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Morning Headlines 8/2/21

August 1, 2021 Headlines 2 Comments

Cerner Reports Second Quarter 2021 Results

Cerner announces Q2 results: revenue up 10%, adjusted EPS $0.80 versus $0.63, exceeding analyst expectations for both.

Exo Raises $220M in Series C Funding

Handheld ultrasound and medical imaging vendor Exo raises $220 million in Series C funding.

Epic to require COVID-19 vaccinations for all US-based staff

Epic will require all of its US-based employees to be fully vaccinated by October 1, with nearly 97% of its Verona-based staff already meeting that requirement.

Monday Morning Update 8/2/21

August 1, 2021 News 2 Comments

Top News


Cerner announces Q2 results: revenue up 10%, adjusted EPS $0.80 versus $0.63, exceeding analyst expectations for both. 

From the earnings call:

  • The company is increasing its earnings outlook for the year.
  • DoD is live at 42 commands and 663 locations with 41,000 activated users. The Coast Guard’s deployment will be completed this year.
  • Cerner says the results of the VA’s strategic review focused on governance, training, and readiness rather than Cerner-caused problems, consistent with the findings of an internal assessment that Cerner conducted earlier this year. It also notes that the DoD’s initial go-live resulted in similar required work in the 12 months following.
  • The search for a CEO replacement for Brent Shafer continues and “has been very active.”
  • The company continues to look for acquisitions that enhance Cerner’s competitive position, exceeds its cost of capital, is accretive over time, and creates shareholder value. Areas being considered cybersecurity, technology to support provider networks operating in both fee-for-service and fee-for value arrangements, and data.
  • Cerner will continue selling unneeded office space that represents half of its owned property.
  • The company laid off 500 employees in the quarter and eliminated 300 open positions, which will deliver $70 million in annualized savings.
  • Asked by an analyst about Amazon’s HealthLake announcement, Travis Dalton said, “There’s a long history of big cap entry and big cap exit from healthcare. There’s an inherent complexity at the intersection of healthcare and IT. I see market interest in areas that we’re focused on is very validating of the growth opportunity that exists.” He added that healthcare data is dirty and requires normalization around Master Data Management.
  • Cerner expects to have 80 provider organizations selling data to life sciences via its Learning Health Network by the end of the year.

Reader Comments

From Ephraim: “Re: news items. How many readers click to the announcement or story you link to?” I don’t track those clicks, but I will say that if I’ve done my job well in summarizing the news item, most readers won’t need to click over. I only run items that I consider newsworthy (which excludes probably 95% of industry PR), so I expect that many readers get the gist (the company, the person, or whatever the item relates to) without actually clicking anything. My experience with Twitter is similar – most people skim the tweet but don’t click to learn more.

From Yes Sars: “Re: COVID-19. Time to start up your COVID-19 news section again?” Maybe, if readers want me to. I thought pandemic doom scrolling was behind us given availability of an effective, safe, and free vaccine, but here we are again with overcrowded hospitals.

HIStalk Announcements and Requests

Jenn put together our HIMSS21 guide (PDF version), which includes the participation information of those of my sponsors that submitted it.

I’ve heard from maybe three tiny companies that they have decided to join Medicomp and Olive in cancelling their HIMSS21 exhibitor plans. The exhibitor count has dropped by only three in the past few days, although that might be questionably useful information unless those companies notify HIMSS and they are removed from the exhibitor list quickly. I will play Las Vegas bookmaker and place the odds at 70% that the conference will go on and will increase those odds to 95% if HIMSS doesn’t cancel it Monday. Not much else could go wrong unless Las Vegas cracks down in ways that would be hard to fathom given its historical focus on protecting tourism revenue. I assume HIMSS won’t refund attendee registration fees under any circumstances since they cover both the in-person and virtual version and the latter allows checking the box as delivered, but exhibitor fees that also include rolled-over HIMSS20 credits would be hit hard if the exhibit hall is cancelled. I would cancel my own attendance except I think readers have a strong interest in living it vicariously. 


It’s a fairly even poll respondent split of who is most responsible for the VA’s Cerner rollout issues. My take: nearly all of the misfires were by the VA, which has a long history of struggling to successfully complete projects, but perhaps compounding the issue is Cerner acting as its own prime contractor. The question is whether Cerner told the VA about the training, infrastructure, budgeting, and support issues and nothing was done, or if Cerner drew a box around what it considered as its responsibility and let VA worry about the rest. Epic’s implementation approach would have put problems front and center, but that doesn’t mean that VA would be as obedient to fix them compared to a health system with hundreds of millions of dollars on the line. DoD seems to be doing pretty well with its Cerner rollouts and using Cerner’s services successfully, or at least we aren’t hearing as much about any problems.

New poll to your right or here: Would you as a patient be OK with having contact with a masked health system employee who hasn’t received COVID-19 vaccine?


On-Demand Webinars:

Key Differences: Value Based Care vs. Fee-For-Service.” Part 1 of a three-part series. Sponsor: Net Health. Presenters: Bill Winkenwerder, MD, chairman, CitiusTech; Josh Pickus, CEO, Net Health. Dr. Bill Winkenwerder, former assistant secretary of defense for health affairs for the US Department of Defense, shares his unique perspective on the future of value-based care (VBC) systems in the public sector and how VBC differs from fee-for-service models in the private sector. This Part 1 webinar covers which aspects of the fee-for-service health system payment model look the most different compared to fully value-based systems (clinical, back-office, analytics, etc.)

Current Innovation and Development in Value-Based Care.” Part 2 of a three-part series. Sponsor: Net Health. Presenters: Bill Winkenwerder, MD, chairman, CitiusTech; Josh Pickus, CEO, Net Health. Dr. Bill Winkenwerder, former assistant secretary of defense for health affairs for the US Department of Defense, shares his unique perspective on the future of value-based care (VBC) systems in the public sector and how VBC differs from fee-for-service models in the private sector. This Part 2 webinar discusses what health systems should know about the transition to value-based care, including macro versus micro shifts.

Future of Value-Based Care: Predictive Analytics, Technology, Policy.” Part 3 of a three-part series. Sponsor: Net Health. Presenters: Bill Winkenwerder, MD, chairman, CitiusTech; Josh Pickus, CEO, Net Health. Dr. Bill Winkenwerder, former assistant secretary of defense for health affairs for the US Department of Defense, shares his unique perspective on the future of value-based care (VBC) systems in the public sector and how VBC differs from fee-for-service models in the private sector. This Part 3 webinar discusses the role analytics will play in the shift to value-based care and how financial and clinical ROIs for analytics-oriented products must differ when applied to FFS and VBC models.

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

Acquisitions, Funding, Business, and Stock

WellSky will acquire Healthify, which connects providers with community-based social services organizations to address social determinants of health of patients. Terms were not disclosed. Healthify had raised $26 million, including $16 million in a Series B round in November 2019.

Handheld ultrasound and medical imaging vendor Exo raises $220 million in Series C funding.

A newspaper in Ireland says that Amwell paid $250 million for Ireland-based SilverCloud Health and $70 million for Conversa Health in the combined acquisition that was announced only at a total of $320 million. The companies had raised $26 million and $34 million respectively and have $15 million in combined annual revenue, meaning Amwell paid 21 times revenue.

