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Morning Headlines 2/24/22

February 23, 2022 Headlines Comments Off on Morning Headlines 2/24/22

Minded, a telehealth platform specializing in managing mental health medication, raises $25M

Medication-based mental health telemedicine startup Minded raises $25 million in a Series A funding round that the company will use to expand beyond the seven states it currently serves.

Omada Health Closes $192 Million Series E Financing to Bring Virtual-First Care to Millions

Omada Health, a virtual chronic care management company, raises $192 million in a Series E funding round, bringing its total raised to nearly $450 million.

OhMD Closes Latest Round of Financing, Led by FCA Venture Partners

Patient engagement and text-based patient-to-provider messaging vendor OhMD secures financing in a funding round led by FCA Venture Partners.

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HIStalk Interviews Patty Hayward, VP, Talkdesk

February 23, 2022 Interviews Comments Off on HIStalk Interviews Patty Hayward, VP, Talkdesk

Patty Hayward, MA is VP of strategy, healthcare and life sciences, of Talkdesk of San Francisco, CA.

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Tell me about yourself and the company.

I’ve been in healthcare IT for the past 25 years. I’ve worked with several organizations to transform processes and procedures in areas such as medication safety and revenue cycle. I worked at Aetna, helping with the first ACOs. I’ve had a lot of stints in population health. Now I’m working with patient experience.

Talkdesk has been around for 10 years. It offers the first cloud-native contact center as a service. It was born out of a hackathon from Twilio. There was a niche in the market that needed to be worked on. The company has kept over 50% of its employees based in product and R&D, which is a huge commitment to innovation, looking at how we can transform and disrupt different areas.

About a year and a half ago, the decision was made to look at specific verticals, with healthcare being the first. That’s when they brought me and other folks on board. For us, it’s all about how to reimagine that patient experience, reduce friction, and help providers offer a different experience than is typical. We want to make sure that it is synchronized across multiple channels and is personalized and convenient.

How do large health systems tailor their digital health strategies in the face of potential competition, but while operating at capacity and with record profits?

Interesting and unique forces are definitely in play. There’s a lot of change in the market. Large retailers are jumping into the market, bringing their experiences to target areas such as primary care, population health, and chronic disease management. That’s going to give them a lot of ability to steer. Whoever you’re dealing with most — your primary care doc or someone who is working with you to manage your chronic disease — is who you will listen to on where you go. Younger generations are interested in different ways of doing business and thinking about healthcare in a different way. Record profits make it attractive for people to jump in, and you are seeing that.

Amazon has the luxury of catering to a self-selected customer base that is comfortable with an online-only relationship. Do providers have a different challenge in accommodating people who may prefer interacting in person or via telephone?

You are seeing this a lot with Medicare Advantage plans. They are obviously targeting the senior population, but they are tech savvy and tech forward in their approach and are using it in a smart way. They are giving a lot of choice and a lot of opportunity to utilize technology selectively, but also using care guides to guide folks through the system, which is much needed when you think about chronic disease patients in the Medicare population. It is difficult to navigate. They are allowing their members to come to them as they can, or as they would like to, whether that’s via voice or via technology. They are also using technology to make their agents efficient. So there are multiple ways to look at technology and how to implement it. It doesn’t have to be patient- or member-facing.

How are health systems using their contact centers differently?

Health systems are starting to look at their contact center as a strategic asset versus just the cost center it was in the past. It is the front door, typically the first touch that a patient has with their organization. We went the NGPX patient experience conference at the beginning of December and one of the things that struck me was that about 95% of the presentations were on HCAHPS scores. Those are acute focused, inside, did we do these certain things. When I had conversations with a lot of folks, the Mayo of course jumped out and started talking about patient experience in a very different way. They still do HCAHPS, because you have to, but they have jumped over to using Net Promoter Score as a measure of patient satisfaction. That’s unusual in the space.

People are starting to think differently about how they can transform to “how did we make you feel” versus “did we do the right things all the time.” A lot of forward-thinking folks are looking at how to do this differently. You are also seeing CMS start to push member experience as a huge piece of how they reimburse, making that one of the biggest metrics that they are using for star rating.

Providers used then-modern technology such as PBX systems or online contact forms to prevent people who needed help from easily accessing their employees. How are they thinking differently about tailoring communications using someone’s preferred method and personalizing the message?

People are talking about things like digital front door. Health systems, especially those that take risk or have their own plans, want more interaction with their patients in the right way. Being able to do things like send a text reminder that is interactive versus “say yes to confirm or no to cancel.” They want to keep that revenue stream going, because if you miss an appointment, that’s money out the door. They want to continue to have those record profits. There are a lot of ways that you can work through that whole aspect.

During COVID, the volumes that hit their switchboards were unmanageable. I talked to several health systems whose entire phone systems were taken down by the volume. People quickly automated as much as possible, standing up IVRs to give automated answers to quick questions, offering chats, and adding FAQs to their websites. Taking simple things that could be easily answered by automation off their switchboards to give their agents time to answer questions and have good interactions.

Forward-thinking ones are looking at the disruptors that are coming into the space and taking patients off of their books. How can we keep up with them? Amazon Care is going after employers, not necessarily patients themselves. Hilton was their first big one. There’s some big innovation in not only the care that is given, but in how they get patients on their rosters.

Most businesses assign a single customer identity and a defined way to interact with them. How well do health systems coordinate the many reasons they might be communicating with someone – clinical care, marketing, reminders, population health, billing – and give their employees a single view into every one of those communications?

The key is integrating with the system of record. If it’s the EHR, you want to make sure that you’ve got a connection to make the API callout so you can see snippets. You aren’t trying to duplicate the EHR – you want the highlights of things that are of interest. We are completely customizable, so we can build that to the experience that you would like. You may have different groups that need different visions. Someone who is in revenue cycle and billing wants a different look than those who work in patient access or care management.

You would want to be able to see if they started it off with a chat. You would authenticate to have a real conversation, be able to see who they are, and be able to do things like patient scheduling. Then if it is escalated, to be able to bring all of that information to that agent’s workspace so that they can see what’s happening and they don’t have to listen all over again. You see that in other verticals, where when people call in, they start with a discussion with an AI agent and then escalate to a human who says, “Give me a minute to get caught up on what you’ve said.” That’s an important aspect that we don’t tend to have in healthcare as much. It’s important to have that integration into the EHR.

Patient portals used to be viewed as consumer-unfriendly, but suddenly they are the well-received launching point for most interactions with patients. How do they fit into the ideal consumer experience?

Patient portals are not going to be real time. I just had my annual physical and it took a week to get a response from my physician. The patient portal can automate things that make sense for patients to do when they are on their computer, such as scheduling appointments, rescheduling, paying their bill, things like that. But a lot of times, people are on their smartphone and want to be able to start a conversation using the chatbot in the corner of the web page.  

Ideally, it’s all tied together and you can see the history. If there’s an interaction that’s recent, you want to be able to pull that in, create intents, and use AI to determine that the person is calling in because they’ve asked their question three times. You should see that as you’re answering the phone call. It’s important to be able to synchronize all these things, which typically doesn’t happen today. You call in and they have no vision into what you’ve been doing. I’ve been with my primary care provider for 19 years and it’s like I’m brand new every time I call.

Providers used to just hang out a shingle and people lined up, so nobody worked too hard to attract new patients. How are chief digital officers or chief experience officers who come in from other industries working with health systems who aren’t used to having to be consumer-friendly?

They are bringing in all sorts of people for these roles. It’s not just folks who are traditional healthcare. You have people coming in from Disney, Best Buy, the retail sector, and the entertainment sector with a viewpoint of what it could look like. They are bringing a different and unique lens to how you can capture more of the populations and become a destination place where people want to go. Mayo Clinic can dictate the kind of patients it wants, and other systems are, like you said, taking the approach that their shingle is out and people are coming.

Disruptors that are coming into the space are going to peel off those more valuable individuals, those who have more money to spend, and offer additional services that they are willing to pay for. If you look at that Amazon Care video, it’s pretty cool to be able to have a virtual visit, and if they can’t solve it on videoconference, they will send someone to your house or your place of work and then deliver your medications in two hours. There’s this full circle of care that can happen that makes it convenient and easy for you to seek the care you need.

Otherwise, folks will avoid doing that and then end up in a worse position or in the ER, which may be profitable if the ER isn’t taking risk. But if they are taking risk, all of a sudden the cost situation flips. That’s where the change is. Fee-for-service loves that ED visit, but with fee-for-value where you take on risk of the population, it’s a different discussion. We are seeing a lot of push towards fee-for-value. It has been going on for over a decade, but we are seeing more folks jumping in and offering different opportunities to grab onto that fee-for-value area and show value back to the government or to employers who are paying the bill.

What developments will we see with the company and industry in the next few years?

You will see AI take a bigger role, both in the things that are easy to automate and those that are not. It will take a huge role in helping the agents with their work, so that information is easily accessible and correct so that you can get it done quickly the first time. Agents will be able to spend more time and emphasis on that empathetic journey that you would like to show to your patients, at least those organizations that do it well.

