Monday Morning Update 2/21/22

Top News

Spok reports Q4 results: revenue down 8%, EPS –$0.86 versus –$2.44.

From the follow-up announcements and earnings call:

• The cloud-based Spok Go, which was introduced in February 2020, will be discontinued and the company will take a $15.7 million impairment charge. Spok says the product’s traction has been limited because of COVID-19, challenges in recruiting and retaining software engineers, and the company’s need to reduce costs and headcount.
• The company will maximize revenue from its legacy product, Spok Care Connect Suite.
• Spok will cut its management team by half and its workforce by one-third in the next 60 days.
• The company will increase its dividend and repurchase $10 million of its shares.
• The company continues to seek a buyer. One interested party is Acacia Research Corporation, whose primary business is buying struggling companies and then filing patent infringement lawsuits to force the purchase of licenses (aka a “patent troll.”) Acacia’s acquisition partner is activist hedge fund Starboard Value, best known in health IT circles for leveraging its tiny position in Cerner into board seats and a “cooperation agreement,” then selling off CERN shares as soon as the price went up as a result.
• Acacia proposed in August 2021 to acquire all outstanding Spok shares for $10.75 in cash. Shares are now at $8.65, valuing the company at $171 million. Spok turned down a $12 per share offer from B. Riley Financial two years ago.
• President and CEO Vincent Kelly says the board’s decisions were influenced by Oracle acquiring Cerner, Stryker acquiring Vocera, and Hillrom (and then Baxter) acquiring Voalte.

Reader Comments

From ViVE Sponsor: “Re: ViVE conference. The attendee list shows 3,000 people, only [low number omitted] of them providers.” Unverified, so I’ve omitted the number. I’ve emailed the conference’s generic email address for press inquiries since that’s the only contact I can find and will update with any response I get. The conference website says it expects 4,000 attendees (it said a year ago that attendance could top 5,500). Readers keep asking me about registration breakouts for ViVE and HIMSS22 that I don’t have, so tell me if you know or if you saw the same list. Meanwhile, the HIMSS22 exhibit hall is looking pretty full with about 800 “real” booths (excluding meeting place, pavilions, interoperability showcase, etc.) and 898 exhibiting companies. I’m hoping that, unlike HIMSS21, it will be worth my time and money to attend.

From TikTokDoc: “Re: videos. Doctors should use them for patient education. Good idea?” TikTok probably isn’t the ideal platform due to its limits on video length, but I can see doctors recording short, generic YouTube videos for patients who have new diagnosis or who need specific information about drugs, procedures, or lifestyle recommendations, then sending those patients a link after their encounter (the videos could be made private on YouTube or not, depending on practice’s goals). I like the idea of recording a quick video recapping the visit and to-do items for the patient’s later review, but malpractice fears probably make that unlikely. I wonder how many telehealth visits are recorded by the patient using screen-capture apps?

HIStalk Announcements and Requests

Few poll respondents include certification or fellowship credentials on their business cards or email signatures, including two-thirds of the folks who have earned them. LinkedIn is full of credentials that I would have to look up  (or in reality, ignore) – some that I’ve seen recently in profile titles (not just in a list) are CCEP, CHPS, CHC, FACP, CDH-E, CRCR, CVAHP, CHPC, GRCP, CSPO, NEA-BC, PMHNP-BC, LP/NREMT-P, and CSSM. I’ve hired and been hired based on minimum educational level, but I’ve never hired anyone or been hired because of a certification. Actually, that’s not entirely true – Epic certification is required for many health IT jobs and is harder to earn and keep than some of the credentials that are issued by member organizations. I’m curious to hear from readers – what health IT job descriptions have you seen in which a specific certification or fellowship is required? 

New poll to your right or here: What were the negative aspects of your most recent PCP visit within the past 12 months?

Best thing I saw in the internet this week:  “Everyone who confuses correlation with causation eventually ends up dead.”

Last chance – if your company is exhibiting or participating in ViVE, send me your information to be included in my conference guide. Some of the activities I’ll be listing for attendees to consider include sponsorship of the welcome reception, happy hours, live podcasts, presentations and demos, evening receptions, and strategy sessions.

Webinars

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

Acquisitions, Funding, Business, and Stock

Real-world data platform network TriNetX acquires Advera Health Analytics, which offers pharmacovigilance software for drug safety concerns.

Radiology workspace vendor Sirona Medical acquires the AI capabilities and related employees of Nines, which offers an AI diagnostic solution for respiratory diseases and a triage system for intracranial hemorrhage. Nines will retain its teleradiology business.

The Columbus business paper runs an excellent profile on AndHealth. I interviewed founder and CEO Matt Scantland last week.

Sales

• Emory Healthcare expands its Sectra enterprise imaging system by adding digital pathology.
• Rush University System for Health offers its employees the Transcarent app for finding health information and health coaching  as part of its medical plan.

People

David Pickering, MBA (Indiana University Health) joins St. Jude Children’s Research Hospital as VP for clinical applications.

Announcements and Implementations

Cleveland Clinic lists its top 10 medical innovations for 2022, whose only health IT entries are AI-powered sepsis detection and analytics for early diagnosis of hypertension.

Government and Politics

The VA moves two of its 130 instances of VistA to AWS in a pilot project.

Stat reports that health tech vendors are worried about the trend of states enacting consumer privacy laws that, unlike HIPAA, give people control over how their data is collected and managed, which will increase regulatory compliance costs. The possible alternative outcome is developing a national standard for managing patient data. 

Other

The Atlantic looks at “Why America Has So Few Doctors” even as an aging, ever-sicker population now has COVID-19 to deal with few primary care doctors available to see them. Reasons:

• US medical education is the longest and most expensive in the developed world, with programs requiring a minimum of eight years of school (degree plus medical school).
• Those years in college leave graduates hundreds of thousands of dollars in debt, encouraging them to pursue whichever specialty pays the most.
• Residency spots and federal funding for them are limited.
• Physicians and physician groups have an economic incentive to claim a physician oversupply to constrain the number of medical school seats.
• Physician groups fight proposals that would allow lower-level clinicians, such as nurses, to do lower-level tasks.
• The medical establishment has made it hard for foreign doctors to practice in the US, especially those from Mexico and Canada whose practice is limited by NAFTA.

Sponsor Updates

• USPTO awards Volpara Health a patent for its method of detecting and quantifying breast arterial calcifications in mammograms.
• Redox releases a new podcast, “WebMD’s Ann Bilyew on Why Scale Matters in a Shifting Market.”

Blog Posts

• 2022 Healthcare Consumer Acquisition Trends to Watch (PatientBond)
• The Importance of Interoperability Rules Compliance for Payers, Providers (Symplr)
• Healthcare: It’s Down to Our Genes (Premier)
• Building Confidence Around Using Helpful Technology (Quil Health)
• Overcoming HCC Challenges in 2022: Provider Burnout, Staffing Challenges, and Coding Gaps (RCxRules)
• 3 things to expect at HIMSS22 (Spok)
• How Accredo Shaved 2 Days Off Its Turnaround Time for Specialty Prescriptions (Surescripts)
• A force to be reckoned with: How Force Therapeutics uses engagement to improve patient care (Talkdesk)
• Do You Have a CAHPS Early Warning System in Place? (Twistle)
• 3 Big Tips for Running a More Organized Front Desk (WebPT)
• 3 Ways Health Plans Can Ensure Risk Adjustment Compliance (Wolters Kluwer Health)
• What Will 2022 Bring for Virtual Care? (VitalTech)
• New CMS 2022 Guidelines: Delivering SAFER Care to Drive Better Outcomes (Zynx Health)

Contacts

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

Morning Headlines 2/18/22

Change Healthcare Falls on Report DOJ to Block UnitedHealth Deal

The Department of Justice will reportedly file a lawsuit to block the proposed $13 billion sale of Change Healthcare to UnitedHealth Group.

ModMed® Acquires Maker of the Klara® Practice & Patient Collaboration Platform

Specialty EHR, PM, and RCM vendor ModMed acquires Klara, which offers a virtual care and collaboration platform, for $200 million.

CompuGroup Medical Acquires Market Leading Laboratory Software Provider AP Easy

CompuGroup Medical acquires anatomic pathology system vendor AP Easy.

News 2/18/22

The Department of Justice will file a lawsuit to block the proposed $13 billion sale of Change Healthcare to UnitedHealth Group, a report says, citing two insiders.

Dealreporter says the sources told it that DOJ cannot identify any divestitures that would ease its anti-competitive concerns.

Change Healthcare reportedly considered selling its payment integrity business to avoid regulatory intervention.

Reader Comments

From Fungible: “Re: HIMSS Accelerate. I can’t figure out how to see the activity there. All I see is promotional posts from HIMSS. Can you ask readers if they are using it?” Same for me. It lists a ton of members, but I don’t see any posts, but then again I’m not following anyone and that might be limiting what I see. Still, even Half Wolf hasn’t posted much of anything. I checked maybe 100 user profiles and I would suspect they were auto-added or something since I didn’t see any that had completed their profile or posted any messages. If you’re using Accelerate, please explain what you’re doing on there. You would think it would be lit up given that HIMSS22 is 25 days away.

From Boris Badenov: “Re: [technology company name omitted]. Has cancelled all meetings and has asked all employees to turn over documents with [EHR vendor] screenshots and other IP by the end of the week. Apparently somehow the company has managed to delete records at an unspecified customer and has caused significant damage.” Unverified, so I’ve omitted both company names. The only way I see this happening is that the tech company was using some kind of scripting and screen-scraping tool that ran amok and deleted data by mimicking user interaction, which the original vendor would not be able to detect or prevent. Cancelling meetings and seizing IP seems odd.

HIStalk Announcements and Requests

Sponsor reminder: tell me what you’ll be doing at ViVE and HIMSS22 and I’ll include you in my conference guides. You’re spending piles of money to participate in the conference, so you might as well publicize it.