Vocera announces Q2 results: revenue up 19%, adjusted EPS $0.15 versus $0.08, beating Wall Street expectations for both. From the earnings call: the company had six sales of more than $1 million in the quarter and follows its largest sale ever to Providence  in Q1. VCRA shares are up 36% in the past 12 months, valuing the company at $1.4 billion.

Spok announces Q2 results: revenue flat, EPS –$0.04 versus $0.20.


  • Health and Social Care Northern Ireland will implement First Databank’s Multilex to provide e-prescribing decision support within Epic.



Guthrie promotes Terri Counts, MHA, RN to SVP/CIO.



MIT Technology Review notes that AI tools that were supposed to help hospitals diagnose or triage COVID-19 patients didn’t accomplish anything, though a few turned out to be harmful. Significant problems included the use of quickly published and low quality data, researchers using data whose provenance wasn’t considered, and showing falsely accurate results by testing systems on the same data they were trained on. One system was trained on chest scans that the researcher didn’t know were limited to children, and instead of the system learning to recognize COVID versus non-COVID patients, it simply learned to recognize that the image was that of a child. Another issue is that researchers can’t make a name for themselves by validating or improving existing models, so they create new models that incorporate all the mistakes that were made by previous researchers.

Epic will require all of its US-based employees to be fully vaccinated by October 1. The company says that nearly 97% of its Verona-based staff already meet that requirement. Epic will require masks for meetings if the room occupancy is 75% or more or if any attendee voices a preference that masks be worn.

Ozarks Healthcare (MO) posts a video of CMIO Priscilla Frase, MD describing how some patients are wearing disguises and pleading anonymity when coming in for COVID-19 vaccine over concerns about the negative reaction of their friends, family, and co-workers.

Sponsor Updates

  • The AI in Action Podcast features OptimizeRx VP of Data and Products Adam Almozlino.
  • Spok announces that all 20 adult hospitals and all 10 children’s hospitals named to US News & World Report’s 2021-22 Best Hospitals Honor Roll use Spok’s secure healthcare communication solutions.
  • Health Catalyst CFO Bryan Hunt will present during the Canaccord Genuity Growth Stock Conference August 11.
  • CareSignal is included in a CHCF case study of engagement results at Axis Community Health.

Blog Posts


Mr. H, Lorre, Jenn, Dr. Jayne.
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HIStalk’s Guide to HIMSS21

July 30, 2021 News, Uncategorized 3 Comments

AGS Health


To arrange a meeting, contact Amy Marie Bergau.

Contact: Amy Marie Bergau, director of marketing

AGS Health is an analytics-driven, technology-enabled revenue cycle management company serving healthcare providers across the US. AGS Health partners with hospitals and physician groups to optimize their revenue cycle through intelligent use of data. The company leverages the latest advancements in automation, process excellence, security, and problem-solving through use of technology and analytics – all made possible with college-educated, trained RCM experts. The company was awarded 2021 Best in KLAS for Outsourced Coding and is highly ranked for Extended Business Office capabilities, scoring in the 90th percentile. AGS Health partners with 85+ clients across different care settings, specialties, and billing systems. It’s revenue cycle … reimagined.

AGS Health CEO Patrice Wolfe will speak on “Growing the Ranks of Female Executives in Healthcare,” Session 124, August 11. Other AGS Health executives will also be attending this event. To meet with an AGS exec, contact Amy Marie Bergau.


Booth 3416

Contact: Jasmine Gee, VP of marketing

Arcadia is dedicated to making a difference with healthcare data. We transform data from disparate sources into targeted insights, putting them in the decision-making workflow to improve lives and outcomes. In doing so, we have created the data supply chain for enterprise-wide, evidence-based healthcare management. Through our partnerships with the nation’s leading health systems, payers, and life sciences companies, we are growing a community of innovation to provide better care, maximize future value, and evolve together to meet emerging challenges and opportunities. For more information, visit

This year we will have some exciting giveaways, including our ever-popular survival kit packed with essentials to keep you going at HIMSS21.



Booth 2461

Contact: Ann Conrath, senior business development executive

CareSignal is a Deviceless Remote Patient Monitoring platform that improves payer and provider performance in value-based care. The company leverages real-time, self-reported patient data and artificial intelligence to produce long-term patient engagement while identifying clinically actionable moments for proactive care. Its evidence-based platform has been proven in 13 peer-reviewed studies and over a dozen payer and provider implementations across the US to sustainably scale care teams to help 10 times more patients, resulting in significant improvements in chronic and behavioral health outcomes and reduced ED utilization. With confidence in its outcomes, CareSignal offers partners at-risk pricing and consistently delivers 4.5 times to 10 times ROI within the first year of its partnerships. For more information, visit our website or try a self-guided demo.

Clinical Architecture


Booth 5654

Contact: Amanda O’Rourke, VP of marketing

Clinical Architecture delivers healthcare enterprise data quality solutions focused on managing vast amounts of disparate data to help customers succeed with analytics, population health, and value-based care. Our solutions produce trusted, actionable data to enable smart decisions that mitigate risk, reduce cost, and improve outcomes.

Founded in 2007 by a team of healthcare and software professionals, Clinical Architecture is the leading provider of innovative healthcare IT solutions focused on the quality and usability of clinical information. Our healthcare data quality solutions comprehensively address industry gaps in content acquisition and management, content distribution and deployment, master data management, reference data management, data aggregation, clinical decision support, clinical natural language processing, semantic interoperability, and normalization.

Check out our latest Informonster stuffed animal toys and learn how we can help you tame your Informonster.



To arrange a meeting, contact Klaudia Rudny.

Contact: Klaudia Rudny, marketing communications specialist

Dina powers the future of home-based care. We are an AI-powered, care-at-home platform and network that can activate and coordinate multiple home-based service providers, engage patients directly, and unlock timely home-based insights that increase healthy days at home. The platform creates a virtual experience for the entire healthcare team so they can communicate with each other – and help patients and families stay connected – even though they may not physically be under the same roof. Dina helps professional and family caregivers capture rich data from the home, using AI to recommend evidence-based, non-medical interventions. For more information, visit

Dina CEO Ashish Shah and Jefferson Health Chief Population Health Officer Katherine Behan will lead the conference session “The Rise of Home-Based Care: Engaging More Patients at Scale,” Thursday, August 12, from 10:15-11:15 am at The Venetian, Lando Room 4301. Shah and Behan will share insights on how to:

  • Identify how digital technology can extend your reach in the home and improve provider and patient/caregiver engagement. 
  • Recognize how hospital-at-home programs can help position your system for value-based payment changes.  
  • Evaluate whether your organization should implement a hospital-at-home model, and how to meet hospital conditions for participation.

About the technology partnership: At the height of the pandemic, Jefferson Health partnered with Dina to launch remote patient monitoring technology to extend care to people who were COVID-positive and recovering in their homes. Now, they have expanded the program to remotely monitor people with chronic conditions such as congestive heart failure, diabetes, and hypertension, and have managed more than 5 million “digital dialogues” to help keep people connected to their care teams.

Dina is not an exhibitor, but you can reach Ashish Shah at or To learn more about Jefferson Health, go to



Booth 5026

Contact: Auna Emery, director of marketing

At our HIMSS booth, 5026, Team Ellkay will host the following activities:

  • Happy hour from 4-6 pm on Tuesday, August 10 and Wednesday, August 11.
  • Talking connectivity, interoperability, and strategies to reach your data management initiatives. 
  • And of course, distributing our delicious LKHoney, produced by our very own honeybees from our headquarters’ rooftop!   

