisition of SCL Health, expanding Intermountain to 33 hospitals, 385 clinics, and 59,000 employees with operations in seven states.

Announcements and Implementations

Amerimed Medical Solutions implements Bamboo Health’s Pings and Spotlights real-time care notification and performance metrics technologies.

A survey of community mental health center executives conducted by Owl and MCHA finds that top priorities are staff training, delivering treatments to the right person at the right time, expanding care access, delivering evidence-based guidelines, and measuring individual outcomes.

A new KLAS report on the EHR market in Europe finds that Dedalus and CompuGroup Medical expanded their market share via acquisitions, with Cerner selling its Selene and Medico products to CGM in shifting its focus to Millennium and I.S.H. Med. Software Medical and Epic had the largest organic growth, while Epic’s performance score topped the list. Low-scoring vendors are ChipSoft and Cambio (Benelux and Northern Europe) and InterSystems and Dedalus (Western Europe), although InterSystems TrakCare has high user satisfaction in Southern Europe, particularly Italy. 

Government and Politics

ONC publishes the agenda for its 2022 Virtual Annual Meeting February 2-3 (education sessions) and April 13-14 (panel sessions, exhibit hall, and networking).

Other

In Germany, a 60-year-old man is arrested for forgery for receiving COVID-19 vaccine injections 90 times to obtain vaccination proof cards to sell. He was caught when he showed up at the same vaccination center on consecutive days.

Sponsor Updates

• The HIT Like a Girl Podcast features Ascom Americas VP of Sales & Business Development Shelly Bond.
• CareMesh publishes a new white paper, “5 Things Hospitals Can Do to Turn Epic into a Powerful Care Coordination Platform.”
• GHX will hold its 2022 Summit May 9-12 at the Diplomat Beach Resort in Hollywood, FL.
• Cerner releases a new podcast, “Breaking down bulk APIs.”
• CHIME and HIMSS pay tribute to health IT visionary David Garets.
• Clearwater publishes a new whitepaper, “The Guide to 405(d) Health Industry Cybersecurity Practices.”
• Diameter Health will present at the virtual NLP Summit April 6.
• Clearsense releases a new Tech Talk video, “The Rise of Clinician Data Scientists.”
• Sonifi Health releases digital whiteboard features that enhance the patient experience in hospital maternity units.

Blog Posts

• Healthcare Leaders Reveal 3 Key Factors in Financial Recovery (Ability Network)
• Top 5 Way Medical Practices Can Combat Inflation (AdvancedMD)
• How Operational Capacity Sensing Enables Successful Always-On Programs (Actium Health)
• It’s 2022. Which Database is Informing Your Real-World Evidence? (Premier)
• An Interview with an Expert on Interoperability in Healthcare (Bamboo Health)
• The great surgical migration: 7 workflows for optimal outpatient procedures (Bravado Health)
• Meditech Expanse: Bringing Ambulatory and Acute Under One EHR (Meditech)
• Ten Tips for a Successful Care-at-Home Program (Current Health)
• Highlights from the HIMSS22 Global Health Conference & Exhibition (Dimensional Insight)
• Honoring All Our Doctors (EClinicalWorks)
• Complex Technology and Its Threat to Healthcare (Enlace Health)

Contacts

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

Morning Headlines 4/5/22

SOC Telemed Stockholders Approve Acquisition by Patient Square Capital

SOC Telemed shareholders approve its sale to healthcare investment firm Patient Square Capital for nearly $300 million.

Advocate Aurora Enterprises acquires leading provider of health monitoring and emergency response solutions

Advocate Aurora Enterprises acquires MobileHelp, which offers remote patient monitoring and personal emergency response systems.

Nurse-1-1 Raises $2.3 Million in Seed Funding, Pioneering “Conversational Marketing for Healthcare”

Nurse-1-1, a nurse chat software startup that works with other digital health companies, raises $2.3 million in seed funding.

Curbside Consult with Dr. Jayne 4/4/22

I spent some time this weekend at a non-healthcare, non-technology conference. It was nice to get away for a few days and spend time learning ways to improve my skills for one of my hobbies.

I’ve been attending this particular conference since 2018, and many of the attendees know about my past life in the emergency department. There were quite a few questions about COVID and whether I think it’s really over. I typically respond that I don’t think it will ever be over, but we’re learning how to cope with it in the US. Because our lives are back to normal, at least in part, many people have forgotten that there are other nations where people still haven’t had adequate opportunities to receive vaccines.

The Our World in Data website is one of my favorites. It shows that a high percentage of people in Africa have yet to receive even one dose of vaccine. It makes you think twice about living in a country where a large number of people still believe that COVID isn’t real and vaccines aren’t safe, despite there having been more than 11 billion doses administered worldwide.

I had some time to kill at the airport, so I participated in an online research study from Harvard University. The study was designed to evaluate strategies to influence vaccine-hesitant individuals to become up to date with the COVID vaccine schedule. Participants were educated on several strategies to try to persuade people to receive vaccines and then were asked to create narrative statements that they felt might work. Messages were to be in response to a patient who was concerned that the vaccine was rushed, that mRNA technology is too new, that fetal cells were used in vaccine development, and that vaccines cause death. The researchers plan to use a natural language processing algorithm to evaluate the messages, and which are best at demonstrating receptiveness. They also gathered data on the respondents’ perception of the concerned patient and whether they would be willing to interact with that person again, which I thought was interesting. I’ll have to keep my eye out for the results of the research in the future.

