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Book Review: Designing for Health: The Human-Centered Approach

June 12, 2024 Book Review Comments Off on Book Review: Designing for Health: The Human-Centered Approach

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Designing for Health: The Human-Centered Approach” is a compelling and concise read from industry long-timers Craig Joseph, MD and Jerome Pagani, PhD, a physician informaticist and behavioral neuroscientist, respectively. They argue that intentional, human-centered design is mandatory for making healthcare work better for providers and patients.

My Takeaways

  • This is a fun, information-packed, and relatively short read at 170 pages that will engage even skimmers and TL;DR types (I have read it twice, in fact).
  • “Human-centered design” sounds preachy and academic, but it’s just the idea of developing solutions that meet the needs of the intended users.
  • The concepts aren’t just about software design and implementation decisions.
  • You are a designer if you, or a committee on which you serve, makes decisions about screen layouts, links, forms, edits, prompts, warnings, and even whether to turn entire functions on.

This is not a purely technical exercise. I recall that Steve Jobs attributed his accidental enrollment in a calligraphy class as forming the entire design-obsessed philosophy of Apple – making hardware so easy to use that the barrier between human and machine was nearly eliminated. Microsoft would unashamedly lead PC users to hacking their Windows registry or modifying obscure settings, while Jobs was adamant that even an “on” button was intrusive and superfluous. We don’t need to get to Jobs-like levels of obsession to improve the status quo and we can choose our battles by looking that the user benefit versus the effort required to deliver it.

This book primarily addresses the needs of physicians and other caregivers rather than patients, but the concepts certainly carry over into the patient experience, which is about as far from human-centered as you can get. Clinicians who aren’t burned out, overworked, or feeling yanked like ivory tower marionettes will deliver better, more human-centered care.

Intentional design matters, the authors say. Everything that gets put in front of a clinician, stuffed into their workflow, or even left to randomness is an intentional decision. Users apply mental shortcuts to get through their day, so the design goal is to make it easy for them to do the right thing.

Six Important Concepts

  1. Make it easy to do the right thing.
  2. GROSS: getting rid of stupid stuff.
  3. Start with the end user (and their context) in mind.
  4. Transparency and predictability.
  5. The stupidity of not listening to your (real) experts.
  6. Continuous improvement.

Go-Live is MVP

Go-live configuration is like a company’s Minimum Viable Product (MVP) that provides core functionality that needs to be refined continuously based on user feedback. However, those users shouldn’t be asked to provide solutions. It’s the designer’s job to review observations and user feedback make the best collective decisions that balance competing needs.

Next Comes AI

It occurred to me that while EHR decisions currently dominate clinician satisfaction and burnout, AI is the next frontier. Implementing AI in healthcare will require thoughtful, human-centered design. That would be an interesting topic for the authors to address.

Conclusion

Design decisions aren’t made solely by EHR application analysts or even CMIOs. Every decision that requires clinicians to collect information, monitor an event queue, respond to patient communications, accept or reject clinical decision support recommendations, or to incorporate new research instead of old habits into deciding which button to click involves intentional design decision.

This book is a good starting point for those who recognize the value of optimizing clinician performance and satisfaction, which will trickle down to better patient outcomes.

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Morning Headlines 6/12/24

June 11, 2024 Headlines Comments Off on Morning Headlines 6/12/24

Oracle Announces Fiscal 2024 Fourth Quarter and Fiscal Full Year Financial Results

Oracle reports Q4 results: revenue up 3%, adjusted EPS $1.63 versus $1.67, missing Wall Street expectations for both.

NeuroFlow Acquires Owl, Creating the Largest End-to-End Platform for Behavioral Health Measurement and Engagement Across the Care Continuum

NeuroFlow, whose system helps risk-bearing healthcare organizations surface and support behavioral health needs, acquires Owl, which offers a measurement-based care platform.

HealWell AI to Acquire VeroSource Solutions and its Cloud-based Health Data Interoperability Platform to Help Large Enterprises Adopt AI-Powered Population Health Capabilities

In Canada, preventative care-focused digital health company HealWell AI acquires healthcare data software vendor VeroSource for $24.5 million.

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News 6/12/24

June 11, 2024 News Comments Off on News 6/12/24

Top News

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Oracle reports Q4 results: revenue up 3%, adjusted EPS $1.63 versus $1.67, missing Wall Street expectations for both.

ORCL shares advanced in extended trading following the announcement as the company announced new cloud sales to Google and OpenAI.

Cerner was barely mentioned in the call and in none of the analyst questions.

From the earnings call:

  • The company sold 30 contracts worth $12 billion in the past quarter.
  • OpenAI will run deep learning and AI workloads on Oracle Cloud Infrastructure.
  • Starting in September, Google Cloud customers can directly access Oracle database services running in Oracle Cloud Infrastructure.
  • CEO Safra Catz said, “I will no longer be breaking out the Cerner business in my results. And even though it will begin to grow modestly throughout the year in both revenue and operating margins, it’s not necessary to break it out any more because it is now operating in a growth mode.”
  • Larry Ellison says that the company can serve small customers, with Oracle deploying small data centers at its own expense – ones that will fit on a ship or submarine – that provide a fall Oracle cloud using six standard half racks in a conventional data center, with the client paying only for the service they use.
  • Ellison says that Oracle is building a 200 megawatt data center and is planning some that are approaching a gigawatt.
  • Ellison says the industry will move to support customers who choose to run multiple clouds:  “We’ll get rid of these fees for moving data from cloud to cloud, and all the clouds will be interconnected, and customers can pick their favorite service from their favorite cloud and mix and match whatever they want to use and do it easily and seamlessly.“

Reader Comments

From HIT Girl: “Re: Ascension. Covering itself in glory yet again.” A member of the Four Tops soul group sues Ascension Macomb Oakland Hospital, alleging that ED employees who were treating him for shortness of breath placed him in a straitjacket, denied him oxygen, and ordered psychiatric tests after he informed them that he was a celebrity with a history of issues with stalkers and fans. Employees believed him only after his wife showed them phone video of him performing with the group at the Grammy Awards, after which the hospital offered a $25 gift card as an apology. Perhaps their skepticism was justified since the singer – who also runs a Los Angeles-based ministry – is 53 years old and the group’s last hit charted three years before he was born. More shocking is that the group, which was formed in 1953, still has a founding member on stage, 88-year-old Duke Fakir. They have upcoming US concert dates.


Webinars

June 26 (Wednesday) noon ET. “Population Risk Management in Action: Automating Clinical Workflows to Improve Medication Adherence.” Sponsor: DrFirst. Presenters: Colin Banas, MD, MHA, chief medical officer, DrFirst; Weston Blakeslee, PhD, VP of population health, DrFirst. What if you could measure and manage medication adherence in a way that would eliminate the burdens of medication history collection, patient identification, and prioritization? The presenters will describe how to use MedHx PRM’s new capabilities to harness the most complete medication history data on the market, benefit from near real-time medication data delivered within 24 hours, automatically build rosters of eligible patients, and identify gaps of care in seconds.

June 27 (Thursday) noon ET. “Snackable Summer Series, Session 1: The Intelligent Health Record.” Sponsor: Health Data Analytics Institute. This webinar will describe how HealthVision, HDAI’s Intelligent Health Management System, is transforming care across health systems and value-based care organizations. This 30-minute session will answer the question: what if you could see critical information from hundreds of EHR pages in a one-page patient chart and risk summary that serves the entire care team? We will tour the Spotlight, an easy-to-digest health profile and risk prediction tool. Session 2 will describe HDAI’s Intelligent Analytics solution, while Session 3 will tour HDAI’s Intelligent Workflow solution.

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


Acquisitions, Funding, Business, and Stock

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NeuroFlow, whose system helps risk-bearing healthcare organizations surface and support behavioral health needs, acquires Owl, which offers a measurement-based care platform.


Sales

  • Landmark Hospital of Cape Girardeau (MO) selects telemedicine services from Doctors Anytime.
  • Alliance Medical will implement Agfa HealthCare’s enterprise imaging software across its 120 imaging sites in the UK.
  • Olympic Medical Center (WA) will enhance its telecardiology program with software and services from Eagle Telemedicine.
  • The University of South Carolina will use Rimidi’s remote patient monitoring technology as a part of the postpartum care offered at an affiliated multispecialty clinic.

People

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Jim Deischer, MBA (Nordic) joins Cardamom Health as VP of finance.

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Teladoc Health names Chuck Divita (GuideWell) CEO.

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Ed Glynn, MD, MBA (HCA Healthcare) joins RhythmX AI as chief clinical officer.

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Ada Health names Nick Altebrando, MA (DayTwo) chief product officer and Yury Rozenman (Propeller Health) SVP of business development.


