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Morning Headlines 10/21/21

October 20, 2021 Headlines Comments Off on Morning Headlines 10/21/21

GoCheck Raises $10 Million in New Funding to Protect More Children from Vision Impairment and Blindness

Digital vision screening technology vendor GoCheck raises $10 million in a funding round led by Hatteras Venture Partners and Pisgah Fund.

Bardavon Health Innovations Secures $90 Million in Series C Funding to Advance True MSK Technology Platform Beyond Workers’ Compensation Care

Worker compensation technology company Bardavon Health Innovations raises $90 million in a Series C funding round.

Marathon Health Unveils First-of-its-Kind Virtual Primary Healthcare

Occupational healthcare company Marathon Health launches a virtual primary care service for employees that includes telemedicine, remote patient monitoring, and care navigation and coordination.

Comments Off on Morning Headlines 10/21/21

Morning Headlines 10/20/21

October 19, 2021 Headlines Comments Off on Morning Headlines 10/20/21

General Catalyst and Jefferson Health Announce Innovation Partnership

General Catalyst and Jefferson Health form an innovation partnership in which the health system will use technologies from the venture capital firm’s Health Assurance Network of companies.

Insiteflow Raises $2.3M to Accelerate Electronic Healthcare Record (EHR) Workflow Interoperability

Insiteflow will use a $2.3 million investment to further develop integration software that enhances the interoperability between third-party apps and EHRs.

TripleBlind Lands $24 Million in Series A Funding Led by General Catalyst and Mayo Clinic, in an Oversubscribed Round

Privacy-enforcing data sharing platform vendor TripleBlind raises $24 million in a Series A funding round that includes the participation of Mayo Clinic.

Comments Off on Morning Headlines 10/20/21

News 10/20/21

October 19, 2021 News Comments Off on News 10/20/21

Top News

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General Catalyst and Jefferson Health form an innovation partnership in which the health system will use technologies from the venture capital firm’s Health Assurance Network of companies.

GC’s Health Assurance Network portfolio includes Commure, Tendo, Transcarent, and Olive.

The announcement suggests that Jefferson will de-emphasize the “hundreds of technology solutions who are vying for a piece of the hospital system’s growing technology budget” and instead will give preference to the General Catalyst-backed vendors.

Retiring Jefferson Health CEO Stephen Klasko, MD, MBA co-wrote “Unhealthcare: A Health Assurance Manifesto” with General Catalyst managing partner and billionaire Hemant Taneja last year.


Reader Comments

From Yuma Dew: “Re: having a PCP who knows you. It seems more important that they know your data.” I agree that “knowing about me” is a lot more important and achievable than “knowing me.” One of the most important clinician functions should be contributing and consuming patient data across providers, even though patients have low expectations and payers don’t seem to care. Thoughts:

  • My direct primary care doctor “knows me” because of the nature of that kind of relationship, but I doubt that has much impact on my health. She still documents the elements she needs to remember.
  • I don’t have records from other providers to review, but if I did, I should expect (and prepare to be disappointed) that they will be available if needed.
  • The provider should review my documentation before my visit, whether in-person or virtual, so they aren’t wasting our limited time together. Taking a 10-second glance at a printout before knocking on the exam room door is not ideal.
  • EHRs aren’t always ideal at allowing providers to tag those parts of a patient’s record that they find especially important or relevant.
  • The provider should document whatever is important to both of us even if it is in narrative form. My perception of symptoms her to-do items for down the road are as important as recording conveniently numeric lab or vital signs data. For that reason, Microsoft Word with speech-to-text might be a better documentation platform than an EHR if it didn’t have to generate bills.
  • We should all choose providers who value our data, maintain it rigorously, and share it with us so we can verify its accuracy and understand their thought process. That data should paint a concise picture for another provider who receives our records via interoperability.
  • Every provider who is being paid to work on the patient’s behalf — specialist, telehealth, therapist, pharmacy, urgent care, etc. — should be held accountable for documenting their work into the patient’s “permanent record” that at this stage of interoperability is mostly a pipe dream. By definition, they are documenting what is important to them, so that same information would likely be important to other providers and thus to the patient. Why should we expect less?

Webinars

October 28 (Thursday) 1 ET. “A New Streamlined Approach to Documentation and Problem List Management in Cerner Millennium.” Sponsor: Intelligent Medical Objects. Presenters: Deepak Pillai, MD, physician informaticist, IMO; David Arco, product manager, IMO; Nicole Douglas, senior product marketing manager, IMO. IMO and Cerner announce the launch of the IMO Core CSmart app, an in-workflow offering to improve clinical documentation and problem list management in Cerner Millennium. The presenters will review the challenges and bottlenecks of clinical documentation and problem list management, discuss how streamlined workflows within Cerner Millennium can reduce clinician HIT burden, and demonstrate how IMO Core CSmart can help clinicians document with ease and specificity, improve HCC coding, and make problem lists more relevant. Additional sessions will be offered on November 17 and December 1.

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


Acquisitions, Funding, Business, and Stock

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Israel-based Navina, whose AI model turns point-of-care data into a “Patient Portrait” for PCPs, raises $15 million in a Series A funding round. The co-founders worked in Israel’s military intelligence AI labs.

Privacy-enforcing data sharing platform vendor TripleBlind raises $24 million in a Series A funding round that includes the participation of Mayo Clinic.

Trinity Health (MI) invests $1 million in digital prescription referral vendor Xealth, increasing its Series B funding round to $25 million.

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Redi.Health raises $1.3 million in seed funding to develop technologies and services for chronic disease management. Offerings currently include a patient-facing app with medication management, symptom tracker, educational content, and PHR. The startup offers pharma support companies the ability to integrate their services with the app. Co-founder and CEO Luke Buchanan was previously with CoverMyMeds, as was co-founder and Head of Business Development Nate Rehm.

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Insiteflow raises $2.3 million. The company has developed integration software to enhance the interoperability between third-party apps and EHRs.

Health insurer software vendor HealthEdge will acquire Wellframe, which offers digital health management solutions for health plans.


Sales

  • UnityPoint Health (IA) will work with B.well Connected Health to offer patients access to all of its digital health tools in a single app.

People

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Fivos hires Susan Andrise (Global Payments) as CFO.

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Availity names former US Navy SEAL Jim McNary (Consortium Health Plans) COO.

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Remote patient monitoring platform vendor Veta Health hires James Sutcliffe (DayToDay Health) as CEO.


Announcements and Implementations

InnovaQor subsidiary Health Technology Solutions announces GA of virtual CIO services focused on IT infrastructure security and management.

Grand Rounds Health and Doctor on Demand rebrand as Included Health, the name of the healthcare navigation and care concierge vendor the merged companies acquired several months ago.


Other

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A CHIME survey of member CISOs finds that nearly 50% have experienced a phishing email or compromising business email at their organizations within the last year, while nearly 30% have suffered through an EHR or system outage. Fifteen percent have experienced a patient safety incident related to a cyber event, and 10% have had to divert patients as a result. Top areas of needed cybersecurity assistance include grants and federal assistance, and on-site guidance and expertise from cybersecurity experts associated with regional extension centers.


