Netsmart acquires post-acute care data analytics vendor SimpleLTC and professional services and consulting firm Selman-Holman, which it will combine with its McBee consulting division.
VA Secretary Denis McDonough says the department’s review of Cerner implementations has concluded and that a timeline for remaining implementations will likely be available in mid-July.
I was born and raised in Houston, Texas. I did my undergrad degree in Europe and then started medical school. I finished up my medical training in Chicago. I’ve been in the EHR space for about 11 years now. I worked for some pretty big consulting companies through 2017 and then started ReMedi Health Solutions, so we are five years in now.
What post-pandemic changes are you seeing with the company and its customers?
When the pandemic hit, we saw everything change, either going virtual or shutting down certain aspects of what was happening in the hospitals. Rightfully so, because of everything that was happening, especially with some of our clients in the Northeast that were being hit with COVID a lot harder than we were down south at that time. What I saw was quick adoption of tools that already existed. I didn’t see anything new come up. I just saw a bunch of people take platforms or technology stacks, put them together, and create what they needed.
Post-pandemic, we assumed that we would have a hybrid model, or even not going back at all to what the norm had been. But I feel like we are getting more back to normal than we had originally anticipated. Some of the workforce wants to be back in the office. They’re trying to get out of the space that they’ve been in for the last 18 months. People are also seeing a different type of productivity versus at home or in the office.
Many health systems are operating under a budget that was created during the pandemic’s bleakest times. Are they reconsidering their priorities or just making it up as they go?
A little bit of both. They were making it up as they went, but now I l feel like the budgets are coming back into the plans they originally had. It is all coming back as if it hadn’t taken that 12- to 16-month pause.
How do you combine the value of a remote go-live with the benefit of having people wandering the halls looking for puzzled or frustrated clinicians who probably won’t open a help desk ticket?
That’s one reason that our virtual model includes a live video feed. It gives the feeling that somebody is there. But your example is why we need some folks to be on ground. We need this hybrid model to engage the physician who we won’t find sitting on a computer or being in a newsfeed, where you could see frustration in any end user. The live feed makes sure that we maintain that emotional connection, but you could have five tablets with one resource supporting all five of those clinics at the same time. The support model will definitely change post-pandemic, and instead of bringing 1,000 resources, you figure out how to bring in a hybrid model of on-site versus remote.
Are you seeing health systems that are worried less about physician EHR satisfaction and instead see the EHR as a way to implement corporate decisions that may take away individual physician choice?
I do see it, but I’m also seeing more physicians getting involved in the administrative side of things, making sure that the right decisions are made for the physicians. That was one of the reasons we came about — we essentially understood both sides of the playing field. It was our job to be that liaison, to help the physicians understand why these decisions were being made from an administrative level. Then on the flip side, help explain to the administrative side of things of why physicians needed certain things.
It is getting harder for physicians to what they need, but it’s also getting more complicated on the IT side as well, where you see both sides of the story.
Are you seeing physician EHR dissatisfaction that is driven by local implementation decisions rather than core product design?
That definitely is one of the reasons. Sometimes what I see, and have seen in the past, is having the knowledge of what the tool can do and how it can drive the efficiency that we are all trying to achieve. Sometimes it starts as simply as that. We’ve seen this across the board. You don’t know what you don’t know. Physicians who I’ve known and worked with have dug into these systems over the last decade and could probably answer any question that a physician might have on what and how they need to do something. They have the inefficiencies in both ways.
When we talk about certain changes, we know there’s a lot that goes behind getting something changed like that. Nine out of 10 times, the physicians will be satisfied, but they just don’t know how to do it. That comes back to, are we talking about training, or upgrades, or new additions? These systems have the capability of doing a lot more than the way the physicians are using them now.
Health systems have said in various recent KLAS reports that they wish their software vendors would take a more active role in telling them how to implement and optimize their systems. Are you seeing more demand for a prescriptive approach that takes advantage of broad vendor experience?
Absolutely, and it makes sense. Why would we not explain these certain milestones or scenarios in the implementation in a better way? We were working with a client 18 months prior to them hitting the switch on the EHR that they had selected. The EHR vendor had a list of items that they were going to run through, but at the end of the day, there was no explanation or details in what needed to be done. Some of these bullet points were engagements that would have taken one or even two months. That is misleading the client.
The consulting company and the EHR vendor have to help them guide and understand the decisions that they are making to maximize satisfaction as a whole for everyone. Not only the end users, but the people who made the decision to bring that EHR vendor in.
Are metrics used to identify users who are struggling or functions that aren’t being used optimally?
We live in a data-driven world. Every metric and every data point that we can grab helps us make a better decision. It helps us explain to our clients, as well as to the vendors, why and how this is happening and how we can mitigate the issue. I don’t look at it as a ticket, but something more detailed than that, that has helped us get success. We have to collect information from one-on-one sessions and at-the-elbow support to get a bird’s eye view and understanding of what’s actually happening.
What changes do you expect to see in the company and in the industry over the next 3-5 years?
Three to five years ago, I thought all of this implementation and conversion activity was going to end. But it seems to be constant due to mergers and acquisitions and systems deciding to replace or upgrade software. We may see the same types of engagements in 3-5 years that we are seeing now. I only hope that we are getting better and better as a whole, the EHR vendors, the hospital organizations, and the consulting companies. How can we make this process better for the actual end users who are going to be using these systems on a daily basis? Can we get rid of the term physician burnout?
Do you have any final thoughts?
We are thankful where we’ve gotten to over the last five years. We’re thankful for all our clients that have trusted us. We are still working with our first client, all the way until our last client. Our firm appreciates that, knowing that we’re giving the value that we said we would. For that, we are thankful for the hospitals that took a chance on us.
Harris acquires physician practice and hospital software vendor Ingenious Med.
Webinars
June 30 (Wednesday) 1 ET. “From quantity to quality: The new frontier for clinical data.” Sponsor: Intelligent Medical Objects. Presenters: Dale Sanders, chief strategy officer, IMO; John Lee, MD, CMIO, Allegheny Health Network. EHRs generate more healthcare data than ever, but that data is of low quality for secondary uses such as population health, precision medicine, and pandemic management, and its collection burdens clinicians as data entry clerks. The presenters will review ways to reduce clinician EHR burden; describe the importance of standardized, harmonious data; suggest why quality measures strategy needs to be changed; and make the case that clinical data collection as a whole should be re-evaluated.
Previous webinars are on our YouTube channel. Contact Lorre to present your own.
Acquisitions, Funding, Business, and Stock
Providence Ventures invests in RxRevu one year after its affiliated health system in Seattle deployed the company’s SwiftRx real-time prescription benefit software.