I also had time to read a study that was recently published and has been regarded as somewhat controversial. The Journal of the Mississippi State Medical Association published the study, “Targeting Value-Based Care with Physician-Led Care Teams” in its January issue. It details findings from Hattiesburg Clinic’s value-based care journey with its Accountable Care Organization. When cost of care was examined, the study revealed that care delivered by non-physician providers who were practicing independently was more expensive than care delivered by physicians. The findings led the Clinic to redesign its care model as well as to publish its findings. Multiple news outlets and physician organizations picked up on the article, leading to headlines about how midlevel practitioners just might not be the answer to the primary care physician shortage at all.

Looking at the organization’s journey, in 2005 it employed a combined total of 26 APPs (advanced practice providers), including nurse practitioners and physician assistants. Today it employs 118. Over the last 15 years, Hattiesburg Clinic had made decisions to expand care teams by allowing these providers to manage primary care patient panels on a largely independent basis. The Clinic has more than 33,000 Medicare beneficiaries and an associated Accountable Care Organization, so it was monitoring its outcomes carefully. The study found that by allowing APPs to operate independently, the organization “failed to meet our goals in the primary care setting of providing patients with an equivalent value-based experience.”

The authors looked at 2017-2019 CMS cost data on Medicare patients who did not have end-stage renal disease and who were not in a nursing home. The data showed that per member, per month spending was $43 higher for patients who had a non-physician in charge of their primary care needs. When applying risk adjustment factors for patient complexity, the difference was $119 per member, per month. Originally, the analysis was to help the organization identify high-cost providers so they could intervene. They didn’t expect the results they identified, including increased testing utilization, more specialist referrals, and more emergency department utilization for patients who were under non-physician care.

They also found that physicians performed better on nine of 10 quality measures, with notable differences in vaccination rates for influenza and pneumococcal disease. Physicians also had higher patient satisfaction scores across multiple domains measured via Press Ganey. Although they concluded that non-physician providers are valuable members of the care team, the organization determined that independent practice was not in the organization’s best interest. They then embarked on a year-long transition that would allow APPs to inform their patients that they would start seeing the supervising physician as well, and that the physician would become the primary care provider of record. Additionally, APPs in specialty areas were restricted from seeing new patient consultation visits except in emergencies or when approved by the referring physician.

There are some interesting factors to note with regard to the findings. First, the Hattiesburg Clinic is focused on value-based care. Their experiences may not translate to organizations that are still operating under a predominantly fee-for-service model. Under the value-based care model, excess testing and referrals cut into the organization’s bottom line, so there’s an inherent level of buy-in for operational changes. In a fee-for-service model, the organization can benefit from certain kinds of overutilization, which doesn’t encourage restricting services. Also interesting is the finding that the patients who had the best quality were those who had alternating visits with both the physician and the APP.

There are also some weaknesses in the study itself, including controlling for years of experience of the APPs compared to years of experience of the physicians, and any variation in the organization’s onboarding and training of different types of providers. Having worked with new and experienced nurse practitioners, physician assistants, and physicians, I’ve seen across the board that inexperience is directly related to the propensity to order increased testing and referrals. When you’ve seen a given clinical presentation hundreds or thousands of times, you’re likely to be more confident in your ability to manage the patient on your own and are also experienced enough to refine testing to the minimum necessary. The published writeup also doesn’t include enough information on the analysis to determine whether some of the differences were statistically significant.

It will be interesting to see if the authors submit their work for the additional scrutiny of one of the national journals and what the findings look like when they are subjected to additional statistical analysis. Although the findings seem dramatic, they underscore the need for critical reading and to determine whether findings are likely to be similar to other situations. There are hundreds of organizations across the country who have the same types of data as Hattiesburg Clinic, and it would be interesting to see whether they reach the same conclusions. We’ve entered an era where there is more healthcare quality and cost data at our fingertips than we’ve ever had, and it’s time to really start using it.

What does your organization think about Hattiesburg Clinic’s findings? Have you looked at this issue yourselves? Leave a comment or email me.

Email Dr. Jayne.

Readers Write: Why Data Quality Matters in Price Transparency Workflows

Why Data Quality Matters in Price Transparency Workflows
By Cory Deagle

Cory Deagle, is chief product officer of RxRevu of Denver, CO.

As a healthcare technology vendor, we often hear that data quality is critical. It’s true that without access to reliable data, providers will question or even ignore key notifications, patient information, and clinical data. Now more than ever, vendors have a responsibility to both identify and improve the data flowing through their pipes.

Real-time prescription benefit (RTPB) – one example of an integrated tool that brings patient-specific coverage and cost data to EHR workflows – has been adopted by thousands of health systems, hospitals, and clinics across the country. This technology allows patients to understand the cost of their medications, including if lower-cost alternatives are available, while they are sitting with their care provider. I’m sure many of us have experienced the unpleasant surprise of arriving at a pharmacy only to find out the medication prescribed had an outrageous price tag. As more and more providers adopt RTPB, this should become a thing of the past.

While RTPB has incredible power to transform the patient experience, unless the vendor is providing a heavy dose of quality checks against the data, providers will notice inaccuracies or incompleteness, rendering the tool useless when making prescribing decisions. In order to resolve this, RTPB vendors must work closely with PBMs and EHRs to translate indistinguishable codes, ensure clinical relevance, and filter unnecessary noise, all with the goal of providing meaningful information so that providers can have better cost conversations with patients.

