News 6/17/22

Top News

An investigative article finds that the websites of 33 of Newsweek’s top 100 US hospitals send Facebook the IP address of people who schedule an appointment online. The Meta Pixel tracker also sends Facebook the doctor’s name and the search term that the user entered to find them.

The hospitals include Hopkins, UCLA, New York Presbyterian, Northwestern, and Duke.

Reporters also found that at least seven health systems have installed Meta Pixel on their patient portals, including Community Health Network, Edward-Elmhurst Health, and Novant Health.

The hospitals may have violated HIPAA in sharing personally identifiable health information with third parties without the consent of patients.

Reader Comments

From Cedar: “Re: pre-Oracle attempts to develop a national EHR. I recall one entrepreneur in the 2000s who had no healthcare experience who announced he was developing a national EHR. I believe it was Jim Clark of Netscape. Are you aware of any other famous Silicon Valley heads who made a big splash and then went nowhere?” Jim Clark’s Healtheon was certainly all over healthcare, trading on his success with Netscape to eventually merge with WebMD. Intel co-founder Andy Grove also hatched grand healthcare technology plans in the mid-aughts that went nowhere. Google and Microsoft had their own arrogance-fueled failures with personal health records. Sun Microsystems made some national noise in the mid-2000s, then sold out to Oracle in 2010. IBM had a bunch of now-forgotten projects. I’ll invite readers to help me recall other big tech companies that showed misplaced confidence in planning to show us healthcare folks how it’s done before slinking away shortly thereafter with the newfound knowledge that you can’t fix a dysfunctional, profit-obsessed healthcare system with technology.

Webinars

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

People

CloudWave promotes Chris Mellyn to VP of marketing.

Aetna/CVS Health promotes Ron Wampler to executive director of interoperability.

Melissa Bell (Intelligent Medical Objects) joins TigerConnect as president.

Cone Health hires Jeetu Nanda, MD, MS, MBA (Cerner) as CMIO.

David Kates, MBA, MSEE (Manifest MedEx) joins Unified Patient Network as CTO.

Opala hires Ken Chandler (Premera Blue Cross) as CEO.

Krista Hawk (HealthPay24) joins Doctivity Health as VP of sales and business development.

Announcements and Implementations

Providence and Microsoft launch a nine-month clinical innovation fellowship.

Walgreens launches a clinical trial business that includes patient recruitment, a decentralized clinical trial platform, and real-world evidence.

Other

The Washington Post calls out Phreesia for using the patient information it collects from its patient check-in app collects to target drug company ads.

A Kaiser Health News investigation finds that 41% of US adults are saddled with healthcare-related debt, much of it hidden in the form of credit card balances, family loans, or provider payment plans. An expert says that debt is a main product of a health system that is “almost perfectly designed to create debt.” One in seven people who have medical debt say they can’t receive further care because of their unpaid bills. The authors note that the Affordable Care Act caps out-pocket costs, but few Americans can afford the $8,700 annual maximum and high-deductible plans require paying thousands of dollars before coverage even begins. 

Sponsor Updates

• EClinicalWorks announces its continued partnership with Witham Health Services (IN) to further improve patient communications and achieve overall operational efficiency in more than 30 locations.
• Diameter Health publishes a new white paper, “Healthcare ROI: How Health Plans Use Diameter Health’s Automated, Scalable Technology to Maximize Value from Clinical Data Investments and Avoid Significant Operational Cost.”
• Pivot Point Consulting promotes Molly Kalinowski to director of managed services application support.
• AGS Health opens an office in Jaipur, India.
• Experian Health releases a new infographic, “The Digital Healthcare Gap: Streamlining the Patient Journey.”
• Research from Juniper Networks finds AI adoption has expanded tenfold across enterprises while governance lags.

Blog Posts

• Why Health Plans Need Automation to Get ROI from Clinical Data (Diameter Health)
• Engaging Inactive Patients Through Personalized Outreach (Get Well)
• 7 Benefits Digital Health Education Brings to Care Management (Healthwise)
• Why your Zero Trust strategy needs a third-party privileged access component (Imprivata)
• EHR Report Distribution: 3 workflow basics for hospital efficiency (Interbit Data)
• Disrupting Healthcare Through Innovation (InterSystems)
• How clinical documentation impacts revenue cycle management (Intelligent Medical Objects)
• How Digital Support Groups Bridge the Patient-Provider Divide (Medhost)
• Physical Therapy Superbill vs. Courtesy Billing: Difference & Uses (MWTherapy)
• Transparency vs Status Quo: Why Point-of-Care Patient Financial Responsibility Calculations Up Your Star Rating (Myndshft)
• Looking for Ways to Keep Patients Enrolled and Engaged in Skin and Wound Clinical Trials? Do This … Not That (Net Health)
• NeuroFlow’s Journey Gallery Improves Access to Self-Guided Behavioral Health Support (NeuroFlow)

Contacts

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

EPtalk by Dr. Jayne 6/16/22

The American Medical Association Annual Meeting is happening in Chicago this week, with the group gathering in person for the first time since the beginning of the COVID-19 pandemic. Many physicians feel the AMA has lost relevance and doesn’t speak for the majority of physicians. Regardless, I found the list of issues that the House of Delegates plans to address to be an interesting commentary on the times:

• Addressing public health disinformation by health professionals.
• Regulating ghost guns.
• Declaring climate change a public health crisis.
• Banning cannabidiol ads in places that children frequent.
• Preventing loss of insurance coverage after the COVID-19 public health emergency ends.
• Urging the Food and Drug Administration to swiftly review and approve over-the-counter status for oral contraceptives.
• Decreasing bias in evaluations of medical student performance.
• Ensuring accessibility of quality childcare for physicians in training.

Additional special sessions will include talks on the need for ethical guidelines around private equity acquisition of physician practices; Hattiesburg Clinic’s results when it looked at the impact of nurse practitioners and physician assistants; having physicians work at the top level of their licensure and not performing non-physician work; and reducing burnout.

I’m not sure how you miss this on a background check, but Bay Area Hospital in Oregon recently fired its chief operating officer after only four days on the job. It was discovered that in 2015, he had been sentenced to serve half a decade in federal prison for committing wire fraud and false representation of a Social Security number. Additionally, he used company credit cards for personal purchases. The hospital claims that it conducts criminal background checks across multiple jurisdictions, so I’d be interested to understand how this one slipped through the cracks.

