Recent Articles:

Morning Headlines 2/17/21

February 16, 2021 Headlines No Comments

CloudMD to Acquire VisionPros, a Rapidly Growing Digital Eyecare Platform with a Robust Suite of Digital Vision Care Tools

Canada-based CloudMD will acquire online eyeglass, contact lens, and online vision test vendor VisionPros for up to $80 million in cash, shares, and performance earn out.

Healthcare-focused SPAC Digital Transformation Opportunities files for a $250 million IPO

Digital Transformation Opportunities, a Bellevue, WA-based blank-check company focused on working with businesses in healthcare IT, plans to raise $250 million in an IPO.

Fastest Growing EMR Provider Medfar Raises Nearly $25 Million Investment Led by Walter Capital Partners

Canadian EHR vendor Medfar Clinical Solutions raises $25 million in an investment round led by Walter Capital Partners.

News 2/17/21

February 16, 2021 News 9 Comments

Top News

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Online scheduling and telehealth vendor Zocdoc receives $150 million in growth financing from Francisco Partners.

The company says that its pricing change two years ago – from a flat per-provider subscription to a per-booking model that angered some doctors who had to pay more and who expressed concern about possible kickback implications – has grown its network by 50% in some states.

Zocdoc has raised $376 million through a Series D round.

Co-founder and former CEO Cyrus Massoumi sued the company last fall, claiming that three officers – two of whom he says he was going to replace – conspired to orchestrate his ouster after eight years. He said in the lawsuit that the company was in steep decline, couldn’t raise further capital, and had resorted to taking on debt at high interest rates. The lawsuit was dismissed by a New York court that said the suit would need to be filed in Delaware instead.


Reader Comments

From Data Broker Not Broke: “Re: Truveta selling anonymized patient data to drug companies and researchers. Is that ethical?” Not in my opinion, especially since those patients get nothing in return and can’t opt out. The hospitals that collect their information as a by-product of selling them medical care don’t even have to let them know beforehand because of HIPAA’s covered entity-friendly “treatment, payment, and operations” terms. Facebook, Google, and other sites violate our privacy in mostly harmless ways and they at least give us their product free in return (try asking those 14 Truveta health systems for some medical freebies). Unlike those apps, though, the information is anonymized and is not used to display something to its owner, so it’s not really visible. We will all be paying in other ways – the deep-pockets drug company customers who are writing the checks to Truveta members will simply jack up their drug prices a little bit more or pocket the higher margins of not having to spend as much on clinical studies. We might as well acknowledge that the wholesome-sounding “medical research” is really just product R&D for drug and device companies, often funded by taxpayers and given to those companies at no cost to sell expensively back to us.

From Huckleberry: “Re: Clubhouse app as an audio-only social network. Have you tried it?” I have not tried it or found reasons to even though I know it’s the latest shiny object. It seems that many platforms initially succeed because early adopters who have a lot of expertise and insight develop a quick following, but then everybody and his imitative brother piles on to fill the endless space with junk just because they can, causing the best of them to move on to seek better company. We’ve seen it with blogs, vlogs, Facebook, Twitter, Medium, podcasts, newsletters, vanity book publishers, YouTube, Google Hangouts, Periscope, and more, where the platform’s best and worst feature is that it democratizes content creation. I expect Clubhouse will get its 15 minutes before it becomes yet another low-value wasteland. Online text is the only medium that allows me to consume it my way – skim quickly or study slowly and click original source links that will be missing in every other format. As to Clubhouse, I don’t know of many folks who could hold my attention for more than a couple of minutes as they babble away in real time. The most interesting people aren’t wasting their time pontificating incessantly to the masses.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Sectra. With more than 30 years of innovation and approaching 2,000 installations worldwide, Sectra is a leading global provider of imaging IT solutions that support healthcare in achieving patient-centric care. Sectra offers an enterprise imaging solution comprising PACS for imaging-intense departments (radiology, pathology, cardiology, orthopedics), VNA, and share and collaborate solutions. The company is leading the way in digital pathology with multiple, fully digital installations throughout the world. Sectra is top-ranked in “Best in KLAS” and #1 in customer satisfaction in US, Canada, and Europe PACS. Thanks to Sectra for supporting HIStalk.


Something jogged my memory of Bats Global Markets, a Kansas City-based stock exchange that was started by former Cerner employee Dave Cummings in 2005. I wrote about it many years ago and I see that it was acquired in early 2017 for $3.2 billion. Cummings remains sole owner of Tradebot, a high-frequency stock trading platform he started in 1999 that at one point was making him $140 million a year in profit. The company holds shares for an average of 11 seconds, had at one point enjoyed a four-year run of positive daily profits on trades, and accounts for 5% of all US stock trades. Cummings has credited his success to the mentorship of Neal Patterson, former chairman and CEO of Cerner. My keyboard’s zero key probably doesn’t have enough click life left to express his net worth. 


Webinars

February 24 (Wednesday) 1 ET. “Maximizing the Value of Digital Initiatives with Enterprise Provider Data Management.” Sponsor: Phynd Technologies. Presenters: Tom White, founder and CEO, Phynd Technologies; Adam Cherrington, research director, KLAS Research. Health systems can derive great business value and competitive advantage by centrally managing their provider data. A clear roadmap and management solution can solve problems with fragmented data, workflows, and patient experiences and support operational efficiency and delivery of a remarkable patient experience. The presenters will describe common pitfalls in managing enterprise information and digital strategy in silos, how to align stakeholders to maximize the value of digital initiatives, and how leading health systems are using best-of-breed strategies to evolve provider data management.

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


Acquisitions, Funding, Business, and Stock

Canada-based CloudMD will acquire online eyeglass, contact lens, and online vision test vendor VisionPros for up to $80 million in cash, shares, and performance earn out.

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Population health management platform vendor Innovaccer is rumored to be arranging funding that will value the company at more than $1 billion.


People

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Dental software vendor Henry Schein One promotes former telemedicine executive Mike Baird, MBA to CEO.

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CompuGroup Medical US names industry long-timer Derek Pickell as CEO. He comes from EMDs, which CGM acquired in late December 2020 for $240 million, and replaces Benedikt Brueckle, who is now CFO.

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Michael Campana (Conduent) joins Health Triangle as VP of marketing.


Announcements and Implementations

Sutter Health will eliminate 277 jobs, most of them in IT.


COVID-19

In Israel, a study of 600,000 people who have received two doses of Pfizer’s coronavirus vaccine finds a 94% drop in symptomatic infections and a 92% reduction in severe illness. The study was the first to show a high level of vaccine efficacy specifically in people 70 and over.

New York Governor Andrew Cuomo admits for the first time that the state’s nursing home COVID-19 death counts were underreported by 40% by omitting long-term care residents who died in hospitals. Cuomo says he delayed giving the information to state legislators for fear it would trigger a federal civil rights investigation.

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The remote, 2.2 million population Brazilian city of Manaus has seen COVID-19 consume nearly all of its hospital and ICU beds and depleted oxygen supplies, with dozens of Brazilians dying of asphyxiation over two days in January alone. Few planes there can transport oxygen, so it must be shipped in a week-long boat trip up the Amazon River. Brazil President Jair Bolsonaro, who has said that COVID-19 is a “measly cold” and a media hoax intended to harm him politically, says it isn’t the federal government’s job to send oxygen to Manaus. Brazil’s COVID-19 death count is at 240,000, second globally only the US’s 486,000.

A Virtua Health spokesperson clarifies reports that bugs in its COVID-19 vaccine self-scheduling system created many duplicate appointments. The scheduling system did not have a defect — it just failed to prevent people from making multiple appointments. The 70% number doesn’t refer to the number of duplicates of the 300,000 total appointments, but rather that of those duplicate appointments it contained, 70% were created  in error because users weren’t sure how to schedule both first- and second-dose appointments or didn’t wait for the confirmation email before scheduling again, allowing 5,000 appointment slots to be opened after calling each of those users to verify their intentions.

Walmart begins scheduling COVID-19 vaccination appointments at some of its stores.

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X Prize founder and entrepreneur Peter Diamandis, MD, MS says he “screwed up” by holding an illegal in-person California summit last month for several dozen wealthy executives who paid more than $30,000 each, saying they would be safe from COVID-19 because of mandatory pre-event and then daily testing and onsite vitamins and doctors. Three weeks later, at least 24 attendees of Abundance 360, including Diamandis himself, have tested positive. Diamandis, who co-founded coronavirus vaccine company Covaxx, admits that he didn’t force attendees to wear masks, but claims the event wasn’t actually a conference but rather a broadcast with a small live audience since most attendees were virtual. Zero of the 35 audiovisual production staff, all of whom wore masks, tested positive.  


Other

Two hospitals in France are hit by ransomware in a single week, while a third cut off network connections to one of its IT suppliers that had been attacked.


Sponsor Updates

  • Beyond profiles Goliath Technologies as a “Top 5 Citrix Solutions Provider, 2021.”
  • Black Book Market Research includes Impact Advisors on its list of top-rated RCM advisory firms.
  • Cerner will sponsor and present virtually at Health Datapalooza February 16-18.
  • The local business paper interviews Diameter Health CEO Eric Rosow.
  • Elsevier advances nursing education by offering innovative virtual reality healthcare simulations to schools across North America.

Blog Posts


Contacts

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

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Morning Headlines 2/16/21

February 15, 2021 Headlines No Comments

Zocdoc Announces $150 Million in Growth Financing from Francisco Partners

Online provider search and appointment-booking app Zocdoc raises $150 million in a private equity round led by Francisco Partners, bringing its total raised to $376 million.

Healthcare startup Innovaccer to enter unicorn club, in talks with Tiger Global for $100-$150 million funding

Sources say analytics and interoperability vendor Innovaccer will soon raise between $100 million and $150 million from investor Tiger Global.

RapidSOS Raises $85M Series C Led by Insight Partners to Scale Emergency Response Data Platform

RapidSOS, a software vendor specializing in aggregating and sharing emergency-related data with first responders, raises $85 million in a Series C funding round.