Here are a few examples of data quality steps that can be taken to improve provider trust in RTPB:

1. Quantity translations. Providers often enter medication quantities in familiar “clinical” terms (4,500 units of a diabetes injectable, for example) instead of entering quantities in “billing” units. Without a correction of the quantity from insulin units to milliliters (the billing unit for this medication), the cost information displayed could be an astounding $101,000. This is due to the fact that the PBM is pricing based on the quantity of insulin units submitted, which can be 100 to 300 times the billing unit. Vendors must be able to translate intended input quantities to ensure an appropriate covered price of $25 is displayed and communicated to the patient.
   Code Mapping: In many cases, drug costs cannot be determined because the National Drug Codes (NDC) used for pricing are obsolete or not recognized by the PBM. In order to receive an accurate price, solutions must automatically find comparable codes to display relevant pricing information.
2. Clinical logic for improved outcomes. In many cases, solutions cannot display pricing information because of user input error. For example, providers often mis-select the days supply, which can lead to errors such as “maximum dose per day.” Best-in-class vendors are able to leverage intelligence to alter days supply issues and enable transaction success. Clinical expertise and medical literature can also be used to hide erroneous results and prioritize meaningful medication alternatives in the workflow.
3. Message normalization. Providers want to focus on patient experience, but unhelpful error messages in the EHR (e.g. drug not found), slow down the ordering processes and drive mistrust in integrated tools. Standardizing errors codes from payer and PBM partners allows for actionable messaging (e.g. this medication is not covered at the selected pharmacy, please select a different pharmacy) and can improve the care experience.

It is the combination of these quality-focused tactics that can create a truly exceptional  and reliable healthcare experience. Technology vendors can no longer meet the bare minimum when delivering data. If they do, providers will ignore data presented to them, and patients will no longer trust the healthcare system they rely on. However, superior data and technology enable better decisions and drive real value in healthcare.

Readers Write: Unleash Human Capacity – And Leave Time for More Breakfast Burritos – With Better OR Scheduling

Unleash Human Capacity – And Leave Time for More Breakfast Burritos – With Better OR Scheduling
By Michael Bronson, MD

Mike Bronson, MD is an anesthesiologist with Providence Mission Hospital of Mission Viejo, CA; CEO of the Ketamine Wellness Clinic of Orange County of Laguna Beach, CA; and founder and CEO of AnesthesiaGo, which was acquired by PerfectServe in January 2022.

My path to becoming an anesthesiologist was, by all accounts, pretty normal. I went to undergrad, moved on to medical school, completed my residency, then joined a private practice. That was always the goal, and checking each of those boxes was fulfilling.

After I joined the practice, though, I started to wonder what was next. My whole life had been structured around working hard and staying focused on the future, and it felt a bit like I had reached the final phase.

Boy, was I wrong.

Like many other physicians, I was eventually thrust into a position that I never expected to inherit. There was some dissatisfaction in our group with the daily case scheduling process, and before I knew it, I was holding the hot potato in my hands.

As I leaned into this new responsibility, I most often found myself wrapping up daily cases around 5 p.m., only to be handed a stack of papers—representing the next day’s cases—and a pencil that was always topped with one of those old-fashioned detachable erasers. Why, you ask? Well, let’s just say changes, mistakes, and oversights were an inevitable part of the process.

This probably sounds relatable if you’ve ever doled out OR case assignments, but I’ll explain for everyone else. Fundamentally, it doesn’t sound too challenging—just put a name next to every case, make sure they’re not in two places at once, make sure they’re qualified to do every case, and make sure they’re credentialed at all locations.

But then come the other considerations. First, the person on call should get the most complicated cases. Second, you’ll find that surgeons often have preferences about who they want—and do not want—in the OR because of prior experiences. And finally, the patient may have a strong preference for a particular anesthesiologist because they were assigned to them previously. We always try to accommodate those requests when possible.

When you put all of this together, things can get messy. Like clockwork, every time I sent out a proposed schedule, calls and texts from colleagues would begin. Maybe somebody was double booked, or maybe there wasn’t enough travel time to get from one location to another. The reasons varied, but changes were always necessary.

In the end, this almost always took an hour or more, and I’ve seen anesthesiology groups where scheduling—which is typically done by a senior anesthesiologist—can take up to two hours. And remember, this is adding time to the end of the scheduler’s day, preventing them from going home or doing other important non-work activities.

If you’re reading this wondering whether technology can be used to improve this process, you’re asking the same question that popped into my mind several years ago. The short answer is yes, there’s a better way.

Scheduling technology isn’t necessarily new, but for a long time, the only vendors that existed were the ones that could take care of monthly scheduling needs: who’s on call, who’s working every day, who’s on vacation, and so forth. That’s a different animal than building a daily OR case schedule.

With intelligent OR case scheduling technology, you can use automation to quickly generate and distribute schedules that are free of the common mistakes people like yours truly would make when building them by hand. We’re all smart and well intentioned, but in this instance, technology is definitely the answer.

Going a step further, we can even champion provider wellness in a meaningful way. If a surgeon works best with a specific anesthesiologist, why not pair them together as much as possible to create an ideal working environment? As it turns out, technology can do that too.

I want to reinforce that none of this means we need to remove the human touch from healthcare. The best technology will make clinicians’ lives easier every day, but it should also give them a chance to provide meaningful oversight. No system is perfect, after all.