In other legal news, a New Hampshire hospital has lost more than seven gallons of the drug fentanyl, which is a synthetic opioid that is 50 times more potent than heroin. Multiple hospital employees have been suspended. Drugs continued to disappear despite precautions that were added after initial losses were identified. A single nurse admitted taking more than half of the missing drugs, but the fate of the rest of the missing drugs continues to be unknown. Board of Pharmacy documents state that the nurse in question stated she took the fentanyl “for her own use as a way of coping with the stress of working during the pandemic” and also gave some to a friend. The nurse died unexpectedly in March. Nursing and pharmacy leaders at the hospital have also been suspended, with decisions on whether the hospital will lose its pharmacy approval expected later this month.

CMS has started levying fines against hospitals for noncompliance with federal price transparency laws. Atlanta-based Northside Hospital was fined more than $1 million due to problems at two facilities. One didn’t have the required consumer-friendly list of standard charges and the other didn’t have the searchable list posted in a prominent manner. CMS has issued a number of warning notices to noncompliant hospitals, but these are the first fines. Of note, neither hospital submitted a plan for corrective action which might have helped them avoid the penalties. One health policy expert cited in the article describes the hospital’s behavior as “contemptuous” in its lack of response or remediation.

A recent report from the Center for Connected Medicine (which is a partnership of Nokia and UPMC) looks at the reasons why patient self-scheduling isn’t advancing. Not surprisingly, lack of physician buy-in is a major factor. The report notes that 88% of respondents plan to prioritize investments in self-scheduling technologies in the coming year.

My primary care physician is part of a large medical group affiliated with a major integrated delivery network, and their efforts towards self-scheduling have been haphazard at best. Each office within the group is allowed to do their own thing, and then within the office, providers can opt in or out. Although I can’t even request an appointment with my physician online (other than sending a message, which I know is annoying to the staff) I can directly book with the nurse practitioners in the office. I’m overdue for calling to schedule my visit since he’s got a six-month wait, but I never seem to find time to make the call. At least I could self-schedule in those precious minutes between Zoom calls while I’m waiting for attendees to arrive at a meeting or while I’m waiting for the next patient to pop into my virtual waiting room. I definitely can’t make a phone call at either of those times.

Being a patient seems to be getting more and more difficult. I waited more than two weeks for some recent results, only to find that the ordering clinician failed to include the clinical history with the order, which might have made a difference in the results. It took four days from when the results posted in the EHR to when my clinician finally messaged me with note that “all is well, have a great summer,” which is a somewhat useless comment when you’re a patient who wants to know what the follow-up plan should be given the clinical history. Additionally, my physician eye detected a comment in the actual result report that called into question the adequacy of the specimen and that doesn’t feel like “all is well” to me.

I was forced to see this clinician because my own physician was out on a medical leave and the wait for new patient visits for other physicians in this specialty can be several months long. The visit itself was less than satisfactory, and after seeing how the results were handled, I’ll be looking to transfer. I’m fortunate to be a physician with plenty of resources, who not only knows how to research clinical guidelines but who could also reach out to friends in this specialty for advice. Both of my favorite “phone-a-friend” docs agreed with my self-created care plan so that’s something, but overall, the situation is just disheartening.

I feel bad for my physician colleague who is out on leave, because I know the backstory and that she not only feels terrible that her sudden illness left the practice in the lurch, but that there’s a good chance that she may not be able to practice medicine again. She’s an employed physician, though, so it falls on the group’s leadership to ensure that patients receive appropriate care in the face of the unexpected. I wonder how many other patients received less than outstanding care in the last few weeks and whether there will be any long-term consequences.

How have physician or other medical staff shortages impacted your own health or your patients’ care? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 6/16/22

Constellation4 Health closes round with new outside investment

Florida-based startup Constellation4 Health raises pre-seed funding and acquires Vulcan Health, an offshoot of Florida Eye Specialists & Cataract Institute that specializes in digital referral management technology.

AI technology platform Excelera to merge with SPAC Future Health ESG

Excelera, a healthcare AI technology vendor focused on helping physicians succeed in value-based care programs, will merge with SPAC Future Health ESG.

Proximie Raises $80 Million in Series C Funding to Accelerate Product Expansion of Full-Service Connected Surgical Platform

Virtual surgery software company Proximie raises $80 million in a Series C funding round, bringing its total funding to $130 million.

Morning Headlines 6/15/22

ResMed to Acquire Medifox Dan, a German Leader in Out-of-Hospital Software Solutions

ResMed will acquire Germany-based MediFox Dan, which offers out-of-hospital software solutions, for $1 billion.

Oracle reviewing Cerner products to identify where third-party tech can be removed

Oracle will review Cerner’s product portfolio to find opportunities to move from third-party technologies to those of Oracle, including moving to Oracle’s cloud infrastructure.

FTC launches probe into mental-health startup Cerebral

The Federal Trade Commission launches an investigation into the advertising and marketing of telemedicine startup Cerebral’s mental health services.

Bardavon Health Innovations Acquires PeerWell to Become First Complete Digital Health Solution Focused on Worker Musculoskeletal Health

Bardavon Health Innovations, whose network offers musculoskeletal health services for workers’ compensation cases, acquires PeerWell, which offers a MSK care coordination platform.

News 6/15/22

Top News

Oracle says in its earnings call that it will review Cerner’s product portfolio to find opportunities to move from third-party technologies to those of Oracle, including moving to Oracle’s cloud infrastructure.

Larry Ellison added that Oracle’s plan for a national health records database is “clearly going to be our largest business.”

HIStalk Announcements and Requests

I’m mostly recovered from my infection that may or may not have been COVID (all tests were negative, so who knows). The upside of being flat-on-back for a week is that I rediscovered the amazing decades-old hospital drama “St. Elsewhere,” of which the entire 137-episode run is available on Hulu. Also occupying my fuzzy-minded time is the first podcast I’ve ever listened to, the spectacular “Gilbert Gottfried’s Amazing Colossal Podcast!,” which like me obsesses over obscure TV shows and one-hit musical wonders as described by guests who were involved.

