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News 8/17/22

August 16, 2022 News No Comments

Top News

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CDC will regain control of hospital-reported COVID-19 data on December 31 when the government’s contract with TeleTracking ends.

HHS hired the patient flow technology company in July 2020 via a direct call to its co-CEO. HHS then instructed hospitals to stop sending their data to CDC and to instead use TeleTracking to populate the HHS Protect system.

TeleTracking has earned $50 million from the contract.


HIStalk Announcements and Requests

HIStalk sponsors who are attending Epic UGM, send me your participation information and I’ll include it in an online guide that I’ll run later this week. I’ve only heard from Availity, FDB, and Sphere so far, not counting the non-sponsors that submitted a form that will unfortunately remain unused. After-hours social events likely abound, so send me your info if you’re running short on invitees.

Mrs. HIStalk drafted me into doing some video recording and YouTube posting for a non-profit where she volunteers. My quickly assembled on-the-cheap technology arsenal involves an IPhone, a $32 wireless lavalier microphone, and Movavi Video Editor Plus 2022, for which I Googled to find an online coupon that dropped the no-subscription-required license down to $40. That software made it easy to edit and connect various video clips with one-click color and volume correction, insert some royalty-free opening music, and add a few text titles. I think I chose wisely (if somewhat randomly) since the Movavi software is easy to use while having a lot of powerful functions that are unobtrusive until needed. I’m not a video expert and have no interest in becoming one, so the small expenditure of cash and effort hit my sweet spot.


Webinars

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


Acquisitions, Funding, Business, and Stock

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UK-based digital healthcare company Babylon denies reports that it may be seeking a buyer as it wrestles with sinking share price. The business, which initially made a name for itself by offering virtual care services to the NHS, has gained a foothold in the US by acquiring 700-physician Meritage Medical Network; health kiosk vendor Higi; and DaytoDay Health, which offers patients pre- and post-visit care education, communication, and clinical support via personal care teams. BBLN went public via a SPAC merger in October 2021 at a valuation of $4.2 billion, with share price having dropped 93% in the ensuing 10 months for a company valuation of $335 million.

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Sema4, which offers precision medicine and clinical trials tools, eliminates 250 jobs, 13% of its workforce. The founder and president has left the company and board. SMFR share price dropped 33% Tuesday on the news and have shed 86% of their value since the company went public via a SPAC merger in July 2021, valuing the company at $611 million.

Chronic disease management software and services company CareHarmony raises $15 million in a Series A funding round.

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Hospital cost management system vendor SpendMend acquires Trulla, which sells pharmacy procurement software. That’s a pretty large misspelling of “visibility” on their webpage above.

Signify Health, the value-based home health provider that is reportedly being pursued by CVS Health, will lay off 489 people beginning October 1. The majority of affected workers work remotely, according to the company, which says the workforce reduction is the result of its decision to shutter its Episodes of Care Services segment.

Enterprise medical imaging vendor Intelerad acquires PenRad Technologies, which offers productivity tools for breast imaging and lung screening.

Activist investor Elliott Management buys a large stake in Cardinal Health and nominates five candidates for board positions. 


Sales

  • Christus Health will implement the KyruusOne provider data management platform to create a digital directory.
  • SSM Health will work with Optum to develop new inpatient care delivery models, billing processes, and patient engagement experiences using clinical technologies and analytics.
  • University of Florida Health Shands chooses Syntellis Performance Solutions for financial planning, cost accounting, and decision support.

People

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Ross Martin, MD, MHA (360 Degree Insights) joins consulting firm Agilian as CMIO.

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Health Gorilla hires Steven Lane, MD, MPH (Sutter Health) as chief medical officer.

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The SSI Group promotes Lori Brocato to SVP of product management.

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University of Chicago Medicine names Maia Hightower, MD (University of Utah Health) chief digital and technology officer.

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Philips will promote Roy Jakobs, head of its connected care business, to president and CEO when Frans van Houten steps down on October 15.