Announcements and Implementations

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St. Luke’s (MN) will transition to Epic as a part of its acquisition by Aspirus Health. They have been running Meditech, I believe.

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Belfast Health and Social Care Trust in Northern Ireland goes live on Epic.

In England, University Hospitals Coventry and Warwickshire NHS Trust will go live on Oracle Health later this week. The organization announced last October that it had paused its rollout plans to work through unspecified issues that were discovered during testing.

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Mount Sinai Medical Center (FL) implements remote patient monitoring capabilities from HealthSnap. Mount Sinai will deploy HealthSnap’s chronic care management services across its primary care facilities beginning next month.

CCS launches PropheSee, an AI-powered predictive model that improves continuous glucose monitoring device adherence rates by up to 50%, saving an estimated $2,200 per patient per year.


Privacy and Security

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The White House partners with Microsoft and Google to offer rural hospitals free and low-cost cybersecurity resources. Google has also committed to launching a pilot program with select rural hospitals to develop cybersecurity capabilities that are tailored to their needs.

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Australian e-prescribing vendor MediSecure faces insolvency as it deals with the effects of a ransomware attack in early May and being denied a government bailout afterward.


Sponsor Updates

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  • SmartSense by Digi sponsors the St. Louis Golf Classic benefiting Autism Speaks.
  • EClinicalWorks publishes a new customer success story, “Streamlining Data Reporting for Primary Care Centers of Eastern Kentucky.”
  • Wolters Kluwer Health announces that its UpToDate clinical decision support solution has been awarded accreditation with commendation from the Accreditation Council for Continuing Medical Education.
  • A hospital in South Carolina prepares to go live on Ascom’s Unite software.
  • KLAS recognizes Availity with its 2024 Points of Light Award for its collaborative work with prior authorization requests and approvals.
  • CereCore releases a new podcast, “What Matters to a Healthcare CFO? EHR Implementation & Strategic Planning Advice.”
  • Divurgent releases a new episode of The Vurge Podcast, “Aspire to Inspire: Chuck Podesta’s Journey of Healthcare IT Leadership and Reinvention.”

Blog Posts


Contacts

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

Comments Off on News 6/12/24

Morning Headlines 6/11/24

June 10, 2024 Headlines Comments Off on Morning Headlines 6/11/24

CityMD Agrees to Pay over $12 Million for Alleged False Claims to COVID-19 Uninsured Program

CityMD, a VillageMD-owned chain of urgent care practices in New York and New Jersey, will pay $12 million to settle allegations that the company submitted false payment claims to a federal COVID testing program for uninsured patients.

Med-Metrix Announces the Acquisition of HBCS, Further Strengthening the Company’s End-to-End RCM Capabilities

RCM software and services vendor Med-Metrix acquires Hospital Billing & Collection Service, a competitor based in Delaware.

Biden-⁠Harris Administration Bolsters Protections for Americans’ Access to Healthcare Through Strengthening Cybersecurity

The White House partners with Microsoft and Google to offer rural hospitals free and low-cost cybersecurity resources.

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Curbside Consult with Dr. Jayne 6/10/24

June 10, 2024 Dr. Jayne 3 Comments

I have a lot of friends who work in the healthcare technology vendor space, and they are always curious to know my thoughts about health system priorities. A lot of them are on the sales side of their respective organizations and are trying to meet quotas, figuring out how they can get a hook with the health system executives that make purchasing decisions.

Of course, when they ask my opinion, they get just that. I can only comment based on the health systems that I know and the conversations that I’ve had. Priorities can vary based on community and regional factors, as well as based on specific challenges that a given organization has faced in recent months, such as cybersecurity incidents, labor challenges, and natural disasters.

McKinsey & Company recently released a report that looked at the investment priorities of health systems. AI always makes the list as something that organizations think will help in their transformation efforts, but it is unclear how much individual systems are investing in those technologies. McKinsey cites a 2023 working paper from the National Bureau of Economic Research as stating that machine learning could result in reductions of healthcare spending of up to $360 billion. However, McKinsey notes that while the majority of respondents to its survey say they are making digital transformation a priority, they also report challenges in resource allocation and planning.

In looking at data on already implemented capabilities, top priority areas include virtual health, revenue cycle management, digital front door, acute care throughput, and ambulatory care efforts. Leaders who were surveyed reported that those areas that might have the biggest impact include AI at the top, followed by virtual health and digital front door.

It’s interesting to see that the most impactful area fell lower on the spectrum of implemented technologies and roughly middle-of-the-road in being ranked as “unplanned” by leaders. From my discussions with leaders, it sometimes feels like AI isn’t being planned for in the same way as other technologies because of overall uncertainty in how to approach it.

The McKinsey survey gathered data on barriers to executing digital and AI transformation in the next two years. The item most commonly earning a number one ranking was “budget or capital limitations,” followed by “legacy systems are difficult to upgrade.” I was surprised that “unaware of the right digital solutions available” scored so low, with only six of 200 respondents ranking it as number one. That makes me wonder if those surveyed really believe that or if they’re just not admitting how challenging it is to find the right answers to some of the sticky situations that they are facing.

The report goes on to recommend five ways that health systems can evolve, including embracing the cloud, building partnerships, cautiously moving to AI, looking beyond off-the-shelf solutions, and changing up how they operate. For the latter two, they offer advice that I’ve been giving healthcare organizations for two decades now. Their example for looking beyond available solutions involves optimizing workflows “to enable more appropriate delegation” in order to save on nursing costs.

Process improvement advocates have been pushing the idea of delegation for years, yet I still regularly encounter physician offices that don’t have delegation policies for medication refills or scheduling overrides. I continue to see organizations that refuse to use proven strategies, such as data-driven float pools for staffing. Maybe now with the idea of technical enablement for delegation, as mentioned in the piece, people will get on board since adding technology often makes things appear more exciting.

As far as the recommendation to operate differently, the article calls for structures with “flatter, empowered, cross-functional teams,” which management consultants have been pushing for as long as I’ve been in the industry. In thinking across my career, I’ve probably only worked on three truly empowered teams the entire time. Too often, I see teams that are withering due to micromanagement and barriers they can’t seem to remove, such as absent organizational support, questionable corporate values, and lack of funding for key resources.

I asked a friend who is a health system administrator to weigh in on the recommendations. She agreed that many organizations need to get back to basics and to focusing their efforts on initiatives that might not seem sexy but that are needed to help build a strong base after the challenges of COVID. These include things like making employees feel valued, providing adequate resources for training and onboarding, and having a dedicated focus on removing the barriers that keep teams from meeting their objectives.

She told me a story about an operating room utilization project that another part of her organization worked on for months, crunching data about supplies, staffing, and room turnover rates. Despite recommendations from their on-the-ground process improvement staff, leaders wouldn’t negotiate with other departments to make frontline operating room staff available for interviews or workflow mapping activities.

It’s hard to fully understand a problem when you’re just looking at data and not talking to the people who do the job day in and day out. And if you’re not talking to the stakeholders, you definitely can’t get their buy-in or their support for your proposed changes.

The process improvement team was frustrated by the leadership barriers and their inability to make progress. They ultimately spent six months and who knows how much money designing a solution that made people feel disenfranchised, which automatically reduced its chances of success from the moment it was announced. After a failed pilot, the organization reopened the project and figured out a way to remove the barriers, with the team performing a significant amount of rework as they were able to get the input of those with the greatest knowledge of the process.

What would the outcome have been if the team had been empowered to do the job they were trained to do in the first place? In addition to providing process improvements six months sooner, they would have had the satisfaction of knowing that their expertise was respected and that they were treated as valuable members of the organization. I wouldn’t be surprised if the members of that team are a retention risk over the coming months, and anyone who has had to crunch staffing numbers knows that it’s always more expensive to replace someone then to use resources that you already have in place.

What do you think about the McKinsey survey and report on organizational investment priorities? Do their findings match what is happening where you are? Leave a comment or email me.

Email Dr. Jayne.

Readers Write: The Role of Human-Centric AI in Virtual Patient Observation

June 10, 2024 Readers Write Comments Off on Readers Write: The Role of Human-Centric AI in Virtual Patient Observation

The Role of Human-Centric AI in Virtual Patient Observation
By Christine Gall, RN

Christine Gall, RN, DrPH, MS is chief nursing officer at Collette Health.

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The integration and expansion of artificial intelligence (AI) in healthcare has certainly seen its fair share of controversial conversations. Discussions about the potential benefits of utilizing AI to mitigate healthcare worker burnout, improve workflow and process efficiency, and enhance patient safety are met with reservations about the impact of AI being used carelessly or without precision.

