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Morning Headlines 8/4/22

August 3, 2022 Headlines No Comments

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

August 2, 2022 Headlines No Comments

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

August 2, 2022 News 5 Comments

Top News

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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

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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.

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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

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

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Northwell promotes Sophy Lu to SVP/CIO.

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

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

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Cardinal Health promotes Michelle Greene, MS to CIO.

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Steven Hendrick (Huron) rejoins Healthlink Advisors as VP.

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

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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

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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.

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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.

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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


Contacts

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

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Morning Headlines 8/2/22

August 1, 2022 Headlines 1 Comment

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

August 1, 2022 Dr. Jayne 1 Comment

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.

Morning Headlines 8/1/22

July 31, 2022 Headlines 2 Comments

Sentry deal doubles Craneware revenue

Scotland-based charge master software vendor Craneware attributes its jump in revenue and earnings to its July 2021 acquisition of US-based pharmacy systems vendor Sentry Data Systems.

Spok Reports Second Quarter 2022 Results

Spok announces Q2 results: revenue down 6%, EPS $0.10 versus –$0.04.

Pediatric Medical Centers Improve the Efficiency of Investigator-Initiated, Multi-Site, Collaborative Research with TriNetX

TriNetX announces members of its Pediatric Collaboratory Network – Children’s National Hospital, WVU Medicine Children’s, Children’s Health, and Johns Hopkins All Children’s Hospital.

Monday Morning Update 8/1/22

July 31, 2022 News 2 Comments

Top News

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Scotland-based charge master software vendor Craneware reports that revenue for the year to the end of June was up 119%. Earnings increased 85% to $50 million.

Much of the jump was attributed to the company’s July 2021 acquisition of US-based pharmacy systems vendor Sentry Data Systems for $345 million at current exchange rates.

Craneware’s entire customer base is in the US, where 40% of all hospitals are its customers.


Reader Comments

From Premature Oraculation: “Re: Oracle rewriting Cerner Millennium. Six to nine months, even to reach a vague beta stage as the Oracle exec says, is not doable.” Agreed. Pharmacy systems are complex, deeply interconnected, and likely to create patient harm if designed or tested poorly. Oracle has the technical expertise to rewrite Cerner pharmacy in less than a year, but they are promising a complete functional redesign of the VA’s version of it. That doesn’t sound like enough time to even convene a VA working group to represent its 171 medical centers, develop basic specifications, and create an approval and signoff structure in both organizations. Even a technical replatforming to modern architecture would be a major undertaking given the testing that would be required, and some argue that expending all that effort just to improve the performance of existing functionality would be a missed opportunity. Still,  give Oracle credit for boldly placing a stake in the ground even though I suspect the company is naively underestimating the complexity of hospital IT systems, especially one that touches patient care directly and that has so many integration points to other modules. Also, whether it makes sense to develop a VA-only custom system and how that would work with customer-facing development tools such as MPages and CCL. I don’t understand why a pharmacy rewrite is important since I haven’t seen publicized VA problems that it would resolve, unless Oracle is talking the ambulatory pharmacy module, which has had some integration issues reported. It’s also true that throwing armies of technologists at a huge development project, especially one that requires endless stakeholder input, doesn’t guarantee a faster or better result.


HIStalk Announcements and Requests

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Poll respondents who plan to attend conferences in the next year are most likely to be found at HIMSS23, a vendor’s user group meeting, or ViVE.

New poll to your right or here: How will Oracle’s acquisition of Cerner impact the VA’s EHR implementation? I’m leaning toward “more likely to be successful” since the project’s challenges – excluding those of the VA itself — are mostly technical and Oracle brings a lot of engineering talent to the table.

Even so, it has been jarring to see how readily Oracle has thrown Cerner under the bus, blaming its lack of technical expertise and its dated architecture after spending $28 billion to buy the company. Maybe Oracle was caught off guard by catching so much congressional heat just weeks after the Cerner keys were handed over. Meanwhile, DoD’s Cerner project hasn’t had many publicized issues or hiccups, which could mean that (a) Leidos as the prime contractor is better than Cerner at keeping federal clients happy or at least quiet; (b) members of Congress aren’t as involved in DoD project oversight or using it to grandstand for their constituents; or (c) the VA’s needs are more complex and heavier on integration with 400,000 employees, care settings ranging from hospitals to private medical practices, and the need to convert data from VistA and other legacy systems going back decades. Project resets are a tough call, as the time spent trying to achieve perfection means losing momentum and enthusiasm. Health system implementations of Cerner, Epic, or anything else are hard enough without politicians dispatching VA OIG to find problems.

I’m pondering the lack of smart edits to date entry everywhere on the web, where the IT shame of Y2K elicited an overreaction of dumbing the computer down to accept only MMDDYYYY dates even when they will always be current or immediate future (like due date, ship date, appointment date, etc.) and it’s pretty obvious that entering “22” means “2022” and not “1922” or “2122.” It’s a contest of whether that wastes more time than clicking “accept cookies”


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

Spok announces Q2 results: revenue down 6%, EPS $0.10 versus –$0.04.

A KHN report notes that two-thirds of hospices are now run as for-profit companies, often by private equity firms. They are paid a fixed daily rate  with little government quality oversight, encouraging them to cut spending and to seek patients who will live longer, such as those with dementia.


Sales

  • LifePoint Health will implement data and analytics solutions from Health Catalyst in its 93 hospitals.