Webinars

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

Acquisitions, Funding, Business, and Stock

ResMed will acquire Germany-based MediFox Dan, which offers out-of-hospital software solutions. ResMed will pay $1 billion for the acquisition, about 12 times net revenue.

Bardavon Health Innovations, whose network offers musculoskeletal health services for workers’ compensation cases, acquires PeerWell, which offers a MSK care coordination platform.

London-based Proximie, which virtually connects surgeons to ORs and cath labs, raises $80 million in a Series C round.

Sales

• Digital health company Zyter selects PatientBond’s psychographic segmentation model and patient engagement software to improve risk stratification and care plan adherence.

People

Cardiovascular Associates of America hires Jack Sunderman, MS (Clearwater Cardiovascular Consultants) as CIO.

Joe Rostock (AllosLogic) joins Avaneer Health as COO.

Amino Health hires Greg Born, MBA (MDsave) as chief growth officer.

CoverMyMeds promotes Clay Courville to chief product officer.

Announcements and Implementations

The University of Miami Health System’s Sylvester Comprehensive Cancer Center implements an internally-developed bilingual symptom and practical-needs screening and referral tool within its Epic EHR. Patients fill out the electronic survey through their patient portal before an appointment and are then triaged to supportive services and/or medical teams during their visits.

Gadsden Regional Medical Center (AL) implements PeriGen’s PeriWatch Vigilance AI-based maternal-fetal early warning system within its labor and delivery department.

Premier expands its PINC AI clinical surveillance technology to long-term care facilities, including automated COVID alerts, outbreak group tracking, documentation, and submission of infections to the CDC.

Startup Rune Labs earns FDA clearance to use its Apple Watch software, combined with a brain signal monitoring implant, to help doctors optimize therapy for Parkinson’s disease.

Government and Politics

HHS issues guidance on using remote communication technologies to provide audio-only telehealth services when OCR’s enforcement discretion is no longer in effect.

Eisenhower Army Medical Center at Fort Gordon (GA) works through patient portal appointment scheduling issues in its new MHS Genesis system, which went live over the weekend. The go-live marked the half-way point for the DoD’s facility-wide rollout of the Cerner-based system. The department anticipates wrapping up the enterprise deployment by the end of 2023.

Other

Surescripts reports that 620,000 prescribers – half of those in the United States – used its Real-Time Prescription Benefit cost and coverage tool between December 2021 and May 2022, a 7.5% year-over-year increase The company attributes the technology’s growth to increased adoption among EHR vendors including Athenahealth, CompuGroup Medical, and Greenway Health.

A UK doctor apologizes to the family of a 92-year-old woman for incorrectly diagnosing her with terminal liver failure during a virtual visit, after which he recommended initiating end-of-life care. The family took her to the hospital, where she recovered fully after a four-day stay.

Sponsor Updates

• Meditech is named 2021 Google Cloud Industry Solution Partner of the Year for healthcare.
• Hamad Medical Corp. and Primary Health Care Corp. adopt Cerner managed technology to deliver better outcomes in Qatar.
• EClinicalWorks releases a new podcast, “Healow Payment Services: Convenient, Electronic, and Easy to Use.”
• Baker Tilly publishes a case study, “Rural hospital draws $1.8 million in annual Medicare reimbursements through status change.”
• WellSky-owned CarePort announces that 2,500 post-acute providers and 13,000 home- and community-based services joints its network in 2021.
• Premier Inc.’s PINC AI will collaborate with R1 RCM to offer expanded end-to-end revenue cycle solutions.
• Change Healthcare, Olive, Optum, Surescripts, Bamboo Health, InterSystems, Diameter Health, Neuroflow, RxRevu, Talkdesk, and Wolters Kluwer will exhibit at AHIP 2022 June 21-23 in Las Vegas.
• CTG will present and host virtual investor meetings at the annual East Coast IDEAS Investor Conference June 23.
• Ellkay has raised $49,000 for the Alpine Learning Group through its team participation in Go the Distance for Autism.

Blog Posts

• 5 Tips to Urgent Care Reputation Management (for 5-Star Reviews) (Experity)
• CloudWave and Tausight: Protecting PHI (CloudWave)
• How technology transformed a medical billing company’s revenue cycle management (Ability Network)
• UKIO and ECR: Agfa HealthCare, enterprise imaging pioneer, showcases radiology innovations at class-leading European events (Agfa HealthCare)
• The Evolution of Coding and What’s on the Horizon (AGS Health)
• Want to reduce claims calls? There’s an API for that. (Availity)
• Got Referrals? How to Improve Measure Results in 5 Minutes (Azara Healthcare)
• Minimizing Revenue Loss Due to Inpatient Status Downgrades (BDO)
• Digitizing CABG prep and at-home follow-up care for improved quality of life (Bravado Health)
• A Healthcare IT Consultant Story: Why You Need a Guide (CereCore)
• Techquity: Using technology and data insights to deliver more equitable patient care (Oracle Cerner)
• Multifactor Authentication: An Extra Layer of Security for Healthcare Organizations and Business Associates (Clearwater)
• A Guide to Better Serving Burnt-Out Physicians (ConnectiveRx)
• Navigate Common EHR Challenges with Stewardship from an Experienced Partner (CTG)
• Take Advantage of Big Data in the Healthcare Industry (Dimensional Insight)
• A Behavioral Health Module That Behaves Like One (EClinicalWorks)
• Value-based Care is the Answer for Humana (Enlace Health)

Contacts

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

Morning Headlines 6/14/22

Oracle’s Cloud Business Shows Momentum, Sending Shares Higher

Oracle’s Q4 cloud revenue has increased 19% to $2.9 billion, sending its shares up and, coupled with its Cerner acquisition, accelerating its business momentum.

Eisenhower Army Medical Center now live with MHS-Genesis, DHA rollout marks half-way point

The DoD’s facility-wide roll out of MHS Genesis, a Cerner project, reaches the half-way point with go-live at Eisenhower Army Medical Center at Fort Gordon in Georgia.

HHS Issues Guidance on HIPAA and Audio-Only Telehealth

HHS issues guidance on how covered healthcare entities can conduct audio-only telehealth appointments in a HIPAA-compliant manner.