Human-centric AI can address some of the concerns related to the algorithmic nature of task automation in traditional AI. The industry has seen a strong shift towards human-centric AI in hospitals for the purpose of prioritizing human needs and augmenting human capabilities rather than replacing them. The nursing community is eager for technology that supports the top priority of nurses — providing excellent and safe care to their patients.

In recent years, AI has enabled the healthcare system to implement revolutionary advancements for the betterment of both frontline healthcare workers and patient safety, particularly in the arena of patient observation.

Continual patient observation is an important tool to enhance patient safety for at-risk patients. Nurse staffing shortages, paired with ever-rising patient acuity, makes continual observation nearly impossible without the help of technology. Many patients in acute care settings are at high risk for falls and accidental self-harm. Human-centric AI-powered virtual patient observation is designed to sharpen the focus of the virtual observer to patients who begin to demonstrate risky behaviors so they can redirect the patient or call for assistance to prevent these events from happening.

A recent study from the American Organization for Nursing Leadership Foundation’s 2024 Longitudinal Nursing Leadership Insight Study found that 20% of nurses want to see an increased utilization of virtual nursing. Virtual patient observation specifically is driving a lot of innovative care practices. The end goal is to leverage human-centric AI to ensure patients’ and clinicians’ safety and well-being, as well as bolster the support systems for caregivers to optimize operational efficiency.

Imagine if hospitals could place a nurse in every single hospital room for an entire shift. That would be wonderful if it was possible. Hospitals have started gravitating towards human-enabled digital innovations that can provide a virtual observer in patient rooms. Virtual observation stations can be placed in rooms, hallways, and main corridors for seamless line of sight of the patient by the virtual observer, and human-centered AI is able to proactively signal subtle changes in patient activity that might lead to patient injury if not redirected. Human-centric AI enables technology to augment and enhance clinician capabilities by extending their reach with the virtual observer, allowing them the reassurance that all of their patients remain in a safe environment even when they are not physically present.

With the application of human-centric AI, providers and nurses can gain insight into overall patient well-being, including sleep patterns, movement, and state of repose. Proactive alerts, enhanced workflows, and intelligent video management provide nurses and caregivers with greater time to practice at the top of their knowledge and expertise, as each patient is continually monitored by virtual colleagues. The insights gained, paired with the uninterrupted observation, is a game-changer not only for hospitals but for the nurses who are caring for patients day in and day out.

Built-in AI tools have been developed to strengthen the impact of virtual observers. Presence detection features alert observers who may look away from their screens for too long and guide them back to focus through increasingly prominent alerts. This technology ensures that the attention of virtual observers remains on their patients, improving patient safety. This feature also supports improved buy-in from hospital leaders with the assurance that the virtual observers are always attentive to their patients.

One of the most important aspects of healthcare is the communication between patient and healthcare provider. Virtual observation powered by human-centric AI is designed to improve contact and communication between the patient and their entire healthcare team. When patients are at their most vulnerable, continuous observation and contact promote patient safety and security. Additionally, nurses and healthcare workers benefit from extended connection to their patients, with virtual observers providing an environment of safety. Patients experience more interaction with the virtual observers, which can enhance their positive perceptions of care.

It is an unfortunate reality that nurses face increased violence in the workplace. A recent National Nurses United report found that 8 in 10 nurses (81.6%) have experienced at least one instance of workplace violence within the past year and nearly half of nurses reported an increase in workplace violence in their unit. Healthcare workplace violence ranges from physical abuse to verbal threats. Virtual observation solutions can improve security for staff as well as patients by utilizing security staff trained in violence mitigation. They can alert a nurse that a patient is exhibiting signs of escalation prior to the nurse entering the patient’s room so that they may execute de-escalation tactics to prevent a violent encounter.

As more hospitals and health systems gravitate towards virtual patient observation solutions, the overarching objective is to improve care delivery for caregivers and enhance safety for patients. Human-centric AI technology can extend the reach of caregivers with continuous virtual observation of patients, ultimately protecting their safety and improving their experience.

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Readers Write: How to Re-Imagine Clinical IT Support

June 10, 2024 Readers Write Comments Off on Readers Write: How to Re-Imagine Clinical IT Support

How to Re-Imagine Clinical IT Support
By Chris Wickersham

Chris Wickersham is assistant VP of customer support at CereCore.

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No one would argue that achieving provider satisfaction is a top goal for those of us who work in healthcare IT support. We also know that when employees on your IT support teams are happy, they provide better, higher quality service.

This led me to consider: how could I achieve both clinician satisfaction and employee satisfaction? What if a slightly different approach to IT service desk operations could lead to more efficiency and productivity for my help desk analysts and their satisfaction?

I began my career working as a healthcare IT analyst and have walked the halls of care settings providing support during go-lives. I have experienced first-hand how minutes matter when troubleshooting IT issues and that streamlined clinical workflows allow care teams to deliver higher quality patient care.

My quest to rethink IT support has been evolving over the past several years and has led to the creation of a clinical service desk. We implemented this service desk model with Epic-based facilities at HCA Healthcare. The results have been a win for clinicians and providers because they have been getting their issues resolved more quickly, and my analysts are working at the top of their license, especially those providing level 2 Epic support.

How is this possible? Here’s a peek into the building blocks of my IT support model.

First, spend time analyzing your organization’s goals for IT support and identify common challenges. I wanted to baseline provider, clinician, and even patient satisfaction as it relates to IT issue resolution and the effects on hospital operations. For example, if the hospital routinely experiences issues with printing discharge instructions, that will impact the timeliness of patients being discharged, patient and clinician satisfaction, and the efficiency of patient throughput.

We analyzed metrics from a variety of perspectives. What were the high-volume issues reported by providers, clinicians, and revenue cycle employees? Did we have recurring workflow challenges or training opportunities? What about EHR-build related incidents?

One of the toughest parts for healthcare IT support can be getting back in touch with a provider or clinician for additional information and follow-up. So, we examined the issue intake process for data quality and efficiency. Was enough information or the right type of information being collected during the first call? If we had had better data to begin with, could we have resolved the issue more quickly for a busy provider or clinical staff?

Next, we evaluated the tools and training. Looking at our high-volume issues in particular, would additional analyst training have helped with resolving the issue at the first point of contact? Would a different level of access enable the level 1 analyst the ability to resolve the issue sooner? Did we have an effective IT service management tool that allows for next-level analysis? Were there configuration, knowledge base, or workflow improvements within the ITSM that could help analysts resolve more issues during the first contact?

Healthcare IT is a team sport. That’s why we took a hard look at our culture and looked for ways to encourage more collaboration among all levels of our analysts. In fact, one of the key drivers in the evolution of our clinical service desk for Epic support has been the focus on “shifting left” the issues handled by our level 2 and level 3 analysts.

Our level 2 and level 3 application support and clinical informatics resources were finding it difficult to focus on project work. Their bandwidth for heads-down time to make progress on Epic initiatives often was limited because they were pulled into resolving support issues.

We began finding opportunities to cross-train and collaborate more. We also developed a training program to bolster application and workflow understanding. We made a significant investment in training our analysts through the Epic certification process, focusing on key workflows where we needed to increase our knowledge base and pairing the interests of service desk analysts with Epic certification opportunities. This training and collaboration have been key to making our shift left strategy a reality.

Finally, we established key performance indicators (KPIs) and reporting metrics to measure the effectiveness of training, analyst access changes, and process improvements. I focus on quality measures, such as first-contact resolution and customer satisfaction and the ability to shift support work left from level 2 to level 1.

If your organization is building an internal clinical service desk, prepare for the significant and intentional investment required, along with a willingness to let go and trust the process of building your own talent pipeline. Be ready to measure results so you can ensure you’re reaping the benefits of your investment and configuring your resource model appropriately.

When executed thoughtfully, the benefits of long-term operational efficiencies, improved clinician satisfaction, and happy employees are well worth the effort.

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Morning Headlines 6/10/24

June 9, 2024 Headlines Comments Off on Morning Headlines 6/10/24

Oracle $16 Billion VA Health Software Scores Badly in Internal Report

An internal VA report finds that less than 20% of its Oracle Health users believe that the system helps them deliver high-quality care and just 13% believe that it helps keep their patients safe.

Anterior grabs $20M from NEA to expedite health insurance approvals with AI

Prior authorization automation startup Anterior raises $20 million in a Series A funding round.

Mount Sinai Health System named 2024 Hearst Health Prize winner

Mount Sinai Health System wins the 2024 Hearst Health Prize for its NutriScan AI application that identifies malnutrition in hospitalized patients by analyzing EHR data.

Comments Off on Morning Headlines 6/10/24

Monday Morning Update 6/10/24

June 9, 2024 News 5 Comments

Top News

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An internal VA report finds that less than 20% of its Oracle Health users believe that the system helps them deliver high-quality care and just 13% believe that it helps keep their patients safe.