Sponsor Updates

  • Change Healthcare releases a new podcast, “Cost Transparency: Driving Better, More Informed Care Decisions.”
  • CHIME releases a new Digital Health Leaders Podcast featuring John Kravitz, chairman of the CHIME Board of Trustees and CIO of Geisinger Health, and Marc Potash, founder and CEO of Certify Global.
  • Clearwater Chief Risk Officer and SVP of Consulting Services Jon Moore will present at The Healthcare MSO Conference October 22 in
  • Dimensional Insight announces it has been named a top performer in KLAS Research’s “Data and Analytics Platforms 2021” report.
  • Tegria publishes a new case study featuring Engage, “EHR Implementation Project Transcends Multiple Natural Disasters.”
  • EZDI will exhibit at the ACDIS Conference October 25-28 in Dallas.
  • Healthcare Triangle advances to Google Cloud Premier Partner status based on its success in building, deploying, and managing Google Cloud solutions for healthcare and life sciences organizations

Blog Posts


Contacts

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

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Comments Off on News 10/20/21

Morning Headlines 10/19/21

October 18, 2021 Headlines Comments Off on Morning Headlines 10/19/21

Grand Rounds Health and Doctor On Demand Rebrand as Included Health

Grand Rounds Health and Doctor on Demand rebrand as Included Health, the name of the healthcare navigation and care concierge vendor the newly merged companies acquired several months ago.

West Monroe eyes platform expansion after MSD deal

A strategic investment from MSD Partners will enable digital consulting firm West Monroe to expand in the US and abroad, beginning with the opening of a new London office next year.

CoverMyMeds, Beam vets found startup taking on chronic disease management

Redi.Health raises $1.3 million in seed funding to develop technologies and services for chronic disease management.

Comments Off on Morning Headlines 10/19/21

Curbside Consult with Dr. Jayne 10/18/21

October 18, 2021 Dr. Jayne 5 Comments

I was feeling a bit bummed this weekend, as I couldn’t attend the HLTH conference due to a previous commitment. I do a little dabbling in amateur radio and had been asked by a local radio club to be a station operator for the World Scout Organization’s “Jamboree on the Air” event. It’s held the same weekend in October every year and is a chance for young people around the world to talk to each other via radio (an internet component was added in 1995). There is always a big contingent from Germany on the air and it’s fun to try to have your scouts reach someone from every state as well as reaching international scouts. Women are typically a small percentage of any amateur radio gathering and I think it’s important for girls to have role models in tech hobbies, so I packed my gear and headed out.

Usually there is a lot of time for chitchat as you’re assembling antennas, staking them out, running cable, and figuring out how things are going to work when you’re trying to operate from a location you’ve never been. My team for the event included a search and rescue specialist, a retired Navy signal operator, an Eagle Scout, and a retired electrical engineer. Whenever people find out I’m a physician, they always ask where I practice, which can be tricky to explain based on what I do. When I mentioned that I’m only practicing virtually right now, the electrical engineer’s ears perked up. It turns out he’s got a little broader experience than electrical engineering. After receiving his degree in the 1960s, he started doing work in the then relatively new arena of biomedical engineering, specializing in the design of technology for the practice of nuclear medicine, but also in expanding the use of computers in healthcare.

Based on that, I figured I could go a little further and tell him that I spend the majority of my time working with electronic health records and emerging technologies such as chatbots, artificial intelligence, etc. and he was very interested. He asked if I had ever heard of “a guy named Larry Weed” and I said of course. Apparently my new radio friend had done some collaboration with him on his problem-knowledge coupler software in the 1980s and had some great firsthand stories about how that technology was received by physicians (not as well as it might have been) and how it evolved. It’s always interesting to learn from people who worked with the founders of our specialty and what they were like not only as innovators but as people. Had I gone to the HLTH conference, I certainly would have missed out on my own healthcare IT oral history project.

The day ended up being a lot of fun and hopefully we were able to get some young people interested in the art of radio. They enjoyed hearing how amateur radio operators can help in natural disasters and other emergencies, and they really loved learning how to craft Morse Code messages using some vintage code keys. Fortunately, conditions were such that they were able to chat with scouts on the radio from coast to coast, but the parents’ eyes were widest when they saw our teenage radio operator having a live Morse Code conversation with someone 2,000 miles away.

Online, they connected with scouts from Iceland, Taiwan, Finland, Japan, Cyprus, the UK, Serbia, and more. One of the highlights of the day was a radio “fox hunt” where the scouts had to use a directional antenna to find a hidden transmitter more than a quarter of a mile away, especially since the reward for successfully finding the fox involved chocolate chip cookies.

In addition to learning about Dr. Weed and his efforts, I picked up a couple of other tidbits along the way. The best radio tip was how to make an easily assembled and effective antenna mast out of a fiberglass paint roller extension pole, and needless to say I have since added one to my collection. We’ll have to see if the Homeowners Association has anything to say when I test it on my front lawn.

Back to HLTH, I’ve been getting some reports from the field, and it sounds like there is some good networking going on. Telehealth seems to be a hot topic, along with remote patient monitoring. I haven’t heard any grumbling about HLTH’s health and safety protocols, which involve not only proof of COVID-19 vaccination, but also a negative test within 72 hours of picking up your attendee badge at the conference. For those unable to get a test at an approved provider, onsite testing is available. Reading through the documentation on the HLTH website, the conference is picking up the tab for the onsite pre-event testing. It notes that optional testing will be available at no cost for anyone who wants to test throughout the event.

In the details, however, it specifies that attendees must have active US health insurance coverage “to receive free onsite services,” which tells me they’re not actually free — there just isn’t a patient payment required. We’ll all be paying for those “free” COVID tests that everyone is getting so they can attend events through higher insurance premiums and increased cost-sharing to the patient. As of this weekend, one of my local sports teams is requiring proof of vaccination or a timely negative test prior to attending events, and local urgent cares are already feeling the pressure.

Tuesday night is the HLTH Foundation Gala, and I hope people will share reports about the evening as well as photos of any sassy shoes or bedazzled masks they may encounter. I’m sure a lot of people have missed being able to dress up and go to events like these, so I’m betting at least one person will go all-out. At $250 per ticket, I hope the dinner is good and the entertainment is engaging. If not, the cocktails will certainly help. Maybe I’ll bust out some high heels and a martini glass and attend in spirit from my living room.

Are you at HLTH, and what’s your take on the event? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 10/18/21

October 17, 2021 Headlines Comments Off on Morning Headlines 10/18/21

Walmart Selects Transcarent To Provide Go-to-Market Solution for Self-Insured Employers

Transcarent will offer Walmart’s pharmacy services to its self-insured employer customers.

West Monroe announces strategic investment by MSD Partners

MSD Partners will make a strategic investment in digital consulting firm West Monroe.

Right on Cue: NBA finds high-tech option for virus testing

The NBA will allow its players to self-test for COVID-19 via Cue Health, which provides a smartphone-connected nasal swab reader to provide results in 20 minutes.

Comments Off on Morning Headlines 10/18/21

Monday Morning Update 10/18/21

October 17, 2021 News Comments Off on Monday Morning Update 10/18/21

Top News

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Transcarent will offer Walmart’s pharmacy services to its self-insured employer customers.