Readers Write: Real-World Data Connects the Patient’s Past, Present, and Future: A Systems-Level Approach to Effective, Holistic Cancer Care

Real-World Data Connects the Patient’s Past, Present, and Future: A Systems-Level Approach to Effective, Holistic Cancer Care
By Miruna Sasu, Ph.D.

Miruna Sasu, PhD, MBA is president and chief executive officer of COTA, Inc. of New York, NY.

Too often, fragmentation across the care continuum prevents the delivery of timely, tailored cancer therapies. By leveraging real-world data to inform our decision-making at the systems level, we can ensure that cancer patients have access to personalized, effective treatments.

For the typical cancer patient, the road to remission is anything but a straight line. From getting the right diagnosis to accessing the most effective therapies, patients face a fragmented and disjointed journey that can be filled with roadblocks and detours.

Part of the problem is the nature of cancer itself. It adapts and evolves to evade treatment, driving oncologists and life sciences companies to continually develop innovative therapies and update their standards of care.

But equally problematic is the way we direct patients along their journey. In too many cases, we cannot access the data-driven insights that we need to make timely decisions with our patients. We struggle to overcome systemic barriers, such as competing incentives and overly narrow methods of care delivery. And we don’t have the shared infrastructure in place to continuously learn from our patients and enhance future decision-making based on the lessons of the past.

Fortunately, we can change the status quo if we adjust our notions of what it means to work together at a systems level  and if we leverage emerging assets, such as real-world data (RWD), to create a more comprehensive, predictive, and personalized pathway to better cancer care for all patients.

Healthcare is an industry of extreme specialization, which brings both benefits and challenges to patient care.

Naturally, it’s crucial to have experts with deep experience in very specific fields to ensure that people with complex conditions get the care they need. But specialization can make it more difficult for patients to get the right care at the right time.

For example, if a patient goes to a podiatrist for pain in their foot, the podiatrist will do everything she can to examine the relevant structures.

If they finds nothing remarkable, however, they likely won’t suspect that the problem might actually be referred pain from ovarian cancer. And chances are, they won’t have access to information about the patient’s mother’s BRCA-1 mutation, which potentially raises the risk of that cancer in the person they are treating. The patient will go home with a recommendation to rest and ice their foot, not a referral to an oncologist, and it may be weeks or months before they get the correct diagnosis.

Both the patient and the podiatrist did everything “right” in this situation, yet the outcome is still suboptimal for everyone involved.

That’s because both our care practices and our patient data are viewed through an overly narrow lens, causing us to miss the big picture and make connections that may fall outside of the traditional site-specific approach to medical care.

In cases like these, what we need is a generalist: a holistic, comprehensive view of the patient, their history, their clinical and non-clinical risks, and all of the other factors that may point to the correct diagnosis or a favorable response to a certain therapy.

Data can be that generalist. By combining RWD from electronic health records; claims; medical devices; patient reports; and other sources with clinical trial information, registry data, and additional inputs, we can begin to develop the systems-level thinking we need to effectively diagnose and treat patients with cancer.

To maximize the value of our data to inform care decisions, we need to reexamine the fundamental architecture of our operating environment.

Life sciences companies, clinical providers, payers, and regulators struggle with trust issues and conflicting incentives that inhibit collaboration and prevent us from working together efficiently as a coordinated system.

If patient data is to be the generalist that unlocks silos in care, we need to stop treating it as proprietary, competitive leverage and start viewing it as a shared resource that can actively save patient lives.

In order to successfully make this shift, we must transcend our individual motivations and more effectively share precise and applicable data-driven insights across the divide so that everyone can benefit from what RWD can tell us about the right patient care.

With this approach, we can begin to take that holistic, bird’s-eye view of patient care that is crucial for identifying and treating cancer as quickly as possible. We can start to build cohorts of similar patients based on rich and comprehensive information about their treatment paths and outcomes. Then, we can predict the experiences of future patients and get them on therapy sooner, make the next correct treatment decision, or enroll them in promising clinical trials.

The result will be better experiences and outcomes for patients and more fuel for innovation for life sciences companies and providers, including a more robust and targeted pipeline for filling clinical trials.

If used correctly, RWD can be the bridge that connects the isolated corners of the care environment and leads us along a smoother, faster, more personalized pathway to high-value cancer care.

RWD will be crucial for understanding how to efficiently pivot for the patient as their story evolves. As we integrate RWD into our decision-making processes, we will need to work together to make certain that it is created, collected, and curated correctly while paying the utmost attention to patient privacy and data security.

We know this won’t be an easy task, especially if we let historical divisions influence our relationships with one another. We know that we have a great deal of work ahead of us to realign incentives, develop our real-world data assets, and set appropriate guardrails for a newly collaborative industry.

However, it can be done. If we can put aside our personal viewpoints and look at the cancer journey through the eyes of a frustrated, frightened patient, we will be able to successfully focus on our shared mission to find new treatments for cancer, improve patient experiences, and ultimately save lives.

Curbside Consult with Dr. Jayne 6/13/22

I was sorry to read of Mr. H’s COVID-like symptoms, which as of his last post hadn’t yet resulted in a positive test. Especially in vaccinated patients, we’re seeing a pattern where antigen testing doesn’t become positive until five days or more after symptoms have started. Although vaccinations are still very good for preventing hospitalizations and death, I’m seeing a fair number of people with some pretty debilitating symptoms as well as a large number of patients with long-COVID symptoms. Best wishes for a speedy recovery for Mr. H.

As a physician who has spent thousands of hours staffing emergency departments and urgent care facilities, I fully support the idea of having interoperable systems to better understand patients’ medication histories. My first informatics employer stood up a private health information exchange (HIE) to help its employed physicians better share data with community physicians who also used the same EHR. It was an exciting time to learn how the connectivity needed to work and to navigate through decisions such as whether we would be an opt-in or opt-out platform in the face of changing privacy laws and state requirements that weren’t keeping up with the times. As the first HIE in the state, if was something to be proud of, but we knew it could be done better and were ready to support broader statewide efforts when they came along.

