News 8/12/22

Top News

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

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

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

Reader Comments

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

HIStalk Announcements and Requests

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

Webinars

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

Acquisitions, Funding, Business, and Stock

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

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

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

People

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

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

Digital Diagnostics hires Chris Meenan (Philips) as CTO.

Announcements and Implementations

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

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

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

Government and Politics

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

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

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

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

Sponsor Updates

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

Blog Posts

• Optimum CareerPath Spotlight – Meet Trevor MacGinitie (Optimum Healthcare IT)
• Hazelden Betty Ford Taps Oracle Cerner and Xealth to Simplify Access to Addiction Treatment and Recovery Content (Cerner)
• A Different Point of View: EHRs Must Evolve into Platforms for Communities of Care (Medicomp Systems)
• The Healthcare Technology World is Becoming Flat (Get-to-Market Health)
• Pharmacists Will Rise to the Occasion with Paxlovid Prescribing (First Databank)
• Why Social Determinants are a Growing Priority (Get Well)
• Laying a foundation for the future: How will healthcare suppliers respond to an increasingly complex healthcare supply chain? (GHX)
• Why Digital Health Tools & Training are Key to Improving Community Health (The HCI Group)
• PROs & PROMs 101: An introduction to patient-reported outcome measures (Intelligent Medical Objects)
• Building Connections Through the Lyniate Partner Program (Lyniate)
• How Clinician-Driven EHR Design Improves the Anesthesia Experience (Medhost)
• The Healthcare Technology World Is Fast Becoming Flat (Get-to-Market Health)
• How personalizing Expanse unlocked new opportunities for patient care at Ozarks Healthcare (Meditech)
• How Post-Acute Leaders Are Solving Prior Authorization & Benefits Verification Challenges (Myndshft)
• A Wound Care Provider’s Alaska Adventure Begins (Net Health)
• The Dire Need for Integrated Behavioral Health in Chronic Care Management (NeuroFlow)
• When every second counts, connections matter (Nuance)
• Leveraging AI to Overcome Revenue Cycle Staffing Shortages (Nym)
• Overcoming frozen thinking in healthcare (Nordic)

Contacts

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

EPtalk by Dr. Jayne 8/11/22

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Email Dr. Jayne.

Morning Headlines 8/11/22

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

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

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

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

VHA Launches New Playbook Outlining Digital Health Care Needs For Patients

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

Morning Headlines 8/10/22

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

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

CPSI Announces Second Quarter 2022 Results

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

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

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

News 8/10/22

Top News

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

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

Reader Comments

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

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

HIStalk Announcements and Requests

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

Webinars

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

Acquisitions, Funding, Business, and Stock

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

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

People

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

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

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

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

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

Randy Fusco (TEKsystems) joins Clearsense as CTO.

Sales

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

Announcements and Implementations

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

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

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

Government and Politics

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

Sponsor Updates

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

Blog Posts

• 3 ways technology can optimize your billing services (Ability Network)
• Streamline the Prior-Authorization Process in 2022 (AdvancedMD)
• Reducing implicit bias in predictive healthcare analytics (Arcadia)
• Technology Can Help Marginalized Communities Gain Access to Behavioral Healthcare (Bamboo Health)
• The Chronic Care Model (ChartSpan)

Contacts

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

Morning Headlines 8/9/22

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

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

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

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

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

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

Curbside Consult with Dr. Jayne 8/8/22

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

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

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

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

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

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

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

Email Dr. Jayne.

Morning Headlines 8/8/22

CVS Plans to Bid for Signify Health

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

Definitive Healthcare Reports Financial Results for Second Quarter Fiscal Year 2022

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

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

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

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

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

Monday Morning Update 8/8/22

Top News

From the Allscripts earnings call:

• CEO Richard Poulton says the company’s potential acquisitions will be chosen to avoid past accusations of the company being “Frankenstein, because things didn’t really work together very well.”
• Acquisitions will focus more on payer and life sciences than providers, but Allscripts is interested in revenue cycle and getting providers paid faster.
• Asked by an analyst about a publicly traded competitor that is predicting a higher growth rate in the provider space, Poulton responded that “talk is cheap” and it’s laughable when someone predicts that their margins will double.
• Asked about existing clients whose contracts cover products that were sold to Constellation as well as some that stayed with Allscripts, Poulton says overlap exists FollowMyHealth and with practice management systems used by large physician practices. He says that the contracts stayed with whichever business owns the products, and where a contract covers multiple solutions that were split between the companies, they will be served by both companies until the contract expires. He added that FollowMyHealth “is not a big piece of the provider business at all.”

Reader Comments

From Jimbo: “Re: API fees. People used to talk a lot about how vendors who send or receive data on behalf of clients would charge for that service. I’m wondering from your readers which ones do?” That was a big deal early on, as some vendors were using a “how much can we make from it” approach to interoperability. Anyone care to weigh in on API-related charges?