You’re going to see a lot more emphasis on providing what in retail they call a delightful journey. Not too many people would call healthcare’s journey delightful. You typically come there stressed out and having a lot of interactions, so being able to deliver an experience like that is important. As we get folks to take care of themselves in the way that is prescribed, how do we activate the patient? How do we get them to think about how to take care of themselves and make the right choices? All of that will start to come together. Smart watches, devices, and different areas will allow you to get a lot more help and a lot more ability to, when you want, get guidance in real time.

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Morning Headlines 2/23/22

February 22, 2022 Headlines Comments Off on Morning Headlines 2/23/22

Cerner Reports Fourth Quarter and Full Year 2021 Results

Cerner, whose acquisition by Oracle remains on track for sometime this year, announces Q4 results: revenue up 4%, adjusted EPS $0.93 versus $0.78.

WellSky® to Acquire TapCloud to Bolster Patient Engagement Technology That Improves the Patient Experience and Lowers Costs

WellSky will acquire TapCloud, whose patient engagement platform collects a one-minute check-in that asks about symptoms, concerns, and available support.

Health Catalyst Announces Intent to Acquire KPI Ninja

Health Catalyst will acquire KPI Ninja, which offers interoperability solutions and population health analytics.

Clinical Data Release Leader MRO Announces Acquisition of MediCopy

Release of information solutions vendor MRO acquires competitor MediCopy.

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News 2/23/22

February 22, 2022 News 1 Comment

Top News

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WellSky will acquire TapCloud, whose patient engagement platform collects a one-minute check-in that asks about their symptoms, concerns, and available support.

WellSky says the patient-generated data will expand its dataset to support the development of care models that predict patient risk factors for deploying interventions.


HIStalk Announcements and Requests

Should we be talking about ICD-11, which is being used in 35 countries?


Webinars

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


Acquisitions, Funding, Business, and Stock

Health Catalyst will acquire KPI Ninja, which offers interoperability solutions and population health analytics.

HealthStream announces Q4 results: revenue up 4%, EPS –$0.01 versus $0.03, beating expectations for both. HSTM shares are up 3% in the past 12 months versus the Nasdaq’s 4% loss, valuing the company at $630 million.

Release of information solutions vendor MRO acquires competitor MediCopy.

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Cerner announces Q4 results: revenue up 4%, adjusted EPS $0.93 versus $0.78. The company’s acquisition for $95 per share by Oracle remains on track for sometime in 2022. Shares closed Tuesday before the announcement at $91.83.


People

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Nicole Rogas, MBA (Experian Health) joins Symplr as president.

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Brian Silverstein, MD (The Chartis Group) joins Innovaccer as chief population health officer.

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Global health pioneer, humanitarian, author, professor, and anthropologist Paul Farmer, MD, PhD died Monday at the university and hospital he had established in Rwanda. He was 62. The non-profit group he co-founded, Partners in Health, was an early proponent of considering social determinants of health, questioning why people were being treated for diseases and then returned to the same circumstances that had helped cause them.


Announcements and Implementations

A top pharmaceutical company deploys OptimizeRx’s digital therapy initiation workflow to streamline patient therapy initiation challenges.

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DCH Health System (AL) implements real-time patient admission and discharge notification technology from Secure Exchange Solutions.

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Windom Area Health (MN) rolls out telemedicine services from TeleHealth Solution for after-hours care.

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Veriff announces GA of identity verification solutions for the healthcare industry that include digital health record protection, automated intake, and secure telemedicine and prescription delivery.


Government and Politics

NIH will require researchers to include a data management and sharing plan in their grant requests, which must include the software or tools that were used to analyze the data and a plan for publishing the data publicly. Information from failed or unpublished studies must also be published to potentially help other researchers. An estimated $10 to $50 billion is spent on US research whose data methods are insufficient, with most of the money coming from federal taxpayers. Experts note that most labs and institutions don’t have data managers and are likely to push the task onto trainees and early-career investigators.

A 33-year-old resident of Pakistan is sentenced to 12 years in prison and ordered to pay $48 million in restitution for submitting fraudulent Medicare claims for 20 home health agencies he had acquired in Illinois, Indiana, Nevada, and Texas using false names. Muhammad Ateeq was also ordered to forfeit a $2.4 million cashier’s check and $1 million in cash. Medicare paid his companies $40 million for services that had not been rendered, with DOJ noting that he had control of their billing and EHR systems.


Privacy and Security

HHS’s cybersecurity office publishes a report on EHRs in healthcare, which is mostly a glossy overview of the status quo. They urge healthcare organizations to  review Remote Desktop Protocol and consider protecting it with a VPN that uses multi-factor authentication, use endpoint detection and response, and implement email tools that filter URLS and move attachments to a sandbox.


Other

Some interesting thoughts on digital health companies from investor and former Livongo CFO Lee Shapiro of  7wire Ventures, interviewed by Marissa Schlueter of OMERS Ventures:

  • Companies need a cash runway of 18-24 months to weather current market turbulence and should be prepared to describe their expected path to profitability to investors.
  • Startups need a CFO, or at least an experienced controller, by their third year to prepare for the historical documentation that investors will want to review down the road in their C and D funding rounds.
  • The market valuation of some publicly traded companies is less than the cash on their balance sheets and those could become acquirers or acquisition targets.
  • Some companies suffer from Shiny Object Syndrome in expanding in too many markets or attacking multiple go-to-market channels.
  • Companies whose revenue is less than $50 million will need to merge to attain the scale that is needed to address the challenges of health plans.
  • Virtual-only companies could merge with brick-and-mortar companies to create an omnichannel brand.
  • Shapiro recommends that investors should watch what hedge funds are doing, some of which are turning to the bargains that are available in the public market instead of private market investing.

Sponsor Updates

  • Azara Healthcare has earned Certified Data Stream status for NCQA’s Data Aggregator Validation Program.
  • Bamboo Health has joined the National Association of Mobile Integrated Healthcare Providers.
  • Clearwater publishes a new white paper, “Keeping Patient Data Secure in the Cloud.”
  • Change Healthcare releases a new podcast, “Enterprise Imaging in the Cloud: Adoption and Outlook.”
  • Enlace Health will exhibit and present at the 2022 Healthcare Bundled Payments Conference February 24-25 in Nashville.

Blog Posts


Contacts

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

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Morning Headlines 2/22/22

February 21, 2022 Headlines Comments Off on Morning Headlines 2/22/22

VillageMD Acquires Healthy Interactions, a Patient Education Platform Proven to Increase Medication Adherence for Chronic Conditions

Primary care company VillageMD acquires Healthy Interactions, a developer of digital patient education programs geared toward increasing medication adherence.

National Medical Billing Services Announces Acquisition of National Billing Partners

National Medical Billing Services, an RCM company serving ASCs and surgical practices, acquires competitor National Billing Partners.

HerMD Adds $10M in Series A Funding to Scale Its Physical Clinics and Launch Virtual Services Throughout the US

Women’s healthcare provider HerMD raises $10 million in a Series A funding round led by Jazz Venture Partners

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Curbside Consult with Dr. Jayne 2/21/22

February 21, 2022 Dr. Jayne 6 Comments

I’ve had a fair amount of work-related travel in the last few weeks and have noted the distinct lack of business travelers in the friendly skies. Others in the industry have noted the same, as companies have shifted away from in-person meetings in favor of ever-present videoconferencing software.

Airlines have been strapped for business during the pandemic and are trying to capture revenue from the pent-up demand of individuals wanting leisure and family travel. As a result, we’re seeing some overall changes in routes and schedules. We’re also seeing changes to flights after they’re already booked, which might be tolerated by leisure travelers, but which creates a mess for those of us traveling for work.

In the last week, I’ve received four flight change notifications that shift my departures or arrivals enough that I need to fly in a day early or stay a date later in order to meet the client’s meeting request. It feels like the days of being able to fly in and out of some cities on the same day are soon going to be over, if they’re not already. Even if the flight change notifications are acceptable, I’ve run into issues with airline websites not updating appropriately to allow travelers to update their Outlook calendars with the new flight information. It’s a small thing, but when you add up a number of annoyances, it definitely compounds.

With declining numbers of business travelers, the whole airline experience feels messier and more disorganized. I’ve been in several TSA PreCheck lines with people who don’t understand the process and start unpacking their laptops and liquids, which aggravates not only their fellow travelers, but the TSA agents, who seem a more aggravated than their baseline state. Boarding processes seem to take longer as people fumble with their phones and their overstuffed carry-on bags. People seem to be less attentive, probably more focused on their phones or music than on what’s happening around them.

I had to coach some newbie Southwest Airlines passengers through the fact that there aren’t any assigned seats on that carrier. Clearly, they missed the four different announcements that were made by various gate agents and flight attendants during the process and seemed upset that they didn’t have reserved seats. I’m guessing they didn’t make their own reservations since the lack of seat assignments is pretty obvious during the Southwest booking process.

I always joked about creating the all-business airline if I ever arrive at a position where I am insanely wealthy. I would pay more to fly with people who could board quickly, stow their luggage efficiently, and not act sassy to the flight crew. Being able to deplane quickly and move past the jetway exit without having to stop and adjust one’s overflowing open-top tote bag would also be a plus. After the things I’ve seen this week, I think zippers or some other mechanism of secure closure should be mandatory on all carry-on bags, but that would be asking a lot when we can’t even get people to exhibit civil behavior.

