News 8/4/21

Top News

Renown Health opens a Transfer and Operations Center to better coordinate care across 27 counties in California and Nevada.

The center, which includes remote home monitoring capabilities using technology from Masimo, will soon add remote monitoring for its tele-ICU services.

The center will coordinate all incoming patient arrivals, match patients to beds, coordinate transportation and housekeeping services, offer ICU monitoring and telehealth visits, monitor patients at home, and provide emergency and disaster management information.

HIStalk Announcements and Requests

HIMSS21 will almost certainly go on as scheduled next week. Medicomp, Olive, and Imprivata are the only big vendors I know of that have cancelled attendance, although companies aren’t required to publicly announce their decision to stay home. I usually stick to the exhibit hall and skip the celebrity keynotes and educational sessions that often aren’t actually educational, but if there’s a must-see HIMSS21 event that has caught your eye that I should know about, tell me.

Looking ahead to next week, it’s hot as blazes in Las Vegas and COVID-19 is running rampant through unvaccinated residents and visitors. My intense dislike of Las Vegas is a benefit since I have always avoided the virus’s hunting grounds of celebrity chef restaurants, casinos, and seas of people at their worst behavior. I’ll stick to the conference areas almost entirely, attend no events, mask up everywhere, and likely forget many times to do the silly-looking but epidemiologically superior elbow bump instead of shaking hands.

I’m surprised at how many companies and people have touted their HIMSS21 attendance on LinkedIn and Twitter, spelled everything correctly, then embarrassingly ended with “#HIMMS21.”

Webinars

On-Demand Webinars:

“Key Differences: Value Based Care vs. Fee-For-Service.” Part 1 of a three-part series. Sponsor: Net Health. Presenters: Bill Winkenwerder, MD, chairman, CitiusTech; Josh Pickus, CEO, Net Health. Dr. Bill Winkenwerder, former assistant secretary of defense for health affairs for the US Department of Defense, shares his unique perspective on the future of value-based care (VBC) systems in the public sector and how VBC differs from fee-for-service models in the private sector. This Part 1 webinar covers which aspects of the fee-for-service health system payment model look the most different compared to fully value-based systems (clinical, back-office, analytics, etc.)

“Current Innovation and Development in Value-Based Care.” Part 2 of a three-part series. Sponsor: Net Health. Presenters: Bill Winkenwerder, MD, chairman, CitiusTech; Josh Pickus, CEO, Net Health. Dr. Bill Winkenwerder, former assistant secretary of defense for health affairs for the US Department of Defense, shares his unique perspective on the future of value-based care (VBC) systems in the public sector and how VBC differs from fee-for-service models in the private sector. This Part 2 webinar discusses what health systems should know about the transition to value-based care, including macro versus micro shifts.

“Future of Value-Based Care: Predictive Analytics, Technology, Policy.” Part 3 of a three-part series. Sponsor: Net Health. Presenters: Bill Winkenwerder, MD, chairman, CitiusTech; Josh Pickus, CEO, Net Health. Dr. Bill Winkenwerder, former assistant secretary of defense for health affairs for the US Department of Defense, shares his unique perspective on the future of value-based care (VBC) systems in the public sector and how VBC differs from fee-for-service models in the private sector. This Part 3 webinar discusses the role analytics will play in the shift to value-based care and how financial and clinical ROIs for analytics-oriented products must differ when applied to FFS and VBC models.

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

Acquisitions, Funding, Business, and Stock

CPSI announces Q2 results: revenue up 15%, EPS $0.42 versus $0.12. CPSI shares are up 28% in the past 12 months versus the Nasdaq’s 37% rise, valuing the company at $464 million.

Registry data and analytics company CorEvitas acquires Vestrum Health, which offers data culled from retina care-focused EHRs for research, analytics, and commercialization. CorEvitas rebranded, quite understandably, from Corrona earlier this year.

CORHIO and Health Current merge to form Contexture, an umbrella organization that will oversee the respective HIEs’ work in Colorado and Arizona.

Sales

• Health Recovery Solutions selects Lyniate’s Rhapsody integration technology to enhance customer connectivity with its remote care solutions.
• Eastside Health Network will use Arcadia’s analytics to improve the value-based care performance of its provider network in Washington.
• Idaho Health Data Exchange selects Orion Health’s Amadeus HIE platform.
• St. Vincent Health (CO) implements Infor’s CloudSuite Healthcare for resource management.
• Ashley Clinic (KS)  will use Emerge’s ChartGenie, ChartScout, and ChartPop data conversion and integration technologies during its EHR conversion later this year.

People

The Missouri Hospital Association hires Jon Dolittle (Mosaic Medical Center – Albany) as president and CEO. He was a senior business developer for Cerner from 1998 to 2009.

Mads Kvalsvik (Madaket Health) joins UCM Digital Health as CTO.

WellHive hires Chris Faraji (Salesforce) as EVP.

Announcements and Implementations

ChartSpan provides bi-directional data exchange between its chronic care management platform and provider EHRs using Ellkay’s integration capabilities.

First Databank will offer its clients RxRevu’s prescription cost and coverage solution, allowing physicians to choose cost-effective medications based on patient pharmacy benefits in their EHR workflows.

PadInMotion rebrands to Equiva and announces GA of its new health relationship management software, which combines patient engagement, care management, and marketing capabilities.

CitiusTech develops Medictiv, a open healthcare AI model directory of more than 250 ready-to-use models for data science and digital health teams.

Memorial Sloan Kettering Cancer Center establishes MSKCC India, a virtual care service for cancer patients in India that will use telemedicine technology from India-based IClinic and oncology expertise from New York City-based MSKCC providers.

Surescripts announces GA of Care Event Notifications and enhancements to its Medication History for Populations service.

Data privacy vault vendor Skyflow announces a PHI-specific, API-delivered Healthcare Data Privacy Vault.

UNC Health extends its mobile app functionality, which was developed with Gozio Health, to include MyChart access, visit scheduling, and wait time display.

Cerner is named as the hospital category winner in the ECR Now FHIR App Challenge for electronic case reporting for COVID-19 and other diseases of public health interest. Cerner’s solution sends a near real-time Electronic Initial Case Report to the Association of Public Health Laboratories AIMS platform, whose development was funded by CDC. The solution is open source and has been made available by Cerner to non-Cerner clients and EHRs.

Sphere launches a patient self-scheduling tool called Book My Doc that extends its Health IPass revenue cycle management and patient engagement platform.

Other

This would be an embarrassing way for a hospital to get hacked. Security researchers warn of vulnerabilities in Swisslog Healthcare’s Ethernet-connected pneumatic tube systems, which are used in 3,000 hospitals worldwide. A new firmware update offers fixes for all but one of the known issues.

Sponsor Updates

• Surescripts makes its Medication History for Populations service available to Lightbeam Health Solutions customers.
• The Chartis Group announces 13 promotions – three directors and 10 principals.
• CloudWave sponsors the New Bridge Medical Center Foundation 2021 golf outing.
• EZDI releases a new case study, “Auburn Community Hospital Improves Bottom Line – Impact Totaling $1.03MM by Implementing EZDI’s CAC.”
• RxRevu partners with First Databank to expand the delivery of its prescription coverage and cost data as a supplementary service to FDB’s network of clinical drug information customers.
• UnityPoint Health expands its use of SOC Telemed’s Telemed IQ telemedicine software and psychiatrists to an additional four hospitals in Iowa.

Blog Posts

• 5 ways to maximize revenue on every claim (Ability Network)
• How a Texas family practice uses technology to overcome barriers to chronic care management (AdvancedMD)
• Roundtable takeaways: home- and community-based care, and new care models (CarePort)
• The Top Three Components Your Medicare AWV Program Needs (ChartSpan)
• Countdown to HIMSS21 (Optimum Healthcare IT)
• The Future of Telehealth Following the COVID-19 Pandemic (Dimensional Insight)
• “Game-Changing” Technology Connects Care at Redeemer Health (Dina)
• When Prisma Can Lead to Better Care (EClinicalWorks)
• Success at a glance: Turning incomplete patient data from COVID-19 testing and vaccinations into valid reimbursable claims (Experian Health)

Contacts

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

Morning Headlines 8/3/21

ChrysCapital-backed GeBBS Healthcare Acquires Aviacode

RCM vendor Gebbs Healthcare Solutions acquires Aviacode, which offers medical coding and compliance services.

Juno Medical Raises $5.4M in Seed Financing to Reimagine Primary Care for the 99%

New York City-based Juno Medical will use $5.4 million in seed financing to expand its clinic footprint, virtual care services, and price transparency capabilities.

Vestrum Health Joins CorEvitas

Registry data and analytics company CorEvitas acquires Vestrum Health, which offers data culled from retina care-focused EHRs for research, analytics, and commercialization.

Curbside Consult with Dr. Jayne 8/2/21

Like most of us, it’s been a long time since I’ve attended an in-person conference. Often, the sessions aren’t terribly memorable, and once I get home, I rarely consult my notes.

One of the exceptions was a presentation I attended at the American Medical Informatics Association Annual Symposium some years ago, where the topic covered patient portal use among children and adolescents. I remember the speakers talking about how their institution did the difficult work of defining what elements could be shared, which should be shared, and how to best set up various age and proxy restrictions for the best outcome.

Fast forward, and now we’re dealing with not only the limitations of patient privacy and EHR capabilities, but the impact of interoperability and information blocking rules. JAMA Pediatrics had a good viewpoint article about this last week. Working with patients who are minors can be challenging, especially as they move through the adolescent years and become candidates for certain healthcare services that can be kept confidential to some degree, such as pregnancy, sexual health, mental health, and related care. It’s always been a fine line that we’ve had to walk, because although we can restrict that information in the medical records, parents and guardians may still receive the bills and insurance correspondence.

For those who might not be in the data-sharing trenches, the article provides a nice overview of what HIPAA and HITECH have required as far as making records available. It also summarizes the 21st Century Cures Act and information blocking rules. As far as information blocking goes, there is a subset of situations where information blocking might be allowable, including technical infeasibility, preventing harm, and privacy. Those caring for minors might need to use one of these exceptions to protect patient confidentiality, especially considering that states have differing requirements as far as protecting restricted categories of information such as mental / sexual health services and contraception.

Clinicians have to understand those state rules and what parents might be able to see, and they also need to fully understand what features their EHRs might provide to help them with this daunting task. Some EHRs I’ve worked with allow users to mark specific data elements as “sensitive” and block release; others require the user to create separate encounter notes where an entire visit’s documentation is blocked from release. Less-savvy users might not understand these nuances, leading to negative consequences for patients, not to mention increased liability for themselves and their institutions.

The article also notes that the flow of data must also protect information provided by caregivers who might have a need to keep certain history elements from the patient, such as adoption status, genetic diseases, or other pieces of family history that a patient might not be mature enough to absorb. Another tricky area noted by the authors is the maternal data that is contained in a newborn’s EHR chart. This information often includes sensitive testing (HIV, hepatitis, sexually transmitted infections) as well as information on maternal drug and alcohol use, intimate partner violence screening, and more. Disclosing the mother’s protected health information to other caregivers can be a problem if not handled carefully.

The article mentions benefits of information sharing and jogged my mind on some of those aspects from the AMIA presentation. When I was in a traditional family medicine practice, we often spent the majority of the 17-year-old well visit discussing “Healthcare Adulting 101” so patients could understand their health information and how to best access it as they headed to college or otherwise into adulthood. With the rise of patient portals, adolescent patients may be able to schedule their own visits, request refills, and more. Education is needed so they understand the difference between urgent messages, non-urgent needs, and the best ways to navigate our often-chaotic healthcare system.

For adolescents with complex medical histories who have the ability to participate in self-management programs, having access to their information can be valuable and can help them get the best outcomes. Patients can partner with their parents for co-management, but organizations must be careful that common policies (such as reducing parental access to the chart during the teenage years) do not inadvertently hamper successful family dynamics. It’s quite a tightrope that that care teams walk at times and I thought the article was a good reminder for the rest of us. Unfortunately, since it appeared in a pediatric-specific journal, I’m not sure how much external visibility it will get.