HIStalk Announcements and Requests

Inconclusiveness is evident among poll respondents who weighed in on how Oracle’s acquisition of Cerner will impact the VA’s implementation.

New poll to your right or here, repeating a poll question I asked three years ago:  For those over 50, what is the #1 thing you wish you had done differently?

I’m interested in the dynamic of being laid off via a Zoom call from your home office. I think I would rather accept the corporate coup de grace remotely and in private versus being marched out of the office under the shocked but relieved gaze of co-workers. Those affected are surely stunned by the impersonal, scripted process regardless of its service location, but in my experience from being on both sides of layoffs, it’s best to get it done quickly and consistently and then send the person home so they can react in their own way elsewhere. I recall asking hospital security to be unobtrusively nearby when we were telling a bunch of our IT folks that their services were no longer needed, which seemed kind of slimy when it involves people you’ve known for years, but you never know how people will react. Then comes the classic Kubler-Ross stages of grief: (a) it surely was a mistake that will be fixed or customers and co-workers will rise in protest to override my dismissal; (b) management is clueless in failing to value my contribution to this train wreck of a company; (c) maybe I should have seen it coming, changed teams, or changed behavior less-valuable people got to keep their jobs; (d) realizing that the “please come back” call isn’t coming and the team and/or company is running fine; and finally (e) accepting what happened as unchangeable and figuring out how to move on. It’s dangerous deriving so much of your identity from a job that someone else can end with an Excel formula.

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

Webinars

August 10 (Wednesday) 12:30 ET. “Navigating healthcare’s data quality challenge: An actionable discussion.” Sponsor: Intelligent Medical Objects. Presenters: Alastair Allen, CTO, Better; Dale Sanders, chief strategy officer, IMO. Achieving a consolidated patient record is challenging in an environment of hospital M&A, where EHR rip-and-replace projects are expensive and HIEs and FHIR connectivity haven’t significantly accelerated progress. The underlying problem is that systems don’t speak the same language due to a lack of comprehensive, persistent clinical terminology and data standards adoption. UK-based Better offers a unique, FHIR-based approach to integrating disparate EHR data. The presenters will explore how to improve clinical data quality and how interoperable information can be used to support patient safety, reimbursement, and population health management.

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

Acquisitions, Funding, Business, and Stock

The Wall Street Journal reports that value-based home care provider Signify Health, which has been exploring strategic alternatives, will likely receive an acquisition bid from CVS Health. The company’s NYSE share price values it at $4.7 billion.

Healthcare commercial intelligence vendor Definitive Healthcare reports Q2 results: revenue up 37%, EPS –$0.05, beating expectations for both. The company says it will continue to make acquisitions, expecting to close one or two per year. DH shares dropped 16% Friday following the announcement. They jumped 40% on their first day of trading in September 2021, but have since lost 43% of their value versus the Nasdaq’s 16% loss, valuing the company at $2.4 billion.

People

Spok promotes Mike Wallace to president / COO and Calvin Rice, CPA to CFO.

Government and Politics

The federal government posts an earlier-than-expected RFP for implementation of an EHR for the Indian Health Service.

The VA’s Cerner system goes down for several hours due to database corruption. The outage reportedly also affected DoD and Coast Guard sites.

Privacy and Security

The UK’s NHS 111 non-emergency call line is affected by a cyberattack on its systems, causing delays in dispatching ambulances, booking appointments, obtaining referrals, and having emergency prescriptions filled. The affected patient management, electronic patient record, and care management are operated by vendor Advanced.

Other

Customers of NC-based eye care practice EHR/PM vendor Eye Care Leaders accuse the company of concealing its ransomware attacks in 2021 that included a week-long outage, claiming that the vendor ignored IT requests, threatened them legally, was unable to restore current practice data because it backed its systems up only weekly, and may have failed to file the required breach notice with OCR. They also claim that the company didn’t reduce their next month’s subscription fee despite failing to meet their uptime service level agreement. Several practices have signed on to a proposed class action lawsuit to break their contracts, get their data, and seek payment for damages. CEO Roni Amiel’s experience includes stints as CIO / CISO of NYC Department of Health and Mental Hygiene and Blythedale Children’s Hospital.

Sponsor Updates

• West Monroe staff volunteer with Boys Hope Girls Hope of Colorado to offer students career pathways insight, interview tips, and college internships.
• EClinicalWorks releases a new podcast, “Improving Patient Safety by Avoiding Medical Abbreviations.”
• Pivot Point Consulting promotes Kelly Robinson to senior operations specialist.
• Relatient releases a new Dash Talk Podcast, “Activating Patients Through Targeted Messaging and Segmentation: A One Pediatrics Case Study.”
• Surescripts releases a new podcast, “There’s a Better Way: Smart Talk on Healthcare and Technology, “The Nightmare & Silver Lining: Walgreens’ Tasha Polster on the Impact of COVID-19.”
• Talkdesk CEO Tiago Paiva is recognized as the UC Leader of the Year during the UC Awards presented by UC Today.
• Zynx Health partners with clinical data and intelligence company LogicStream Health to deliver advanced performance improvement capabilities to health systems.