One of my flights this week almost had to go back to the gate due to a belligerent passenger who refused to wear his mask. Whether you agree with masking or not, thinking that you’re going to be able to bully a flight crew isn’t a good idea. Had we been forced to return to the gate, I think some of the passengers might have also considered taking justice into their own hands, given the number of short connections at the other end of this flight.

At least I’ve taken enough trips recently that I feel like I’ve got my travel mojo back and am back to my usual packing efficiency. I did somehow forget toothpaste on a flight earlier this month, but it was a good excuse to visit a local pharmacy and to also pick up some dark chocolate as well as the necessities. The workplaces I’ve visited are significantly more casual than they were pre-pandemic, with jeans being the norm at several places where we would have received glaring looks had we worn them before.

I’m working with a couple of companies that have embraced an outdoorsy vibe and I’m hoping for longer-term engagements where hiking pants can be a permanent part of my business travel wardrobe. I’ve had to make some adjustments in how many snacks I pack for a trip, though, because airport concession offerings remain significantly limited at most of the places I’ve been. My home airport still has half its restaurants and about a third of the newsstand shops closed, and you never know what you’re going to find when you arrive somewhere you haven’t been in a while.

For me, one of the biggest adjustments of traveling has been operating exclusively on my laptop. Over the last couple of years, I’ve apparently become spoiled by the setup in my home office, which includes not only a screaming-fast PC, but monitors that make me feel like I’m working at mission control rather than in a converted spare bedroom.

When I do have to do videoconference meetings with clients while I’m traveling, it’s a trick to balance the meeting software with any materials I might need to use while still being able to see the faces of the team I’m meeting with. I keep experimenting with different approaches and maybe something will stick, although it seems to be easier to get things the way I like them with Zoom than when I have to use Teams or GoToMeeting. I’d be interested to hear what usability experts think of the various conferencing software options – there are definitely some I like better than others, and of course a couple that I’d be happy never having to use again.

For those of you who are traveling again, what are the most striking changes you’re seeing with your clients and your travel patterns? Have you come up with new hacks that make things easier? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Interviews Amihai Neiderman, CEO, Nym

February 21, 2022 Interviews Comments Off on HIStalk Interviews Amihai Neiderman, CEO, Nym

Amihai Neiderman is co-founder and CEO of Nym of New York, NY.

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Tell me about yourself and the company.

I’m an engineer by training, in computer science. I did my bachelor’s in math and computer science when I was 14. Later on, I joined the Israeli army and did mostly cyberintelligence. After I left the army, I was influenced by my wife — she’s an MD-PhD ENT surgeon – and I started Nym. We do autonomous medical coding.

How do you distinguish autonomous medical coding from computer-assisted coding?

Computer-assisted coding is a tool that helps coders, giving them suggestions on the most appropriate code to use. It doesn’t make the final decision. Our fully automated solution requires zero human intervention. We code a chart in around two to two and a half seconds on average, then submit it directly to the billing systems in our clients’ facilities without anybody having to review those charts to make sure that the coding is correct. From there, it’s usually being sent directly to the payers. We completely remove the human from the loop.

Do payers trust the system’s consistent coding more than that of humans, where human coders may not all code the same way?

That was one of the reasons that it was hard to do automated coding until now. There was this lack of trust between the payers and providers, for obvious reasons, probably. The unique approach that we took when we started Nym is language understanding into clinical intelligence, what we call today clinical language understanding.

We can generate an audit trail that gives providers an end-to-end explanation of our entire thought process. If one of our clients ever gets a denial, an audit request, or even just during the onboarding process, they can assess and understand how we’re doing our coding. They can review those audit trails. We’re not hiding anything. We’re proud to show our internal thought processes and how we ended up deciding the right codes to use.

Payers who are receiving our audit trails are starting to become more interested in learning more about our solution, because we are not hiding anything and we have full transparency into our logic. They are usually afraid of fraud, waste, and abuse. We can show on the fraud part that we have nothing fraudulent in our process. It addresses that trust issue in a very interesting way.

Do you test in parallel with the customer’s human coders during implementation to measure the impact?

Yes. We know that our clients are moving something that is business critical for them. If we make a mistake, they could be exposed to compliance risk. They could lose revenue. We do a shadowing period, where when we do side-by-side coding for 30 or 45 days, depending on the client and the complexity of the project that we’re doing with them. During this shadowing period, we will have weekly or biweekly meetings with them and let the client choose choose any charts that they wish to review. They have access to our audit trails through a dashboard.

Sometimes they understand for themselves why we code something in a different way than their coders. Sometimes they’ll want to surface it up to us for an explanation of why we coded it this way when they might have done it differently. If we need to, we reconfigure our system based on their standard operating procedures.

How often do payers ask to review the audit trails, both initially and after they become comfortable with the system’s coding?

The payers don’t have direct access to the audit trails. It’s only if our clients decide to submit the audit trails as part of their appeal process if something was denied, or for an audit process that they have with the payers. Our relationships are directly with the providers who are our clients. But we do see from some of our clients in our periodic review that there is a significant drop in denials rates. Mostly because one of the things that we’re striving for is high coding accuracy, following the guidelines to the letter. You won’t see a lot of deviations.

That’s one of the beauties of using software to do coding. It is deterministic. You’re going to get the exact same results every single time. Once you become confident that you know that the results are up to your standard, you’re going to have reproducible results every single time.

Are issues with fraud, waste, and abuse usually caused by improper coding or are the provider’s notes themselves inaccurate?

We only code charts where we are fully comfortable with our understanding of those charts. If we see ambiguity, contradictions, or missing documentation, we drop those charts and let them go through the client’s ordinary process. Coders can reach out to the physicians if they need to. We code charts only when we are 100% certain that we fully understand everything in them. If there is any missing information, or if the chart might have any issues that will lead us to have wrong coding, we will just drop them. We are not taking any risk there.

Do clients implement your system primarily for efficiency or for accuracy?

Every organization has their own reasons for using our system. Sometimes it is speed. Provider groups that take five days to a week and a half to get their charts coded now see it happen in two and a half seconds. That reduces several days from their days in AR, giving them more cash on hand to operate their business.

Sometimes organizations, especially those who have tried outsourcing, usually offshore coding, encounter compliance issues and quality issues. Running an entire operation to try to reduce the compliance risk is expensive and not usually as fruitful as they believe. They are looking for a better solution to help them from a compliance perspective. This is where we come in.

In other cases, it’s reduced cost and improving their overall revenue cycle operations. We show the client that we are not just impacting directly their coding operations, but we will do it much faster than any one coder will do and we’re going to have a reduced number of denials, meaning fewer people that have to do scrubbing and running the appealing process. We affect the entire revenue cycle process downstream from us on the coding side.

Companies, including Google, are using natural language processing to support searching electronic charts and extracting data from free text notes. Will Nym use its experience in extracting chart information to extend beyond billing functions?

Definitely. When we started the company, we took a whole different approach into language understanding. What you see most of the bigger companies doing, almost all of them actually across the board, is using language models or AI solutions that weren’t tailored for healthcare, which has its own unique needs and problems. You gave Google as an example. They have an AI solution that solves their issues for search for understanding websites or news articles, but it’s not necessarily tailored for healthcare.

We built our own. We take a lot of pride in this. We built our own AI stack for language understanding, for clinical language understanding, and for coding that is specific for the healthcare domain. We’re a great coding company, but what we are really good at is capturing clinical narrative. Capturing the true clinical picture of what happened to a patient. Once you understand this, coding is a relatively easy thing to do. Because we built this strong technology and invested a lot of time in doing this, we can expand to other product lines or areas, using this technology to power new products.

Why does Israel produce so many successful entrepreneurs?

The vast majority come from a couple of well-known intelligence units in the army. One is the unit I served in, called 8200. It’s not the army that people envision or what they’ve seen in a movie. You get a lot of responsibility at the age of 18. You can become an officer when you’re 20, commanding soldiers and being tasked with some of the most complex things that could change the course of our history. They encourage you to do whatever it takes. 

There’s a mandatory army service, so people get replaced all the time. You come in, do your three years of service or four or five if you extend it. New ideas are being surfaced all the time. People come in and challenge what people have done before them. You have a huge number of new ideas coming all the time and people are energized to try them. I was lucky enough to serve in a place where I was constantly asked to innovate and was given the backing of my commanders to do it.

What parts of your background have been most relevant to being an entrepreneur? What do you find most challenging?

I was doing cryptoanalysis in the army. When we started the company, we knew that we were going to tackle a challenging problem that some of the largest healthcare key companies have tried and failed to solve for the better part of the last 20 years. We needed some of the best problem solvers in the world to work with us, so a lot of our R&D folks are people who we knew back from the army. My co-founder Adam Rimon and I both served in the cryptoanalysis department, which was a good place to find great problem solvers. That has helped us with the early work of trying to prove that the unique approaches that we took to solve the problem could actually work. We had the right people to do this.

The challenge is that the army doesn’t teach you how to manage a company. The army has a very different management style than what you’ll see anywhere else. I felt pretty relaxed because of the nature of the business that we were doing back there, but it’s still not very similar to what you’ll see in a company. We had to learn a few things the hard way, but we try to fail fast, learn from it, and not repeat the same mistakes again. As long as we have a smart team that can follow the same kind of principle, then it’s OK make mistakes. 