Stone Point Capital acquires and combines Verisys and Aperture Health, creating a company focused on credentialing, enrollment, and provider data management. Aperture Health CEO Charlie Falcone will lead the new company.
Utilization management software and physician services company Xsolis secures a $75 million investment from Brighton Park Capital. The company recently hired Mandy Cruz (Sunquest) as VP of customer delivery and Tim Mueller (Optum) as VP of client success.
Healthcare governance, risk, and compliance solutions vendor RLDatix acquires UK-based Allocate Software,. which offers human capital management solutions.
Hospital IQ, an operational management software vendor based in Massachusetts, raises $25 million in a Series C funding round.
Nearly 500 One Medical employees (excluding physicians and other clinicians) announce their intent to unionize to address the mistreatment they say they’ve suffered during the pandemic. Their complaints include:
The company’s mismanaged COVID-19 vaccine program, which wound up making national news after company whistleblowers alerted the media to the fact that ineligible patients – some with ties to leadership – received the vaccine ahead of eligible patients, resulting in a congressional investigation.
Sub-par care for community members who couldn’t afford One Medical’s typical membership fees.
One Medical went public earlier this year, and acquired senior-focused primary care company Iora Health several weeks ago for $2 billion.
Sales
CyncHealth, an HIE that serves seven Midwestern states, selects Lyniate’s Rhapsody software to improve participant onboarding, privacy, and security.
Marshfield Clinic Health System (WI) will implement NowPow’s community services referral software.
USMD Health System and WellMed (TX) select Leading Reach’s referral communication and care coordination software.
The North Estonia Medical Centre joins the TriNetX network to increase its engagement with the international healthcare research community.
UBC will use Surescripts Specialty Enrollment service in its biopharma support services that include REMS enrollment, clinical studies and registries, and patient support services.
In Canada, six Ontario hospitals will implement a shared regional instance of Cerner Millennium.
People
Chuck Podesta (UConn Health) joins Renown Health as CIO.
Eron Kelly (Amazon Web Services) joins Inovalon as president.
Announcements and Implementations
The Multiple Myeloma Research Foundation will use data normalization services from Intelligent Medical Objects to improve clinical data from its CureCloud and CoMMpass clinical trial programs.
A new KLAS report on security and privacy consulting services finds that Meditology, Clearwater, and CynergisTek top the list of companies that are most often viewed as partners by customers. The report notes that Impact Advisors has the highest overall performance score at 99.1 on a 100-point scale even though its security offering is less widely known. Clients of audit-focused firms such as Deloitte, EY, and PwC are more likely to seek less-prominent companies in search of higher value or staff quality, with Deloitte customers in particular reporting problems with executive involvement, quality, delays, and its perceived use of a B-team of inexperienced employees
Other
Ireland’s health service facilities continue to operate under downtime procedures after a ransomware attack took out their computer systems six weeks ago. The health service estimates that recovery costs will exceed $600 million.
Sponsor Updates
Cerner employees assemble 300 hygiene kits, prepare 100 dental bags, and stuff 2,000 envelopes for its Care Kits and Healthe Kids Screenings programs.
Dina CEO Ashish Shah will speak at the Home Care 100 Leadership Conference June 30.
Lumeon publishes “The Future of Digital Transformation in Healthcare Report 2021.”
Surescripts announces that last year more than 745,000 individuals and organizations used its Clinical Direct Messaging to improve transitions of care, send immunization notifications, coordinate medication management efforts and achieve federal incentives requiring the use of secure electronic messaging.
Stone Point Capital acquires and combines Verisys and Aperture Health, creating a company focused on credentialing, enrollment, and provider data management.
It’s been an interesting week, and one I’d rather not repeat. I took a brief break from the healthcare IT trenches to do some volunteering at a youth camp, and the theme for the week quickly became “A Series of Unfortunate Events.”
All of our pandemic handwashing and sanitation skills were put to full use as the camp experienced an outbreak of norovirus, which is something I wouldn’t wish on anyone. The state epidemiologists had a rapid response and the camp was quick to put all participants in lockdown while they worked to determine the source of the outbreak.
Since they weren’t sure if the affected campers brought it with them or caught it at camp, all food service venues were closed. The National Guard quickly rolled in with thousands of boxes of MREs (meal ready to eat) and the dining experience was an adventure for many. I highly recommend the chili mac, although the penne with vegetable sausage crumbles wasn’t bad either. As to the Pop Tarts that were welded together by the vacuum packing process, I have no comment.
After the initial contact tracing, campers were released from the strict lockdown to do hikes and fishing with their campsite cohorts while further investigation occurred. I was surprised by how little our participants were phased by everything going on around them, although I attribute that to spending the better part of the last year and a half trying to avoid COVID-19.
After campers were tired of hiking, board games were delivered to the groups and some vicious rounds of Connect Four and Blokus ensued, followed by The Game of Life, which I didn’t know was still in production. It was great to see kids interacting with each other in non-electronic ways and experiencing some of the board games their “elders” grew up with.
The following day, we were cleared to return to activities, but food service was still stalled. Due to some just-in-time supply chain snags, the camp staff was forced to clean out local Sam’s Club and Costco warehouses for breakfast supplies. Lunch was another round of MREs, and since the majority of participants hadn’t eaten one before (let alone three), we prepared to triage additional gastrointestinal complaints. Fortunately, the norovirus cases had stabilized and the field hospital that had been configured was put to little use and we could go back to managing the sprains, abrasions, and blisters we expected. Unfortunately, at the end of the week, we had three medical evacuations by helicopter and one by ambulance, so things weren’t as quiet as we hoped.
It’s always a challenge to see how medical care is rendered in the great outdoors. I’m glad that the majority of the participants stayed healthy since so many camps were canceled last summer. There were certainly some memories created that will last a lifetime, but based on the overall experience, I was for once glad to return to my overflowing inbox. Having an actual bed instead of a cot was also a big plus.
I recently accepted a couple of new clients and am trying to sort out the schedules for the various engagements as I wind down a few projects at the end of the month. Although I’m excited for new things, I’ll miss the teams that I’ve worked with over the last year. But that’s my goal as a consultant – helping clients move forward and celebrating with them when they become self-sustaining. The baby birds are leaving the nest and I couldn’t be prouder of the work they’ve done along the way.
My mailbox contained quite a few HIMSS-related emails, including some party invites, so that added a bit of excitement to the day. I’ve scheduled a couple of Exhibit Hall Booth Crawl sessions with some of my favorite people and hopefully there will be enough excitement on the show floor that it will make for good reading material. I was less excited about my invitation to HIMSS Executives Circle events, which included a VIP luncheon with Alex Rodriguez. I’m a little skeptical about what he has to offer to the healthcare IT world in the form of a keynote address, let alone what might be discussed in a less formal setting, so I took a pass.