One of the major benefits of even our limited regional system was being able to see prescription histories and to identify patients who were visiting multiple physicians for controlled substances, or who were trying to refill their medications sooner than they should. Having the data made it easier to have those uncomfortable conversations with patients so that we could try to arrange appropriate follow up. From those experiences, it was natural to be a champion for Physician Drug Monitoring Programs (PDMPs) when they were first proposed. Some states were faster in creating these programs than others, and at least one state still doesn’t have a true statewide platform. As soon as one became available to me, I signed up, and before long I was using it nearly every day.

My last urgent care employer had a large number of midlevel providers seeing patients – nurse practitioners and physician assistants outnumbered the physicians nearly three to one. In my location, those providers weren’t allowed to sign up for the PDMP on their own, but required a sponsoring physician to allow them to be a delegate on their account. I thought that was unusual since those providers can prescribe controlled substances in my state as long as they have the name of their collaborating physician on the prescription, but I’m not the one who makes the rules. Several of the nurse practitioners asked me to sponsor them even though I wasn’t their collaborating physician. Apparently, the physician owners (who were the collaborating physicians for many of the midlevels) refused to sponsor them for the PDMP because they didn’t want it to create inefficiency in the workflow.

I found that approach to be short-sighted as well as non-collegial, so I agreed to sponsor a few of them who I had worked with for years and knew very well. They continued to use the system under my sponsorship until I left the practice and terminated the linkage between our accounts. It looks like their collaborating physicians still won’t sponsor them, because every two weeks I get an email from the PDMP noting that I still have open requests for sponsorship. In thinking about the fears of inefficiency, it’s likely more complex than that since the practice dispensed medications on a cash basis (including controlled substances) and was well known for making sure providers were “treating the heck out of symptoms.” Patient satisfaction was also a big push and of course it takes more time to counsel a patient about something you might find in the PDMP versus just prescribing medication. The practice also refused to install technology that would allow e-prescribing of controlled substances, so you get the picture. Attitudes like that are part of why I no longer work there, but one does still have to think about the impact of any new systems on efficiency.

An article in JAMA Health Forum addressed the topic this week, with findings that having a PDMP that’s integrated with the EHR led to increased use of prescribing recommendations by primary care clinicians. It shouldn’t be surprising to anyone that if you have a solution that makes it easy to do the right thing, people will be more likely to actually do the right thing. The researchers looked at 43 clinics and how they used the Minnesota PDMP. There were 21 clinics that had the PDMP integrated with the EHR, which reduced the need for a separate login to the outside system while also lowering the need to intentionally think about using the PDMP.

Monthly query rates for the non-integrated sites were 6.6 per clinician before the intervention versus 6.9 after. Monthly query rates for the integrated sites were 8.8 before the intervention and 14.8 after. Additionally, the findings showed a greater impact of the EHR integration on less-experienced clinicians, which they noted “may reflect a less inflexible practice style and/or faster uptake of new features in the EHR.” While the study was underway, Minnesota initiated a mandate that clinicians query the PDMP before prescribing opioid drugs, which led to an uptick in query counts in both groups, although that increase was more significant for prescribers in the intervention group.

There are several potential limitations to the study, including the fact that it didn’t directly assess opioid prescribing. The study was also limited to a single health system and its affiliated prescribers within a limited geographic range, although there was inclusion of urban, suburban, and rural areas. The study also could not identify whether queries were clinically appropriate or not or whether the PDMP queries led to providers deciding to not prescribe controlled substances when they otherwise might have. The authors do plan to look at this in a further analysis using information from the EHR.

I do hope that those who are trying to increase the adoption of EHR-integrated solutions use information like this to show that they can have a positive impact on provider workflow. They can also have a significant impact on patient outcomes when it comes to identifying patients who might benefit from an intervention with regard to controlled substances. I’m interested to see what results other organizations may have had with EHR integration and how their clinicians responded to it.

Have you integrated your state’s PDMP with your EHR? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 6/13/22

Boulder Care raises $36M to grow telehealth platform to treat opioid addiction

Substance use disorder telemedicine startup Boulder Care raises $36 million in a Series B round that brings its total funding to $50 million.

Cognosante Awarded Contract to Modernize Pennsylvania Patient and Provider Network

The Pennsylvania Department of Human Services awards Cognosante a $16 million contract to migrate the state’s Patient and Provider Network and Public Health Gateway to a new HIE platform.

IBM CEO explains why he offloaded Watson Health: Not enough domain expertise

IBM Chairman and CEO Arvind Krishna says the company sold Watson Health to Francisco Partners for $1 billion in January because IBM just didn’t have the domain expertise to keep the product viable in healthcare.

Monday Morning Update 6/13/22

Top News

Oracle Executive Chairman and CTO Larry Ellison says in a Cerner acquisition update that hospital EHRs – he names Cerner, Epic, and Allscripts – fragment records across providers because each hospital buys and operates its own, preventing providers from accessing a patient’s records in an emergency and limiting the value to public health researchers.

Ellison says Oracle will create a national EHR database that is continuously updated via updates from provider EHRs. Providers will be able to access identifiable information if authorized by the patient, while public health researchers would be limited to a de-identified view.

Ellison says Millennium will be significantly enhanced with voice UI, AI models, and automated clinical management. He mentioned the oncology decision support work of Project Ronin, of which Ellison is a co-founder.

Much of the presentation touted Oracle’s other healthcare offerings, such as ERP, workforce management, clinical trials, and cloud services.

Cerner will operate under the name Oracle Cerner, according to several references in the presentation.

HIStalk Announcements and Requests

Poll respondents are evenly split about feeling welcome and appreciated when contacting their preferred hospital. One commenter says the hospital person always reads the appropriate script even though it’s clear their main job is as a goalie to keep people from talking to someone who could answer questions. ServiceWithaSnarl says that the academic medical center where they work as a physician faculty member at least gives everyone equally horrible service, physician or not.

New poll to your right or here: How often do you read or send work-related email and messages on evenings and weekends?

Webinars

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

Acquisitions, Funding, Business, and Stock

IBM Chairman and CEO Arvind Krishna tells attendees at a stock market analyst conference that the company sold Watson Health to Francisco Partners for $1 billion in January because IBM just didn’t have the domain expertise to keep the product viable in healthcare. The company is now focused on developing Watson’s AI capabilities for automated order-taking at fast-food chains and IT operational efficiencies.