Stop by our booth anytime during exhibit hours or pre-schedule in person and virtual meetings here.

As a nationwide leader in healthcare connectivity, Ellkay has been committed to making interoperability happen for nearly 20 years. Ellkay empowers hospitals and health systems, providers, diagnostic laboratories, healthcare IT vendors, payers, and other healthcare organizations with cutting-edge technologies and solutions. Ellkay is committed to ongoing innovation, and developing cloud-based solutions that address the challenges our partners face. Our solutions facilitate data exchange, streamline workflows, connect the care community, improve outcomes, and power data-driven and cost-effective patient-centric care. With over 58,000 practices connected, Ellkay’s system capability arsenal has grown to over 700 EHR/PMS systems across 1,100 versions. To learn more about Ellkay, please visit

The HCI Group


Booth 2632

Contact: Chris Parry, VP of marketing

We are excited to share that Cris Ross of Mayo Clinic will join Ed Marx at the HCI booth to present on patient experience and digital health. In addition, we will be talking about virtual care, reducing IT operating costs, automation, security, and more. We’re inviting healthcare leaders to view HealthNxt, a unified enterprise platform that brings together all things virtual care to enable an enhanced patient and clinician experience.



Booth C413

Contact: Karli Mertins, marketing manager

HCTec and Talon will be at HIMSS21 at booth C413, offering attendees free, onsite help-desk cost assessments. We are also available by appointment to share our wide range of service offerings and look forward to discussing the future of managed IT support for healthcare systems and providers.

HCTec recently acquired Talon, an industry leader in managed IT helpdesk services, regularly rated by KLAS as a top performer in help desk services for clinicians, IT resources, and patients. Based in Tennessee, best-in-class IT services firm HCTec delivers innovative healthcare IT staffing, managed services, and EHR expertise to diverse health systems and healthcare provider organizations across the US.

LexisNexis Risk Solutions


To arrange a meeting in the LexisNexis-hosted HIMSS Living Room, contact Tamyra Hyatt.

Contact: Elly Wilson, marketing manager

LexisNexis Risk Solutions Healthcare is hosting the HIMSS Living Room in the Titian Ballroom 230A on level 2. Drop by, put your feet up, and recharge. While you’re there, take a minute to learn about how we can help your organization use the power of advanced analytics to increase patient engagement and improve care. Go to our HIMSS21 information page to request a meeting and to download featured literature. Our healthcare solutions leverage identity, medical claims, and provider data to deliver powerful insights: 

  • Interoperability Exchange: Normalize and enrich patient data with a single API.   
  • Identity Access Management: Authenticate identities across all access points.   
  • Absolute Patient Matching: Mitigate over/under linking penalties.   
  • Social Determinants of Health: Understand individuals’ risks and help improve wellness.

OBIX by Clinical Computer Systems


Booth C200-20

Contact: Christina Olson, director of sales

The team from OBIX by Clinical Computer Systems will be available to meet with you at Caesars Forum Conference Center in the Academy Ballroom within the Interoperability Showcase. You will find us at our kiosk, booth C200-26, and participating in The Newborn Experience Connected Demonstration.

Join us as we demonstrate how the OBIX Perinatal Data System provides L&D units with distinguished surveillance and archiving capabilities. Its design has the clinicians in mind by delivering a comprehensive solution for central, bedside, and remote electronic fetal monitoring. We will also highlight the OBIX BeCA fetal monitor (*with the Freedom for wireless monitoring), a device that fits at the bedside while offering an accurate and clear visual of the status of the fetus and mother. Using the system’s e-tools, with its FHR tools, and the UA tool, assist clinicians’ critical thinking and management of electronic fetal monitoring as well as the monitoring of uterine activity parameters, crucial to safe labor in support of their day-to-day care provided to patients. See how we work cooperatively with industry-leading EHR companies to secure a seamless integration between systems to deliver a premier, perinatal software solution for obstetrics patient care. Together, we can improve outcomes for mothers and babies. 

*The OBIX BeCA fetal monitor and the Freedom – used for wireless monitoring, will be available in our kiosk for closer inspection.

Optimum Healthcare IT


Booth MS855

Contact: Larry Kaiser, VP of marketing and communications

Optimum Healthcare IT is a Best in KLAS healthcare IT staffing and consulting services firm based in Jacksonville Beach, Florida. Optimum provides world-class professional staffing services to fill any need, as well as consulting services that encompass advisory, EHR implementation, training and activation, managed services, enterprise resource planning, technical services, and ServiceNow – supporting our client’s needs through the continuum of care. Our leadership team has extensive experience in providing expert healthcare staffing and consulting solutions to all types of organizations. At Optimum Healthcare IT, we are committed to helping our clients improve healthcare delivery by providing world-class staffing and consulting services. By bringing the most proficient and experienced consultants in the industry together to work with our clients, we work to customize our services to fit their organization’s goals. Together, we place the best people and implement proven processes and technology to ensure the success of our clients.



To arrange a meeting in room MP550, contact Andrew Robertson.

Contact: Andrew Robertson, senior director, technical solutions

PatientKeeper’s EHR optimization software streamlines clinical workflow, improves care team collaboration, and fills functional gaps in existing hospital EHR systems. With PatientKeeper as the “system of engagement” complementing the EHR, providers can easily access and act on all their patient information from smartphones, tablets, and Web-connected PCs. In addition, PatientKeeper’s Charge Aggregator solution helps maximize revenue for provider organizations by streamlining the professional coding and billing workflow in central billing offices that process charges from disparate systems across a health network. PatientKeeper has more than 75,000 active users across North America and the UK.



Booth 3011

Contact: Monica Giffhorn, VP of marketing

Come to booth 3011 and enter to win an Apple Watch. Don’t miss the session “Healthcare Compliance Analytics in Practice” with Nick Culbertson, CEO of Protenus, and Alessia Shahrokh, compliance investigations manager at UC Davis Health. The session will take place on Tuesday, August 10 at 11:00 am at the Caesars Forum 123.



To arrange a meeting, contact Ashley Stevens.

Contact: Ashley Stevens, VP of provider sales

Quil’s digital-forward health engagement platform does not replace, but rather enhances, the patient-provider experience, strengthening the established, trusted relationships that patients have built with their doctors, pharmacists, PTs, etc., while removing the natural silos between provider, payor, employer, patient, and caregiver. As the most comprehensive solution on the market, we are creating a fully integrated experience. Stop by the Comcast Business booth to hear more about Quil’s engagement solutions and platform.

Platform Capabilities:

  • Available on all panes of glass: Web, smartphones, tablets and on Comcast Xfinity TV service nationwide. 
  • Delivers health system branded, personalized, and dynamic digital care plans. 
  • Captures patient-reported outcomes and interprets scores for clinical research and intervention.
  • Performs remote patient monitoring through patient self-reported information and integration with IoT devices. 
  • Delivers alerts and notifications to patients, caregivers, and providers to nudge patients back on track or inform the care team of required intervention. 
  • Integrated into the EHR-based clinical workflow and patient portal experience and provides detailed patient analytics through client enterprise application.