The survey of 2,000 VA users was conducted in March and April by KLAS, which told VA officials that their scores were the worst they have ever seen.

The Bloomberg article also notes that while Oracle is touting the DoD’s implementation, it fared only slightly better, with 30% of its surveyed users saying that the system helps them deliver high-quality care.

Another VA report says that while it hopes to raise user satisfaction scores to be comparable with those in non-VA hospitals, the $16 billion Oracle Health system – which has gone live in just six VA facilities since its first in October 2020 — may never reach the satisfaction levels of the VA’s homegrown VistA product.


HIStalk Announcements and Requests

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The ratio of poll respondents who have a worsened opinion of Oracle Health compared to those with an improved opinion is 10 to 1.

New poll to your right or here: Do you agree with an Oracle exec’s claim that Epic’s Judy Faulkner is the biggest obstacle to interoperability? EVP Ken Glueck wrote that “everyone in the industry” understands that this is the case, so I’m interested in the poll results and any comments you would care to add. 

I’ll soon announce new sponsors who responded to my suggestion to wangle some freebies out of Lorre during the usual slow summer. She is also reaching out to a few companies that we had to cancel after they went radio silent due to staff changes or other internal disarray. Note: the only thing you can buy from me is a sponsorship — I don’t sell video interviews or sponsored content, although marketing people seem shocked to hear that since many sites do.


Webinars

June 26 (Wednesday) noon ET. “Population Risk Management in Action: Automating Clinical Workflows to Improve Medication Adherence.” Sponsor: DrFirst. Presenters: Colin Banas, MD, MHA, chief medical officer, DrFirst; Weston Blakeslee, PhD, VP of population health, DrFirst. What if you could measure and manage medication adherence in a way that would eliminate the burdens of medication history collection, patient identification, and prioritization? The presenters will describe how to use MedHx PRM’s new capabilities to harness the most complete medication history data on the market, benefit from near real-time medication data delivered within 24 hours, automatically build rosters of eligible patients, and identify gaps of care in seconds.

June 27 (Thursday) noon ET. “Snackable Summer Series, Session 1: The Intelligent Health Record.” Sponsor: Health Data Analytics Institute. This webinar will describe how HealthVision, HDAI’s Intelligent Health Management System, is transforming care across health systems and value-based care organizations. This 30-minute session will answer the question: what if you could see critical information from hundreds of EHR pages in a one-page patient chart and risk summary that serves the entire care team? We will tour the Spotlight, an easy-to-digest health profile and risk prediction tool. Session 2 will describe HDAI’s Intelligent Analytics solution, while Session 3 will tour HDAI’s Intelligent Workflow solution.

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


Acquisitions, Funding, Business, and Stock

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Waystar raises $968 million in its IPO, which values the company at $3.7 billion. Nasdaq-traded WAY shares opened Friday morning at $21.50 and closed at $20.70. Waystar lost $50 million in each of the past two years.

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OHSU will lay off at least 500 of its 21,000 employees. The health system is pursuing an acquisition of Legacy Health, touting its own financial strength and its intention to use $1 billion in bond offerings over 10 years to improve infrastructure.


People

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Specialty EHR/PM vendor Nextech hires Rusty Frantz, MS (NextGen Healthcare) as CEO.


Announcements and Implementations

Mount Sinai Health System wins the 2024 Hearst Health Prize for its NutriScan AI application that identifies malnutrition in hospitalized patients by analyzing EHR data.

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A McKinsey survey finds that most health system executives see digital transformation as a high, but underfunded, priority. They named virtual health and digital front doors as potentially offering the biggest benefit. Top challenges are the limitations of their legacy systems, lack of budget, and workforce readiness. Satisfaction with digital investments is high, but the self-assessed lack of rollout progress leads McKinsey to question whether they are scaling their digital programs effectively.


Government and Politics

The VA completes its rollout of VA Health Chat in all VISNs, offering VA health services by chat as powered by CirrusMD.

Idaho ends its contract with the Idaho Health Data Exchange, citing its lack of financial transparency and previous bankruptcy. State watchdogs found that the non-profit had spent $94 million, most of it from federal grants, but the state’s creation of it as a private, non-profit corporation allowed it to operate with minimal state oversight.


Privacy and Security

Ascension’s cybersecurity event update indicates that it has restored EHR access to six of its markets and remains on track to complete all of them by June 14. It warns patients that their patient portal may not show medical record data after May 8 – the date its systems went offline – since the information that was collected on paper must now be entered into the EHR.


Sponsor Updates

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  • Healthcare IT Leaders staff stock shelves and help shoppers at The Our Neighbors’ Table Market in Amesbury, MA.
  • Visage Imaging will exhibit at the Society for Imaging Informatics in Medicine (SIIM 2024) Annual Meeting in National Harbor, MD, June 27-29.
  • CereCore publishes the latest edition of its “Partnership Perspectives” digital magazine.
  • Wolters Kluwer Health partners with the Black Nurse Collaborative to increase focus on improving advocacy for underrepresented groups in nursing.
  • Nordic releases a new “Designing for Health” podcast titled “Interview with Kit Delgado, MD.”
  • Redox publishes a new case study, “Ambience Healthcare selects Redox to integrate their AI Operating System – reducing clinician documentation time by 80%.”
  • Rhapsody publishes a case study, “OU Health standardizes on Epic & Corepoint Integration Engine amidst M&A activity.”
  • RLDatix launches the RLDatix Safety Institute to research safety design and care delivery risk reduction best practices.
  • Sectra launches a new diagnostic IT module for genomics within molecular pathology, developed in collaboration with the University of Pennsylvania Health System.
  • Surescripts publishes the “QHIN Use Case Guide: 17 Clinical & Business Scenarios.”
  • Tegria will present at the International Performance Management Institute Healthcare IT Institute June 10 in Orlando.

Blog Posts


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

Morning Headlines 6/7/24

June 6, 2024 Headlines Comments Off on Morning Headlines 6/7/24

Healthcare software firm Waystar raises $968 mln million in IPO, sources say

Waystar reportedly raises $968 million in its IPO, giving it a valuation of $3.69 billion.

Walmart shut down its healthcare clinics after losses reached nearly a quarter of a billion dollars

Endpoints News reports that Walmart lost $230 million last year alone on its Walmart Health clinics before announcing their closure a few weeks ago.

Health Catalyst Acquires Oncology-Focused Health Technology Company Carevive

Health Catalyst acquires Carevive Systems, which offers cancer treatment support tools for oncology providers and life sciences researchers.

DirectTrust and Digital Therapeutics Alliance Announce Partnership to Provide Accreditation for Digital Therapeutics Industry

DirectTrust launches an accreditation program for digital health apps, which will use privacy, security, transparency, and interoperability criteria as provided by the Digital Therapeutics Alliance trade association.

Comments Off on Morning Headlines 6/7/24

News 6/7/24

June 6, 2024 News 5 Comments

Top News

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Endpoints News reports that Walmart lost $230 million last year alone on its Walmart Health clinics before announcing their closure a few weeks ago. It launched the business in April 2019.

The company had opened just 51 clinics of its planned 1,000; failed in its attempt to pivot from cash-paying customers to value-based care programs with insurers; and attracted only 932 attributed Medicare Advantage patients versus its goal of 9,600.

Former employees say the company underinvested in marketing to the point that even in-store shoppers weren’t aware of the clinics. Two employees say the company will shut down all locations on June 28.

This excellent article was written by Senior Health Tech Reporter Shelby Livingston, MS, who covered healthcare with Modern Healthcare and Business Inside before joining Endpoints News just over a month ago.


Reader Comments

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From HIT_Consulting_Insider: “Re: Nordic. I’ve heard they laid off 70 core staff and potentially 300 across their family of brands. A rumor is also circulating that Bon Secours Mercy Health and its VC arm Accrete Health Partners are considering selling the company. I think a lot of the industry would be interested in knowing if either of these are accurate. Thanks for all that you do to provide transparency in the industry.” Reported by multiple readers, who also said that President Don Hodgson, who was announced seven weeks ago as the company’s next CEO to replace the retiring Jim Costanzo, was part of the RIF (the company didn’t confirm this, but his bio has been removed from its executive page). Nordic previously acquired S&P Consultants, Bails, and Healthtech. Accrete is led by Bon Secours Mercy Health CDO Jason Szczuka, JD. A Nordic spokesperson provided this response to my inquiry:

Like many of our health care clients and partners, Nordic is navigating economic challenges and has reassessed its strategic priorities to adapt to ongoing market shifts. Reductions are always a last resort, and after careful examination of our business, we have made the difficult decision to implement a 2% reduction in force. Our recent changes have been due to a variety of standard business activity, including planned retirements and departures to explore new opportunities. Our parent company, Accrete Health Partners, is committed to helping ensure that Nordic is best positioned to be successful for years to come.