My inbox also had its usual complement of LinkedIn invites from people I don’t know who are clearly trying to sell me something, so there was plenty of deleting going on. (Sorry, Fruit Street, you might as well give up at this point.) The usual ads from Office Depot and Staples didn’t entice me to buy anything, nor did Lenovo. Next, I perused messages from my professional organizations and there I found something that caught my eye. ONC has launched an initiative for the public to complete the sentences “Because of interoperability, before/by 2030 [who] will [what]” or “Because of interoperability, _____ before/by 2030” as a part of its Health Interoperability Outcomes 2030 project.
ONC plans to use the public feedback to inform a prioritized set of interoperability outcomes and a road map for what health interoperability can achieve over the next decade. I’ve definitely got a few ideas to throw into the mix:
Because of interoperability, I will be able to carry my complete medical record on my phone by 2030.
Because of interoperability, by 2030 a new physician will have complete access to my records before I even walk in the office door or pop up in their telehealth queue.
Because of interoperability, by 2030 I will never be asked again for a fax number.
Because of interoperability, by 2030 I can update my records across disparate care delivery organizations with a few keystrokes rather than a dozen visits and phone calls.
Because of interoperability, by 2030 I can see all my own images and films.
Because of interoperability, we need to have a unique patient identifier before 2030.
The last one is my favorite, but unfortunately that goal has become more political than patient centric, so we’ll have to see how long it takes. The public can visit the Health Interoperability Outcomes 2030 page to submit a response, or use Twitter to tag #HealthInterop2030 to @ONC_HealthIT if they want to go the social media route. Submissions will be accepted through July 30, so get those creative juices flowing.
What are your goals for the next decade, personally or professionally? Leave a comment or email me.
Kindbody, a provider of fertility services using proprietary technology, raises $62 million in a Series C funding round that brings its total raised to $122 million.
Health Catalyst will acquire patient engagement technology vendor Twistle, which it says will allow it to offer a comprehensive population health management solution to healthcare providers and life sciences companies.
SEC filings indicate that Health Catalyst will pay up to $170 million for Twistle, which has $8 million in annual revenue and will lose an expected $3 million in 2022.
Reader Comments
From William Pay: “Re: Doxo. Our hospital is getting complaints from patients about Doxo. The consumer bill pay network is paying for Google search results for specific hospital names.” Doxo came up in the top handful of my Google results for some randomly chosen hospital names plus “online bill pay.” The link leads to specific webpages that Doxo has created for those hospitals. Each hospital’s Doxo page clearly says that Doxo has no connection to that hospital. Doxo has generated 185 complaints on the Better Business Bureau website, quite a few of them from people who had problems with fees or delayed payment resulting from their use of Doxo to pay their hospital bills. Several business and city government websites have warned their customers against using Doxo, with some of them directly calling Doxo a scam.
From Informatics MD: “Re: Epic Sepsis Model. The published work is important and highlights the need for internal validation, but their experience is not shared by our institution or others we’ve interfaced with since. The implication is that health systems implemented the model without validation or careful oversight. We validated it in a unique, limited setting (the ED) and found its performance to be acceptable enough to proceed with cautious implementation through a controlled quality improvement intervention. Our results are forthcoming, although we can’t discuss them yet due to standard journal embargo policy.”
HIStalk Announcements and Requests
Personal connections enabled half of poll respondents to get their present jobs.
New poll to your right or here: Should companies pay remote workers based on their local cost of living?
Webinars
June 30 (Wednesday) 1 ET. “From quantity to quality: The new frontier for clinical data.” Sponsor: Intelligent Medical Objects. Presenters: Dale Sanders, chief strategy officer, IMO; John Lee, MD, CMIO, Allegheny Health Network. EHRs generate more healthcare data than ever, but that data is of low quality for secondary uses such as population health, precision medicine, and pandemic management, and its collection burdens clinicians as data entry clerks. The presenters will review ways to reduce clinician EHR burden; describe the importance of standardized, harmonious data; suggest why quality measures strategy needs to be changed; and make the case that clinical data collection as a whole should be re-evaluated.
Previous webinars are on our YouTube channel. Contact Lorre to present your own.
Acquisitions, Funding, Business, and Stock
Shares of Doximity closed at $55.98 on Friday, valuing the physician social network platform vendor at $10 billion. The company booked $207 million in revenue and $50 million in net income in the latest fiscal year. CEO Jeff Tangney has beneficial ownership of $3 billion worth of shares.
Announcements and Implementations
HIMSS announces that Dwight Schrute from “The Office” (actor Rainn Wilson) will keynote at HIMSS21. HIMSS says he will deliver a hilarious, insightful talk full of anecdotes and warmth.
Government and Politics
Britain’s Health Secretary Matt Hancock resigns after a tabloid publishes photos of him kissing a health advisor-lobbyist in early May before indoor cross-household contact was allowed under national COVID-19 restrictions. He and the advisor, who he appointed, are married to others. The government is investigating whether the photos were intentionally leaked. Hancock’s replacement will be former Chancellor and Home Secretary Sajid David.
Other
UF Health (FL) restores its EHR at its Leesburg and The Villages campuses after nearly a month of ransomware-caused downtime.
Sponsor Updates
Divurgent launches a Customer Experience Program focused on creating additional value for its clients before, during, and after an engagement.
Vocera announces that its solutions are used in six out of 10 children’s hospitals included in the latest US News & World Report honor roll.
EClinicalWorks releases a new customer success story, “Record Retrieval Made Easy with Prisma.”
Optimum Healthcare IT adds The University of Texas at San Antonio Alumni Association to its Optimum CareerPath apprenticeship program.
Summit Healthcare publishes a new client use case, “Cody Regional Health Enlists Summit Healthcare’s Integration Services to Support Epic Migration.”
EY announces that Protenus co-founder and CEO Nick Culbertson is an Entrepreneur of the Year 2021 Mid-Atlanta Award finalist.
Parity.org includes Quil Health on its 2021 Best Companies for Women to Advance list.
Ascom expands its Unite software ecosystem with the addition of the new Unite Collaborate communication application.
Twistle publishes a new case study, “ChristianaCare: Improving Detection and Management of Postpartum Hypertension.
Well Health receives a Rising Star Award as part of the 2020-2021 South Coast Business & Technology Awards.
Vyne Medical releases a new podcast, “The New Era of Patient Access and Revenue Cycle.”
June 25, 2021WeekenderComments Off on Weekender 6/25/21
Weekly News Recap
Health Catalyst announces its acquisition of Twistle.