ReMedi Health Solutions


To arrange a meeting, contact GP Hyare.

Contact: GP Hyare, managing director

ReMedi Health Solutions is a national healthcare IT consulting firm specializing in peer-to-peer, physician-centric EHR implementation and training. We’re a clinically-driven company committed to improving the future of healthcare. Our mission is to provide comprehensive healthcare solutions that support enhanced patient care, efficient clinical workflows, and improved performance for healthcare systems.



Booth 4071

Contact: Andy Moorhead, VP of sales
949.387.3747 x3821

Sphere, powered by TrustCommerce, is trusted by more than a third of the nation’s 100 largest health systems to facilitate their integrated patient payments. With more than 15 years of supporting healthcare providers, Sphere helps its clients process payments anytime, anywhere – securely, in compliance, and connected with core business software including EHRs like Epic. Sphere’s Health IPass solution collects more patient dollars while improving engagement from pre-arrival to final payment. By simplifying the check-in, intake, and payment processes through a user-friendly mobile platform, patients know what they will owe and can pay with ease. Stop by our booth to see a demo and to enter to win Apple AirPods Pro.



Booth 5637

Contact: Jessica Baker, senior PR and social media marketing manager

We hope you’ll visit Spok at HIMSS21 in booth 5637 (near the Epic booth), and at the HIMSS Interoperability Showcase, booth C200-136 at Caesars Forum Conference Center, where we’ll showcase Spok Go, our industry-leading clinical communication and collaboration platform. This unified communication platform enables hospitals and health systems to use one platform to enhance clinical workflows and improve patient care – including clinical, laboratory, and radiology workflows. Spok will also present its innovative new ReadyCall Text waiting room pager. ReadyCall Text enables seamless waiting room and on-site communication for patients or visitors using a small, convenient messaging device. Messages provide simple instructions or information to the user without the need to return to the staff desk. This paging solution allows staff to be more productive, spending less time managing waiting areas and more time attending to the immediate needs of patients and other visitors. The ReadyCall text pager’s antimicrobial casing design eliminates germs on contact, reducing the risk of microorganisms spreading within a building or person-to-person, making Spok an industry leader in providing this type of protection. 

Spok will also offer some exciting giveaways. Receive a Starbucks gift card when you schedule a demo in the booth. In addition, scan your badge for the chance to win one of three daily drawings for a $500 airline voucher. Learn more and book a demo or meeting at



Booth C437-38

Contact: Carlene Anteau, VP of marketing

Twistle’s patient engagement software keeps patients on track with their plan of care between visits and encounters, which improves outcomes, lowers costs, and builds brand loyalty. Attendees should visit Twistle’s booth to learn how to build a solid business case for your patient engagement initiatives and gather tips on best practices that drive 90%+ adoption.     Visitors will also be able to talk to Twistle leaders about its recent acquisition by Health Catalyst and our future plans! We envision great product synergies through the automatic initiation of Twistle’s secure patient messaging protocols based on Health Catalyst’s identification of individual health risks, gaps in care, and unmet quality measures, and we want to hear your thoughts on other use cases!

Those who visit the booth can learn about #pinksocks, a phenomenon that ignited a movement at HIMSS15, which will be continued at HIMSS21. A limited supply of #pinksocks will be gifted at the booths to represent a shared belief that we can all do our part to make a positive impact on the world and change it for the better.

All attendees are also encouraged to enter a drawing to win free software and services to help them overcome health disparities. Three winners will be announced on Thursday, August 12 at 3:30 pm, and may choose one of the following pathways:

  • Managing chronic obstructive pulmonary disease (COPD) or congestive heart failure (CHF) patient populations to improve quality of life.
  • Supporting the pregnancy journey or detecting postpartum hypertension, which is particularly helpful for rural populations, but certainly applicable for an entire patient panel.
  • Diagnosing and managing high blood pressure to prevent over-treatment and support lifestyle changes that reduce the risk of heart attack and stroke.

Weekender 7/30/21

July 30, 2021 Weekender No Comments


Weekly News Recap

  • HIMSS21 attendees will be required to wear masks following CDC’s updated guidance and state and local emergency orders.
  • Two HIMSS21 exhibitors announce that they have decided not to participate based on COVID conditions in Las Vegas.
  • Cerner’s Q2 revenue and earnings beat Wall Street expectations.
  • Avera Health sells its 230-employee telemedicine services company to a private investment firm.
  • Amwell acquires a digital mental healthcare company and an automated virtual care vendor for a combined $320 million.
  • England’s System C acquires medication management vendor WellSky International and renames it CareFlow Medicines Management.
  • Clinical data and genomic platform vendor Sema4 goes public via a SPAC merger at a valuation of $3 billion.

Best Reader Comments

There is such a thing as momentum and popular sentiment. This is politics playing out in the healthcare space. Imagine that the very concept of EMRs becomes tainted. It’s a Failure and it’s No Good, Anyone Can See That. Medicine would not change and modernize in ways that it desperately needs to modernize.This is what happened to the metric system in the United States. Yet, and this is very important, the metric system only failed in the US. Why? It was a political failure. You see, the problem wasn’t the metric system. The metric system is successful everywhere that isn’t the US. And I challenge you to come up with a reason that doesn’t sound like total nonsense. For example, America is Exceptional, is a nonsense reason. Yet that’s still the comfortable go-to trope of those anti-metric proponents. Meanwhile EMR technology has a LOT more value to offer than the metric system does. (Brian Too)

Regarding McLeod: What? They are ditching Cerner after only two years being active! Such a waste of time, money, etc. (Bigdog)

Ever since the HITECH Act gave HHS authority to impose ever-increasing EHR requirements, it has seemed that ONC has continually sought additional additions to those requirements, whether they make sense or not. No one disputes that these are not good ideas, but one surely can dispute how much one can expect the industry can absorb, especially when the documentation requirements and other bureaucracy continue to increase. I don’t dispute the value, just the pace of adoption and the expectations on our providers. (Bill Spooner)

Watercooler Talk Tidbits


Readers funded the Donors Choose teacher grant request of Ms. D in Texas, who asked for a set of Big Books for her first-grade class. She reported in December, “This year has been a little different some of my students are home and some are here with me in class. We use all the technology available to help bridge the distance. The first book I read to them was our ‘Polar Bear, Polar Bear, What Do You Hear?’ I was ALONE in the room and reading to the children, it was an odd feeling, but it was so nice to have a book that the students could see the book and my expressions. With regular sized books I would have to project it and then they would not be able to see my face. As a teacher of mainly low-income students, I love being able to give my students the chance to ‘have’ something that they may only see in a store. There is just something about having a large book that literally makes the students feel like they are part of the story. Thank you again for taking the time to enhance the education of a young child.”


Bringing home an Olympic gold medal in fencing is third-year University of Kentucky medical student Lee Kiefer. Her sister and 2011 NCAA fencing champion is an OB-GYN resident, their mother is a psychiatrist, and their father is a former Duke varsity fencing captain who is now a neurosurgeon.

The two Arkansas Children’s hospitals report that 24 pediatric patients are hospitalized with COVID-19, 50% more than any previous pandemic peak. Seven are in ICU and two are on ventilators. Half of the inpatients are aged 12 and over and are thus eligible to be vaccinated, but none of those hospitalized had been.