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Nicole Dowsley, MBA (Genomind) joins Clearwater as chief transformation officer.

Verato hires Richard Jordan (Sutherland) as chief commercial officer.


Announcements and Implementations

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NextGen will apply to ONC to become a TEFCA-enabled, vendor-agnostic Qualified Health Information Network. According to the company, it is the first ambulatory-specific vendor to apply to become a QHIN.

The California Department of Public Health will implement lab result collection and reporting software developed by Manifest MedEx as part of its new Surveillance and Public Health Information Reporting and Exchange. Manifest MedEx, Diameter Health, and Lyniate developed the SaPHIRE system.

Duke Health (NC) implements Scanslated’s interactive radiology reporting service at its three hospitals and 14 outpatient imaging facilities.

Australia’s Northern Territory Government deploys the first phase of its $182 million patient health record system. Built on InterSystems TrakCare software, the technology will ultimately replace six legacy systems.


Government and Politics

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The 6th Medical Group at Macdill Air Force Base (FL) and Fox Army Health Center (AL) will go live in the next wave of MHS Genesis deployments on September 24.

FDA will allow hearing aids to be sold over the counter to people who have mild to moderate hearing loss, starting in the next few weeks. FDA says that 80% of the 30 million Americans who have hearing loss don’t seek help, audiologist exams aren’t covered by insurance, and the market is dominated by a handful of companies that sell the devices for thousands of dollars. Experts say that FDA’s decision will spur innovation that could radically change the way that hearing devices work and look. My prediction is that the future’s hearing aids will be like listening to the Spotify phone app on Beats by Dre wireless buds, because why not? Get in there, Apple.


Privacy and Security

Conifer Health Solutions reports that an unauthorized user gained access earlier this year to a Microsoft Office business email account that was associated with Brookwood Baptist Medical Center (AL). The RCM vendor has been unable to determine if the personal information of BBMC patients has been accessed. 

An internal report determines that an IT systems failure in May at four hospitals in the UK cost $686,000 and led to the cancellation of 1,000 appointments. The report also revealed that the outage, which was caused by a VMware software defect, led to 330 incidents of patient harm.


Other

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Researchers and stroke experts from Wake Forest University School of Medicine (NC) and Atrium Health Wake Forest Baptist’s Comprehensive Stroke Center develop COMprehensive Post-Acute Stroke Services – Care Plan, a digital health tool that uses algorithms to create custom-made care plans for stroke patients. The COMPASS-CP tool can be embedded within a patient’s EHR and integrated with remote patient monitoring programs. Wake Forest’s Innovations arm has created Care Directions Inc. to commercialize the technology.

A study published in a data science journal finds that digital health companies are sending data to Facebook to target user advertising, sometimes violating their own policies that prohibit user tracking across websites. The authors found that participants in an online cancer community had their activity tracked by apps from Color Genomics, Myriad Genetics, Invitae, Health Union, and Ciitizen. The only company of the five companies to inquiries by Forbes was Health Union, which said it tracks information but gives users the option to accept or reject cookie-based tracking, also noting that the company isn’t bound by HIPAA because it isn’t a provider. Facebook parent Meta said the companies should not be sharing user information using its Business Tools.

Physician and author Danielle Ofri, MD, PhD describes in an article in The Atlantic why her experience took her from telemedicine skeptic to advocate, labeling it as “an indisputable complement to in-person care:”

  • She saw how hard it was for patients to miss a day’s pay to take public transportation to office visits.
  • Telemedicine dropped her no-show rate to nearly zero since patients weren’t canceling because of unexpected job demands or transportation difficulties.
  • Eye contact has improved, as she can focus on the on-screen patient rather than the computer screen, and they can see each other face-to-face without masks.
  • She can see the patient’s living situation and get to know them better by meeting their families and aides.
  • Research has shown that routine physical exams are “largely ceremonial” and chronic illness mostly requires cognitive and conversational interaction.
  • Providers, like patients, can work from home if they have sick children or are affected by COVID-19.