But in the end, shouldn’t we all be hyper focused on identifying and improving dated processes like the one I described? For me, getting home later every day because of scheduling duties meant less time with my family, and I had fewer chances to enjoy a favorite pastime with my son: grabbing a breakfast burrito.

Let’s all continue to think of better ways to unleash more human capacity by freeing ourselves from age-old processes that require too much time and effort. Less time being frustrated, more time caring for patients, and more time getting breakfast burritos with my son.

Morning Headlines 4/4/22

RE: U.S. Federal Trade Commission and the U.S. Department of Justice Request for Information on Merger Enforcement

The American Hospital Association tells federal regulators that hospital mergers, including associated technology benefits, lower costs and create better outcomes, benefiting their patients and communities.

Gozio Health Announces Financial Partnership with Morgan Stanley Expansion Capital

Wayfinding software company Gozio Health secures an undisclosed amount of funding from Morgan Stanley Expansion Capital.

Visante and TRG offer expanded pharmacy informatics and technology

Hospital pharmacy consulting firm Visante acquires The Robertson Group, which offers pharmacy informatics and technology consulting.

Monday Morning Update 4/4/22

Top News

The American Hospital Association tells federal regulators that hospital mergers lower costs and create better outcomes, benefiting their patients and communities.

AHA specifically calls out the technology benefits of mergers:

• Expanded repositories of clinical and cost data.
• Real-time support of diagnoses and treatments.
• Advanced analytics.
• Large health systems making advanced technologies available to their smaller affiliates that otherwise couldn’t afford them.

AHA says the government’s merger guidelines don’t require big changes and should retain market definitions as a component of competition analysis.

AHA adds the FTC and DOJ should focus instead on “anticompetitive mergers and deceptive conduct by insurance companies.” It specifically supports DOJ’s lawsuit to block UnitedHealth Group’s planned acquisition of Change Healthcare.

Reader Comments

From Brody Brodock: “Re: solutions that connect patients to clinical trials. I know of one, Ciitizen, although they seem to do only cancer trials.”

HIStalk Announcements and Requests

The employers of most poll respondents will focus this year getting and keeping employees and developing new offerings.

New poll to your right or here: For those who were laid off or terminated more than five years ago: what was the impact on your career? I did a similar survey years ago and it was shocking to see the super-high percentage of folks who said their unplanned job loss was a positive career event. As I often say, who wants to work for a company that lays people off, especially if you’re one of them? Although today’s truth is that nearly every company lays people off, kicking one set of “valued associates” to the curb while publicly bragging on company success that requires a fresh batch.

I received a large donation for Donors Choose and funded a bunch of classroom projects.

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

Webinars

April 6 (Wednesday) 1 ET. “19 Massive Best Practices We’ve Learned from 4 Million Telehealth Visits.” Sponsor: Mend. Presenter: Matt McBride, MBA, founder, president, and CEO, Mend. Virtual visits have graduated from a quickly implemented technical novelty to a key healthcare strategy. The challenge now is to define how telehealth can work seamlessly with in-person visits. This webinar will address patient satisfaction, reducing no-show rates to single digits, and using technology to make telehealth easy to use and accessible for all patients. The presenter will share best practices that have been gleaned from millions of telehealth visits and how they have been incorporated into a leading telemedicine and AI-powered patient engagement platform.

On demand: “Cybersecurity Threats Facing Healthcare Today.” Sponsor: Net Health. Presenters: Jason James, MS, CIO, Net Health; Monique Hart, MBA, CISO, Piedmont Healthcare; Jeffrey Rosenthal, , MBA CIO, Reliant Rehabilitation; David Jollow, MBA, CISO, Healogics. The panel of CIO and CISO leaders will discuss the cyberthreats that healthcare faces today. They will review security priorities for the increasingly complex healthcare IT environment that includes cloud-based applications, an increased number of endpoints that include connected devices and patient wearables, and patient portals.

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

Acquisitions, Funding, Business, and Stock

Buyouts magazine awards Francisco Partners its “Deal of the Year” recognition for carving out medical device integration technology vendor Capsule Technologies and selling it to Royal Philips for $635 million in early 2021 at a 233% gross internal rate of return. Qualcomm acquired Capsule Technologie (its original name as a France-headquartered company) in 2015 and made it part of Qualcomm Life, which Francisco Partners acquired in February 2019. FP renamed the business to Capsule Technologies, refocused it back on addressing inpatient hospital communications, hired former Spok CEO Hemant Goel to lead the company (he’s now at NThrive / FinThrive), and acquired clinical monitoring technology vendor Bernoulli Health, all in its first six months of ownership. FP sold the company to Philips two years after acquiring it, where it operates as Philips Capsule.

Hospital pharmacy consulting firm Visante acquires The Robertson Group, which offers pharmacy informatics and technology consulting.

People

Debra Carpenter, PhD (Crowe Healthcare Risk Consulting) joins Tri-State Memorial Hospital as CIO.

Change Healthcare hires Edward Baird (Spectralink) as VP of strategic accounts.

Industry long-timer Joyce Sensmeier, MS, RN retires as senior advisor of informatics at HIMSS.

Announcements and Implementations

Cerner won’t require non-client facing employees to be vaccinated until June 6, when workers are expected to return to in-office work.