People

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Department of Veterans Affairs promotes Jonathan Nebeker, MD, MS to national CMIO and executive director of clinical informatics.


Announcements and Implementations

TriNetX announces members of its Pediatric Collaboratory Network – Children’s National Hospital, WVU Medicine Children’s, Children’s Health, and Johns Hopkins All Children’s Hospital.


Other

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Bizarre: in Punjab, India, the health minister performs a surprise inspection of a medical college hospital, and finding a lack of cleanliness, orders the health sciences vice-chancellor to lie on a patient’s dirty bed. The 72-year-old hospital executive, who is a spinal surgeon and member of India’s medical regulatory body, resigned over the incident afterward, saying that obtaining a replacement mattress under the government’s laborious purchasing process takes nine months. Critics called the event “cheap theatrics” that will demoralize employees. I’m fascinated by the cultural dynamics that prevented the executive from refusing the demand of the health minister, a farmer who did not attend college and who has no healthcare experience.


Sponsor Updates

  • Optimum Healthcare IT names Krista Bramlage (Cross Country Healthcare) managed services business development executive.
  • Diameter Health releases a new infographic, “How Payers Can Get More ROI on Investments in Clinical Data.”
  • Surescripts releases a new episode of There’s a Better Way: Smart Talk on Healthcare and Technology Podcast, “How COVID-19 Has Upended Assumptions About Care.”
  • G2 names Symplr a leader in clinical communications and collaboration, and HIPAA-compliant messaging.

Blog Posts


Contacts

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

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Morning Headlines 7/29/22

July 28, 2022 Headlines No Comments

Teladoc loses $3 billion in three months, stock plummets 24%

Teladoc Health shares drop 18% on Q2 results: revenue up 18%, EPS –$19.22 versus –$0.86, missing Wall Street expectations for both.

NeuroFlow Launches a Comprehensive Referral Network to Meet Demand for Behavioral Health Care

Behavioral health integration vendor NeuroFlow launches a referral network of behavioral health providers, tele-therapy companies, and tele-psychiatry organizations to expand access to care.

BD Acquires MedKeeper to Offer Cloud-based, Connected Pharmacy Software

BD acquires MedKeeper, which offers cloud-based hospital pharmacy applications for IV verification and medication delivery tracking.

News 7/29/22

July 28, 2022 News 2 Comments

Top News

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Teladoc Health reports Q2 results: revenue up 18%, EPS –$19.22 versus –$0.86, missing Wall Street expectations for both.

The loss was driven by a Q2 impairment charge of $3 billion, which followed a $6.3 billion charge in Q1.

Share price dropped 18% Thursday after the announcement, valuing the company at $5.7 billion. Teladoc’s market capitalization was over $40 billion in early 2021. It paid $18.5 billion to acquire Livongo in the fall of 2020.

From the earnings call:

  • The company is optimistic about its chronic care business that came from its acquisition of Livongo, but its pipeline is slower than expected due to competition and employer financial uncertainty.
  • Its BetterHelp online therapy business grew revenue 40% year over year, which was still on the low end of company expectations as smaller private competitors have priced their services unsustainably low to earn market share.
  • The $3 billion impairment charge was driven by an increased discount rate and the decreased market multiples for other digital health companies.
  • The company will look at its cost structure to maintain near-term profitability and will market bundles of services to prospects.
  • Teladoc is entering into more value-based arrangements, where payment is driven by clinical outcomes or cost savings.

HIStalk Announcements and Requests

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The June 2020 expiration date of my 2016-vintage, seldom-used Asus Chromebook meant it could no longer receive Chrome OS or Chrome browser updates, so I decided to shell out $99 for a comparable Lenovo one from Best Buy. My only requirement was the same 11.6 inch screen, which I like because it’s barely bigger than my standard IPad in a package that weighs just 2.4 pounds. It feels elegant, the keyboard is nice, and when I logged into Chrome OS , everything was right where it was on its predecessor, although that means that the intoxicating new-computer smell was offset by the lack of satisfaction I would have earned from successful setup tinkering. It seems crazy that an entirely usable computer, as theoretically underpowered as it might be, costs less than $100.


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

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Payment integrity platform vendor ClaimLogiq acquires SyTrue, which offers natural language processing technology for medical claims and coding. ClaimLogiq says NLP will give clinicians and coders the ability to make rapid payment integrity decisions.

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NextGen Healthcare reports Q1 results: revenue up 5%, adjusted EPS $0.16 versus $0.25, beating investor expectations for both. NXGN shares are up 15% in the past 12 months versus the Nasdaq’s 18% loss, valuing the company at $1.2 billion.

BD acquires MedKeeper, which offers cloud-based hospital pharmacy applications for IV verification and medication delivery tracking.


Sales

  • Availity is named as the single-source technology partner for California’s provider directory utility.
  • Vizient will offer its members digital patient engagement and behavior change programs from PatientBond.

People

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Malissa Bennett (Optum) joins Curation Health as chief commercial officer.

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Tegria promotes Brian Bircher to RVP of sales.

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Austin Awes (Infor) joins Commure as VP of sales – platform.

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Optimum Healthcare IT hires Chris Mader (TotalTek) as chief revenue officer.


Announcements and Implementations

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AmerisourceBergen launches DTx Connect, which allows patients to access physician-prescribed digital therapeutics and diagnostics via EHR-integrated ordering and patient fulfillment monitoring.