Sponsor Updates

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  • HCTec sponsors AltaMed Foundation’s East LA Meets Napa charity fundraiser to help women and families access necessary resources.
  • Arcadia makes its research available in the Prognos Marketplace for life science customers.
  • CHIME releases a new 30th Anniversary Podcast featuring 2005 CHIME Board Chair Pat Skarulis.
  • Dresner Advisory Services names Dimensional Insight an overall leader in business intelligence in its annual Industry Excellence Awards.
  • Sectra will launch the next generation of its Education Portal for medical educators and students this fall.

Blog Posts


Contacts

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

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Morning Headlines 8/16/22

August 15, 2022 Headlines No Comments

NextGen Healthcare Announces Intention to Become a Qualified Health Information Network

NextGen becomes the first ambulatory-focused vendor to apply to become a TEFCA-enabled Qualified Health Information Network.

Babylon Denies Acquisition Rumors

UK-based digital healthcare company Babylon denies it is contemplating putting itself up for sale as it wrestles with sinking share prices after going public nearly one year ago.

CareHarmony Secures $15 million in Series A Funding Led by Maverick Ventures

Chronic disease management software and services company CareHarmony raises $15 million in a Series A funding round.

Curbside Consult with Dr. Jayne 8/15/22

August 15, 2022 Dr. Jayne 3 Comments

As clinical informaticists, many of us wonder whether the technology that we are championing really hits the mark. I was excited to see this study that appeared recently in Applied Clinical Informatics. Titled “Health Information Technology Use among Chronic Disease Patients: An Analysis of the United States Health Information National Trends Survey,” it attempted to look at several important factors, including: perceptions of health between patients with disease and those without; usage of health information technology depending on which chronic diseases might be present; the evolution of health information technology over the last half decade; and whether patients with specific chronic diseases are more likely to use specific IT tools.

This is exactly the kind of thing that gets us out of bed in the morning – being able to better understand how people might use the tools we deploy, and whether we can shift what we’re working on to improve how we meet their needs. We all know that chronic diseases are a problem and that the sickest 5% or so of the population are using the majority of healthcare resources. Chronic diseases also kill people, and many of them steal away patients’ productive years and the time they have to spend with loved ones. Many organizations are spending a great deal of technology resources to try to better manage chronic diseases, so it’s important to know how patients are interacting with those offerings.

What did the authors define as chronic diseases? They used a straightforward definition, namely those diseases lasting longer than a year that require lifestyle change and ongoing medical attention. In the US, approximately 60% of us have chronic diseases, with 40% having two or more. In crafting the plan for the study, they also had to identify a consistent description of health information technology: “the electronic systems health care professions and patients use to store, share, and analyze health information.” This includes electronic health records, medication adherence solutions, virtual reality therapy applications, and more.

The authors used the Health Information National Trends Survey (HINTS) with data from 2014 to 2020, comparing self-perceived health factors with health information technology usage and presence of chronic disease. The HINTS database is interesting because it is generated by the results of consumer-facing surveys that are obtained via mail. The survey instrument includes over 120 questions. Controls were put in place for demographics and comorbid conditions. Part of the survey involves questions on self-perception of health, including asking patients to score their health on a five-point scale from excellent to poor. They were also asked about their confidence in their ability to take good care of their healthcare needs.

The authors found that certain patient groups, such as those with lung disease, depression, and cancer, had an increased likelihood of technology use. Patients with other conditions, including diabetes, hypertension, and cardiovascular disease, tended to use technology tools at rates similar to patients without chronic disease. As far as confidence levels, patients with chronic disease were less likely to be confident in their ability to take care of their own health. Patients without any diseases were more likely to be “completely confident” than those with comorbid conditions.

The authors also found that over the time period studied, patients generally increased their use of health information technology offerings. They found that age had an impact on technology usage, with a 3% decrease in odds of using a tool for every year increase in age, even when controls were in place for race / ethnicity, educational attainment, chronic disease, and smoking status. They noted that usability and availability could be motivating factors for technology use and pointed out mental health applications as an example: “Previous review studies have shown the sheer among of online CBT [cognitive behavioral therapy] tools, the wide range in styles of therapy, and the statistically significant improvement in outcomes for patient engaging with these tools. With such effective tools already available for depression patients, it makes sense that more patients with depression are engaging with HIT.”