Blog Posts

• Hospital Marketing: How to Use Market Segmentation to Improve Patient Activation and Retention (PatientBond)
• Nurses of Note Awards 2022: The Senior Manager of Clinical Professional Development (PerfectServe)
• Medication decision support systems help build a resilient digital healthcare foundation (Wolters Kluwer Health)
• 7 ways contact center AI provides better customer experiences (Talkdesk)
• How to Leverage Communication and Data to Improve Patient Handoffs (TigerConnect)
• Allina’s Journey: Improving Outcomes for Total Joint Replacement (Upfront Healthcare)
• A Framework for Achieving Your Smart, Connected Hospital Vision (Vocera)
• The ROI of RTM: Maximizing Profitability with Remote Therapeutic Monitoring (WebPT)
• Improving Readmission Rates: Strategies for Skilled Nursing Teams (Zynx Health)

Contacts

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

Morning Headlines 8/5/22

WVU Medicine’s partnership with DHS is ending

Davis Health System (WV) and WVU Health will end their partnership due to Davis Health’s decision to implement Cerner, rather than adopt WVU Health’s cost-prohibitive Epic system.

Allscripts Announces Second Quarter of 2022 Results

Allscripts announces Q2 results: revenue up 7%, adjusted EPS $0.18 versus $0.18, beat revenue expectations, but falling short on earnings.

Atropos Health Announces $14M Series A, Taps Co-founder as CEO

Atropos Health, which offers a digital consultation service for providers, raises $14 million in a Series A funding round.

Veritas completes merger of RCM firms Coronis and MiraMed

Veritas Capital merges recently acquired RCM vendors Coronis and MiraMed Global Services to offer providers end-to-end RCM software and services.

News 8/5/22

Top News

Davis Health System (WV) and WVU Health will end their partnership due to a planned change in EHR vendors.

DHS announced in February 2022 that it will implement Cerner under the CommunityWorks model, saying that while Epic and Cerner have similar functionality, Epic is unaffordable even when provided through WVU.

DHS says WVU notified it immediately after it announced its EHR decision that it was ending the clinical affiliation due to lack of an integrated system.

A DHS VP says, “It was a substantial difference of millions of dollars … we made the decision to go with Cerner, which will still speak to doctors at WVU or anywhere else in the state, it may just take an extra click … We went back to them and told them we would consider canceling our contract with Cerner if they could give us a new price that was more acceptable to our administration and the board. They said no.”

Reader Comments

From Allaboutlabs: “Re: Epic. Are they searching for a lab ordering partner? There has been some recent activity on genetic testing and EMR integration (Epic and Myriad, Meditech).”

From Bonhomme Richard: “Re: Senior Helpers. I ran across this wild podcast from the spring.” The CEO of home care franchise operator Senior Helpers, which was acquired last year by Advocate Aurora Enterprises, says that home care and personal care companies aren’t data driven because they aren’t paid by Medicare and therefore don’t have outcomes or claims information, placing them at a disadvantage now that Medicare Advantage insurers are starting to pay for such services. The company has developed an “autonomy score” that predicts readmissions and ED visits and is developing ways to prove the cost savings that they provide in preventing falls, encouraging medication adherence, and preventing hospital encounters.

HIStalk Announcements and Requests

Carequality Executive Director Alan Swenson clarified some points from my Monday news of updates to its Carequality Connected Agreement that will allow federal agencies to participate: (a) the updated language was in its general CCA, not anything specific to EHealth Exchange; (b) Carequality has “implementers” rather than “members”; and (c) Carequality is an independent non-profit organization that operates under a management services agreement with The Sequoia Project, which created the initiative but is no longer its parent.

My LinkedIn is awash in “I’ve been laid off and need a job” posts, but what’s interesting is how many of those users publicly thank their former employer for the opportunity they provided (until they didn’t). I understand the need to avoid communicating bitterness or despair while trying to land a new job, but that could be done equally graciously by not referencing the former employer at all, especially since it’s plain to see on the job history. I would find it hard to thank my corporate executioner unless they dispatched me with atypical grace or empathy, but I’ll side with the job-seekers who would gain little from publicly torching a company they didn’t leave until forced.