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Behavioral health integration vendor NeuroFlow launches a referral network of behavioral health providers, tele-therapy companies, and tele-psychiatry organizations to expand access to care. The company’s technology performs digital, population-wide behavioral health screening, then provides AI-powered “best next step” clinical decision support for care teams. I interviewed co-founder and CEO Chris Molaro in March 2022, marveling at his pre-entrepreneur background as an assistant clerk to the US Supreme Court, graduating from West Point and then earning a Wharton MBA, and serving five years as as US Army platoon leader with deployment to Iraq.


Government and Politics

Rep. Mike Bost (R-IL) warns that the House Veterans’ Affairs Committee may consider “pulling the plug” on the VA’s Oracle Cerner implementation if its larger sites don’t go live successfully early next year as the VA has promised. Bost also told a committee that the VA’s Cerner project is “a bad investment at any price” and that the project’s cost could be as high as $63 billion over 25 years “if everything goes wrong, and I see a lot of things going wrong.”

Sen. Mitt Romney (M-UT) proposes creating the Center for Public Health Data as an independent data subagency of HHS. It would create a single system of community-acquired infectious disease health data, including aggregating de-identified hospital and laboratory that is already being collected for real-time access. Former FDA Commissioner Scott Gottlieb, MD supports the idea, saying that CDC’s analysis is too slow to assist local officials who are making decisions and it holds the data from outside review until it reaches its own conclusions.


Sponsor Updates

  • Ellkay earns NCQA Data Aggregator Validation designation, which allows health plans to gather supplemental data for quality measures and to prove its validity. 
  • The specialty medication solution of Surescripts is being used by 24% more prescribers year-over-year who generated 8.2 million prescriptions between January and May, saving patients an average of $535 per prescription.
  • RCM solutions vendor Brundage Group will offer its clients integration from Redox to connect to hospital EHRs.
  • InterSystems opens an office in Auckland, New Zealand, to better accommodate new TrakCare customers at Auckland City Hospital and Starship Children’s Hospital.
  • Juniper Networks will exhibit at Black Hat 2022 August 10-11 in Las Vegas.
  • Myndshft celebrates reaching the milestone of 1 million patients served by its prior authorization platform.

Blog Posts


Contacts

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

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EPtalk by Dr. Jayne 7/28/22

July 28, 2022 Dr. Jayne No Comments

I was exited to see a Tweet from my favorite bowtie-wearing crush Farzad Mostashari @Farzad_MD as he shared information about the Aledade FIRST program, which is designed to support medical residents pursuing family medicine. FIRST stands for Fostering Independence, Readiness, Sustainability, and Togetherness. The program strives to better educate new physicians about value-based care and to equip them for successful careers. Aledade will offer the program to up to 20 second-year family medicine residents who will receive additional training in value-based care and practice management while receiving one-on-one mentorship. Residents can also opt to participate in a subsidized clinical experience. In exchange for agreeing to serve for 3-5 years in an Aledade member practice, clinic, or Community Health Center of their choice, residents will receive monthly stipends, signing bonuses, and more. The program is open to those who intend to practice full-time in North Carolina after completing residency. If we truly want to transition to value-based care, we need clinicians who understand the model and how to maximize patient outcomes. I’ll be looking forward to following it over the next several years.

Lately, I’ve been receiving some random faxes intended for other providers, which I can only assume is from crossed wires deep in some database somewhere. My practice has been trying to correct it, but I suspect it will take some time. Given that context, I was interested to see this Kaiser Health News piece about the challenges of inaccurate provider directories. The article’s introduction is painfully true: “If you have medical insurance, chances are you’ve been utterly exasperated at some point while trying to find an available doctor or mental health practitioner in your health plan’s network.”

As an urgent care physician, I saw hundreds of patients in that situation who ended up in front of me because they didn’t know where else to turn after finding out that the wait was too long,  in-network providers weren’t taking new patients, or providers no longer participated in their insurance plans. Many of these patients needed specialty care that we were not equipped to provide, and they became even more frustrated when they learned that we couldn’t help.

Despite regulations that require accurate provider directories, they’re often a mess. The article cites a study from the Journal of Health Politics, Policy, and Law that found that in a best-case scenario, patients could only schedule timely appointments for urgent issues with about half of the physicians listed in a directory. The worst-case scenario was 28%. For general medical appointments, best case was 64% and worst was 35%. The article notes the challenges in getting providers to update their files with each payer, but from experience, even when providers do provide updates, they are often not incorporated.

Case in point – my previous employer sent termination notices to all plans when I left the practice. I was copied on all the communications. Even as recently as last month, one payer sent me multiple notices that I needed to update their directory and didn’t respond to my attempts to clarify that I hadn’t been a participant in well over a year.

The article closes with some good advice for patients who might find themselves fighting an out-of-network charge despite thinking that a provider was in-network. It recommends taking a screenshot of the provider directory showing the provider’s name, calling the physician office to confirm, and taking notes of the name of each person that was spoken to. That’s more work than the average patient is going to do, even assuming they know that it’s a good idea, which most don’t. Despite recent “no surprises” legislation, fighting unanticipated out-of-network bills is still an irksome task even for those with experience.

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The American Academy of Family Physicians was on fire regarding healthcare technology topics in the recent issue of its FPM Journal (previously known as Family Practice Management). One article looked at strategies for reducing documentation burden through EHR simplification. It called out the fact that changes to documentation require buy-in from leadership, appropriate resource allocation to make changes, and adequate support for implementing change.