Reader Comments

From Slattery: “Re: digital health. Are prescription delivery services really digital health companies or technology disruptors?” Startup folks have been motivated by investors to declare that just about any healthcare business that has a website and app is “digital,” hoping to be anointed as the next high-valuation Facebook or Salesforce. Examples: mail order pharmacies, Medicare Advantage insurers, vanity prescription drug companies, weight loss companies, primary care chains that have developed a basic app, online counseling services, and fitness tracker manufacturers. Health IT websites and publications gush over their latest funding rounds and acquisitions without asking questions such as, (a) are they really doing anything new? (b) can they can improve outcomes or cost? (c) does their incidental use of technology really make them a tech company that can scale with low overhead? and, (d) do they offer a sustainable competitive advantage with a high barrier to entry over the companies that are already serving their potential customers? I also look hard at who is paying for their services and whether those buyers are likely to continue doing so given that companies live or die by recurring revenue that must be predictably extracted from fickle markets. There’s also the telehealth-highlighted tension between giving consumers what they want versus what the science says is best for them in a a transactional environment where they won’t likely see the patient again anyway. Healthcare is different because it’s horrendously expensive, notoriously consumer-indifferent, and loaded with bureaucratic paper-pushers, but odds are slim that a couple of kids and their slick app will take money away from the incumbents. Maybe worst of all is that companies will profit by catering to the most financially capable users while not only failing to make the underlying health system better, but quite possibly making it even worse than it already is for those without those means.

From Tubeless Tired: “Re: blood collection tubes. Our hospital has been told that we can get just half our normal supply of blue top, pink top, and light green top tubes over the next several months. We are asking providers to evaluate the clinical need for tests, evaluate and reduce when possible the frequency of standing orders such as PT/INR, and only draw a tube when actual testing has been ordered instead of as part of any hold request.” This is probably a useful heads-up for informatics teams that will probably need to make system changes to preserve blood tube supplies.


HIStalk Announcements and Requests

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It’s not EHR vendors that are making doctors unhappy, poll respondents say. Good comments: HITPM says doctors are trained and paid to treat acute illness reactively, so the high-earning specialists who swoop in and out of a patient’s life aren’t the ones complaining – it’s the lesser-compensated physicians who help keep people away from those specialists who aren’t happy. IANAL ponders whether doctors who envy their overseas counterparts do so selectively in forgetting that along with the absence of administrative overhead and price-gouging in those countries comes lifetime earnings that could be half or three-quarters less. IANAL also adds that doctors themselves spawned the role of insurers and their overhead by pushing to keep physician compensation private.

New poll to your right or here: In your most recent physician or hospital encounter, did your provider review your records from a different organization?


Webinars

October 28 (Thursday) 1 ET. “A New Streamlined Approach to Documentation and Problem List Management in Cerner Millennium.” Sponsor: Intelligent Medical Objects. Presenters: Deepak Pillai, MD, physician informaticist, IMO; David Arco, product manager, IMO; Nicole Douglas, senior product marketing manager, IMO. IMO and Cerner announce the launch of the IMO Core CSmart app, an in-workflow offering to improve clinical documentation and problem list management in Cerner Millennium. The presenters will review the challenges and bottlenecks of clinical documentation and problem list management, discuss how streamlined workflows within Cerner Millennium can reduce clinician HIT burden, and demonstrate how IMO Core CSmart can help clinicians document with ease and specificity, improve HCC coding, and make problem lists more relevant. Additional sessions will be offered on November 17 and December 1.

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


Acquisitions, Funding, Business, and Stock

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MSD Partners will make a strategic investment in digital consulting firm West Monroe.


Sales

  • Stillwater Medical Center (OK) will implement system integration from Summit Healthcare and patient identity modernization from NextGate to provide a simplified and interconnected health record.
  • Physicians Ambulance Service (OH) chooses Spok Go for communication between ambulance staff and hospitals during critical patient transports.
  • In Switzerland, University Hospital Basel will implement Sectra’s radiology module.

Announcements and Implementations

A Well Health survey of frontline clinical support staff finds that most are burned out by communicating with patients on the telephone, which has worsened during the pandemic as those employees try to coordinate complicated vaccination appointments and to support virtual care. 

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The NBA will allow its players to self-test for COVID-19 via Cue Health, which provides a smartphone-connected nasal swab reader to provide results in 20 minutes. Only unvaccinated players – about one player per team – will be required to take the test on practice, meeting, and travel days, while all players will still need to pass a PCR test right before a game.

In Abu Dhabi, all 59 public and private hospitals, 1,100 clinics, and 380 pharmacies have connected to the Malaffi HIE as mandated by the emirate’s Department of Health.

A Waystar survey of health system executives finds that 64% of organizations plan to implement robotic process automation and/or AI in their revenue cycle in the next three years, most often to improve financial performance.


Other

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A pharma article describes the benefits of using real-world data (such as from EHRs and claims) to develop drugs for rare diseases: (a) patients are dispersed geographically and can’t be easily found and studied otherwise; (b) FDA hasn’t developed study endpoints for conditions that have no approved treatments; and (c) small numbers of patients and doctors mean that symptoms, diagnosis, and progression are hard to understand. The author mentions AllStripes, which uses EHR data (including unstructured physician and encounter notes), imaging data, and genetic testing results. The company recruits individual patients to participate.

Virtual-first health insurance plans cost less and are convenient, but online visits aren’t ideal for first encounters or for detecting new problems. The KHN article also observer that telemedicine doctors are often work-from-home contractors who are paid based on patient volumes and who often don’t have access to medical records from other providers.

Fascinating testimony from the trial of Theranos founder Elizabeth Holmes: the company’s second lab director had zero lab experience or credentials – he was the dermatologist of COO Sunny Balwani. Sunil Dhawan, MD, who replaced the previous (and qualified) director who quit over the company’s questionable technology, testified that he was paid $5,000 per month to sign whatever Balwani sent him, having never met any company employee, patient, or clinician and without knowing anything about its technology.


Sponsor Updates

  • OneMedNet will provide imaging platform vendor Arterys with real-world data to aid in the development, validation, and regulatory approval of its solutions.
  • NetSmart will exhibit at the Fall Conference October 19-21 in Memphis, TN.
  • Pure Storage announces it has been positioned by Gartner as a Leader in the Magic Quadrant for Primary Storage.
  • The Philadelphia Business Journal names Quil Health CEO Carina Edwards a 2021 Woman of Distinction.
  • Redox adds former MuleSoft executive Simon Parmett to its Board of Directors.
  • Goldman Sachs recognizes Talkdesk founder and CEO Tiago Paiva as one of the 100 Most Intriguing Entrepreneurs of 2021 at its Builders + Innovators Summit.
  • Tegria partners with the Seattle Kraken’s One Roof Foundation to support South Park community health initiatives.
  • Vocera publishes a new case study, “MercyOne Elkader Medical Center – Unifying Staff Through COVID-19.”