Curbside Consult with Dr. Jayne 2/15/21

February 15, 2021 Dr. Jayne No Comments

Like many parts of the US, my city has spent the weekend heading deeper into the polar vortex. I’m not a big fan of sub-zero temperatures, let alone wind chills in the negative double digits. We’re expecting snow throughout the night and into the morning, which will make for less-than-fun conditions driving to work in the morning. While some of my physician colleagues were scrambling to move their in-person patients to virtual visits, I reminded them that some of us have to work in person regardless of the weather.

I’m a bit tired of being an all-purpose clinical safety net for practices that don’t want to or otherwise can’t see patients in person, and especially having to see those patients without any supporting medical information. That’s one of the pitfalls of being part of an independent organization. We don’t have access to anyone’s broader medical records, unless you count patients who log into MyChart and hand you their phone. Our state charges exorbitant rates for independent physicians to participate in its health information exchange, so we don’t have that data, either.

Back when I was a community-based family physician, I used to call ahead when I referred patients to urgent care or to the emergency department to let them know what I was thinking and why I was sending the patient. It doesn’t seem like anyone does that any more. Half the time when I try to call a patient’s personal physician to discuss their case, either I don’t get a call back or they act bothered that I even called in the first place. I’ve had a total of two physicians thank me for calling them about their patients in the last six months. One of them was an orthopedic surgeon who not only gave me advice on how to handle the patient’s unique problem, but made the patient an appointment for first thing in the morning while she and I were on the phone discussing the case.

I try to keep positive situations like this one at the top of my thoughts when I’m dreading tomorrow’s bone-chilling and potentially dangerous trek. Due to the pandemic, plenty of people are out of practice driving in poor conditions, so who knows what it will look like. I’d much rather be at home working on technology projects. I have some interesting ones in the works. One takes me into a world where I haven’t had a lot of experience outside the clinical realm, and that’s the perioperative services arena. I’ve been contracted by a health system that is trying to be proactive about the significant number of surgeries that patients have delayed during the pandemic. As COVID-19 numbers begin to fall across the region, they are looking at the best ways to bring those patients back into care.

As you can imagine, a number of the cases are orthopedic in nature – hip and knee replacements, shoulder reconstructions, and the like. For those patients whose procedures were on the books at one time and were rescheduled or canceled during the pandemic, outreach is fairly straightforward. The challenge is identifying the patients who never made it to the surgical scheduling team. Perhaps the procedure had been discussed with a surgeon, some of whom are employed by the health system, so we have access to medical records and can begin to identify those patients depending on how the visits were documented and whether the procedure recommendations were captured in discrete data. Others had surgeries recommended by community-based physicians who are on staff at the system’s hospitals, and identifying those patients is more challenging.

Beyond identifying the patients and their respective procedures, there are several other related projects that I’m being pulled into. They look at various details including surgical scheduling, staffing for perioperative personnel, equipment management, sterilization and central supply processes, and more. One sub-project looks at the surgical instrument preferences for various procedures across surgeons and how they might be standardized. That’s where it gets exciting for me, because I get to try to look at relationships between surgical outcomes and a number of factors, including level of standardization, number of cases performed at the different facilities, staffing, and how those factors might influence each other.

Right now, I’m overseeing the gathering of the data from various sources and its aggregation into a central database. We’re designing the questions we need to ask and looking at known pain points in the processes, from scheduling to day of surgery to follow up. This is where it’s fun to be the outsider, because I don’t know any of the people or the personalities and I’m eager to let the data speak for itself.

I don’t know that Dr. X has been on staff for 30 years and that people tolerate his quirkiness because he’s considered the elder statesman of his subspecialty. I am not swayed by people’s claims that their patients require special equipment different than that used by all their peers. I don’t know any of the stories about why one hospital has been allowed to operate outside the system’s standards or why everyone else is in alignment. I’m eager to see what stories emerge as the data begins to tell its tale. I can also look at data that overarches the procedures and surgeons, such as operating room turnover time, housekeeping data, central supply factors, length of stay data, surgical complications, readmissions data, and more.

The other element that excites me about this project is having support staff to work with who know the system from the inside. It’s not the usual “let’s outsource this” type of project of which I am usually on the receiving end. I get to work with people across the health system who possess deep experience in quality improvement projects and clinical transformation work and are similarly motivated to try to find ways to improve the process as well as patient experiences and outcomes.

I knew this was going to be an interesting project, but now that I’m really involved, I feel like a kid in a candy store. What projects are you most looking forward to this year? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Interviews Kelly Feist, Managing Director, Ascom

February 15, 2021 Interviews No Comments

Kelly Feist, MBA is managing director of Ascom Americas of Morrisville, NC.

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Tell me about yourself and the company.

I started my career as a bedside clinician. I worked for 10 years at a couple of acute care hospitals in Florida in the respiratory care department, covering intensive care units, emergency departments, and neonatal ICUs. I have a strong appreciation for what a clinician experiences each day and their need for not just information, but information that is actionable and easily interpretable.

I joined Ascom on April 6, so my first day was after the pandemic started, which is an interesting way to start with a new company. I was drawn to the company because it is going through a transition and a transformation, moving from capital equipment to  focusing more on workflow, clinicians, and patients. Our healthcare information and communication technology helps clinicians deliver bedside care in an effective way, managing communications between clinicians and from patients to clinicians. We start at the bedside with the patient in the center with nurse call, and then move out to mobility devices. It’s an end-to-end, integrated workflow that becomes increasingly important as we find new ways to manage clinical care while trying to limit contact.

What are the challenges and benefits of collecting and presenting information from hospital monitors to clinicians on mobile devices?

It’s not just hospital monitors, but also ventilators and laboratory test results. A vast amount and a vast variation of information can be presented on mobile devices in the clinician’s hand. It’s not just the information, but the actionable information. We can deliver so much information when we digitize a workflow that was previously analog. We can put a mobile device in the hand of a nurse at the bedside that can receive alerts from all of these different devices — ventilators, patient monitors, lab systems, and so on. A lot of information can hit that handheld and overwhelm the nurse.

The challenge is to identify what information is truly actionable and how that information is escalated so that the nurse can respond in an efficient and informed way to solve the patient’s problem. You can’t overwhelm people with a lot of information and then expect them to decide what’s important and what can wait. The value that we deliver is helping them understand how they should be prioritizing that information so that care providers aren’t overwhelmed by a new workflow that now happens to be digitized. Just because we can digitize it doesn’t mean we should.

Is technology such as AI, which is a term I hesitate to use, improving the ability to automatically prioritize information instead of having each facility or each user set up rules?

I share your reluctance to use the term AI. It is overused, and applying it in a way that makes sense is easier said than done.

I think about whether a hospital already has rules and policies in place. For example, does the facility have a policy for early warning scoring, where they have determined the parameters that can help identify a patient who is at risk for deterioration over time and then raise a flag before they become symptomatic? If that protocol exists, we can program it into the software aspect of our solution. We will raise the flag and create and escalate the communication in an automated way for the care provider to ensure that the patient who is at risk is identified quickly.

Most people don’t realize that the first indicator is typically an increase in respiratory rate. If we see it increase, or see the lactic acid test results increasing, the software can raise the flag, create the communication to the care provider, and escalate it in an automated way. That pays dividends. Healthcare facilities want to spend their capital equipment dollars on something that delivers measurable ROI. That becomes important in making their clinicians more efficient, keeping their patients safe, and increasing their own capacity if they can release patients or discharge them sooner. It’s a lot to say that, but we have done studies that have shown that at the very least, a well-designed, well-executed protocol decreases unplanned ICU admissions, for example.

How much of the nurse’s work can now be performed untethered, working from a mobile device that they carry at all times instead of being tied to a nursing station, a wall-mounted computer, or a computer on wheels?

As we are working with customers who are deploying these solutions, we find that the idea of the nursing station is going away. The push is to move the nurses and the frontline care providers closer to the patient and away from a centralized nursing station. This is the first real change that mandates finding new and better ways to manage that workflow.

It’s easy to think that we can apply technology to a workflow and change behavior because the technology exists, but the hardest thing to do in a clinical environment is to change the behavior of the care providers. Behavior change is always the hardest thing to affect. But if we can take our technology and support existing behaviors and make them more efficient, then we all win. The patient wins, the care provider wins, and the company wins.

That’s what we are focused on. As care and nurses move away from centralized nursing stations to something that is more distributed, it becomes important to have a communication device that pushes alerts to your hand. It allows instant communication to the care provider who knows that there’s a problem. Typically there’s also a secondary escalation path, so if that person is busy and can’t leave what they are doing, they can press a button and move it on to the next person, who can then respond. This allows us to build in safety nets.

I don’t think it’s reasonable at this point to think that all clinical documentation that goes into an EHR, for example, will go through a mobile device. Anyone who tries to type emails on their IPhone or their Android device understands why that is a challenge. But we can support the use of the EHR. Our goal at Ascom is not to compete with EHRs that are in place, but rather to support workflows and behaviors that enable and facilitate better use of the EHR. If we can close some workflow gaps at the clinician level and get the data into the EHR for a continuous health record, that is important. If we support the implementation of the EHR and make it successful, we can affect real change in the clinical process, and ultimately the outcome of the patient.

How can technology replace the continuous communication that occurs at the nursing station?

The mobile device becomes important. How well does it integrate into the overall workflow? How easy is it for the staff to communicate to one another, either voice-to-voice or via secure text message, or to receive alerts? When we think through an alerting process, there’s alerting the primary caregiver. But if that primary caregiver can’t respond, there has to be a secondary alert target, and then even beyond secondary, what we would call a catch net solution. Making sure that there’s a Plan A, a Plan B, and a safety net becomes important, because that central station doesn’t always exist any more. And even if it does exist, it isn’t always staffed 24/7.

We have to make it possible for communication to happen in an expedited way that fits into the workflow and meets the needs of the clinician where the clinician is. We are accomplishing that with mobility solutions, the software that drives the mobility solutions, and even starting at the bedside with the nurse call system so that the patient can communicate their needs as well.

What are the best practices in using technology to enable patients to communicate directly with staff to improve satisfaction, but avoiding overwhelming the employees who have to respond?