Doximity shares surge on their first day of NYSE trading, valuing the company at $7 billion.
Tegria acquires KenSci.
Researchers say that Epic Sepsis Model performs poorly in identifying potential cases of sepsis.
GE Healthcare names Pater Arduini as its next president and CEO.
England’s NHS publishes a draft patient data strategy.
NextGen Healthcare announces that President and CEO Rusty Frantz will leave the company.
Amazon announces a four-week, virtual AWS Healthcare Accelerator program for startups.
California launches a digital COVID-19 vaccination record system.
ONC invites colleges and universities to apply for its $80 million public health IT workforce program.
Best Reader Comments
As former CIO, I am wondering if all of the billions (trillions?) spent on EMRs, etc. have really improved care / outcomes. Based on the very simple measure of life expectancy, I would say no. I am sure that billing and documentation has improved and the industry has amassed warehouses full of data for interesting studies. I know that I will be critiqued for use life expectancy as the single measure, but it is easily available and is a fundamental outcome. This should be embarrassing for a country that already had the highest cost and low life expectancy compared to other advanced economies. (Former CIO)
If you step outside the hyped world of AI/ML, a hospital system would not implement a new clinical protocol (for example, if this were a written risk-stratification model for sepsis) without it first being testing, validated, published, and even then they usually want to wait for the Professional Societies to back the protocol before widely accepting and integrating it into practice. Please explain then why hospitals are just blindly accepting these AI/ML algorithms, when there is already a standard for approving clinical decision-making tools? I suspect a large part of the issue here is that there is still not enough medical involvement / integration into the IT/IS departments at many hospitals. Their governance models still view IT and the EHR as a cost center and not a strategic asset to the organization, and think the enhancements that are being added during EHR upgrades are all functionality updates, when in fact they are slipping more and more clinical content and tools into the upgrades. (HITPM)
Coming from the overhyped world of AI/ML, I would tease apart validation of the model and validation of protocol. No model will be 100% accurate, so validating a model comes down to “sufficiently accurate” (trading off precision and recall) and some sort of explainability. In our work on sepsis models, we achieved AOC over 0.8 with the ability to see precisely which parts of the medical record led to the conclusion. We did not commercialize it, not because it was invalid, but because it needed to drive a clinical protocol that added value. And that’s the issue. First, practitioners’ intuitive sense is really good, so any model has to find marginal incremental cases that they’d miss. Second, you need to design, validate, and implement a clinical protocol for what to do when the model alarms. This has a poor ROI. (Dan G)
They [Doximity] display pharmaceutical ads to doctors. Similar to how Practice Fusion made money, but Doximity has lower risk because ad fraud is harder to bring lawsuit or regulatory action against compared to pushing oxy via EHR decision support. (IANAL)
Watercooler Talk Tidbits
Readers funded the Donors Choose teacher grant request of Ms. C in Mississippi, who asked for an IPad and accessories to allow her to create videos of her classroom instruction for students who need extra review or if COVID-19 forced her school to close. She reported in December, “Thankfully we have not had to teach virtually so far, but having an IPad makes it possible for me to record classes that students can use for review if they need extra help on a particular objective. I enjoy having a fun way to intervene with struggling students by having them play educational games on the IPad that reinforce and review skills we are learning each day. School has changed so much this year and technology has become such an important part of our school day. Thank you for making this project possible.”
Casamba founder and executive chairman Ronnie Amrany buys a waterfront house on Hollywood, FL that sets the record for the highest price paid in that area at $6.9 million. Net Health acquired the therapy EHR vendor in March 2021.
Eleanor Slater Hospital (RI) COO/CFO Christopher Feisthamel takes advantage of an obscure state HR law to avoid repeat attempts to lay him off. Rhode Island’s “leave to protect” provision allows a state employee to hold up to three state jobs at the same time, and if fired from one, they can return to their previous job and “bump” whoever holds it. More than 1,600 state employees have leave-to-protect status, making it hard to fire them.
St. Vincent Hospital (MA) bans activist members of the Catholic Worker Movement from hospital property after they perform an “exorcism of the demon of corporate greed” in the lobby against hospital owner Tenet Healthcare to support striking nurses.
In India, friends of a man who was receiving COVID-19 vaccine record a video showing a distracted nurse removing a disposable syringe and injecting it without first drawing up the vaccine. Nobody noticed until one of the friends looked at the video later. The nurse has been removed from duty and the man will be brought back to receive his first dose.
Shares in Doximity, which set an IPO share price of $26 versus the expected range of $20 to 23, close at $53.00 on their first day of trading on the New York Stock Exchange.
Shares in Doximity, which set an IPO share price of $26 versus the expected range of $20 to 23, close at $53.00 on their first day of trading on the New York Stock Exchange, valuing the physician network vendor at $7 billion.
Reader Comments
From Muumuu Summer: “Re: Epic. Are you hearing that they seem to be losing more employees than usual? It seems like they are bringing back a previous break-the-glass strategy by having senior people cover open positions until they can be filled, which can leave clients without a permanent person for months.” Epic clients are welcome to report their experience.
From Watcher of the Data: “Re: Avaneer and blockchain. You are dead right about this. The most amusing part of this is that blockchain won’t ‘solve’ the interoperability problem – it can become useful only once the problem has been solved.”
From Percolator: “Re: Epic’s sepsis model. Cerner has a free one that gets little use, and the company has had trouble selling models for other conditions. Every condition needs to be mapped to hospital work flow – who do you alert and how, and what is the recipient supposed to do? These models add little incremental value because (a) doctors are already very good at detecting sepsis and starting antibiotics, and (b) 90% of sepsis is community acquired before the patient is admitted. ‘Watch this patient more closely’ is not worth much, especially if doctors and nurses already suspect sepsis.” Thanks. I’ve removed identifying information since I wasn’t sure this comment was intended for public display.
From Ossify: “Re: Epic’s sepsis model. Why should anyone care what the algorithm does as long as it works?” You wouldn’t want to harm someone, either by overtreating or undertreating, because a software model was trained on a bunch of data and “learned” from facts that are clearly irrelevant or not universally applicable. Example: Epic developed a patient no-show model awhile back that incorporated the patient’s religion and body mass index in predicting whether they would show up for appointments, and researchers found that removing those features didn’t reduce the model’s predictive powers but eliminated some inequity issues. Did Epic really think those factors were relevant, or was their data science knowledge insufficient? Then there’s the “what do we do with this” issue – should appointments be double-booked in case those patients really do skip their appointments (and what happens if they don’t?) or perhaps could the information be less invasively and more constructively used to send reminders or to understand that particular patient’s possible issues with venue location, transportation, or available hours that could be resolved by suggesting a different location? AI is amazing for being able to detect data patterns that humans haven’t, but if pitched to replace or even enhance expert judgment, it’s the customer’s job to make sure that the algorithms work in their particular situation. I’m not sure the average health system has the expertise to make those evaluations, so that’s why outside review is a reasonable recommendation.