The piece paired nicely with another article that I ran across, this one about using artificial intelligence systems to sort through electronic health records. The study looked at the amount of time that clinicians spent reviewing clinical data during patient visits and whether an AI system could help organization patient information prior to review. The study was small, with only 12 gastroenterologists participating. Each participant received two clinical records, one in the standard format and one that had been optimized via AI. They were then required to search the record to try to answer more than 20 clinical questions. The AI-optimized records allowed physicians to answer the clinical questions faster with equivalent accuracy. Nearly all the physicians stated they preferred the optimized records to the standard.

Even though the study was small and really needs to be redone with a larger number of physicians across multiple specialties and with multiple samples per physician, it got me thinking. What if you could use AI optimization to tackle the pediatric data- sharing problem? What if AI could be used to augment clinician efforts to seek out and appropriately tag or restrict sensitive information? Could AI-enabled tools run in the background while physicians are documenting and alert them to state laws about the information they’re adding to the chart, and do so right at the point of documentation? What if our systems could actually allow us to work smarter and could help make it easier to do the right thing the majority of the time? I think that’s the goal that most of us have in clinical informatics, although it’s often difficult to deliver those advantages to our users.

For those of you in the pediatric informatics trenches, how well are the tools available to you doing? Are they making it easier to manage information sharing or more difficult? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Interviews Ashish Shah, CEO, Dina

Ashish Shah is co-founder and CEO of Dina of Chicago, IL.

Tell me about yourself and the company.

I started with Dina six years ago. I was previously the CTO and head of product for Medicity and was there eight years, before and after the acquisition by Aetna. Dina offers an AI-powered care-at-home platform and network that supports hospitals and health plans as they transition to monitoring patients in the home and other post-acute settings. We call this Care Traffic Control.

We’ve talked before about my father, who passed away suddenly shortly after Aetna acquired Medicity. I was a healthcare executive who had helped thousands of hospitals connect to ambulatory care sites, but that didn’t improve my dad’s situation. He had home health aides and spent time in senior centers, but those caregivers had no way to share information.

What effect has the pandemic had on the demand for at-home care as well as the company’s business?

The pandemic shined a bright light on what we need to do and accelerated it even further. Prior to the pandemic, Dina was 100% focused on organizing all of the resources outside of traditional facility-based healthcare, whether that was post-acute rehab facilities or in-home services. We knew we needed to do a better job to support the silver tsunami, the 10,000-plus people each day who are turning 65 years old. 

We would get a lot of head nods, and that was important, but COVID unfortunately accelerated that tsunami and gave us a glimpse of what it’s like when the traditional healthcare system is overrun. That cemented our place in the market. Clearly, complex things will continue to happen in the high-quality facilities. That’s never really going to change. There may be some automation and further optimization that takes place, but that’s still the right care setting for the right types of things.

Virtual care, whether it’s telehealth or some combination of remote patient monitoring, became critical. But these things need to be complemented by a third important delivery vehicle, which is in-home care. Not just traditional home health, but mobile lab and imaging, courier services, and a host of other capabilities that can be brought to you. The world was trained on things coming to you through the pandemic, not just in healthcare, but in all aspects of life. So in many ways, it made it super obvious for everyone. Now the race is on to equip the industry as fast as we can.

How do you see that shift away from the four walls of a hospital or a clinic being a threat, an opportunity, or both to the traditional health system?

It’s tricky. It’s hard to be a health system leader today because you have your feet in two different boats, two different business models. It’s hard to look away from how healthcare has been financed to date in a fee-for-service world. That creates some real challenges. Many health system operators were challenged in COVID by not having a consistent revenue flow, either through capitated payments or other at-risk payments.

It was interesting that in a industry that doesn’t have enough labor as it relates to physicians or nurses or other support staff, some organizations had to contemplate reducing headcount. I guess it was necessary to make the money work, but it was definitely challenging to witness that.

The opportunity as we hopefully come out of COVID is to accelerate health plans and providers having conversations around creating predictable revenue streams that are more based on value-based care type programs. The art is to make sure that there’s no attrition in revenue. In many ways, it’s the same type of conversation from 10 years ago when I was at Aetna. But now that we’ve had COVID, that took it from a theoretical concept to something that we need to solve as an industry.

What does the typical care network look like for a senior who has one or more chronic conditions and how do the members that participate in that care network coordinate or communicate with each other?

It’s very, very complicated. A typical senior or somebody whose health is complex could be on seven plus medications. They may need support with activities of daily living. That’s a non-medical home care service, which is different than a certified Medicare home health type service that may provide skilled nursing and physical therapy, really an extension of a service that you would get in a facility, but now being delivered in a home. So complex med management, personal care support with activities of daily living, perhaps some skilled needs that are required. That’s not even including primary care and specialty interactions as well.

A lot of what we are looking to do is to coordinate all of those logistics so that you can match or exceed the experience that you would receive in a facility. The market definitely wants it, but it’s easier said than done.

How does that care team structure or those care decisions differ for someone who is covered by a Medicare Advantage or a Medicaid Managed Care plan instead of traditional Medicare or Medicaid?

When I work with many folks on the home care side of things, they’re so passionate and they are wonderful organizations. But one of their biggest challenges and obstacles that they face is, how do we ultimately get that care financed that they know that the market needs and that creates value? I love what Medicare Advantage plans and Managed Medicaid plans are doing right now.

I’ll start with Medicare Advantage, because it’s a little bit more progressive and new relative to Managed Medicaid, which has been doing some of these things for some time. Medicare Advantage has introduced the concept of supplemental benefits — the extras, if you will, above and beyond Medicare fee-for-service — that will allow the Medicare Advantage plan to innovate and introduce new offerings like non-medical home care, nutrition support, transport, or other types of things that are not covered by a traditional Medicare plan. In the effort of delighting the member, addressing in some cases social determinants of health or other healthcare needs that can bend the cost curve, but also help that member meet their healthcare objectives. Really neat programs. We are in the early phase of this, but this is bringing online non-medical services or social determinant-oriented services that are being paid for, that are attracting members, but also change the outcome story.

Medicare, and CMS in particular, were wise to hatch the program years ago and then continue to invest in it and then allow the free markets to innovate. They have a  program called VBID, value-based insurance design, that is a vehicle for registering and testing for new types of benefits. If they work, then they ultimately graduate into the scope of things that MA plans can reimburse for. So it’s a really neat program.

On the Managed Medicaid side, in-home services, for example, are covered under what’s called LTSS, long-term support services. This is the goal of trying to meet the member in their home and community and unlocking alternatives to traditional long-term nursing home care. It’s a neat program that has been around for a while, but there’s some complexity in trying to manage that.

We’ve seen insurers that range from tech-heavy startups to Optum go big into Medicare Advantage, and some of those companies are providing health services directly. How will that change traditional hospital care, home care, and long-term care?

For Medicare Advantage plans, it’s bringing members online in a race or land grab moment that hasn’t existed before. The only option if you were a senior before was to be on Medicare fee-for-service. You could have bought your own private health plan, but now with Medicare Advantage plans, there’s a race to go manage outreach to these members, unlock a superior experience, and turn on new benefits that we know can change the arc of healthcare and the finance of healthcare.

Three years ago, 25% of Medicare-eligible members enrolled in a Medicare Advantage plan. Now we’re north of 40%, so it is growing rapidly. Many solid organizations are innovating. I think it’s wise that they are trying to establish a direct connection with the person to better understand their needs. Some go as far as delivering the care themselves, while others have invested in care coordinators or counselors who take a more proactive role in navigating that member through all of their needs. It is neat to see.

There are a lot of innovative organizations out there. Not just on the MA side of things, but organizations that partner with MA plans, like Oak Street Health, for example, or Iora, showcasing for the market a brand new community or home-based delivery model. I think we will continue to see that scale because it makes sense. Not to mention that people like it, which is sometimes hard to say about things that we do in healthcare, to get people to actually say that they enjoy the experience.

A problem has always been that outside the 9:00 to 5:00 window, people who weren’t hospitalized or in a SNF had to call 911 or go to the ED to have any changes in their health evaluated, including those that turn out to not be urgent. Have those insurers who have skin in the game addressed the unnecessary use of those services?

It’s clearly a problem that people have been studying for a long time. We’ve tried a lot of different things, from raising awareness to your health plan or the ACO to let them know that when somebody is in a emergency department. But in many ways, that’s too late, even though it creates intervention opportunities.

I’ll give you an example of a company like Dispatch Health. We know some of the folks there — we overlapped inside of the Aetna portfolio companies going back, so we are fans of them, the company, and the model. They took a new approach. They started by bringing urgent care to you rather than having you come into an ER, which was costly and had a lot of other ramifications. Not to mention that maybe you didn’t actually need to be an emergency room. They’ve started to chip away at the problem by redeployment of almost like a paramedic model to your home to manage triage for routine things, then escalate and navigate you to another site of care if it’s needed. In some cases, it may not be needed. In some cases, it may translate into something that leads to a telehealth encounter with a specialist that they bring into the mix.

There’s a lot of creative solutions that are coming into place. It’s not one size fits all. It’s not whether it will be telehealth, or in-person visits, or home care. The challenge for us as an industry over the next five to 10 years is to bring the best of all of that together with the right care at the right place at the right time. It sounds cliché, but that’s the challenge that we all have, and that’s what Dina is working on.

How do you see the company changing over the next several years as these market conditions change?

We no longer have to convince people why we exist. In the early days when you start a company, that’s a lot of the discussion. Tell me about the problem that you’re trying to solve, tell me why is it a really big problem, and tell me why it’s a big market opportunity. It was clear to many, including our early investors, when we talked about the aging demographics in the country and globally. COVID has expanded our market opportunity to include all people that are struggling with some sort of healthcare-related need. 

For us, it’s really about execution.To simplify our story, we use terms like “care traffic control” to create a visual of equipping hospitals and health plans with the infrastructure to be able to move from monitoring patients in ICU units and in hospital beds and shift that paradigm to coordinating, navigating, activating, and monitoring patients in their homes and communities. The solution we put into the market is a network of resources that are medical and non-medical in nature. We’ve got lightweight technology that allows us to engage with patients and families and understand what’s happening when a healthcare person is not in front of them. We do a lot with data. We bring all that information back to create opportunities to proactively delight that person and meet their needs on a continuous basis.

The organizations that are attracted to that today are health plans, like MA plans or Managed Medicaid, but also large provider groups that have started to go down their path to value-based care. I think that in five to 10 years, this will be everywhere. I don’t think it’s farfetched to think that every home is going to operate like a virtual primary care clinic, where it’s not just your residence, but an actual site of care that the healthcare ecosystem knows how to interact and work with.

It’s exciting. It’s what I wanted for my family before. I can see the convenience for it in this day and age. Our challenge is to make it happen now.

Morning Headlines 8/2/21

Cerner Reports Second Quarter 2021 Results

Cerner announces Q2 results: revenue up 10%, adjusted EPS $0.80 versus $0.63, exceeding analyst expectations for both.

Exo Raises $220M in Series C Funding

Handheld ultrasound and medical imaging vendor Exo raises $220 million in Series C funding.

Epic to require COVID-19 vaccinations for all US-based staff

Epic will require all of its US-based employees to be fully vaccinated by October 1, with nearly 97% of its Verona-based staff already meeting that requirement.

Monday Morning Update 8/2/21

Top News

Cerner announces Q2 results: revenue up 10%, adjusted EPS $0.80 versus $0.63, exceeding analyst expectations for both. 