HIStalk Announcements and Requests

I’m looking for interesting people to interview from outside the vendor world. I enjoy talking to folks who are insightful, articulate, and wryly cynical, with extra points for being a loose cannon who is unmuzzled by employer media policies. It only takes about 20 minutes via a Zoom session. Contact me. Writing this made me ponder how many CEO interviews I’ve done, of which I counted 766.

I’m feeling like a Luddite in admitting that I don’t really know what Apple Pay is or why I should use it instead of those hunks of plastic that live in my well-worn wallet. Remediating that will be my weekend project.

Today’s unrequested mini grammar reminder: use “who” as a relative pronoun only when referring to people (“I have a friend who likes to play golf”) and use “that” when referring to everything else (“I have a dog that is hungry.”) Bonus tip: don’t use “amount” when referring to countable nouns. “The company laid off a large amount of employees” should instead be “a large number of employees.” I don’t criticize incorrect usage, including my own, but I try hard to make it easier to understand me and I correct article submissions before I run them.


Webinars

June 26 (Wednesday) noon ET. “Population Risk Management in Action: Automating Clinical Workflows to Improve Medication Adherence.” Sponsor: DrFirst. Presenters: Colin Banas, MD, MHA, chief medical officer, DrFirst; Weston Blakeslee, PhD, VP of population health, DrFirst. What if you could measure and manage medication adherence in a way that would eliminate the burdens of medication history collection, patient identification, and prioritization? The presenters will describe how to use MedHx PRM’s new capabilities to harness the most complete medication history data on the market, benefit from near real-time medication data delivered within 24 hours, automatically build rosters of eligible patients, and identify gaps of care in seconds.

June 27 (Thursday) noon ET. “Snackable Summer Series, Session 1: The Intelligent Health Record.” Sponsor: Health Data Analytics Institute. This webinar will describe how HealthVision, HDAI’s Intelligent Health Management System, is transforming care across health systems and value-based care organizations. This 30-minute session will answer the question: what if you could see critical information from hundreds of EHR pages in a one-page patient chart and risk summary that serves the entire care team? We will tour the Spotlight, an easy-to-digest health profile and risk prediction tool. Session 2 will describe HDAI’s Intelligent Analytics solution, while Session 3 will tour HDAI’s Intelligent Workflow solution.

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


Acquisitions, Funding, Business, and Stock

Executive search firm Direct Recruiters, Inc. acquires Health Innovations, which recruits in the areas of population health, value-based care, and innovation. Radiologist David Gorstein, MD, managing director of Health Innovations, will lead DRI’s population health practice.

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Digital stethoscope manufacturer and AI algorithm developer Eko Health raises $41 million in Series D financing, which it will use to expand access to its AI-powered, FDA-approved detection tools for cardiac and pulmonary disease.

Health Catalyst acquires Carevive Systems, which offers cancer treatment support tools for oncology providers and life sciences researchers. The company’s platform offers treatment planning, remote symptom monitoring, post-treatment care, and applied analytics.


Announcements and Implementations

DirectTrust launches an accreditation program for digital health apps, which will use privacy, security, transparency, and interoperability criteria as provided by the Digital Therapeutics Alliance trade association.


Government and Politics

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Senator Ron Wyden (D-OR) blames HHS for healthcare cyberattacks, saying that it has failed to regulate and oversee the industry. He says in a letter to HHS Secretary Xavier Becerra that the health sector shouldn’t be allowed to self-regulate cybersecurity. He wants HHS to:

  • Mandate technical cybersecurity standards for systemically important entities (SIEs) such as clearinghouses and large health systems.
  • Require SIEs to demonstrate that they can recover quickly from attacks.
  • Conduct cybersecurity audits as required by HITECH, including those organizations that haven’t had HHS audits performed.
  • Provide cybersecurity technical assistance to providers.

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A federal judge rules against FTC’s attempt  to block the $320 million sale of two North Carolina hospitals to Novant Health, ruling that the hospitals would likely close otherwise. North Carolina’s state treasurer had filed a friend-of-the-court brief supporting FTC’s request.

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Mobile telehealth carts that were placed in rural New York schools remain unused as the state legislature eliminates funding for school telemedicine programs. One school district was counting on the state’s plan to pay two-thirds of the annual $16,000 operating cost to contract with provider Mobile Primary Care, with the remainder to be covered by billing the insurance of parents. The district had hoped to reduce COVID-skyrocketed absenteeism and to consider offering mental health support.


Privacy and Security

Ascension restores EHR access to its Florida, Alabama, Austin, Tennessee, and Maryland markets and remains on track to complete restoration by the end of next week. A ransomware attack took its systems offline on May 8.


Sponsor Updates

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  • Pivot Point Consulting sponsors Kootenai Health Foundation’s annual golf tournament.
  • Inovalon, Availity, Surescripts, Arcadia, Ellkay, FinThrive, First Databank, Symplr, InterSystems, and Wolters Kluwer Health will exhibit at AHIP 2024 June 11-13 in Las Vegas.
  • EClinicalWorks announces that Rocky Mountain Women’s Clinic (ID) and Stone Mountain Health Services (VA) have implemented its Sunoh.ai virtual medical scribe technology.
  • First Databank names Grant Ripperda software engineer, Andrea Mitchell data test engineer, and Sean Murphy software test supervisor.
  • Five9 US Radiology Specialists shares insights on areas it could automate and what AI means for its organization.
  • Optimum Healthcare IT publishes a new issue of its “The Optimum Pulse” newsletter.
  • Linus Health will sponsor the Alzheimer’s Foundation of America 2024 Educating America Tour stop in Boston on June 12.
  • Thomas Medical Centre in Singapore goes live on Meditech Expanse.
  • MRO releases a new episode of its MRO Exchange: Connecting Healthcare Executives Podcast, “Healthmap Solutions CIO Bill Moore.”
  • NeuroFlow releases a new Bridging the Gap Podcast, “Policy Updates Shaking Up Integrated Care.”

Blog Posts


Contacts

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

EPtalk by Dr. Jayne 6/6/24

June 6, 2024 Dr. Jayne Comments Off on EPtalk by Dr. Jayne 6/6/24

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ONC is seeking feedback on a recent white paper that highlights its vision for Health Equity by Design. The organization is formulating strategies to reduce healthcare disparities by including health equity throughout the creation and implementation of health IT policies, programs, and workflows. The approach aids in identifying gaps and disparities and creates an environment where “technology itself anticipates, avoids, and reduces, not exacerbates, health disparities.” Additional outcome goals include mitigating systemic inequities and improving person-centered decision-making, implementing population health interventions, and strengthening public health. Comments can be provided through June 10 at 11:59 p.m. ET.

Having worked in emergency and urgent care settings for the majority of my career, I’ve seen how the lack of easily accessible mental health services adds to overcrowded waiting rooms and delays patients from receiving appropriate care. A recent initiative in Oklahoma equips police officers and Certified Community Behavioral Health Clinics with IPads for telehealth visits, helping reduce the number of emergency visits and hospitalizations for mental health issues. More than 30,000 devices have been deployed to the field, allowing faster patient interventions in a less resource-intensive manner.

Police officers no longer have to wait with patients at the emergency department, and patients have a shorter wait time for lower-acuity care that better matches their needs. The statistics are impressive – a 93% reduction in inpatient hospitalizations for mental health crisis over a six-year period, and $62 million in savings. The program has expanded to provide IPads directly to behavioral health patients, further reducing the need for costly interventions. I hope other states, counties, and cities take note of this program and consider implementing it in their own areas.

A project for one of my clients led me to dig into the new final rule from the Office for Civil Rights (OCR) and CMS that is designed to prohibit discrimination in AI based on data points such as age, gender, race, and ethnicity. It’s great to have regulations, and this one in particular brings 558 pages of PDF joy, but it’s unclear how this will be enforced. AI bias can be difficult to detect, and when identified, there’s a chance that organizations will be subject to their own biases in determining how to address it. The presence of a formal rule opens the door for whistleblowers and reports of problems from end users, which should help keep the industry honest.

One of the important elements in the rule is the definition of the term “patient care decision support tool” as “any automated or non-automated tool, mechanism, method, technology, or combination thereof used by a covered entity to support clinical decision-making in its health programs or activities.” That definition encompasses everything from EHR-embedded AI clinical decision support to paper checklists found at the bedside, and everything in between. Hopefully this will serve as a catalyst for organizations to ask some questions about tools they have in place or are considering, including reviewing the data being used to trail the model or validate the tool, making the tool’s decision-making process transparent, identifying how people will be involved in the implementation and monitoring of tools, and describe the steps that will be taken if there is a suspicion that harm has occurred.