They concluded that additional study is needed to gain better understand of the specific factors that may influence adoption of health technology and that the knowledge gained from those studies should be used to improve technology offerings and user experience in an effort to improve overall utilization. One summary sentence gave me a chuckle: “…studies have shown that when providers encourage online medical record use, patient usage goes up, but many providers are not encouraging use…” I just had a conversation the other day with an early-career clinical informaticist who was asking for tips on increasing patient portal adoption as a way to reduce the use of laboratory results letters. It didn’t sound like their practice had done any of the basics, such as providing information to patients during the office visit either as discussion, formal handouts, or exam room signs. They had yet to include information on the availability or functionality of the portal on billing statements or other existing communication streams. Given those factors, it wasn’t surprising that adoption was poor. I explained how one hospital I worked with used summer interns in facility lobbies to help register patients. My colleague was surprised that the approach was even a thing.

The authors also noted the need to look at the impact of COVID-19 on technology usage beginning in 2020. They also identified limitations in the HINTS data including its relatively low response rate, the fact that the survey has evolved over time, and that earlier versions of the questionnaire didn’t include questions that could have contributed to the study. HINTS also didn’t include adequate data on newer technologies, such as remote patient monitoring, or certain chronic conditions such as kidney disease or post-stroke complications.

I’ll definitely be reaching out to some of my informatics colleagues as we gather around the virtual water cooler. It will be interesting to see what they think and whether their institutions are doing anything formal to look at these factors. We’re always looking for a silver bullet that will really help us drive the needle and include clinical outcomes, although it’s never quite as simple as we would like it to be.

For the six in 10 of us with chronic conditions, are you doing anything personally to engage with health information technology with respect to your condition? Do you think it makes a difference, or is just another thing that takes up time or falls by the wayside? Leave a comment or email me.

Email Dr. Jayne.

Readers Write: AI in Imaging: Improving Outcomes Across the Care Continuum

August 15, 2022 Readers Write No Comments

AI in Imaging: Improving Outcomes Across the Care Continuum
By Calum Cunningham

Calum Cunningham, MBA is SVP/GM of healthcare diagnostic imaging for Nuance Communications of Burlington, MA.

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The role of AI in medical imaging has been top-of-mind for a number of years, particularly as deep learning algorithms continue to improve to the point they can even identify findings that are not detectable by the human eye. As these solutions gain traction and adoption in clinical practice, more radiologists acknowledge the need for familiarity with the role AI plays in imaging and how to successfully integrate it into radiology workflows. In fact, RSNA recently launched its first-ever certificate program for imaging AI.

While the benefits to radiologists are significant and broad  — enhanced efficiency, greater satisfaction by automation for repetitive and mundane tasks, and freedom to focus on what matters most — AI in imaging, more specifically an integrated imaging network, adds value across the care continuum.

The radiology workflow is at the heart of a patient’s journey, informing healthcare decisions at the point of care, but also traveling both upstream and downstream. Once a patient’s images have been captured, radiologists depend on a range of technological platforms to integrate those images, relevant patient data, and AI services (such as automated 3D visualization solutions) from across the healthcare ecosystem.

When a radiologist reads a mammogram, for example, they need more than just the images from the patient’s most recent study. The patient’s previous images, information from the medical record (e.g., history, demographics, and symptoms), and increasingly, AI-powered diagnostic models are all essential to helping the radiologist accurately, comprehensively, and efficiently prepare the report.