A care environment typically has registered nurses who are responsible for a level of care, and then often healthcare technicians or licensed nurse practitioners. If we can segregate the requests that come from the patient — based on need, priority, and criticality — to the right provider of those services, then we can get a faster response to the patient.

Patient satisfaction is incredibly important to our care providers, to the facilities that they work for, and to us. If we can make it a little bit more streamlined so that when the patient has a request — it could be, “I need a glass of water” — there’s a way for that patient to communicate and it can go to the LPN. It can go to a targeted recipient that can provide that service without them taking up time of the nurse who might be working with another patient on something that is more critical. But if it’s a critical need, the communication goes to the nurse. We can filter where the request goes based on priority to make sure that the patient gets the response they need in a timely manner.

What are the company’s goals in healthcare over the next few years?

Healthcare is our biggest growth opportunity. For my region in the US and Canada, it’s where the majority of our revenue comes from. The pandemic has shown how impactful we can be to the healthcare community.

As an example, when I started, field hospitals were springing up all over the place, such as at the Javits Center in New York City and McCormick Place in Chicago. They needed to give all patients in beds access to nurse call functionality. We were tapped to provide a lot of the technology for those field hospitals, and it felt good to be able to serve the community in a way that had impact. A lot of the field hospitals didn’t get a lot of census, but the fact that we were able to meet the needs of the community when those needs occurred was important.

Workflows have changed because of the pandemic and we are trying to decrease contact where we can to keep both patients and staff members safe. Ascom can play a big role in that. Those workflow adaptations aren’t all going to go away when the pandemic is over. We have to keep innovating on how we make communications more streamlined, more effective, how we get them to the right person, and how we ensure that priority items are escalated appropriately. Those will remain important. With virtual visits and other changes, we will need to monitor patients at home effectively. Ascom can play a part in that realm as well.

Do you have any final thoughts?

The workflow changes that we are experiencing as a result of the pandemic aren’t going to go away. Keeping the patient and clinician provider at the center of what we do will make healthcare delivery more efficient, and that will make us successful as a company. Focus on the patient and the provider.

Morning Headlines 2/15/21

February 14, 2021 Headlines No Comments

Dexcom Launches Inaugural Venture Capital Fund

Continuous glucose monitoring device vendor Dexcom launches a venture capital fund that will identify and invest in opportunities to supplement its core business.

Vocera Announces Fourth Quarter 2020 Financial Results

Vocera announces Q4 results: revenue up 14%, adjusted EPS $0.28 versus $0.15, beating Wall Street expectations for both.

Sutter Health’s layoffs to total 277, mostly in IT

Sutter Health (CA) files documents with state regulators outlining its plans to fire hundreds of IT workers.

OCR Settles Sixteenth Investigation in HIPAA Right of Access Initiative

HHS OCR settles its 16th HIPAA Right of Access case, with Sharp HealthCare paying $70,000 for taking seven months to send an electronic copy of a patient’s records to a third party.

Sharecare and Falcon Capital Acquisition Corp. Reach Agreement to Combine, Creating Publicly Traded Digital Health Company

Sharecare will merge with SPAC Falcon Capital in a deal that will value the newly combined company at $3.9 billion.

Monday Morning Update 2/15/21

February 14, 2021 News No Comments

Top News

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A new GAO report recommends that the VA stop its implementation of Cerner until all known critical issues have been addressed.

The VA agrees in principle, but says it won’t stop the rollout and instead will test and mitigate risks.

Most of the GAO’s data came from work performed last fall. VA has since closed most of the high-severity issues that GAO noted. Just 55 of the previous nearly 400 issues remain open.The VA says it will have all issues resolved by January 2022.

Next up for go-live is Puget Sound Health Care System in Q4 2021. 


Reader Comments

From DAX Facts: “Re: Nuance’s DAX ambient clinical intelligence. Users have told me that their hospitals are finding it hard to generate ROI because just freeing up physician time doesn’t necessarily result in more visits or revenue. What are your thoughts on how much value DAX adds and how that will be reflected in its pricing?” I’ve been wondering that myself, especially after last week’s Nuance earnings call in which DAX consumed a lot of company and analyst discussion that I assume reflects financial expectations. DAX customers mentioned in the earnings include Duke Health, San Joaquin Hospital, Mercy Health, Rush, WellSpan, Connecticut Children’s, and Cooper Health. I would be interested in firsthand experience at a macro level, i.e. how do physicians like it and is the expectation that it will pay for itself? Let me know and I’ll keep you and your organization anonymous, of course. I’ll also add that hospitals aren’t good at turning newfound employee free time into anything more than a less-stressful workday, which offers some burnout benefits but doesn’t excite CFOs who have to write the checks.

From Damocles: “Re: Cerner’s bankrupt client who owes $63 million in an arbitration judgment. You are correct that it was Belbadi Enterprises. Cerner is still pursuing taking possession of a Vancouver, WA property that was held by a subsidiary by way of the company’s former CEO. Cerner hired forensic accountants and investigators who found that the company moved money back and forth with that subsidiary, even though Vandevco / Belbadi claimed that no tie exists. Also stiffed were consulting firms who were hired to install Cerner for the UAE’s Ministry of Health and Populations, which were left with unpaid bills when MOHP signed a direct contract with Cerner and cut Belbadi out of the deal. I’m sure it’s a sensitive issue since Belbadi is still an active entity in the UAE and the former CEO is a member of one of the ruling families, even though he lined his pockets with money that should have gone to Cerner and other vendors.” It’s good to be king, or in this case, brother of your country’s minister of justice and the 10th richest UAE citizen.

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From IHeartHIStalk: “Re: counterfeit N95 masks from China. Meanwhile, small US manufacturers can’t find mask buyers.” The New York Times profiles DemeTech, a family-run Miami business that invested tens of millions of dollars in mask manufacturing equipment and spent nine months earning federal approval to sell N95 masks, but now the owner can’t find buyers for the 30 million masks he has in inventory and he is laying off employees. Despite vows to “buy American,” health systems, medical supply distributors, and state governments don’t want to change their buying habits or spend a bit more on masks that are made in this country. Manufacturers are also being hurt by Facebook and Google advertising bans that were intended to thwart mask profiteers. Big players like 3M and Honeywell, spurred by the Defense Production act, are selling 120 million masks each month, mostly to distributors that resell to hospitals who need more than twice that number.


HIStalk Announcements and Requests

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Poll respondents would be most concerned about credit card or payment information in the event their medical records were disclosed. The good news there is: (a) I would hope that most PM/EHR systems don’t retain credit card information or store it via a payment processor’s secure system; and (b) you can always cancel a credit card and start over with no repercussions, unlike having your medical information disclosed to the world. Behind credit card information is behavioral information, and far behind that is a list of social habits. After that, most people don’t really care.

New poll to your right or here: In your most recent physician or hospital encounter, were your electronic records from one or more other providers reviewed?

I dropped by Walgreens Friday to procure vital medical supplies (Valentine’s Day cards, candy, and stuffed animals) and saw that they are giving COVID-19 vaccine shots by appointment. It was a bit jarring after reading and writing so much about the vaccine over many months to see unexcited employees calling people up from their waiting area chairs to get their injection. Chain drugstores are all about the foot traffic that generates high-margin impulse sales (like Valentine’s Day cards, candy, and stuffed animals) and COVID-19 vaccinations will see dozens of millions of people traipsing through their aisles to the back of the store in two visits. Sometimes a business’s biggest challenge, and a profitable one if they can pull it off, is to get people into their store for the first time.

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Welcome to new HIStalk Platinum Sponsor Gyant (pronounced “giant.”) The San Francisco-based company’s empathic, intuitive virtual assistant guides patients through the complexity of their digital healthcare journeys, driving more meaningful patient-doctor engagement. It reduces clinical strain and support staff overhead, improves outcomes, and exceeds patient expectations. The company’s conversational AI learning loop handholds patients from the virtual front door through their entire clinical journey by integrating deeply into EHR workflows and driving higher levels of efficiency that improve patient outcomes and make them feel truly valued. Thanks to Gyant for supporting HIStalk.

Here’s a Gyant explainer video I found on YouTube.

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

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Listening: new from reader-recommended Starcrawler, some LA teen punk rockers who sound kind of like L7 meets the New York Dolls and Iggy and the Stooges. That’s a lot of musicality and 1970s influence from kids who are barely old enough to drive. Their live shows are apparently pretty nuts.


Webinars

February 24 (Wednesday) 1 ET. “Maximizing the Value of Digital Initiatives with Enterprise Provider Data Management.” Sponsor: Phynd Technologies. Presenters: Tom White, founder and CEO, Phynd Technologies; Adam Cherrington, research director, KLAS Research. Health systems can derive great business value and competitive advantage by centrally managing their provider data. A clear roadmap and management solution can solve problems with fragmented data, workflows, and patient experiences and support operational efficiency and delivery of a remarkable patient experience. The presenters will describe common pitfalls in managing enterprise information and digital strategy in silos, how to align stakeholders to maximize the value of digital initiatives, and how leading health systems are using best-of-breed strategies to evolve provider data management.

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


Acquisitions, Funding, Business, and Stock

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Continuous glucose monitoring device vendor Dexcom launches a venture capital fund that will identify and invest in opportunities to supplement its core business. The fund will focus on sensing technology, analytics, remote patient monitoring, and population health management.

Vocera announces Q4 results: revenue up 14%, adjusted EPS $0.28 versus $0.15, beating Wall Street expectations for both. Shares jumped 25% Friday following the announcement, with VCRA shares up 76% in the past 12 months versus the Dow’s 6% gain, valuing the company at $1.7 billion. Vocera said in the earnings call that Q4 bookings were the highest in the company’s history as COVID-19 has elevated hospital priority for communication and workflow solutions that keep employees safe.    


Announcements and Implementations

Well Health announces that its COVID Vaccination Self-Scheduling is available to providers through self-scheduling partners. The system allows scheduling both appointments, maximizes doses through appointment optimization, follows up for second doses, and provides secure message to patients regardless of whether they are registered in the EHR.