From the earnings call:

• The company is increasing its earnings outlook for the year.
• DoD is live at 42 commands and 663 locations with 41,000 activated users. The Coast Guard’s deployment will be completed this year.
• Cerner says the results of the VA’s strategic review focused on governance, training, and readiness rather than Cerner-caused problems, consistent with the findings of an internal assessment that Cerner conducted earlier this year. It also notes that the DoD’s initial go-live resulted in similar required work in the 12 months following.
• The search for a CEO replacement for Brent Shafer continues and “has been very active.”
• The company continues to look for acquisitions that enhance Cerner’s competitive position, exceeds its cost of capital, is accretive over time, and creates shareholder value. Areas being considered cybersecurity, technology to support provider networks operating in both fee-for-service and fee-for value arrangements, and data.
• Cerner will continue selling unneeded office space that represents half of its owned property.
• The company laid off 500 employees in the quarter and eliminated 300 open positions, which will deliver $70 million in annualized savings.
• Asked by an analyst about Amazon’s HealthLake announcement, Travis Dalton said, “There’s a long history of big cap entry and big cap exit from healthcare. There’s an inherent complexity at the intersection of healthcare and IT. I see market interest in areas that we’re focused on is very validating of the growth opportunity that exists.” He added that healthcare data is dirty and requires normalization around Master Data Management.
• Cerner expects to have 80 provider organizations selling data to life sciences via its Learning Health Network by the end of the year.

Reader Comments

From Ephraim: “Re: news items. How many readers click to the announcement or story you link to?” I don’t track those clicks, but I will say that if I’ve done my job well in summarizing the news item, most readers won’t need to click over. I only run items that I consider newsworthy (which excludes probably 95% of industry PR), so I expect that many readers get the gist (the company, the person, or whatever the item relates to) without actually clicking anything. My experience with Twitter is similar – most people skim the tweet but don’t click to learn more.

From Yes Sars: “Re: COVID-19. Time to start up your COVID-19 news section again?” Maybe, if readers want me to. I thought pandemic doom scrolling was behind us given availability of an effective, safe, and free vaccine, but here we are again with overcrowded hospitals.

HIStalk Announcements and Requests

Jenn put together our HIMSS21 guide (PDF version), which includes the participation information of those of my sponsors that submitted it.

I’ve heard from maybe three tiny companies that they have decided to join Medicomp and Olive in cancelling their HIMSS21 exhibitor plans. The exhibitor count has dropped by only three in the past few days, although that might be questionably useful information unless those companies notify HIMSS and they are removed from the exhibitor list quickly. I will play Las Vegas bookmaker and place the odds at 70% that the conference will go on and will increase those odds to 95% if HIMSS doesn’t cancel it Monday. Not much else could go wrong unless Las Vegas cracks down in ways that would be hard to fathom given its historical focus on protecting tourism revenue. I assume HIMSS won’t refund attendee registration fees under any circumstances since they cover both the in-person and virtual version and the latter allows checking the box as delivered, but exhibitor fees that also include rolled-over HIMSS20 credits would be hit hard if the exhibit hall is cancelled. I would cancel my own attendance except I think readers have a strong interest in living it vicariously. 

It’s a fairly even poll respondent split of who is most responsible for the VA’s Cerner rollout issues. My take: nearly all of the misfires were by the VA, which has a long history of struggling to successfully complete projects, but perhaps compounding the issue is Cerner acting as its own prime contractor. The question is whether Cerner told the VA about the training, infrastructure, budgeting, and support issues and nothing was done, or if Cerner drew a box around what it considered as its responsibility and let VA worry about the rest. Epic’s implementation approach would have put problems front and center, but that doesn’t mean that VA would be as obedient to fix them compared to a health system with hundreds of millions of dollars on the line. DoD seems to be doing pretty well with its Cerner rollouts and using Cerner’s services successfully, or at least we aren’t hearing as much about any problems.

New poll to your right or here: Would you as a patient be OK with having contact with a masked health system employee who hasn’t received COVID-19 vaccine?

Webinars

On-Demand Webinars:

“Key Differences: Value Based Care vs. Fee-For-Service.” Part 1 of a three-part series. Sponsor: Net Health. Presenters: Bill Winkenwerder, MD, chairman, CitiusTech; Josh Pickus, CEO, Net Health. Dr. Bill Winkenwerder, former assistant secretary of defense for health affairs for the US Department of Defense, shares his unique perspective on the future of value-based care (VBC) systems in the public sector and how VBC differs from fee-for-service models in the private sector. This Part 1 webinar covers which aspects of the fee-for-service health system payment model look the most different compared to fully value-based systems (clinical, back-office, analytics, etc.)

“Current Innovation and Development in Value-Based Care.” Part 2 of a three-part series. Sponsor: Net Health. Presenters: Bill Winkenwerder, MD, chairman, CitiusTech; Josh Pickus, CEO, Net Health. Dr. Bill Winkenwerder, former assistant secretary of defense for health affairs for the US Department of Defense, shares his unique perspective on the future of value-based care (VBC) systems in the public sector and how VBC differs from fee-for-service models in the private sector. This Part 2 webinar discusses what health systems should know about the transition to value-based care, including macro versus micro shifts.

“Future of Value-Based Care: Predictive Analytics, Technology, Policy.” Part 3 of a three-part series. Sponsor: Net Health. Presenters: Bill Winkenwerder, MD, chairman, CitiusTech; Josh Pickus, CEO, Net Health. Dr. Bill Winkenwerder, former assistant secretary of defense for health affairs for the US Department of Defense, shares his unique perspective on the future of value-based care (VBC) systems in the public sector and how VBC differs from fee-for-service models in the private sector. This Part 3 webinar discusses the role analytics will play in the shift to value-based care and how financial and clinical ROIs for analytics-oriented products must differ when applied to FFS and VBC models.

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

Acquisitions, Funding, Business, and Stock

WellSky will acquire Healthify, which connects providers with community-based social services organizations to address social determinants of health of patients. Terms were not disclosed. Healthify had raised $26 million, including $16 million in a Series B round in November 2019.

Handheld ultrasound and medical imaging vendor Exo raises $220 million in Series C funding.

A newspaper in Ireland says that Amwell paid $250 million for Ireland-based SilverCloud Health and $70 million for Conversa Health in the combined acquisition that was announced only at a total of $320 million. The companies had raised $26 million and $34 million respectively and have $15 million in combined annual revenue, meaning Amwell paid 21 times revenue.

Vocera announces Q2 results: revenue up 19%, adjusted EPS $0.15 versus $0.08, beating Wall Street expectations for both. From the earnings call: the company had six sales of more than $1 million in the quarter and follows its largest sale ever to Providence  in Q1. VCRA shares are up 36% in the past 12 months, valuing the company at $1.4 billion.

Spok announces Q2 results: revenue flat, EPS –$0.04 versus $0.20.

Sales

• Health and Social Care Northern Ireland will implement First Databank’s Multilex to provide e-prescribing decision support within Epic.

People

Guthrie promotes Terri Counts, MHA, RN to SVP/CIO.

Other

MIT Technology Review notes that AI tools that were supposed to help hospitals diagnose or triage COVID-19 patients didn’t accomplish anything, though a few turned out to be harmful. Significant problems included the use of quickly published and low quality data, researchers using data whose provenance wasn’t considered, and showing falsely accurate results by testing systems on the same data they were trained on. One system was trained on chest scans that the researcher didn’t know were limited to children, and instead of the system learning to recognize COVID versus non-COVID patients, it simply learned to recognize that the image was that of a child. Another issue is that researchers can’t make a name for themselves by validating or improving existing models, so they create new models that incorporate all the mistakes that were made by previous researchers.

Epic will require all of its US-based employees to be fully vaccinated by October 1. The company says that nearly 97% of its Verona-based staff already meet that requirement. Epic will require masks for meetings if the room occupancy is 75% or more or if any attendee voices a preference that masks be worn.

Ozarks Healthcare (MO) posts a video of CMIO Priscilla Frase, MD describing how some patients are wearing disguises and pleading anonymity when coming in for COVID-19 vaccine over concerns about the negative reaction of their friends, family, and co-workers.

Sponsor Updates

• The AI in Action Podcast features OptimizeRx VP of Data and Products Adam Almozlino.
• Spok announces that all 20 adult hospitals and all 10 children’s hospitals named to US News & World Report’s 2021-22 Best Hospitals Honor Roll use Spok’s secure healthcare communication solutions.
• Health Catalyst CFO Bryan Hunt will present during the Canaccord Genuity Growth Stock Conference August 11.
• CareSignal is included in a CHCF case study of engagement results at Axis Community Health.

Blog Posts

• Solving the issues Part 3: Purpose-built workflow – Moving beyond the worklist (Nuance)
• Creating Opportunities in Huma Services: Two Insiders’ View (Netsmart)
• Closing Gaps in Care: 3 Simple Methods for Providers (PatientBond)
• How Organizations in the Retail, Healthcare, and Financial Services Industries are Pioneering Customer Experience (Avtex)
• Providers Take Note: Huron Perth Embraces Electronic Documentation Tools and Processes (PatientKeeper)
• Emergency Departments, Substance Use Disorders, and Federal Laws (PatientPing)
• 4 Revenue Cycle Transformations to Watch in 2021-2022 (Pivot Point Consulting)
• Epic User Settings Deep Dive (ReMedi Health Solutions)
• Advice from one of the world’s largest digital pathology implementations (Sectra)
• 2022 PFS Proposed Rule Part 3: APP, Advanced APM and MSSP Proposal (Impact Advisors)
• 10 Lessons Learned after over a Million Telemedicine Consults (SOC Telemed)
• What to know about automated compliance tools (Spirion)
• Becoming great: 5 common characteristics of the best hospitals (Spok)
• Patient video education has a new dynamic duo: The Wellness Network joins Krames in WebMD’s push to deepen patient engagement services (Krames)
• The Cost of an EHR Downtime (Summit Healthcare)
• 5 ways to optimize call abandonment rate (Talkdesk)
• The Next Mile: A Blueprint for Addressing Vaccine Hesitancy (Upfront Healthcare)
• Celebrating Sys Admins for Daily Contributions That Elevate Healthcare (Vocera)
• 5 success strategies every Federally Qualified Health Center needs to know (Waystar)
• 5 Things Bad Rehab Therapy Clinic Managers Say (WebPT)
• Well ChatAssist AI: AI-Enabled Conversations for Healthcare (Well Health)
• 4 ways payers are using clinical data to address COVID-19 challenges (Wolters Kluwer Health)
• Addressing Social Determinants of Health through Functional Design and Human Touch (VitalTech)

Contacts

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

HIStalk’s Guide to HIMSS21

AGS Health

To arrange a meeting, contact Amy Marie Bergau.

Contact: Amy Marie Bergau, director of marketing
amy.bergau@agshealth.com
312.975.4333

AGS Health is an analytics-driven, technology-enabled revenue cycle management company serving healthcare providers across the US. AGS Health partners with hospitals and physician groups to optimize their revenue cycle through intelligent use of data. The company leverages the latest advancements in automation, process excellence, security, and problem-solving through use of technology and analytics – all made possible with college-educated, trained RCM experts. The company was awarded 2021 Best in KLAS for Outsourced Coding and is highly ranked for Extended Business Office capabilities, scoring in the 90th percentile. AGS Health partners with 85+ clients across different care settings, specialties, and billing systems. It’s revenue cycle … reimagined.

AGS Health CEO Patrice Wolfe will speak on “Growing the Ranks of Female Executives in Healthcare,” Session 124, August 11. Other AGS Health executives will also be attending this event. To meet with an AGS exec, contact Amy Marie Bergau.

Arcadia.io

Booth 3416

Contact: Jasmine Gee, VP of marketing
jasmine.gee@arcadia.io
617.501.7736

Arcadia is dedicated to making a difference with healthcare data. We transform data from disparate sources into targeted insights, putting them in the decision-making workflow to improve lives and outcomes. In doing so, we have created the data supply chain for enterprise-wide, evidence-based healthcare management. Through our partnerships with the nation’s leading health systems, payers, and life sciences companies, we are growing a community of innovation to provide better care, maximize future value, and evolve together to meet emerging challenges and opportunities. For more information, visit Arcadia.io. 