Sales

• The Pennsylvania Department of Human Services awards Cognosante a $16 million contract to migrate the state’s Patient and Provider Network and Public Health Gateway to a new HIE platform the company will also help to develop.

People

First Databank hires Any Comeau (Greensea Systems) as SVP of sales and marketing.

Mobile Heartbeat names Annabaker Garber, RN, PhD chief clinical officer.

Matthew Grose (Optum) joins Ōmcare as CTO.

Thomas Bartiromo (Children’s Hospital of Philadelphia) joins Tower Health (PA) as VP/CTO.

Doctivity promotes Cathryn Connolley-Kluck to president and Haili Coombe to VP of client engagement and software product innovation.

Announcements and Implementations

Carilion Clinic (VA) integrates TytoCare’s telemedicine software and devices into its virtual care program.

Other

In Canada, Hamilton Health Sciences employees celebrate the seven-hospital system’s Epic go-live.

A recent study from Net Health company Focus on Therapeutic Outcomes finds that 82% of physical therapy patients with low back pain who received rehabilitation via telemedicine during the pandemic were very satisfied with their treatment results. Outcomes were found to be equally effective and visits as efficient as in-office appointments.

Sponsor Updates

• EVisit wins a silver Digital Health Award in the connected digital health: telehealth/RPM category.
• Black Book Research announces that Netsmart has earned the 2022 award for highest customer satisfaction in its annual client experience performance ratings for enterprise behavioral health EHR vendors.
• Everbridge joins the AWS Independent Software Vendor Accelerate program.
• FDB names Patrick Mulry customer success manager.
• Nordic posts a video titled “The Impact of Cloud on Patient Care.”
• Healthwise wins a merit Digital Health Award in the digital health media/publications: video category.
• Imprivata wins three awards from Cyber Defense Magazine in the categories of most comprehensive identity and access management, next gen identity security, and market leader privileged access management.
• The Empowered Patient Podcast features Medicomp Systems CEO Dave Lareau.
• NTT Data publishes a new case study showcasing how its solutions have improved Independent Health’s IT experience for employees and transforms its infrastructure services.
• Symplr partners with human resources analytics company Visier to develop healthcare workforce analytics to help organizations more effectively recruit, hire, and retain staff.

Blog Posts

• The Value of Hybrid Care for Emergency Departments and EMS (EVisit)
• Using digital patient payment solutions to expedite healthcare collections (Experian Health)
• Navigators: The Human Heart of Virtual Care Navigation (Get Well)
• Save Your Top AP Talent from Back-office Burnout (GHX)
• A “Neutral Zone” for Data Sharing Allows Researchers to Share Data for Drug Discovery While Remaining HIPAA-compliant, Preventing Data Leaks (Healthcare Triangle)
• Keys to a Successful Chart Abstraction Project (Healthcare IT Leaders)
• Is your hospital unwittingly making these healthcare downtime mistakes? (Interbit Data)
• How Collaborative IT Can Unlock Collaborative Care (InterSystems)
• Interpreting clinical terminology with NLP (Intelligent Medical Objects)
• What Rural Hospitals Can Do About Denial Management Right Now (Medhost)
• 9 questions to ask your EHR vendor (Meditech)
• Understanding Work Conditioning vs. Work Hardening in PT (MWTherapy)
• 5 Content Marketing Strategies for your Rehab Therapy Website (Net Health)
• Our Mission Together: Healthcare and Digital Transformation in the UK (Nordic)

Contacts

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

Morning Headlines 6/10/22

Oracle’s Ellison Pitches US Health Database With Power of Cerner

Oracle board chairman and CTO Larry Ellison shares the company’s plans for newly-acquired Cerner including developing a national system of anonymized digital health records and updating Millenium with voice interface, more telehealth features, and disease-based AI models.

Northside Hospital fined more than $1 million for failing to publish medical prices

CMS issues the first civil money penalties against hospitals that failed to comply with federal price transparency laws, with Georgia’s Northside Hospital system fined more than $1 million.

H1 secures an extension on its Series C to further its mission of creating a healthier future through the use of connected and accessible healthcare data

Clinical, scientific, and research data company H1 adds funding to its Series C investment, bringing the round’s total to $123 million.

News 6/10/22

Top News

CMS issues the first civil money penalties against hospitals that failed to comply with federal price transparency laws.

Northside Hospital Atlanta will pay $883,000, while Northside Hospital Cherokee will pay $214,000.

CMS says that Northside Hospital Atlanta ignored its warning notice and argued that the best way for patients to obtain pricing information is to use its Price Estimate telephone line.

Northside Hospital Cherokee also ignored CMS’s warning and also intentionally removed previously posted pricing files from its website.

HIStalk Announcements and Requests

I’ve been miserably ill for five days with COVID symptoms that may not actually be COVID since antigen tests and PCR were negative. I have extreme fatigue, a temperature and cough, muscle weakness, reduced visual acuity, and brain fog. I’m sure I’ve made mistakes, so bear with me.

Webinars

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

Acquisitions, Funding, Business, and Stock

The acquisition of Nordic Consulting Partners by Accrete Health Partners reportedly cost $400 million.

Providence-owned Tegria combines six of its legacy companies to form Advata, which will focus on improving patient outcomes using advanced analytics.

People

Amwell hires Carrie Nelson, MD, MS (Advocate Aurora Health) as chief medical officer.

Surescripts names Frank Harvey, MBA (ATLS Investments) as CEO.

Julie Haluska, MPA (AllianceOne) joins HealthRecon Connect as VP of enterprise sales.

Sponsor Updates

• PatientBond publishes a new case study, “Improving Patient Satisfaction Rates for Specialty Pharmacy.”
• Pivot Point Consulting promotes Matt Curtin to managing director, enterprise client solutions.
• Symplr embeds Visier’s people analytics capabilities in its recruiting solution to support deeper insights into people management and decision-making.
• Nordic publishes a video titled “Considerations for successful EHR extensions.”
• Quil Health CEO Carina Edwards will keynote at the virtual Connected Health Summit June 16.