Government and Politics

HHS OCR settles its 16th HIPAA Right of Access case, with Sharp HealthCare paying $70,000 for taking seven months to send an electronic copy of a patient’s records to a third party. OCR originally closed the case after giving Sharp technical assistance, but the patient filed a second complaint two months later when the records had still not been sent.


COVID-19

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US COVID-19 cases and hospitalizations continue their steep downward trend, with just 69,000 hospitalized patient versus nearly double that number just a few weeks ago. Still, the numbers are higher now than in the spring and summer surges.

CDC reports that 51 million COVID-19 vaccine doses have been administered of the 70 million distributed (72%), split nearly evenly between the Pfizer and Moderna products. 

UK scientists find that the B117 coronavirus variant is not only more infectious, which was previously documented, but it also appears to be 30% to 70% more lethal given limited study so far. If that finding holds after further research, spread of the variant could disproportionally increase hospitalizations and deaths even beyond just causing a higher number of infections. In Canada, Newfoundland and Labrador is already seeing a B117-fueled outbreak and has escalated mitigation measures.

New Jersey’s vaccine hotline stops booking appointments after callers report that they were given incorrect information. The state says it will provide extra training for the hotline’s 2,000 agents and is working out software problems with vendor Microsoft. The state had weeks of outages with its online registration system, warning that Microsoft’s Vaccine Management system may never work. The state says Microsoft doesn’t have enough support people and some of them are offshore and thus unavailable during US working hours.

In yet another example of COVID-19 vaccination software shortcomings, FDA is still trying to bring up its BEST system for monitoring vaccine side effects using real-world evidence. BEST will eventually be able to review the medical records of 100 million people in real time, but it relies on EHR and claims data that aren’t always filed for no-charge vaccinations. The system is also so new that FDA hasn’t yet calculated the rates of background problems with people who haven’t received the vaccine, so they can’t easily identify unusual events. For now, the federal government is using several other systems that don’t share information, including the 30-year-old FDA/CDC VAERS system for self-reported vaccine problems.

Virtua Health finds a bug in its vaccination self-scheduling system when it notices that 70% of its 300,000 appointments are duplicates, requiring 10,000 phone calls to work out the duplications but freeing up 5,000 open slots by doing so. They didn’t indicate the software they use, but the signup form uses Epic MyChart. UPDATE: A Virtua Health spokesperson clarifies that the scheduling system did not have a bug, it just didn’t prevent people from making multiple appointments. The 70% number doesn’t refer to the number of duplicates of the 300,000 total appointments, but rather that of those duplicates, 70% of them were made in error due because users weren’t sure how to schedule both first- and second-dose appointments or didn’t wait for the confirmation email before scheduling again.

New York Governor Andrew Cuomo’s top aide admits that the state withheld data about COVID-19 deaths in nursing homes because it feared an investigation by the federal Justice Department. The state’s nursing homes have had 15,000 COVID-19 deaths, nearly double the previously reported total, which the state did not confirm until faced with a court order. Cuomo issued an executive order in March 2020 that required nursing homes to readmit their residents following their hospitalization for COVID-19 treatment, but state health officials have claimed – without providing details – that the high rate of nursing home deaths was caused by infected employees and not the residents themselves.

The federal government has not developed a plan to allocate COVID-19 vaccine for the 6,000-employee US Public Health Service, telling them that they should visit military treatment facilities that are sometimes turning them away in confusion about whether they are eligible (all of them are, per the Pentagon’s priority list). Public Health Service officers are being deployed to deliver care to COVID-19 patients and to work on mass vaccination programs.

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The Atlantic explains how the small, poor country of Bhutan controlled coronavirus so well that it has recorded just one COVID-19 death:

  • The country can’t afford to run an expensive US-style health system, so it focuses instead on public health and prevention.
  • Within two weeks of China’s first report to the WHO of an unknown pneumonia outbreak, Bhutan drafted an emergency plan and started screening people at airports.
  • With six hours of discovering its first confirmed COVID-19 case in early March – an American tourist – the Yale-educated epidemiologist who is its health minister had 300 possible contacts traced and quarantined.
  • The government issued clear daily updates.
  • Bhutan banned tourists, closed schools and public institutions, closed entertainment venues, and urged mask-wearing and distancing.
  • The government paid for hotel accommodations and meals for those who were quarantined.
  • The first positive case outside of quarantine triggered a national three-week lockdown in which the government delivered food and medicine to every household.
  • The king’s relief fund provided financial assistance to those who had lost income, created a national registry for vulnerable citizens, and sent packages of medical items to every resident over 60.

Other

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Stanford researchers find that higher-ranked children’s hospitals that have their own EHR instead of sharing one with an adult hospital perform better in rankings. I can offer many reasons for this correlation that go beyond the article’s suggestion that these hospitals don’t treat children as “small adults” or that their systems are all that different given that they use the same couple of vendors. I’m also skeptical that EHR’s configuration and use has a measurable effect on objective quality measures (did those hospitals show improvement after they implemented their systems?) I would also question whether rankings derived from self-reported US News & World Report surveys are reflective of quality. Maybe the most important unanswered question is whether children’s hospitals that deploy their own standalone EHRs are able to configure them differently (or are more likely to do so) than those that follow broader rules because they share a system with an adult hospital. That would make a better study – take a few ordering pathways that peds hospitals do differently (medication dose range checking, growth charts, use of patient identifiers, etc.) and see if they are implemented differently in standalone versus shared EHRs, and if they are, determine whether that’s because of EHR limitations or corporate choice.

Informatics experts in Switzerland say there’s no such thing as “your electronic medical record” there, as some clinics are still using paper records and fax machines and the system is fragmented by having both government-run and private systems. Cantons even used fax machines to send COVID-19 case information to the federal government for tracking. Data stored in silos, the experts say, will stand in the way of using promising AI applications.


Sponsor Updates

  • OptimizeRx announces the pricing of the previously announced underwritten public offering of 1,325,000 shares of its common stock at $49.50 per share.
  • Cerner supports mass COVID-19 vaccinations around the world.
  • Redox releases a new podcast, “From Buzzword to Buzzer-Beater: How SDOH stands to take COVID head on.”
  • TriNetX will work with German hospital organization VUD to build a collaborative network of university hospitals and medical schools as part of the TriNetX global health research network.
  • Well Health makes COVID-19 vaccination self-scheduling capabilities available through multiple industry-leading partners.

Blog Posts


Contacts

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

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Katie the Intern 2/12/21

February 12, 2021 Katie the Intern 2 Comments

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Interview: Rafid Fadul, MD, MBA, executive medical director, Wheel; and director of pulmonary medicine, Blanchard Valley Health System.

Katie

Email me or connect with me on Twitter.

Weekender 2/12/21

February 12, 2021 Weekender 3 Comments

weekender


Weekly News Recap

  • Fourteen large health systems form Truveta to provide anonymized patient data for research.
  • Value-based care coordination and payments vendor Signify Health prices its IPO at a valuation of $5.3 billion.
  • Cerner meets Q4 earnings expectations, beats on revenue.
  • CPSI misses Wall Street’s expectations for both revenue and earnings.
  • HHS OCR enters its 15th settlement involving providers that failed to provide patients with timely copies of their medical records.
  • Nuance acquires Saykara.
  • A security researcher finds problems with 30 popular health apps and their APIs.
  • Duke spinout Clinetic, which monitors EHR activity to identify patients for clinical trials and next care steps, raises $6.4 million in equity.

Best Reader Comments

It seems like Cerner is going for the data play for their growth. That’s what Allscripts told Wall Street for the past five years and they never were able to execute on it. The solution in that space is not really a technology as much as it is a social process. Maybe they can pull it off. On a different note, CPSI seems to be more in the outsourced to Overseas billing business than in the EHR business these days. (IANAL)

This seems to me to be part of an ongoing problem space that really shouldn’t be part of a free market society. We have seen many examples of VCs buying facilities and clinics then turning them into profit centers. Be that through purchase of rural hospitals and using the lab systems to “outsource” labs at many multiples of the normal cost, or hospitals aggressively pursuing clinical debt up to and including leans on homes and garnishment. The stories are numerous and from credible sources (KHN, NPR, DOJ). Frankly, we shouldn’t allow venture capitalists into our health systems — their mission is to turn a profit and they use the opaqueness of the HC system to do that. A $46,000 rabies shot that normally costs $3,000? (AnInteropGuy)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. P in Pennsylvania, who asked for three sets of books covering math, space, and the environment for her elementary school class. She reports, “These books have made a big difference in our classroom. Since I am teaching virtually, I have recorded myself reading the books to the children. This way they can go back and listen whenever they wish. There are definite favorites. I don’t blame the children, I have my picks too. When we return back to in-person classes, these books will have a special home. They will have there own special shelves for easy access for the children. I can see them being read for years to come.”

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A patient in Canada who is undergoing treatment for throat cancer panics when new CT scan results that he saw on MyChart referred twice to his lung cancer. He couldn’t reach his oncologist, but the hospital connected him with the radiologist, who apologized that the transcription system had misheard his dictated “tongue” and instead documented “lung.” The patient says of his stressful reaction, “It confirmed my impression that the healthcare system has yet to establish an effective way for caregivers and patients to communicate except through in-person, video, or telephonic visits. I’ve not been successful in getting questions answered using the Cancer Centre’s Patient Support Line. And so far, MyChart has mostly wasted my time or misled me … I’m struck that when I read my CT report, I saw immediately that the reference to ‘lung’ was anomalous. If a layperson can see an anomaly, could we train an AI to catch one? Don’t dismiss the thought. I certainly don’t want a robot that autocorrects CT reports. But I do want one that can register surprise when something unexpected happens.”

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NASA will offer 1,000 employees, including astronauts, a Fitbit Charge 4 device and Fitbit’s Ready for Work app to help them decide whether they are experiencing COVID-19 symptoms and should stay home from work during the critical pre-flight period. The app tracks resting heart rate, heart rate variability, and respiratory rate and allows users to self-report symptoms, temperature, and possible COVID-19 exposure.