This year we will have some exciting giveaways, including our ever-popular survival kit packed with essentials to keep you going at HIMSS21.

CareSignal

Booth 2461

Contact: Ann Conrath, senior business development executive
ann.conrath@caresignal.health
708.359.7136

CareSignal is a Deviceless Remote Patient Monitoring platform that improves payer and provider performance in value-based care. The company leverages real-time, self-reported patient data and artificial intelligence to produce long-term patient engagement while identifying clinically actionable moments for proactive care. Its evidence-based platform has been proven in 13 peer-reviewed studies and over a dozen payer and provider implementations across the US to sustainably scale care teams to help 10 times more patients, resulting in significant improvements in chronic and behavioral health outcomes and reduced ED utilization. With confidence in its outcomes, CareSignal offers partners at-risk pricing and consistently delivers 4.5 times to 10 times ROI within the first year of its partnerships. For more information, visit our website or try a self-guided demo.

Clinical Architecture

Booth 5654

Contact: Amanda O’Rourke, VP of marketing
amanda_orourke@clinicalarchitecture.com
317.580.6400

Clinical Architecture delivers healthcare enterprise data quality solutions focused on managing vast amounts of disparate data to help customers succeed with analytics, population health, and value-based care. Our solutions produce trusted, actionable data to enable smart decisions that mitigate risk, reduce cost, and improve outcomes.

Founded in 2007 by a team of healthcare and software professionals, Clinical Architecture is the leading provider of innovative healthcare IT solutions focused on the quality and usability of clinical information. Our healthcare data quality solutions comprehensively address industry gaps in content acquisition and management, content distribution and deployment, master data management, reference data management, data aggregation, clinical decision support, clinical natural language processing, semantic interoperability, and normalization.

Check out our latest Informonster stuffed animal toys and learn how we can help you tame your Informonster.

Dina

To arrange a meeting, contact Klaudia Rudny.

Contact: Klaudia Rudny, marketing communications specialist
krudny@dinacare.com

Dina powers the future of home-based care. We are an AI-powered, care-at-home platform and network that can activate and coordinate multiple home-based service providers, engage patients directly, and unlock timely home-based insights that increase healthy days at home. The platform creates a virtual experience for the entire healthcare team so they can communicate with each other – and help patients and families stay connected – even though they may not physically be under the same roof. Dina helps professional and family caregivers capture rich data from the home, using AI to recommend evidence-based, non-medical interventions. For more information, visit  DinaCare.com.

Dina CEO Ashish Shah and Jefferson Health Chief Population Health Officer Katherine Behan will lead the conference session “The Rise of Home-Based Care: Engaging More Patients at Scale,” Thursday, August 12, from 10:15-11:15 am at The Venetian, Lando Room 4301. Shah and Behan will share insights on how to:

• Identify how digital technology can extend your reach in the home and improve provider and patient/caregiver engagement. 
• Recognize how hospital-at-home programs can help position your system for value-based payment changes.  
• Evaluate whether your organization should implement a hospital-at-home model, and how to meet hospital conditions for participation.

About the technology partnership: At the height of the pandemic, Jefferson Health partnered with Dina to launch remote patient monitoring technology to extend care to people who were COVID-positive and recovering in their homes. Now, they have expanded the program to remotely monitor people with chronic conditions such as congestive heart failure, diabetes, and hypertension, and have managed more than 5 million “digital dialogues” to help keep people connected to their care teams.

Dina is not an exhibitor, but you can reach Ashish Shah at ashish@dinacare.com or DinaCare.com. To learn more about Jefferson Health, go to JeffersonHealth.org.

Ellkay

Booth 5026

Contact: Auna Emery, director of marketing
auna.emery@ellkay.com
520.481.2862

At our HIMSS booth, 5026, Team Ellkay will host the following activities:

• Happy hour from 4-6 pm on Tuesday, August 10 and Wednesday, August 11.
• Talking connectivity, interoperability, and strategies to reach your data management initiatives. 
• And of course, distributing our delicious LKHoney, produced by our very own honeybees from our headquarters’ rooftop!   

Stop by our booth anytime during exhibit hours or pre-schedule in person and virtual meetings here.

As a nationwide leader in healthcare connectivity, Ellkay has been committed to making interoperability happen for nearly 20 years. Ellkay empowers hospitals and health systems, providers, diagnostic laboratories, healthcare IT vendors, payers, and other healthcare organizations with cutting-edge technologies and solutions. Ellkay is committed to ongoing innovation, and developing cloud-based solutions that address the challenges our partners face. Our solutions facilitate data exchange, streamline workflows, connect the care community, improve outcomes, and power data-driven and cost-effective patient-centric care. With over 58,000 practices connected, Ellkay’s system capability arsenal has grown to over 700 EHR/PMS systems across 1,100 versions. To learn more about Ellkay, please visit Ellkay.com.

The HCI Group

Booth 2632

Contact: Chris Parry, VP of marketing
chris.parry@thehcigroup.com

We are excited to share that Cris Ross of Mayo Clinic will join Ed Marx at the HCI booth to present on patient experience and digital health. In addition, we will be talking about virtual care, reducing IT operating costs, automation, security, and more. We’re inviting healthcare leaders to view HealthNxt, a unified enterprise platform that brings together all things virtual care to enable an enhanced patient and clinician experience.

HCTec

Booth C413

Contact: Karli Mertins, marketing manager
kmertins@hctec.com
262.695.1871

HCTec and Talon will be at HIMSS21 at booth C413, offering attendees free, onsite help-desk cost assessments. We are also available by appointment to share our wide range of service offerings and look forward to discussing the future of managed IT support for healthcare systems and providers.

HCTec recently acquired Talon, an industry leader in managed IT helpdesk services, regularly rated by KLAS as a top performer in help desk services for clinicians, IT resources, and patients. Based in Tennessee, best-in-class IT services firm HCTec delivers innovative healthcare IT staffing, managed services, and EHR expertise to diverse health systems and healthcare provider organizations across the US.

LexisNexis Risk Solutions

To arrange a meeting in the LexisNexis-hosted HIMSS Living Room, contact Tamyra Hyatt.

Contact: Elly Wilson, marketing manager
elly.wilson@lexisnexisrisk.com
320.333.8478

LexisNexis Risk Solutions Healthcare is hosting the HIMSS Living Room in the Titian Ballroom 230A on level 2. Drop by, put your feet up, and recharge. While you’re there, take a minute to learn about how we can help your organization use the power of advanced analytics to increase patient engagement and improve care. Go to our HIMSS21 information page to request a meeting and to download featured literature. Our healthcare solutions leverage identity, medical claims, and provider data to deliver powerful insights: 

• Interoperability Exchange: Normalize and enrich patient data with a single API.   
• Identity Access Management: Authenticate identities across all access points.   
• Absolute Patient Matching: Mitigate over/under linking penalties.   
• Social Determinants of Health: Understand individuals’ risks and help improve wellness.

OBIX by Clinical Computer Systems

Booth C200-20

Contact: Christina Olson, director of sales
christina.olson@obix.com
224.357.2653

The team from OBIX by Clinical Computer Systems will be available to meet with you at Caesars Forum Conference Center in the Academy Ballroom within the Interoperability Showcase. You will find us at our kiosk, booth C200-26, and participating in The Newborn Experience Connected Demonstration.

Join us as we demonstrate how the OBIX Perinatal Data System provides L&D units with distinguished surveillance and archiving capabilities. Its design has the clinicians in mind by delivering a comprehensive solution for central, bedside, and remote electronic fetal monitoring. We will also highlight the OBIX BeCA fetal monitor (*with the Freedom for wireless monitoring), a device that fits at the bedside while offering an accurate and clear visual of the status of the fetus and mother. Using the system’s e-tools, with its FHR tools, and the UA tool, assist clinicians’ critical thinking and management of electronic fetal monitoring as well as the monitoring of uterine activity parameters, crucial to safe labor in support of their day-to-day care provided to patients. See how we work cooperatively with industry-leading EHR companies to secure a seamless integration between systems to deliver a premier, perinatal software solution for obstetrics patient care. Together, we can improve outcomes for mothers and babies. 

*The OBIX BeCA fetal monitor and the Freedom – used for wireless monitoring, will be available in our kiosk for closer inspection.

Optimum Healthcare IT

Booth MS855

Contact: Larry Kaiser, VP of marketing and communications
lkaiser@optimumhit.com
516.978.5487

Optimum Healthcare IT is a Best in KLAS healthcare IT staffing and consulting services firm based in Jacksonville Beach, Florida. Optimum provides world-class professional staffing services to fill any need, as well as consulting services that encompass advisory, EHR implementation, training and activation, managed services, enterprise resource planning, technical services, and ServiceNow – supporting our client’s needs through the continuum of care. Our leadership team has extensive experience in providing expert healthcare staffing and consulting solutions to all types of organizations. At Optimum Healthcare IT, we are committed to helping our clients improve healthcare delivery by providing world-class staffing and consulting services. By bringing the most proficient and experienced consultants in the industry together to work with our clients, we work to customize our services to fit their organization’s goals. Together, we place the best people and implement proven processes and technology to ensure the success of our clients.

PatientKeeper

To arrange a meeting in room MP550, contact Andrew Robertson.

Contact: Andrew Robertson, senior director, technical solutions
arobertson@patientkeeper.com
857.540.9634

PatientKeeper’s EHR optimization software streamlines clinical workflow, improves care team collaboration, and fills functional gaps in existing hospital EHR systems. With PatientKeeper as the “system of engagement” complementing the EHR, providers can easily access and act on all their patient information from smartphones, tablets, and Web-connected PCs. In addition, PatientKeeper’s Charge Aggregator solution helps maximize revenue for provider organizations by streamlining the professional coding and billing workflow in central billing offices that process charges from disparate systems across a health network. PatientKeeper has more than 75,000 active users across North America and the UK.

Protenus

Booth 3011

Contact: Monica Giffhorn, VP of marketing
monica.giffhorn@protenus.com
410.995.8811

Come to booth 3011 and enter to win an Apple Watch. Don’t miss the session “Healthcare Compliance Analytics in Practice” with Nick Culbertson, CEO of Protenus, and Alessia Shahrokh, compliance investigations manager at UC Davis Health. The session will take place on Tuesday, August 10 at 11:00 am at the Caesars Forum 123.

Quil

To arrange a meeting, contact Ashley Stevens.

Contact: Ashley Stevens, VP of provider sales
astevens@quilhealth.com
614.893.2419

Quil’s digital-forward health engagement platform does not replace, but rather enhances, the patient-provider experience, strengthening the established, trusted relationships that patients have built with their doctors, pharmacists, PTs, etc., while removing the natural silos between provider, payor, employer, patient, and caregiver. As the most comprehensive solution on the market, we are creating a fully integrated experience. Stop by the Comcast Business booth to hear more about Quil’s engagement solutions and platform.

Platform Capabilities:

• Available on all panes of glass: Web, smartphones, tablets and on Comcast Xfinity TV service nationwide. 
• Delivers health system branded, personalized, and dynamic digital care plans. 
• Captures patient-reported outcomes and interprets scores for clinical research and intervention.
• Performs remote patient monitoring through patient self-reported information and integration with IoT devices. 
• Delivers alerts and notifications to patients, caregivers, and providers to nudge patients back on track or inform the care team of required intervention. 
• Integrated into the EHR-based clinical workflow and patient portal experience and provides detailed patient analytics through client enterprise application.

ReMedi Health Solutions

To arrange a meeting, contact GP Hyare.

Contact: GP Hyare, managing director
g.hyare@remedihs.com
281.413.8947

ReMedi Health Solutions is a national healthcare IT consulting firm specializing in peer-to-peer, physician-centric EHR implementation and training. We’re a clinically-driven company committed to improving the future of healthcare. Our mission is to provide comprehensive healthcare solutions that support enhanced patient care, efficient clinical workflows, and improved performance for healthcare systems.