With that in mind, it’s timely that Epic Systems has released a new “AI Trust and Assurance Suite” that is designed to help clients test and monitor their AI models. According to announcements from Epic, the software is designed to automate data collection and mapping and to ensure consistency. Since one can’t really see Epic’s documentation unless one is an Epic customer (or someone violates all kinds of rules by slipping one a copy,) it’s unclear how this tool will work for the numerous Epic clients who have custom fields and their own unique ways of using data.

Epic says it will release the tool’s monitoring templates and data dictionaries as open-source software this summer, which should help clients who have custom AI models or who are using tools from third parties. Still, that’s a significant burden on clients who will have to analyze the tool and its functions carefully. I doubt many organizations have analysts budgeted to address it, so we’ll have to see what the speed of uptake looks like.

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I’ve been mentoring a resident physician who is considering a fellowship in clinical informatics. One of our recent conversations was around the role of generative AI in academic pursuits. Most organizations I have encountered have come to the conclusion that they can’t prevent students from using the latest and greatest digital tools, but that guardrails need to be in place to preserve academic integrity. Oregon Health & Science University Professor William Hersh, MD has a clear policy for the “Introduction to Biomedical & Health Informatics” course that provides guidance to students. Key points include that generative AI systems can be useful tools but should not be used to substitute one’s own knowledge; and students can ask generative AI systems for content, but final responses — including those in discussions, quizzes, tests, and term papers — should reflect the student’s “own thinking, judgment, and language.” It is also noted that students shouldn’t shortchange their learning by relying on generative AI, and that the need for a fundamental core of knowledge and understanding is needed by practitioners in the field.

Pediatric dermatology researchers are celebrating their victory over ChatGPT as detailed in a recent study that looked at accuracy rates on board-type questions. They tested ChatGPT versions 3.5 and 4.0 using questions from the American Board of Dermatology as well as “Photoquiz” questions from the journal Pediatric Dermatology. Although ChatGPT 4.0 gave human pediatric dermatologists a run for their money in some areas, the humans outperformed both versions overall. Researchers call on clinicians to understand the tools and how they might be helpful in practice.

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The Institute for Safe Medication Practices has released additional guidance on actions needed to prevent drug name selection errors when facilities are using automated medication dispensing cabinets. Although vendors have taken steps to improve their products, some features require a customer to opt in to the newer safety features through manual configuration or software updates. The Institute is calling on vendors to support dynamic search functions and standardized medication names, and for care delivery organizations to educate staff, analyze workflows, and require indications for certain overrides.

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I spent some time this week helping teach CPR to a local youth group. Attendees were amazed at how much easier it looks in movies and television. Some of the participants were smaller physically and couldn’t generate the force needed to do effective compressions, but they were great at recognizing the signs that CPR is needed and demonstrating how to take charge of a scene. If you’re not certified in CPR and use of the AED (automated external defibrillator), consider taking a class. At minimum, consider learning about hands-only CPR from our friends at the American Heart Association and identifying where AEDs might be kept in your daily travels. Bystanders recently initiated CPR at my local Costco. Will you be ready if the time comes?

Email Dr. Jayne.

Comments Off on EPtalk by Dr. Jayne 6/6/24

Morning Headlines 6/6/24

June 5, 2024 Headlines Comments Off on Morning Headlines 6/6/24

Direct Recruiters, Inc., a Starfish Partners Company and Health Innovations, LLC Join Forces to Revolutionize Healthcare Staffing and Analytics

Direct Recruiters announces that it will acquire Health Innovations, a staffing firm specializing in placing clinical executives and analytics leaders.

Eko Health scores $41M to detect heart and lung disease earlier and more accurately

Smart stethoscope developer Eko Health raises $41 million in Series D funding, bringing its total raised to $165 million.

Solarity Announces Strategic Growth Investment from TA

Automated clinical data processing vendor Solarity announces an undisclosed amount of funding from TA Associates.

Comments Off on Morning Headlines 6/6/24

Healthcare AI News 6/5/24

June 5, 2024 Healthcare AI News Comments Off on Healthcare AI News 6/5/24

News

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Researchers at George Mason University’s public health school create MeAgainMeds.com, a free AI-powered website that uses self-reported patient history and data that was extracted from 3.6 million patient records to help patients and clinicians choose the antidepressant that is most likely to be effective for them.

Kimberly Powell, healthcare VP/GM at Nvidia, says that she expects healthcare to be more affected by AI than any other industry, particularly in the area of drug discovery.


Business

Evolent acquires the software and development team of Machinify’s prior authorization and utilization management products. Machinify will continue its work with payer applications.

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Innovaccer launches an AI-powered healthcare contact center that combines all available data to personalize the call center interaction of consumers.

Tampa General Hospital chooses Palantir Technologies to create an AI-powered care coordination system.

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Spain-based AI medical triage chatbot vendor Mediktor acquires Sensely, which offers patients chat-based help with insurance.


Research

Researchers find that applying retrieval-augmented generation – where an AI system searches a specified database to craft its answers – improved the accuracy of ChatGPT-4 in answering cancer-related questions from 57% to 84%. However, it performed poorly when faced with conflicting advice statements from clinical trials, expert opinions, or committee recommendations.


Other

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Children’s National Hospital hires Alda Mizaku, MS (Mercy) to the newly created role of VP/chief data and AI officer.

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Montefiore Einstein Comprehensive Cancer Center doubles the colonoscopy completion rate among patients who cancelled or no-showed their colonoscopy appointments by using the AI tool MyEleanor from MyndYou to conduct voice call outreach. More than half of patients that the system called stayed on the line and half agreed to be transferred to a human navigator to reschedule.

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Johns Hopkins palliative care doctor and cartoonist Nathan Gray, MD creates a fascinating “op-comic” for the LA Times that describes his experience with his hospital’s ambient documentation pilot project. He says that he had to learn to suppress the urge to type and had to remember to speak his findings out loud, but enjoyed “not having a screen stand as a dividing wall between doctor and patient.” He found that the program generated an accurate, coherent summary of the conversation even when it didn’t follow an obvious structure. His biggest complaint is that as a palliative care doctor, the AI ignored the hopes, dreams, and fears of the patient in seemingly mistaking that part of the conversation as chitchat.


Contacts

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

Comments Off on Healthcare AI News 6/5/24

HIStalk Interviews Jeff Richards, Co-Founder and COO, SnapCare

June 5, 2024 Interviews Comments Off on HIStalk Interviews Jeff Richards, Co-Founder and COO, SnapCare

Jeff Richards, MS, MBA is co-founder and chief development and operation officer of SnapCare.

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Tell me about yourself and the company.

I spent the first 19 years of my career as a clinician and administrator in anesthesia at a large public health teaching hospital here in Atlanta, Georgia. Grady Hospital was connected to Emory University, which where I went to school. I educated clinicians that came in. I eventually moved into a leadership role, where I dealt with the complex balancing act that every administrator does — providing some clinical care, overseeing a staff of almost 100, and doing the schedule, which was the seed for launching this company with my partner in Atlanta.

When I went back and got an MBA in 2016, I wrote a paper about a mobile healthcare staffing app. Out of the blue, a classmate of mine from 19 years before reached out and said, hey, can you help me with my startup? It’s called SnapNnurse. I had not intended to start a company when I went to MBA school, but I teamed up with her and we went out to raise capital. We talked to lots of VCs who said, this is a brilliant idea, healthcare often lags behind, and creating a mobile-friendly platform for clinicians to sign up and for facilities to book staff is right on time, in 2017 anyway. We ended up raising $1 million in seed capital in the summer of 2017, launched the company, had good success here in Atlanta, and created a marketplace with about 60 facilities and 10 ,000 clinicians. 

Two and a half years into our entrepreneurial journey, COVID hit. We couldn’t have known that the platform would scale the way it did or predict the benefit of how we interact with social media to sign up clinicians. We pointed it at that situation, turned into a rapid response company, and essentially grew to a billion-dollar company in 2021 and 2022, deploying thousands of clinicians in all 50 states and scaling into a different entity.

In the last 10 months, we’ve rebranded from SnapNurse to SnapCare because we’ve become a broader workforce solution, not just a contingent staffing mobile application. It’s also well past nurses and goes into the entire healthcare clinician continuum other than physicians, which we don’t staff, but do subcontract.

How has the clinician labor market and the use of contract resources changed in the past year or two as healthcare organizations tried to resolve the pandemic-caused, unsustainable labor cost trajectory?

That unprecedented demand was what was needed at the time. You needed to move clinicians around the country as fast as you could from the different hotspots, sometimes happening simultaneously. As the pandemic waned, that demand went away and went below many of the pre -pandemic levels. 