Webinars

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

Acquisitions, Funding, Business, and Stock

Specialty EHR, PM, and RCM vendor ModMed acquires Klara, which offers a virtual care and collaboration platform, for $200 million. ModMed is the former Modernizing Medicine, which eliminated and conjoined some of its letters in December 2021 in hopes of “capturing the company’s mission and reflecting its modern user experience.” I’m not sure it actually worked.

SimpleHealth, which offers subscription-based birth control prescribing services and products via a $15 annual online consultation and low-cost prescriptions, acquires birth control pill reminder vendor Emme. 

CompuGroup Medical acquires anatomic pathology system vendor AP Easy.

Medication and computer cart manufacturer Capsa Healthcare acquires mobile computer workstation vendor Humanscale Healthcare.

Sales

• Four companies choose Canvas Medical’s EMR and healthcare payments platform for digital health developers: Patina (primary care for adults 65+), Circulo (services for physical and behavioral health), UpLift (mental health), and Vivante (digestive health and wellness).
• Ohio State University Wexner Medical Center will analyze claims data from LexisNexis Risk Solutions to identify the needs of underserved communities and choosing optimal service locations.
• Vanderbilt University Medical Center chooses Biofourmis to support a study in which cancer patients will be monitored at home instead of the usual 7-10 day hospitalization following administration of an oncology drug. The system will continuously collect heart rate, temperature, oxygenation levels, and respiratory rate and will measure blood pressure every 4-6 hours, with the results presented on a notification-powered clinician dashboard.
• Healthcare API vendor Particle Health replaces its homegrown master patient index with Verato Universal MPI.
• NextGen Healthcare chooses Verato Universal MPI to incorporate patient matching into its Health Data Hub to integrate information from disparate EHRs.
• The US Social Security Administration contracts with Cerner to electronically transfer disability claims information the EHRs of its customers.
• Insurer Florida Blue, a subsidiary of GuideWell, automates prior authorization approval via AI-powered clinical reviews that are powered by Olive’s AI platform.

People

Industry long-timer Tomas Gregorio, MBA (University Hospital) joins Wellforce as SVP of IT operations.

Impact Advisors promotes Liam Bouchier to VP.

Streamline Health promotes Ben Stilwell, EMBA to president and CEO of ite EValuator Solutions business, also hiring Amy Sebero (NThrive) as chief growth officer for that unit.

Announcements and Implementations

Black Book names 50 recently funded emerging solutions that are challenging the healthcare technology status quo, evaluated by 4,000 healthcare respondents who scored 377 solutions on 18 KPIs.

The Marion County Health Department (WV) goes live on Epic. The health department first experienced Epic when WVU Medicine set up COVID-19 vaccination clinics in Marion County in early 2021.

The Hartford business paper profiles clinical data transformation platform vendor Diameter Health, which grew headcount by 25% last year and expects to hit 100 employees next year. I interviewed CEO Eric Rosow a couple of weeks ago.

Government and Politics

Politico reports that the VA’s pilot of a technology that speeds up benefits decision-making – cutting the average wait time from 100 days to 21 – is being criticized by labor unions that don’t want the jobs of 60,000 VA Benefits Administration placed at risk.

KHN reports that counties and cities that oppose COVID mitigation measures are forming their own health departments and contracting the work out to for-profit companies.

Other

Blind people who received a “bionic eye” implant from Second Sight Medical Products from 2013 to 2019 to gain a small amount of low-resolution vision see their world go dark as the company abandons the technology and approaches bankruptcy after an exodus of its executives and a sale of its assets at auction. Second Sight’s 350 users had its technology installed at a cost of up to $500,000, many of whom complained about poor results. The company is moving on to brain implants.

Sponsor Updates

• Availity launches Availity Essentials Plus, a low-cost subscription service that gives providers online access to more payers through its HIPAA-compliant Essentials platform.
• Fortified Health Security hires Sarah McNulty as executive assistant.
• Optimum Healthcare IT publishes a case study in analyzing and streamlining EpicCare Ambulatory error queues at PeaceHealth.
• NeuroFlow creates a video describing how it helps health plans reduce the costs of care by giving them better behavioral health insights.
• Medicomp Systems releases a new episode of its Tell Me Where It Hurts Podcast featuring CEO Dave Lareau.
• RCx Rules recaps its 2021 success, which includes adding 25 customers and strengthening its HCC coding capabilities by adding Chart Prep Engine.
• Netsmart launches the EveryDayMatters Podcast.
• Meditech announces its HIMSS22 activities.
• Nordic releases a new podcast, “How interoperability and cloud transformations can support healthcare organizations.”

Blog Posts

• Importance of Nurses Recognizing Nurses – Today and Always (Get Well)
• Brush Up on Dental Health IT (Healthcare Growth Partners)
• 3 Ways That Patient Education Improves Safety and Quality of Care (Healthwise)
• An Epic Community Connect Program: M&A without the A (Impact Advisors)
• Continuing the power of One Word (Intelligent Medical Objects)
• Important Promoting Interoperability Requirements for 2022 (Medhost)
• Overcoming HCC Challenges in 2022: Provider Burnout, Staffing Challenges, and Coding Gaps (RCx Rules)
• Healthcare in 2022: The fluid way forward (Meditech)
• PTA Reimbursement 2022: A Look at the Final Fee Schedule (MWTherapy)
• What is patient engagement to a Patient Access Center Manager? A CEO’s primer (Nuance)

Black Book Research’s list of the 50 top-rated emerging health IT vendors for 2022 includes the following HIStalk Sponsors:

• Bamboo Health
• Enlace Health
• Healthcare Triangle·
• Redox
• Symplr

Contacts

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

EPtalk by Dr. Jayne 2/17/22

I enjoyed this short piece on “Overrated tech: 5 tools execs think hospitals should skip.” Suggestions given by health system executives include proprietary technology, augmented / virtual reality, applications written for on-premises use, and niche technology. Rounding out the list was the undead of business equipment: the fax machine. I’m always amazed when hospital or medical licensing forms want a fax number. No matter how hard we work to get away from them, the little machines soldier on.

If I had to add a couple of overrated technologies to the list, I’d suggest the following: freestanding patient portals that don’t integrate with the EHR, home monitoring devices that don’t have a neat and tidy way of sending data to the responsible physician, and emergency department wait-time displays on billboards and websites. If you have time to compare wait times, then it’s less likely that the emergency department is the right location for your care.

The new calendar year has set my continuing medical education counter back to zero, so I’ve been keeping an eye out for good online presentations that also deliver CME hours. Despite the fact many of us have been working virtually for years now, I still see quite a bit of bad behavior on webinars. You would think that with all our collective experience, people would have gotten better at being professional when on large group webinars. I’ve seen enough annoying habits that I could write a “tips and tricks” document. The highlight reel:

• If you are a host or presenter and know you’re not going to allow verbal audience participation, please set up the webinar so that the audience is in listen-only mode. If you forget to do this, hopefully you know how to mute everyone. There will always be some person driving, making lunch, or taking their phone and the webinar to the restroom.
• For audience members, pay attention to what the presenters say about fielding questions. If they ask you to put your questions in the Q&A area as opposed to in the chat, please do so. As someone who runs a lot of webinars, it’s hard to manage multiple streams, so usually we pick one way to handle things. Our organization’s policies might keep us from locking down the other functionality or hiding it from you, but you’ll get a better response if you do as the presenter asks.
• Also for hosts, the whole idea of “we’re going to start about five minutes late to allow people time to join” is extremely disrespectful to those who were prepared and on time. Although you might think you’re doing us a favor and telling us that so we can multi-task for a few minutes, the reality is that a good chunk of your audience is aggravated by it, while another chunk will delve into email or texting and you won’t get them fully back when it’s actually time. If everyone started on time, maybe latecomers would learn a lesson.

Speaking of pushing deadlines, HIMSS has extended the registration discount for HIMSS22 through February 22, citing organizational budget and travel permission issues. I know a number of organizations that are still under no-travel restrictions. Although COVID cases are easing, hospital staffing is still a struggle. Teams are exhausted and there’s often no hope for replenishing the bench. I think leaders are increasingly aware of the optics of jetting off to Orlando while their teams are still underwater.

HIMSS also notes they are adding programming and speakers, including sessions on aging and loneliness, policy updates, and international perspectives. I’m not sure that the addition of those topics would make me want to go if I hadn’t already booked, so it also feels like a “registrations are low, let’s see how many other people we can drag through the door” type maneuver.

HIMSS also continues to send emails trying to get attendees to sign up for events that require additional fees, such as the Women in Health IT Networking Reception. It costs $55 for a 90-minute event, which despite the advertising, doesn’t seem like enough time to “share stories, recognize and celebrate your peers, and form valuable connections that will last a lifetime.” Maybe I’ll engineer my schedule to eyeball the event during peak entry and exit times, though – I’m sure there will be some outstanding shoes to be seen.

Thinking about these events makes me wish Mr. H would reconsider the idea of throwing an HIStalk kegger in some parking lot. There’s an undeveloped lot across the street from my hotel that would be perfect. That would be a real way to make memories that would last a lifetime, I’m sure.

A lot of my work as a CMIO revolves around using EHRs and related technologies, such as clinical decision support, to reduce variability in patient care. A recent piece looked at how physicians within a single health system often make different treatment choices for identical patient scenarios. Certain physicians were much more likely to use recommended standards of care than their peers, which can be concerning if not following the standards leads to variability that worsens outcomes.

The authors looked at 14 “straightforward” clinical scenarios (as opposed to complex cases) to score physician performance. Some of the scenarios looked at surgical procedures, where the top surgeons opted for non-surgical interventions at greater rates than their low-performing peers. This supports the idea that wasteful spending is often tied to inappropriate care. It will be interesting to see how hospitals respond to this since they make a good amount of money from the questionable surgical procedures compared to the non-surgical interventions.

An intrepid reader sent me this picture from a healthcare facility that should remain nameless. It looks like they’re having an issue with their emergency call system, so they hit the Home Depot and stocked up on stick-on doorbells. The handwritten label is a nice touch. I’m not sure what The Joint Commission or any other accrediting body would think of the solution, but it does have a certain resourcefulness to it.