Sphere

Booth 4071

Contact: Andy Moorhead, VP of sales
andy.moorhead@spherecommerce.com
949.387.3747 x3821

Sphere, powered by TrustCommerce, is trusted by more than a third of the nation’s 100 largest health systems to facilitate their integrated patient payments. With more than 15 years of supporting healthcare providers, Sphere helps its clients process payments anytime, anywhere – securely, in compliance, and connected with core business software including EHRs like Epic. Sphere’s Health IPass solution collects more patient dollars while improving engagement from pre-arrival to final payment. By simplifying the check-in, intake, and payment processes through a user-friendly mobile platform, patients know what they will owe and can pay with ease. Stop by our booth to see a demo and to enter to win Apple AirPods Pro.

Spok

Booth 5637

Contact: Jessica Baker, senior PR and social media marketing manager
jessica.baker@spok.com
701.213.5939

We hope you’ll visit Spok at HIMSS21 in booth 5637 (near the Epic booth), and at the HIMSS Interoperability Showcase, booth C200-136 at Caesars Forum Conference Center, where we’ll showcase Spok Go, our industry-leading clinical communication and collaboration platform. This unified communication platform enables hospitals and health systems to use one platform to enhance clinical workflows and improve patient care – including clinical, laboratory, and radiology workflows. Spok will also present its innovative new ReadyCall Text waiting room pager. ReadyCall Text enables seamless waiting room and on-site communication for patients or visitors using a small, convenient messaging device. Messages provide simple instructions or information to the user without the need to return to the staff desk. This paging solution allows staff to be more productive, spending less time managing waiting areas and more time attending to the immediate needs of patients and other visitors. The ReadyCall text pager’s antimicrobial casing design eliminates germs on contact, reducing the risk of microorganisms spreading within a building or person-to-person, making Spok an industry leader in providing this type of protection. 

Spok will also offer some exciting giveaways. Receive a Starbucks gift card when you schedule a demo in the booth. In addition, scan your badge for the chance to win one of three daily drawings for a $500 airline voucher. Learn more and book a demo or meeting at resources.spok.com/himss21.

Twistle

Booth C437-38

Contact: Carlene Anteau, VP of marketing
carlene.anteau@twistle.com
303.330.1018

Twistle’s patient engagement software keeps patients on track with their plan of care between visits and encounters, which improves outcomes, lowers costs, and builds brand loyalty. Attendees should visit Twistle’s booth to learn how to build a solid business case for your patient engagement initiatives and gather tips on best practices that drive 90%+ adoption.     Visitors will also be able to talk to Twistle leaders about its recent acquisition by Health Catalyst and our future plans! We envision great product synergies through the automatic initiation of Twistle’s secure patient messaging protocols based on Health Catalyst’s identification of individual health risks, gaps in care, and unmet quality measures, and we want to hear your thoughts on other use cases!

Those who visit the booth can learn about #pinksocks, a phenomenon that ignited a movement at HIMSS15, which will be continued at HIMSS21. A limited supply of #pinksocks will be gifted at the booths to represent a shared belief that we can all do our part to make a positive impact on the world and change it for the better.

All attendees are also encouraged to enter a drawing to win free software and services to help them overcome health disparities. Three winners will be announced on Thursday, August 12 at 3:30 pm, and may choose one of the following pathways:

• Managing chronic obstructive pulmonary disease (COPD) or congestive heart failure (CHF) patient populations to improve quality of life.
• Supporting the pregnancy journey or detecting postpartum hypertension, which is particularly helpful for rural populations, but certainly applicable for an entire patient panel.
• Diagnosing and managing high blood pressure to prevent over-treatment and support lifestyle changes that reduce the risk of heart attack and stroke.

Weekender 7/30/21

Weekly News Recap

• HIMSS21 attendees will be required to wear masks following CDC’s updated guidance and state and local emergency orders.
• Two HIMSS21 exhibitors announce that they have decided not to participate based on COVID conditions in Las Vegas.
• Cerner’s Q2 revenue and earnings beat Wall Street expectations.
• Avera Health sells its 230-employee telemedicine services company to a private investment firm.
• Amwell acquires a digital mental healthcare company and an automated virtual care vendor for a combined $320 million.
• England’s System C acquires medication management vendor WellSky International and renames it CareFlow Medicines Management.
• Clinical data and genomic platform vendor Sema4 goes public via a SPAC merger at a valuation of $3 billion.

Best Reader Comments

There is such a thing as momentum and popular sentiment. This is politics playing out in the healthcare space. Imagine that the very concept of EMRs becomes tainted. It’s a Failure and it’s No Good, Anyone Can See That. Medicine would not change and modernize in ways that it desperately needs to modernize.This is what happened to the metric system in the United States. Yet, and this is very important, the metric system only failed in the US. Why? It was a political failure. You see, the problem wasn’t the metric system. The metric system is successful everywhere that isn’t the US. And I challenge you to come up with a reason that doesn’t sound like total nonsense. For example, America is Exceptional, is a nonsense reason. Yet that’s still the comfortable go-to trope of those anti-metric proponents. Meanwhile EMR technology has a LOT more value to offer than the metric system does. (Brian Too)

Regarding McLeod: What? They are ditching Cerner after only two years being active! Such a waste of time, money, etc. (Bigdog)

Ever since the HITECH Act gave HHS authority to impose ever-increasing EHR requirements, it has seemed that ONC has continually sought additional additions to those requirements, whether they make sense or not. No one disputes that these are not good ideas, but one surely can dispute how much one can expect the industry can absorb, especially when the documentation requirements and other bureaucracy continue to increase. I don’t dispute the value, just the pace of adoption and the expectations on our providers. (Bill Spooner)

Watercooler Talk Tidbits

Readers funded the Donors Choose teacher grant request of Ms. D in Texas, who asked for a set of Big Books for her first-grade class. She reported in December, “This year has been a little different some of my students are home and some are here with me in class. We use all the technology available to help bridge the distance. The first book I read to them was our ‘Polar Bear, Polar Bear, What Do You Hear?’ I was ALONE in the room and reading to the children, it was an odd feeling, but it was so nice to have a book that the students could see the book and my expressions. With regular sized books I would have to project it and then they would not be able to see my face. As a teacher of mainly low-income students, I love being able to give my students the chance to ‘have’ something that they may only see in a store. There is just something about having a large book that literally makes the students feel like they are part of the story. Thank you again for taking the time to enhance the education of a young child.”

Bringing home an Olympic gold medal in fencing is third-year University of Kentucky medical student Lee Kiefer. Her sister and 2011 NCAA fencing champion is an OB-GYN resident, their mother is a psychiatrist, and their father is a former Duke varsity fencing captain who is now a neurosurgeon.

The two Arkansas Children’s hospitals report that 24 pediatric patients are hospitalized with COVID-19, 50% more than any previous pandemic peak. Seven are in ICU and two are on ventilators. Half of the inpatients are aged 12 and over and are thus eligible to be vaccinated, but none of those hospitalized had been.

AdventHealth’s Central Florida Division cancels non-emergency surgeries and hospital-based outpatient procedures as its COVID-19 patient count swells to 1,000, exceeding that of the previous peak in January. Florida reported 18,000 new cases Thursday, the biggest one-day increase since January.

In England, a husband and wife who are both doctors whose licenses have been suspended face charges of selling puberty-blocking drugs to children via their internet-only online transgender clinic. Helen Webberley, MBChB, LLM  is working from Spain in what she calls a “global” enterprise, exploiting a loophole that allows any EU doctor’s prescriptions to be filled in the UK. The website lists 35 employees. The drugs she prescribes are being used to block puberty while the young patient considers their gender options, but the psychological and growth effects of the drugs on children are unknown.

A California cyclist who was hoping to land a spot in the Tokyo Olympics crashes on a Pennsylvania velodrome track, with his several resulting injuries resulting in a $200,000 out-of-network bill from two hospitals. Phil Gaimon was covered by two health insurance policies, but Lehigh Valley Health Network billed $152,000 for services an expert said should have cost $21,000. They billed $26,000 for a night in the ICU and $30,000 for one in the burn unit, which Gaimon said was only because the hospital had no other beds available. He lives in California, one of 33 states that prohibits surprise medical bills for insured patients, but the state’s authority applies only to in-state providers.

In Case You Missed It

• News 7/30/21
• EPtalk by Dr. Jayne 7/29/2
• Readers Write: Green Light: Why Healthcare Providers Need to Migrate to NCPDP’s Updated E-Prescribing Standard
• Readers Write: Inside the Most Challenging Data Problem in Healthcare
• HIStalk Interviews Justin Dearborn, CEO, PatientBond
• An HIT Moment With … Steve Shihadeh
• News 7/28/21
• Curbside Consult with Dr. Jayne 7/26/21
• HIStalk Interviews Vik Krishnan, GM, Intrado Digital Workflows
• Monday Morning Update 7/26/21

Get Involved

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• Sign up for email updates
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• Contact Mr. H

Morning Headlines 7/30/21

Hughes & Company Raises $116 Million For First Private Equity Fund

Private equity firm Hughes & Company closes its first fund at $116 million, which will make investments of $5 million to $20 million in lower middle market healthcare software and technology enabled companies.

Opportunity Trifecta: ISA, SVAP and Draft USCDI Version 3 Feedback Period Now Open

ONC opens the synchronized feedback period for the Interoperability Standards Advisory, the Standards Version Advancement Process, and the draft United States Core Data for Interoperability Version 3.

WellSky® to Acquire Healthify to Enhance Social Services Care Coordination Across the Continuum

WellSky, a healthcare software, analytics, and services company, will acquire social services referral software vendor Healthify.

News 7/30/21

Top News

HIMSS will require HIMSS21 attendees and exhibitors to wear masks on the conference campus. This decision follows publication of new CDC guidelines and state and local emergency orders.

HIMSS says that 18,000 people have registered for the in-person and virtual versions of HIMSS21. HIMSS19 had 43,000 registrants.

Clark County’s test positivity rate is at 15.5%. County hospitalizations are at 1,000 versus early January’s all-time high of around 1,400.

Medicomp cancelled its HIMSS21 participation Thursday afternoon, the first company that has told me directly that deteriorating COVID conditions convinced them to stay home.

Reader Comments

From Oliver Twist: “Re: HIMSS21. It’s time to do the right thing and cancel. As much as I want it to happen, it would be the wrong decision, and the only reason to proceed is financial. If public health is not a HIMSS priority, what is? Just don’t wait until next week and add to the hardship.” I’m waiting until the weekend to see if HIMSS cancels the event (a couple of companies have told me they’re doing the same). If they don’t cancel, I’m probably 60% likely to attend, down from 100% a few days ago, but that number is declining as I weigh the ever-worsening risk versus reward as evidenced by new studies regarding Delta variant breakthrough infections, the possibility of tapering vaccine protection, and the potential of developing long COVID from a mild breakthrough infection. Plus HIMSS22 is just 227 days away and should be the first non-asterisked HIMSS conference since 2019. I have $895 invested in rolled-over HIMSS20 registration fees, a few hundred dollars in a flight that probably isn’t refundable, and $1,000 for the OnPeak-booked hotel that appears to be refundable minus one night. I feel sorry for HIMSS, which weathered the financial hit and no-refund fallout of HIMSS20, only to see the pre-Christmas joy of cheering on the Pfizer trucks that were delivering the miracle of science dashed by the reality that a lot of people are indifferent or hostile to science.

From HIMSS Fail: “Re: HIMSS21. Disappointed that HIMSS isn’t offering the Nursing Informatics Symposium virtually. My registration fees for last year were transferred to this year, but as a healthcare professional, I don’t think it’s responsible given the rise in the Delta variant to travel to Las Vegas and be exposed to crowds of people. HIMSS has had a year to figure out how to host a virtual an in-person conference. So I’ve lost my registration fees and perhaps in the future HIMSS will lose my membership fees.”