Blog Posts


Contacts

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

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Comments Off on Monday Morning Update 10/18/21

Weekender 10/15/21

October 15, 2021 Weekender 3 Comments

weekender 


Weekly News Recap

  • Intelerad acquires Ambra.
  • Healthcare Triangle shares drop after IPO.
  • GetWellNetwork renames itself to Get Well.
  • A security researcher documents widespread security vulnerabilities in FHIR APIs.
  • Best Buy announces its planned acquisition of Current Health.
  • Cerner President and CEO David Feinberg, MD, MBA kicks off the virtual Cerner Health Conference with a call to “eliminate the noise in healthcare.”
  • SSM Health outsources services, including digital transformation and RCM, to Optum and will send 2,000 employees to the company.
  • The VA contracts for a year-long cost review of its Cerner implementation.

Best Reader Comments

The NPfIT attempted to build a system rather than buy one. My pet theory is that this is part of why the NHS failed with NPfIT. Having an existing system to implement automatically puts all sorts of conceptual stakes in the ground. You not only get the What will this system do, you also get the How and the Why laid out for you. Ultimately, this is why purchasing third-party software eclipsed homegrown systems. Well, that and the ability to spread the development costs around. (Brian Too)

I believe this announcement [of the VA’s 12-month Cerner implementation cost review] still requires far more of an explanation than was given. I think an explanation can be given that protects the identities and dignity of VA employees, but also makes it clear that changes are underway. This organization still serves a gigantic public need for a very valued constituency. Our veterans really do deserve a lifetime of strong support from the VA. I want to recognize that there is a lot of good work the VA does in fulfilling that mission. This project sounds like a corner where the VA may not be living its values. (Accountabilibuddy)

UHC is amassing a huge presence in healthcare (data, contracted patient lives, POC resources, etc), where they can use their position to control cost and access, much in the same way people fear digital companies like Google having access to large amounts of healthcare data. Your CIO audience should be concerned about the motives of these vendors, short and long term. They are in it to make money, many times at the expense of patients. (Susanna Stevens)

I don’t want to diminish [Seve] Job’s legacy in tech, because it is truly massive. That said, I think his early death is a good parable for Apple (and others) attempts to break into healthcare technology. Steve Jobs died because he thought he was smarter than oncologists who had studied cancer for years, and appeared to think he was smarter than the healthcare delivery system as a whole. Had Jobs pursued traditional treatment as soon as his cancer was detected, he would very likely be alive. He should be a very real warning to every startup and VC that thinks they are smarter than the people who have actually been doing it for their whole career. (Elizabeth H. H. Holmes)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. R in Oklahoma, who asked for a tripod stand and microphone for conducting virtual classes. She reports, “I am beyond blessed to have people like you continue to believe in the importance in education even during difficult times. Teaching online is difficult as it is, but knowing I have wonderful people like you who are willing to go the extra mile warms my heart and gives me the energy to keep doing the best I can for my students. Thank you once again and may God bless you for your contribution to this wonderful project.”

In England, an NHS nurse is fired for refusing psychiatric help after losing her lawsuit against a hospital that she claimed was secretly hypnotizing her, which she says caused headaches, breathing difficulty, uncontrollable flatulence, and unspecified attacks on her private parts.

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Harborview Medical Center (WA) nurse Guy Maddison, RN launches a podcast that interviews hospital workers about the challenges of caring for COVID patients. Maddison is also the bass player for Seattle cult grunge band Mudhoney.

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England’s Leeds Teaching Hospitals responds good naturedly to a sign’s spelling error that was called out on Twitter.


In Case You Missed It


Get Involved

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Sign up for email updates
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Morning Headlines 10/15/21

October 14, 2021 Headlines Comments Off on Morning Headlines 10/15/21

Intelerad and Ambra Health Combine to Form the Global Industry Leader in Cloud PACS and Enterprise Imaging

Imaging management platform vendor Intelerad acquires competitor Ambra Health for a reported $250 million.

Medsphere Systems Corporation Acquires Systeem Medical

Medsphere acquires Plano, TX-based Systeem Medical, which offers managed IT services to medical practices.

Digital health veterans launch virtual primary care clinic for patients with chronic disease

Marley Medical announces the launch of its membership-based virtual primary care clinic for patients with chronic conditions alongside a $9 million seed funding round.

Comments Off on Morning Headlines 10/15/21

News 10/15/21

October 14, 2021 News Comments Off on News 10/15/21

Top News

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Imaging management platform vendor Intelerad acquires competitor Ambra Health, whose clients include Johns Hopkins Medicine, Memorial Hermann, and New York Presbyterian.

The reported price was $250 million, valuing the combined companies at nearly $2 billion.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor EVisit. The Mesa, AZ-based company simplifies healthcare delivery with its market-leading virtual care platform, which works seamlessly across enterprise service lines and departments to improve outcomes, reduce costs, and boost revenue by enabling healthcare organizations to deliver faster, more accessible virtual care using their own network of providers across any specialty. With its distinct and leading position in the telehealth marketplace as a business-to-business company supported by a team of expert virtual care consultants, the flexible, end-to-end technology platform can match and virtualize any clinical workflow. Its system does not come with a competing provider network. EVisit is helping HCOs, including the largest systems in the US, innovate and succeed in today’s changing healthcare market. The company is the leader in the “Forrester Wave: Virtual Care Platforms in Digital Health, Q1 2021” and is a representative vendor in the “Gartner 2020 Market Guide for Virtual Care Solutions.” See them at HLTH21 next week. Thanks to EVisit for supporting HIStalk.

I found a brand new EVisit overview video on YouTube.


Webinars

October 28 (Thursday) 1 ET. “A New Streamlined Approach to Documentation and Problem List Management in Cerner Millennium.” Sponsor: Intelligent Medical Objects. Presenters: Deepak Pillai, MD, physician informaticist, IMO; David Arco, product manager, IMO; Nicole Douglas, senior product marketing manager, IMO. IMO and Cerner announce the launch of the IMO Core CSmart app, an in-workflow offering to improve clinical documentation and problem list management in Cerner Millennium. The presenters will review the challenges and bottlenecks of clinical documentation and problem list management, discuss how streamlined workflows within Cerner Millennium can reduce clinician HIT burden, and demonstrate how IMO Core CSmart can help clinicians document with ease and specificity, improve HCC coding, and make problem lists more relevant. Additional sessions will be offered on November 17 and December 1.

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


Acquisitions, Funding, Business, and Stock

Shares in healthcare cloud and data technology vendor Healthcare Triangle closed down 10% on their first day of trading Wednesday. They shed another 2.5% at Thursday’s market close, valuing the company at $118 million.

Medsphere acquires Plano, TX-based Systeem Medical, which offers managed IT services to medical practices.

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Walgreens invests another $5.2 billion in value-based primary care center operator VillageMD, increasing its stake to 63% and supporting the opening of 1,000 in-store practices by 2027.

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GetWellNetwork renames itself to Get Well.


Sales

  • Atlantic Health System will implement Syft’s enterprise-wide supply chain management system.
  • In Netherlands, Amsterdam UMC chooses Infor CloudSuite Healthcare with the support of system integrator Avaap.
  • Virginia Cardiovascular Specialists selects HealthSnap’s remote patient monitoring platform for chronic condition management.

People

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Industry long-timer Matthew Tuck, MBA (IRIS) joins NextGen Healthcare as VP of account management.