The radiologist’s report likewise becomes part of the integrated imaging network, which breaks down the siloes that traditionally exist between care teams, administrators, payers, and other third parties. Sharing key imaging data with administrative, coding, and billing teams, for example, means supporting the organization’s financial resilience. These teams depend on accurate, comprehensive reports to protect the organization’s revenue cycle. When radiologists harness the power of AI to deliver more content-rich reports, insurance claims may be cleaner, which can result in appropriate reimbursements from payers. Similarly, sharing imaging data in this way can also streamline prior authorizations for treatments, surgeries, and prescriptions.

The downstream impacts don’t end there, however. Health plans and self-insured employers can take advantage of the integrated network to improve coordination and collaboration in ways that can address care quality and cost. Life science companies can make use of these insights to identify candidates for clinical trials.

An integrated imaging network also benefits healthcare provider organizations, which can apply AI-generated insights from diagnostic imaging to support earlier disease diagnosis as well as inform treatment options and planning. Perhaps one of the more exciting aspects of an integrated imaging network is the potential impact on patient follow-up adherence. When a radiologist includes an imaging follow-up recommendation in their report, only about half of those recommendations are adhered to. Not only does this represent a significant risk to the patient in terms of treatment and outcomes, but it can also create liability risks for the providers, not to mention the adverse impact on financial performance for the healthcare organization. The integrated imaging network can help close the loop on these follow-up recommendations, automating certain aspects of provider and patient communication to reduce the risk of delayed diagnosis.

In short, by seamlessly sharing clinical and imaging data and applying AI-generated insights and automation, organizations can maximize the value of existing healthcare IT infrastructure across the care continuum while improving patient outcomes.

Readers Write: What’s Missing from Healthcare’s Consumerization Conversation is Physicians

August 15, 2022 Readers Write No Comments

What’s Missing from Healthcare’s Consumerization Conversation is Physicians
By Casey Jenkins

Casey Jenkins, MBA is VP of product management for Epocrates of Watertown, MA.

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The consumerization of healthcare is a trend that’s spreading like wildfire in the HIT industry. Healthcare organizations are increasingly turning to technology systems that create more consumer-friendly interactions for patients with the intention of ultimately improving access to care and boosting patient satisfaction.

Recent research supports this, finding that 74% of healthcare leaders are planning to invest in technologies that drive consumerization. This includes investing in technologies like telehealth, self-scheduling, text correspondence, online payment applications, and accessible patient portals. However, there’s one vital group that’s missing in healthcare’s consumerization conversation — physicians.

Due to the growing pressure to give patients the consumer-grade experience they are accustomed to in other areas of their lives, the physician experience has been deprioritized as a result. That needs to change, as rates of physician burnout are skyrocketing due to factors like information overload and administrative burden. It’s vital that the HIT industry also prioritizes the physician experience as the trend of healthcare consumerization continues to grow. Physicians are consumers, too – they’ve learned and adapted to everyday technology, and physician-facing technology needs to reflect this shift as well.

There are numerous ways that more consumer-friendly technology for physicians can alleviate their pain points in practice. One way is incorporating more personalization capabilities into the clinical information-seeking process. Today’s clinicians simply don’t have enough time in the day to stay abreast of the latest clinical information and can often feel overwhelmed. In fact, a recent study found that 64% of physicians reported not having time to stay up to date in their field.

Stronger personalization capabilities in clinical information tools can help by providing more curated information that’s updated and relevant to a specific physician’s practice and area of interest. This concept emulates the level of personalization that companies like Amazon, Facebook, and Netflix have created and that we’ve all come to expect across all our technology interactions. Personalization in clinical information tools can take the form of a data feed, much like a social media-style feed, that understands what information a specific physician is researching or seeing in the clinic and then presents relevant information in an organized and logical manner. This empowers physicians to sharpen their focus during the information-seeking process and ultimately make a more positive impact around patient care.

The push for more consumerization in physician-facing technology also includes a need for a stronger translation of science into technology applications to help curb information overload. In a recent survey, 89% of physicians reported that more clinical data isn’t always the answer. The right data at the right time is what is most important. When we can connect the right person and information at the right place and time within the clinician / physician workflow, that is when physicians will be able to provide the best-quality care.