What kind of entertaining solutions have you seen when your organization just needs to make do? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Interviews Brian Yarnell, President, Bluestream Health

Brian Yarnell is founder and president of Bluestream Health of New York, NY.

Tell me about yourself and the company.

I got started in healthcare 10 years ago. Prior to that, I worked in digital media, consumer behavior, and data-driven analysis for retail, manufacturing, marketing, and sales. I have quite a bit of background dealing with consumers and big data. I sold my first health tech company about seven years ago to Hillrom. That was a business called Starling, where we built a replacement for a nurse call system that routed out throughout the hospital and used intelligent workflows.

We shifted gears and founded Bluestream after that, with the idea of figuring out a better way to bring real people, through video, to a patient’s bedside. At the time, we didn’t really anticipate what was going to happen outside the hospital. We were thinking through how we could better provision these relationships between a remote provider and a patient.

Providers rushed to offer telehealth services via whatever video platform was quick and easy to roll out, but the novelty of interacting with patients by video has worn off. What virtual health platform capabilities are needed to provide a good patient and clinician experience?

Things have evolved fairly quickly. I think of it as a continuum. Those technologies that you mentioned were effectively video, which is a commodity at this point. Beyond the basic video connection, things have evolved from telehealth all the way to what I would call virtual-first healthcare. If you think of it in that context, the video piece is the last mile, but it’s really about opening up front doors for patients and meeting them where they are and how they want to be engaged.

The idea of patient portals and downloadable apps has generally not succeeded. The big things that people ought to be focusing on for virtual care is, how do you get in front of a patient, wherever that patient is, and however that patient feels like engaging? Then for clinicians, starting to take some of these brick-and-mortar workflows and make them virtual so that you can do all the great things that you might do in person, but do them remotely.

What elements of a virtual visit most strongly affect patient satisfaction?

We recently added Net Promoter Score, thinking about my marketing background prior to healthcare, to the platform. We know specifically what impacts patient satisfaction. It’s not just the bedside manner of the clinician. It’s what happens when somebody shows up a day early, an hour early, or 20 minutes early for an appointment. You can’t leave people in limbo. You have to be “consumery” in terms of how you engage folks and walk them through this process, even if they show up at the wrong time.

Making experiences that feel like a consumer-driven website. Give people information, expectations, and tools to engage, even if they are not necessarily at the front door at the right time. Then, post-visit, what happens when you wrap up with a clinician? What happens when something goes off the rails and you have to reconnect? All along the way, from showing up early or showing up on time to the visit, dropping the visit, concluding the visit, providing a real framework that still hand-holds the patient and has that consumery feel without being overly technical, overly burdened with lots of bells and whistles.

What virtual options can be offered to patients who have limited technology or bandwidth?

One of the things that we’ve seen as being successful is getting folks like MAs and assistants to tee up the call for physicians. You certainly don’t want the physician troubleshooting cameras, networks, and things like that. But you can have lower-cost, higher-availability resources work with the patient first and do a handoff.

But as you said, some folks aren’t going to get there in terms of tech. What we’ve seen be successful is automation to reconnect these people, to literally point out where you have to click to accept camera permissions. But some folks, like my mom, will never get there, and in those cases, you have to be willing to work with telephones. We’ve seen people doing emergency medicine consults , ET3 [emergency triage, treat, and transport] programs where the reality is that a large portion of the population is going to pick up a phone and dial it. You have to be able to route those visits in with the same attention and same priority as the people who are fully into the smartphones and video.

Health systems initially saw virtual visits as a distraction that should be turfed off to third-party companies that provided not only the platform, but the providers. Now that virtual visits are here to stay, are they treating them more like a full-fledged, branded patient experience?

Absolutely. You hit on a really important point. If you gave a hospital a $1.5 billion a year and a half or two years ago, they would have built a new wing. Now, they have to be thinking about how to build virtual experiences.

These vendors that you talked about that offered a lifeline of virtual visits with the provider network behind it will compete for those patient relationships with the hospitals as the world shifts towards more consumer-facing, on-demand care. The hospitals need to think about how to implement these programs to prevent their vendors from cannibalizing their core business. That becomes important in a transition into a value-based framework.

How does virtual health avoid becoming commoditized, where consumers see all encounters as equal and just choose the cheapest or first-available provider?

Consumers expect it immediately and pervasively. What you’re talking about is this preponderance of front doors that appear to come from all different places.

We and other vendors are starting to equip health systems and traditional healthcare delivery platforms with the ability to cast this wide net. Even though you may come through an insurance company’s website, a phone number on the back of your insurance card, a kiosk in a homeless shelter — very different experiences and a different type of front door — you’re going to start funneling those visits into a common pool provider. People like Teladoc have done that for years. The difference is that health systems are getting smarter about getting in that game and funneling visits from non-traditional places into their provider group.

Healthcare didn’t follow other businesses in looking at the lifetime value of acquiring and retaining a customer. Is that changing?

Absolutely. We have customers all across the spectrum, from people who just pay the bills of ambulatory visits to those who fully participate in these risk-based programs. The more sophisticated folks are looking at the cost of acquisition and  the cost of attrition.

What happens when a non-traditional player, such as Walmart, CVS, or Amazon, gets your patient? They’re not coming back. When you get into this modality where you are getting compensated for the cost of keeping the patient healthy, the lifetime value of patients goes up substantially. Smarter health systems, more strategic entities like some of the pay-viders, are playing that game of, how do you capture as many relationships as you can and keep them? Because you want to be on the winning side of that equation of people who are getting paid to manage a population effectively.

How does a health system’s marketing strategy change when those relationships are established during virtual visits and that involve consumers who may not require a health system’s services for a long time?

We’re seeing more sophisticated health systems, even the traditional ones, get smarter about using tools that let them take the providers they already have. A lot of them are large physician employers, and they have a pool of providers. What they don’t have is access to a patient until that patient has a heart attack or gets hit by a car. To empower those providers to get in front of patient, they are establishing commercial partnerships with large, self-insured employers, with insurance companies, and with municipalities that need healthcare coverage in housing projects and homeless shelters. Establishing lots of diverse front doors — whether it’s a walk-in clinic in the inner city or a health clinic in a Federally Qualified Health Center — and proactively identifying.

They cast a wide net to get patients. The branding might not even be their own, but they’ve got to be funneling those patients to the providers that they are already paying to be on the bench.

Are we in the early days of virtualizing the clinician workforce, where most of them already prefer to live in urban areas?

The hub-and-spoke model is a real thing, being able to have centers of excellence and making them accessible to remote communities, whether it’s because they are socioeconomically disadvantaged or because they are physically remote. The big risk is brain drain. You don’t want to be in a situation where you have no local providers who have expertise any more, because if somebody walks into a hospital and needs follow-up care, they want to have a good experience with a local community member. You’ll start seeing some of that shift into more urban hubs or more centralized hubs, and it’s a little bit of a risk.

Most people would be happy if virtual primary could deliver results equivalent to in-person visits. Are areas that can deliver arguably superior outcomes, such as behavioral health and chronic condition monitoring, drawing equally enthusiastic interest?

We do a lot of behavioral health. We do it inside acute settings, like emergency rooms and inpatient units, and we do it outside of acute settings. The big difference is, are you trying to keep someone out of the hospital and from incurring healthcare costs, or are you trying to adequately address somebody’s needs when they set foot in the door? Either case is a big one, low-hanging fruit with an event that has the potential to cost a lot of money and cause a lot of headaches if you don’t address it up front.

Behavioral health is a good one. We see the measurable impact with our customers and our partners. We can bring in a behavioral health expert, such as a clinical psychiatrist, to write an order for a patient in well under an hour, when in an ED, it might otherwise be a one-day or a three-day wait. It’s a big difference.

Outside the hospital, I would lump in behavioral health with access to things like emergency medicine, these mission-critical things that cause people to go to a hospital or to incur additional costs. We have 911 and ET3 programs that drive down the number of visits by 50%. It’s a big deal, and there’s a reason people are focusing there.

Are health systems interested in having their providers virtually help paramedics, long-term care, and home health providers who otherwise don’t have many options except to send the patient to the hospital’s ED?

Definitely, and even more so as you think about the systemic cost of care delivery. New York City Health + Hospitals is one of our customers. They tie directly into the 911 system. They deliver their services down into SNFs. They tie into first responder devices in ambulances and fire trucks. 

The underlying theme there is that they don’t want people going to the hospital. So when you dial 911 and it’s not life-threatening, they are going to get you in front of a clinician. If you need a paramedic, they’re going to try to get you virtually in front of a clinician. Even when you show up in person, they don’t want transport you, because the systemic cost of moving someone from a SNF back to the hospital is somewhere in the range of $10,000. You can absolutely prevent that from happening if you have the right safety net in place in terms of clinicians and folks like that.

What changes do you expect to see in the virtual visit concept and in the company’s business over the next few years?

What will drive the evolution of our business as a platform provider, and probably more importantly the business of traditional health systems and payers, is this shift towards value-based care and on-demand access to care. That’s just ubiquitous, and it will be painful for health systems to adapt to do that, because they are used to filling beds and physically getting their hands on people.

There are a lot of new folks coming into the market. Amazon and Walmert are better equipped to present consumers with what they want, when they want it. A lot of work will go into equipping these traditional providers with the tools to rise to meet consumers where they are. The mantra of the American consumer is that “I know what I want, and I want it now.” This notion of trying to make a better patient portal and that type of thing is never going to succeed. You have to give people what they want and then work out how to route these things intelligently and drive critical outcomes from them.

Morning Headlines 2/17/22

HHS Awards Nearly $55 Million to Increase Virtual Health Care Access and Quality Through Community Health Centers

HHS awards $55 million to 29 HRSA-funded community health centers to aid them in expanding their virtual care capabilities.

Ro Raises $150 Million from Existing Investors to Expand its Direct-to-Patient Healthcare Model

Virtual care company Ro raises $150 million in a funding round led by ShawSpring Partners, bringing its total raised to over $1 billion.