From MyAlias: “Re: HIMSS21. Word is that vendors and health systems are pulling out. Are you hearing the same?” No, but companies wouldn’t necessarily tell me. Last year’s pullout was evidenced by diminishing numbers on the frequently updated HIMSS20 exhibitor list, which I haven’t seen with the HIMSS21 list. It could be that the exhibitor list isn’t being updated the same way, and regardless we wouldn’t easily know how many provider organizations have banned travel to Las Vegas. Let me know if your employer has cancelled your planned attendance.

From Calico: “Re: HIMSS21. Is the exhibitor count apples to apples with that of previous years? Half the usual number doesn’t seem like a bad turnout.” That includes a bunch of first-time exhibitors and 125 or so companies that booked a meeting room (either instead of or along with a regular booth). I see 410 occupied booths in Sands Expo of 200 square feet or larger, so that leaves maybe 285 good-sized booths that aren’t in MP. Jump to 400 square feet – still pretty modest – and you’re down to about 65 companies. I haven’t run the lists to see which of the usual suspects won’t be exhibiting.

From Rashaverak: “Re: Epic. Accused of paying health systems exorbitant amounts to use its ~20 often inaccurate predictive diagnosis models. Epic says it doesn’t do marketing, but it appears its practices are no different than any other software vendor.” Stat News says unidentified employees of several health systems told its reporters that Epic’s sepsis prediction model is unreliable, but Epic pays hospitals incentives for using them in its voluntary Epic Honor Roll programs.

HIStalk Announcements and Requests

Listening: the reader-recommended new album from Blue Oyster Cult. It sounds good, in a snarly biker kind of way, for band whose remaining original members are 76 (Eric Bloom) and 73 (Buck Dharma). The video includes some self-parody when BOC’s original drummer Albert Bouchard pops in to provide “more cowbell.” There’s also a Spinal Tap reference.

Webinars

On-Demand Webinars:

“Key Differences: Value Based Care vs. Fee-For-Service.” Part 1 of a three-part series. Sponsor: Net Health. Presenters: Bill Winkenwerder, MD, chairman, CitiusTech; Josh Pickus, CEO, Net Health. Dr. Bill Winkenwerder, former assistant secretary of defense for health affairs for the US Department of Defense, shares his unique perspective on the future of value-based care (VBC) systems in the public sector and how VBC differs from fee-for-service models in the private sector. This Part 1 webinar covers which aspects of the fee-for-service health system payment model look the most different compared to fully value-based systems (clinical, back-office, analytics, etc.)

“Current Innovation and Development in Value-Based Care.” Part 2 of a three-part series. Sponsor: Net Health. Presenters: Bill Winkenwerder, MD, chairman, CitiusTech; Josh Pickus, CEO, Net Health. Dr. Bill Winkenwerder, former assistant secretary of defense for health affairs for the US Department of Defense, shares his unique perspective on the future of value-based care (VBC) systems in the public sector and how VBC differs from fee-for-service models in the private sector. This Part 2 webinar discusses what health systems should know about the transition to value-based care, including macro versus micro shifts.

“Future of Value-Based Care: Predictive Analytics, Technology, Policy.” Part 3 of a three-part series. Sponsor: Net Health. Presenters: Bill Winkenwerder, MD, chairman, CitiusTech; Josh Pickus, CEO, Net Health. Dr. Bill Winkenwerder, former assistant secretary of defense for health affairs for the US Department of Defense, shares his unique perspective on the future of value-based care (VBC) systems in the public sector and how VBC differs from fee-for-service models in the private sector. This Part 3 webinar discusses the role analytics will play in the shift to value-based care and how financial and clinical ROIs for analytics-oriented products must differ when applied to FFS and VBC models.

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

Acquisitions, Funding, Business, and Stock

Cerner will announce Q2 earnings Friday morning at 9:00 ET, which will be a much-followed event given its CEO search and takeover speculation. UPDATE: Cerner reports that revenue was up 10%, adjusted EPS $0.80 versus $0.63, beating analyst expectations for both.   

Telehealth provider Amwell will acquire digital mental health platform vendor SilverCloud Health and text-based automated patient interaction developer Conversa Health for a combined $320 million.

Avera Health (SD) sells its telemedicine services company Avera ECare to a private investment firm that will take on its 230 employees and rename the company Avel Ecare. Services include behavioral health, correctional health, emergency, hospitalist, ICU, pharmacy, school health, specialty clinic, and senior care. Terms of the acquisition were not announced.

Clinical performance management technology vendor MDmetrix announces a $6 million Series A funding round and a name change to AdaptX. Co-founder and CEO Warren Ratliff, JD was co-founder and COO of Caradigm.

Private equity firm Hughes & Company closes its first fund at $116 million, which will make investments of $5-$20 million in lower middle market healthcare software and technology enabled companies. The firm has an active investment in Azara Healthcare and exited its stake in Aldera, Aperture, and IN2L.

Sales

• UMass Memorial Health chooses Halo Health for clinical communication and collaboration.

People

US Army Lieutenant Colonel Alison Murray, MS, MSN, RN is assigned to clinical informatics specialist and CMIO at Dwight D. Eisenhower Army Medical Center. She has also been named a recipient of the Order of Military Medical Merit.

MDClone promotes Erin Giegling to VP of marketing.

Scottsdale Institute promotes Janet Guptill, MPH to president and CEO.

Announcements and Implementations

Health Catalyst announces PowerLabor, an AI-enabled view of health system labor data that is part of its Financial Empowerment Suite.

Cerner will sell its Continuous Campus in Kansas City, KS as a predominantly hybrid work model reduces its real estate needs.

Dubai-based Etisalat Digital launches a cloud-based EHR to meet the UAE government’s requirement for a centralized, connected medical record for every citizen and resident.

The digital arm of India’s Apollo Hospitals Group will launch a Microsoft Teams-based solution that will offer virtual visits with Apollo physicians, prescription ordering, and scheduling lab sampling at home.

Well Health launches ChatAssist AI, a chatbot that it says completes 95% of patient-provider conversations without human intervention. Epic user Sansum Clinic’s six-month pilot focused on the chatbot’s use for telehealth, portal enrollment, insurance verification, and COVID-19 vaccination. 

A new KLAS report on nurse and staff scheduling finds that the strongest products for using predictive analytics to manage staffing up to two months in the future are Symplr ShiftSelect and HealthStream ANSOS Staff Scheduling. Those products were acquired by their current vendors in February 2019 and November 2020, respectively. Cerner Clairvia delivers high customer satisfaction for same-day analytics.

Government and Politics

ONC opens the synchronized feedback period for the Interoperability Standards Advisory, the Standards Version Advancement Process, and the draft United States Core Data for Interoperability Version 3.

Sponsor Updates

• Meditech will host its virtual Expanse Summer Showcase August 10-11.
• First Databank VP of Clinical Content Joan Kapusnik-Uner co-authors the study, “Using Medicare Data to Assess the Proarrhythmic Risk of Non-Cardiac Treatment Drugs that Prolong the QT Interval in Older Adults: An Observational Cohort Study.”
• The Atlanta Healthcare Entrepreneur Meetup will feature Jvion Chief Marketing Officer Lizzy Feliciano August 5.
• Medicomp’s Tell Me Where It Hurts Podcast features Jessica Cox, RN from Holy Name Medical Center.
• Meditech publishes a new case study, “Emanate Health Advances COVID-19 Contact Tracing with Meditech Professional Services.”

Blog Posts

• Operational Resilience: Grow Your Business Despite Increasing Threats (Everbridge)
• EMR vs. EHR: Understanding Electronic Health and Medical Records (Experity)
• Is a Digital Rounding Solution Right for Your Organization? (GetWellNetwork)
• Cerner Recognized as a Leader in Diversity, Equity and Inclusion by Forbes, Kansas City Chamber (Cerner)
• Optimize Your Labor Management with Health Catalyst PowerLabor (Health Catalyst)
• 2022 PFS Proposed Rule Part 2: MIPS Value Pathways (MVPs) Proposals (Impact Advisors)
• Looking Back and Leaping Forward: How Unprecedented Times Shaped the Way of the Future for Health Seekers’ Online Experience (Loyal)
• Why A Patient Engagement Solution May Not Be the Best Choice for Patient Experience (Lumeon)
• Digital vaccination passports put a new twist-er on leaving your house (Lyniate)
• CMS Ups the Ante on Price Transparency Compliance (Medhost)
• 8 Powerful Team Building and Motivational Strategies for Physical Therapists (MWTherapy)

Contacts

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

EPtalk by Dr. Jayne 7/29/21

As I get ready for HIMSS, people always ask me what’s on my must-see list for the year. The Medicomp booth is always at the top because the people are friendly, the product is solid, and they always have the good carpet for giving your feet a break. I enjoyed their two-story booth in the past because it provided an interesting view of the HIMSS spectacle.

Notwithstanding the physical space, Medicomp has a couple of cool things to talk about this year. The first item is the new Holy Name EHR, built using Medicomp solutions and brought live in their emergency department in the middle of a pandemic. Having spent way too much time in the ED trenches, I’m eager to see what they came up with in their custom solution compared to the off-the-shelf products.

The second Medicomp item I want to learn more about is the plan for partnership with CPSI to integrate the Quippe Clinical Data Engine into the CPSI platforms. I’ve been a big fan of Quippe for a long time since it has the power to help the EHR surface important information at the point of care. One of my favorite features is its ability to tag different clinical findings across time, so physicians can easily see where a symptom appeared previously. CPSI is used in many community hospitals and integrating Quippe will add some bells and whistles that will help build on quality initiatives and make documentation more efficient. While academic centers and large integrated delivery networks get a lot of attention, community hospitals enjoy having nice toys, too. Hopefully the integration will go quickly and get some cool tools into the clinicians’ hands.

Social media is everywhere, and I always enjoy having new emojis to enhance my communications. The new @VaccineEmoji is gaining traction and will provide a welcome alternative to the much maligned bloody syringe. The new emoji is modeled on a Rosie the Riveter-esque arm with a bandage strategically located over the deltoid muscle. Designers hope it will help in public health messaging, although the emoji is still awaiting approval by web text organizations. The director-general of the World Health Organization even supported it on World Emoji Day, which I didn’t know until recently was a thing.

I participated in a telehealth roundtable this week and one of the hot topics was medical licensure for telehealth physicians. Those who practice telehealth exclusively often have a dozen or more licenses, which can be burdensome and costly to maintain. Some states participate in the Interstate Medical Licensure Compact, and while it streamlines the licensure process somewhat those licensed in participating states, physicians still have to obtain individual licenses. Telehealth advocates are lobbying for relief, including licensure reciprocity or potentially a federal-level license that would allow people to practice in any state.

I live on a state border. Back in the day, I could care for my technically out-of-state patients over the phone without concern. Now, however, that is considered telemedicine, and my choices were to either get another license or stop caring for those patients over phone and video. The license process was a pain, especially the part where they wanted me to submit my high school transcript – a data point which makes absolutely no sense for determining whether a physician is worthy of licensure. One would think the medical degree, board certification certificate, etc. would be enough. Still, I had a good laugh with my high school’s registrar who promised to find my transcript on microfiche. One approach being championed by the Alliance for Connected Health includes a Medical Excellence Zone, which would be a group of states that recognize each other’s licenses as long as the physician doesn’t create a physical office in the other states.

In addition to being an annoyance for border dwellers like me, it is also a barrier to very specialized or renowned physicians who want to provide second opinion services to patients without the inconvenience of travel or distance. A federal licensure approach would likely benefit these physicians most, although many states will resist. The precedent is there for physicians credentialed by the Department of Veterans’ Affairs for telehealth. I learned from another panelist about the Sports Medicine Licensure Clarity Act of 2018, which apparently allows team physicians to care for their athletes in any state where the athlete or team is playing, as long as they hold a valid license in at least one state. If it’s good enough for professional athletes, shouldn’t it be good enough for the rest of us?