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Medical equipment tracking software vendor Cohealo hires Tom Cady (Kareo) as COO.


Announcements and Implementations

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Several big-name health systems form the Advanced Care at Home Coalition advocacy group, which will seek to extend COVID-driven payment coverage for at-home care permanently.

Nordic opens a security operations center at its Madison, WI headquarters.

Sentara Martha Jefferson Hospital (VA) goes live on enterprise imaging from Mach7 Technologies. Twelve Sentara hospitals have migrated 22.5 million studies from multiple PACS into Mach7’s vendor-neutral archive.

Bluestream Health announces Care Navigator, which offers patients a personalizable page and link from which they can initiate a app-free visit in which a dropped connection will reconnect automatically.

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CHIME names Daniel Barchi, MEM, CIO of New York-Presbyterian Hospital, as its CIO of the Year.

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GE Healthcare and Apprise Health Insights launch an HHS-funded real-time hospital occupancy solution in Oregon that will be implemented statewide next year. The system will be expanded beyond beds and ventilators to include specialty bed, PPE ED, and ECMO capacity as extracted from hospital EHRs.

A small study of the Epic Signal event log activity finds that ambulatory care network physicians who spent less time working in the EHR, especially in managing their inbox, were more likely to quit. The authors speculate that the counterintuitive findings may have been caused by physicians who were planning to leave and thus were winding down their patient activities or that EHR-proficient doctors may have been more marketable for new jobs. They also think that EHR workload or burnout is perhaps less directly related to turnover than other studies have suggested.

A Kyruus survey finds that consumers are increasingly using and preferring digital access channels to research providers, services, and care sites. Health plan websites have a strong role that is growing. Consumers place high value on understanding insurance acceptance, clinical expertise, reputation, and appointment availability and 40% of them prefer booking appointments online. 

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KLAS looks at health systems that manage downside risk contracts, which make up just 10% of the average system’s revenue. Successful organizations say that contract management is crucial and that interoperability with systems and payers needs to improve to apply advanced analytics. Vendors that primarily serve ambulatory providers – such as Azara Healthcare, HealthEC, and Cedar Gate Technologies – earner higher functionality ratings, while Innovaccer scores well for integration in larger organizations. Allscripts customers report frustration with interface management.


COVID-19

A highly anticipated study finds that it’s OK to mix and match initial vaccine doses and boosters, and in fact those people who initially received Johnson & Johnson’s vaccine initially mounted a stronger immune response when given a Moderna or Pfizer booster instead of another round of J&J.

FDA’s vaccine advisory committee unanimously recommends approving a half-dose booster for Moderna’s COVID-19 vaccine for the same high-risk groups for which Pfizer’s vaccine was cleared.

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Time magazine describes how a cobbled-together chain of acquired pharmacies took advantage of loosened telehealth rules, millions in PPP loans, and demand for unproven COVID-19 treatments to make millions selling ivermectin and hydroxychloroquine at exorbitant prices via telemedicine visits, sometimes failing to deliver the expected medication to the desperate families of unvaccinated patients. Ravkoo, a “digital pharmacy” whose predecessor organization had several executives charged with running various opioid and kickback schemes, has not drawn scrutiny from the federal government even though customers – most of them referred by partner America’s Frontline Doctors — complain of price-gouging, lack of responsiveness, and threats about negative reviews.


Other

A security researcher finds that FHIR APIs are vulnerable to hacking, noting that a single log-in provided access to 4 million patient and clinician records. Every FHIR app tested gave access to the information of other people. EHR security was strong, but third-party data aggregators and mobile apps were full of security holes. The report calls for use of API security shielding solutions such as that offered by study sponsor Approov.

An EpicShare report describes how Seattle Children’s involves its patient family advisory councils in technology decisions. Parents provided input on its initial Epic and MyChart configuration for scheduling complex appointments, requesting prescription refills, and providing access to multiple caregivers. The council also tested its virtual visit access instructions for patients early in the pandemic. 


Sponsor Updates

  • Everbridge announces that its CareConverge telemedicine solution has won a 2021 Stratus Award from the Business Intelligence Group.
  • Black Book Research recognizes Fortified Health Security as a top outsourcing vendor for cybersecurity.
  • Jvion CMO John Frownfelter, MD will present a Tech Talk on AI and health equity at HLTH October 18 in Boston.
  • Kyruus publishes its fifth annual “Patient Access Journey Report.”
  • University of Michigan Health-West expands its adoption of Nuance’s Dragon Ambient EXperience across its entire primary care group.

Blog Posts


Contacts

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

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Comments Off on News 10/15/21

EPtalk by Dr. Jayne 10/14/21

October 14, 2021 Dr. Jayne Comments Off on EPtalk by Dr. Jayne 10/14/21

As my readers know, I’m a big fan of prevention. I went this week for my regular dental visit and was interested to see a wireless headset sitting on a charger on the dental hygienist’s counter where she usually charts. She mentioned that they had installed a new system that would allow her to dictate her findings as she was performing my preliminary examination, so my informatics senses were tingling.

Looking closer as she was getting ready, I noticed that an Echo Dot had also been added to the exam room, so I figured it was part of the new solution. Unfortunately, the system failed to respond to the wake word after several tries. Since patient care was the priority and not troubleshooting the technology, she said she was going to go “old school” and key in the data manually as they had done in the past. It was disappointing not to be able to see their new toy in action, but I have to give them full credit in doing what was better for the patient (and likely for their schedule). As always, I scheduled my six-month follow up before I left, so hopefully the system will be better behaved in April.

Digital transformation has certainly impacted care delivery organizations, but it is also impacting those that support clinicians. The American Academy of Family Physicians announced last week that they are no longer requiring a certain number of live Continuing Medical Education (CME) hours for physicians to maintain membership. In the past, physicians had to report 25 hours of live CME every three years. Reductions in the availability of live meetings due to the COVID-19 pandemic impacted the ability of physicians to claim these credits, leading initially to the AAFP granting extensions on the time needed to obtain the hours.

However, AAFP also realized that the definition of “live” has become more fluid in the digital world. Rather than deal with the complexity of defining whether “live” means “in person” versus “virtual” versus “livestream” or something else, they’re eliminating the category altogether in the name of allowing active members “to pick the learning formats that best suit their needs and preferences.” Active members will still need to report 150 hours of CME every three years and half must have the AAFP Prescribed credit designation, so we’re not entirely to the point where we have total flexibility in how we obtain our CME. The response in the comments section was overwhelmingly positive, so kudos to AAFP for helping make physicians’ lives at least a tiny bit less complicated.

Speaking of blurred lines between in-person interactions and other modalities, I enjoyed learning more about what Cleveland Clinic is doing at its Indian River Hospital in Florida. As part of a new program, patients are being “seen” by mental health providers during emergency department visits, an approach that not only reduces the time for patients to receive services, but is improving quality. Psychiatric consultations are being seen in less than an hour versus the 24 hours that could occur previously. Often, treating psychiatric concerns in the emergency setting can be a challenge, and in my area, we recently opened a dedicated psychiatric emergency department to better serve patients in a more welcome environment. From the day it opened, though, it’s been at capacity, so maybe augmentation with telehealth resources – either there or within traditional emergency departments – is something to think about.