Equip Raises $58 Million Series B Funding Round to Revolutionize Eating Disorder Treatment

Equip, a virtual eating disorder treatment startup, raises $58 million in a Series B funding round.

Epitel Secures $12.5 Million Series A Financing for Wearable, Wireless EEG Monitoring System

Epitel, which specializes in seizure detection and remote patient monitoring, raises $12.5 million in a Series A funding round.

HIStalk Interviews Matt Scantland, CEO, AndHealth

Matt Scantland is founder and CEO of AndHealth of Columbus, OH.

Tell me about yourself and the company.

AndHealth is a digital health company that is focused on helping people reverse chronic illnesses. We started with migraine and are seeing patients for that now. We are soon launching for some of the most common and disruptive autoimmune conditions.

I’ve made a career of combining technology and healthcare. I started college thinking that I would be a doctor and ended up being a programmer, so I combined these two things in my career. Probably the biggest advantage that I have had is to have worked alongside an incredible team for my entire career, in some cases, literally going back to my internship in college. Many of these folks helped us build our last company, CoverMyMeds. They have been joined at AndHealth by a new group of telehealth experts and clinicians.

Each of us have our own “why” that we are at AndHealth. For me, I knew I had to do something like this because my own doctor helped me realize that I needed to participate in my healthcare. That was back in 2011, when my first son was born. At the time, I was busy with CoverMyMeds, but I knew that if I ever had a chance to do another company, I wanted it to be a company that helps support patients to participate in their own healthcare. That leads us to where we are today.

You intentionally use the term “disease reversal” as opposed to “disease management.” How do you distinguish those?

For many years now in our industry, we have focused on this idea of disease management, which is to try to tamp down the progression of cost and disease escalation. We now know that many chronic illnesses can be brought into remission if we can get the patient to change the behavior that is responsible for about 80% of our health. Once we understand that reversal is possible, the key question is, how do you achieve it? The answer is that you need to engage patients in a course of change. We have built a disease reversal company. We have built the whole business around how to support patients in making that change.

How does the approach differ from traditional office-based encounters?

The big idea is that we can get to reversal when we can get patients to participate. The core question then is, how do you get people to participate? We’ve built the company around what we’re calling a digital center of excellence that helps to make that participation easier. One important element of it is moving from delivery of care of that’s episodic and on-premise to one that is continuous and virtual.

For example, one of our early patients suffered from chronic migraine. She had moved around our healthcare system for years and years, never able to get to a state of disease remission and never able to figure out exactly, in the moment of a migraine, how to cope with the situation other than going to the emergency room. By moving this care to something that is continuous, we were able to dramatically shorten the feedback loop between trying a particular healthcare step and seeing whether it worked, to the point that we were able to optimize her acute medication and also identify the root cause of her migraine.

When we optimized the acute medication that kept her out of the emergency room, we had time then to work on actually reversing the disease. Her root cause ended up being a food intolerance issue that, despite many years in our healthcare system, had never been found. Once we were able to identify that food intolerance issue, we had moved this diffuse idea that we have around behavior such as “eat better” to the equivalent of a shellfish allergy, where just this one step was the difference between illness and health.

The tightness of that feedback loop makes it such that people with shellfish allergies almost never are eating shellfish. But compare that to someone with a cardiometabolic disease, where sticking to a nutritional program is hard. The only difference is how clear that feedback loop is. By moving to this style of care, we are able to shorten that feedback loop.

When we do that, we help the patient achieve a high return on effort. We don’t need to turn the patient into an Olympic athlete when we know the precise root cause of their illness. We just need to address that particular root cause. When we combine that with focusing on diseases that patients are highly motivated to solve, typically because of pain and disruption, then we are able to achieve a higher level of engagement than has ordinarily been seen in these digital health services, which have tended to focus on diseases that, while important, are pretty difficult to engage patients in early in the progression of the disease.

That’s why we started with migraine and autoimmune conditions. They share common root causes with these other illnesses. We can engage the patient in something they care about today because of the pain and disruption, but because of the shared root causes, we end up solving these other issues as a side effect.

Some of the app-focused programs assume that patients will change if offered education videos, scripted coaching, and reminders to modify their lifestyle. How much of your program will be based on psychology rather than technology?

We have built the DNA of the company around the science of how behavior happens. The more we have learned about that science, the more we have learned how big the opportunity is to do better. We do that by understanding the difference between health aspirations and health behaviors. The biggest lever that we have in our healthcare system to create behaviors that support health is to make them easier to do what we call create ability. For many people, we can create ability by making something that used to be time-consuming and expensive quick and inexpensive or free.

That psychology, building around the behavior design, is super important and is a through line in the company, from our technology to our business model and to the actual healthcare delivery. One important distinction between what we are doing at AndHealth and a lot of what has happened before is that we are actually the patient’s doctor rather than a wellness app. When we are the patient’s doctor, we are able to harness the credibility that comes with that.

Patients have shown our healthcare system that what they want is the most specialized expert care that they can get for their particular condition. Each of our reversal centers of excellence is staffed by experts in that therapeutic area, who take on the patient in the practice of healthcare so that we can manage medications, do labs, and have the whole set of healthcare services at our fingertips.

No one disputes that a percent of a patient’s health is behavior. The question is, do people believe that it’s possible to help them change? A core idea that we have at the company that comes from my own life and the life of the people here is that everyone can change if we give them the support to do so, and if we ask them to make a change that they care about.  That’s why we focused on these areas and why we think this delivery model can help support people. It’s tougher to engage people with the garden variety app that counts steps. That’s not solving a problem that patients care about. That’s why we think this is different.

How does a patient’s primary care doctor participate?

That collaboration is such an important idea that we named the company AndHealth to reflect the idea that we can’t do this alone. We see ourselves as part of what I think will be a transformation in our healthcare system that we do mostly outside of the company, rather than inside. While we become the patient’s headache specialist, there are about 40 million migraine sufferers in the United States and only 2,000 headache specialists. This is one of the key challenges that we are helping patients solve, the problem of access. Even if you have good health insurance, the ability to get into a care team that understands how to treat migraine is hard.

By moving this care to a model that is more accessible and is available continuously, we are able to make a big difference in the lives of these patients. You can think of us as a referral from a patient’s primary care doctor or from their employer, because we are an employer-sponsored health benefit that helps complement the healthcare that the employer is providing to their employee.

How hard is it to convince employers and health plans to pay for your service?

Ultimately, we need to prove that we are achieving life-changing results for patients. If we can do that in this area, it will be an important new way that patients get access to care.

One of the reasons that we started with migraine is that leading employers are starting to recognize it as a silent issue, lurking just beneath the surface, much like how the best employers started to recognize mental health five years ago. It had historically been dismissed. It had historically not had great treatment options. It wasn’t generating the claims that caused it to get on anyone’s radar. It was a chicken-egg issue. If there wasn’t good access to care, there weren’t many claims, so it didn’t get onto the radar of employers. 

But we now know that migraine is the leading cause of short-term disability for most employers. It’s a huge contributor to turnover. Because it disproportionately impacts women and people of color, it’s a lever against diversity, equity, and inclusion objectives for employers. We think that a proposition that is focused around increasing access to super high-quality care in a therapeutic area that impacts many of these employers, 20% of the employee base, and is actionable because patients are engaged around this disease, will be taken up by many employers. We are seeing that so far in the market.

Can you survey employees or look at company records to identify the opportunity, unlike wellness apps where employers may get some non-specific value from helping their employees with weight, exercise, or stress?

Exactly. It’s rare that we’re in a meeting with an employer where someone in that meeting doesn’t say, “I have migraines. That has been an incredibly difficult part of my life that has made it difficult for me to show up in the way that I want to at work.” Because it’s common, and historically patients haven’t seen a lot of good treatment options, we are hearing from employers that this is important to solve. Now that we know that it is solvable, there’s a lot of interest in engaging.

It’s similar in autoimmune conditions, although what’s a little different in autoimmune is it has gotten a lot of employer attention because the costs are so high. For the conditions that we are treating, simplifying a little bit, there’s about $40,000 in costs per employee, per year for those who suffer from the conditions. A good bit of it is pharmacy cost, but there’s also significant healthcare cost. That has gotten more attention, but migraine employees are expensive from a claims perspective and especially from a productivity perspective.

AndHealth isn’t primary care, where we need to be able to treat a patient who shows up with anything, and where we have a relatively diffuse cost or value proposition to an employer. This is something that’s targeted at the disease states that, one, are the most expensive and disruptive, and two, by narrowing, give us an opportunity to have a learning system that gets better really fast.

One of the underappreciated elements of digital health is the degree to which when we narrow and then run this through software where we’re force-multiplying the expertise of clinicians, we move to a learning system that is improving quickly. We have a credible chance to move in these therapeutic areas from a new company to the foremost expert quickly by narrowing. That makes achieving results for patients dramatically easier than if we tried to see a patient who shows up with any condition.

What are the most important lessons you learned from starting, growing, and selling CoverMyMeds?

The biggest lesson was to find a way to collaborate with the healthcare system. Because if we want to do something big, we need the help of the people that are already here. We can be transformative without being disruptive. That idea is so important. That’s why we called the company AndHealth rather than OrHealth. That’s a really important one.

The other is the idea of people first, putting not just the patient first in everything we do, but winning through our employees. We ended up being on Glassdoor as one of the top 20 employers in the country in the past. While we think the tactics that will get us there are different, because the world is different than it was 10 years ago, we are focused on being a place where clinicians and technologists can come to build something that makes a big impact for patients, but also makes a big impact in their career. Those two things are core DNA in the company.

What would you like to see happen with the company in the next few years?

We have already shown that we can produce what we think are life-changing outcomes. In our first study in migraine, we were able to get to a 60% remission rate for patients. What we want to do in the next couple of years is show that we can do that at scale for employers and in a way that generates a value proposition that makes this part of the benefits package for the leading employers. It’s about showing that we can create those life-changing outcomes with patients, in collaboration with employers, at a scale that ends up making a difference for the world. If we can do that, that is success.