From Bagna Cauda: “Re: mental health apps. Which ones are best?” I’m skeptical that any of them accomplish much given the lack of peer-reviewed studies on their outcomes. FDA seems to lack interest in holding their developers accountable even when they are clearly being pitched for use in medical or psychological situations. It doesn’t help that psychological counseling itself may have outcomes that are hard to prove. Lastly, the nature of these behavioral health app companies is that they are pandering to investors who demand fast growth Silicon Valley style, which means their customers will have minimal human involvement and instead will interact with scalable, cookie cutter technology that offers the opposite of the human interaction that many people crave. It also seems that some vendors expect users to stop paying once the limited value of the app becomes clear, so they refocus on selling to employers and insurers (healthcare excels at separating the people who consume a service from those who pay for it).
Webinars
June 30 (Wednesday) 1 ET. “From quantity to quality: The new frontier for clinical data.” Sponsor: Intelligent Medical Objects. Presenters: Dale Sanders, chief strategy officer, IMO; John Lee, MD, CMIO, Allegheny Health Network. EHRs generate more healthcare data than ever, but that data is of low quality for secondary uses such as population health, precision medicine, and pandemic management, and its collection burdens clinicians as data entry clerks. The presenters will review ways to reduce clinician EHR burden; describe the importance of standardized, harmonious data; suggest why quality measures strategy needs to be changed; and make the case that clinical data collection as a whole should be re-evaluated.
Previous webinars are on our YouTube channel. Contact Lorre to present your own.
Acquisitions, Funding, Business, and Stock
Providence-owned Tegria acquires healthcare AI vendor KenSci.
Subscription-based opioid use disorder virtual care vendor Bicycle Health raises $27 million in a Series A funding round.
National emergency medical services provider Priority Ambulance acquires software vendor Randseco, which offers the StatCall digital patient logistics solution that supports information exchange among ambulances, hospitals, payers, and non-medical transportation services.
The University of Texas Health Science Center at Houston engages ReMedi Health Solutions to offer personalization training for 2,000 clinicians in 18 specialties as it implements Epic. The company also provided an AI-powered virtual assistant for workflow help and tipsheets.
People
Healthcare IT Leaders hires Patrick Dougherty (Allscripts) as CTO.
Pallav Sharda, MBBS, MBA, MMI (Google) joins employer bundled health services platform vendor Carrum Health as chief product officer.
Well Health hires John Knotwell, MBA (Get Bridge) as chief revenue officer and Marissa Morrison (Foursquare) as VP of people.
RCM services vendor Kemberton names Deanna Gray (Millennia) as SVP of customer success.
Peter Arduini (Integra LifeSciences) is named president and CEO of GE Healthcare, effective January 3, 2022.
Virtual-first urgent care and primary care clinic HealthTap promotes co-founder and COO Sean Mehra, MBA to CEO.
Announcements and Implementations
Healthcare Triangle releases DataEZ, a cloud-based analytics service that that can manage large quantities of data, including real-world data from remote monitoring, digital health services, and clinical trials.
Medical imaging software vendor Novarad announces GA of a software-only version of its CryptoChart image sharing product that uses a QR code to access the cloud-based information.
Rehabilitation therapy platform vendor WebPT recaps its recent accomplishments – 20,000 clinic customers and a 40% market share, release of its Digital Patient Intake tool, key leadership appointments, and launch of an integrated virtual visit solution.
WellSky-owned CarePort announces a care coordination solution for ambulatory providers, which will allow them to connect patients to home- and community-based organizations directly from their EHR and to maintain two-way communication during the referral process.
3M will establish a Digital Science Community in Dublin, Ireland, employing 100 people to do R&D work for its HIS division.
MGMA and WhiteSpace Health release MGMA DataDiscovery, a physician practice performance analytics tool for medical groups.
Allscripts-owned Veradigm and pharma contract research organization PRA Health Sciences develop an EHR-based clinical research network that uses Veradigm’s StudySource platform.
Texas Children’s Pavilion for Women launches PeriWatch Vigilance in Malawi, with the fetal monitoring system being provided at no charge by PeriGen.
Omny Health develops a de-identified EHR data repository for dermatologic pharma research, offering the data of 7.5 million patients that was collected from 1,000 dermatology providers. The company announced GA of its anonymized data research platform in early May. Co-founder and CEO Mitesh Rao, MD, MS was Stanford Health Care’s chief patient safety officer through 2017 and remains an emergency medicine professor at the Stanford University School of Medicine.
Other
England’s NHS publishes a draft data strategy that outlines NHSX’s use of data to give patients better access and control, to allow systems to share records, and to support research. It calls for the NHS app to allow patients to review test results, medication lists, procedures, and care plans and to be able to manage appointments, refill prescriptions and contact health and care staff. NHS also responded to concerns about its data-sharing plans by committing to publish a health data transparency statement by 2022.
Epic spokesperson Barbara Hernandez responds to the study in which Michigan Medicine researchers found that its sepsis alerting tool performed poorly, leading the authors to urge health systems to review the inner workings and past performance of such algorithms before using them in patient care. Epic’s points:
Customers have access to the full model, its formulas, and its accuracy measurements, all of which are published on Epic’s UserWeb.
The authors used a hypothetical approach that did not consider the analysis and tuning that is required before real-world deployment.
The tool has helped clinicians provide life-saving interventions to thousands of patients that might have been missed otherwise.
Michigan Medicine provided a positive review of the system in a UGM presentation in describing how pediatric patients are screened within two minutes of developing symptoms.
Meanwhile, one of the authors of the Epic Sepsis Model article that was published in JAMA Internal Medicine – nephrologist, assistant professor, and machine learning lab director Karandeep Singh, MD, MMSc of University of Michigan Medical School – provides further information via Twitter:
The authors ruled out configuration and mapping errors that often create low data AUCs (area under the curve). Epic’s AUCs were much higher in its own sensitivity analysis.
Singh notes that AUC is driven by two factors – the method of calculation (which was not a factor in their study) and the outcomes being considered (which was significantly different). Epic defines sepsis as presence of an ICD-10 code whose usage varies so much among hospitals that nearly nobody trusts it, including CDC and CMS, which don’t rely on the code to track sepsis or measure sepsis outcomes, respectively. The authors used the criteria that UM sepsis committee developed for quality measures tracking, which is a composite of the CDC and CMS definitions.