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This is American culture and its healthcare system in a nutshell. Tessica Brown uses Gorilla Glue spray adhesive as a replacement for hair spray in a pinch, then spends 22 hours in the ED trying to get it removed. The daycare owner was finally freed of her adhesive hair net by a plastic surgeon, but meanwhile earned dozens of millions of TikTok video views, raised $22,000 in a GoFundMe to cover her medical bills for “this unfortunate ordeal,” and is reportedly planning to sue Gorilla Glue for misleading her (she denies reports that she’s suing). Not to be outdone, a fellow Louisiana resident – who previously earned his 15 minutes of fame on Dr. Oz for participating in the “ice cream challenge” of licking the contents of a carton of ice cream and putting it back on the store’s freezer shelf for someone else to buy — attempts to prove that Brown was exaggerating by gluing a Solo cup to his lip, then videoing himself triumphantly licking it off. That didn’t work as planned and he, too, ended up in the ED, where doctors peeled the cup off.

A UK hospital asks midwives to change their childbirth-related terms to be more inclusive – “mother” will be replaced by “birthing parent;” “her” will be retired in favor of “them;” “maternal” will become “maternal and parental;” and the new term for “father” will be “co-parent.”

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A Texas nurse whose car was pinned between two semi trucks in the early morning 100-car I-35W accident that killed six people crawls out through her trunk to free herself, hops the highway barrier to hitch a ride with a co-worker going the opposite direction, and goes to work.

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Cerner Charitable Foundation Program Manager Allison Chael worked her other job as a Kansas City Chiefs cheerleader last weekend. Each team had to choose eight members of its cheerleading squad — the Chiefs have 33 cheerleaders on the roster – and they were not allowed on the playing field for this year’s game.

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Cheering on the other side of the Super Bowl field was Tampa General Hospital ICU nurse and Buccaneers cheerleader Anastasia Lusnia, RN.


In Case You Missed It


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Morning Headlines 2/12/21

February 11, 2021 Headlines No Comments

Providence, 13 other health care systems back data platform Truveta

Providence and several other big health systems form Truveta, a Seattle-based startup that will provide its hospital owners, drug companies, and researchers with anonymized patient data for approved research projects.

Watchdog: pause on VA’s $16B electronic health records project might be needed

A GAO report recommends that the VA postpone new Cerner implementations until it can address critical severity and high severity test findings.

Signify Health IPO prices well above expectations, valuing company at over $5.3 billion

Value-based care coordination and payments vendor Signify Health prices its IPO at a valuation of $5.3 billion.

Cerner Reports Fourth Quarter and Full-Year 2020 Results

Cerner reports Q4 earnings: revenue down 3%, adjusted EPS $0.78 versus $0.75, meeting earnings expectations and exceeding on revenue.

News 2/12/21

February 11, 2021 News 5 Comments

Top News

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Providence and several other big health systems form Truveta, a Seattle-based startup that will provide its hospital owners, drug companies, and researchers with anonymized patient data for approved research projects.

The company notes that its information spans health systems and thus, unlike that offered by insurance companies, does not disproportionately represent white and insured patients. 

Truveta, which is run by former Microsoft executive Terry Myerson, has hired 53 employees.

As with all such companies, patients do not share in the profit of having their information sold or used and are not required by HIPAA to be notified of the arrangement.


HIStalk Announcements and Requests

I ran across the latest HIMSS tax filings, for the year ending June 30, 2019, and provided a brief summary. The version that includes the first half of 2020 – and thus some of the HIMSS20 damage – will be posted in July.

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Thanks to PatientKeeper for quickly snapping up the top-of-page banner spot for a long-term run. They have been an HIStalk sponsor since June 2008.

Listening: new from Jagwar Twin, the solo project of singer-songwriter Roy English. It’s modern, mostly upbeat pop with a hip hop edge, without the usual one-track collaborations, overreliance on computers, and profanity. I also ran across some amazing 1960s soul (from the viral hits chart of Portugal, for some reason) of Memphis-born soul singer-songwriter William Bell, who recorded for the legendary Stax Records, got drafted into the Army for a two-year hitch, had a couple of hits and awards, and is still playing at 81 years of age. His is the joyous, gospel-influenced music that could only come from America. I don’t recall ever hearing his stuff, but it is remarkable.


Webinars

February 24 (Wednesday) 1 ET. “Maximizing the Value of Digital Initiatives with Enterprise Provider Data Management.” Sponsor: Phynd Technologies. Presenters: Tom White, founder and CEO, Phynd Technologies; Adam Cherrington, research director, KLAS Research. Health systems can derive great business value and competitive advantage by centrally managing their provider data. A clear roadmap and management solution can solve problems with fragmented data, workflows, and patient experiences and support operational efficiency and delivery of a remarkable patient experience. The presenters will describe common pitfalls in managing enterprise information and digital strategy in silos, how to align stakeholders to maximize the value of digital initiatives, and how leading health systems are using best-of-breed strategies to evolve provider data management.

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


Acquisitions, Funding, Business, and Stock

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Value-based care coordination and payments vendor Signify Health prices its IPO at a valuation of $5.3 billion. The company’s CEO is Kyle Armbrester, MBA, who along with several of his executive team peers, used to work for Athenahealth.

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Cerner reports Q4 earnings: revenue down 3%, adjusted EPS $0.78 versus $0.75, meeting earnings expectations and exceeding on revenue. CERN shares dropped slightly on the news and down 1% over the past 12 months versus the Nasdaq’s 46% gain, valuing the company at $24 billion. From the earnings call:

  • The company says it has reduced annualized operating expenses by $300 million in the past two years and has reduced its product set from 25,000 features to 400 products.
  • Cerner expects to create a $1 billion health network business by 2025.
  • Asked by an analyst how the company can simultaneously address losing market share to Epic as well as convincing customers to choose Cerner in innovative areas where it competes with new companies, President Don Trigg says Cerner was built to work on the current business as well as to identify new growth opportunities that may be adjacencies or new markets. They are looking at new buyer types beyond providers, such as payer, employer, government, and pharma.
  • Trigg said in response to a question about how it will work with pharma contract research organizations following its acquisition of Kantar Health that Cerner’s differentiators are data as well as access to patients and providers. The acquisition allows linking data to support capabilities needed for late-stage drug trials.
  • Cerner expects the acquired Kantar Health to generate about $150 million in revenue for 2021 even with COVID-19 slowdowns.
  • The company may divest a limited number of assets in 2021, but is mostly interested in acquisitions.
  • Health systems that participate in Cerner’s Learning Health Network share the revenue that Cerner earns from drug companies.
  • Cerner’s federal business generates $1 billion per year and is growing at a mid-teens percentage rate. It sees opportunity in contracting with new agency work, especially on the network side, and the company will become more efficient with its experience as a prime contractor.
  • The company took a $20 million charge that was due to an entity in the Middle East declaring bankruptcy. That entity wasn’t named, but I assume it was Belbadi Enterprises, a sole proprietorship that was formed by Abu Dhabi’s former health minister that signed a deal in 2008 to provide Cerner to UAE hospitals. Cerner was awarded $62 million, but was never paid, and then failed in its attempt to seize Oregon real estate that was owned by a related company.

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CPSI announces Q4 results: revenue down 5%, EPS $0.22 versus $0.78, missing Wall Street expectations for both and sending shares down 11%. CPSI shares are up 25% in the past 12 months versus the Nasdaq’s 46% gain, valuing the company at $446 million. The company said in the earnings call that it has hired an advisor to review its business in hopes of increasing shareholder value. It also said in an SEC filing that it will reduce its workforce by 1%, or 21 employees.


Sales

  • Nuvance Health chooses SymphonyRM for data science-powered consumer engagement, including Next Best Actions, outreach and consumer preference management, and market analytics.
  • In England, West Hertfordshire NHS Trust signs a 10-year, $41 million contract for Cerner.
  • Florida’s Agency for Health Care Administration will deploy the PULSE (Patient Unified Lookup System for Emergencies) Enterprise platform of Audacious Inquiry for public assistance around COVID-19 and hurricanes.
  • Community Health Network selects Jvion’s CORE (Care Optimization and Recommendation Enhancement) to allow care navigators to reach out to vulnerable ACO members who are deferring care during the pandemic.
  • Saint Peter’s University Hospital (NJ) will implement CarePort Interop, an event notification system from WellSky-owned CarePort that supports compliance with new CMS Condition of Participation requirements.

People

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Mary Lantin, MPH (Optum) joins Diameter Health as president/COO.

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Innovaccer hires industry long-timer John Pigott (Allscripts) as management director of its payer and life sciences sales team.

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Aver hires Michael Johnson (Rx30) as chief revenue officer.

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EFamilyCare, which offers family caregivers virtual support from experts to reduce hospitalizations, promotes Naveen Kathuria, JD to CEO.


Announcements and Implementations

The HCI Group earns Meditech UK Ready implementation certification.

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FDA issues 510(K) clearance to B-Secur’s ECG algorithm library for signal conditioning, heart rate, and arrhythmia analysis. The Northern Ireland-based company’s technology can be licensed by medical technology vendors and is approved for home and healthcare environments.

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Well Health and Twilio partner to offer providers two patient engagement options, particularly around COVID-19 vaccination – supporting providers who want to built custom workflows using Twilio’s SMS and voice delivery APIs and those who would prefer to roll out Well’s Health pre-built platform that supports bidirectional texting, email, telephone, and live chat in 19 languages.

Smarter Health, which sells a payer-provider data integration platform in Southeast Asia, will offer data analytics from Health Catalyst.

Arkansas State Hospital goes live on Medsphere’s CareVue Cloud EHR and RCM Cloud.

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A new KLAS report on clinical documentation improvement finds that Iodine, ChartWise, and Optum lead in performance, while 3M 360 Encompass is often considered because of its strong technology but service and support lags and customers complain about being nickeled and dimed.


Government and Politics

Renown Health (NV) will pay $75,000 to settle HIPAA Right of Access charges that it took 11 months to send an electronic copy of a patient’s records to her attorney.