Morning Headlines 2/16/22

Athenahealth Acquired by Hellman & Friedman and Bain Capital

Bain Capital and Hellman & Friedman finalize their $17 billion acquisition of Athenahealth.

Memora Health Announces $40M Financing To Scale Platform for Simplifying Complex Care Delivery

Automated care management company Memora Health raises $40 million, bringing its total funding to just over $50 million.

$1.13M settlement proposed in Inmediata Health in lawsuit over 2019 data breach

Puerto Rico-based claims clearinghouse Inmediata will pay $1.13 million to settle a class action lawsuit filed by patients who were affected by a 2019 data breach in which the company failed to secure patient data online, enabling search engines to serve up PHI in search results.

News 2/16/22

Top News

The $17 billion sale of Athenahealth to a pair of private equity firms has been completed.

Reader Comments

From Elizabeth Holmes: “Re: Circadia Health. Touts how they do remote patient monitoring, but FDA’s clearance says specifically that ‘The Circadia C 100 System is not indicated for active patient monitoring.’” I emailed the company to clarify, but haven’t heard back. The website says that the touchless system issues a daily report of respiratory rate and time in bed, which seems to be in conformance with FDA’s requirement that its system not be used to monitor vital signs and is “for retrospective analysis only.” Still, the company’s website touts its capability to “prevent the 3rd leading cause of death” in managing acute respiratory distress syndrome, COPD, sepsis, and pneumonia while earning post-acute care facilities a 2% Medicare incentive payment.

HIStalk Announcements and Requests

HIStalk sponsors who are exhibiting at or attending ViVE and HIMSS22 – click the link, complete the short form, and I’ll include you in my online and downloadable guide. You may recall from last week that my poll respondents gave as their #2 reason for visiting a booth as simply knowing ahead of time the activities that will be presented there, so share your plans and maybe get more feet onto your expensively rented carpet.

Webinars

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

Acquisitions, Funding, Business, and Stock

PriorAuthNow, which offers automated, real-time prior authorization software for providers and payers, raises $25 million in funding. The company says its technology has helped Cleveland Clinic staff reduce the prior authorization process from 45 minutes to four minutes.

Kidney care company DaVita acquires transplant software vendor MedSleuth for an undisclosed sum.

Radial Analytics, a patient care transition software startup based in Concord, MA, raises $3 million in funding.

Automated care management company Memora Health raises $40 million, bringing its total funding to just over $50 million.

Sales

• Community Health Systems (TN) selects remote patient monitoring and virtual care technology from Cadence.
• Davis Health System (WV) will implement Cerner across its three hospitals beginning this summer.

People

Azara Healthcare hires Todd Schlesinger (Jvion) as VP of sales.

Patti Baran (Teladoc Health) joins AliveCor as SVP, Healthcare Americas.

Announcements and Implementations

Little Rock Air Force Base Clinic (AR) will transition to the DoD’s Cerner-powered MHS Genesis system next month. The department plans on rolling out MHS Genesis at 54 facilities this year, which would see the technology deployed at more than half of all military hospitals and clinics.

Guthrie County Hospital & Clinics (IA) will go live on Epic this weekend.

A Tegria-commissioned Harris Poll survey finds that 69% of Americans would consider switching providers to gain access to same-day appointments, convenient locations, and self-scheduling. More than half would be willing to have their first visit with a new provider conducted virtually, although only 37% of those over 65 agree.

Government and Politics

VA Acting Deputy CIO Laura Prietula tells attendees at an AFCEA Bethesda health IT event that the department has made significant improvements to its EHR data transfer processes, adding that it has standardized the majority of the high-priority datasets that are being transferred from VistA to Cerner’s Millennium and HealtheIntent platforms.

Privacy and Security

Puerto Rico-based claims clearinghouse Inmediata will pay $1.1 million to settle a class action lawsuit filed by patients who were affected by a 2019 data breach in which the company failed to secure patient data online, enabling search engines to serve up PHI in search results. I mentioned at the time that the majority of the 1.6 million patients alerted about the breach had never heard of the company. Many received multiple notification letters, with some of those being addressed to other patients.

Avita Health System (OH) notifies patients of a network security incident last week that forced it to revert to downtime procedures.

Other

I’m not sure I noticed until reading the CHIME update below that former HIMSS President and CEO Steve Lieber has been working for CHIME as chief analytics officer since October 2021.

Sachin Jain, MD, MBA says big tech firms have accomplished basically nothing in healthcare because scale is hard to achieve, fee-for-service hasn’t gone anywhere so improving health isn’t a priority, managing healthcare means managing risk, and margins are small. He says companies like Apple need to stop tinkering around healthcare’s edges and instead buy a big health system, where they can demonstrate the benefits of technology, make the argument for value-based care, and integrate payers and providers. He says Amazon’s dabbling in the grocery business didn’t amount to much until it bought Whole Foods.

This is an interesting thought about primary care in considering non-healthcare markets, where generalists could be squeezed out by specialists on the upper end, and on the lower end, by less-expensive substitutes who follow protocols that those experts approve.

Sponsor Updates

• CHIME launches new media resource Digital Health Insights as a digital destination for healthcare industry professionals.
• Ellkay will exhibit at Greenway Health’s Engage conference February 18-23.
• The Kansas Hospital Association’s Health Services subsidiary selects ChartSpan as its exclusive chronic care management partner.

Blog Posts

• Patient-centered Care: 3 Ways Data is Transforming Behavioral Health Outcomes (Arcadia)
• The Doctor Will See You Now: Why Patient Experience Matters (CereCore)
• All the Ingredients for Population Health Management (EClinicalWorks)
• MEDITECH to Showcase Expanse at Inaugural ViVE Conference – March 6-9 in Miami (Meditech)

Contacts

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

HIStalk Interviews Gidi Stein, MD, PhD, CEO, MedAware

Gidi Stein, MD, PhD is co-founder and CEO of MedAware of Ra’anana, Israel.

Tell me about yourself and the company.

I started my career as a software engineer many years ago. I was a VP of research and development and the CTO of several startups in the early 1990s. At some point, I vowed never to do startups again, changed my career course, and went to medical school. I was the oldest medical student in Tel Aviv University. I graduated, specializing in internal medicine, did a PhD in computational biology, and held executive roles in one of Israel’s leading hospitals. MedAware is a software company that uses artificial intelligence and smart algorithms to identify medication-related risks and save lives.

What points in the process of ordering and administering medications are most likely to introduce patient harm that existing systems won’t detect?

The flow that begins with the prescriber ordering the medication, the pharmacy approving it, and then administering it or having the patient visit an outpatient pharmacy — all of these situations are basically covered, in some way, by existing systems. But after the patient is already on the meds, after they are  home or are already admitted, things can go wrong. Laboratory abnormalities are found. Vital signs change. Patients can deteriorate into shock or have acute renal failure or anemia. These changes impact the risk that is inflicted on them by their meds, and some have drug events that are related to the medications that they are receiving. Current solutions are usually not good at tracking this, monitoring these patients, and picking up those risks in the post-prescribing, post-dispensing period. Most of the problems we find are there.

What are the alerting challenges that are unique to smart infusion pumps?

Smart infusion pumps are IV pumps that “know” the medications that are being provided to the patient by that pump. The nurses program these pumps in terms of the medication to be administered, the patient’s weight, the rate, the dose, how long the infusion should take, etc. In each of these steps, there can be a typo, a click of the wrong button, or mis-programming. The current systems are similar to the electronic medical record in being not very good at identifying these risks. The alerts that they generate are mostly false alarms, which drive alert fatigue. It’s similar to what we do with electronic medical records — we know how to identify pump programming errors and do this through our partnership with Baxter.

How do you identify an exception to normal practice to generate an alert?

We assume that nurses, physicians, and pharmacists know their jobs. They don’t need MedAware or any of us to teach them how to practice. But you can be the best poet in the world and still have typos that a spellchecker will find. You can be the best doctor in the world and still need that intelligent spellchecker to identify these typos in prescriptions or the programming of pumps. This is where the outlier piece is more relevant.

We published research two years ago with Sheba Medical Center, a large hospital here in Israel, in which we analyzed the errors that physicians make when they’re tired, overworked, or don’t have specific experience with the medications they are prescribing. Two times, three times, eight times as many errors are made when physicians are tired, overworked, working in an overcrowded ER, and especially when they are prescribing medications that they are not used to prescribing. We’ve seen that more and more with COVID in the last two years.

How does the technology coexist with an EHR to reduce alert burden?

What is unique about our system is that the alert burden is very, very low. Current systems can generate alerts in about 20% of medications or medical orders. We provide less than 2%, almost 1%, of the alert burden. The accuracy of the alerts we provide is very high, more than 85% as compared to less than 5% in the current solutions. In most of the cases, physicians — and we monitor this continuously — change their order following our intervention. Instead of applying rules like current systems, we do something more intelligent in applying more sophisticated algorithms to understand the prescription patterns in each hospital, in each care setting, and identify the outlier behavior as a potential error. These are usually consistent with the physician saying, “Oh, I didn’t mean to do that. I’m going to change that.” We see that every day

Are the EHR alerts suppressed by replacing them with yours?

It depends on the client. It depends on the workflow. In some cases, we completely replace the current systems and we are able to generate very few alerts and change the whole experience of providers. In other cases, we focus more on the pharmacy, where all the medical orders are funneled to, so we’re able to surface the catastrophic problems for the pharmacy to focus on. Our engine can be applied in different settings and in different workflows. It really depends on the client and the setting, even inside infusion pumps.

Does the alerting intelligence use the clinician’s individual patterns, or does it look only at their facility’s collective experience?

It’s more detailed than that. It’s at the level not only of the institution, but of the specific department and boiling down to specific prescribing patterns. It really depends on the amount of data that we have in each institution and our ability to model the “normal” behavior based on this data. The more data we have, the more accurate we can be. We can drill down to more refined accuracy and resolution.