The author provides an example of institutional policies not keeping up with government simplification of Evaluation and Management guidelines. Their project team engaged subject matter experts to identify ways in which documentation could be simplified, used clinician surveys to identify problematic workflows, and worked with technology teams to identify the best solutions. The authors also noted the need for providers to take advantage of basic EHR functionality such as templates or exam defaults, along with time management strategies such as completing notes throughout the day rather than saving them for the end of the day. I continue to see physicians who will complain endlessly about EHR templates that don’t meet their needs, but who are unwilling spend the time to update them to better suit their needs. If the article spurs even a handful of physicians to take steps to improve their workflows, it has value.

The second article that caught my eye listed five administrative tasks where technology could improve physician workflow. The list includes some features that are readily available in EHRs, including the calculation of patient risk scores and synthesis of data needed to facilitate pre-visit planning. The list also features technology-assisted workflows, such as using voice recognition for visit documentation and using digital solutions to assist with prior authorization tasks. Although many practices are using EHRs, I would wager that a minority are fully optimized and there is still much for clinicians to incorporate into their day-to-day workflows.

The third article addressed quality metric reporting and why practices are struggling to rebound from the impacts of COVID-19. It highlights three burdens impacting practices: the emotional burden, the workload burden, and the payment burden. Technology can help with workload through automation and delegation, allowing diverse members of the care team to assist in closing care gaps and recommending services for patients. It can also help with the payment burden through solutions that promote improved charge capture, demonstration of higher quality in the face of risk-based contracts and ensuring that incentives are maximized. As noted in the previous articles, these efforts take time and resources, but it’s important for organizations to understand that making the effort now will pay dividends in the future and to provide leadership to make changes a reality.

How is your organization using technology to bolster struggling primary care practices? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 7/28/22

July 27, 2022 Headlines 2 Comments

Payment Integrity Leader ClaimLogiq Acquires NLP Pioneer SyTrue

Payer-focused payments company ClaimLogiq acquires healthcare natural language processing technology vendor SyTrue.

NextGen Healthcare Reports Fiscal 2023 First Quarter Results

Despite Q1 revenue growth, NextGen’s revised 2023 revenue and earnings estimates cause shares to drop 5% in after-hours trading.

VA’s $16 billion health records overhaul may be scrapped if fixes aren’t made

House lawmakers say VA administrators will have to seriously consider pulling the plug on its EHR modernization efforts if improvements aren’t made in time for further roll outs early next year.

Readers Write: The Next Frontier for Healthcare Consumerization

July 27, 2022 Readers Write No Comments

The Next Frontier for Healthcare Consumerization
By Aaron Fulner

Aaron Fulner, MS is senior director of product marketing at Edifecs of Bellevue, WA.

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The pandemic accelerated consumers’ move to the driver’s seat of their healthcare. Consumers are using digital health devices now more than ever and are demanding a personalized, on-demand healthcare experience. To meet these heightened expectations, the healthcare industry needs to better stitch together all of the pieces – telehealth, artificial intelligence (AI) and machine learning, and interoperability standards – to create a comprehensive delivery model. A model, where data can be exchanged quickly and accurately. This is the next frontier for the consumer healthcare movement.

To reach this next stage, the healthcare industry needs to ensure data can be shared seamlessly across the healthcare system to best equip providers with real-time health information. Here’s how we get there:

Expand Telehealth from Acute Care to Chronic Condition Management

It’s no secret that telehealth use skyrocketed during the pandemic. Even following its peak in 2020 and 2021, telehealth usage is still 38 times higher than prior to the pandemic. Patient and provider muscle memory is changing, and telehealth is now the go-to for urgent care needs. The next chapter of the telehealth story includes a movement from tele-urgent care to telehealth for chronic care management and preventative care. This is especially important as 40% of adults in the U.S. reported avoiding medical care due to the pandemic. This means providers are playing catch up to ensure patients’ routine and preventative care needs are met.

Additionally, as providers work to offer comprehensive care to patients, they must have access to rich datasets about each patient. This includes using administrative information from encounter and enrollment files as well as clinical data stored in electronic medical records.  A comprehensive view of a patient enables the provider to be an informed partner in the care of a patient.

Integrate Artificial Intelligence and Machine Learning into the Internet of Things

Beyond telehealth, consumers are embracing the Internet of Things (IoT) to monitor their health at home. These digital health devices – smart watches, exercise bikes, glucose monitors, etc. – are used by more consumers today than ever before. For example, a recent Rock Health analysis found that digital health wearable ownership increased from 13% of consumers surveyed in 2015 to 45% in 2021.  The question remains: How can the industry enhance the impact of these tools with machine learning and artificial intelligence (AI)?

Remote monitoring devices combined with machine learning and AI create a powerful tool for providers by delivering real-time information and changes in patient health. For example, if a patient’s glucose is low, a glucose monitoring device with a layer of machine learning and AI proactively sends a notice to their provider to reach out and determine if a change in their care plan is appropriate. Ultimately, this gives providers the data to intervene earlier, work with more patients at a time, and improve margins.

Connect Consumer Digital Health Device Data with Provider Workflows

This increase in digital health tool utilization is ushering in a flood of new patient data. To move forward, the industry must integrate siloed data into provider workflows so providers can deliver holistic care. Connecting consumer health data with provider workflows signifies the convergence of healthcare and business data management standards.