Singh raises the possibility that Epic’s model may infer sepsis from the ordering of sepsis-related medications, with the model’s data “leakage” making it look better than it really is.
Epic’s model identified only a tiny percentage of patients that clinicians would have otherwise missed.
Singh concludes that UM is using the model as part of a broader sepsis intervention that includes frequent nursing checks, but will be revisiting the model’s usage.
Singh’s recommendations to Epic, which he presented to its data science team in April, include releasing its models publicly for independent review as Cerner has done, increasing the transparency of the model’s coefficients and modeling code, and making it easier for Epic customers to run competing open models instead of limiting them to those offered by the company as “a walled-garden app store.”
Vanderbilt University Medical Center informatics professor and department chair Kevin Johnson, MD, MS posts “Living Through Going Live,” a video recap of VUMC’s 2017 go-live on Epic.
Sponsor Updates
Newfire Global Partners offers its team members an interoffice exchange program, such as employees from its Ukraine office working and culture-exploring on Croatia.
Users rate Halo Health the top clinical communication and collaboration platform in G2’s latest “Clinical Communication and Collaboration Grid Report.”
Health Data Movers publishes a new client story, “Data Conversion for Oncology EHR to Epic.”
InterSystems announces the latest release of its Iris data platform, which includes adaptive analytics capabilities and additional SQL extensions for analytics to improve the process of implementing an enterprise data fabric architecture.
Jvion will present at the Home Care 100 Leadership Conference June 27-30 in Marco Island, FL.
June 24, 2021Dr. JayneComments Off on EPtalk by Dr. Jayne 6/24/21
In follow up to this year’s changes to the Evaluation & Management coding requirements, the American Medical Association announces clarifications that will hopefully make the codes easier to implement. The technical corrections updates are supposed to “add clarity and answer lingering questions.” The code updates were originally designed to reduce administrative burden on physicians while making it easier to document, although many organizations still have their providers hunting for bullet points because they haven’t made the required educational efforts to ensure everyone is on board with the changes.
The technical corrections include clarification on what constitutes “major” and “minor” surgeries as well as refinement of the meaning of “discussion” between physicians and other members of the care team, adding texts and instant messaging as methods as long as the process is interactive. It also further defined the meaning of “analyzed.” At this point, the corrections only apply to codes for outpatient or office settings.
For providers who are terrified of coding audits, anything that adds clarity is certainly welcome. My former employer took E&M coding completely out of the hands of providers, locking us out of the coding screens and shifting the work to coders. Although skilled, they were not certified professional coders, so the idea that charges were going out without my review always made me a little uncomfortable and was one of the reasons leading up to my departure.
The VA’s Cerner EHR modernization project is poised to receive an additional $56 million in budgeted funds for the 2022 program year. The additional funds are slated to support implementation at additional medical centers as well as to support infrastructure upgrades. According to a May report by the Office of the Inspector General, the VA’s facilities need electrical work, HVAC upgrades, and additional network cabling. More than two thirds of the VA’s medical centers are over 50 years old, with the average age being 58.
I’m always excited to learn about how technology is impacting public health, so I enjoyed reading a recent JAMA Surgery article about the “Association of Rideshare Use With Alcohol-Associated Motor Vehicle Crash Trauma.” The authors set out to determine whether use of rideshare services decreased impaired driving, resulting in changes to motor vehicle trauma rates. They looked at data from the Houston, TX metropolitan area that included hospital data and court records on convictions for impaired driving, along with rideshare data from Uber and Google. They found that “rideshare volume had a significant negative correlation with the incidence of motor vehicle-associated trauma, and this was most evident in those younger than 30 years; a significant decrease in convictions for impaired driving was associated with the introduction of rideshare services.” That’s fantastic news for those of us who have ever had to staff a trauma bay.
I thought summer was going to be a slow time for me, but I’ve picked up some projects that are going to take a lot more of my time than I thought. Based on some of the slowdowns in 2020, I’m happy to have the work and even happier that organizations feel stable enough to go back and work on projects that were truncated or even canceled by the pandemic. Some of the things I’m working on include vaccination campaigns, chronic disease outreach, and cancer screening campaigns. (As far as colorectal cancer screening is concerned, did you know that 45 is the new 50? If you’re 45 or older, it’s time to consider a colonoscopy or stool testing.) These are the bread-and-butter kinds of initiatives that I wish more organizations would work on. I’m working with a handful of patient engagement solutions across my clients and it has been an interesting exercise to compare their capabilities.
I was glad to enjoy some blue skies recently, though, and would encourage everyone to find time to just let your brain turn off. Or, if you’re not into just sitting around watching crops grow, consider reading a book just for enjoyment or hanging out with friends you haven’t connected with in a while, even if it has to be virtual. Many of us have been working hard over the last year and a half that COVID-19 has been with us and it’s time to recharge our batteries. Although I’m very confident in the performance of vaccines against the virus as we know it now, it feels like it’s only a matter of time before some kind of other proverbial shoe drops. When it does, I want to be rejuvenated and ready for action. I’ll be taking a couple of days to do some rock climbing and other adventures and to continue to reset my brain and to get ready for whatever gets thrown at me next.
HIMSS is approaching and I received my first emails this week, asking if I was interested in scheduling meetings. Both vendors were ones I hadn’t heard of, so maybe the “new normal” HIMSS is an opportunity for smaller companies to share their messages without being buried in the noise. One of the vendors has a lot to learn about email marketing – other than the “schedule a meeting” link, nothing in the email was dynamic. I couldn’t even click on a company logo to go to a website and learn more about what the company does. The scheduling link at least took me to a part of the company’s website where I could tour, but I still don’t fully understand what they do.
In talking with some of my usual HIMSS buddies, one is moving to the Caribbean so will not attend, one is putting their final plans together, and the other is onboard with planning our annual booth crawl. I am still curious what the social scene will look like and whether there will be off-campus events with food and beverage offerings or whether most vendors are doing the Wednesday afternoon exhibit hall happy hour.
Have intel on the HIMSS social scene? Leave a comment or email me.
DrChrono will use a new $12 million investment from Orix to build out its telemedicine capabilities and enhance its existing EHR and practice management solutions.
Australia’s New South Wales government hopes to spur a COVID-19 economic recovery by funding its digital government platform, which will include the first phase of a NSW Health EHR replacement.
The Epic Sepsis Model predicts sepsis poorly while flooding clinicians with inappropriate alerts, a Michigan Medicine study concludes.
The authors note that while hundreds of hospitals are using the Epic-distributed model, the company has divulged little about its methods or its real-world performance.