COVID-19

CDC reports that 45 million doses of the 66 million COVID-19 vaccine doses that have been distributed have been administered (68%). Anthony Fauci, MD predicts that an increased supply of vaccine will allow any American to get a shot who wants one by April, but logistical limits will make achieving herd immunity unlikely before late summer. A new poll finds that one-third of Americans definitely or probably won’t get the vaccine, which predicts both an epidemiologic challenge as well as a shift from a shortage of supply to a deficiency of demand.

FDA issues emergency use authorization to a combination of two Eli Lilly monoclonal antibodies (bamlanivimab and etesevimab) for the treatment of COVID-19 in patients who are over 65 or who have other medical conditions, where risk of hospitalization and death can be reduced by 70%. Also new in COVID-19 treatment: the RECOVERY study finds that tocilizumab reduces mortality, inpatient stay length, and a need for ventilation of patients who are hypoxic and have inflammation.

Volunteer technologists have quickly developed vaccination appointment websites that centralize information from multiple sites in each state, but the beneficiaries are usually tech-savvy people who have time on their hands to cruise for appointments, not necessarily disadvantaged groups who have the highest need. Some of the sites don’t take into account eligibility differences between a state and individual counties, such as in California where the state’s 65-year-old threshold is overridden by the 75-year cutoff of some counties, leading people to show up at sites with their system-generated appointment and barcode in hand only to be turned away because they don’t meet county criteria.

The federal government says that a flood of fake 3M N95 masks from China is the most consistent COVID-19 scam, as hospitals have in some cases distributed the counterfeit masks to frontline workers. 3M says that 10 million counterfeit masks have been seized and it has fielded 10,500 authenticity questions. On the other hand, testing has found that the fake masks actually work about as well as the real thing, even though they are harder to breathe through and seal-and-fit isn’t always adequate.

Overrun hospitals in Mexico are sending COVID-19 patients home, where they are likely to die because their families can’t get oxygen tanks. A national shortage has caused the price to jump to $800 for the smallest tank (10 times the US price) and criminal groups are hijacking trucks carrying the tanks and stealing them at gunpoint from hospitals that are then sold by uncertified profiteers from their cars. Desperate family members are also paying thousands of dollars for oxygen concentrators that don’t necessarily work.

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India will use Co-WIN to manage its efforts to inoculate 300 million people for COVID-19 by August, which has no ability to extract high-priority people from a list based on age and comorbidities. Epidemiologists say that the only surefire way to hit the numbers target is to go door to door and sign high-risk people up. They also question whether Co-WIN will be used to collect private health data since signing up for a shot automatically creates a national health ID that is supposed to be voluntary.


Other

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The IT director of 15-bed critical access hospital Syringa Hospital (ID) urges its board to stick with Cerner instead of following its plan to use Epic from Kootenai Health. The hospital says it is switching to gain cost savings and better connectivity to other Epic hospitals, but the IT director says it would “really grieve me” to re-do the work and warns that not all information will convert. She adds that Epic isn’t in the top five EHRs for small hospitals. A board member said she appreciates the input, but the IT director’s view is slanted because “that’s her baby,” adding that the board expected the hospital’s leadership to come to them with a recommendation and instead they were divided.


Sponsor Updates

  • Altruista Health adds evidence-based medical content from Healthwise to its GuidingCare care management and population health software.
  • Change Healthcare has joined the Health Evolution Forum as a leadership partner.
  • The Chartis Center for Rural Health publishes a new report, “Crises Collide: The COVID-19 Pandemic and the Rural Health Safety Net.”
  • Over the past 12 months, Glytec’s FDA-cleared EGMS software has been used in an additional 6,500 beds and is now partnering with over 300 healthcare facilities across the country.
  • The HCI Group launches a new podcast, “DGTL Voices with Ed Marx.”
  • LexisNexis Risk Solutions announces its “Top 100 Hospice and Home Health Agencies Rankings for 2020.”
  • NextGate achieves HITRUST CSF Certification to further mitigate risk in third-party privacy, security, and compliance.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
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HIStalk Interviews Abhishek Begerhotta, CEO, 314e

February 11, 2021 Interviews No Comments

Abhishek Begerhotta, MS, MBA is founder and CEO of 314e of Pleasanton, CA.

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Tell me about yourself and the company.

I founded 314e in 2004. I used to work as a programmer on a project that IBM had undertaken to create a clinical information system for Kaiser Permanente. In around 2004, I think, Kaiser fired IBM and hired Epic. The rest is history. That’s when I founded 314e to provide services to Kaiser. Since then, we have worked with over 250 organizations across the healthcare value chain, including providers, payers, med tech, and life sciences companies. Our core areas of competence are EHR implementations, cloud, data engineering and analytics, interoperability, and automation. We take pride in delivering high quality at a reasonable price to our customers. 

How are hospitals complying with the requirement to send ADT messages to the patient’s other providers?

We are working with a few customers on this. They all seem to have different issues and challenges, but I am unfortunately not up to speed on all of the details. I know that there are newer healthcare communication platforms emerging that facilitate this. 314e’s Muspell XI tool can also send ADT notifications, and we are working with a customer to integrate our tooling into their enterprise service bus to deliver these notifications to the right providers.

Where do most health systems fall in your eight-level Healthcare Analytics Adoption Model, and how are they prioritizing their next steps?

We think that most are somewhere in the middle, Level 3-5. We certainly have customers that are at Level 7, and we have helped them get there. Most organizations we know struggle with managing complex ETLs and getting data to a warehouse. The processes are brittle and do not support any form of self service or business agility.

We are seeing a trend towards adoption of cloud analytics platforms like Databricks on Snowflake running on Azure / AWS. These systems give the basic infrastructure on top of which high quality BI, AI/ML workloads, etc. can be run. Our customers are tapping us to migrate from decades-old warehouses to such more modern data lake / warehouse environments to get to Level 6 and higher. In fact, we are helping several customers today in collating EMR, imaging, lab, registration, claims, patient satisfaction, and home health types of data into FHIR-based enterprise data lakes. This results in getting to Level 4-5 in under a year.

Will the move to virtual implementation and support services continue even after some degree of normal travel resumes?

The pandemic has really exposed a lot of inefficiencies and waste in the healthcare industry, and one of those is the cost of travel and lost productivity for implementation consulting.  With the shift to virtual, we’re adapting and becoming accustomed to doing things remotely, leveraging modern technologies like Teams and Zoom.  

There are certainly some things lost by not having those face-to-face interactions where you build and strengthen relationships and alignment between IT and operations. So I do believe that some key personnel will start traveling more frequently when normal travel resumes. But overall, my gut tells me this trend of virtual implementations will continue.  

Training and at-the-elbow support, specifically for new implementations, are two key areas that are presenting unique challenges for our clients to deliver virtually. I anticipate, at least for new implementations, that we will see those services resume to more in-person.  We have spent considerable investment developing solutions and a product for our clients to address ongoing new hire training and ongoing on-the-job performance support which can be delivered digitally anytime, anywhere and provides on-demand targeted training assistant embedded in the EHR workflow. That trend is moving to more virtual.

How much interest or potential are you seeing in robotic process automation?

RPA adoption has been turbocharged by the pandemic. Providers and payers have both realized that RPA can make the processes more efficient and reliable in addition to the cost savings it brings. A Gartner report published in the middle of 2020 said that around 5% of healthcare providers in the US have invested in RPA and that this number will reach around 50% in the next three years. However, almost all of our customers have started at least one pilot initiative around RPA in some way, shape, or form, and many have at least one proof-of-concept in place. Most of them don’t have in-house capability to deal with this and are working with partners like 314e. 

As a company, we are very bullish on automation, web automation as well as desktop app automation. We are building products to help customers deploy RPA to automate enterprise workflows. We believe that there is a need for an RPA framework which can allow healthcare providers to quickly and easily deploy an army of bots for different problems and design an orchestration system to manage these bots. We are piloting our bot orchestration system with a customer today. 

How will payer-to-payer data exchange improve member experience?

CMS mandated the payer-to-payer data exchange to prevent fragmented member data from getting stuck in silos with different payers. Members can now have one unified record of all their health data, including claims data. This allows for a true continuum of care, not just across providers, but also across payers as the member switches jobs and possibly moves from one payer to the other. Payers need to use USCDI for this exchange. 314e has invested heavily in FHIR to help payers power such an exchange. 

What 3-5 year goals do you have for the company?

At 314e, we are playing the long game; the infinite game. We started out as a few people helping a large IDN with data conversion. Then we got into staff augmentation on Epic implementations. But today we are true technology partners to customers across the healthcare continuum. Our goal is to become the go-to technology provider of services for cloud, analytics, integration, innovation, and automation for healthcare.

We want to do this by IP-led service delivery and products. We already have multiple products in the market, including one that we call Speki, which means “wisdom” in Old Norse. Speki is a content, help, video delivery platform with a SMART on FHIR launch. It is currently on the Epic App Orchard. We can take instructor-led EHR training, convert it into byte-sized chunks, and make that searchable and viewable from within the EHR.

Similarly we have a FHIR-based enterprise data lake product that we call Muspell. It supports archival and clinical data repository use cases and can be a data aggregation platform used by providers and payers. We run this on top of Databricks and it is available on both AWS and Azure. We have dozens more product innovations that we want to bring to market in the next 3-5 years.

EPtalk by Dr. Jayne 2/11/21

February 11, 2021 Dr. Jayne No Comments

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Even with all the turmoil the US has gone through in the last several months, the institutions of government are still going strong, and the folks at CMS have not missed a beat. They did, however, extend the deadline for submission of 2020 data for the Medicare Promoting Interoperability Program. You now have until April 1, 2021 at 11:59 p.m. ET to attest through the QualityNet portal.

New Hampshire lawmakers have introduced HB 602, which aims to eliminate existing provisions protecting telehealth coverage. It would eliminate coverage entirely for audio-only services, which may have the unintended consequence of reducing access for those either not able to access the internet or who aren’t technically savvy enough to manage audio/video links. Surprisingly, one of the bill’s sponsors, Representative Jess Edwards, was one of the co-sponsors of the 2020 law that created payment parity for telehealth coverage.