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JAMIA Open published an article last week looking at an AI-based system that can flag medication errors in the EHR by looking at clinician ordering behavior in context. Researchers looked at pharmacy orders over a two-week period in a major metropolitan hospital system. The goal was to identify orders requiring pharmacist intervention then to further refine it within a given clinical context. Contextual data included specialty, clinician type (attending, resident, midlevel provider), day of the week, time of day, and the therapeutic class of the medication. The data used was from two weeks in July 2017, which somewhat limits the study – July is when new interns start and residents typically advance, resulting in changing responsibilities. The authors note this, and also that the small sample wouldn’t account for seasonal variations. Still, it’s important work, and developing effective systems to help reduce medication errors is a good thing.

I’m prepping tonight for a community presentation about COVID-19 vaccines, as a local volunteer organization tries to push its vaccination rate beyond 90%. I expect quite a few questions about third doses versus boosters as well as the usual questions about vaccines in general. I’m on a couple of groups’ COVID advisory panels, so I have to keep up with a steady stream of news along with being able to play my own little version of “MythBusters” every time I do a public forum. Today provided some interesting material about long COVID, which now has been officially defined by the World Health Organization. The clinical case definition of “Post COVID-19 Condition” as it is called includes lingering fatigue, shortness of breath, and cognitive dysfunction (also referred to as “brain fog”). Symptoms may continue for months after the initial COVID infection and are often severe enough to prevent patients from completing daily activities. Additionally, other explanations for the symptoms must be excluded before a patient is considered to have the condition.

In parallel, the US Centers for Disease Control and Prevention formally added an ICD-19 code for long COVID: U09.9 Post COVID-19 Condition, Unspecified. Additional guidance from the US Department of Health and Human Services explains that the condition can be considered a disability under the Americans with Disabilities Act. For those who think that COVID-19 infection is not a big deal, I hope we can look back in a few decades and it’s actually true. In the short term, however, I have significant concerns about the overall cost of COVID care to our health system and ultimately to the global economy. Seems like the $20 vaccine is looking like more of a bargain every day compared to the potential of hospitalization, disability, and death.

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CMS announced that the Quality Payment Program website will no longer support Internet Explorer 11 after October 13, 2021. I was shocked by the fact that approximately 2% of users access the site through IE 11. If you’re still using it, you’re missing out on the features offered by other browsers, so hopefully those users will like what life is like on the other side of the fence.

What’s your favorite browser? Leave a comment or email me.

Email Dr. Jayne.

Comments Off on EPtalk by Dr. Jayne 10/14/21

Morning Headlines 10/14/21

October 13, 2021 Headlines Comments Off on Morning Headlines 10/14/21

Healthcare Triangle, Inc. Announces Pricing of $13.0 Million Initial Public Offering

Healthcare Triangle debuts on the Nasdaq in an IPO of $4 per share, with a goal of raising $13 million.

Lark Health Raises $100 Million Series D Funding Round Led by Deerfield Management

Mental health coaching app company Lark Health raises $100 million in a Series D funding round, which it will use to advance virtual care integrations with payers.

ScienceIO leaves stealth with millions to structure health data

Health data aggregation and curation startup ScienceIO raises $8 million in a seed funding round.

Comments Off on Morning Headlines 10/14/21

HIStalk Interviews Shawn DeWane, CEO, TransformativeMed

October 13, 2021 Interviews 2 Comments

Shawn DeWane is CEO of TransformativeMed of Seattle, WA.

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Tell me about yourself and the company.

TransformativeMed focuses on the clinical workflows of physicians and nurses. Healthcare is a team sport and COVID-19 has made this a focal point. We are looking to bring a revolution to healthcare IT by delivering smart technology, smart algorithms, and the organization of clinical information in an intuitive manner so that clinicians can effectively and efficiently impact patient lives with a strong patient safety aspect.

We got our start in rounding and handoffs, then moved into other smart care capabilities, such as diabetes. The focus of our company has always been around research and development, done in partnership with our customers. Some of those customers are among the most prestigious in the country, so we have some great thought leadership as a result. Clinician satisfaction is high, in the 95th percentile range. Our implementation experience is exceptional. The product is sticky and clinicians love it. We are in 26 health systems around the country and we have one overseas. We have over 170 hospitals that use the products. There are a lot of hospitals that we are not in and a lot of beds that we’re not servicing at the moment, so we have a lot of opportunity, a lot of green space in front of us.

I grew up in rural Northern Illinois in a Midwest farmland culture that emphasizes hard work and fair dealings. I’ve hade a successful career in healthcare IT and technology and have developed a system of sorts that I can assess, grow, and scale businesses with great talent. My focus has always been around relationships and a fundamental commitment to delivering success to customers and my teams. Some of the key bodies of work that are most significant for me in the past are a 13-year run with IDX, then McKesson, and most recently with Hayes. My wife of 37 years and I live in the Chicagoland area. We have three great kids, all adults and on their own.

How would you describe the relationship between Cerner and Epic and companies that develop embedded or connected apps that extend the capabilities of their core EHR products?

I’ve had a great deal of experience with large enterprise EMR production systems through McKesson and IDX. They typically can’t handle the level of precision a clinician needs for problem-based care. With the changing landscape that COVID brings to the table, it makes it even harder for an EMR system to be both nimble and effective in addressing patient care. Problem-based care and the precision of what the clinician needs is at the heart of why a company like TransformativeMed exists. Recently a CMIO of one of our customers, a large health system, told us that we come in with the eyes of a clinician and know exactly what they need. That’s really what it boils down to.

User testimonials on your website talk about how your product improves clunky EHRs, provides financial benefit, and increases clinician satisfaction. Do those comments get back to the EHR vendors in highlighting seeming shortcomings in their products?

Some of that probably does happen. My experience with large enterprise production systems do just that. It’s hard for them to be nimble and focused on the moment and the issue when you’re standing over a patient, whether you’re a nurse or a physician. The ability of a system to be able to gather information, suggest a treatment of care, and then document that back into the EMR — that level of efficiency in a fluid situation is difficult for a large production system to handle. At some point it is what it is, but we make the EMR what the user thought they should have gotten.

How much of clinician EHR dissatisfaction and burnout is caused by plain-vanilla implementations that avoid personalization for individuals and clinical specialties?

Each specialty has its own angle that they’re coming at in terms of the problem that the patient presents. You have to have smart care algorithms to address the unique needs of the specialty and by type. Not just the needs of the physician, but of the nurse as well. The cumulative nature of what happened, what is presented in the moment, what to do, and then the further documentation along the lines of that specialty is what TransformativeMed does, which is what users like the most.

Some issues are time-based, where I get 15 minutes extra a day or 30 minutes extra a day or two hours extra a day back into my life so I can see more patients. Bed capacity management, especially these days, is chronic. How do I treat the patient as effectively as possible and move them into a discharge status so I can make that bed available to another patient? All of that is expedited and made more efficient when you have specialty-based algorithms to provide them the information they need.

Does the underlying architecture of EHRs support real-time capabilities and user personalization?