We just run, run quickly. We try to learn as fast as we can. One thing that we want to bring into the company and to the healthcare space is rapid prototyping. See if something works. If it doesn’t, you throw it away. If it does, great, you iterate over it and it creates value almost from Day 1 of the company.

Where do you see the company going in the next few years?

We are building great business in the coding space. The quality of our product and our results speak for themselves. We get our clients just from word of mouth, and our clients are highly referenceable. It sometimes amazes me that we are coding several million charts per year. We have three coders right now on the team who are serving as subject matter experts, but are not doing the coding itself. We are building a great coding company, bringing in work, adding to the client base, and expanding our footprint. We are going to be the top coding company in that area.

While we are doing this, we are also maturing our core technology. Our CLU engine gets better all the time. The more clients that we’re seeing, the more edge cases that we’re seeing, the better it gets and the smarter it gets. This allows us to take this unique core technology that we built and apply it in other areas that we’re still exploring. Coding is interesting because it sits between the clinical side and the revenue cycle side. We have the opportunity to influence the clinical side, to assist physicians both in the documentation side of the house and the revenue cycle process downstream from us.

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Morning Headlines 2/21/22

February 20, 2022 Headlines Comments Off on Morning Headlines 2/21/22

Spok Announces New Strategic Business Plan

Spok reports Q4 results and announces that it will cut its management team by half and its workforce by one-third in the next 60 days as it continues to seek a buyer.

TriNetX Acquires Pharmacovigilance Leader Advera Health Analytics

Real-world data platform network TriNetX acquires Advera Health Analytics, which offers pharmacovigilance software for drug safety concerns.

Sirona Medical Acquires Nines and Key Personnel

Radiology workspace vendor Sirona Medical acquires the AI capabilities and related employees of Nines, which offers an AI diagnostic solution for respiratory diseases and a triage system for intracranial hemorrhage.

Comments Off on Morning Headlines 2/21/22

Monday Morning Update 2/21/22

February 20, 2022 News 8 Comments

Top News

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Spok reports Q4 results: revenue down 8%, EPS –$0.86 versus –$2.44.

From the follow-up announcements and earnings call:

  • The cloud-based Spok Go, which was introduced in February 2020, will be discontinued and the company will take a $15.7 million impairment charge. Spok says the product’s traction has been limited because of COVID-19, challenges in recruiting and retaining software engineers, and the company’s need to reduce costs and headcount.
  • The company will maximize revenue from its legacy product, Spok Care Connect Suite.
  • Spok will cut its management team by half and its workforce by one-third in the next 60 days.
  • The company will increase its dividend and repurchase $10 million of its shares.
  • The company continues to seek a buyer. One interested party is Acacia Research Corporation, whose primary business is buying struggling companies and then filing patent infringement lawsuits to force the purchase of licenses (aka a “patent troll.”) Acacia’s acquisition partner is activist hedge fund Starboard Value, best known in health IT circles for leveraging its tiny position in Cerner into board seats and a “cooperation agreement,” then selling off CERN shares as soon as the price went up as a result.
  • Acacia proposed in August 2021 to acquire all outstanding Spok shares for $10.75 in cash. Shares are now at $8.65, valuing the company at $171 million. Spok turned down a $12 per share offer from B. Riley Financial two years ago.
  • President and CEO Vincent Kelly says the board’s decisions were influenced by Oracle acquiring Cerner, Stryker acquiring Vocera, and Hillrom (and then Baxter) acquiring Voalte.

Reader Comments

From ViVE Sponsor: “Re: ViVE conference. The attendee list shows 3,000 people, only [low number omitted] of them providers.” Unverified, so I’ve omitted the number. I’ve emailed the conference’s generic email address for press inquiries since that’s the only contact I can find and will update with any response I get. The conference website says it expects 4,000 attendees (it said a year ago that attendance could top 5,500). Readers keep asking me about registration breakouts for ViVE and HIMSS22 that I don’t have, so tell me if you know or if you saw the same list. Meanwhile, the HIMSS22 exhibit hall is looking pretty full with about 800 “real” booths (excluding meeting place, pavilions, interoperability showcase, etc.) and 898 exhibiting companies. I’m hoping that, unlike HIMSS21, it will be worth my time and money to attend.

From TikTokDoc: “Re: videos. Doctors should use them for patient education. Good idea?” TikTok probably isn’t the ideal platform due to its limits on video length, but I can see doctors recording short, generic YouTube videos for patients who have new diagnosis or who need specific information about drugs, procedures, or lifestyle recommendations, then sending those patients a link after their encounter (the videos could be made private on YouTube or not, depending on practice’s goals). I like the idea of recording a quick video recapping the visit and to-do items for the patient’s later review, but malpractice fears probably make that unlikely. I wonder how many telehealth visits are recorded by the patient using screen-capture apps?


HIStalk Announcements and Requests

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Few poll respondents include certification or fellowship credentials on their business cards or email signatures, including two-thirds of the folks who have earned them. LinkedIn is full of credentials that I would have to look up  (or in reality, ignore) – some that I’ve seen recently in profile titles (not just in a list) are CCEP, CHPS, CHC, FACP, CDH-E, CRCR, CVAHP, CHPC, GRCP, CSPO, NEA-BC, PMHNP-BC, LP/NREMT-P, and CSSM. I’ve hired and been hired based on minimum educational level, but I’ve never hired anyone or been hired because of a certification. Actually, that’s not entirely true – Epic certification is required for many health IT jobs and is harder to earn and keep than some of the credentials that are issued by member organizations. I’m curious to hear from readers – what health IT job descriptions have you seen in which a specific certification or fellowship is required? 

New poll to your right or here: What were the negative aspects of your most recent PCP visit within the past 12 months?

Best thing I saw in the internet this week:  “Everyone who confuses correlation with causation eventually ends up dead.”


Last chance – if your company is exhibiting or participating in ViVE, send me your information to be included in my conference guide. Some of the activities I’ll be listing for attendees to consider include sponsorship of the welcome reception, happy hours, live podcasts, presentations and demos, evening receptions, and strategy sessions.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Real-world data platform network TriNetX acquires Advera Health Analytics, which offers pharmacovigilance software for drug safety concerns.

Radiology workspace vendor Sirona Medical acquires the AI capabilities and related employees of Nines, which offers an AI diagnostic solution for respiratory diseases and a triage system for intracranial hemorrhage. Nines will retain its teleradiology business.

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The Columbus business paper runs an excellent profile on AndHealth. I interviewed founder and CEO Matt Scantland last week.


Sales

  • Emory Healthcare expands its Sectra enterprise imaging system by adding digital pathology.
  • Rush University System for Health offers its employees the Transcarent app for finding health information and health coaching  as part of its medical plan.

People

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David Pickering, MBA (Indiana University Health) joins St. Jude Children’s Research Hospital as VP for clinical applications.


Announcements and Implementations

Cleveland Clinic lists its top 10 medical innovations for 2022, whose only health IT entries are AI-powered sepsis detection and analytics for early diagnosis of hypertension.


Government and Politics

The VA moves two of its 130 instances of VistA to AWS in a pilot project.

Stat reports that health tech vendors are worried about the trend of states enacting consumer privacy laws that, unlike HIPAA, give people control over how their data is collected and managed, which will increase regulatory compliance costs. The possible alternative outcome is developing a national standard for managing patient data. 


Other

The Atlantic looks at “Why America Has So Few Doctors” even as an aging, ever-sicker population now has COVID-19 to deal with few primary care doctors available to see them. Reasons:

  • US medical education is the longest and most expensive in the developed world, with programs requiring a minimum of eight years of school (degree plus medical school).
  • Those years in college leave graduates hundreds of thousands of dollars in debt, encouraging them to pursue whichever specialty pays the most.
  • Residency spots and federal funding for them are limited.
  • Physicians and physician groups have an economic incentive to claim a physician oversupply to constrain the number of medical school seats.
  • Physician groups fight proposals that would allow lower-level clinicians, such as nurses, to do lower-level tasks.
  • The medical establishment has made it hard for foreign doctors to practice in the US, especially those from Mexico and Canada whose practice is limited by NAFTA.

Sponsor Updates

  • USPTO awards Volpara Health a patent for its method of detecting and quantifying breast arterial calcifications in mammograms.
  • Redox releases a new podcast, “WebMD’s Ann Bilyew on Why Scale Matters in a Shifting Market.”

Blog Posts


Contacts

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

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Morning Headlines 2/18/22

February 17, 2022 Headlines Comments Off on Morning Headlines 2/18/22

Change Healthcare Falls on Report DOJ to Block UnitedHealth Deal

The Department of Justice will reportedly file a lawsuit to block the proposed $13 billion sale of Change Healthcare to UnitedHealth Group.

ModMed® Acquires Maker of the Klara® Practice & Patient Collaboration Platform

Specialty EHR, PM, and RCM vendor ModMed acquires Klara, which offers a virtual care and collaboration platform, for $200 million.

CompuGroup Medical Acquires Market Leading Laboratory Software Provider AP Easy

CompuGroup Medical acquires anatomic pathology system vendor AP Easy.

Comments Off on Morning Headlines 2/18/22

News 2/18/22

February 17, 2022 News 3 Comments

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The Department of Justice will file a lawsuit to block the proposed $13 billion sale of Change Healthcare to UnitedHealth Group, a report says, citing two insiders.