They also note that at UM, clinicians would have needed to investigate 109 Epic-flagged patients to find one that required sepsis intervention.
The article warns of “an underbelly of confidential, non-peer-reviewed model performance documents that may not accurately reflect real-world model performance.”
An accompanying JAMA Internal Medicine editorial warns that Epic’s model was developed in just three US health systems six years ago and health systems should validate and recalibrate such models before implementing them. They draw the parallel that just as clinician decision support rules are reviewed by local clinicians before they are offered for use in patient care, local data scientists should evaluate any algorithms that were developed elsewhere.
Reader Comments
From Map Bucks: “Re: pay for remote work. My health IT employer is considering adjusting pay to local conditions for those who work remotely (the company is in an expensive metro area). Does this seem OK?” It’s a complex issue. The black-and-white side of me says that companies should pay based on the job, not where the worker sits while performing it. A Dallas company might not be able to hire someone from the Bay area for what it pays locally, but that candidate always has the option to move to Texas. Companies shouldn’t pay more just because an employee chooses a long commute, a more expensive house, or to live across the state line where it costs more – that seems to be a slight creep toward socialism, as in “you need to give me a raise to perform the same work because our new child is costing us more.” I would also not put it past some employees to fake their residence to earn more, such as borrowing a relative’s New York City address. Perhaps the stickiest issue is reducing compensation for someone who leaves an expensive metro, although that doesn’t make sense to me. My hot take is that the job is worth what it’s worth and the employee is free to live wherever they want but also with the expectation that their voluntary choice doesn’t affect their paycheck.
From D.V. Wormer: “Re: Avaneer. Which problem of interoperability can blockchain really solve?” Dean Wormer, instead of being a downer who undermines the work of roomfuls of vendor marketing people, just mindlessly accept that the US healthcare system lags the civilized world in accessibility, outcomes, and cost only because we don’t use enough AI, blockchain, and robotic process automation (try not to notice that those many countries who outperform us also don’t use it and that the folks touting those technologies are the same ones who sell it). IBM is involved in Avaneer, which isn’t a strong indicator of commitment, and so far the only customers I’ve seen mentioned are also Avaneer investors. Blockchain is a hammer looking for nails that never seem to get pounded, and while healthcare has a ton of inefficiency and lack of interoperability (weren’t government-subsidized EHRs and HIEs supposed to fix those problems?), the historic safe bet is to be skeptical of companies that pre-profess their technology’s ability make it better. I’ve been in health IT enough to skew cynical, so I’ll invite more glass-half-fullers to weigh in. I’ll be as interested as the next person to see hard data from an Avaneer-using health system that saves a ton of money and passes those savings along to patients (if for no other reason, because that has never happened in our profit-motivated system).
Webinars
June 24 (Thursday) 2 ET: “Peer-to-Peer Panel: Creating a Better Healthcare Experience in the Post-Pandemic Era.” Sponsor: Avtex. Presenters: Mike Pietig, VP of healthcare, Avtex; Matt Durski, director of healthcare patient and member experience, Avtex; Patrick Tuttle, COO, Delta Dental of Kansas; Chad Thorpe, care ambassador, DispatchHealth. The live panel will review the findings of a May 2021 survey about which factors are most important to patients and members who are interacting with healthcare organizations. The panel will provide actionable strategies to improve patient and member engagement and retention, recover revenue, and implement solutions that reduce friction across multiple channels to prioritize care and outreach.
June 30 (Wednesday) 1 ET. “From quantity to quality: The new frontier for clinical data.” Sponsor: Intelligent Medical Objects. Presenters: Dale Sanders, chief strategy officer, IMO; John Lee, MD, CMIO, Allegheny Health Network. EHRs generate more healthcare data than ever, but that data is of low quality for secondary uses such as population health, precision medicine, and pandemic management, and its collection burdens clinicians as data entry clerks. The presenters will review ways to reduce clinician EHR burden; describe the importance of standardized, harmonious data; suggest why quality measures strategy needs to be changed; and make the case that clinical data collection as a whole should be re-evaluated.
Previous webinars are on our YouTube channel. Contact Lorre to present your own.
Acquisitions, Funding, Business, and Stock
NextGen Healthcare announces that President and CEO Rusty Frantz will leave under a “mutual separation” agreement that is effective immediately. He has also left the company’s board. Frantz did not indicate the reason for his departure, but he said in a statement that leaving the company will allow him to “put 100% of my focus on my most important priority – my family.” The company has launched a search for his replacement. Frantz took the role in June 2015, with NXGN share price increasing 5% in that time versus the Nasdaq’s 181% gain.
Cleerly, which applies AI to coronary imaging to predict heart attacks, launches itself with a $43 million Series B funding round. Founder and CEO James Min, MD was a professor of radiology and medicine at Weill Cornell Medical College, where the company’s technology was developed.
RCM services vendor Services Solutions Group, formerly the services division of NThrive, renames itself to Savista.
Sales
Arkansas Pediatric Clinic chooses Emerge data conversion and integration solutions for its migration to Athenahealth.
FirstLight Home care joins Dina’s digital home care coordination network.
The Ohio State University Wexner Medical Center will offer Type 2 diabetes patients access to Teladoc Health’s Livongo for Diabetes Program.
People
Industry long-timer Tim Knoll, MBA (PatientSafe Solutions) joins healthcare staff safety technology vendor Strongline as VP of sales.
Glytec hires Nausheen Moulana, MBA, MSEE (Kyruus) as CTO.
Ascend Medical hires Michael Justice, MBA (Trinisys) as CTO.
Meera Kanhouwa, MD, MHA (Deloitte) joins Ernst & Young Global Consulting Services as executive director in digital health. Her experience includes 10 years as a US Army ED physician with deployment during Operation Desert Storm.
Announcements and Implementations
Amazon launches AWS Healthcare Accelerator, a four-week virtual program for 10 startups that will learn about using AWS to develop healthcare solutions.
A new KLAS report on population health management technology vendors finds that Arcadia, Epic, and Innovaccer stand out.
Government and Politics
A federal appeals court rejects Stanford Healthcare’s argument in a $500 million Medicare billing fraud case involving records Epic-enabled upcoding and unbundling of charges.The complaint says that Stanford doubled its Medicare revenues without increasing its expenses, which the complaint says could only be done by creative coding.
In Australia’s New South Wales, NSW Health will receive $105 million from the state’s digital services initiative for the first phase of its EHR replacement project, with additional funds budgeted from its COVID-19 relief package to expand telehealth and to improve integration between ambulance services and hospital EDs.