How does an organization analyze their alerting patterns to determine that your system can help?

It’s common knowledge. We don’t have to persuade the customers that the current alert burden is too high and that they are ignoring most of the alerts. The challenge is to persuade them that it’s not necessary — they could do it differently and it could be a different experience for the provider. They find that hard to believe. One of the things that we do in most of our clients is take a little bit of historical data and show them what we find. This is the “aha” moment, because with most of the stuff that we find, they were not aware that it is happening in their own back yard. That easily triggers the “OK, I want this.”

How much of the capability that your system has was made possible by advances in AI, and where do you see AI finding a place in healthcare?

Our solution uses many type of algorithms, from the simplest statistical analysis to really robust AI with deep learning, neural networks, and all the buzzwords that come with it. We use the most sophisticated part of AI for specific use cases, one of them being to identify cases in which the patient receives the wrong meds. Either the physician clicked on the wrong patient or drug was given to the wrong patient.

Understanding the clinical context of the patient and the relevance of this specific medication to that patient’s profile is an extremely hard task to do. We’ve been able, for several years now, to identify and to classify the medication as, is this relevant for this patient, or is this not relevant for this patient? It doesn’t have to be even something dangerous. It could be a two-year-old male child who is ordered birth control pills. It wouldn’t kill him, but he definitely doesn’t need it and it’s a complete outlier for that child. This is an extreme case, but there are a lot of more simpler ones that are hard to detect by anything else than using sophisticated AI. Our point is that we would rather use the simplest methodology to fix the problem, but in some cases, you need something that is more complex.

The use of AI in healthcare will find its place. It’s still struggling. W see very nice solutions in the imaging world where companies identify risks in CTs or MRIs and surface them up to the clinicians that hey, you have pulmonary emboli, CVA, or a critical event that you have missed –put it on top of the file.

The fine line is understanding and comprehending that we are not here to replace the clinicians. We are here to help them make better decisions. We are not here to teach them medicine. We are not here to tell them what to do. Just being that safety net to make sure that they don’t type the wrong thing. This approach can grow into more helping with diagnosis and procedures and providing a better prescribing and platform for clinicians, as long as we don’t even think or say that we can replace them or do their job, because that just doesn’t make any sense,

Where do you see the company in the next few years and the use of technology like yours in healthcare?

We have developed a unique engine that can be applied in different places in the industry. Our strategy on the business front is to partner with larger companies that have embedded solutions — in medical devices, decision support, or anything in the medication delivery space — where we can make their data smarter. We can make their systems and devices perform better. This is the path of growth to the company going forward. Baxter is one example. We have more that are coming and the future is looking good.

Morning Headlines 2/15/22

Nevada Tech Company Brisk Health Launches Mobile Urgent Care

Las Vegas-based Brisk Health launches app-based telemedicine and urgent care house call services.

PriorAuthNow Raises $25 Million to Expedite Healthcare Authorizations

PriorAuthNow, which offers automated prior authorization software for providers and payers, raises $25 million, bringing its total funding to $57 million.

DaVita Acquires MedSleuth, Deepens Efforts to Improve Transplant Experience

Kidney care company DaVita acquires transplant software vendor MedSleuth for an undisclosed sum.

Curbside Consult with Dr. Jayne 2/14/22

I started the HIMSS22 vaccine verification process today, and we’ll have to see if it works this time. Last year, when I still planned to attend the event in person, I started the process and never received conformation that my vaccine submission had been validated. The current process includes uploads of both a government-issued ID and the vaccine card. I tried using my passport this time to see if it works any better than my driver’s license did last year.

The emails I’m receiving from HIMSS22 vendors have started to increase in frequency, but I have yet to see a marketing campaign that really stands out. I’m trying to do a little planning every day so I can stay ahead of the game and avoid a flurry of organizing at the end.

This weekend’s hot topic in the virtual clinical informatics physician lounge is a petition to extend the so-called “practice pathway” for board certification in clinical informatics. The practice pathway, which is scheduled to expire in 2022, allows a certification mechanism for those of us who didn’t complete formal fellowships in clinical informatics. To be eligible for certification, physicians must demonstrate three years of practice in the field, with at least 25% of professional time in informatics. Physicians can also be eligible if they complete a 24-month master’s or PhD program in biomedical informatics, health sciences informatics, clinical informatics, or a related subject.

A number of clinical informaticists are supportive of extending the practice pathway, particularly due to the disruption caused by the COVID-19 pandemic. They note issues with the availability of residency and fellowship rotations that disrupted the ability of participants to complete their programs. Proponents cite a shortage of certified informaticists and the expected need for roles in thousands of hospitals and clinics. They also note the large number of physicians who have been practicing clinical informatics but who might not have the time or financial resources to pursue a fellowship. Others are concerned about the ability of fellowship programs to ramp up enough to be able to train the numbers of informaticists required to staff the workforce.

Others are opposed to leaving the practice pathway open. Some feel that the option hurts fellowships, leading to decreased applications and filled positions. Personally, I think the low salaries paid to fellows are at least partially responsible for decreased applications, not to mention the disruption to your career if you’re already practicing in the field. There is also concern that the practice pathway creates a lower standard. In my experience employing clinical informaticists, I’m not sure the board certification really makes a difference. It’s more of a check-the-box formality for some, but I’m perfectly happy hiring a seasoned informaticist who can do the job that needs to be done regardless of their certification status.

I obtained my certification through the practice pathway, having practiced clinical informatics exclusively in the seven years prior to certification. At that point in my career, there was no chance that I would consider leaving an EHR implementation at a major health system to complete academic pursuits. I used the Board’s content outline to craft a study plan and spent nearly six months reading more than a dozen college-level textbooks to prepare for the exam. Other than some specific and highly technical questions, the majority of the board examination involved topics that I dealt with on a daily basis in my informatics practice. One physician commenting on the issue noted that as data experts, we should be looking for proof that there are differences in outcomes when clinical informaticists are certified through the practice pathway versus through the fellowship pathway.

Board certification is a hot topic for physicians in general. Most boards require physicians to participation in a process called Maintenance of Certification. Depending on the board, physicians have to participate in continuing medical education, complete performance improvement projects, document evidence of professionalism, and complete a demonstration of knowledge. Those knowledge demonstrations vary. Some still require the traditional high-stakes examinations, and others allow longitudinal assessments. Most physicians aren’t interested in cramming for a high-stakes exam, especially when we’re tested over content that is no longer part of our daily practice. There is no immediate feedback on questions that are missed and it’s a generally miserable experience.

The last time I took one of those exams, I had a pat-down by the testing center employees and was treated like a criminal before even entering the testing room. There have been recent reports of physicians who were treated poorly at testing centers, including one lactating physician who was offered “accommodations” for pumping that failed to include a private area, a table or counter, or even an electrical outlet for the pump. She was forced to pump in a bathroom stall and the time spent counted against her limited exam breaks. I can’t imagine the mount of stress that added to the situation.

Specialty boards are trying to update their Maintenance of Certification processes to make them less onerous for physicians. However, there isn’t evidence that participating in the process makes physicians better at their jobs. I agree that for those of us participating in the longitudinal assessments, the process helps physicians become more proficient at finding information they don’t know.

Since I’ve been in urgent care for the last decade, I can handle most of the board questions that cover the musculoskeletal, digestive, and respiratory systems without blinking. Trauma is also a slam dunk and I’m solid with dermatology, infectious disease, and psychiatry. For maternity care, which I haven’t practiced in a very long time, I end up resorting to reference materials to handle those questions, just like I consult with practicing maternal care physicians in real life. Hopefully, the process is teaching physicians how to find information when they don’t know it off the tops of their heads, and to do so efficiently. However, it sometimes just feels like a game that we have to play.

Has there been any chatter about clinical informatics board certification in your organization? Are you for or against extending the practice pathway? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 2/14/22

Doximity Announces Fiscal 2022 Third Quarter Financial Results

Medical social network operator Doximity announces Q3 results and that it will acquire physician on-call scheduling app vendor Amion for up to $83 million.

Announcing Radial Analytics’ $3M Round led by Initialized Capital

Radial Analytics, a patient care transition software startup based in Concord, MA, raises $3 million in a funding round led by Initialized Capital.

Vocera Announces Fourth Quarter 2021 Financial Results

Vocera announces Q4 results: revenue up 16%, adjusted EPS $0.29 versus $0.28, beating analyst expectations for both.

LifeOmic Acquires Bavard, an Enterprise-grade Conversational AI Platform

Precision digital healthcare company LifeOmic acquires Bavard, which offers AI-powered digital assistant technology.

Monday Morning Update 2/14/22

Top News

Medical social network operator Doximity announces Q3 results: revenue up 67%, adjusted EPS $0.29 versus $0.07, beating Wall Street expectations for both. Shares jumped up sharply on the news, up 14% in the past 12 months versus the Dow’s 2% increase. The company’s valuation is at $16 billion, with co-founder and CEO Jeff Tangney holding 33% of shares. From the earnings call:

• Doximity is acquiring physician on-call scheduling app vendor Amion for up to $83 million and will integrate its offering with Doximity’s secure messaging, CV, referral, and telehealth tools.
• Chief Commercial Officer Joe Kleine will retire this fall, to be replaced with Paul Jorgensen.
• Continuing medical education credits issued are up 25% quarter over quarter as in-person education is being increasingly replaced with online programs.
• Job postings quadrupled year on year as physicians sought new opportunities.
• The company’s video telehealth platform earned Best in KLAS over Microsoft Teams, Zoom, and other services.
• Drug companies whose sales reps can’t visit doctors in person are moving to digital marketing programs and eliminating sales positions. The company says that the count of drug reps has doubled since the mid-1990s to 81,000, but it expects 10% of those reps to lose their jobs in the next couple of years.
• CEO Jeff Tangney says that Fortune 500 companies spend 70% of their marketing budget on digital channels, while healthcare is at 23%.