Dealreporter says the sources told it that DOJ cannot identify any divestitures that would ease its anti-competitive concerns.

Change Healthcare reportedly considered selling its payment integrity business to avoid regulatory intervention.


Reader Comments

From Fungible: “Re: HIMSS Accelerate. I can’t figure out how to see the activity there. All I see is promotional posts from HIMSS. Can you ask readers if they are using it?” Same for me. It lists a ton of members, but I don’t see any posts, but then again I’m not following anyone and that might be limiting what I see. Still, even Half Wolf hasn’t posted much of anything. I checked maybe 100 user profiles and I would suspect they were auto-added or something since I didn’t see any that had completed their profile or posted any messages. If you’re using Accelerate, please explain what you’re doing on there. You would think it would be lit up given that HIMSS22 is 25 days away.

From Boris Badenov: “Re: [technology company name omitted]. Has cancelled all meetings and has asked all employees to turn over documents with [EHR vendor] screenshots and other IP by the end of the week. Apparently somehow the company has managed to delete records at an unspecified customer and has caused significant damage.” Unverified, so I’ve omitted both company names. The only way I see this happening is that the tech company was using some kind of scripting and screen-scraping tool that ran amok and deleted data by mimicking user interaction, which the original vendor would not be able to detect or prevent. Cancelling meetings and seizing IP seems odd.


HIStalk Announcements and Requests

Sponsor reminder: tell me what you’ll be doing at ViVE and HIMSS22 and I’ll include you in my conference guides. You’re spending piles of money to participate in the conference, so you might as well publicize it.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Specialty EHR, PM, and RCM vendor ModMed acquires Klara, which offers a virtual care and collaboration platform, for $200 million. ModMed is the former Modernizing Medicine, which eliminated and conjoined some of its letters in December 2021 in hopes of “capturing the company’s mission and reflecting its modern user experience.” I’m not sure it actually worked.

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SimpleHealth, which offers subscription-based birth control prescribing services and products via a $15 annual online consultation and low-cost prescriptions, acquires birth control pill reminder vendor Emme. 

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CompuGroup Medical acquires anatomic pathology system vendor AP Easy.

Medication and computer cart manufacturer Capsa Healthcare acquires mobile computer workstation vendor Humanscale Healthcare.


Sales

  • Four companies choose Canvas Medical’s EMR and healthcare payments platform for digital health developers: Patina (primary care for adults 65+), Circulo (services for physical and behavioral health), UpLift (mental health), and Vivante (digestive health and wellness).
  • Ohio State University Wexner Medical Center will analyze claims data from LexisNexis Risk Solutions to identify the needs of underserved communities and choosing optimal service locations.
  • Vanderbilt University Medical Center chooses Biofourmis to support a study in which cancer patients will be monitored at home instead of the usual 7-10 day hospitalization following administration of an oncology drug. The system will continuously collect heart rate, temperature, oxygenation levels, and respiratory rate and will measure blood pressure every 4-6 hours, with the results presented on a notification-powered clinician dashboard.
  • Healthcare API vendor Particle Health replaces its homegrown master patient index with Verato Universal MPI.
  • NextGen Healthcare chooses Verato Universal MPI to incorporate patient matching into its Health Data Hub to integrate information from disparate EHRs.
  • The US Social Security Administration contracts with Cerner to electronically transfer disability claims information the EHRs of its customers.
  • Insurer Florida Blue, a subsidiary of GuideWell, automates prior authorization approval via AI-powered clinical reviews that are powered by Olive’s AI platform.

People

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Industry long-timer Tomas Gregorio, MBA (University Hospital) joins Wellforce as SVP of IT operations.

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Impact Advisors promotes Liam Bouchier to VP.

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Streamline Health promotes Ben Stilwell, EMBA to president and CEO of ite EValuator Solutions business, also hiring Amy Sebero (NThrive) as chief growth officer for that unit.


Announcements and Implementations

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Black Book names 50 recently funded emerging solutions that are challenging the healthcare technology status quo, evaluated by 4,000 healthcare respondents who scored 377 solutions on 18 KPIs.

The Marion County Health Department (WV) goes live on Epic. The health department first experienced Epic when WVU Medicine set up COVID-19 vaccination clinics in Marion County in early 2021.

The Hartford business paper profiles clinical data transformation platform vendor Diameter Health, which grew headcount by 25% last year and expects to hit 100 employees next year. I interviewed CEO Eric Rosow a couple of weeks ago.


Government and Politics

Politico reports that the VA’s pilot of a technology that speeds up benefits decision-making – cutting the average wait time from 100 days to 21 – is being criticized by labor unions that don’t want the jobs of 60,000 VA Benefits Administration placed at risk.

KHN reports that counties and cities that oppose COVID mitigation measures are forming their own health departments and contracting the work out to for-profit companies.


Other

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Blind people who received a “bionic eye” implant from Second Sight Medical Products from 2013 to 2019 to gain a small amount of low-resolution vision see their world go dark as the company abandons the technology and approaches bankruptcy after an exodus of its executives and a sale of its assets at auction. Second Sight’s 350 users had its technology installed at a cost of up to $500,000, many of whom complained about poor results. The company is moving on to brain implants.


Sponsor Updates

  • Availity launches Availity Essentials Plus, a low-cost subscription service that gives providers online access to more payers through its HIPAA-compliant Essentials platform.
  • Fortified Health Security hires Sarah McNulty as executive assistant.
  • Optimum Healthcare IT publishes a case study in analyzing and streamlining EpicCare Ambulatory error queues at PeaceHealth.
  • NeuroFlow creates a video describing how it helps health plans reduce the costs of care by giving them better behavioral health insights.
  • Medicomp Systems releases a new episode of its Tell Me Where It Hurts Podcast featuring CEO Dave Lareau.
  • RCx Rules recaps its 2021 success, which includes adding 25 customers and strengthening its HCC coding capabilities by adding Chart Prep Engine.
  • Netsmart launches the EveryDayMatters Podcast.
  • Meditech announces its HIMSS22 activities.
  • Nordic releases a new podcast, “How interoperability and cloud transformations can support healthcare organizations.”

Blog Posts

Black Book Research’s list of the 50 top-rated emerging health IT vendors for 2022 includes the following HIStalk Sponsors:

  • Bamboo Health
  • Enlace Health
  • Healthcare Triangle·
  • Redox
  • Symplr

Contacts

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

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EPtalk by Dr. Jayne 2/17/22

February 17, 2022 Dr. Jayne Comments Off on EPtalk by Dr. Jayne 2/17/22

I enjoyed this short piece on “Overrated tech: 5 tools execs think hospitals should skip.” Suggestions given by health system executives include proprietary technology, augmented / virtual reality, applications written for on-premises use, and niche technology. Rounding out the list was the undead of business equipment: the fax machine. I’m always amazed when hospital or medical licensing forms want a fax number. No matter how hard we work to get away from them, the little machines soldier on.

If I had to add a couple of overrated technologies to the list, I’d suggest the following: freestanding patient portals that don’t integrate with the EHR, home monitoring devices that don’t have a neat and tidy way of sending data to the responsible physician, and emergency department wait-time displays on billboards and websites. If you have time to compare wait times, then it’s less likely that the emergency department is the right location for your care.

The new calendar year has set my continuing medical education counter back to zero, so I’ve been keeping an eye out for good online presentations that also deliver CME hours. Despite the fact many of us have been working virtually for years now, I still see quite a bit of bad behavior on webinars. You would think that with all our collective experience, people would have gotten better at being professional when on large group webinars. I’ve seen enough annoying habits that I could write a “tips and tricks” document. The highlight reel:

  • If you are a host or presenter and know you’re not going to allow verbal audience participation, please set up the webinar so that the audience is in listen-only mode. If you forget to do this, hopefully you know how to mute everyone. There will always be some person driving, making lunch, or taking their phone and the webinar to the restroom.
  • For audience members, pay attention to what the presenters say about fielding questions. If they ask you to put your questions in the Q&A area as opposed to in the chat, please do so. As someone who runs a lot of webinars, it’s hard to manage multiple streams, so usually we pick one way to handle things. Our organization’s policies might keep us from locking down the other functionality or hiding it from you, but you’ll get a better response if you do as the presenter asks.
  • Also for hosts, the whole idea of “we’re going to start about five minutes late to allow people time to join” is extremely disrespectful to those who were prepared and on time. Although you might think you’re doing us a favor and telling us that so we can multi-task for a few minutes, the reality is that a good chunk of your audience is aggravated by it, while another chunk will delve into email or texting and you won’t get them fully back when it’s actually time. If everyone started on time, maybe latecomers would learn a lesson.

Speaking of pushing deadlines, HIMSS has extended the registration discount for HIMSS22 through February 22, citing organizational budget and travel permission issues. I know a number of organizations that are still under no-travel restrictions. Although COVID cases are easing, hospital staffing is still a struggle. Teams are exhausted and there’s often no hope for replenishing the bench. I think leaders are increasingly aware of the optics of jetting off to Orlando while their teams are still underwater.

HIMSS also notes they are adding programming and speakers, including sessions on aging and loneliness, policy updates, and international perspectives. I’m not sure that the addition of those topics would make me want to go if I hadn’t already booked, so it also feels like a “registrations are low, let’s see how many other people we can drag through the door” type maneuver.