As a telehealth physician, audio-only visits can be high quality interactions. In addition to the limitations above, some patients are just not comfortable on video due to their living environment or other factors. We’ll have to see whether this bill makes it through the process or not.

The ongoing usefulness of telehealth is discussed in this recent Journal of the American Medical Association editorial. The authors note that both patients and clinicians may want to continue virtual visits and that those visits could be as effective as in-person visits or used in conjunction with in-person visits as a hybrid model. Concerns about use of telehealth in the absence of hands-on examinations are valid, particularly when considering the overuse of expensive tests in lieu of physical diagnostic skills. Still, some conditions don’t require extensive physical examinations, but do require a physician’s cognitive effort.

For example, I was diagnosed with a food allergy a few years ago and I now doubt that diagnosis. I’m trying to get a second opinion from an allergist. The next available appointment that meshes with my work schedule is two and a half months away. No physical exam elements are part of this evaluation, and I recently had a full physical exam with the findings available in the shared EHR. Essentially, I need a learned expert to perform a review of my existing records and have a discussion with me about the risks/benefits of testing to determine whether it’s worth trying to proceed.

I’m willing to pay for the physician’s knowledge, experience, and time, but the construct in which we operate requires me to drive halfway across town to do it instead of being able to teleconference with the provider in the open slot that she has on Friday that would work with my schedule except for the drive time.

Of course, not every visit is suitable to a non-visit approach, but it’s time we think outside the box and focus on patient access, delivering high-value care in ways that are win-win for everyone involved. Real concerns also exist about fraud, abuse, and low-quality care. I would argue, however, that telehealth can be an important adjunct to whole-person care and for scenarios where a physical exam isn’t necessary or a recent exam is well documented. It could save a substantial amount of time and money for all parties involved.

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I’m continuing to follow up on some random leads from the Consumer Electronics Show. One of them was a note that I made for voice-activated faucets. Kohler has launched a not only operate on command, but can measure specific amounts of water. The faucet also connects with a smartphone app that allows households to monitor water usage and be notified if it appears anything is out of the ordinary. Some models even offer a “wash hand” command that will instruct a user through the recommended steps for handwashing, including audible guides for lathering, cleaning, and rinsing. For parents who are tired of hearing two rounds of “Happy Birthday” as they try to instill good habits, it’s tempting, but the $1,700 MSRP is daunting. Most of us will have to go back to the old-fashioned egg timer and some adult supervision.

I enjoyed having easy access to the CES materials and sessions for a reasonable time after the show. Whatever HIMSS plans for its hybrid conference in August, I hope they improve their learning management system, because trying to find the sessions you want to watch after the fact is sometimes daunting. As someone who used the HIMSS sessions in the past for Maintenance of Certification credit for my informatics boards, it always seemed like the sessions I wanted to attend were on top of each other and watching after the conference was the answer. I hope they announce more information soon about the hybrid format, because I need to make some hotel decisions soon.

I had some additional adventures as a patient this week. The local hospital sent me an email reminding me that I had a bill due that I actually paid a month ago. I tried to use the integrated chat function to get it clarified, and the first thing I experienced was that despite the chat requiring me to enter the bill’s ID code along with the amount due (so that it could presumably be made available for the agent when he arrived in the chat), the agent asked me whether the bill was for a different amount that has never appeared on my account. I also quickly noticed that the chat client had no audio indicator that the agent had messaged me, so I had to sit there and stare at it to know if there was a communication. The agent kept telling me I had a zero balance despite the email and the home page that clearly showed a balance, and then told me not to worry about it.

I asked him to please escalate the fact that the system is sending balance due emails to patients with zero balances, since I’m a referring physician as well as a patient and know that would bother my patients as much as it bothered me. He then decided to tell me it is a known issue and that they are working with the vendor to resolve. I’m not sure why he didn’t tell me that up front when he realized my issue looked like one of the known issues, or why he decided to tell me once I said I was a physician, but either way, It wasn’t outstanding customer service. I hope the vendor gets their act together and fixes the defect soon because it’s annoying to say the least.

Do you feel like your healthcare team has accurate billing practices? Or do you see a high volume of patient complaints? Leave a comment or email me.

Email Dr. Jayne.

HIMSS Financial Highlights

February 11, 2021 News No Comments

This information is from the 2018 Form 990 of HIMSS, which covers the tax year ending June 30, 2019. The 2019 form, which will include the first half of 2020 when HIMSS20 was cancelled, will be filed in July 2021.


Income and Expense

Total revenue: $112 million (up 18% from the previous year)
Total expenses: $91 million (down 5.5% from the previous year)
Revenue less expenses: $21.2 million (versus a $1.2 million loss the previous year)


Program Service Revenue

Conferences: $42.8 million
Corporate sponsorships: $13.1 million
Membership: $12.9 million
Advertising and media: $10.0 million (classified as unrelated business revenue)
Analytics and maturity models: $3.0 million


Revenue from Related Organizations

HIMSS Media: $13.2 million
HIMSS Analytics: $3.0 million
Personal Connected Health Alliance: $2.6 million
HIMSS Europe: $1.6 million

HIMSS also reported taxable partnerships through its Healthbox consulting firm. 


Major Expenses

Conferences: $15.9 million
IT: $6.4 million
Occupancy: $2.2 million
Travel: $4.1 million


Highest Compensated Employees

Steve Lieber, former president and CEO: $2,666,485 (retired December 2017)
Hal Wolf, president and CEO: $1,291,414
Carla Smith, EVP: $671,788 (resigned November 2018)
Bruce Steinberg, managing director, international: $548,909
John Whelan, EVP, HIMSS Media: $426,732
Blain Newton, EVP, HIMSS Analytics: $451,265
Stephen Wretling, chief technology and innovation officer: $393,866
Patricia Mechael, EVP, Personal Connected Health Alliance: $355,787 (six months)

Total salaries and wages: $38 million for 459 employees, plus $4.1 million in pension plans and other employee benefits.


Morning Headlines 2/11/21

February 10, 2021 Headlines No Comments

Alleva Raises Seed Funding to Further Capacity to “Help the Helpers”

Behavioral health EHR startup Alleva raises an undisclosed amount of seed funding, bringing its total raised to $3 million.

OCR Settles Fifteenth Investigation in HIPAA Right of Access Initiative

Renown Health in Nevada will pay $75,000 to settle allegations that it violated HIPAA by failing to fulfill a patient’s medical records request in a timely manner, including sending digitized records to a third party.

Therapy Brands, backed by Lightyear Capital, Oak HC/T, is up for sale

Therapy Brands, parent company of numerous mental and behavioral health software brands, puts itself up for sale.

Morning Headlines 2/10/21

February 9, 2021 Headlines No Comments

Sitka Secures $14M in Series A Financing Led by Venrock to Help Transform Specialty Care

Virtual consult company Sitka raises $14 million in a Series A round led by Venrock.

Nuance Announces First Quarter 2021 Results

Nuance announces Q1 results: revenue down 4%, adjusted EPS $0.20 versus $0.22, beating Wall Street expectations for both.

Gentem Health Closes $10 Million Series A Financing to Help Private Medical Practices Streamline and Accelerate Insurance Reimbursements

Several weeks after raising $3.7 million, medical billing startup Gentem Health raises $10 million in a Series A round led by Vulcan Capital.

News 2/10/21

February 9, 2021 News No Comments

Top News

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Nuance acquires Saykara, a developer of automated charting software.

Saykara founder and CEO Harjinder Sandhu, PhD was an executive in Nuance’s healthcare research and development division before co-founding automated patient engagement company Twistle in 2011 and Saykara in 2015.

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Nuance will assign Saykara’s 30 employees to its Dragon Ambient Experience (DAX) team. A stock analyst asked Nuance how they would keep Sandhu since “he keeps leaving and developing more stuff you guys are buying” (he was a co-founder of Nuance acquisition MedRemote as well). Nuance CEO Mark Benjamin says the opportunity with the acquisition was to combine the scientists of both companies.

I interviewed Harjinder Sandhu this past October, when I asked him how he would compare Saykara’s Kara to Nuance’s DAX.


Reader Comments

From Equity Management Person: “Re: SPACs. Here are some counterpoints.” Thanks for providing an expert’s point of view in response to my cheap-seats comment about the SPAC phenomenon. EMP makes these points:

  • SPACs have two years to consummate a deal per their IPO documents. 
  • As a result, It’s a target-rich environment and a lot of SPACS are doing value-creating transactions.
  • An inherent backstop exists to prevent SPACs from rushing into bad deals. They have to convince sophisticated institutional sponsors who have veto rights that the deal is a good one. Those investors get their initial investment back if the company fails to close a deal.
  • SPACs are technically equivalent to IPOs except that the SPAC sponsor takes a lot of the fees than investment banks would take during a formal IPO underwriting.
  • It’s an interesting question why SPACS are suddenly so popular, but target companies are deliberately selecting that route given other options (IPOs, direct listings, and strategic sales), so SPACs offer what those companies think is the most attractive package of valuation, governance, and deal certainty.
  • SPACs are unlikely to be stranded because of a lack of follow-on capital and investor interest. The sponsor is a a core institutional block holder who is invested in the success of the company. The company will have greater access to capital and better long-term outcomes than being let go into a market without any backers except investment banks, which offer little credibility to institutional investors by their association and research overage.

From Dry Heat: “Re: Super Bowl commercials. You should have a similar contest for health IT vendor ads.” I’m not sure that companies in our industry have the media savvy or cash to produce jaw-dropping ads given their niche B2B audience, but an ad contest for HIMSS conference week would be fun in the presence of adequate enthusiasm, even in the form of creative video messages rather than “commercials.” My favorite Super Bowl commercial is “Terry Tate: Office Linebacker,“ but it’s also an illustration of entertainment versus commercial success — Reebok ended it fairly quickly despite endless watercooler buzz because the connection to the company was subtle and sales were mostly unaffected. Reebok shoe competitor K-Swiss later produced the most profanely funny and Tate-like video I’ve seen (NSFW and definitely don’t click if you don’t know for sure that you like the always-offensive and profane “Eastside & Down.”) K-Swiss was brave for featuring Kenny Powers, MFCEO, but buzz aside, they sold the money-hemorrhaging company to a Korea-based outfit shortly after.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor ChartSpan. The Greenville, SC-based company is the largest managed service provider of chronic care management (CCM) programs in the United States. It provides turnkey managed care coordination and compliance programs for doctors, clinics, and health systems. ChartSpan manages patient care coordination and value-based programs for more than 100 of the most successful practices and health systems in the United States. In addition, ChartSpan offers a SaaS-based Annual Wellness Visit program that allows practices to maximize their AWV capture rate by simplifying the AWV process. Through these offerings, ChartSpan is able to help practices increase their reimbursements while improving patient outcomes. Thanks to ChartSpan for supporting HIStalk. 