Blog Posts

• Making the Case for a Digital Revolution in Market Access (OptimizeRx)
• Financial Health: How to Thrive in Healthcare’s Changing Landscape (Premier)
• Driving Departmental ROI (Protenus)
• What is call center software and how does it work? (Talkdesk)
• Enabling Hospital Personnel through ServiceNow’s Powerful Access Catalog (Optimum Healthcare IT)
• How to decrease patient no-show appointments (TigerConnect)
• New eBook: Simplify Your Revenue Cycle Workflow Through Automation (RCxRules)
• 4 Private Practice Management Mistakes and How to Fix Them (WebPT)
• Evaluating Patient Communication Solutions – Realistic Timelines (Well Health)

Contacts

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

EPtalk by Dr. Jayne 6/9/22

Since there have been so many dramatic changes to many workplaces over the last two years, many companies are re-evaluating the meaning of the workweek. I always keep my eye out for articles on this topic, as well as literature from other countries where work-life balance seems to be much higher priority than it is in the US. There have been several writeups this week about a move in the United Kingdom for large numbers of workers to adopt a four-day work week. There are 3.000 workers taking part in a six-month project to assess whether shortening the work week will alter productivity, employee turnover, company revenue, and more.

The article mentions strategies different companies have taken in trying to alter the work week, including streamlining meetings and reducing inefficiencies. Kickstarter, which is small at only 90 employees, has given them Fridays off. I know of quite a few larger companies that don’t necessarily give people Friday off, but instead offer “Focus Fridays” and other themes where employees are supposed to have uninterrupted work time without meetings or distractions. For employees who are self-motivated, this can be a solid strategy. One of the health systems I worked for pre-pandemic allowed employees to work remotely one day each week and I have to say it was some of the most productive time I had, because in the pre-Zoom era, there weren’t any meetings or calls.

Another strategy that I see some companies offering as a means to improve work-life balance is that of unlimited time off. In speaking with friends that work at a large tech company where this is the norm, it can be less of a benefit than advertised, since workers who aren’t accustomed to tracking time off may not take full advantage of the paid time off that they might have received under a more traditional system. Although when these programs were initially rolled out, there was a lot of concern about people abusing it, many companies find that workers actually spend less time away from the office. I’ve worked with plenty of people over the years who only took days off when they were “forced” to in order to get the days off the books.

Other groups are offering dedicated days where employees are supposed to focus on self-care. Advocate Aurora Health is one of those, offering “renewal days” where employees are supposed to meet together for support. I found it interesting that their original program was a three-day workshop designed to focus on finding meaning in work while building skills to combat burnout, stress, and compassion fatigue but it has since been compressed into a single-day program. That seems such a parallel to everything that has happened since January 2020, where most healthcare workers are expected to do more with less even in the face of previously unheard-of stressors. I still hear about plenty of healthcare organizations that are trying to combat serious organizational issues through the application of pizza lunches and therapy dogs so I’m not sure we’re making much progress.

The University of Missouri launches a telehealth program to train rural primary care physicians in the use of Canvas Dx with the goal of supporting autism diagnoses. The tool, from Cognoa, will be added to the platform used by the University of Missouri ECHO Autism Communities Research Team. The group will explore the time it takes from a physician’s initial concern that Autism may be a factor to a diagnostic determination via Canvas Dx. Earlier diagnoses should lead to earlier interventions and hopefully better outcomes for patients and families. The study plans to recruit up to 15 clinicians to evaluate as many as 100 children at risk for autism spectrum disorder or developmental delay. As a side note: has anyone ever noticed that the MU logo contains a mule? I don’t know how many times I’ve seen the logo but never the mule.

US Representatives Madeleine Dean (Pennsylvania) and Larry Bucshon (Indiana) introduced a bill this week that aims to protect healthcare workers from violence. It is modeled after existing protections created for airline and airport workers. The Safety from Violence for Healthcare Employees (SAVE) Act would make assault or intimidation of hospital employees a crime. Representative Bucshon is a physician, so I’m disappointed that the bill appears to focus on hospital workers and not on the tens of thousands of healthcare workers in other locations where they might be even more vulnerable, including ambulatory offices and home care. Workers in those locations don’t have anywhere near the level of security or assistance found in the average hospital. As a healthcare worker who was left out of vaccine allocations because I didn’t work for a hospital (despite delivering a high volume of COVID care) it looks like we haven’t learned and will continue to propose short-sighted policies.

One of my healthcare providers recently notified me of a data breach that may have exposed my personal health information. According to the documentation, the organization learned that an “unauthorized person” gained access to a subset of employee email accounts over a more than three-week period. Investigators were not able to determine whether emails or attachments were actually viewed, but the emails included data on both patients and research subjects including names, birth dates, addresses, medical records, insurance information, Social Security numbers, and more. It’s not clear now many patients have been impacted but they promise to reinforce training on avoiding suspicious emails and to make enhancements to email security, so it seems obvious to me how the breach occurred. Depending on what data might have been exposed, some patients will receive credit monitoring and identity protection services. Regardless, it’s going to be unnerving for many of us for a long time to come. At this point I get a breach notification every year or two, so it seems there is a lot of opportunity for improvement among the various members of my healthcare team.

Judging from my social media feeds, many people are taking advantage of what they perceive to be a “normal” travel season. I’ve seen plenty of pictures from amazing places, but my own summer will be a little low key this year. I’m juggling some big projects and a go live, so I’ll only be occasionally off the grid. It just gives me more time though to plan the next big adventure.

What are your summer travel plans, or are you going the staycation route? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 6/9/22

Bon Secours bags Nordic Consulting Partners in $400M-plus deal

Sources report that Accrete Health Partners’ acquisition of Nordic Consulting, first announced last week, is valued at just over $400 million.

Arnot Health says technical issues resolved

Arnot Health (NY) resolves computer hardware issues that first surfaced in early May, leading to weeks of outages.

Data breach at health care organization may affect 2 million

Imaging and ambulatory surgical services provider Shields Health Care Group reports a March data breach that may impact 2 million patients.

Morning Headlines 6/8/22

Oracle Completes Acquisition of Cerner

Oracle has closed its deal to acquire Cerner for $28 billion.