To date, the Health Insurance Portability and Accountability Act (HIPAA) and recent interoperability rules declare the consumer as the agent of personal health data. Meanwhile, Health Level Seven International (HL7)’s Fast Healthcare Interoperability Resources (FHIR) and the Da Vinci Project have established the technical standardizations with consumer data and how it is exchanged across stakeholders.The Office of the National Coordinator for Health Information Technology (ONC) is leading the final push through its Trusted Exchange Framework and Common Agreement (TEFCA), which outlines business rules for data exchange and determines allowable uses for payment, reimbursement, and care data without consumers’ permission. The last mile for closing this gap between consumer data, payer, and provider workflows lies in empowering service providers to adopt these standards industry-wide.

The key to the future of healthcare consumerization is to determine how data is exchanged across the healthcare industry to better inform care, improve provider workflow, and integrate digital health data solutions into one place.

Readers Write: The ABCs of Using NLP for SDOH

July 27, 2022 Readers Write 1 Comment

The ABCs of Using NLP for SDOH
By Marty Elisco

Marty Elisco, MBA is CEO of Augintel of Northbrook, IL.

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It has been established loud and clear: social determinants of health (SDOH) have a huge impact, even more than physical health, in determining the overall well-being of individuals. Yet obtaining an understanding of how specific SDOH factors affect individual patients is extremely difficult because SDOH data is not methodically collected by clinicians and social workers. This is a problem.

Unfortunately, it is just too difficult and time-consuming for clinicians to make sense of all the SDOH data because most SDOH data is buried in patient notes. This ultimately inhibits their ability to consume the data to inform decisions about individuals receiving care.

Natural language processing (NLP), a key discipline of AI that uses computers to understand the written word, tackles this problem head on. I encourage hospitals and health and human services organizations to explore NLP in their practices, particularly as technological innovation in this area is rising across healthcare.

Listed below are the simple ABCs of why health and human services organizations and hospitals should adopt NLP to make sense of SDOH. But before diving into the list, I want to emphasize: the technology is now here. NLP has matured significantly over the last five years, and it is now a proven method to extract key concepts in narrative healthcare data, such as SDOH, from text.

Cost Savings and More Efficient Care

Clinicians and case workers spend an overwhelming amount of time combing through narrative data — for example, reading typed or handwritten patient notes and case notes — to understand the status of their patient and think through potential courses of treatment. All of this time spent reviewing unstructured data is time that could be better spent in any number of ways, such as spending more time with patients.

The beauty of NLP is that it automatically highlights impactful indicators and trends across case or patient notes, thereby quickly revealing SDOH to the case workers and clinicians on the case. An NLP platform relieves health and social services workers of the time it takes to comb through the staggering amount of records by readily highlighting SDOH across a case.

Improved Outcomes

NLP empowers caseworkers and clinicians with the information they need to make impactful decisions and allow supervisors to maximize quality of care delivered. This is because NLP provides a deeper understanding of a patient or case.

The Gravity Project is a national public collaborative creating diagnostic codes for SDOH factors with the goal of having those codes incorporated into the existing list of medical diagnosis codes. The idea for the Gravity Project originated in 2017, and prior to then, hospitals and health and human services organizations had no way of incorporating SDOH into their care besides entering it in free-form into patient notes, even though it is now widely understood that a range of social, environmental, and economic factors impact health status often greater than the actual delivery of health services. NLP can extract the information in unstructured data and translate that to Gravity codes to support the diagnostic process. These diagnoses can lead to treatments and interventions that improve outcomes.

Risk Mitigation

NLP enables organizations to quickly identify patients at the highest level of risk so interventions can be provided. I firmly believe that you can only truly identify risk by understanding what is included in the narrative data. Most risk stratification systems today simply look at claims data to do this. But claims data is an incomplete picture. If care coordinators had a full picture through SDOH, then they would have a much better tool to identify those who are at most risk, and where early interventions can be referred to prevent serious health conditions from occurring.

The case for using NLP is as easy as ABC. Described above are three tangible benefits to hospitals and health and human services organizations for incorporating NLP into their practices. All players in the healthcare ecosystem share the ultimate goal of improving outcomes while saving costs, and NLP is a surefire way to do just this.

Morning Headlines 7/27/22

July 26, 2022 Headlines No Comments

Clearwater Adds 24/7 Managed Detection and Response Services and HITRUST, CMMC and PCI Certification Services Through Acquisition of Tech Lock

Healthcare cybersecurity, compliance, and risk management vendor Clearwater acquires RevSpring subsidiary Tech Lock, which offers similar services for a variety of industries including healthcare.

Mayo Clinic, Mercy Collaborate to Globally Transform Patient Care

Mayo Clinic and Mercy announce a 10-year partnership in which they will transform their de-identified treatment and outcomes data into actionable insights for improved patient care.

RLDatix Acquires Galen Healthcare Solutions

Governance, risk, and compliance vendor RLDatix acquires Galen Healthcare Solutions, which offers system support, implementation, optimization, data migration, and cloud-based legacy system retirement.

Elation Health Announces $50M Series D for Innovative Primary Care

Primary care EHR vendor Elation Health raises $50 million in a Series D funding round, increasing its total to $109 million.