Webinars

August 10 (Wednesday) 12:30 ET. “Navigating healthcare’s data quality challenge: An actionable discussion.” Sponsor: Intelligent Medical Objects. Presenters: Alastair Allen, CTO, Better; Dale Sanders, chief strategy officer, IMO. Achieving a consolidated patient record is challenging in an environment of hospital M&A, where EHR rip-and-replace projects are expensive and HIEs and FHIR connectivity haven’t significantly accelerated progress. The underlying problem is that systems don’t speak the same language due to a lack of comprehensive, persistent clinical terminology and data standards adoption. UK-based Better offers a unique, FHIR-based approach to integrating disparate EHR data. The presenters will explore how to improve clinical data quality and how interoperable information can be used to support patient safety, reimbursement, and population health management.

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

Acquisitions, Funding, Business, and Stock

Allscripts announces Q2 results: revenue up 7%, adjusted EPS $0.18 versus $0.18, nearly all of those numbers attributed to its Veradigm business since it has sold everything else. Revenue beat Wall Street expectations, but earnings fell short.

CVS Health says in its earnings call that it will expand its services in primary, care, provider enablement, and home health, adding that it is already the country’s largest provider of retail health services with its MinuteClinics. CVS adds that “we can’t be in primary care without M&A” that will involve companies with a strong management team, strong technology, and the ability to scale, with a deal expected by the end of the year. It will emphasize value and consumer experience in offering virtual care and using its MinuteClinics and pharmacists as local access points. CVS passed on the chance to acquire primary care chain One Medical, which then accepted a $3.9 billion offer from Amazon. CVS has previously told investors that it hopes to own or manage up to 350 primary care clinics by the end of 2024, with a preference for practices that have experience in value-based care.

London-based Cera – which offers remote patient monitoring, homecare visits, and telehealth — raises a $320 million funding round.

Atropos Health, which offers a digital consultation service for providers, raises $14 million in a Series A funding round and names Brigham Hyde, PhD as CEO. The company says it solves the “evidence gap” via a publication-grade, just-in-time summary of real-world evidence that is extracted from millions of de-identified patient encounters.

Sales

• Stanford Medicine will study COVID-19 health outcomes using Komodo Health’s Sentinel application, AI analytics, and de-identified patient data.
• The Iowa Board of Pharmacy uses Bamboo Health’s PMP Gateway solution to integrated the state’s prescription monitoring program with provider EHRs.

People

The VA names David Massaro, MD, MBA, MS as the functional champion of its Oracle Cerner implementation, on detail from the VHA’s Office of Health Informatics.

Therapy Brands hires Jeff Shoreman (Magnitude Software) as CEO.

Bravado Health promotes Mallory Taylor to CEO.

Edifecs hires Raymond Bonnett, MBA (NextGen Healthcare) as VP of professional services, Mark Filiault (Diagnostic Robotics) as VP of payer sales, Chip Acton (Zipari) as VP of solution consulting, and Brian Hanley, MPAff (Nava) as VP of public sector sales.

Kyle Swarts (Curation Health) joins AiHealth as SVP of growth and marketing.

Megan Schmidt (Monarch Medical Technologies) joins Ellkay as VP of product management.

Announcements and Implementations

The Q3 trends report by Pivot Point Consulting, a Vaco Company finds that venture funding is down 40% so far this year versus last year; no digital health IPOs have occurred; and easing of virtual care red tape such as interstate provider credentialing is scheduled to end in February.

Sponsor Updates

• Bluestream Health announces that its technology powers New York State’s COVID-19 “Test to Treat” program.
• ChartSpan announces a partnership with group purchasing organization Health Resource Services.
• Experity publishes a new e-book, “Learn How Successful Urgent Cares Make Business Decisions.”
• Donations from FDB help fund National Council for Prescription Drug Programs Foundation grants of $295,000, which help to fund research dedicated to enhancing patient safety, expanding patient access to care, and expanding the role and value of the pharmacist.
• Wolters Kluwer Health donates clinical decision support tools including UpToDate, Lexicomp, and Lippincott Procedures to Mercy Ships, a humanitarian organization that operates two floating hospitals for underprivileged populations.
• HCTec supports Aspirus Health as a sponsor of its 2022 Golf Classic.
• Loyal earns SOC 2 Type II certification.
• Healthcare IT Leaders is ranked among the largest staffing firms in the US, according to Staffing Industry Analysts.
• Intrado names Tyler Remund (Sanford Health) senior product manager.

Blog Posts

• Rim to Rim: What is Data’s True Potential for Healthcare? (InterSystems)
• Interoperability in healthcare: The role of TEFCA (Intelligent Medical Objects)
• How Analytics Power Revenue Cycle Optimization (Medhost)
• Da Vinci Standards, Decoded: 3 Eye-Opening Ways Every Provider, Payer & HIT Vendor Will Reap Rewards (Myndshft)
• Predictive Analytics and Value-Based Care: Defining Value (Net Health)
• Creating the Standard of Digital Care: An Enterprise-Grade Approach to Population Behavioral Health (NeuroFlow)
• Why it’s essential to have an integrated strategy for AI in radiology (Nuance)

Resources: Consulting Engagement Request for Information, Sponsor Guide.