EMR systems are sound technology to store batches of information like lab data, nurse documentation, or physician documentation, but it’s gathering up that into an efficient way to present those findings to the provider at the time of care for the patient. That efficiency of gathering that and presenting an algorithm for care is where TransformativeMed fits in. The ability to gather effectively, present it in a smart manner, and then — and this is the main thing — to be able to document back to the EMR while in the event, the moment with the patient. That’s the part that creates the efficiencies.

How much of the company’s efforts will be driven by which EHRs you work with and how you work with them?

We are embedded at the EMR level through FHIR API kind of technology. It’s important to get that connection and linkage done correctly. It’s also important to make sure that all of the rich features and functions that the clinicians need are intact. We have some partnerships with clients to make sure that from a qualitative point of view, everything works the way it should. We have some other partners lined up to make sure that that happens.

Whether it’s Epic or Allscripts, the quality of the connection and delivery of the function for efficient problem-based care delivery are the focus. We are on that journey, it’s moving along pretty well, and we’re going to continue that journey. We are going to take a more qualitative approach and make sure that it’s done right.

Is it difficult to create or maintain a brand identity when clinicians may not be able to tell which parts of the system were provided by the EHR vendor and which parts came from TransformativeMed?

Because the embedded nature of the solution, the clinician really doesn’t know that they are in TransformativeMed, because it is just brought in from the Cerner screen or the Epic screen. There’s a seamless nature to it that is very attractive to clinicians.They don’t have to toggle in and out of one system to another.

From a branding point of view, CORES is the brand title. Physicians who have used CORES want to use it again. If physicians are thinking about getting a solution that CORES addresses, the referrals are made. We get inbound interest from clinicians who want CORES because their colleague used it at a different health system. There’s a seamless usage of that through the UI, but the CORES brand is very strong out there.

Has their been interest in making the company part of a vendor or consulting organization?

Valuation and general value are dependent on the revenue you have coming in, your customer satisfaction, and the breadth and depth of products that you have. Right now our focus is to grow the company in a sustainable manner. If our customers are happy, they will stay with us and our revenue will continue to grow. We will have to see from there.

Where do you see the company’s recent work with the VA in Puget Sound leading?

We are super excited and honored. I’m very excited to be able to have an impact on the care of veterans. It’s a nice mission for our company. We have a great culture, but it’s a special honor to be able to do this.

This initial site will go fairly rapidly. We should have some pretty good results in the next two or three months. With that said, as we make progress through the rest of the VA, we will have some great use cases as a result. We are looking for other avenues with the government as well. It’s going great so far and we expect great results and are looking forward to further use of the product throughout the VA.

How will the VA and your other customers determine the impact of implementing your product?

We always do a compare and contrast of the situation before we were installed and afterwards as a use case. We document what the problem was, what we did, and what the results were. We will be doing the same thing with the VA.

The specific aspects that we will look to impact here will be around rounding and handoffs, and also with diabetes care and management for both the physicians and the nurses. They will be permeated throughout the VA. We expect to chart and document those results. 

In the short term, we will be able to coordinate care better. As I mentioned before, healthcare is a team sport. Statistically, you’ll see in a typical episode that maybe 50 clinicians of one sort or another are involved in a patient’s care. We’ll be able to coordinate that better. We’ll be able to hand off that information better and they will use their time more efficiently.

On the diabetes side, diabetes care is fluid and it’s conditional depending on a number of factors. We will be able to coordinate that better, especially with the CMS regulations that are coming out around performance and generally regulating diabetic care. We will be positioned to affect the diabetic care of the veterans that we’ll be serving.

Where do you see the company’s future over the next three or four years?

We are focused on adding new customers, keeping our customers happy as they typically are while expanding the footprint in our customer base. We are going to look to a lot of revenue growth, a lot of expansion into both the government and international markets. We will invest in additional product development, research and development for new modules to help support our customers. We are looking at not just solutions for residents, hospitalists, or endocrinologists, but a number of other areas to continue to expand our footprint.

Morning Headlines 10/13/21

October 12, 2021 Headlines Comments Off on Morning Headlines 10/13/21

Best Buy to acquire Current Health to help make home the center of health

Best Buy will acquire home monitoring platform vendor Current Health, which raised a $43 million Series B round earlier this year.

“We Must Eliminate the Noise,” Reflected Cerner’s New President and CEO

Cerner President and CEO David Feinberg, MD, MBA kicks off the virtual Cerner Health Conference with a call to “eliminate the noise in healthcare” by getting the right information to the right people at the right time.

HealthVerity awarded CDC contract for real-world healthcare data to advance COVID-19 response

CDC will use HealthVerity’s privacy-protected data exchange to develop a real-world dataset for projects related to COVID-19, viral hepatitis, and HIV.

Comments Off on Morning Headlines 10/13/21

News 10/13/21

October 12, 2021 News 3 Comments

Top News

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Best Buy will acquire home monitoring platform vendor Current Health, which raised a $43 million Series B round earlier this year.

Co-founder and CEO Christopher McCann will remain with the company. He completed a master’s in computer engineering and left medical school in Scotland to start the company in 2015 with his co-founder and CTO, who had just completed a PhD in computing science.


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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Cerner President and CEO David Feinberg, MD. MBA kicks off the virtual Cerner Health Conference with a call to “eliminate the noise in healthcare” by getting the right information to the right people at the right time. He mentioned the essential clinical dataset, defined by 12 Cerner clients in 2016 as the EHR data elements that are essential for providing quality care.


Sales

  • CDC will use HealthVerity’s privacy-protected data exchange to develop a real-world dataset for projects related to COVID-19, viral hepatitis, and HIV.

People

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Andrea Marks (UnitedHealth) joins Walmart as VP of clinical performance, overseeing the clinical data and analytics team.


Announcements and Implementations

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MSU Health Care (MI) leverages remote Care Everyday patient monitoring technology from Higi as part of its RPM program for patients with chronic conditions.


Government and Politics

Rumors of an enterprise Epic implementation across the NHS in England begin swirling after NHS England Director of Transformation Ian O’Neil attended “high-level meetings” with Epic CEO Judy Faulkner. Adding flame to the fire of speculation is the fact that Tim Ferriss, NHS England’s new head of digital transformation, comes from Massachusetts General Hospital, which rolled Epic out in 2016.

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In Canada, Newfoundland and Labrador’s COVID-19 vaccine passport system crashes just a few hours after launching due to overwhelming traffic. At one point, 600 QR codes were being downloaded every minute to the province’s NLVaxPass app.


Sponsor Updates

  • Netsmart VP and GM AJ Peterson and customers present at the American Health Care Association/National Center for Assisted Living 2021 Convention and Expo through October 13 in Washington, DC.
  • Istishari Hospital in Jordan selects Wolters Kluwer Health’s UpToDate and Medi-Span Clinical clinical-decision support tools.
  • CareSignal publishes a new case study featuring The Andrews Center, “High-Touch Care: Remote Patient Monitoring for Mental Health Identifies Potential Crises Ahead of Time.”
  • CHIME awards 10 healthcare organizations the highest level of its Digital Health Most Wired Survey.
  • CloudWave’s OpSus Healthcare Cloud attains SSAE18 standards certification renewal plus HITRUST.