Recent Illinois legislation HB 3308 establishes payment parity for numerous telehealth services through 2027. Audio-only telehealth and asynchronous telehealth services were expanded as well. The bill also prevents payers from requiring an in-person visit before telehealth services can be delivered and keeps them from requiring patients to provide a reason for requesting telehealth. It also protects patients who request in-person care by preventing payers from requiring virtual visits and protects providers by preventing insurers from mandating delivery of telehealth services.

Breakthrough COVID-19 is real, y’all, and it hit close to home as one of my fully-vaccinated family members added an undesirable diagnosis to his problem list. It’s heartbreaking to see people who did such a good job avoiding infection now being impacted, but the transmissibility of the delta variant is definitely in play in my community, as is the abject lack of masking. My former employer is seeing record-breaking numbers of patients, a sizable percentage of whom are unvaccinated and test positive, although the vaccinated positive patients are becoming more numerous.

Looking for testing options, both Walgreens and CVS were booked for days and he didn’t want to be exposed to other illnesses at urgent care, so I was able to get him scheduled at the local county health clinic. Drive-through appointments were abundant and I was able to go online at midnight to book an 8:30 a.m. appointment. The only negative of the county health process was the lack of practical medical advice provided to the patient – his only follow up was a link to his lab result that simply said “detected.” Not every patient is going to readily understand that it means positive or what to do next. Fortunately, I was able to provide isolation and self-care advice, so we’re hoping for a speedy recovery.

HIMSS21 will be requiring masks as well as vaccines, and I truly hope it doesn’t turn into a super spreader event. I’m waiting for my academic colleagues to get hit with travel bans again, so my planned catch-up opportunities may be dwindling.

What are your HIMSS21 plans? Is it time to throw in the towel? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 7/29/21

Amwell Enhances Virtual Care Platform with Two Acquisitions: SilverCloud Health and Conversa Health

Amwell will acquire digital mental healthcare company SilverCloud Health and automated virtual care company Conversa Health for a combined $320 million.

Avera Health Announces Acquisition of Avera ECare by Aquiline Capital Partners

Aquiline Capital Partners acquires Avera Health’s telehealth services company, which serves 600 sites in 32 states.

Cerner Corp. plans to sell off major Kansas City area campus after move to hybrid work

Cerner will put its nearly empty Continuous Campus up for sale as it streamlines its real estate needs to accommodate remote workers.

AdaptX Receives $6 Million Series A Funding; Announces Name Change from MDmetrix to Reflect Transformative Impact for Clinical Management

Clinical performance improvement company MDmetrix changes its name to AdaptX and secures $6 million in a Series A funding round led by Vulcan Capital.

Readers Write: Green Light: Why Healthcare Providers Need to Migrate to NCPDP’s Updated E-Prescribing Standard

Green Light: Why Healthcare Providers Need to Migrate to NCPDP’s Updated E-Prescribing Standard
By Andrew Mellin, MD

Andrew Mellin, MD, MBA is VP/CMIO of Surescripts of Arlington, VA.

When you see a green traffic light, what action comes to mind? Assumingly, “go.” But as late as the 1920s, a green light meant stop in some American cities and go in others, creating a dangerous driving experience for drivers used to different systems for traffic lights and patterns. As a result, the Federal Highway Administration mandated in 1935 the national standardization of the red, yellow, and green color scheme that we know today.

Although we don’t often think about standards, they are essential for standardizing materials, products, methods, and services, which result in safety, efficacy, efficiency, and quality control. This is especially true across healthcare.

Since 1997, the National Council for Prescription Drug Programs, or NCPDP, has maintained a national standard known as SCRIPT for electronic prescriptions. The NCPDP SCRIPT Standard for e-prescribing facilitates the transfer of prescription data between various healthcare stakeholders and plays an important role in helping reduce administrative burdens for providers and increasing patient safety.

Unlike traffic lights, healthcare technology is constantly evolving and improving. That’s why in 2018, the Centers for Medicare & Medicaid Services (CMS) issued a final rule adopting the NCPDP SCRIPT Standard v2017071 for E-Prescribing and Medication History for Medicare Part D. This standard sets out to modernize e-prescribing and medication history and improve patient safety and clinician workflows.

Most of the industry has migrated to this new standard, and the tremendous work that thousands of stakeholders across the country have done to upgrade their pharmacies and electronic health records should be applauded. But healthcare providers who haven’t completed this process are subsequently missing out on new features and risk potential disruption to their ability to electronically prescribe medications.

SCRIPT v2017071 makes hundreds of improvements to the e-prescribing process. The enhancements from this version fall into three categories: information sharing, patient safety, and administrative burdens.

The 2017071 standard adds new data segments, elements, and codes to prescriptions that more clearly communicate the prescriber’s intent to the pharmacy. In terms of patient safety, prescribers can now share patient allergies and preferred language with the pharmacy. Finally, the standard helps minimize manual processes that require healthcare providers and pharmacies to step outside their workflows to exchange critical patient care information. For example, it enables pharmacies to request prescriptions for medications they have not previously dispensed electronically versus using fax machines or making telephone calls.

CMS required that healthcare providers sunset the previous NCPDP SCRIPT Standard – v10.6 – by December 31, 2019. With the CMS deadline now more than 18 months behind us, the rest of the healthcare industry is officially retiring SCRIPT v10.6. For healthcare providers who don’t complete their migration by September 1, 2021, their users may begin experiencing service disruptions and will not have access to Surescripts E-Prescribing services.

Migration to SCRIPT Standard v2017071 takes time and work, so healthcare providers must not delay. Organizations can navigate their transition by talking to their EHR or e-Prescribing vendor and by leveraging resources like the NCPDP SCRIPT Implementation Recommendations guide.

NCPDP SCRIPT is more than a standard; it represents our innovative efforts to find better ways to share information and support the health and wellbeing of patients in the United States. The migration light is green, so healthcare providers must hit go.

Readers Write: Inside the Most Challenging Data Problem in Healthcare

Inside the Most Challenging Data Problem in Healthcare
By Navdeep Alam

Navdeep Alam, MS is CTO of Abacus Insights of Boston, MA.

Payer data is one of the most exciting assets in healthcare, holding the most promise for dynamic, meaningful change to the way care is delivered and paid for. It’s also the most challenging data problem to exist in the industry. 

We may not always realize it, but payer data is often the center of discussion around dinner tables across the country. Whether we’re talking about which treatments are covered by our health plan, how much our prescriptions cost, or how our specialists and primary care physicians interact — or fail to interact — we’re actually talking about payer data. When we have questions about our care, the first call we make is to our health plan, and we hope they have the wisdom and expertise to point us in the right direction. 

Payers are the hub of healthcare. Our health plan is where we as consumers begin when we’re trying to navigate the healthcare landscape. Where do we go to receive care? What treatments are best for us as individuals? Which pharmacies can fill our prescriptions?

As we interact with the healthcare system over our lifetimes, our experiences are eventually filed as insurance claims. Health plans hold treasure troves of rich, complex data about the patient journey, information that is critical to understanding how we as individuals experience healthcare. 

This is why healthcare can be so complicated: We have barely scratched the surface in realizing the potential of payer data. 

Healthcare data does not come from a single source. It comes from electronic health records, primarily used for documenting clinical data. It comes from pharmacy records, which were designed primarily for inventory management. And it comes from insurance claims, which lack detail about the patient journey but are necessary for tracking our experiences across the healthcare system. All of this data is growing at an exponential rate. Over 1.2 billion clinical documents are produced annually in the United States, and that figure is growing at a rate of 48% per year — and it’s all held by health plans. 

Health plans are ingesting millions of data points every day, and all of it is necessary to ensure that we, as patients, are receiving the right care at the right cost. If this data were clean and structured in the same format, it could paint a beautifully elaborate picture of how we experience healthcare every day. But it is not: 80% of medical data, for example, is unstructured and therefore disconnected from the wider healthcare system. 

Ultimately, all data challenges across the healthcare system become payer data challenges. Our health plans are burdened with the responsibility of mediating these challenges and piecing together all of the fragments of our healthcare experiences. When we switch plans, those challenges are exacerbated: all of our information is siloed within our old plans, and our new plans are barred from seeing a full picture of our medical histories. This disjointedness within the system, coupled with prohibitive privacy regulations, is how we end up with multiple sources of “truth” for every patient. The result is wide variations in the quality and cost of care we ultimately receive. 

The healthcare industry has been attempting to confront these issues for decades, despite spending nearly $2.1 billion annually to try to resolve them. These challenges can be boiled down to three major roadblocks. 

• Data capture. There is a longstanding inability among health plans to capture clean, and complete data in a timely manner. This is largely due to legacy systems and the continuation of highly manual data processes as best practice, all of which lead to a bevy of downstream issues. 
• Data cleanliness. Payers receive and ingest millions of messy, mis-formatted data points from different providers, data suppliers, and vendors every day. The lack of standardization of these data creates inaccuracies and inconsistencies. Fragmented data often remains siloed within health plans, non-interoperable and underused.
• Data sharing. The lack of standardization of data within health plans makes data sharing impossible. CMS’s interoperability mandate is a much-needed first step toward addressing this issue and will certainly be a driver toward more efficient data sharing practices, but it is exactly that, a first step.

Overcoming these challenges is not impossible, but it requires the best tools and immediate action. According to a recent PwC survey, only 53% of payers have mapped out their data to see what will be impacted by the CMS interoperability mandate. Even more concerning: only 24% of healthcare executives said they see the mandate as a strategic opportunity. Here’s how payers can act now to unlock and realize the full potential of their data.

• Clean up data. Now more than ever, patients have greater control over their data — data which, at the moment, is largely fragmented and incomplete. Payers should strive to achieve a single source of truth for each member. Doing so will allow plans to develop personalized member benefits and give providers a complete view of each patient, allowing them to make more informed clinical decisions and empowering patients to stay healthier, longer.
• Advocate for and improve interoperability. The CMS mandate is a necessary first step, but simply following the mandate is a missed opportunity to innovate and create real change in the ways in which we experience healthcare. It is imperative that payers take up the mantle and champion interoperability from this point forward. We cannot wait for the next iteration of interoperability regulations to improve the quality of healthcare data. Payers should be contemplating ways to ingest quality data, generate new insights, and work with one another to meaningfully engage patients as we experience healthcare.
• Democratize the use of payer data. Payers cannot drive innovation themselves. The promise of interoperability will only be realized once payer data is shared widely, allowing others to drive innovation, improve connectivity, and enhance our interactions with the healthcare system. By giving patients control over their healthcare data, we’re opening a new realm of possibilities. It is upon payers to lead the charge as we step into the future of healthcare.

With the CMS interoperability mandate, health plans have the chance to change the narrative: what has historically been an industry data challenge is now a business opportunity. By taking  action to unlock healthcare data today, health plans can drive efficiency within the industry and innovate to build a more seamless, engaging, and dynamic healthcare system.

HIStalk Interviews Justin Dearborn, CEO, PatientBond

Justin Dearborn is CEO of PatientBond of Salt Lake City, UT.

Tell me about yourself and the company.

I started with PatientBond as CEO in January of this year. Prior to PatientBond, I was CEO of Merge Healthcare from June 2008 through October 2015, when Merge Healthcare was acquired by IBM and formed the basis for Watson Health for a while until their next big acquisition. I took a pause after that in healthcare, went and did a few other things in different industries, and then found my way back to healthcare.

I took your 12-question Patient Classifier psychographic segmentation survey. What are health systems learning about using consumer insights in their outreach and messaging?

I saw you took the classifier, so thank you. You and I are both priority jugglers at a high rate. You fall into multiple categories, and then we segment you based on the highest category, and you are very high and I’m very high on the priority juggler spectrum of the model.