Contacts

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

EPtalk by Dr. Jayne 8/4/22

Some days are more challenging than others when it comes to finding healthcare IT topics worthy of blogging about, but this week brought plenty of interesting and/or entertaining content to my door. In the category of “hospitals behaving badly,” we have Nebraska’s Bryan, which recently updated its dress code policy. The purpose of the policy change was to remove restrictions on hair colors, but it was delivered with additional commentary regarding “messy buns,” including pictures of rogue hairstyles. Social media is now alive with the hashtag #showmeyourbuns along with plenty of comments about hospitals worrying about the wrong things while they’re struggling to retain staff members. I share my own messy bun pic in solidarity. And yes, those are cocktail picks holding it together.

Also on my list is HLTH, otherwise known as spammiest conference ever. I thought HIMSS was bad with the volume of email it generates, but since I registered for HLTH, it feels like I have something from them every day. Do I really care who the first 200 sponsors to register are, or how great HLTH thinks its hosted buyer program is? Why is every other email focused on topics related to women? What about other groups that are inequitably served by our healthcare delivery systems, such as minorities, children, or the elderly? To be honest, it feels like pandering, and I’ve started keeping track. I haven’t attended previously, but I’m already tired of the conference hyping itself. You already have my money (and a fair amount of it, at that), so dial it down, already.

CMS is looking for public input on improving Medicare Advantage programs. The organization wants to understand how programs are working for Medicare beneficiaries as well as to understand whether the programs are improving outcomes and decreasing costs. For those not familiar with the programs, Medicare Advantage is also sometimes referred to as “Medicare Part C” and involves contracting with private insurance providers that typically offer not only the traditional Medicare benefits, but also coverage such as vision or dental. Most of them also offer prescription drug coverage (Medicare Part D). In general, they function similar to HMO programs with narrow networks in an effort to better control costs. Comments are encouraged from insurance plans, providers, beneficiaries, patient advocates, states, employers, unions, and others who are stakeholders.

I ran across several articles about telehealth services for mental health, and nearly all of them mentioned the shortage of behavioral health therapists, counselors, social workers, and case managers. One article had a profound headline: “Want to Keep People Working in Mental Health? Pay Them More $$, Experts Say.” One expert cited in the piece stated it would take a $13 increase in hourly wages to keep people from leaving the field. She notes the challenges of the new 988 national suicide prevention hotline in that states have to figure out how to fund it. She’s been able to hire less than half the staff she needs and comments that her crisis center is competing with retail and entertainment employers for available workers who often gravitate to lower-stress, higher-paid positions.

The article notes the wide disparity in access to psychiatrists as an example of the workforce challenges, with New York state having 612 psychiatrists per 100,000 people where Idaho might have one psychiatrist for the same population. Other factors causing workforce challenges include greater awareness of the need for mental health services as well as increased numbers of referrals for care. One of my colleagues recently referred an adolescent to the emergency department for suicidal thoughts, and after 16 hours, the patient still hadn’t received a psychiatric assessment. Ultimately the family left the emergency department without being seen after their primary care physician crowdsourced a same-day psychiatric referral on Facebook. It shouldn’t be that way, but it is, and most people are unaware how poorly our systems are running.

There’s also the matter of escalating abuse and violence against hospital staff. The death of a South Carolina hospital mental health technician was recently ruled a homicide as the technician had been kicked by a patient while staff was trying to restrain her. The staffer, Kevin Robinson, had worked at the facility for 11 years and was only 40 years old. Incidents like this are truly tragic and when young people hear about them, it’s no surprise they’re not gravitating towards jobs in the field.

Last but not least, I spent some time with my parents this week and received a crash course in “patient experience with the local Veterans Affairs health care clinic.” Due to flooding in the area, my dad called the clinic to make sure that the staff was able to make it in. The reply he received was “oh, we’re here, come on in, baby,” which made both him and my mom laugh. The staff at his local clinic is outstanding and the veterans are treated with the care they deserve. The information systems they work with are challenging at times, though, and apparently between his last visit and this one he somehow underwent a religious conversion in the EHR without requesting an update. He was surprised at how much time the staff spent with him going through a variety of screening instruments and taking a detailed history, a much longer duration than the staff at his non-VA primary care office has ever spent with him. I reassured him that it was a good thing they’re doing things like screening for suicide risk and fall risk.