The following HIStalk sponsors will exhibit at HLTH 2021 October 17-20 in Boston:

  • InterSystems
  • NTT Data
  • CoverMyMeds
  • Olive
  • Cerner
  • Ellkay
  • Infor
  • Jvion
  • Quil
  • RxRevu
  • Talkdesk
  • Well Health
  • CloudWave
  • Dina
  • Gyant
  • Health Catalyst
  • Lumeon
  • Pure Storage
  • Relatient
  • Upfront Healthcare

Blog Posts


Contacts

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

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Morning Headlines 10/12/21

October 11, 2021 Headlines Comments Off on Morning Headlines 10/12/21

Brave Care, The Leader in Technology-Powered Pediatric Clinics, Raises $25M in Series B Investment led by Mednax, Inc.

Brave Care raises $25 million in a Series B funding round led by Mednax, bringing its total raised to nearly $50 million.

SSM Health and Optum Launch Innovative Collaboration to Make Quality Care More Accessible and Affordable

SSM Health will work with Optum to develop inpatient care management, digital transformation, and RCM solutions to improve patient experiences and outcomes.

SoftBank Bet Values Autism-Care Provider Elemy at $1.15 Billion

Pediatric behavioral healthcare company Elemy raises $219 million in a Series B funding round, bringing the startup’s total funding to $323 million.

Comments Off on Morning Headlines 10/12/21

Curbside Consult with Dr. Jayne 10/11/21

October 11, 2021 Dr. Jayne 1 Comment

Early in my informatics career, I worked on a health information exchange project. It was during the early days of HIEs, and many of the challenges were legal and operational as opposed to technical. We had to wade through the minefield of consent, debating opt-in versus opt-out models within the confines of the laws of multiple states. We also had to address access issues, decide when break-the-glass functionality could be used, and create policies and procedures around auditing access to the data and ensuring appropriate use. Only once those thorny issues were settled could we begin to define the clinical data sharing model and determine what information would be shared from what sources.

We then had to work through the technical issues. We had to decide whether we wanted ambulatory office visits to automatically query the HIE versus whether providers would have a manual trigger to prompt data sharing. We had to address hosting issues as well, along with the pure limitations of the product we had, since we had purchased our solution from a company whose strategy was still evolving. There were dozens of interfaces to evaluate and integrate, and we had to create a solution that would provide immediate value while not breaking the bank, buying ourselves time to bring up the rest of the data feeds. The big draw for our solution was its ability to allow providers to incorporate discrete data from the HIE into their charts so that they could use it instantly within the context of the patient encounter.

We didn’t necessarily see them coming, but many issues we faced though turned out to be political in nature. Unknown to us, the CIO of the health system with which our physician group was affiliated had his own HIE plans, and they didn’t involve us. He had secured funding for his own HIE and had crafted a strategy without any input from the thousands of ambulatory physicians who were clamoring to be connected. His solution was more of a viewable repository that was document based rather than enabling the exchange of discrete data. The last thing our physicians wanted was to have to sift through textual information and then perform data entry tasks in order to incorporate that information in their own records, so you can guess whose solution was more popular.

Needless to say, he spent a lot of his time trying to kill off our project. Not only would our HIE concept provide more value, but we were planning to deploy it for a fraction of the cost of what he had planned. He also wasn’t terribly fond of having to work with physician informaticists, let alone one who was relatively young and decidedly sassy.

Since we were technically independent despite the affiliation, we pressed ahead and implemented quickly, helping physicians from day one. Our most valued feature was assisting in reconciling medication lists from different sources and identifying patients who might be seeking controlled substances from multiple physicians. Other solid features involved supplying data for problem and diagnosis lists as well as laboratory and biometric data.

Although I moved on before our little HIE reached maturity, I still regard it as one of the best projects I ever worked on, and also the most educational for me as a clinical informaticist. I learned more about discrete data, interfaces, and interoperability in those months than I probably did in the first five years of my career. In the early days of data normalization, I also learned that laboratory directors don’t like it when outsiders find problems with their data, and if you’re going to question senior physicians who are twice your age, you had better come ready with plenty of facts and examples because it’s going to be difficult to convince them that their system isn’t perfect.

Since then, I’ve kept my eye out for interesting HIE stories and have enjoyed seeing how exchanges have evolved over time. Although many of the technology issues have stabilized, there are a host of challenges that are both operational and financial. A Brookings Institution blog post caught my attention last week. It reviewed some of the digital transformation that has occurred as a result of the COVID-19 pandemic, including increased adoption of telehealth and the rise of healthcare technology startups and retail healthcare.

The authors note that the transformation is also impacting the health information exchange world, raising questions about how HIEs fit into the larger healthcare ecosystem. Where traditional HIEs typically involve data exchange among physicians and hospitals, there is a growing need to incorporate data from a multitude of other sources. Since many of the newer players, including retail clinics, involve large national organizations, there is motivation for them to maintain their own medical records without necessarily having to integrate with traditional provider or hospital organizations.

Additionally, given functionality required by federal incentive programs, patients now have a greater ability to view, download, and transmit their own health information. The authors note that new features such as Apple’s iOS Health Records functionality allow patients to communicate more directly with their physicians. However Epic, was not included in the Apple implementation. They summarize, “Not only can these companies choose which HIEs to work with, but they disrupt the original purpose of HIEs, which was to centralize medical care for improved efficacy of patient care.” This means that HIEs may need to play a new role in the marketplace, and the authors list strategies for HIEs to try to remain relevant:

  • Diversify network members and data types to stay relevant.
  • Include knowledge discovery in their focus.
  • Work horizontally and vertically to meet patients and providers where they are.

These are certainly important points. HIEs are going to need to widen their user base and make sure they stay current in understanding the needs of their constituents. HIE use cases have gone far beyond catching patients who are seeking duplicate prescriptions (most states have prescription drug monitoring programs for that now) to providing opportunities for analysis of broad aggregations of patient data that could provide valuable information for public health as opposed to being merely push/pull platforms. In the third point, the authors propose that HIEs consider mergers and acquisitions to expand in similar service lines, such as collaborating with HIEs in neighboring states, where vertical integration would allow them to better integrate with their current data suppliers and consumers or add stakeholders such retail healthcare providers.

The authors also note that further HIE growth may be limited by other factors. These include concerns over patient privacy and worries about increased regulation.

For the latter, there are concerns that charging a fee for data exchange might be construed as information blocking, so there are plenty of issues to resolve there. I’d also mention that they need to worry about cyberattacks and maintaining adequate financial resources to ensure solvency.

In our current environment, they also need to be wary of becoming embroiled in political controversies. For clinicians, sharing vaccine information through HIEs has been a tremendous benefit and allows us to have complete records on pediatric patients and avoid giving duplicate immunizations. In our polarized political climate, I wouldn’t be surprised to see certain states try to make it illegal for healthcare organizations to share COVID-19 vaccination data.

HIEs have always had tremendous potential, but the road to success has been a rocky one and there have been quite a few failures along the way. I’m hopeful that the current generation of HIE leaders understands the challenges and that those leaders are getting creative about ways to ensure longevity and a bright future.

What role do you see for HIEs in the coming years? Leave a comment or email me.

Email Dr. Jayne.

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