Other

England scales back its pandemic surveillance programs in a move toward living with COVID-19 rather than trying to eliminate it, raising concerns among health experts that the dialed-back data systems will not support the early detection of new surges and variants. Britain was the global leader in performing random community testing, genomic sequencing, and combining the results with electronic medical records and epidemiology to provide the world with much of its COVID intelligence.

Amazon Web Services posts a job for head of worldwide health technology solutions, which involves building health system relationships, working with partners, and creating AWS business opportunities.

Sponsor Updates

• VisiQuate founders and staffers travel to Ensenada, Mexico with Baja Bound to build a house for a working family.
• The Urban Health Today Podcast features PeriGen CEO Matthew Sappern and his insights on rural maternity deserts, nursing burnout, and how AI is helping.
• Protenus will exhibit at the NADDI National Healthcare Facility Rx Diversion Summit April 25-26 in Raleigh, NC.
• TigerConnect will exhibit at AONL 2022 April 11-14 in San Antonio.
• TriNetX has signed a partnership agreement with Mitsui to expand its global research network in Japan.
• Consulting magazine names West Monroe partners Christina Powers and Melanie Prestridge Leading Women in Technology in the future leader and excellence in client service categories, respectively.

Blog Posts

• Pharma USA Takeaways: Implementing a Practical Approach to AI and Real-World Data that Improves Care Journeys (OptimizeRx)
• One Big Question: How can we improve the human experience of healthcare? (Olive)
• How Insurers Can Make Improvements for Medicare Open Enrollment (PatientBond)
• Use Technology in 5 Ways to Ease Administrative Burden (Symplr)
• Culture is Priority #1: The Cornerstone of Impact Advisors (Impact Advisors)
• Five Steps to a Successful Healthcare Analytics Program (Premier)
• How the Right Digital Health Tools Can Help Providers Operate at the Top of Their License (Quil Health)
• 14 phone-based customer support best practices (Talkdesk)
• Software in Cash-Based Practice, Part 3: Streamlining Clinic Communications (WebPT)

Contacts

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

Weekender 4/1/22

I will call this a “very special Weekender,” as the old TV shows used to say, as I limit this episode to a Donors Choose update. Feel free to skip this if you are looking for health IT news only.

Alex Benson, MPA is a long-time HIStalk reader, former Cerner executive, and SVP/GM of Bardavon Health Innovations since last year. He emailed to say that the company was interested in supporting the Donors Choose program. Which they did, in a generous way that needs its own post because the list of projects it funded is long.

Overland Park, KS-based Bardavon Health Innovations is a workers’ compensation digital health partner whose “clicks and mortar” technology connects its national network of physical therapists to self-insured employers to offer injury prevention, treatment, and work readiness solutions. There’s quite a bit of Cerner DNA in the company – Cliff Illig and Zane Burke are investors and board members, Ed Enyeart is CFO, and Jeff Steiner and Alex are general managers.

The company’s donation fully funded these Donors Choose teacher grant requests that I chose:

• Math manipulatives for Ms. F’s elementary school class in Miami, OK.
• Headphones for Ms. G’s elementary school class in Naples, FL.
• Science and STEM materials for Ms. W’s elementary school class in Miami, OK.
• Math learning tools for Ms. T’s middle school class in Montgomery, AL.
• Math learning tools for Ms. E’s elementary school class in Casa Grande, AZ.
• Math learning centers for Ms. P’s elementary school class in Washington, DC.
• Science sensory kits for Ms. H’s pre-kindergarten class in Washington, DC.
• Number recognition kits for Ms. G’s pre-kindergarten class in Columbus, IN.
• Robotics parts for the robotics teams of Mr. E’s magnet school in Van Nuys, CA.
• Sight words puzzles for Ms. B’s special education class in Brooklyn, NY.
• Storytelling kits for Ms. M’s elementary school class in Miramar, FL.
• Phonics and reading material for Mr. H’s elementary school class in Orlando, FL.
• Education centers for the kindergarten class of Ms. O in Staten Island, NY.
• Emotional support books and supplies for Ms. J’s elementary school class in Houma, LA.
• Math manipulatives for Ms. M’s elementary school class in Moore, OK.
• Flexible seating for Ms. R’s elementary school class in Kansas City, KS.
• Autism calm and focus tools for Ms. M’s autism preschool class in Glendale, AZ.
• Behavioral specialist supplies and games for the elementary school class of Ms. M in Las Vegas, NV.
• Dramatic play kits for language and social skills for Ms. K’s kindergarten class in Universal City, TX.
• Classroom organization mailboxes for Ms. B’s first grade class in Erie, PA.
• A set of 14 books for Ms. B’s elementary school class in Kansas City, MO.
• Science invention kits for Ms. M’s high school class in Kansas City, MO.
• 30 scientific calculators for Mr. F’s elementary school class in Kansas City, MO.
• Headphones and dry erase markers for Ms. C’s kindergarten class in Orlando, FL.
• STEAM bins for Ms. S’s elementary school class in Naples, FL.
• Sensory exploration kits for Ms. T’s special needs kindergarten class in Kernersville, NC.
• Soccer team supplies for Ms. F’s elementary school class in Yuma, AZ.
• Reading reward book purchase gift cards for Ms. S’s elementary school class in Bronx, NY.
• Building kits for Ms. G’s elementary school class in Sylmar, CA.
• A shelter and water cooler for the track team of Ms. M’s high school medical science class in Bronx, NY.
• Teaching resources for the speech therapy class of Ms. B in Detroit, MI.
• Mental health materials for the elementary school counseling sessions of Ms. R in Los Angeles, CA.
• Math and writing resources for the elementary school class of Ms. Z in Phoenix, AZ.
• Literary skills tools for Ms. D’s elementary school class in Eastpointe, MI.
• Behavior and sensitivity books for Ms. S’s elementary school class in Fresno, CA.
• English-Spanish dictionaries for Ms. G’s middle school ESL class in Indianapolis, IN.
• Classroom supplies for the autism elementary school class of Ms. H in Mesa, AZ.
• Headphones for the math intervention middle school class of Ms. P in Brighton, MA.
• Basketballs for the boys and girls teams of Ms. Q in Glendale, AZ.
• Decorations for the alternative prom for special needs students, voted by the school’s National Honor Society as an official project, for Ms. V’s high school in Buckeye, AZ.
• A mobile easel for the COVID-affected second grade class of Ms. M in Westminster, CA.