They made sure he had instructions for accessing the patient portal and encouraged him to sign up. He’s proficient with MyChart and other online services, so was surprised that it ended up taking several hours to get signed up for the VA’s portal. Part of that was due to authentication and identify proofing. It was interesting to hear a non-informaticist’s explanation of the process. When he was finally able to access the system, he immediately pulled up his visit note, which was a whopping 49 pages. He thought the view / download capabilities were cool and it was nice to see how a patient perceives something like View / Download / Transmit that most clinical informaticists take for granted. His VA has not yet implemented Cerner, so I’ll have to keep an eye out for when that transition occurs so I can see how it goes from the patient perspective.

What topics in healthcare or healthcare IT caught your eye this week? How do you feel about messy buns in the workplace? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 8/4/22

Homeward Secures $50 Million in Series B Funding to Improve Access to High-Quality Healthcare in Rural Communities

Rural hybrid care company Homeward raises $50 million in a Series B funding round, bringing its total raised to $70 million.

CareTrack Health Secures $2.5 Million Investment from Hybrid Capital Partners

Patient adherence software vendor CareTrack secures $2.5 million from Hybrid Capital Partners.

Athenahealth Implements DrFirst’s Digital Engagement Solution to Encourage Patients to Follow Prescribed Treatment Plans

Athenahealth integrates DrFirst’s RxInform patient medication notification software with its EHR to improve medication adherence.

Morning Headlines 8/3/22

Lyniate Merges with CareCom, Further Extending Capabilities of Interoperability Leader

Lyniate acquires Denmark-based clinical terminology management vendor CareCom.

Hawley Calls for FTC Review of Amazon’s One Medical Acquisition

Sen. Josh Hawley (R-MO) asks the FTC to review Amazon’s planned acquisition of One Medical, which he says gives Amazon too much power to push non-prescription blood pressure medications at Whole Foods that are based on One Medical patient data.

VA names functional champion for electronic health record modernization program

The VA tasks David Massaro, MD – formerly an executive within the VHA’s Office of Health Informatics – with coordinating the development and implementation of the agency’s EHR modernization program across its offices.

News 8/3/22

Top News

Oracle lays off staff in its marketing and customer experience divisions. Some Oracle Cerner employees also appear to be affected, according to this Reddit thread sent over by a reader, which includes rumors of the departure of several former high-level Cerner executives.

Oracle is pursing $1 billion in annual compensation savings, which probably means the loss of 5,000 to 10,000 jobs of its 140,000.

Webinars

August 10 (Wednesday) 12:30 ET. “Navigating healthcare’s data quality challenge: An actionable discussion.” Sponsor: Intelligent Medical Objects. Presenters: Alastair Allen, CTO, Better; Dale Sanders, chief strategy officer, IMO. Achieving a consolidated patient record is challenging in an environment of hospital M&A, where EHR rip-and-replace projects are expensive and HIEs and FHIR connectivity haven’t significantly accelerated progress. The underlying problem is that systems don’t speak the same language due to a lack of comprehensive, persistent clinical terminology and data standards adoption. UK-based Better offers a unique, FHIR-based approach to integrating disparate EHR data. The presenters will explore how to improve clinical data quality and how interoperable information can be used to support patient safety, reimbursement, and population health management.

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

Acquisitions, Funding, Business, and Stock

Lyniate acquires Denmark-based clinical terminology management vendor CareCom. It’s the health data integration company’s second acquisition of the year, having purchased patient identity management company NextGate in March.

Business Insider describes how weight loss startup Calibrate uses technology not only to scale its business growth, but also to scale its business cutbacks, but without the empathy and support it claims to offer customers. The company laid off 150 employees, some of whom had just started their jobs the same week, via a two-minute webinar for which they were given 30 minutes notice. Calbrate’s subscribers pay $138 per month to get a prescription for GLP-1 weight loss drugs such as semaglutide along with virtual coaching, then they or their insurance pay hundreds of dollars each month for the drug itself.

Dandelion Health launches a platform by which health systems can sell de-identified patient data to life sciences companies to train their AI systems, with its first two members being Sharp HealthCare and Sanford Health.

Sales

• Gaylord Specialty Healthcare (CT) selects Meditech Expanse.
• Valley Health (VA) will implement Epic in its own instance instead of through Inova Health System in a 16-month, $50 million project.

People

Scott Raymond, MHA, RN (NetApp) is named chief information and innovation officer of Nebraska Medicine.

Northwell promotes Sophy Lu to SVP/CIO.

Brady Thomas (Specialized Bicycle Components) returns to Divurgent as chief of staff.

Iodine Software hires Priti Shah, MBA (Finvi) as chief product officer.

Cardinal Health promotes Michelle Greene, MS to CIO.

Steven Hendrick (Huron) rejoins Healthlink Advisors as VP.

Michael Ruffino, MBA (Hillrom) joins About as VP of health system partnerships.

Industry long-timer Simon Hawken, who led US and European sales for Merative (formerly IBM Watson Health), died July 25.