As that was happening, we had evolved from a technology platform. Our orientation and what we had built changed. We said, why don’t we put the technology that we use to mobilize clinicians, engage them, match them, attract them, onboard them, credential them, and deploy them, in the hands of clients themselves? Why not empower them by plugging them into the software?

As that demand was waning, we were in the midst of rebranding into the company that we are today. Facilities are struggling from contingent staffing. There’s a lot that we can offer them as a company to help them manage their internal staff and attract, credential, and onboard candidates more efficiently than they do today.

The moving around of clinicians was like a shell game, where the supply was limited and the demand for their services was at least temporarily unlimited, which predictably sent pay rates up. Will we ever have enough clinicians to avoid ever-increasing compensation as organizations poach them from each other?

When we started this company, my research in MBA school was in the state of Georgia. In 2007, the Georgia state legislature commissioned a study to better understand and predict the healthcare workforce shortage. What they predicted was that without a massive change in the number of school schools and the number of educators – which is a huge piece of this puzzle – and the investment to support all of that, there would be a healthcare healthcare workforce shortage would begin to peak in 2017, which was when I was writing the paper. The legislature did the right thing and was correct in their assessment, but they did not fund the initiatives that would would have alleviated the problem. 

To your question, the answer is a decade-long investment across the country to enable the number of clinicians who are going into school and the number of educators that are needed. A lot of resources got pulled away as facilities attracted clinicians out of educational roles to work at the bedside. It is a complex problem in the sense that that’s a decade-long fix, with lots of steps in between.

AI will probably play a role in the solution. It’s in telehealth. It’s in the way that you manage the internal staff. We recently did an acquisition, a company called Medecipher, that has a machine learning and AI algorithm for predictive analytics. It helps deploy internal staff across a six- or eight-week schedule to better match the acuity of the clinician, their specific certifications and qualifications, to the census and to the acuity of the patients. They are in different departments throughout a facility. There are absolutely tools and technologies that are on the table to help manage it, but the big picture solution is to increase the supply of clinicians.

I think AI is the future of this industry. It’s often an overused buzzword, but there’s a there’s a fast-paced change going on. Artificial intelligence has changed the speed with which technology keeps doubling the capacity. Moore’s Law, which was established by Gordon Moore in the 1960s, says that the number of transistors in a microchip doubles approximately every two years. Somehow through technology innovations and the number of chips and the way we make those chips internationally, we’ve maintained that.

Everyone thinks that AI has only come along in the last couple of years, but it has been decades in the making. But in the last 12 years, the speed with which the capacity for AI — which is software, it’s not hardware — has been doubling at a rate of every 3.4 months. It gets a little geeky to get that specific, but the highlight is that at the end of the year, it’s 400% more capable. Every quarter, things are getting faster and faster and faster. 

I think we are in the beginning of a two-ish year run where the way facilities and clinicians engage will be heavily driven by AI. The companies that figure that out and leverage it will be the leaders ,and clinicians will be attracted to them because of how they can interact, get access to jobs and onboard, and maintain their credentials. All of it will be significantly easier than it is today.

How are organizations using an internal resource pool and related technologies to reduce their reliance on higher-cost outside resources?

The internal resource pool for us is a natural, the other side of the coin of the Medecipher acquisition. Number one would be to deploy Medecipher and use no contingent staff whatsoever, just better utilizing the staff that you have. Then combining it with our platform, which has a shift booking engine and matching algorithm to ensure that every facility has a pool of PRN type candidates, often without benefits at a slightly higher rate, who do that for flexibility. Maybe they work at two or three locations around town.

Most organizations don’t have the technology to send out the shift requests, send reminders, and ensure that once they do work, they get notifications to submit time cards and things like that. This is basic technology that we have used for years, and that is the offering to take that and use it to develop internal resource pool. We think that the smartest combination is to combine that with a predictive analytics scheduling solution.

Moving people around to unfamiliar facilities with different practices must create some degree of patient safety risk, plus it seems logical that a clinician would prefer to pick up extra shifts at their home organization rather than moving around. Are employers trying to create an environment to support that?

Absolutely. The facilities as employers want to ensure that. The larger part of their workforce is made up of full -time employees with full-time benefits and the facility is working well for them. But there is always a sizeable percentage, five to 10% – which is hundreds of people when you’re talking about 4,000 or 5,000 clinicians — who want  to work in a more flexible way and may opt out of benefits. It may not be that they’re moving to different facilities across town. It could be that it’s a system that has two or three hospitals that are in relatively close proximity. For the option of the flexibility, to have a little more control over their schedule, they are willing to opt out of benefits.

To move them around and to mobilize them in the smartest way, you need a technology platform that can help distribute the shift requests, send reminders, and support an on-call backup auto notification that can go two or three levels deep into those who didn’t get the shift but have opted in to be in an on-call capacity.  Those are basic bread and butter techniques to ensure that you have the staff when you need them and where you need them. That technology, whether its sounds staggeringly innovative or not, is missing in most facilities. We offer it as a platform.

What are the benefits of your transparent pricing promise?

We hear from facilities the same thing that I felt myself as an administrator at Grady. I’m paying this high bill rate, but what are you paying the clinician? Inevitably, somebody will get it out of the clinician. Administrators are already frustrated because they don’t want to be using contingent staffing, so they do it in a somewhat begrudging way. But it should be transparent. You should know where the dollars are going. When you’re hiring someone at a premium, dollars also go to the stipend, because you’ve relocated them. If it’s a local contractor, then you’re going to see what that margin is. 

It’s a promise of trust to our clients that when when they use contingent staff, they know what it costs. We have such trust and confidence in our technology that we have driven the cost down. Those margins are much lower than a traditional legacy staffing agency, which often has brick and mortar buildings, a larger group of staff, and lower utilization of technology that require it to maintain a higher margin to pay for all of that.

Why do health systems use your services to recruit for making direct hires?

Some facilities need to make 300 hires and their HR department is not up to do that, so they seek us out. The way we differentiate ourselves is twofold. Because of our cost structure as a technology company, we can do it for less and have some of the lowest one-time costs for permanent placement when you’re doing direct hire. Then, the way we combine the our platform with social media to reach out to candidates is a broader way to access them and whatever pools they are in. The message leverages what the facility wants to do, whether they want to have an incentive like a sign-on bonus or speak to the benefits that they offer at their facility. Our reach and the interactivity of the platform with social media is another differentiator. Overall, it’s cost and the technology platform itself.

Where does the company go from here?

It’s really the shift from external contingent human capital management — the contingent staffing world whether technology enabled or not — into an increasingly pure SaaS product, where significant elements of the business are dedicated to predictive analytics. That’s the reason for the acquisition that’s only two months old. Leveraging the internal resource pool, and only when they have exhausted those techniques as well as permanent placement and have decided to use contingent staffing, to use a best in class marketplace that can aggregate PRN contract staffing, leveraging the technology across multiple different agencies to leverage the cost, get it down. We differentiate ourselves from contingent staffing competitors by seeing ourselves as constantly transforming further down the pathway towards a technology-only company.

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Morning Headlines 6/5/24

June 4, 2024 Headlines Comments Off on Morning Headlines 6/5/24

Sword Health Introduces Phoenix, the First AI Care Specialist and Raises $130 Million in a Mix of Primary and Secondary Sale, Increasing Valuation to $3 Billion

Sword Health, which offers AI-powered digital support solutions for issues related to musculoskeletal problems, physical therapy, and pelvic therapy, raises $130 million.

Cybersecurity Event Update

Ascension restores EHR access in its Florida, Alabama, and Austin markets, and hopes to make the system available to the entire organization by June 14.

WM to Acquire Stericycle, a Leader in Medical Waste Services, for $7.2 Billion

Waste Management will acquire Stericycle, which specializes in medical waste disposal, compliance training, and secure information destruction, for $7.2 billion.

AssureCare Acquires Cureatr and SinfoniaRx Technology

AssureCare acquires the medication management technologies of Cureatr, which abruptly shut down last October, and of Cureatr affiliate SinfoniaRx Technology.

Comments Off on Morning Headlines 6/5/24

News 6/5/24

June 4, 2024 News 2 Comments

Top News

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Ascension says in a June 4 cyberattack update that it has restored EHR access in its Florida, Alabama, and Austin markets. It hopes to use that experience to make the EHR available to the entire organization by next Friday, June 14.

The health system adds that its retail pharmacy, home delivery, and specialty pharmacy sites have reopened and can once again receive prescriptions electronically.

Ascension’s systems have been offline for four weeks.

Ascension warns that remediation of its other systems is ongoing and will require time to complete.


Reader Comments

From Janky: “Re: conferences. How do companies justify the ROI of exhibiting? It’s not like every exhibitor goes home with a fistful of hot leads or commitments for on-site follow-up.” I don’t run conferences, but I’ll describe how I position the value of sponsoring my site that goes beyond lead generation or immediate pipeline building.