Other
KHN notes that big US health systems are opening medical facilities in other countries, such as Cleveland Clinic spending $1 billion to open a clinic across the street from London’s Buckingham Palace Garden that will offer only profitable elective surgeries and treatments in hopes of attracting American expatriates and rich Europeans. The article questions why those systems, which don’t pay taxes, are allowed to pursue such aggressive international business moves.
Sponsor Updates
Healthcare Growth Partners advised Medullan on its sale to ZS.
University of Texas as San Antonio joins Optimum Healthcare IT’s healthcare IT apprenticeship program.
Premier announces the 2021 winners of its Breakthrough Awards.
Goliath Technologies offers a free Citrix Health Check.
KLAS recognizes Arcadia as a leader in market energy and customer experience in its “2021 Population Health Management Overview” report.
TeleConsult Europe selects enterprise imaging from Agfa HealthCare.
Azara Healthcare names George McGovern (MedTouch) VP of finance and Charlene Grasso (Cambridge Consultants) director of HR.
The local news profiles CareSignal’s partnership with Americares and the Greater Hickory Cooperative Christina Ministry to serve vulnerable populations.
Cerner shares a new client achievement, “South Miami-Dade hospital reaches HIMSS Stage 6, 7 and wins Enterprise Davies Award in same year.”
Ellkay will exhibit at the virtual AHIP Institute & Expo June 22-24.
The following HIStalk sponsors have been recognized in Black Book’s latest customer satisfaction ranking of financial software solutions:
Enterprise patient identifier solutions – Experian Health
NextGen Healthcare announces that President, CEO, and board member Rusty Frantz has agreed to a “mutual separation” and will step down from his executive roles immediately.
Amazon announces the launch of its AWS Healthcare Accelerator, a 10-week program for startups focusing on cloud-based remote patient monitoring, voice technology, analytics, patient engagement, and virtual care solutions.
June 21, 2021Dr. JayneComments Off on Curbside Consult with Dr. Jayne 6/21/21
I’m a little over a month past my departure from the world of brick-and-mortar patient care. Since then, I’ve been seeing patients in a couple of different telehealth venues, and it’s been a good experience overall.
Putting on my clinical hat, I would say the biggest weaknesses of the systems I use are that they don’t have the same EHR features as you would find in an in-person practice. Sometimes that makes it difficult to understand the patient’s history or their medication list, but given the transactional nature of urgent care telehealth services, it’s not insurmountable. I never thought I would say that I felt “spoiled” by having a certified EHR with all the bells and whistles, but maybe that was the case.
Most of my friends who are in traditional practice settings are still doing some percentage of their visits as telehealth, even as the pandemic eases. This applies to both specialists and subspecialists. Even surgeons are doing plenty of virtual visits, especially in the post-operative, follow up, and second opinion arenas.
Patients like the convenience, but I hear a lot of stories about physicians trying to juggle virtual and in-person appointments in the same day. There are plenty of initiatives across the US to make telehealth a permanent fixture in our healthcare system and the majority of people I’ve spoken with think this is a good idea.
The few naysayers that I’ve heard from are concerned that telehealth is becoming a way for physicians to increase their bottom line, performing telehealth visits where they previously might have a phone call with a patient. This leads to a concern that telehealth will drive up overall healthcare expenditures. Kaiser Health News cites data from PitchBook that the yearly global telehealth market could top $300 billion by 2026, nearly five times the levels seen in 2019.
I don’t doubt that there are bad actors in some organizations that claim to be offering telehealth. Certainly I’ve heard the stories about the two-minute visits and the services that essentially sound like pill mills. On the other hand, I’ve heard the stories of patients spared hundreds of miles of travel in order to get second opinions along with those who are now able to see subspecialists of a caliber not available in their home communities.
I’m trying to arrange a telehealth consultation for a family member who requires genetic testing. Their insurance carrier will only pay for the testing if it is ordered by a genetic counselor, who typically doesn’t perform a physical exam and so there’s not a lot of need for an in-person visit. The patient has had multiple physicians recommend the testing and understands the ramifications of testing, so requiring the additional visit feels like a barrier to care, especially since the patient is an hourly worker in an essential field.
There’s no question that telehealth needs to fit into the overall plan of care for patients, and that it shouldn’t be another source of fragmentation. I’m not sure how well the direct-to-consumer telehealth companies do with sending records back to the patient’s primary physician or other members of the care team. From what I hear, interoperability is pretty low unless the patient belongs to a health system who has partnered with the telehealth company.
In my past life as an urgent care physician, I frequently saw patients who had been referred for in-person care by a telehealth physician who felt that the patient’s condition wasn’t appropriate for telehealth or for specific testing, such as a rapid strep test or a COVID-19 test. Out of curiosity, I always asked which platform the patient had used, and very few of them actually knew the name of the service. Usually they arrived at it from an employer website, so I’m not sure the telehealth platforms are creating much loyalty beyond that with the employer representatives who handle the contracting.
I also saw plenty of patients who had been treated via telehealth in a manner that was inconsistent with the current standard of care. Often these patients came to urgent care because they weren’t getting better or because they had spoken with a friend or family member who said the course of treatment didn’t sound right. Those visits frequently require some degree of finesse because you don’t know exactly what happened in the previous visit or how the patient’s symptoms might have changed between that time and your visit.
Other times, however, you know the care provided didn’t pass the sniff test, especially when patients were given antibiotics that were not indicated for a given diagnosis or when they pull up their visit summary documents on their phones and the care plan can only be described as off the wall. We certainly see those issues play out from in-person care encounters as well, so it’s not necessarily a telehealth problem.
Being in the telehealth trenches allows me to do my work from anywhere, which I tried out for the first time recently. It was a little strange to pack my required white coat in my suitcase along with my sunscreen and flip flops, and I have to admit I was worried about whether I could get the right camera angles to make it look like I wasn’t in a hotel, but everything worked out. I still think that wearing a white coat to show that you are a physician (versus wearing it because it has nice pockets to hold all the things you need) is a little strange, but it’s required on my platform as a sign of professionalism. Personally, I wish the white coat would become extinct for infection control purposes, but it will probably stick around for the remainder of my career.
I see a need for large organizations, especially integrated delivery networks, to spend some time thinking through their telehealth strategies and make sure they make sense for growth and care delivery since many of them reached their current states out of desperation and necessity. There are still plenty of people out there using freestanding telehealth platforms that force physicians to do a lot of data entry and double work, and for their sake, I hope they can transition to integrated systems. The next two to five years will be interesting as far as seeing where telehealth takes us and what value it can deliver.
Ever talked to your doctor while she’s sitting on the beach? Leave a comment or email me.
Going to ask again about HealWell - they are on an acquisition tear and seem to be very AI-focused. Has…