AdventHealth’s Central Florida Division cancels non-emergency surgeries and hospital-based outpatient procedures as its COVID-19 patient count swells to 1,000, exceeding that of the previous peak in January. Florida reported 18,000 new cases Thursday, the biggest one-day increase since January.


In England, a husband and wife who are both doctors whose licenses have been suspended face charges of selling puberty-blocking drugs to children via their internet-only online transgender clinic. Helen Webberley, MBChB, LLM  is working from Spain in what she calls a “global” enterprise, exploiting a loophole that allows any EU doctor’s prescriptions to be filled in the UK. The website lists 35 employees. The drugs she prescribes are being used to block puberty while the young patient considers their gender options, but the psychological and growth effects of the drugs on children are unknown.


A California cyclist who was hoping to land a spot in the Tokyo Olympics crashes on a Pennsylvania velodrome track, with his several resulting injuries resulting in a $200,000 out-of-network bill from two hospitals. Phil Gaimon was covered by two health insurance policies, but Lehigh Valley Health Network billed $152,000 for services an expert said should have cost $21,000. They billed $26,000 for a night in the ICU and $30,000 for one in the burn unit, which Gaimon said was only because the hospital had no other beds available. He lives in California, one of 33 states that prohibits surprise medical bills for insured patients, but the state’s authority applies only to in-state providers.

In Case You Missed It

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Morning Headlines 7/30/21

July 29, 2021 Headlines No Comments

Hughes & Company Raises $116 Million For First Private Equity Fund

Private equity firm Hughes & Company closes its first fund at $116 million, which will make investments of $5 million to $20 million in lower middle market healthcare software and technology enabled companies.

Opportunity Trifecta: ISA, SVAP and Draft USCDI Version 3 Feedback Period Now Open

ONC opens the synchronized feedback period for the Interoperability Standards Advisory, the Standards Version Advancement Process, and the draft United States Core Data for Interoperability Version 3.

WellSky® to Acquire Healthify to Enhance Social Services Care Coordination Across the Continuum

WellSky, a healthcare software, analytics, and services company, will acquire social services referral software vendor Healthify.

News 7/30/21

July 29, 2021 News 9 Comments

Top News


HIMSS will require HIMSS21 attendees and exhibitors to wear masks on the conference campus. This decision follows publication of new CDC guidelines and state and local emergency orders.

HIMSS says that 18,000 people have registered for the in-person and virtual versions of HIMSS21. HIMSS19 had 43,000 registrants.


Clark County’s test positivity rate is at 15.5%. County hospitalizations are at 1,000 versus early January’s all-time high of around 1,400.


Medicomp cancelled its HIMSS21 participation Thursday afternoon, the first company that has told me directly that deteriorating COVID conditions convinced them to stay home.

Reader Comments

From Oliver Twist: “Re: HIMSS21. It’s time to do the right thing and cancel. As much as I want it to happen, it would be the wrong decision, and the only reason to proceed is financial. If public health is not a HIMSS priority, what is? Just don’t wait until next week and add to the hardship.” I’m waiting until the weekend to see if HIMSS cancels the event (a couple of companies have told me they’re doing the same). If they don’t cancel, I’m probably 60% likely to attend, down from 100% a few days ago, but that number is declining as I weigh the ever-worsening risk versus reward as evidenced by new studies regarding Delta variant breakthrough infections, the possibility of tapering vaccine protection, and the potential of developing long COVID from a mild breakthrough infection. Plus HIMSS22 is just 227 days away and should be the first non-asterisked HIMSS conference since 2019. I have $895 invested in rolled-over HIMSS20 registration fees, a few hundred dollars in a flight that probably isn’t refundable, and $1,000 for the OnPeak-booked hotel that appears to be refundable minus one night. I feel sorry for HIMSS, which weathered the financial hit and no-refund fallout of HIMSS20, only to see the pre-Christmas joy of cheering on the Pfizer trucks that were delivering the miracle of science dashed by the reality that a lot of people are indifferent or hostile to science.

From HIMSS Fail: “Re: HIMSS21. Disappointed that HIMSS isn’t offering the Nursing Informatics Symposium virtually. My registration fees for last year were transferred to this year, but as a healthcare professional, I don’t think it’s responsible given the rise in the Delta variant to travel to Las Vegas and be exposed to crowds of people. HIMSS has had a year to figure out how to host a virtual an in-person conference. So I’ve lost my registration fees and perhaps in the future HIMSS will lose my membership fees.”

From MyAlias: “Re: HIMSS21. Word is that vendors and health systems are pulling out. Are you hearing the same?” No, but companies wouldn’t necessarily tell me. Last year’s pullout was evidenced by diminishing numbers on the frequently updated HIMSS20 exhibitor list, which I haven’t seen with the HIMSS21 list. It could be that the exhibitor list isn’t being updated the same way, and regardless we wouldn’t easily know how many provider organizations have banned travel to Las Vegas. Let me know if your employer has cancelled your planned attendance.

From Calico: “Re: HIMSS21. Is the exhibitor count apples to apples with that of previous years? Half the usual number doesn’t seem like a bad turnout.” That includes a bunch of first-time exhibitors and 125 or so companies that booked a meeting room (either instead of or along with a regular booth). I see 410 occupied booths in Sands Expo of 200 square feet or larger, so that leaves maybe 285 good-sized booths that aren’t in MP. Jump to 400 square feet – still pretty modest – and you’re down to about 65 companies. I haven’t run the lists to see which of the usual suspects won’t be exhibiting.

From Rashaverak: “Re: Epic. Accused of paying health systems exorbitant amounts to use its ~20 often inaccurate predictive diagnosis models. Epic says it doesn’t do marketing, but it appears its practices are no different than any other software vendor.” Stat News says unidentified employees of several health systems told its reporters that Epic’s sepsis prediction model is unreliable, but Epic pays hospitals incentives for using them in its voluntary Epic Honor Roll programs.

HIStalk Announcements and Requests

Listening: the reader-recommended new album from Blue Oyster Cult. It sounds good, in a snarly biker kind of way, for band whose remaining original members are 76 (Eric Bloom) and 73 (Buck Dharma). The video includes some self-parody when BOC’s original drummer Albert Bouchard pops in to provide “more cowbell.” There’s also a Spinal Tap reference.


On-Demand Webinars:

Key Differences: Value Based Care vs. Fee-For-Service.” Part 1 of a three-part series. Sponsor: Net Health. Presenters: Bill Winkenwerder, MD, chairman, CitiusTech; Josh Pickus, CEO, Net Health. Dr. Bill Winkenwerder, former assistant secretary of defense for health affairs for the US Department of Defense, shares his unique perspective on the future of value-based care (VBC) systems in the public sector and how VBC differs from fee-for-service models in the private sector. This Part 1 webinar covers which aspects of the fee-for-service health system payment model look the most different compared to fully value-based systems (clinical, back-office, analytics, etc.)

Current Innovation and Development in Value-Based Care.” Part 2 of a three-part series. Sponsor: Net Health. Presenters: Bill Winkenwerder, MD, chairman, CitiusTech; Josh Pickus, CEO, Net Health. Dr. Bill Winkenwerder, former assistant secretary of defense for health affairs for the US Department of Defense, shares his unique perspective on the future of value-based care (VBC) systems in the public sector and how VBC differs from fee-for-service models in the private sector. This Part 2 webinar discusses what health systems should know about the transition to value-based care, including macro versus micro shifts.