Announcements and Implementations

A study of 2,000 Ascension employees finds that adherence to organizational COVID-19 policies improved by 4.9% in the two-week study period when they were texted a reserved date for vaccination using the Relatient system, although no difference was observed from the control group once the vaccination deadline was reached.

Government and Politics

Carequality expands its interoperability framework to federal agencies via an update to its Carequality Connected Agreement that will allow those organizations to opt in to EHealth Exchange’s Carequality Bridge.

The 42nd Medical Group (AL) at Maxwell Air Force Base and 1st Special Operations Medical Group (FL) at Hurlburt Field will transition to Oracle Cerner-based MHS Genesis next month.

Sen. Josh Hawley (R-MO) asks the Federal Trade Commission to perform a high-priority review of Amazon’s planned acquisition of One Medical, which he says gives Amazon too much power to push non-prescription blood pressure medications at Whole Foods that are based on One Medical patient data (note to the Senator – I agree to some extent with your concerns, even though blood pressure medications are not sold without a prescription at Whole Foods or anywhere else in the US).

Other

The Washington Post obtains a confidential government review of a January 2021 report by the White House’s US Digital Service, which says the country’s organ transplant matching system — operated by the United Network for Organ Sharing, or UNOS — is outdated, unreliable, dependent on manual data entry, and of unknown security status. The report concludes that the non-profit UNOS, which developed the system 36 years ago, is a monopoly that should be broken up in separating its role as a system vendor from that of a transplant policy organization. The federal government pays $6.5 million annually to UNOS under an agreement that requires it to buy the system for $55 million if it switches vendors.

Fox Chase Cancer Center (PA) nurses Maria Market, RN and Allison Ward, RN, MSN create the Oral Chemo Tracker, an EHR-compatible smart form that helps clinicians better monitor oral chemotherapy. The pair developed the digital form last year after a review found that just 33% of oral chemotherapy patients had a documented plan, only 7% were assessed for adherence, and none had record of steps taken to address non-adherence.

Sponsor Updates

• Wolters Kluwer Health makes Monkeypox content free to clinicians worldwide in response to the WHO-declared global health emergency.
• Ascom expands its channel partner network in Canada to better serve acute care customers in the areas surrounding Montreal.
• Bamboo Health names Amber Rogers proposal manager, Meredith Dougherty customer success manager, Whitney Minard implementation specialist, and Ibrahim Alabi associate product manager.
• Oracle Cerner publishes a new client achievement, “Allies in opioid stewardship: Fort HealthCare implements high-risk alerts to combat epidemic.”
• Loyal reaffirms its commitment to health data privacy and security with SOC 2 Type II certification.
• Divurgent publishes a new client success story, “On-Demand Staffing.”
• Ellkay earns Validated Data Stream Designation via the new NCQA Data Aggregator Validation program.
• Well Health promotes Tyler Ledbetter to manager of enterprise sales development.

Blog Posts

• Best Practices for Negotiating Health Insurance Contracts (AdvancedMD)
• Prioritizing CDI on the Ambulatory Side of healthcare facilities (AGS Health)
• Data analytics pave ACOs’ path to success (Arcadia)
• Interoperability: We have technology, data standards, and a compelling use case – so why isn’t everyone on board? (Availity)
• How digitizing at-home care can improve recovery for hysterectomy and c-section patients (Bravado Health)
• Interoperability Without a Directory is Like Blue Cheese Without Celery! (CareMesh)
• Is Outsourcing an Answer to Financial Pressures Post-Pandemic? (CereCore)
• How to Maximize Medicare Shared Savings (ChartLogic)
• Creating the Standard of Digital Care: An Enterprise-Grade Approach to Population Behavioral Health (NeuroFlow)
• Understanding Insider Threats and How to Protect Your Organization (Clearwater)
• Fighting for Medication Access and Adherence: Market Outlook Beyond 2022 (ConnectiveRx)
• Closing the Gap Between Patients and Their Records (EClinicalWorks)
• The Case for Health Data Interoperability (EVisit)

Contacts

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

Morning Headlines 8/2/22

Carequality Interoperability Framework Expands To Allow Federal Participation

Carequality expands its interoperability framework to allow the participation of federal agencies, courtesy of updated agreements with existing member EHealth Exchange.

PE-backed Zelis buys Spectrum’s Payer Compass

Healthcare payment company Zelis Healthcare acquires healthcare pricing solutions business Payer Compass, which gears its services toward employers and payers, for $180 million.

Oracle Cuts Workers in US Customer Experience Unit

Confirming earlier reports, Oracle lays off staff in its marketing and customer experience divisions as it buckles down on revitalizing Cerner’s work with the VA.

Curbside Consult with Dr. Jayne 8/1/22

I’m always excited to read about technology that makes a difference at the point of care or improves the patient experience in a significant way. Two articles with solutions that fit the bill popped into my inbox this weekend.