HIMSS also continues to send emails trying to get attendees to sign up for events that require additional fees, such as the Women in Health IT Networking Reception. It costs $55 for a 90-minute event, which despite the advertising, doesn’t seem like enough time to “share stories, recognize and celebrate your peers, and form valuable connections that will last a lifetime.” Maybe I’ll engineer my schedule to eyeball the event during peak entry and exit times, though – I’m sure there will be some outstanding shoes to be seen.

Thinking about these events makes me wish Mr. H would reconsider the idea of throwing an HIStalk kegger in some parking lot. There’s an undeveloped lot across the street from my hotel that would be perfect. That would be a real way to make memories that would last a lifetime, I’m sure.

A lot of my work as a CMIO revolves around using EHRs and related technologies, such as clinical decision support, to reduce variability in patient care. A recent piece looked at how physicians within a single health system often make different treatment choices for identical patient scenarios. Certain physicians were much more likely to use recommended standards of care than their peers, which can be concerning if not following the standards leads to variability that worsens outcomes.

The authors looked at 14 “straightforward” clinical scenarios (as opposed to complex cases) to score physician performance. Some of the scenarios looked at surgical procedures, where the top surgeons opted for non-surgical interventions at greater rates than their low-performing peers. This supports the idea that wasteful spending is often tied to inappropriate care. It will be interesting to see how hospitals respond to this since they make a good amount of money from the questionable surgical procedures compared to the non-surgical interventions.

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An intrepid reader sent me this picture from a healthcare facility that should remain nameless. It looks like they’re having an issue with their emergency call system, so they hit the Home Depot and stocked up on stick-on doorbells. The handwritten label is a nice touch. I’m not sure what The Joint Commission or any other accrediting body would think of the solution, but it does have a certain resourcefulness to it.

What kind of entertaining solutions have you seen when your organization just needs to make do? Leave a comment or email me.

Email Dr. Jayne.

Comments Off on EPtalk by Dr. Jayne 2/17/22

HIStalk Interviews Brian Yarnell, President, Bluestream Health

February 17, 2022 Interviews Comments Off on HIStalk Interviews Brian Yarnell, President, Bluestream Health

Brian Yarnell is founder and president of Bluestream Health of New York, NY.

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Tell me about yourself and the company.

I got started in healthcare 10 years ago. Prior to that, I worked in digital media, consumer behavior, and data-driven analysis for retail, manufacturing, marketing, and sales. I have quite a bit of background dealing with consumers and big data. I sold my first health tech company about seven years ago to Hillrom. That was a business called Starling, where we built a replacement for a nurse call system that routed out throughout the hospital and used intelligent workflows.

We shifted gears and founded Bluestream after that, with the idea of figuring out a better way to bring real people, through video, to a patient’s bedside. At the time, we didn’t really anticipate what was going to happen outside the hospital. We were thinking through how we could better provision these relationships between a remote provider and a patient.

Providers rushed to offer telehealth services via whatever video platform was quick and easy to roll out, but the novelty of interacting with patients by video has worn off. What virtual health platform capabilities are needed to provide a good patient and clinician experience?

Things have evolved fairly quickly. I think of it as a continuum. Those technologies that you mentioned were effectively video, which is a commodity at this point. Beyond the basic video connection, things have evolved from telehealth all the way to what I would call virtual-first healthcare. If you think of it in that context, the video piece is the last mile, but it’s really about opening up front doors for patients and meeting them where they are and how they want to be engaged.

The idea of patient portals and downloadable apps has generally not succeeded. The big things that people ought to be focusing on for virtual care is, how do you get in front of a patient, wherever that patient is, and however that patient feels like engaging? Then for clinicians, starting to take some of these brick-and-mortar workflows and make them virtual so that you can do all the great things that you might do in person, but do them remotely.

What elements of a virtual visit most strongly affect patient satisfaction?

We recently added Net Promoter Score, thinking about my marketing background prior to healthcare, to the platform. We know specifically what impacts patient satisfaction. It’s not just the bedside manner of the clinician. It’s what happens when somebody shows up a day early, an hour early, or 20 minutes early for an appointment. You can’t leave people in limbo. You have to be “consumery” in terms of how you engage folks and walk them through this process, even if they show up at the wrong time.

Making experiences that feel like a consumer-driven website. Give people information, expectations, and tools to engage, even if they are not necessarily at the front door at the right time. Then, post-visit, what happens when you wrap up with a clinician? What happens when something goes off the rails and you have to reconnect? All along the way, from showing up early or showing up on time to the visit, dropping the visit, concluding the visit, providing a real framework that still hand-holds the patient and has that consumery feel without being overly technical, overly burdened with lots of bells and whistles.

What virtual options can be offered to patients who have limited technology or bandwidth?

One of the things that we’ve seen as being successful is getting folks like MAs and assistants to tee up the call for physicians. You certainly don’t want the physician troubleshooting cameras, networks, and things like that. But you can have lower-cost, higher-availability resources work with the patient first and do a handoff.

But as you said, some folks aren’t going to get there in terms of tech. What we’ve seen be successful is automation to reconnect these people, to literally point out where you have to click to accept camera permissions. But some folks, like my mom, will never get there, and in those cases, you have to be willing to work with telephones. We’ve seen people doing emergency medicine consults , ET3 [emergency triage, treat, and transport] programs where the reality is that a large portion of the population is going to pick up a phone and dial it. You have to be able to route those visits in with the same attention and same priority as the people who are fully into the smartphones and video.

Health systems initially saw virtual visits as a distraction that should be turfed off to third-party companies that provided not only the platform, but the providers. Now that virtual visits are here to stay, are they treating them more like a full-fledged, branded patient experience?

Absolutely. You hit on a really important point. If you gave a hospital a $1.5 billion a year and a half or two years ago, they would have built a new wing. Now, they have to be thinking about how to build virtual experiences.

These vendors that you talked about that offered a lifeline of virtual visits with the provider network behind it will compete for those patient relationships with the hospitals as the world shifts towards more consumer-facing, on-demand care. The hospitals need to think about how to implement these programs to prevent their vendors from cannibalizing their core business. That becomes important in a transition into a value-based framework.

How does virtual health avoid becoming commoditized, where consumers see all encounters as equal and just choose the cheapest or first-available provider?

Consumers expect it immediately and pervasively. What you’re talking about is this preponderance of front doors that appear to come from all different places.

We and other vendors are starting to equip health systems and traditional healthcare delivery platforms with the ability to cast this wide net. Even though you may come through an insurance company’s website, a phone number on the back of your insurance card, a kiosk in a homeless shelter — very different experiences and a different type of front door — you’re going to start funneling those visits into a common pool provider. People like Teladoc have done that for years. The difference is that health systems are getting smarter about getting in that game and funneling visits from non-traditional places into their provider group.

Healthcare didn’t follow other businesses in looking at the lifetime value of acquiring and retaining a customer. Is that changing?

Absolutely. We have customers all across the spectrum, from people who just pay the bills of ambulatory visits to those who fully participate in these risk-based programs. The more sophisticated folks are looking at the cost of acquisition and  the cost of attrition.

What happens when a non-traditional player, such as Walmart, CVS, or Amazon, gets your patient? They’re not coming back. When you get into this modality where you are getting compensated for the cost of keeping the patient healthy, the lifetime value of patients goes up substantially. Smarter health systems, more strategic entities like some of the pay-viders, are playing that game of, how do you capture as many relationships as you can and keep them? Because you want to be on the winning side of that equation of people who are getting paid to manage a population effectively.

How does a health system’s marketing strategy change when those relationships are established during virtual visits and that involve consumers who may not require a health system’s services for a long time?

We’re seeing more sophisticated health systems, even the traditional ones, get smarter about using tools that let them take the providers they already have. A lot of them are large physician employers, and they have a pool of providers. What they don’t have is access to a patient until that patient has a heart attack or gets hit by a car. To empower those providers to get in front of patient, they are establishing commercial partnerships with large, self-insured employers, with insurance companies, and with municipalities that need healthcare coverage in housing projects and homeless shelters. Establishing lots of diverse front doors — whether it’s a walk-in clinic in the inner city or a health clinic in a Federally Qualified Health Center — and proactively identifying.

They cast a wide net to get patients. The branding might not even be their own, but they’ve got to be funneling those patients to the providers that they are already paying to be on the bench.

Are we in the early days of virtualizing the clinician workforce, where most of them already prefer to live in urban areas?

The hub-and-spoke model is a real thing, being able to have centers of excellence and making them accessible to remote communities, whether it’s because they are socioeconomically disadvantaged or because they are physically remote. The big risk is brain drain. You don’t want to be in a situation where you have no local providers who have expertise any more, because if somebody walks into a hospital and needs follow-up care, they want to have a good experience with a local community member. You’ll start seeing some of that shift into more urban hubs or more centralized hubs, and it’s a little bit of a risk.

Most people would be happy if virtual primary could deliver results equivalent to in-person visits. Are areas that can deliver arguably superior outcomes, such as behavioral health and chronic condition monitoring, drawing equally enthusiastic interest?