Many teachers responded quickly and I usually get updates (often with photos) to report how the donated items were used. Just to be clear, I receive these emails, but Bardavon Health Innovations provided the money.

Get Involved

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Morning Headlines 4/1/22

Thomas H. Lee Partners Acquires Intelligent Medical Objects

Private equity firm Thomas H. Lee Partners acquires Intelligent Medical Objects for a reported $1.5 billion.

Zephyr AI Raises $18.5 Million in Seed Funding Led by Lerner and M-Cor

Precision medicine and drug discovery analytics vendor Zephyr AI raises $18.5 million in seed funding.

Medical image sharing startup raises $16M

PocketHealth, a medical image-sharing startup based in Toronto, raises $16 million in a Series A funding round led by Questa Capital.

News 4/1/22

Top News

Private equity firm Thomas H. Lee Partners acquires Intelligent Medical Objects for a reported $1.5 billion.

Reader Comments

From Kaizen: “Re: HIMSS22. I meant to wander by the booths of Intetics (from the Ukraine) and First Line Software (Russia). Wondering if anyone checked them out and how their traffic was.” Offshore developer Intetics has (or maybe “had”) offices in Kyiv, Kharkiv, and other cities in Europe and the US. Software engineering firm First Line Software  has a US headquarters and lists offices in other countries that don’t include Russia. Anybody drop by their HIMSS22 booths? UPDATE: First Line provided an update – the US-based company formerly had a presence in Russia, but in protest of that country’s invasion of Ukraine, has pulled its people out and severed all ties with Russia. For that, I’m adding a little plug for its services with real-world evidence data, health data management and governance, AI/ML, systems development and integration, and clinical quality and safety systems.

From Green Lantern: “Re: clinical trials. Wondering if there are good systems that help patients find them?” I think most systems are aimed at physicians who are helping connect their patients to trials, so other than ClinicalTrials.gov, I don’t know of any that are intended for consumer use. Reader input is welcome.

HIStalk Announcements and Requests

Keep an eye on Epic’s website Friday for their annual creative April Fool’s shenanigans. I had a dream that the fake news included a retirement announcement from Judy that, in a bit of excellent Epic wit, turned out to be sadly real.

I’ll let others share their Dave Garets anecdotes since I have just this one. It was at the opening session at a long-ago HIMSS conference, and the stage curtains opened to a band playing some searing, nasty, surprisingly loud blues that made me want to drink a breakfast beer and take up smoking. Finally, I thought, HIMSS has hired some actual musical pros instead of bringing in the usual white bread “Up with People” Disney day-jobbers who shoot for “inspiration,” but instead hit “collective embarrassment.” The band wrapped up way too soon and its members turned out to be Dave, Jonathan Teich, and some other health IT folks I’ve forgotten, all of whom had spent time as professional musicians.

I’m trying not to snicker at the expert insight that is being widely offered unsolicited by attendees of “HIMMS.”

Webinars

April 6 (Wednesday) 1 ET. “19 Massive Best Practices We’ve Learned from 4 Million Telehealth Visits.” Sponsor: Mend. Presenter: Matt McBride, MBA, founder, president, and CEO, Mend. Virtual visits have graduated from a quickly implemented technical novelty to a key healthcare strategy. The challenge now is to define how telehealth can work seamlessly with in-person visits. This webinar will address patient satisfaction, reducing no-show rates to single digits, and using technology to make telehealth easy to use and accessible for all patients. The presenter will share best practices that have been gleaned from millions of telehealth visits and how they have been incorporated into a leading telemedicine and AI-powered patient engagement platform.

On demand: “Cybersecurity Threats Facing Healthcare Today.” Sponsor: Net Health. Presenters: Jason James, MS, CIO, Net Health; Monique Hart, MBA, CISO, Piedmont Healthcare; Jeffrey Rosenthal, , MBA CIO, Reliant Rehabilitation; David Jollow, MBA, CISO, Healogics. The panel of CIO and CISO leaders will discuss the cyberthreats that healthcare faces today. They will review security priorities for the increasingly complex healthcare IT environment that includes cloud-based applications, an increased number of endpoints that include connected devices and patient wearables, and patient portals.

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

Acquisitions, Funding, Business, and Stock

Precision medicine and drug discovery analytics vendor Zephyr AI raises $18.5 million in seed funding.