The first discussed a smartphone app that can help identify skin cancer in older patients. Researchers from Stanford Medicine used an app called SkinIO after seeing that the COVID-19 pandemic had created barriers to patients accessing dermatology services. They noted that for older patients, a 37% decrease in visit volume correlated with a 23% decrease in skin cancer diagnoses.

The SkinIO app helps patients capture photos of concerning skin lesions and routes them to dermatologists. The app doesn’t try to make a diagnosis, but rather highlights lesions that meet certain criteria and lets the physicians know that additional review is advised. The study was small, occurring between November 2020 and July 2021. There were 27 patients enrolled, all of whom resided in senior living communities in the San Francisco area. Researchers visited the sites in person to collect skin images, using a dermatoscope to further evaluate high-risk lesions. The SkinIO app flagged 63% of the lesions as needing further attention, although researchers ruled out cancer in the majority of those submissions. However, three of the lesions were determined to be cancer, leading researchers to conclude that the app can be a helpful resource, although it’s not 100% accurate.

For the average patient who might be able to make a dermatology appointment, the app might not be as useful. But for a patient with mobility impairment or someone in a skilled nursing facility who might require additional services to support an in-person visit, it could be a useful adjunct. It could also be helpful for patients that have numerous moles and would benefit from additional evaluation beyond the traditional full-body skin exam they might receive once a year.

I checked out the SkinIO website to see how they were positioning the solution. I expected it to be marketed to dermatologists, and it is, with additional features such as automated mole-mapping and tracking of changes over time as key points. They’re also positioning it for health systems, perhaps to be integrated into primary care settings to allow greater referral of high-risk lesions to dermatologists within a given integrated delivery network. The angle I didn’t expect was marketing towards employers. At first glance, it might be a good employee wellness offering for industries where the conditions that contribute to skin cancer are present. Examples of workers who might benefit include those in the utility, landscaping, forestry, hospitality, entertainment, parks and recreation, and maritime industries. I’ve added the company to my watch list. It will be interesting to see how they do over the next couple of years.

The second article covered one of the industry’s buzzword topics: precision medicine. There are plenty of people excited about the topic. Being able to figure out the perfect therapy for a patient based on their genetic makeup or other measurable factors is exciting. Who wouldn’t want a treatment that was perfectly tailored for them? It sounds great, but actually making it a reality in our increasingly broken healthcare system is a challenge. For example, I recently implemented a new EHR that has some pretty exciting pharmacogenomic content. Unfortunately, the health system implementing it has not made the decision to store the results of pharmacogenomic testing as discrete data, rendering the content useless. The article talks about such patient-level data as the “fuel” that is needed to power the advanced analytics “engine” that drives precision medicine.

Once the organization makes the decision to incorporate discrete data, other factors need to be addressed, such as ensuring that clinicians know what changes to make based alerts that might appear, and that they trust the system to a level where they’re willing to take action. Clinicians will also need support using the tool, especially if incorporating it makes visits take longer due to the need for additional counseling and education for the patient. A physician who is already trying to cram a 30-minute visit into a 20-minute time slot is more likely to fall into old and familiar patterns rather than trying something new. If they need to research a proposed therapy or read deeper to understand what an alert is trying to tell them, then tailoring a treatment is likely to be a no-go.

The article notes this, and additional mentions that the complexity of our health care system is also a factor. Tailored treatments will also need to take into account patient factors such as symptoms, history, and preferences as well as societal factors such as access to care and impacts from social determinants of health. I’d go further to suggest that insurance coverage, treatment cost, and financial resources are likely to trump all other factors for the majority of patients in the US.

The article uses diabetes care as an example, where additional factors need to be added to precision medicine algorithms that are used for older adults — lived experience, support networks, current living situation, and more. For patients with cognitive impairment, limited social support, or other resource constraints, the situation is even more complex. In my experience, adding culture and personal / family values to the list of considerations is key.

I’ve seen patients flatly reject cost-effective treatments that are standard of care because they are perceived as being at odds with cultural practices or beliefs. I remember one family where the mother wouldn’t consent to a necessary surgery for her child because of a perception that the child would have to live with “mutilation.” Those are the elements that it will be challenging to add to an algorithm, because they’re not readily quantified and often only come to light in a crisis or through a longstanding physician-patient relationship, which is all to frequently the exception rather than the norm.

The authors propose that we need to go beyond the traditional thought of precision medicine as “the right treatment for the right patient at the right time” to incorporate the element of “each patient’s unique context.” I wholeheartedly agree and look forward to additional work as we continue to quantify those contextual factors in ways that allow us to take action at the point of care.

How is your organization approaching precision medicine? Leave a comment or email me.

Email Dr. Jayne.