We do a lot of behavioral health. We do it inside acute settings, like emergency rooms and inpatient units, and we do it outside of acute settings. The big difference is, are you trying to keep someone out of the hospital and from incurring healthcare costs, or are you trying to adequately address somebody’s needs when they set foot in the door? Either case is a big one, low-hanging fruit with an event that has the potential to cost a lot of money and cause a lot of headaches if you don’t address it up front.

Behavioral health is a good one. We see the measurable impact with our customers and our partners. We can bring in a behavioral health expert, such as a clinical psychiatrist, to write an order for a patient in well under an hour, when in an ED, it might otherwise be a one-day or a three-day wait. It’s a big difference.

Outside the hospital, I would lump in behavioral health with access to things like emergency medicine, these mission-critical things that cause people to go to a hospital or to incur additional costs. We have 911 and ET3 programs that drive down the number of visits by 50%. It’s a big deal, and there’s a reason people are focusing there.

Are health systems interested in having their providers virtually help paramedics, long-term care, and home health providers who otherwise don’t have many options except to send the patient to the hospital’s ED?

Definitely, and even more so as you think about the systemic cost of care delivery. New York City Health + Hospitals is one of our customers. They tie directly into the 911 system. They deliver their services down into SNFs. They tie into first responder devices in ambulances and fire trucks. 

The underlying theme there is that they don’t want people going to the hospital. So when you dial 911 and it’s not life-threatening, they are going to get you in front of a clinician. If you need a paramedic, they’re going to try to get you virtually in front of a clinician. Even when you show up in person, they don’t want transport you, because the systemic cost of moving someone from a SNF back to the hospital is somewhere in the range of $10,000. You can absolutely prevent that from happening if you have the right safety net in place in terms of clinicians and folks like that.

What changes do you expect to see in the virtual visit concept and in the company’s business over the next few years?

What will drive the evolution of our business as a platform provider, and probably more importantly the business of traditional health systems and payers, is this shift towards value-based care and on-demand access to care. That’s just ubiquitous, and it will be painful for health systems to adapt to do that, because they are used to filling beds and physically getting their hands on people.

There are a lot of new folks coming into the market. Amazon and Walmert are better equipped to present consumers with what they want, when they want it. A lot of work will go into equipping these traditional providers with the tools to rise to meet consumers where they are. The mantra of the American consumer is that “I know what I want, and I want it now.” This notion of trying to make a better patient portal and that type of thing is never going to succeed. You have to give people what they want and then work out how to route these things intelligently and drive critical outcomes from them.

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Morning Headlines 2/17/22

February 16, 2022 Headlines Comments Off on Morning Headlines 2/17/22

HHS Awards Nearly $55 Million to Increase Virtual Health Care Access and Quality Through Community Health Centers

HHS awards $55 million to 29 HRSA-funded community health centers to aid them in expanding their virtual care capabilities.

Ro Raises $150 Million from Existing Investors to Expand its Direct-to-Patient Healthcare Model

Virtual care company Ro raises $150 million in a funding round led by ShawSpring Partners, bringing its total raised to over $1 billion.

Equip Raises $58 Million Series B Funding Round to Revolutionize Eating Disorder Treatment

Equip, a virtual eating disorder treatment startup, raises $58 million in a Series B funding round.

Epitel Secures $12.5 Million Series A Financing for Wearable, Wireless EEG Monitoring System

Epitel, which specializes in seizure detection and remote patient monitoring, raises $12.5 million in a Series A funding round.

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HIStalk Interviews Matt Scantland, CEO, AndHealth

February 16, 2022 Interviews 2 Comments

Matt Scantland is founder and CEO of AndHealth of Columbus, OH.

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Tell me about yourself and the company.

AndHealth is a digital health company that is focused on helping people reverse chronic illnesses. We started with migraine and are seeing patients for that now. We are soon launching for some of the most common and disruptive autoimmune conditions.

I’ve made a career of combining technology and healthcare. I started college thinking that I would be a doctor and ended up being a programmer, so I combined these two things in my career. Probably the biggest advantage that I have had is to have worked alongside an incredible team for my entire career, in some cases, literally going back to my internship in college. Many of these folks helped us build our last company, CoverMyMeds. They have been joined at AndHealth by a new group of telehealth experts and clinicians.

Each of us have our own “why” that we are at AndHealth. For me, I knew I had to do something like this because my own doctor helped me realize that I needed to participate in my healthcare. That was back in 2011, when my first son was born. At the time, I was busy with CoverMyMeds, but I knew that if I ever had a chance to do another company, I wanted it to be a company that helps support patients to participate in their own healthcare. That leads us to where we are today.

You intentionally use the term “disease reversal” as opposed to “disease management.” How do you distinguish those?

For many years now in our industry, we have focused on this idea of disease management, which is to try to tamp down the progression of cost and disease escalation. We now know that many chronic illnesses can be brought into remission if we can get the patient to change the behavior that is responsible for about 80% of our health. Once we understand that reversal is possible, the key question is, how do you achieve it? The answer is that you need to engage patients in a course of change. We have built a disease reversal company. We have built the whole business around how to support patients in making that change.

How does the approach differ from traditional office-based encounters?

The big idea is that we can get to reversal when we can get patients to participate. The core question then is, how do you get people to participate? We’ve built the company around what we’re calling a digital center of excellence that helps to make that participation easier. One important element of it is moving from delivery of care of that’s episodic and on-premise to one that is continuous and virtual.

For example, one of our early patients suffered from chronic migraine. She had moved around our healthcare system for years and years, never able to get to a state of disease remission and never able to figure out exactly, in the moment of a migraine, how to cope with the situation other than going to the emergency room. By moving this care to something that is continuous, we were able to dramatically shorten the feedback loop between trying a particular healthcare step and seeing whether it worked, to the point that we were able to optimize her acute medication and also identify the root cause of her migraine.

When we optimized the acute medication that kept her out of the emergency room, we had time then to work on actually reversing the disease. Her root cause ended up being a food intolerance issue that, despite many years in our healthcare system, had never been found. Once we were able to identify that food intolerance issue, we had moved this diffuse idea that we have around behavior such as “eat better” to the equivalent of a shellfish allergy, where just this one step was the difference between illness and health.

The tightness of that feedback loop makes it such that people with shellfish allergies almost never are eating shellfish. But compare that to someone with a cardiometabolic disease, where sticking to a nutritional program is hard. The only difference is how clear that feedback loop is. By moving to this style of care, we are able to shorten that feedback loop.

When we do that, we help the patient achieve a high return on effort. We don’t need to turn the patient into an Olympic athlete when we know the precise root cause of their illness. We just need to address that particular root cause. When we combine that with focusing on diseases that patients are highly motivated to solve, typically because of pain and disruption, then we are able to achieve a higher level of engagement than has ordinarily been seen in these digital health services, which have tended to focus on diseases that, while important, are pretty difficult to engage patients in early in the progression of the disease.

That’s why we started with migraine and autoimmune conditions. They share common root causes with these other illnesses. We can engage the patient in something they care about today because of the pain and disruption, but because of the shared root causes, we end up solving these other issues as a side effect.

Some of the app-focused programs assume that patients will change if offered education videos, scripted coaching, and reminders to modify their lifestyle. How much of your program will be based on psychology rather than technology?

We have built the DNA of the company around the science of how behavior happens. The more we have learned about that science, the more we have learned how big the opportunity is to do better. We do that by understanding the difference between health aspirations and health behaviors. The biggest lever that we have in our healthcare system to create behaviors that support health is to make them easier to do what we call create ability. For many people, we can create ability by making something that used to be time-consuming and expensive quick and inexpensive or free.

That psychology, building around the behavior design, is super important and is a through line in the company, from our technology to our business model and to the actual healthcare delivery. One important distinction between what we are doing at AndHealth and a lot of what has happened before is that we are actually the patient’s doctor rather than a wellness app. When we are the patient’s doctor, we are able to harness the credibility that comes with that.

Patients have shown our healthcare system that what they want is the most specialized expert care that they can get for their particular condition. Each of our reversal centers of excellence is staffed by experts in that therapeutic area, who take on the patient in the practice of healthcare so that we can manage medications, do labs, and have the whole set of healthcare services at our fingertips.

No one disputes that a percent of a patient’s health is behavior. The question is, do people believe that it’s possible to help them change? A core idea that we have at the company that comes from my own life and the life of the people here is that everyone can change if we give them the support to do so, and if we ask them to make a change that they care about.  That’s why we focused on these areas and why we think this delivery model can help support people. It’s tougher to engage people with the garden variety app that counts steps. That’s not solving a problem that patients care about. That’s why we think this is different.

How does a patient’s primary care doctor participate?

That collaboration is such an important idea that we named the company AndHealth to reflect the idea that we can’t do this alone. We see ourselves as part of what I think will be a transformation in our healthcare system that we do mostly outside of the company, rather than inside. While we become the patient’s headache specialist, there are about 40 million migraine sufferers in the United States and only 2,000 headache specialists. This is one of the key challenges that we are helping patients solve, the problem of access. Even if you have good health insurance, the ability to get into a care team that understands how to treat migraine is hard.

By moving this care to a model that is more accessible and is available continuously, we are able to make a big difference in the lives of these patients. You can think of us as a referral from a patient’s primary care doctor or from their employer, because we are an employer-sponsored health benefit that helps complement the healthcare that the employer is providing to their employee.