Additionally, the HIT industry can help streamline workflows by putting the tools clinicians need in front of them for a more intuitive, easy-to navigate experience. This includes incorporating more thoughtfully designed interactions and experiences with the tools physician most frequently use.

Beyond that, the HIT industry can turn to familiar user experiences like a navigation bar. For example, navigation bars on social media apps include things like notifications, direct messages, or saved posts. In a HIT platform or technology system, a navigation bar could provide quick access to the key features a clinician needs at the point of care. like the patient’s medical chart or the medical news reel with the latest clinical developments. The HIT industry should lean into what people find familiar when determining how to put technology at a clinician’s fingertips.

As there continues to be a societal shift in what we expect from technology, the HIT industry needs to bring the physician experience into the fold of healthcare consumerization to truly improve healthcare outcomes. Stronger consumerization in physician-facing technology has the potential to reduce feelings of information overload, streamline workflows, and empower physicians to provide the best care possible to their patients.

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

August 15, 2022 Readers Write 1 Comment

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

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

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

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

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

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

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

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

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

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

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

Unsure of where to begin? Consider:

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

    Morning Headlines 8/15/22

    August 14, 2022 Headlines No Comments

    Digital health unicorn Truepill conducts third round of layoffs in 2022

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

    Growth Report: Oracle Cerner continues to expand client relationships

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

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

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

    Monday Morning Update 8/15/22

    August 14, 2022 News No Comments

    Top News

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

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

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

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


    Reader Comments

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


    HIStalk Announcements and Requests

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

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


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


    Webinars

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


    Acquisitions, Funding, Business, and Stock

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

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

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

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


    Sales

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

    People

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

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


    Government and Politics

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


    Privacy and Security

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


    Other

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

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

    Sponsor Updates

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

    Blog Posts


    Contacts

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

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    Morning Headlines 8/12/22

    August 11, 2022 Headlines No Comments

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

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

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

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

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

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

    News 8/12/22

    August 11, 2022 News No Comments

    Top News

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

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

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


    Reader Comments

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


    HIStalk Announcements and Requests

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


    Webinars

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


    Acquisitions, Funding, Business, and Stock

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

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

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


    People

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

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

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    Digital Diagnostics hires Chris Meenan (Philips) as CTO.


    Announcements and Implementations

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

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

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


    Government and Politics

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

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

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

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


    Sponsor Updates

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

    Blog Posts


    Contacts

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

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    EPtalk by Dr. Jayne 8/11/22

    August 11, 2022 Dr. Jayne 2 Comments

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

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

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

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

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

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

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

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

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

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

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

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

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

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

    Email Dr. Jayne.

    Morning Headlines 8/11/22

    August 10, 2022 Headlines No Comments

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

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

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

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

    VHA Launches New Playbook Outlining Digital Health Care Needs For Patients

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

    Morning Headlines 8/10/22

    August 9, 2022 Headlines No Comments

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

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

    CPSI Announces Second Quarter 2022 Results

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

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

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

    News 8/10/22

    August 9, 2022 News No Comments

    Top News

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

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


    Reader Comments

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

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

    HIStalk Announcements and Requests

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


    Webinars

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


    Acquisitions, Funding, Business, and Stock

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

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


    People

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

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

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

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

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

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    Randy Fusco (TEKsystems) joins Clearsense as CTO.


    Sales

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

    Announcements and Implementations

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

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

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


    Government and Politics

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


    Sponsor Updates

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

    Blog Posts


    Contacts

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

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    Morning Headlines 8/9/22

    August 8, 2022 Headlines No Comments

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

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

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

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

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

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

    Curbside Consult with Dr. Jayne 8/8/22

    August 8, 2022 Dr. Jayne 6 Comments

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

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

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

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

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

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

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

    Email Dr. Jayne.

    Morning Headlines 8/8/22

    August 7, 2022 News 5 Comments

    CVS Plans to Bid for Signify Health

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

    Definitive Healthcare Reports Financial Results for Second Quarter Fiscal Year 2022

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

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

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

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

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

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