Introducing Advata, a Software Company Improving Patient Outcomes Through Advanced Analytics

Providence-backed Advata launches as an RCM analytics and clinical decision support software company leveraging integrated solutions from KenSci, Colburn Hill Group, Alphalytics, Lumedic, Quiviq, and MultiScale.

Virtual addiction startup Bicycle Health rides Series B to $83M

Virtual opioid use disorder treatment provider Bicycle Health raises $50 million in a Series B funding round, bringing its total raised to $83 million.

News 6/8/22

Top News

Oracle shares see a slight uptick on the news that the company has closed its deal to acquire Cerner for $28 billion.

Webinars

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

Acquisitions, Funding, Business, and Stock

Bain Capital has acquired a majority stake in LeanTaaS, a technology vendor specializing in hospital operations and capacity management optimization. The company, founded by CEO Mohan Giridharadas in 2010, has raised nearly $238 million. Its cloud-based software is used by over 500 hospitals and 130 health systems.

People

Lyniate promotes Scott Galbari to president, COO, and CISO; and hires Mikael Andén (Intelerad Medical Systems) as EVP of sales.

Surescripts names Frank Harvey (ATLS Investments) CEO. Harvey succeeds Tom Skelton, who announced his intent to retire late last year.

Mark Costanza (Spok) joins MobileSmith as chief client and operations officer.

Announcements and Implementations

Stanford Health Care (CA) implements interactive bedside patient entertainment and hospital services technology from Sonifi Health.

Great Falls Clinic (MT) has implemented Phreesia’s patient intake technology.

LeadingReach announces GA of care coordination analytics.

Medical Center Health System (TX) rolls out a patient portal app incorporating EHR technology from Cerner and video visit capabilities from Amwell.

Government and Politics

After more than a year of training, Martin Army Community Hospital at Fort Benning in Georgia will go live on MHS Genesis this weekend.

A new report from the Australian Digital Health Agency finds that routine patient visit information is still missing from many health records within the national My Health Record system, launched in 2012 with a price tag of over $1.4 billion. Patient use has also been wanting, with just 2.69 million out of the nation’s 23 million patients accessing their information since the system’s launch. Physicians have found the software’s design to be problematic, with many preferring to instead access patient data via their hospital’s EHR.

Plans to implement a Cerner-based EHR across facilities on Prince Edward Island have come to a halt due to usability issues. The province had hoped to have all sites live by 2020. Forty-three clinics and 118 physicians have been connected to the system, with 100 more clinicians still to go. The same software has been in use at Island Health hospitals for over a decade. Two independent reviews of that $178 million implementation have been conducted based on physician complaints of poor usability and patient safety risks.

The State of Wisconsin eliminates EHR integration fees to encourage more providers to connect to its electronic prescription drug monitoring program.

Other

The latest release of the Philips Capsule Surveillance solution has received 510(k) market clearance from the FDA.

UT Southwestern Medical Center researchers have found that access to telemedicine visits and continuous glucose monitoring during the pandemic helped diabetic pediatric patients control their glucose levels and stay out of the hospital at rates similar to pre-pandemic levels.

Apple adds medication list creation, reminders, and critical interaction alert features in its latest iOS update.

A small study conducted at a stroke clinic within the UC San Diego Health system has found that patient satisfaction with telemedicine visits improved when patients were texted a log-in link when the physician was ready for the appointment, rather than queuing in a virtual waiting room. Over half of patients were seen early during the two and a half month study, while zero were seen late, resulting in time savings of nearly an hour. As a result, the health system is rolling out the text messaging option to high-volume primary care and surgical care clinics this summer. The text-to-video technology was developed by Doximity.

Sponsor Updates

• AGS Health will exhibit at CHIACON22 Convention & Exhibit June 12-15 in Riverside, CA.
• Baker Tilly publishes a new case study, “Product value communication results in new payer coverage for diagnostic testing coverage.”
• Cerner publishes a new client achievement story, “Clinicians at pediatric health system save charting time following ambulatory optimization.”
• CHIME releases a new CHIMEcast Podcast, “Challenge, Change, and Resilience with Michael Jefferies.”
• Clearwater names Mike Scheerhorn (Everly Health) to its compliance and privacy consulting team.
• Current Health has been named the 2022 Frost & Sullivan Company of the Year in the global virtual home care platform industry.
• CarePort adds predictive analytics for post-acute care planning after discharge to its CareManagement and Insight solutions.
• Patient privacy monitoring company Protenus updates its website.
• OptimizeRx completes integration of TelaRep’s one-click prescriber connectivity solution with its Therapy Initiation and Persistence Platform.
• Diameter Health partners with Smile CDR, giving customers the ability to implement Diameter Health’s Fusion technology for upcycling data along with Smile CDR’s clinical data repository capabilities.

Blog Posts

• Value-based Care Can Be More Than a Buzzword: Thoughts on Health Plan Priorities (Diameter Health)
• What Will the Future of Healthcare Look Like? (Experity)
• Recent HIPAA Breaches: How to Avoid an Email Breach & Secure Your Practice (AdvancedMD)
• Where Interoperability is Succeeding in Healthcare (Arcadia)
• Leveraging Care Coordination for Success Under the CMS Kidney Care Choices Model (Bamboo Health)
• Physician opinion: Quality metrics fail to measure improved outcomes (Bravado Health)
• Health Literacy and the Patient Portal: Start Assessing Your Community and Facility (CereCore)
• Why Nurses Are Joining the Great Resignation and What Can Be Done (ConnectiveRx)
• Navigate Common EHR Challenges with Stewardship from an Experienced Partner (CTG)

Contacts

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

Morning Headlines 6/7/22

Aledade Raises $123 Million Series E to Accelerate Growth in Medicare Advantage and Support Primary Care Physicians With Expanded Services

Tech-enabled practice management company Aledade secures $123 million in Series E funding, bringing its total raised to nearly $420 million.

LeanTaaS Announces Growth Investment by Bain Capital Private Equity to Fuel Leading AI-Driven Platform for Hospitals to Achieve Operational Excellence

Bain Capital has acquired a majority stake in LeanTaaS, a software vendor specializing in hospital operations and capacity management optimization.

Minneapolis women’s telehealth clinic Visana Health raises $2.6 million

Virtual women’s healthcare company Visana Health raises $2.6 million in a seed funding round.