How hard is it to convince employers and health plans to pay for your service?

Ultimately, we need to prove that we are achieving life-changing results for patients. If we can do that in this area, it will be an important new way that patients get access to care.

One of the reasons that we started with migraine is that leading employers are starting to recognize it as a silent issue, lurking just beneath the surface, much like how the best employers started to recognize mental health five years ago. It had historically been dismissed. It had historically not had great treatment options. It wasn’t generating the claims that caused it to get on anyone’s radar. It was a chicken-egg issue. If there wasn’t good access to care, there weren’t many claims, so it didn’t get onto the radar of employers. 

But we now know that migraine is the leading cause of short-term disability for most employers. It’s a huge contributor to turnover. Because it disproportionately impacts women and people of color, it’s a lever against diversity, equity, and inclusion objectives for employers. We think that a proposition that is focused around increasing access to super high-quality care in a therapeutic area that impacts many of these employers, 20% of the employee base, and is actionable because patients are engaged around this disease, will be taken up by many employers. We are seeing that so far in the market.

Can you survey employees or look at company records to identify the opportunity, unlike wellness apps where employers may get some non-specific value from helping their employees with weight, exercise, or stress?

Exactly. It’s rare that we’re in a meeting with an employer where someone in that meeting doesn’t say, “I have migraines. That has been an incredibly difficult part of my life that has made it difficult for me to show up in the way that I want to at work.” Because it’s common, and historically patients haven’t seen a lot of good treatment options, we are hearing from employers that this is important to solve. Now that we know that it is solvable, there’s a lot of interest in engaging.

It’s similar in autoimmune conditions, although what’s a little different in autoimmune is it has gotten a lot of employer attention because the costs are so high. For the conditions that we are treating, simplifying a little bit, there’s about $40,000 in costs per employee, per year for those who suffer from the conditions. A good bit of it is pharmacy cost, but there’s also significant healthcare cost. That has gotten more attention, but migraine employees are expensive from a claims perspective and especially from a productivity perspective.

AndHealth isn’t primary care, where we need to be able to treat a patient who shows up with anything, and where we have a relatively diffuse cost or value proposition to an employer. This is something that’s targeted at the disease states that, one, are the most expensive and disruptive, and two, by narrowing, give us an opportunity to have a learning system that gets better really fast.

One of the underappreciated elements of digital health is the degree to which when we narrow and then run this through software where we’re force-multiplying the expertise of clinicians, we move to a learning system that is improving quickly. We have a credible chance to move in these therapeutic areas from a new company to the foremost expert quickly by narrowing. That makes achieving results for patients dramatically easier than if we tried to see a patient who shows up with any condition.

What are the most important lessons you learned from starting, growing, and selling CoverMyMeds?

The biggest lesson was to find a way to collaborate with the healthcare system. Because if we want to do something big, we need the help of the people that are already here. We can be transformative without being disruptive. That idea is so important. That’s why we called the company AndHealth rather than OrHealth. That’s a really important one.

The other is the idea of people first, putting not just the patient first in everything we do, but winning through our employees. We ended up being on Glassdoor as one of the top 20 employers in the country in the past. While we think the tactics that will get us there are different, because the world is different than it was 10 years ago, we are focused on being a place where clinicians and technologists can come to build something that makes a big impact for patients, but also makes a big impact in their career. Those two things are core DNA in the company.

What would you like to see happen with the company in the next few years?

We have already shown that we can produce what we think are life-changing outcomes. In our first study in migraine, we were able to get to a 60% remission rate for patients. What we want to do in the next couple of years is show that we can do that at scale for employers and in a way that generates a value proposition that makes this part of the benefits package for the leading employers. It’s about showing that we can create those life-changing outcomes with patients, in collaboration with employers, at a scale that ends up making a difference for the world. If we can do that, that is success.

Morning Headlines 2/16/22

February 15, 2022 Headlines Comments Off on Morning Headlines 2/16/22

Athenahealth Acquired by Hellman & Friedman and Bain Capital

Bain Capital and Hellman & Friedman finalize their $17 billion acquisition of Athenahealth.

Memora Health Announces $40M Financing To Scale Platform for Simplifying Complex Care Delivery

Automated care management company Memora Health raises $40 million, bringing its total funding to just over $50 million.

$1.13M settlement proposed in Inmediata Health in lawsuit over 2019 data breach

Puerto Rico-based claims clearinghouse Inmediata will pay $1.13 million to settle a class action lawsuit filed by patients who were affected by a 2019 data breach in which the company failed to secure patient data online, enabling search engines to serve up PHI in search results.

Comments Off on Morning Headlines 2/16/22

News 2/16/22

February 15, 2022 News 7 Comments

Top News

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The $17 billion sale of Athenahealth to a pair of private equity firms has been completed.


Reader Comments

From Elizabeth Holmes: “Re: Circadia Health. Touts how they do remote patient monitoring, but FDA’s clearance says specifically that ‘The Circadia C 100 System is not indicated for active patient monitoring.’” I emailed the company to clarify, but haven’t heard back. The website says that the touchless system issues a daily report of respiratory rate and time in bed, which seems to be in conformance with FDA’s requirement that its system not be used to monitor vital signs and is “for retrospective analysis only.” Still, the company’s website touts its capability to “prevent the 3rd leading cause of death” in managing acute respiratory distress syndrome, COPD, sepsis, and pneumonia while earning post-acute care facilities a 2% Medicare incentive payment.


HIStalk Announcements and Requests

HIStalk sponsors who are exhibiting at or attending ViVE and HIMSS22 – click the link, complete the short form, and I’ll include you in my online and downloadable guide. You may recall from last week that my poll respondents gave as their #2 reason for visiting a booth as simply knowing ahead of time the activities that will be presented there, so share your plans and maybe get more feet onto your expensively rented carpet.


Webinars

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


Acquisitions, Funding, Business, and Stock

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PriorAuthNow, which offers automated, real-time prior authorization software for providers and payers, raises $25 million in funding. The company says its technology has helped Cleveland Clinic staff reduce the prior authorization process from 45 minutes to four minutes.

Kidney care company DaVita acquires transplant software vendor MedSleuth for an undisclosed sum.

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Radial Analytics, a patient care transition software startup based in Concord, MA, raises $3 million in funding.

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Automated care management company Memora Health raises $40 million, bringing its total funding to just over $50 million.


Sales

  • Community Health Systems (TN) selects remote patient monitoring and virtual care technology from Cadence.
  • Davis Health System (WV) will implement Cerner across its three hospitals beginning this summer.

People

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Azara Healthcare hires Todd Schlesinger (Jvion) as VP of sales.

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Patti Baran (Teladoc Health) joins AliveCor as SVP, Healthcare Americas.


Announcements and Implementations

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Little Rock Air Force Base Clinic (AR) will transition to the DoD’s Cerner-powered MHS Genesis system next month. The department plans on rolling out MHS Genesis at 54 facilities this year, which would see the technology deployed at more than half of all military hospitals and clinics.

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Guthrie County Hospital & Clinics (IA) will go live on Epic this weekend.

A Tegria-commissioned Harris Poll survey finds that 69% of Americans would consider switching providers to gain access to same-day appointments, convenient locations, and self-scheduling. More than half would be willing to have their first visit with a new provider conducted virtually, although only 37% of those over 65 agree.


Government and Politics

VA Acting Deputy CIO Laura Prietula tells attendees at an AFCEA Bethesda health IT event that the department has made significant improvements to its EHR data transfer processes, adding that it has standardized the majority of the high-priority datasets that are being transferred from VistA to Cerner’s Millennium and HealtheIntent platforms.


Privacy and Security

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Puerto Rico-based claims clearinghouse Inmediata will pay $1.1 million to settle a class action lawsuit filed by patients who were affected by a 2019 data breach in which the company failed to secure patient data online, enabling search engines to serve up PHI in search results. I mentioned at the time that the majority of the 1.6 million patients alerted about the breach had never heard of the company. Many received multiple notification letters, with some of those being addressed to other patients.

Avita Health System (OH) notifies patients of a network security incident last week that forced it to revert to downtime procedures.


Other

I’m not sure I noticed until reading the CHIME update below that former HIMSS President and CEO Steve Lieber has been working for CHIME as chief analytics officer since October 2021.

Sachin Jain, MD, MBA says big tech firms have accomplished basically nothing in healthcare because scale is hard to achieve, fee-for-service hasn’t gone anywhere so improving health isn’t a priority, managing healthcare means managing risk, and margins are small. He says companies like Apple need to stop tinkering around healthcare’s edges and instead buy a big health system, where they can demonstrate the benefits of technology, make the argument for value-based care, and integrate payers and providers. He says Amazon’s dabbling in the grocery business didn’t amount to much until it bought Whole Foods.

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This is an interesting thought about primary care in considering non-healthcare markets, where generalists could be squeezed out by specialists on the upper end, and on the lower end, by less-expensive substitutes who follow protocols that those experts approve.


Sponsor Updates

  • CHIME launches new media resource Digital Health Insights as a digital destination for healthcare industry professionals.
  • Ellkay will exhibit at Greenway Health’s Engage conference February 18-23.
  • The Kansas Hospital Association’s Health Services subsidiary selects ChartSpan as its exclusive chronic care management partner.

Blog Posts


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