HIStalk Announcements and Requests

The fortunes that conference exhibitors spend on fancy booths, catering, glossy presentations, and tchotchkes generate a lower return than the free options – choosing and coaching your booth reps carefully and letting people know ahead of time what you’ll be doing in your expensive patch of carpet. My #1 recommendation is, as always, to confiscate the phones of those who are working the booth – humans seeking information are an irritating intrusion into their cyber-bliss.

New poll to your right or here: Does your business card or email signature list a certification or fellowship credential? I’ve stopped listing both since in my case, their value seems to accrue more to issuers who are looking for recurring revenue than for holders to prove their competence or ethics. Some are still hard to earn and maintain (CPA or PMP, for example) and I would use those if directly relevant to a current or desired job. I also don’t understand listing questionably rigorous, non-selective “executive education” on LinkedIn, especially in lieu of having earned an actual degree from an accredited school. Business card alphabet soup and sitting in front of “I love me” walls plastered with framed, yellowing certificates is a fascinating study in occupational vanity. I’m always intrigued that sales executives, CEOs, and startup founders are often light on formal education, having set a path while young in which formal education would have been a multi-year distraction from their destined accomplishments. I should run a poll asking respondents if they report to someone with less-impressive education credentials.

If your HIStalk sponsor company is spending money to participate in ViVE and HIMSS22, why not boost attention to your involvement with a free entry in my conference guides? Those links lead to forms where you tell me about what you’re doing, which I need to know in the next couple of weeks since said conferencing is imminent.

Welcome to new HIStalk Gold Sponsor Biofourmis. The fast-growing, Boston-based global health technology company is focused on leveraging software and data science to deliver virtual care and develop novel digital therapies. Its robust care management platform, Care@Home, enables remote disease management across a range of medical conditions for acute, post-acute, and chronic care. The solution utilizes medical-grade wearables to continuously collect patient data, which is analyzed by Biovitals, Biofourmis’ highly sophisticated, clinically validated AI-powered predictive analytics engine. With support from Biofourmis’ in-house clinical care team, payers and providers can leverage the solution to predict clinical deterioration in advance of a critical event, which enables earlier interventions for better outcomes and cost savings. Likewise, the company discovers, develops, and delivers clinically validated digital therapeutics. These monotherapies or “pill plus” prescription therapeutics support payers and providers in improving patients’ lives while reducing healthcare utilization and associated costs. Thanks to Biofourmis for supporting HIStalk.

Webinars

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

Acquisitions, Funding, Business, and Stock

Vocera announces Q4 results: revenue up 16%, adjusted EPS $0.29 versus $0.28, beating analyst expectations for both. Stryker’s $3 billion acquisition of the company remains on track.

Sales

• Northwest Primary Care (OR) implements Deviceless Remote Patient Monitoring from CareSignal, a Lightbeam Health Solutions Company.

People

Salesforce promotes David Cousins, MS to SVP of healthcare and life sciences.

ReMedi Health Solutions hires Scott Collins (Futura Mobility) as chief revenue officer.

Announcements and Implementations

Virtual care and digital therapeutics company Biofourmis launches Biofourmis Care, a chronic condition management system and virtual care team for heart failure, hypertension, diabetes, lipid management, and atrial fibrillation. The service includes automated medication management for optimizing therapy.

HIMSS22 in-person attendees who plan to voluntarily provide proof of COVID vaccination have until March 11 to use the pre-show online process of Safe Expo, which will send confirmation that allows picking up a conference badge. Attendees who used Safe Expo for HIMSS21 can use last year’s verification based on their email address, which took me a grand total of perhaps 10 seconds today (good job on that, HIMSS). The alternative is to show vaccination proof or a negative result no older than from the previous day at the onsite verification desk, which is ideal for folks who want to kick off their HIMSS22 experience by waiting in line (or “on line” for you New Yorkers).

For those who were annoyed by the HIMSS21 virtual program ambassadors (Dr. Jayne was, emphatically) they will be back for HIMSS22, adding nearly zero value with their chirpy omnipresence.

Other

In Netherlands, the government’s National Coordination Center for Patient Spreading – which hoped to address COVID-19 admission surges by distributing patients across multiple hospitals – paid $1.4 million for a real-time hospital capacity tracking system that was developed by two of the organization’s advisors. The manually updated system proved to be unreliable, to the point that seriously ill patients were being taken to hospitals that showed available beds even though they were full. The government eventually bought the software company itself in a no-bid deal.

Sponsor Updates

• The local paper profiles Cooper University Health Care’s implementation of Nuance’s Dax ambient clinical intelligence solution.
• EClinicalWorks releases a new podcast, “Handling Hospital Notifications with Direct Messaging.”
• AGS Health will exhibit at the ACDIS Virtual Summit February 16-17.
• OptimizeRx CEO William Febbo will speak at the Bank of America Annual HCIT and Digital Health Conference February 23.
• Nordic releases a new podcast, “How interoperability and cloud transformations can support healthcare organizations.”
• Commitment to customer success drives growth at RCxRules in 2021.
• Surescripts congratulates DAW Systems, winner of the 2021 Surescripts White Coat Award for highest e-prescribing accuracy.
• SyTrue caps off a year of tremendous growth in its client base, number of employees, and transaction volume.
• Verato publishes a new report, “Achieving a 360 Degree View of the Patient: Why Accurate Patient Identity is Critical to Health System Success.”

Blog Posts

• Why value-based purchasing matters now to home health agencies (Ability Network)
• Where Will “Homeless Data” Live? (Nordic)
• 5 questions for identifying candidate processes for automation in healthcare (Olive)
• Healthcare Trends in 2022: Top 6 Needs to Consider for Medical Groups (PerfectServe)
• Accelerate the Healthcare Provider Onboarding Process (Symplr)
• Two Healthcare Supply Chain Technologies to Get Excited About (Premier)
• From surviving to thriving – how health plans can drive change and improve healthcare (Redox)
• 4 Prescribing Flags in the EHR – And How Real-Time Prescription Benefit Solves Them (RxRevu)
• Top health technology hazards (and how to address them) (Spok)
• NLP Solutions Can Drive Payer Efficiencies – But They Are Not All Equal (SyTrue)
• The 5 pros and cons of contact center BPO (Talkdesk)
• An Update from our CEO: Another Strong Year for RCxRules and Our Clients (RCx Rules)
• Healthcare Can’t Go Backward When the Pandemic Ends (Tegria)
• EMR or Claims? Here’s Why You Need Both. (TriNetX)
• Patient Engagement Best Practices for Life Science Companies (Twistle)
• Simplify Clinical Communication with Vocera Cloud-Based Solutions (Vocera)
• Today the world, tomorrow the moon (Volpara Health)
• You’ve Landed a New Patient: Now What? (WebPT)
• A 2022 Guide to Choosing a Patient Engagement Platform (Well Health)

Contacts

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

Weekender 2/11/22

Weekly News Recap

• AndHealth, founded by CoverMyMeds co-founder Matt Scantland, exists stealth mode and raises $57 million in funding.
• Germany-based Ada expands its Series B round to $120 million and plans aggressive expansion to the US.
• Senators form a commission to consider updating HIPAA.
• Best in KLAS named.
• NThrive will acquire Pelitas.
• Premier reports Q2 results.

Best Reader Comments

I have been interviewed by the CEO of a company once, and I walked away from it thinking “what do you actually *do* that this is how you spend your time?” To me it indicates poor leadership and an inability or unwillingness to build a team that can do the job independently. (HIT Girl)

I sometimes wonder if the unspoken role of the EMR is to remind and support the clinicians. What did they do, when did they do it, and why? As long as your capability includes interviewing the clinicians, maybe an incomplete EMR/EHR isn’t the worst thing. POC activities can continue. However the higher level goals we set, including Population Health surveys? Those typically mean that interviews of the onsite clinicians are too slow and introduce unwanted errors into the process. (Brian Too)

Watercooler Talk Tidbits

Readers funded the Donors Choose teacher grant request of Ms. M in Phoenix, who asked for headphones for her second grade class. She reports, “These headphones have made a huge difference for learning and our classroom environment. Students now have access to accommodations and differentiation when utilizing our online programs. As well, it helps keep our classroom environment quieter and peaceful when using our technology. We are so thankful for these! We use them every day! Thank you for supporting our classroom!”

A Florida doctor claims that he was duped by the owner of a sober living facility who is accused of insurance fraud in having the doctor order 30,000 urine tests as the facility’s medical director – the owner called them “liquid gold”– that netted the owner $31 million.

Doctors and advanced practice registered nurses in Tennessee argue over a pending state bill that would eliminate the existing requirement that doctors sign off on 20% of the charts of APRNs every 30 days. Nurses say the requirement means patients are paying for the time of a doctor they didn’t see and nurses are restricted from opening independent practices in rural areas, while the Tennessee Medical Association says nurses would rather live in cities just like doctors anyway. Tennessee is one of 26 states that require chart review.

The state of Oklahoma is paying an unnamed doctor$15,000 for each prisoner who is executed under the state’s death penalty. The doctor doesn’t actually administer the drugs used – they start the IV and verify that the correct drugs have been prepared. The doctor also earns $1,000 per day for attending weekly training.

Alamance Regional Hospital (NC) welcomes 25 National Guard troops who will help the hospital deal with staffing shortages.

Epic employee volunteers create handmade Valentine’s Day cards for the 300 people who are serviced by SSM Health’s Meals on Wheels program.

In Case You Missed It

• News 2/11/22
• EPtalk by Dr. Jayne 2/10/22
• HIStalk Interviews Clay Ritchey, CEO, Verato
• HIStalk Interviews Kyle Silvestro, CEO, SyTrue
• News 2/9/22
• HIStalk Interviews Russell Branzell, CEO, CHIME
• Curbside Consult with Dr. Jayne 2/7/22
• HIStalk Interviews Torbjörn Kronander, CEO, Sectra
• Monday Morning Update 2/7/22

Get Involved

Sponsor
Report a news item or rumor (anonymous or not)
Sign up for email updates
Connect on LinkedIn
Contact Mr. H

Morning Headlines 2/11/22

Ideawake Closes Investment with HealthX Ventures to Democratize Innovation on the Frontlines in Healthcare

HealthX Ventures invests in Ideawake, which offers a platform for healthcare leaders to engage employees and their ideas for saving money and improving care via time-based challenges that are transparently tracked.