3M Announces Plans to Create Long Term Value Through Spin-Off of Health Care Business

3M will spin off its healthcare business into a stand-alone company focused on health IT, wound care, oral care, and biopharma filtration.

News 7/27/22

July 26, 2022 News 3 Comments

Top News

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Governance, risk, and compliance vendor RLDatix acquires Galen Healthcare Solutions, which offers system support, implementation, optimization, data migration, and cloud-based legacy system retirement.

The CEO of RLDatix is industry long-timer Jeff Surges (Healthgrades, Allscripts, Merge Healthcare).


HIStalk Announcements and Requests

The wildly uncertain intricacies of email delivery, spam filters, and company email server policies mean that HIStalk update subscribers are constantly falling off my list as undeliverable, often without realizing it. Sign up and you’ll know first when I post something new. You won’t get spam from me or anyone else and don’t worry about getting multiple emails – the list ignores duplicate email addresses.


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

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Healthcare cybersecurity, compliance, and risk management vendor Clearwater acquires RevSpring subsidiary Tech Lock, which offers similar services for a variety of industries including healthcare. Tech Lock leadership will transition to senior roles within the new Clearwater subsidiary.

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Former pharma bro and just-released federal convict Martin Shkreli launches Druglike, a drug discovery software platform. He says its use will benefit patients with rare disease, which a cynic might add would include those parasitic disease sufferers who saw the price of 60-year-old drug Daraprim jump from $14 to $750 per tablet after it was acquired by the former hedge manager’s company. Druglike will run computational chemistry problems on the computers of “miner” users who will be paid in tokens called MSI (Martin Shkreli Inu).

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Theator, which uses AI to derive insights from surgery videos, announces a Series A funding round of $39.5 million. Mayo Clinic joined the round as an investor and commits to using the company’s video analytics.

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Automated patient intake software company Health Note raises $17 million in a Series A funding round led by SignalFire.

3M will spin off its healthcare business into a stand-alone company focused on health IT, wound care, oral care, and biopharma filtration. 3M had attempted to sell off its health information systems revenue cycle and software business earlier this year.

AI-powered data quality company Cornerstone AI raises $5 million in seed funding.

Cloud, managed services, and analytics company Healthcare Triangle opens an office in Singapore, where it expects to create 500 jobs over the next five years.

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Cleerly raises $192 million in a Series C funding round, bringing its total raised since launching last year to $248 million. The company has developed predictive intelligence and clinical decision support software for patients with heart disease.

Columbus-based chronic condition management technology vendor AndHealth will triple its headcount in a new space downtown. The company was launched in 2021 by CEO Matt Scantland, who sold his previous company CoverMyMeds to McKesson for $1.1 billion in 2017. I interviewed him in February 2022.

7wireVentures portfolio company Caraway emerges from stealth mode with a $10.5 million seed funding round. It will offer mental health, reproductive, and physical healthcare services to college-aged women.

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Primary care EHR vendor Elation Health raises $50 million in a Series D funding round, increasing its total to $109 million. Ascension Vendors and Jonathan Bush were among the round’s participants.


Sales

  • Presbyterian Healthcare Services (NM) selects Commure’s Strongline staff safety alert system to better protect employees at its 70 facilities.
  • Deep River & District Hospital, Kemptville District Hospital, and Winchester District Memorial Hospital in Ontario will go live on Epic in November.
  • Akron Children’s Hospital will use analytics and population health management software from Health Catalyst.
  • St. Dominic Hospital and and Southwest Mississippi Regional Medical Center will go live on Epic next year through their affiliation with Franciscan Missionaries of Our Lady Health System.
  • UPMC (PA) signs a five-year contract with Microsoft for its cloud computing, AI, and machine-learning software.
  • Cooper University Health Care (NJ) will implement Sectra’s enterprise imaging technology.

People

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Harsha Panyadahundi (Wolters Kluwer) joins Sharecare as CTO.

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CareJourney names Mah-Jabeen Soobader (Archway Health) chief analytics officer.

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University of Florida Health promotes Jiang Bian to the new role of chief data scientist.

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Brad Porter (Fisher & Paykel Healthcare) will become CEO of Orion Health when his father-in-law, Orion founder and CEO Ian McCrae, steps down in late August. McCrae will remain involved as an executive director focused on products.

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Teladoc Health names Mike Waters (Providence) COO.

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Jerald West, PhD (AdvanSix) joins Access as CISO.

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Change Healthcare promotes Benjamin Gold to VP of product management.


Announcements and Implementations

Vital announces GA of CareAdvisor, whose tools track health progress and discharge readiness and and offer care plans and educational content.

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Experity adds a business intelligence module to its EHR and practice management software for urgent care clinics.


Government and Politics

Sources report that the Roseburg VA Health Care System’s Cerner-based EHR went partially offline for several hours last week due to a system overload that affected patient registration.


Other

An AMA survey of consumers finds that 92% think their health data shouldn’t be sold, and while most respondents are comfortable with their doctors and hospitals using their data, they are least comfortable having it used by a prospective employer or technology companies. Nearly all want app developers to disclose how their data is used, 88% think hospitals and doctors should review apps before they are given access to health data, and 75% want the chance to approve use of their data in advance and to be able to opt out.

Studies find that despite federal and state requirements for health plans to keep their provider directories current, consumers are still wasting time trying to book appointments with listed providers who no longer take insurance or new patients, and in some cases, receive services only to be charged out-of-network prices because of insurer directory errors.