Future of Value-Based Care: Predictive Analytics, Technology, Policy.” Part 3 of a three-part series. Sponsor: Net Health. Presenters: Bill Winkenwerder, MD, chairman, CitiusTech; Josh Pickus, CEO, Net Health. Dr. Bill Winkenwerder, former assistant secretary of defense for health affairs for the US Department of Defense, shares his unique perspective on the future of value-based care (VBC) systems in the public sector and how VBC differs from fee-for-service models in the private sector. This Part 3 webinar discusses the role analytics will play in the shift to value-based care and how financial and clinical ROIs for analytics-oriented products must differ when applied to FFS and VBC models.

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

Acquisitions, Funding, Business, and Stock

Cerner will announce Q2 earnings Friday morning at 9:00 ET, which will be a much-followed event given its CEO search and takeover speculation. UPDATE: Cerner reports that revenue was up 10%, adjusted EPS $0.80 versus $0.63, beating analyst expectations for both.   

Telehealth provider Amwell will acquire digital mental health platform vendor SilverCloud Health and text-based automated patient interaction developer Conversa Health for a combined $320 million.


Avera Health (SD) sells its telemedicine services company Avera ECare to a private investment firm that will take on its 230 employees and rename the company Avel Ecare. Services include behavioral health, correctional health, emergency, hospitalist, ICU, pharmacy, school health, specialty clinic, and senior care. Terms of the acquisition were not announced.

Clinical performance management technology vendor MDmetrix announces a $6 million Series A funding round and a name change to AdaptX. Co-founder and CEO Warren Ratliff, JD was co-founder and COO of Caradigm.

Private equity firm Hughes & Company closes its first fund at $116 million, which will make investments of $5-$20 million in lower middle market healthcare software and technology enabled companies. The firm has an active investment in Azara Healthcare and exited its stake in Aldera, Aperture, and IN2L.


  • UMass Memorial Health chooses Halo Health for clinical communication and collaboration.



US Army Lieutenant Colonel Alison Murray, MS, MSN, RN is assigned to clinical informatics specialist and CMIO at Dwight D. Eisenhower Army Medical Center. She has also been named a recipient of the Order of Military Medical Merit.


MDClone promotes Erin Giegling to VP of marketing.


Scottsdale Institute promotes Janet Guptill, MPH to president and CEO.

Announcements and Implementations

Health Catalyst announces PowerLabor, an AI-enabled view of health system labor data that is part of its Financial Empowerment Suite.

Cerner will sell its Continuous Campus in Kansas City, KS as a predominantly hybrid work model reduces its real estate needs.

Dubai-based Etisalat Digital launches a cloud-based EHR to meet the UAE government’s requirement for a centralized, connected medical record for every citizen and resident.


The digital arm of India’s Apollo Hospitals Group will launch a Microsoft Teams-based solution that will offer virtual visits with Apollo physicians, prescription ordering, and scheduling lab sampling at home.


Well Health launches ChatAssist AI, a chatbot that it says completes 95% of patient-provider conversations without human intervention. Epic user Sansum Clinic’s six-month pilot focused on the chatbot’s use for telehealth, portal enrollment, insurance verification, and COVID-19 vaccination. 


A new KLAS report on nurse and staff scheduling finds that the strongest products for using predictive analytics to manage staffing up to two months in the future are Symplr ShiftSelect and HealthStream ANSOS Staff Scheduling. Those products were acquired by their current vendors in February 2019 and November 2020, respectively. Cerner Clairvia delivers high customer satisfaction for same-day analytics.

Government and Politics

ONC opens the synchronized feedback period for the Interoperability Standards Advisory, the Standards Version Advancement Process, and the draft United States Core Data for Interoperability Version 3.

Sponsor Updates

  • Meditech will host its virtual Expanse Summer Showcase August 10-11.
  • First Databank VP of Clinical Content Joan Kapusnik-Uner co-authors the study, “Using Medicare Data to Assess the Proarrhythmic Risk of Non-Cardiac Treatment Drugs that Prolong the QT Interval in Older Adults: An Observational Cohort Study.”
  • The Atlanta Healthcare Entrepreneur Meetup will feature Jvion Chief Marketing Officer Lizzy Feliciano August 5.
  • Medicomp’s Tell Me Where It Hurts Podcast features Jessica Cox, RN from Holy Name Medical Center.
  • Meditech publishes a new case study, “Emanate Health Advances COVID-19 Contact Tracing with Meditech Professional Services.”

Blog Posts


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EPtalk by Dr. Jayne 7/29/21

July 29, 2021 Dr. Jayne No Comments


As I get ready for HIMSS, people always ask me what’s on my must-see list for the year. The Medicomp booth is always at the top because the people are friendly, the product is solid, and they always have the good carpet for giving your feet a break. I enjoyed their two-story booth in the past because it provided an interesting view of the HIMSS spectacle.

Notwithstanding the physical space, Medicomp has a couple of cool things to talk about this year. The first item is the new Holy Name EHR, built using Medicomp solutions and brought live in their emergency department in the middle of a pandemic. Having spent way too much time in the ED trenches, I’m eager to see what they came up with in their custom solution compared to the off-the-shelf products.

The second Medicomp item I want to learn more about is the plan for partnership with CPSI to integrate the Quippe Clinical Data Engine into the CPSI platforms. I’ve been a big fan of Quippe for a long time since it has the power to help the EHR surface important information at the point of care. One of my favorite features is its ability to tag different clinical findings across time, so physicians can easily see where a symptom appeared previously. CPSI is used in many community hospitals and integrating Quippe will add some bells and whistles that will help build on quality initiatives and make documentation more efficient. While academic centers and large integrated delivery networks get a lot of attention, community hospitals enjoy having nice toys, too. Hopefully the integration will go quickly and get some cool tools into the clinicians’ hands.


Social media is everywhere, and I always enjoy having new emojis to enhance my communications. The new @VaccineEmoji is gaining traction and will provide a welcome alternative to the much maligned bloody syringe. The new emoji is modeled on a Rosie the Riveter-esque arm with a bandage strategically located over the deltoid muscle. Designers hope it will help in public health messaging, although the emoji is still awaiting approval by web text organizations. The director-general of the World Health Organization even supported it on World Emoji Day, which I didn’t know until recently was a thing.

I participated in a telehealth roundtable this week and one of the hot topics was medical licensure for telehealth physicians. Those who practice telehealth exclusively often have a dozen or more licenses, which can be burdensome and costly to maintain. Some states participate in the Interstate Medical Licensure Compact, and while it streamlines the licensure process somewhat those licensed in participating states, physicians still have to obtain individual licenses. Telehealth advocates are lobbying for relief, including licensure reciprocity or potentially a federal-level license that would allow people to practice in any state.

I live on a state border. Back in the day, I could care for my technically out-of-state patients over the phone without concern. Now, however, that is considered telemedicine, and my choices were to either get another license or stop caring for those patients over phone and video. The license process was a pain, especially the part where they wanted me to submit my high school transcript – a data point which makes absolutely no sense for determining whether a physician is worthy of licensure. One would think the medical degree, board certification certificate, etc. would be enough. Still, I had a good laugh with my high school’s registrar who promised to find my transcript on microfiche. One approach being championed by the Alliance for Connected Health includes a Medical Excellence Zone, which would be a group of states that recognize each other’s licenses as long as the physician doesn’t create a physical office in the other states.