AndHealth, the Digital Health Company for Reversing Migraine and Autoimmune Diseases Raises $57 Million in Financing for Growth

AndHealth — which offers app-based, employer-sponsored treatment, coaching, and medication management for migraine – comes out of stealth mode and raises $57 million in funding.

Signify Health to acquire Caravan Health, accelerating the movement to value-based healthcare

Signify Health, which offers technology, analytics, and provider networks geared towards value-based payment programs, will acquire ACO enablement company Caravan Health for $250 million.

2nd Watch Expands Data & Analytics Capabilities with Acquisition

Cloud services company 2nd Watch acquires cloud data and analytics consultancy Aptitive.

News 2/11/22

Top News

AndHealth — which offers app-based, employer-sponsored treatment, coaching, and medication management for migraine – comes out of stealth mode and raises $57 million in funding.

Investors include Francisco Partners and the AMA’s venture capital arm.

The company will launch a second service line for autoimmune diseases.

AndHealth’s founder and CEO is Matt Scantland, who co-founded and led CoverMyMeds through its $1.4 billion acquisition by McKesson in 2017.

Reader Comments

From Orion Pictures: “Re: HIMSS22. An internal document I saw lists just [unverified number omitted] people attending, which also includes at least some vendors.” I’m hesitant to publish the number that was cited because (a) it’s super low; and (b) my only HIMSS contact who would have verified its accuracy no longer works there. HIMSS claims that nearly 19,000 people – including exhibitor staff – attended HIMSS21 in person, although it sure didn’t look like that many. We’re just a month away and COVID-19 is waning a bit, so I would say everybody has already decided if they are going or not. I’ll be doing my usual daily write-ups, although I expect to be COVID-robbed of my beloved MedData scones.

HIStalk Announcements and Requests

HIStalk sponsors – submit your participation information in the ViVE and HIMSS conferences and I’ll include your company in my guide to each.

Welcome to new HIStalk Platinum Sponsor Owl. Owl gives behavioral health organizations better data, better insights, and better outcomes with its data-driven, evidence-based solutions. Leading organizations — including Main Line Health, Amita Health, Inova Health, Polara Health, and Aurora Mental Health Center — rely on Owl to expand access to care, improve clinical outcomes, and prepare for value-based care. Owl makes measurement-based care easy to engage patients, optimize treatment, improve care, reduce clinician burden, and capture data to optimize business performance. Thanks to Owl for supporting HIStalk.

Webinars

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

Acquisitions, Funding, Business, and Stock

HealthX Ventures invests in Ideawake, which offers a platform for healthcare leaders to engage employees and their ideas for saving money and improving care via time-based challenges that are transparently tracked. I interviewed CEO Coby Skonord last fall, who summarized, “It empowers anyone at the front lines of the organization, regardless of role or title, to make their voice heard based upon the quality of their idea versus their job title.”

Nuance announces Q1 results: revenue down 7%, adjusted EPS $0.08 versus $0.20. The company’s acquisition by Microsoft remains on track for the end of the first calendar quarter.

Ascension will turn over operation of its hospital-based laboratories in 10 states to Labcorp, which will also buy the health system’s outreach lab business. Ascension will also offer patients services of pharma contract research organization Labcorp Drug Development, which the company created in 2014 with its acquisition of Covance for nearly $6 billion.

Cloud services company 2nd Watch acquires cloud data and analytics consultancy Aptitive.

Thirty Madison, which runs online businesses for hair loss, migraines, GI problems, and allergies, will acquire Nurx, which offers female-focused online services for contraception, STI testing, HIV prevention, and dermatology. Thirty Madison says its combined businesses will bring in $300 million in revenue in 2022.

Germany-based Ada, which offers AI-based health assessments and care, extends its Series B funding round to $120 million. The company plans to expand aggressively into the US market.

Israel-based Scopio, which offers slide-scanning and AI analysis technology to allow peripheral blood smears to be analyzed by pathologists remotely, raises $50 million.

Sales

• Jupiter Medical Center (FL) will deploy Vocera’s Smartbadge wearable and Edge smartphone app for team communication and collaboration. It will also implement Vocera Ease application to allow care team members to communicate with patient-designated friends and family members.

People

Healthwise names Andy Binder, MS, MBA (HP) as COO.

Pharmacy solutions vendor Transaction Data Systems hires Robert Ven (Intrado) as CTO.

Socially Determined hires Paul Matsui (The Antigrav Group) as chief strategy officer and Mike Considine (TransUnion) as chief product officer.

Sandeep Sabharwal, MBA (Accenture) joins Impact Advisors a managing partner and board member.

Announcements and Implementations

CoverMyMeds publishes its annual Medication Access Report, with these findings:

• 84% of patients had to delay or skip in-person healthcare visits in 2021, with primary care being the most-missed visits.
• The percentage of patients who skipped medications because of cost rose from 36% in 2020 to 51% in 2021.
• 84% of patients had a telehealth visit in 2021, about equally split between PCPs and specialists. Their most commonly stated reasons for choosing telehealth were COVID-19, convenience, and reduced wait time.
• Nearly all respondents say they have electronic access to their medical records and can share it with providers.
• Three-fourths of providers can’t see plan-specific prescription costs, deductibles, and pharmacy-specific pricing  in their EHR. Nearly all can’t see social determinants of health information.
• Pharmacists say that the highest-value task they can’t perform on their computer system is checking prior authorization status. They also note that providers don’t usually submit prior authorization requests until the pharmacy contacts them, which delays treatment.

Ascom forms new professional services and customer success organizations to support its healthcare collaboration and communication solutions business.

Government and Politics

US Senators Bill Cassidy, MD (R-LA) and Tammy Baldwin (D-WI) form a commission that will make recommendations to Congress about updating HIPAA.

NBC News covers ONC’s December 31 deadline for certified EHR developers to provide FHIR APIs, also noting the progress that has been made in the industry’s implementation of EHRs. .

A GAO report reviews the military’s expansion of telehealth for mental health services during the pandemic, with these lessons learned:

• March 2020 guidance allowed providers to use consumer videoconferencing technologies such as FaceTime and to offer services using their personal devices.
• Use of telehealth reduced the stigma of seeking mental health care since in-person services required sitting in a clinic waiting room in full uniform that includes service member name.
• Group sessions were problematic because of confidentiality concerns, the need to train providers on how to lock the virtual room to uninvited participants, and the level of computer equipment and web camera required.
• Providers need to obtain the location and contact information of patients at high risk or with suicidal thoughts so that local authorities can be contacted to perform a wellness check if contact is lost.
• Providers were given training on the technology, the administrative process, and the privacy requirements of conducting virtual visits.

A new report finds that 14% of 1,000 randomly selected hospitals are complying with the HHS requirement that they post their real prices online. HCA Healthcare, Ascension, and CommonSpirit Health – whose combined revenue is $120 billion — had just two compliant hospitals of their 361.

Other

KLAS reports that some Cerner customers are forming contingency plans in reacting to company changes that include hiring a new CEO, a revenue cycle management pivot, executive turnover, and an announced acquisition by Oracle. Notes:

• Cerner’s overall KLAS performance scores haven’t changed over five years and under three CEOs, while confidence in the company’s ability to deliver has declined.
• Some customers attribute their success to their own efforts rather than those of Cerner.
• CEO David Feinberg will need to improve overall customer success, break the company’s history of broken promises and nickel-and-diming, and establish its new revenue cycle product.
• Many customers question Cerner’s choice of the old Soarian platform to develop RevElate, noting that the product is rated only in the 60s and sometimes takes customers years to use effectively. They also question how the lack of native integration will work in an industry that has mostly moved away from standalone applications.
• Company acquisitions tend to work out well about half the time, and when they don’t, customers are twice as likely to abandon the vendor.

The Wall Street Journal notes the sudden proliferation of mashed-up CIO titles to reflect wider responsibilities beyond infrastructure and experience that becomes more customer-focused and operational. Examples: chief technology, operations, and transformation officer (CTOTO) and chief information, data, and digital officer.

Sponsor Updates

• Healthcare Growth Partners advises NThrive in its acquisition of Pelitas.
• Impact Advisors celebrates its 15th anniversary.
• Symplr completes its acquisition of Midas Health Analytics solutions from Conduent.
• Lumeon names Brittany Jones (Memora Health) senior director of business development.
• NTT has been selected by the Arizona Health Care Cost Containment System to provide Medicaid Enterprise Systems Roadmap consulting services for Arizona and Hawaii.

Blog Posts

• Social Determinants of Health: Closing the Gap (Get Well)
• Leveraging Everyday Technology to Improve Diabetes Outcomes for Patients Battling Social Determinants of Health (Glytec)
• A 4-Step Approach to Medical Device Security (The HCI Group)
• 2022 Outlook: Health Insurers Face Tech Challenges (Optimum Healthcare IT)
• We Need to Talk: Why Vital Conversations Are So Important in Healthcare (Healthwise)
• Clinical Data is a Resource Waiting To Be Tapped (Diameter Health)
• 20 Heart-Healthy Ways to Fit Exercise into Your Workday (Healthcare IT Leaders)
• Biden administration’s new cybersecurity directive champions Zero Trust (Imprivata)
• Browsing the Future of Healthcare (InterSystems)
• The role of clinical terminology in pharmacogenomics (Intelligent Medical Objects)
• Leveraging Patient Access APIs to Optimize Risk Adjustment Efforts (LexisNexis Risk Solutions)
• Caring for the Caregivers Through Better Service (Medhost)
• 5 Stories of Success with Meditech Solutions (Meditech)
• A Banner Year for Integrated Behavioral Health (NeuroFlow)
• What is patient engagement to a Patient Access Center Manager? A CEO’s primer (Nuance)

Contacts

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