Here’s a good “what we do” intro video from ChartSpan that also defines the value of chronic care management.

I subscribed to the online edition of the AP Stylebook since I refer to it often in choosing to follow most (but not all) of its own standards. Below are some I follow except when I slip up:

  • Spell out numbers from one to nine but use numerals for anything 10 and above. Exceptions: spell out any number used as the first word of a sentence (“Ninety tourists visited”) and if the number precedes a unit of measure that doesn’t refer to time (“he made a 6-foot putt” but “a six-month delay.”)
  • Regardless of how a company stylizes its own name, do not use all-capital letters unless they are pronounced individually (“IBM” is correct, “MEDITECH” is not, and “EPIC” is a figment of your imagination because even they can’t understand why people all-caps their name); do not use symbols (“MModal,” not “M*Modal”); and capitalize the first letter (“Athenahealth” rather than “athenahealth.”)
  • Periods and commas always go inside quotation marks.
  • Capitalize job titles only if they are formally assigned and are included right before the person’s name. It is “Epic President Carl Dvorak,” but “Carl Dvorak, president of Epic.”
  • Use “health care” instead of “healthcare” even though the latter is in the dictionary. (I’m an AP outlaw in this issue mostly because of laziness in knowing I have to type it out many times each day).
  • Don’t use copyright or trademark symbols — they are just for the company’s marketing materials.
  • Plurals of words of any size require adding only an S with no apostrophe (“it will be in the low 20s,” “this is a meeting of CIOs”) except for those of one letter (“he earned four A’s”).
  • Use “coronavirus” to refer to the virus and “COVID-19” as the disease it causes. Do not shorten to “COVID” or use “Covid.”

I noticed that the Walgreens website wasn’t working this morning, which from Googling seems to have been the case for a couple of days.


Webinars

February 24 (Wednesday) 1 ET. “Maximizing the Value of Digital Initiatives with Enterprise Provider Data Management.” Sponsor: Phynd Technologies. Presenters: Tom White, founder and CEO, Phynd Technologies; Adam Cherrington, research director, KLAS Research. Health systems can derive great business value and competitive advantage by centrally managing their provider data. A clear roadmap and management solution can solve problems with fragmented data, workflows, and patient experiences and support operational efficiency and delivery of a remarkable patient experience. The presenters will describe common pitfalls in managing enterprise information and digital strategy in silos, how to align stakeholders to maximize the value of digital initiatives, and how leading health systems are using best-of-breed strategies to evolve provider data management.

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


Acquisitions, Funding, Business, and Stock

Talent solutions company Ettain Group acquires INT Technologies, a veteran-owned staffing and consulting company that serves a variety of industries including healthcare.

Sitka raises $14 million in a Series A funding round, increasing its total to $22 million. The company offers PCPs the ability to virtually consult with specialists using its VConsult software.

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Paging Weird News Andy: microbial sciences company Seed Health acquires Auggi, whose AI technology analyzes pictures of bowel movements to assess gastrointestinal health. Auggi also offers an app for use in clinical trials, while Seed will launch a consumer app this year.

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Nuance announces Q1 results: revenue down 4%, adjusted EPS $0.20 versus $0.22, beating Wall Street expectations for both. The company said in the earnings call that revenue for Dragon Medical and Dragon Ambient Experience (DAX) rose 22% over Q1 of last year, with DAX contributing $10 to 20 million in annual recurring revenue and customers expanding their implementation to additional medical specialties.


Sales

  • Bayhealth (DE) will implement Infor’s CloudSuite Healthcare, Clinical Bridge, D/EPM, and True Cost technologies.
  • The Center for Human Development (MA) selects Netsmart’s CareFabric software to unify workflows across its 80 programs and services.
  • Summit Healthcare announces that nine health systems have contracted for Summit Scripting Toolkit, its robotic process automation platform.

People

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Jeff McHugh (R1 RCM) joins Innovaccer as regional VP of sales.

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Bret Cottick (Olive) joins Medical Informatics Corp. as national VP of sales.


Announcements and Implementations

Beauregard Health System (LA) goes live on Meditech Expanse with consulting help from Engage.

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Wake Forest Baptist Health (NC) implements RxRevu’s SwiftRx Direct real-time prescription benefit software.

Blessing Health System (IL) develops a home-based care program for COVID-19 patients using remote patient monitoring and telemedicine software from Cloud Dx.

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The 377th Medical Group at Kirtland Air Force Base in New Mexico will go live on Cerner Millenium in April as part of the DoD’s continued rollout of MHS Genesis.

True Health (FL) leverages Emerge’s ChartGenie and ChartScout technologies in its conversion to Athenahealth.


COVID-19

All US COVID-19 measures are trending down significantly to early fall 2020 levels, with the hospitalization number slipping to around 80,000. US deaths are at 465,000, 20% of the world’s total. CDC reports that 42 million of 59 million distributed vaccine doses have been administered (71%).

The hottest topic among epidemiologists – should the 90 million Americans who have already had COVID-19 receive just one dose of vaccine? Consensus seems to be yes given the performance of the vaccines in clinical studies and the need to maximize the use of a limited supplies of vaccines.

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Another software developer takes it upon themselves to create an easy-to-use COVID-19 vaccination sign-up site. Huge Ma, a 31-year-old Airbnb software engineer, spends five days developing TurboVax, which compiles all available New York City appointments from the several signup systems and locations. Others have developed similar sites in New York and elsewhere. A Manhattan clinical psychologist who realized that none of her elderly relatives could have made their own appointments by finding the sites and booking a time slot online before someone grabs them concludes, “The system is set up to be a technology race between 25-year-olds and 85-year-olds. That’s not a race, that’s elder neglect.”


Other

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A security researcher’s analysis of 30 popular health apps (they weren’t named) finds problems:

  • 50% of the apps store sensitive patient information.
  • 100% of API endpoints were subject to BOLA attacks (broken object-level authorization) that can allow access to full patient records.
  • 50% of the apps allowed clinicians to access to records of any patient by changing the URL that is passed in the “GET” command.
  • 100% of the apps failed to implement certificate pinning to prevent person-in-the-middle attacks.
  • 77% of the apps used hard-coded API keys that never expire and 7% use hard-coded names and passwords.
  • 50% of APIs did not authenticate requests with tokens.

Imagine if this were a hospital: a remote hacker gains access to a Florida city’s water treatment system and increases the amount of sodium hydroxide to dangerous levels, which was luckily noticed and quickly reversed by a supervisor who happened to observe the change happening on his computer screen. The city has disabled the remote access function that the hacker used.

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Another news item that may bear healthcare lessons, especially about consumer usability and how medical apps are supported. The family of a 20-year-old student sues trading firm Robinhood after he kills himself upon seeing his account balance reach a $730,000 loss. Alex Kearns, who tried unsuccessfully to reach someone at the company several times before taking his own life, didn’t actually owe $730,000 – he didn’t realize that Robinhood’s on-screen balance didn’t include the value of his unexercised options, which would have given him an overall $16,000 profit. The last words of his suicide note, in which he said he had “no clue” about what he was doing, were, “How was a 20-year-old with no income able to get assigned almost $1 million worth of leverage?” The company says it has improved its user interface, added help desk staff, and started asking new users about their finances and trading experience.


Sponsor Updates

  • Ettain Group wins ClearlyRated’s Best of Staffing Client and Talent Diamond Awards for the 10th consecutive year.
  • Cerner staffers help vaccinate 2,300 people at its headquarters in Kansas City, MO.
  • Spok makes its Spok Go clinical workflow automation tool available in Australia.
  • The local paper profiles consulting firm Divurgent and the ways in which it has helped support hospitals during the pandemic.
  • AdvancedMD will cover half of the dues for 40 new members of the Association of Independent Doctors.
  • Alcatel-Lucent Enterprise hosts its first global virtual conference for partners.
  • Central Logic saw record-breaking growth, awareness, and momentum in 2020 as health systems have increased their focus on “operating as one.”
  • Collective Medical joins the Healthix Vendor Interoperability Program.
  • The State of California-Emergency Medical Services Authority selects Elsevier to deliver a COVID-19 online learning program for nurses.
  • Ellkay will present during the virtual HIMSS Central & North Florida Chapter event on February 17.
  • Emerge hires Jake Harvey (Salesforce) as customer experience manager.
  • Nine Summit Healthcare customers sign on for the company’s Scripting Toolkit and Robotic Process Automation platform.
  • CityMD (NY) improves its Net Promoter Score after implementing patient engagement software, including virtual line capabilities, from Experity.
  • CarePort customer John Muir Health (CA) adds Connect and Insight capabilities to better track and manage patients across care settings.
  • Emanate Health (CA) works with Meditech Professional Services to develop disease investigation and contact tracing dashboards in its Meditech Expanse EHR.

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Reader Comments

  • Vikas Chowdhry: Will AI (I prefer the term Machine Learning - ML) magically fix all the incentives that have been created in the US heal...
  • Brian Too: I dunno. Seeking an answer in AI for America's healthcare woes seems a little desperate. LIke, adding one magic new in...
  • meltoots: You forgot that politics will have to be programmed in your AI. On both sides of the aisle, misinformation, doing things...
  • IANAL: So what should Cerner do though? They have some market issues because the largest potential or current customers have at...
  • Ghost of Andromeda: That's exactly the opportunity here! Cerner is struggling and could really use someone who knows how to execute with dis...

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