In addition to being an annoyance for border dwellers like me, it is also a barrier to very specialized or renowned physicians who want to provide second opinion services to patients without the inconvenience of travel or distance. A federal licensure approach would likely benefit these physicians most, although many states will resist. The precedent is there for physicians credentialed by the Department of Veterans’ Affairs for telehealth. I learned from another panelist about the Sports Medicine Licensure Clarity Act of 2018, which apparently allows team physicians to care for their athletes in any state where the athlete or team is playing, as long as they hold a valid license in at least one state. If it’s good enough for professional athletes, shouldn’t it be good enough for the rest of us?

Recent Illinois legislation HB 3308 establishes payment parity for numerous telehealth services through 2027. Audio-only telehealth and asynchronous telehealth services were expanded as well. The bill also prevents payers from requiring an in-person visit before telehealth services can be delivered and keeps them from requiring patients to provide a reason for requesting telehealth. It also protects patients who request in-person care by preventing payers from requiring virtual visits and protects providers by preventing insurers from mandating delivery of telehealth services.

Breakthrough COVID-19 is real, y’all, and it hit close to home as one of my fully-vaccinated family members added an undesirable diagnosis to his problem list. It’s heartbreaking to see people who did such a good job avoiding infection now being impacted, but the transmissibility of the delta variant is definitely in play in my community, as is the abject lack of masking. My former employer is seeing record-breaking numbers of patients, a sizable percentage of whom are unvaccinated and test positive, although the vaccinated positive patients are becoming more numerous.

Looking for testing options, both Walgreens and CVS were booked for days and he didn’t want to be exposed to other illnesses at urgent care, so I was able to get him scheduled at the local county health clinic. Drive-through appointments were abundant and I was able to go online at midnight to book an 8:30 a.m. appointment. The only negative of the county health process was the lack of practical medical advice provided to the patient – his only follow up was a link to his lab result that simply said “detected.” Not every patient is going to readily understand that it means positive or what to do next. Fortunately, I was able to provide isolation and self-care advice, so we’re hoping for a speedy recovery.

HIMSS21 will be requiring masks as well as vaccines, and I truly hope it doesn’t turn into a super spreader event. I’m waiting for my academic colleagues to get hit with travel bans again, so my planned catch-up opportunities may be dwindling.

What are your HIMSS21 plans? Is it time to throw in the towel? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 7/29/21

July 28, 2021 Headlines No Comments

Amwell Enhances Virtual Care Platform with Two Acquisitions: SilverCloud Health and Conversa Health

Amwell will acquire digital mental healthcare company SilverCloud Health and automated virtual care company Conversa Health for a combined $320 million.

Avera Health Announces Acquisition of Avera ECare by Aquiline Capital Partners

Aquiline Capital Partners acquires Avera Health’s telehealth services company, which serves 600 sites in 32 states.

Cerner Corp. plans to sell off major Kansas City area campus after move to hybrid work

Cerner will put its nearly empty Continuous Campus up for sale as it streamlines its real estate needs to accommodate remote workers.

AdaptX Receives $6 Million Series A Funding; Announces Name Change from MDmetrix to Reflect Transformative Impact for Clinical Management

Clinical performance improvement company MDmetrix changes its name to AdaptX and secures $6 million in a Series A funding round led by Vulcan Capital.

Readers Write: Green Light: Why Healthcare Providers Need to Migrate to NCPDP’s Updated E-Prescribing Standard

July 28, 2021 Readers Write 1 Comment

Green Light: Why Healthcare Providers Need to Migrate to NCPDP’s Updated E-Prescribing Standard
By Andrew Mellin, MD

Andrew Mellin, MD, MBA is VP/CMIO of Surescripts of Arlington, VA.


When you see a green traffic light, what action comes to mind? Assumingly, “go.” But as late as the 1920s, a green light meant stop in some American cities and go in others, creating a dangerous driving experience for drivers used to different systems for traffic lights and patterns. As a result, the Federal Highway Administration mandated in 1935 the national standardization of the red, yellow, and green color scheme that we know today.

Although we don’t often think about standards, they are essential for standardizing materials, products, methods, and services, which result in safety, efficacy, efficiency, and quality control. This is especially true across healthcare.

Since 1997, the National Council for Prescription Drug Programs, or NCPDP, has maintained a national standard known as SCRIPT for electronic prescriptions. The NCPDP SCRIPT Standard for e-prescribing facilitates the transfer of prescription data between various healthcare stakeholders and plays an important role in helping reduce administrative burdens for providers and increasing patient safety.

Unlike traffic lights, healthcare technology is constantly evolving and improving. That’s why in 2018, the Centers for Medicare & Medicaid Services (CMS) issued a final rule adopting the NCPDP SCRIPT Standard v2017071 for E-Prescribing and Medication History for Medicare Part D. This standard sets out to modernize e-prescribing and medication history and improve patient safety and clinician workflows.

Most of the industry has migrated to this new standard, and the tremendous work that thousands of stakeholders across the country have done to upgrade their pharmacies and electronic health records should be applauded. But healthcare providers who haven’t completed this process are subsequently missing out on new features and risk potential disruption to their ability to electronically prescribe medications.

SCRIPT v2017071 makes hundreds of improvements to the e-prescribing process. The enhancements from this version fall into three categories: information sharing, patient safety, and administrative burdens.

The 2017071 standard adds new data segments, elements, and codes to prescriptions that more clearly communicate the prescriber’s intent to the pharmacy. In terms of patient safety, prescribers can now share patient allergies and preferred language with the pharmacy. Finally, the standard helps minimize manual processes that require healthcare providers and pharmacies to step outside their workflows to exchange critical patient care information. For example, it enables pharmacies to request prescriptions for medications they have not previously dispensed electronically versus using fax machines or making telephone calls.

CMS required that healthcare providers sunset the previous NCPDP SCRIPT Standard – v10.6 – by December 31, 2019. With the CMS deadline now more than 18 months behind us, the rest of the healthcare industry is officially retiring SCRIPT v10.6. For healthcare providers who don’t complete their migration by September 1, 2021, their users may begin experiencing service disruptions and will not have access to Surescripts E-Prescribing services.

Migration to SCRIPT Standard v2017071 takes time and work, so healthcare providers must not delay. Organizations can navigate their transition by talking to their EHR or e-Prescribing vendor and by leveraging resources like the NCPDP SCRIPT Implementation Recommendations guide.

NCPDP SCRIPT is more than a standard; it represents our innovative efforts to find better ways to share information and support the health and wellbeing of patients in the United States. The migration light is green, so healthcare providers must hit go.

Readers Write: Inside the Most Challenging Data Problem in Healthcare

July 28, 2021 Readers Write 2 Comments

Inside the Most Challenging Data Problem in Healthcare
By Navdeep Alam

Navdeep Alam, MS is CTO of Abacus Insights of Boston, MA.


Payer data is one of the most exciting assets in healthcare, holding the most promise for dynamic, meaningful change to the way care is delivered and paid for. It’s also the most challenging data problem to exist in the industry. 