  • Everything a company does, including making sales, happens because someone has heard of them, probably repeatedly. One-shot exposure, regardless of the medium, will rarely be enough to seal a deal.
  • Exposure isn’t just to prospects, but also potential partners, acquirers, acquisition targets, investors, executive hires, and consultants who may influence prospects. Most of the sponsors I lose is because a company — very often another of my sponsors –buys them.
  • Our industry has quite a few competitive niches with specific audiences, and conferences and sponsorships will probably reach some who are outside traditional marketing channels.
  • Prospects often make buying decisions based on an early recommendation by a non-C level employee who tips their boss off to a possible solution to their specific problems. You can’t just cold call C-level employees hoping for magic. Don’t ignore the influence that is wielded by attendees and readers who are at the mid-executive level or who are clinicians.
  • It’s impossible to tell which kind of exposure, and to which people, will provide a pathway to success until after the fact.
  • My conclusion is that companies that expect dramatic, short-term, easily-measurable ROI from conference participation or being a sponsor will do a one-and-done because they don’t see that result. Those who see it as patiently building a foundation and making industry connections in often intangible ways will end up reaping the benefit over the longer term.

Webinars

June 6 (Thursday) noon ET. “From Data to Decisions: The Vital Combination of AI and Human Expertise in Patient Care.” Sponsor: DrFirst. Presenters: David Wetherhold, MD, CMIO of ambulatory systems, Scripps Health; Dana Darger, RPh, director of pharmacy, Monument Health Rapid City Hospital; Colin Banas, MD, MHA, chief medical officer, DrFirst. In this Epic Med Management Fireside Chat, two health system leaders will share real-world examples of how AI is working in concert with their clinicians to streamline medication management by populating medication histories into Epic. generating initial drafts of patient conversations, and summarizing complex information. The presenters will also cover the latest developments on the critical and expanding role of pharmacists in patient care.

June 27 (Thursday) noon ET. “Snackable Summer Series, Session 1: The Intelligent Health Record.” Sponsor: Health Data Analytics Institute. This webinar will describe how HealthVision, HDAI’s Intelligent Health Management System, is transforming care across health systems and value-based care organizations. This 30-minute session will answer the question: what if you could see critical information from hundreds of EHR pages in a one-page patient chart and risk summary that serves the entire care team? We will tour the Spotlight, an easy-to-digest health profile and risk prediction tool. Session 2 will describe HDAI’s Intelligent Analytics solution, while Session 3 will tour HDAI’s Intelligent Workflow solution.

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


Acquisitions, Funding, Business & Stock

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Waste Management will acquire Stericycle for $7.2 billion. Stericycle specializes in medical waste disposal, compliance training, and secure information destruction. It sold off its patient engagement solutions business to Carenet Health in 2022. I remember the Stericycle team always having fun, candy-filled booths during the heyday of HIMSS.

UPMC acquires Washington Health System (PA), which includes two hospitals and 18 practices. Washington Health will presumably move its Veradigm inpatient and EClinicalWorks outpatient EHRs to UPMC’s new Epic system.

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Healthcare workflow automation software startup Keragon launches with $3 million in funding. The company specializes in using AI to synchronize patient data across different apps in real time.

Sword Health, which offers AI-powered digital support solutions for issues related to musculoskeletal problems, physical therapy, and pelvic therapy, raises $130 million in financing that increases its valuation to $3 billion. The company also announces a conversational AI tool called Phoenix that conducts natural conversations with patients, provides them with verbal feedback, and summarizes their performance for their clinician.


Sales

  • Visage Imaging signs new customers Consulting Radiology, Nationwide Children’s Hospital, Nicklaus Children’s Hospital, Moffitt Cancer Center, and US Radiology Specialists.
  • WellSpan Health (PA) will enhance primary care delivery with wraparound behavioral healthcare services and technology from Concert Health.
  • Johns Hopkins Health Plans launches a multi-payer portal powered by Availity Essentials to help providers manage benefits, claims, and authorizations.

People

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Adam Hameed, MBA (GrandPad) joins Glooko as president of connected care.

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Baptist Health South Florida promotes Sha Edathumparampil to chief digital and information officer.

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Eagle Telemedicine names Kat Thousand, RN, MHA (Envision Healthcare) VP of clinical services.

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Sherman Sanchez, MHA (BN Consulting) joins Dina as president.

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SSM Health (IL) hires Saad Chaudhry, MPP, MS (Luminis Health) as chief digital officer.

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Health Recovery Solutions promotes Jason Comer, JD to CEO.


Announcements and Implementations

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A new KLAS report finds that the move to the cloud for image viewing and/or storage is happening quickly, with Visage Imaging and Sectra generating both high customer confidence and market interest. Customer perception of Intelerad’s cloud strategy is mixed, while users of GE HealthCare question its ability to execute. Visage Imaging, Agfa HealthCare, and Sectra top the list in “confidence in vendor’s strategy for imaging in the cloud.” The biggest concerns about moving to the cloud are cost, privacy and security, the bandwidth and infrastructure that are required, and system performance.


Privacy and Security

Several London hospitals declare a critical incident and cancel procedures due to a ransomware attack on pathology services vendor Synnovis. The company is a partnership between Synlab UK and Ireland, Guy’s and St Thomas’ NHS Foundation Trust, and King’s College Hospital NHS Foundation Trust.

A judge rules that CMS inappropriately lowered the 2024 Medicare Advantage star ratings of SCAN Health Plan, which cost the plan hundreds of millions of dollars in reduced federal bonuses. As a result, the government will pay SCAN $250 million, which is likely to encourage other MA plans to seek a recalculation of their bonuses. Experts say that the star system doesn’t accurately reflect quality of care.


Sponsor Updates

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  • Groups of Availity HR staff work with Challenges Inc. to build and personalize wagons for Nemours Children’s Hospital and Ronald McDonald House Charities.
  • Wolters Kluwer Health will offer ConsortiEX’s Assure-Trak IV Workflow Management in its Simplify+ compounding compliance suite.
  • Healthcare Growth Partners launches HGP Health IT Momentum Index, which offers a real-time view into health IT M&A, investment value, and valuations.
  • Visage Imaging’s Director of Customer Experience Steve Deaton participates in a new video titled “The Imaging Wire Show: Throwing Out the Imaging Playbook with Apple Vision Pro.”
  • Optimum Healthcare IT publishes a new case study titled “EMR Test Management at Methodist Le Bonheur Healthcare.”
  • Get-to-Market Health founder Steve Shihadeh joins Penn Presbyterian Medical Center’s board of trustees.
  • Loyal announces that its consumer health platform is now available on the Oracle Healthcare Marketplace.
  • Business Awards UK recognizes Altera Digital Health UK with its IT Product of the Year Award for its Sunrise solution.
  • Arcadia publishes a new guide, “3 solutions to master data management.”
  • Arrive Health publishes a new whitepaper, “The Crushing Weight of Prior Authorization and What You Can Do About It.”
  • AvaSure will integrate CLEW’s advanced clinical surveillance solutions with its virtual care platform.
  • Biofourmis will present at the Hospital @ Home Leadership Summit June 5 in Boston.
  • Cardamom Health CEO Vivek Swaminathan celebrates the launch of the Wisconsin Investment Fund, a VC initiative that will initially invest $100 million in startups throughout the state.
  • Clinical Architecture partners with Ready Computing to offer healthcare organizations an industry-leading solution to consolidate, manage, and improve the quality of clinical data at scale.
  • DrFirst announces that its AI-powered SmartRenewal solution earned high ratings from customers in KLAS Research’s latest First Look report.

Black Book announces the 2024 awards for the highest user experience and customer satisfaction in health plan technology and outsourcing, recognizing the following HIStalk sponsors:

  • Symplr – end-to-end provider data management and credentialing solutions.
  • Inovalon – payer cloud platform.
  • Surescripts – payer member safety, PBM, and pharmacy solutions.
  • Availity – clearinghouse alternative solutions.

Blog Posts

Sponsor Spotlight

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Revuud has launched a new AI matching functionality designed to revolutionize talent acquisition. This advanced matching algorithm swiftly sifts through talent profiles, pinpointing candidates whose skills, experiences, and preferences perfectly align with job requirements. By leveraging continuous learning from user interactions, feedback, and successful matches, the system refines its capabilities over time, delivering increasingly accurate and relevant results. This innovation promises significant time savings, expediting the hiring process by rapidly identifying the most suitable candidates.


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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RECENT COMMENTS

  1. The poem: Well, it's not it's not the usual doggerel you see with this sort of thing. It's a quatrain…

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  3. The link in the Seema Verma story (paragraph?) goes to the Forbes article about Judy Faulkner. Since it is behind…

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