Sponsor Updates

  • Experity will host the 2023 Urgent Care Connect conference February 22-23 in Aventura, FL.
  • EClinicalWorks releases a new customer success story featuring Orthopaedic Institute of Ohio, “Prisma: How Better Data Improves Care and Reduces Costs.”
  • AGS Health publishes a new e-book, “5 Reasons to Select AGS Health as Your Offshore Service Provider.”
  • OptimizeRx partners with Cooler Screens to offer healthcare advertising agencies  a pharmacy advertising presence for their pharma clients via retail surfaces, such as the doors of in-store coolers.
  • Bamboo Health sponsors the National Association of State Mental Health Program Directors Annual 2022 Meeting.
  • Cerner publishes a new client achievement, “The University of Tennessee Medical Center automates processes to optimize throughput and reprioritize valuable resources.”
  • Nordic releases a new episode of its “DocTalk” video series.
  • CloudWave announces the availability of its OpSus Recover disaster recovery service in the AWS Marketplace.
  • The B2B Leadership Podcast features Dimensional Insight VP of Marketing Kathy Sucich, “How Putting Employees First Makes You a Better Leader.”
  • Divurgent will present at the Arch Learning Collaborative Summit July 27.
  • Optimum Healthcare IT joins TriZetto Consulting Partner Network. 

Blog Posts


Contacts

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

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Morning Headlines 7/26/22

July 25, 2022 Headlines No Comments

Theator, an AI platform that analyzes surgery videos, closes out its Series A at $39.5M

Theator, which uses AI to derive insights from videos of operations, caps its Series A funding round at $39.5 million.

Your Pediatrician is a Message Away: Announcing Summer Health and our $7.5M Seed Round from Sequoia and Lux

Text message-based concierge care provider Summer Health announces $7.5 million in seed funding.

VA Roseburg medical center hit with electronic health records outage

The Roseburg VA Health Care System’s Cerner-based EHR went down for several hours last week due to a patient registration programming glitch.

HIStalk Interviews Matt Roberts, Healthcare Industry Practice Lead, Juniper Networks

July 25, 2022 Interviews No Comments

Matt Roberts is global practice lead, healthcare industry of Juniper Networks of Sunnyvale, CA.

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Tell me about yourself and the company.

I’ve been in healthcare IT for over 20 years. Right out of college, I started working in network closets, doing desktop rollouts as part of an internship with Health Midwest back in 2000. I was supporting one of the first Cerner Millennium projects in Kansas City, which led to them offering me a job that I accepted. I worked for Cerner for 10 years, living in hospitals and clinics. I helped them set up one of the first HIEs at the Tiger Institute at University of Missouri. I had an offer come my way to take my healthcare expertise over to the networking industry and I joined a company called Brocade. I led their healthcare go-to-market for roughly six years before we were acquired.

I’m now at Juniper, which is a pure play networking and security company. We are absolutely focused on delivering simple and secure experiences for those who run the networks, and even more importantly, the patients, the clinicians, and the staff who depend on the network.

What are the biggest network challenges of health systems?

We see a lot of Band-Aided networks. I’m a big fan of treating the cause, not the symptom, so when we  look at what happened through the pandemic, there was a lot of stress. It was a dark place for all of us. We all have our own experiences, but it was tough. Through tough, we find ways to innovate.

During this time, many providers discovered that their network should have, and could have, been a more strategic asset, probably more so than originally perceived. We walk up to a water faucet, we turn it on, and we expect water to come out. That was the perception of the network. Until it goes down, nobody really cares. But we have seen the whole delivery model shift, so we have moved to a more virtual model and distributed model, Everything is Internet of Things.

As things continue to shift, you have to take a look at the network. It has become more important. A healthy network puts the organization in a position to scale, to integrate emergent technologies. The chief nursing officer walks in and says, “I need this technology connected today.” IT has always been a “no” center. It has to become a “yes” center and say, “We are going to be able to accommodate that for you and figure out how to integrate it into the workflows.”

How extensive is the need to re-architect health system networks due to consolidation, where new care venues of all kinds need to be brought into the connectivity fold?

Consolidation and acquisition play a major role in being able to integrate the technology seamlessly. As seamless as some of it sounds, you are also often acquiring organizations that don’t have the same standards that you have. How do you rely on integrating proprietary technologies and the way things have been architected at a technical layer from a topology standpoint? You may have to unwind some things to get that new system on board, whether it happens to be multiple hospitals or multiple clinics. It plays a critical role.

Open standards, or standards-based technologies, are important for this exact purpose. Being able to onboard quickly, to integrate seamlessly, and to provision your networks more efficiently, as opposed to having to wait weeks, months, and even sometimes years when you start to get into the project work.

Is it challenging to bring those new locations and networks up to security standards?

Yes. Security gaps are everywhere. The harsh reality is that no one vendor does it all. When you start to look holistically at the security posture of the organization, we are doing something differently at Juniper. We treat the entire network as an enforcement domain, looking at every connection point that exists within your network. It’s not just next-generation firewall, DLP, or an ATP appliance or software. Cyber criminals are getting smarter, where minutes, much less days and hours, aren’t fast enough. How do you identify and mitigate a threat immediately as it comes in?

I use the analogy of how many locks you have on your door at home. You have deadbolt, a push button, an extra lock, a Ring doorbell, and maybe a German Shepherd behind the door. You have multiple layers of different protection. When you look at your security posture, there’s not a one-all, be-all.