Sales

• Blessing Health System chooses Biofourmis for its hospital-at-home program that includes biosensors, a patient companion app, and analysis of wearable streaming data and patient-reported outcomes using the AI-powered Biovitals Analytics Engine.
• Carevive Systems will use technology from Datavant to de-identify its oncology patient experience data and connect it for sale to life sciences companies.

People

Dina promotes Tim Coulter to president, where he will also continue in his role as COO.

Keith Tode, MBA (IPM.ai) joins Net Health as VP of clinical research.

Sansum Clinic promotes Sean Johnson, MHA, RN to CIO.

Announcements and Implementations

New Zealand Health IT renames itself to the Digital Health Association.

Intermountain Healthcare will use a $100,000 grant from Intel to purchase 70 additional cameras for its Patient Safety Monitoring remote observation program. Intermountain says the program reduces room traffic and thus COVID exposure, frees up CNA time, and allows immunocompromised caregivers to continue caring for patients.

Telehealth vendor Hims & Hers Health will refer its patients who have complex clinical needs to primary and urgent care provider Carbon Health.

Medchart — which provides patient-authorized records release to legal, insurance, and research customers – announces Marble, an API that makes that information available to developers.

Athenahealth announces improved gender-affirming care capabilities for AthenaOne.

Surgical Information Systems moves to a new corporate headquarters in the Avalon community of Alpharetta, GA.

Government and Politics

Practice Fusion will pay $200,000 to settle federal charges that it failed to comply with the terms of its $145 million EHR opioid kickback settlement in January 2020. The US Attorney alleged that Practice Fusion failed to maintain and fund an Oversight Organization as the settlement required, which the company denied.

A former Yale University ED finance director pleads guilty to stealing $41 million from the medical school by repeatedly authorizing purchases of Suface Pros and IPads, which she broke into individual orders to fall within her $10,000 purchasing authority, then having the items shipped to a business that sold the devices and paid her a cut. Yale didn’t notice until an anonymous tipster questioned her high purchasing volume and why she was placing the equipment into her own car. Her purchasing limit means that she had to generate 4,000 purchases at $10,000 each over eight years – around two purchase orders per weekday — that the School of Medicine failed to notice. Federal investigators say Jamie Petrone-Codrington spent the money on cars, real estate, and travel, also raising the IRS’s interest for not filing tax returns that should have generated $6 million in federal taxes. She will forfeit $560,000 in her business’s bank account, two Mercedes, a Land Rover, two Cadillac Escalades, and a Dodge Charger, along with several real estate holdings. She faces up to 23 years in prison.

Other

Jonathan Bush explains that despite the impediments to interoperability – the challenge of building cross-app experiences, anti-competitive behavior, and broader networks that raise trust issues – he is optimistic:

To steal from Inigo Montoya: I know something that perhaps you do not know. COVID has ushered in a massive explosion in the number and funding of digitally forward, virtual-first healthcare providers. These companies have incredible outcomes, almost no fixed cost base (compared to old med), and an always-on, super convenient access layer. They are also almost all “focus factories” in that they take on one narrow problem, but solve it on a national level. As focus factories, they selfishly WANT a shared record. The amazing irritable bowel syndrome team at Oshi Health has absolutely no designs on taking over your diabetes care someday, but would really like a real-time holistic picture of their patients! They don’t just want federated data because it is clinically and ethically superior, but because they make more money when it exists. The incentives were not so for the Facebook application developer community of the Open Graph era and not so for the medical record guardians of Old Med.

Sponsor Updates

• CTG publishes a white paper titled “Continued Acceleration—Digital Transformation in 2022.”
• Cerner recaps Children’s National Hospital’s go-live on its clinically driven revenue cycle as an ITWorks client.
• Symplr CEO B.J. Schaknowski is named to the board of Susan G. Komen.
• Everbridge teams with technology leaders to offer a critical communications platform to support humanitarian efforts in Ukraine.
• First Databank becomes the NCPDP Foundation’s inaugural Patient Safety Founder Gift Donor with a donation of $100,000.
• Well Health names Malissa Miot (Carium) Northeast enterprise director of sales.
• InterSystems is recognized with the Business Intelligence Solution Provider of the Year award in the Data Breakthrough Awards program.
• The InteropNow! Podcast features Lyniate Chief Marketing Officer Michelle Blackmer in a new episode, “Removing the Confusion of Interoperability Solutions with Lyniate.”
• Meditech congratulates its customers that were included in The Chartis Group’s lists of top 100 rural and community, and critical access hospitals
• NTT Data is accepting applications for the NTT Data Hackathon as part of TechGig Code Gladiators 2022.

Blog Posts

• Managing Epic Community Connect Recipients’ Loss of Control (Impact Advisors)
• ServiceNow Knowledge Articles Empower All (Optimum Healthcare IT)
• Intelligent Healthcare Orchestration Can Reduce Burnout (About)
• More Insights from HIMSS 2022 (Part 2) (EVisit)
• New Naloxone Formulation Signifies Progress in Preventing Opioid-Related Adverse Events (First Databank)
• Inclusive Innovation: Repurposing Technology in Service of Health Equity (Get Well)
• Choosing a Managed Services Partner for EHR Support – Part 3 (HCTec)
• Reflections on HIMSS22: The Importance of Reconnecting (Healthwise)
• Staving Off March (security) madness: Digital identity management is your key defense strategy (Imprivata)
• Why You Should Invest in Upcycling Clinical Data (Diameter Health)
• A helping hand for health information exchanges (Intelligent Medical Objects)
• How Provider Data Management Helps Health Systems Embrace Healthcare Consumerism (Kyruus)
• Using Personalized AI to Make Communities (Heart) Healthier (Loyal Health)
• Our HIMSS22 Reflections: Re-imagining Care and Innovative Partnerships (Medhost)
• Strategies to Mitigate the Physical Therapist Shortage in 2022 (MWTherapy)
• Responding to the Challenges with MHealth Apps for Depression and Suicide Prevention (NeuroFlow)
• Guidelines will rule the world (Nordic)