What a health plan, payer, physician group, or specialty pharmacy is trying to activate in their client, member, or patient determines how they start using the psychographics and segmentation platform. Ultimately it is to trigger and activate positive behavior, such as keeping an appointment, filling out a survey, or all the way to collections or the financial side. It is triggering that process.

What all of our clients and most health systems are starting to realize is that they need to treat their patients similar to a consumer. One size does not fit all. Some segments of the population react well to physician-based messaging, where your doctor wants you to do X, Y, and Z. That segment of the population will do that without any other prompting or any other pushing needed. But a large portion of the population that doesn’t react the same. 

A lot of healthcare is messaging is towards the one segment. We dynamically personalize it based on what segment we’re speaking to. The customer doesn’t need to understand the concepts, but they are seeing the results in better engagement with the patient, more engagement, and getting across the spectrum of things from marketing outreach to medication adherence to really involved specialty pharmacy workflows.

It really depends on the workflow you are trying to achieve. But the bottom line is better engagement with your patient or member because you are speaking to them in a modality they want to use, in language they want to hear, and in words that they need to see to be activated.

Do providers ask their patients questions specifically to create a more accurate psychographic profile, or do they infer it from existing information?

Our system learns. We think you want to be communicated this way, in this frequency, and using these words. If it’s an ongoing communication path, our system will learn. We thought you would like text messaging and you need to see one message a day to activate this behavior, but it turns out now that one message a week in an email is better. We can learn from that and personalize the communication path based on that.

Health systems have done a great job, and are getting better all the time, at using AI to harvest their claims data. If it’s an existing patient, they have that data. They might have some socioeconomic data or social determinants of health data. If the health system has those components, we say, great, let us append the psychographic segmentation model to that – it will be even smarter, better outreach because you’re going to have historical data, which is informative for sure.

But what psychographics really gets to is the why and the how. It doesn’t focus on the historical. The historical can be informative, and there are certain things you can tell from a ZIP code or a salary that might impact payment ability, but really what the psychographics does is get behind the why and the how. This came out of Procter & Gamble and a number of high-quality, consumer-facing companies have used this for decades to segment consumers on a mass scale, as well as individual, and we can do both as well.

The classifier allows us to segment you with 91% accuracy. If we didn’t have that relationship, or if you were doing a marketing outreach to attract patients that you don’t know, we would take a national compiler’s database and append our model to it. That would be three times more accurate than chance on segmenting you properly, but it’s still not the number we get if you do the 12 questions.

Many people heard of psychographics in relation to Cambridge Analytica or Facebook collating a lot of data without user knowledge or permission to study their behaviors. Did these examples teach us that psychographics does or doesn’t work, especially in healthcare where the results would be used to improve the individual’s outcomes instead of trying to influence them for less-noble purposes?

I’ll start with the last piece of that. We believe in the health systems that we are working with. We believe in the payers. It’s really about activating positive behavior — making sure you take your medication, making sure you do your annual physical, or prompting you the best we can to get your colonoscopy. I think we would all agree that these are healthy behaviors. We’re not showing the data. In that case of Cambridge and Facebook, if the hospital did license the Facebook data — which we did at Tribune Company, for instance — that would still be separate data. That would go more to the social determinants of health datasets, and we could still use that and append psychographics to that.

To the first part of the question, part of our challenge with PatientBond has been awareness. Since I came in with the Series C investment round, we have been doing more on the outreach, more brand-building. We have started engaging with KLAS and Advisory Board and things like that. Frankly, the company didn’t have the budget to do it in the past. Half of our engagements are evangelizing, so a couple of calls will involve explaining the psychographics model, the history and genesis of that, how we get the data, what the clinical efficacy is, etc. 

Usually light bulbs start popping on. The client, the health system or payer, will start coming up with use cases. Could you do this? How do we operationalize it here? It’s a little bit of, I’ll say, free consulting and evangelizing. But once we get into a pilot mode, it pretty much takes care of itself. Then someone from the marketing or strategy group typically owns the project.

Absolutely awareness is still a challenge, but we’re working on that daily. There was a great paper put out by McKinsey about a month and a half ago that mentioned psychographics a number of times and the way they engage patients more effectively. That was unprompted by us. They found us and did the research and didn’t call us on it. Same with the Advisory Board. They put out a good case study with TriHealth and we were not contacted, but we were named. They both had some great results. So it really is about awareness.

Last year, of course, it was difficult to get mind share with the obvious situation at hand with the pandemic. This year is around awareness of PatientBond and the mission. It’s hard to say in healthcare IT. I was at Merge Healthcare and we had great products, but it’s hard to differentiate yourself. Most of the segments in healthcare are pretty crowded with vendors, but I can say there is no other company doing psychographic segmentation modeling and has our platform. 

There’s a lot of M&A on the AI side that do claims data analysis. Systems will recommend what they think would be the outcome based on historical, which is good stuff as well, but really nobody uses psychographics. A lot of the situations we are in are not competitive, but involve evangelizing and explaining in the first couple of calls.

Are health systems reluctant to apply marketing techniques to patient relationships that are more intimate than just consumer awareness campaigns? Or have their marketing folks not been involved and that will change with the new emphasis on consumerism as overseen by C-level executives?

I truly believe it’s the latter. It’s just coming of age. I’ve spent 10 years in healthcare and I can remember growing up that you didn’t see marketing from health systems, your doctor, or your hospital. I grew up around Northwestern Hospital and they didn’t advertise, but they do now. They have marketing budgets. They have data scientists.

That has evolved for the better. How to engage. How do people want to be communicated with, like text messaging versus email or IVR? Or, do you need to talk to a human being? We are informing them on how to best communicate.

That has been going on in CPG, consumer packaged goods, for 30 years. CPG used it effectively. Proctor & Gamble are masters at consumer marketing, but they don’t necessarily have the one-to-one relationships that can be built at health systems. You’re not as intimate when you’re buying Tide detergent, so when they are applying psychographics to something like Tide, it is more of a carpet bombing. They’ll profile an area and say, this area is over-indexed for priority jugglers, and here’s the messaging, here’s the labeling, and here’s what we need to do to resonate here.

But with health systems, it is truly one to one. Once they are a member or patient client, it’s one to one, and we truly personalize it for each one. That’s a huge, huge upside and more productive.

I truly believe it is awareness. In none of the calls that I’ve been on in the past six months — and there have been a lot —  did the chief marketing or chief strategy officers not get it, not believe in it, or decide that “we’re good with what we’re doing.” It’s more of, this is really intriguing,. How would we operationalize this? How does this work with our CRM? How does it work with our EMR? There’s has been a lot of great commentary, feedback, and follow-on loops.

I would say it’s coming fast. We probably would have seen a bigger uptake last year but for the pandemic, but as hospitals get back to normal a little bit, it is all about treating the patient as if they have choices, which they do. Probably this year or maybe next year, people will be paying 50% out of pocket for their total healthcare costs. We’ve been talking about it for 10-15 years, but the patients will be in charge. They are starting to make decisions somewhat based on price, how they like doing business, and how they like the relationship. That has been evolving for a while, but it’s going to cross the 50% threshold here very soon, and patients will act like consumers. It’s coming and it’s going to come fast.

We’re seeing that increasing COVID-19 vaccine uptake isn’t a simple as informing people who are uninformed, so now we are trying to understand their beliefs and nudge them accordingly. Has that raised awareness that targeting patients who meet some criteria and hitting them with cookie-cutter messages probably won’t work?

That’s a great analogy. We surveyed 4,000 people with 400 questions around motivation for vaccination. We came out of that with a ton of data. It is coming to light right now that you can’t treat everybody the same. It’s not all about just being an anti-vaxxer. There are other motivations and other things you can point out, and it’s information. Some people need more information. Some need to have their clergy talk to them about it. It’s all starting to come out as we hit the wall. We predicted four months ago that we would hit the wall in June at about 65%. We were spot on. We had this great data built into the platform as how to basically get people who are close over the hump and off the fence.

We have been trying to get that data out there. The challenge is who ultimately is motivated and incentivized to get people who aren’t vaccinated to get vaccinated. Now it has become more of a public service. For health systems, it’s for the common good, but do they even have a relationship with people who aren’t vaccinated their community? Not always. Early on, employers were being hands off because it was a hot potato. It was hard for us, and it still is hard for us, to find a group that has the incentives to get behind this.

We are willing to share the data and share our insights on how we feel that you can move the needle on that. But that has been a challenge because there has been no ownership. The federal government is supportive of it, but other than making it free, there’s really not much else. To your comment, we are absolutely, definitely informed that you can’t treat everyone the same. You can’t have one billboard. That’s not going to resonate with all the groups.

What will the company’s strategy be over the next few years?

It’s about marketing awareness. We’ve tripled the go-to-market team, the sales team, in the first six months of the year. We’ll grow 100% this year, and I think we’ll continue that path. The really attractive piece for me coming in was that we have a somewhat “friends and family” board of directors. There’s really only one entity of professional money, which is First Trust, who has a legacy investment and is a great partner. The rest are family office and individual. It allows me to manage the company for growth and to see this thing through.

We have a huge runway ahead of us. I don’t have any investor pressure. There’s no timeline. We have enough of a platform, and it keeps growing weekly, that we can remain private and self-funded for eternity. Eventually we’ll come to a decision point in a couple of years about an IPO or something else, which is the natural evolution of an early-stage growth company, but the good piece for me was not having external pressure from traditional venture capital investors.

An HIT Moment With … Steve Shihadeh

An HIT Moment With … is a quick interview with someone we find interesting. Steve Shihadeh is founder of Get-to-Market Health of Malvern, PA.

What advice are you giving clients about participating in HIMSS21 and HIMSS22?

I am very hopeful that HIMSS22 will return to a more normal trade show to meet the pent-up demand on both the vendor and provider side. 

With all of the COVID churn, mask debates, and travel challenges, we are advising clients who want to go to HIMSS21 to be surgical about their investment. By this, I mean that they should have a narrow list of who they want to visit and what they want to accomplish and generally be in and out in a day or so to keep expenses to a minimum. 

I get the sense that vendors are being cautious about investing, and a quick look at signups bear that out. If vendor attendance is light, I would have to guess that provider participation will be down significantly as well.

How are companies changing their marketing strategy?

With in-person trade shows effectively non-existent since March 2020 — by the way, every client we have talked to has felt that the virtual shows were a bust — companies have adapted marketing significantly to keep their businesses vital.

A few clients have upped their webinar game with real thought leadership and way more nuanced selling than in the past.

I continue to be impressed by how much mileage our clients are getting out of social. They are making use of multiple channels and keeping it edgy and interesting. The really sophisticated companies are getting participation across their employee base, which is greatly amplifying their messaging.

We have participated with our clients in a number of focus groups, and while you don’t get the reach of large-scale events, you certainly get to go way deeper. It seems like picking the right attendees and having a solid structure to the events reaps the most reward.,

How has the sales process changed post-pandemic?

Value prop, value prop, value prop. With in-person meetings dramatically reduced in both number and time allowed on site, companies need to more than ever translate their bells and whistles into things that matter to the client. How exactly does it save money? How exactly does it positively impact clinical workflow and outcomes? How exactly does my taking a meeting with you help my organization dig out of this COVID hole?

What are the most important things you look at when asked to perform due diligence for a potential health IT investment or acquisition?

Value prop, value prop, value prop. Just kidding, but not really. Investors get this more than anyone and want to deeply understand a company’s storyline and associated ROI. Investors at different stages – seed, venture, growth equity, private equity, strategic — will have different expectations, but they all need to understand how you truly differentiate and how you truly help a provider with a key challenge.

What clues will the HIMSS21 exhibit hall provide about the direction of the health IT market and the companies in it?

The health tech market is coming back red hot, in my opinion. The pandemic has broken the status quo and providers are finding new ways to use technology and new problems it can solve. Hopefully HIMSS21, albeit with a lighter attendance than in the past, gives us a glimpse at how companies have responded to the many opportunities presented by the COVID crisis.

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