Healthcare is among the top industries, maybe number one, for cyber criminal activities because the information is so rich. You have to look at new ways instead of just throwing a bunch of firewalls out. Protect the entire domain and know what’s going on in the entire domain. Then be able to identify something that looks fishy and shut it down so it doesn’t propagate through the entire network.

What changed during the pandemic?

The network is the lifeblood of the healthcare enterprise, like the vascular system of the human body that pumps our blood to and from the heart. The network is your vascular and immune system. If you don’t have a healthy network, the organization is at risk. The pandemic created gaps. But we see positivity as people understand how strategic the network is. It’s not just watching how the packets pass and getting bits and bytes to their destination without latency. You have to look at the whole thing, the hard and soft costs around the economics. Are you buying the same brand because that’s all you’ve known for the last 20 years? Look at what’s fit for purpose. Look at what molds well to what your organization is trying to do. Are there better organizations out there that are leading edge about trying to help also make you more efficient?

That’s where we come in. We are focused  on experiences. If you’re the IT operator, on the network or help desk teams, or an end user such as a doctor or nurse or a radiologist sitting at home, how can that network work for you? Or how can you not have to pick up the phone and call the help desk if you’ve got a really crappy connection? We are starting to see small, medium, and large entities, from smaller hospitals to larger health systems, looking at the network. It’s exciting because they are looking at newer technologies that are different from what they have done over the past 20 years. 

The industry has evolved so much. It involves AI. It involves a lot of capabilities that have moved beyond the marketing hype that allow you to focus on not only delivering a 24/7/365 experience, but to put you in a position where the network is working for you versus having to dig and spend hours trying to troubleshoot issues. That’s where we can help as well.

How are organizations using indoor location services?

When I talk about location services, everything is built into our access point. Think w-fi. We use what’s called virtual Bluetooth low energy. We have a patented array that sits in the access point. We are the only one in the industry that does that. In the Gartner Magic Quadrant for indoor location services, we are in the leader quadrant far over to the right. We are the only networking vendor in that particular space.

Delivering location services is a journey, to be fair. An organization has to have a strategy around that. It starts at looking at the use case. Maybe you want to greet people as they walk in the front door and offer them a turn-by-turn indoor navigation experience because of late or missed appointments or people getting lost throughout the facility. Maybe you want to track critical medical assets because wheelchairs and pumps are getting lost – studies have found that 20 to 30% of mobile medical equipment is lost or stolen. You can deliver these location services directly off of wi-fi now instead of buying a bunch of different pieces and parts and overlay RTLS systems.

However, we integrate seamlessly with those. We’re an open standards-based company. The value for healthcare is to look at open API strategies, to look at exchanging SDKs and other software defined kits, to integrate into other entities like Stanley and CenTrak so you don’t have to do a rip and replace. Cost preservation is big in healthcare. I’ve been in healthcare 20 years and I want to save healthcare a lot of money and make it more efficient. We seeing an uptick in all the different types of location use cases to get a consumer engagement platform in place. Hospitals and health systems can engage with patients and guests while also helping their staff become more productive.

What about proximity alerts involving visitors or employees?

It is opening more opportunities. It creates this platform for IOT, but it also creates a platform for at least understanding who is coming into your facility. We don’t record PHI. We’re just looking at devices. If you walk in with a  Bluetooth capable or enabled device, such as a phone, it  can be detected. You see this in retail, hospitality, and a lot of different industries. We can get within one to three meters, or even closer to the one-meter mark by using  BT11 devices.

That lets you understand what is happening with your facility’s foot traffic. It came more important in the heat of COVID for proximity tracing and dwell times. If a facility needs to disperse a hot zone, they can push a notification out to everybody who was congregating when they shouldn’t have been. We can do these directly out of our dashboarding capabilities and the integration work that we can do with engagement type devices over mobile.

What healthcare developments will we see in the company and the industry over the next few years?

We literally are changing the game again. The accolades are out there. Everybody can go look and see from a lot of the analyst community and industry recognitions that we truly are improving the end-to-end visibility. Insights into users, devices, and applications creates a fine-tuned experience for clinicians, patients, and the people who are running the networks.

We are dramatically simplifying the operation. Using AI to proactively notify IT when there’s a problem, provide a fix, and automatically open up trouble tickets in ServiceNow or whatever your ticketing system is. Imagine not having to chase a doctor or nurse to ask them to re-create an issue. We are eliminating all of that.

Nobody has seen this in healthcare. It’s a foreign concept, and it sounds too good to be true, but the reality is that we are changing the dynamics of how we make people more efficient. Talk about provisioning all those acquired clinics and hospitals as we mentioned before. We can use the cloud and microservices so that the AP and the switches are ready. As soon as you acquire somebody, and you have plans to basically roll out a new network, with single-click activation it literally can be plugged in as soon as you ship it to that device. Or let’s say that the clinic is two hours away and somebody can’t travel there, you can have somebody do this over distance, reducing the truck rolls, the touches, provisioning networks by 50 to 70% better.

Nobody has seen it in healthcare, and this is where we get excited. This is where I get excited sharing my message with you on what we’re doing. We are at an interesting time where people are coming out of the pandemic and doing digital transformation initiatives. The network should be considered when you start throwing all of these other things on top of it. That’s your foundation, and we want to make sure that you have the most modern foundation that is possible, one that can scale for many, many years.

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