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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EPtalk by Dr. Jayne 3/31/22

A recent survey conducted by the American Medical Association found that 85% of responding physicians are using telehealth in their practices. Approximately 60% of physicians agreed or strongly agreed that telehealth enables the provision of high-quality care. I wasn’t surprised by the breakdown of visit types – 93% of them are offering video visits and 69% of them are offering audio-only visits. More than half of respondents say they are motivated to increase the use of telehealth in their practices. Uptake of other telehealth services, such as remote monitoring, seemed low at only 8%. As far as other interesting statistics, more than half of physicians indicated that telehealth had improved job satisfaction. The online survey was conducted anonymously, with 2,000 physicians responding.

A lot of people think that true telehealth services have to include both audio and video, but in my experience as a telehealth physician, it seems that the majority of patients are happy with audio-only services. Physicians have mixed feelings about doing audio-only visits. It’s definitely easier to assess whether people have an increased rate of breathing when you can see them, and you can quickly gauge their overall level of distress. Especially when caring for sick children, I like to see if they are clingy and how consolable they are as part of the evaluation.

For many adults seeking telehealth services, however, observation and other elements of physical examination don’t add much to the clinical picture. Ultimately it should be a balance, taking into account the patient’s preferences and the clinician’s comfort level with different telehealth modalities. There are plenty of studies that indicate that inclusion of audio-only services results in greater telehealth access among underserved populations, older patients, those who seek care in safety net facilities, and some demographic subsets.

Although there’s a lot of enthusiasm about telehealth, other sources look at telehealth from a different lens. One survey commissioned by UnitedHealth Group found that 55% of physicians are frustrated by managing unrealistic patient expectations for virtual visits. About half are also frustrated by issues with audio and video technology. Providers who responded to the UnitedHealth survey were less optimistic about telehealth’s impact on job satisfaction, with only 25% saying it was improved. There was also division on the role telehealth plays with regard to physician burnout – 30% said it increased burnout, while 30% said it reduced it. I’m sure the perceptions are valid at both ends of the continuum since I’ve seen some outstanding telehealth implementations and some that are marginal at best. I do hope that those organizations that plan to continue making it a large part of their patient care strategies spend the time and money to optimize their offerings for both patient benefit and clinician satisfaction.

Henry Ford Health unveils a new brand, dropping the word “system” from its name. According to its press release, removing “system” places more emphasis on the word “health” and broadens the vision. The new logo drops the iconic Henry Ford signature and oval and adds three shades of blue as well as a swath of purple. The purple is certainly eye-catching, but I’m not sure what to think about the different blues. The organization plans to roll out the new branding to its largest facilities first, with others phasing in the new branding over the next few years. Along with the visual branding, Henry Ford Health is launching an omnichannel ad campaign titled “I Am Henry.” It includes stories from the organization’s patients, employees, and from the communities it serves.

The organization’s press release notes that the “new logo clearly transitions the identity from one steeped in the visual history of founder Henry Ford, to a brand expression focused on humanity, backed by a powerful heritage of innovation and drive.” I’m not sure I fully feel that, but I’m willing to play along. On one of my recent projects, I learned an incredible amount about marketing, branding, and how different visuals can evoke specific responses from viewers. Looking critically at the new logo, I find the font rather intriguing. The majority of the letters are strong and uncomplicated, but the leg of the R adds a bit of whimsy. The swooping crossbar of the leading H pulls you into the name, and the trailing H feels downright playful. The purple feels a little too bright compared to the blues, but that’s just me. I’d be interested to hear what the marketing gurus out there think of it compared to my decidedly amateur opinion.

I learned last night that a physician who I worked closely with during my residency took his own life on Monday. He was a few years ahead of me in training . The loss of a young and talented physician (as well as a father and spouse) is tragic. Each year, 300 to 400 physicians die by suicide. Even if we personally are not at risk, the odds are that someone we work with might be struggling. The grief was particularly heavy since Wednesday was Doctors’ Day in the US, which was created to honor physicians for their dedication and their service to humanity. Knowing that some physicians feel there is no way to get through the challenges is heartbreaking, especially since I’ve lost two colleagues this way in under two years.

Judging by the reports in some of my social media feeds, the day was subdued for many, with occasional “snacks in the breakroom” celebrations. One physician reported that their organization gave everyone a book on wellness, which for many frontline physicians has become synonymous with pizza parties and therapy dogs. Another received a heart-healthy cookbook that appeared to be left over from a recent cardiology department open house based on the sticker gracing the back cover. I doubt hospital executives think about the idea that their selections might be posted on nationwide Facebook groups as a humorous counterpoint to those “best places to work” lists. Sadly, some physicians reported receiving no recognition in the clinic at all. With all the work physicians have put in over the last couple of years, I’m hoping that for them Doctors’ Day 2023 will be a better one.

Did your organization do anything to mark Doctors’ Day? Leave a comment or email me.

Email Dr. Jayne.