We may not always realize it, but payer data is often the center of discussion around dinner tables across the country. Whether we’re talking about which treatments are covered by our health plan, how much our prescriptions cost, or how our specialists and primary care physicians interact — or fail to interact — we’re actually talking about payer data. When we have questions about our care, the first call we make is to our health plan, and we hope they have the wisdom and expertise to point us in the right direction. 

Payers are the hub of healthcare. Our health plan is where we as consumers begin when we’re trying to navigate the healthcare landscape. Where do we go to receive care? What treatments are best for us as individuals? Which pharmacies can fill our prescriptions?

As we interact with the healthcare system over our lifetimes, our experiences are eventually filed as insurance claims. Health plans hold treasure troves of rich, complex data about the patient journey, information that is critical to understanding how we as individuals experience healthcare. 

This is why healthcare can be so complicated: We have barely scratched the surface in realizing the potential of payer data. 

Healthcare data does not come from a single source. It comes from electronic health records, primarily used for documenting clinical data. It comes from pharmacy records, which were designed primarily for inventory management. And it comes from insurance claims, which lack detail about the patient journey but are necessary for tracking our experiences across the healthcare system. All of this data is growing at an exponential rate. Over 1.2 billion clinical documents are produced annually in the United States, and that figure is growing at a rate of 48% per year — and it’s all held by health plans. 

Health plans are ingesting millions of data points every day, and all of it is necessary to ensure that we, as patients, are receiving the right care at the right cost. If this data were clean and structured in the same format, it could paint a beautifully elaborate picture of how we experience healthcare every day. But it is not: 80% of medical data, for example, is unstructured and therefore disconnected from the wider healthcare system. 

Ultimately, all data challenges across the healthcare system become payer data challenges. Our health plans are burdened with the responsibility of mediating these challenges and piecing together all of the fragments of our healthcare experiences. When we switch plans, those challenges are exacerbated: all of our information is siloed within our old plans, and our new plans are barred from seeing a full picture of our medical histories. This disjointedness within the system, coupled with prohibitive privacy regulations, is how we end up with multiple sources of “truth” for every patient. The result is wide variations in the quality and cost of care we ultimately receive. 

The healthcare industry has been attempting to confront these issues for decades, despite spending nearly $2.1 billion annually to try to resolve them. These challenges can be boiled down to three major roadblocks. 

  • Data capture. There is a longstanding inability among health plans to capture clean, and complete data in a timely manner. This is largely due to legacy systems and the continuation of highly manual data processes as best practice, all of which lead to a bevy of downstream issues. 
  • Data cleanliness. Payers receive and ingest millions of messy, mis-formatted data points from different providers, data suppliers, and vendors every day. The lack of standardization of these data creates inaccuracies and inconsistencies. Fragmented data often remains siloed within health plans, non-interoperable and underused.
  • Data sharing. The lack of standardization of data within health plans makes data sharing impossible. CMS’s interoperability mandate is a much-needed first step toward addressing this issue and will certainly be a driver toward more efficient data sharing practices, but it is exactly that, a first step.

Overcoming these challenges is not impossible, but it requires the best tools and immediate action. According to a recent PwC survey, only 53% of payers have mapped out their data to see what will be impacted by the CMS interoperability mandate. Even more concerning: only 24% of healthcare executives said they see the mandate as a strategic opportunity. Here’s how payers can act now to unlock and realize the full potential of their data.

  • Clean up data. Now more than ever, patients have greater control over their data — data which, at the moment, is largely fragmented and incomplete. Payers should strive to achieve a single source of truth for each member. Doing so will allow plans to develop personalized member benefits and give providers a complete view of each patient, allowing them to make more informed clinical decisions and empowering patients to stay healthier, longer.
  • Advocate for and improve interoperability. The CMS mandate is a necessary first step, but simply following the mandate is a missed opportunity to innovate and create real change in the ways in which we experience healthcare. It is imperative that payers take up the mantle and champion interoperability from this point forward. We cannot wait for the next iteration of interoperability regulations to improve the quality of healthcare data. Payers should be contemplating ways to ingest quality data, generate new insights, and work with one another to meaningfully engage patients as we experience healthcare.
  • Democratize the use of payer data. Payers cannot drive innovation themselves. The promise of interoperability will only be realized once payer data is shared widely, allowing others to drive innovation, improve connectivity, and enhance our interactions with the healthcare system. By giving patients control over their healthcare data, we’re opening a new realm of possibilities. It is upon payers to lead the charge as we step into the future of healthcare.

With the CMS interoperability mandate, health plans have the chance to change the narrative: what has historically been an industry data challenge is now a business opportunity. By taking  action to unlock healthcare data today, health plans can drive efficiency within the industry and innovate to build a more seamless, engaging, and dynamic healthcare system.

HIStalk Interviews Justin Dearborn, CEO, PatientBond

July 28, 2021 Interviews No Comments

Justin Dearborn is CEO of PatientBond of Salt Lake City, UT.


Tell me about yourself and the company.

I started with PatientBond as CEO in January of this year. Prior to PatientBond, I was CEO of Merge Healthcare from June 2008 through October 2015, when Merge Healthcare was acquired by IBM and formed the basis for Watson Health for a while until their next big acquisition. I took a pause after that in healthcare, went and did a few other things in different industries, and then found my way back to healthcare.

I took your 12-question Patient Classifier psychographic segmentation survey. What are health systems learning about using consumer insights in their outreach and messaging?

I saw you took the classifier, so thank you. You and I are both priority jugglers at a high rate. You fall into multiple categories, and then we segment you based on the highest category, and you are very high and I’m very high on the priority juggler spectrum of the model.

What a health plan, payer, physician group, or specialty pharmacy is trying to activate in their client, member, or patient determines how they start using the psychographics and segmentation platform. Ultimately it is to trigger and activate positive behavior, such as keeping an appointment, filling out a survey, or all the way to collections or the financial side. It is triggering that process.

What all of our clients and most health systems are starting to realize is that they need to treat their patients similar to a consumer. One size does not fit all. Some segments of the population react well to physician-based messaging, where your doctor wants you to do X, Y, and Z. That segment of the population will do that without any other prompting or any other pushing needed. But a large portion of the population that doesn’t react the same. 

A lot of healthcare is messaging is towards the one segment. We dynamically personalize it based on what segment we’re speaking to. The customer doesn’t need to understand the concepts, but they are seeing the results in better engagement with the patient, more engagement, and getting across the spectrum of things from marketing outreach to medication adherence to really involved specialty pharmacy workflows.

It really depends on the workflow you are trying to achieve. But the bottom line is better engagement with your patient or member because you are speaking to them in a modality they want to use, in language they want to hear, and in words that they need to see to be activated.

Do providers ask their patients questions specifically to create a more accurate psychographic profile, or do they infer it from existing information?

Our system learns. We think you want to be communicated this way, in this frequency, and using these words. If it’s an ongoing communication path, our system will learn. We thought you would like text messaging and you need to see one message a day to activate this behavior, but it turns out now that one message a week in an email is better. We can learn from that and personalize the communication path based on that.

Health systems have done a great job, and are getting better all the time, at using AI to harvest their claims data. If it’s an existing patient, they have that data. They might have some socioeconomic data or social determinants of health data. If the health system has those components, we say, great, let us append the psychographic segmentation model to that – it will be even smarter, better outreach because you’re going to have historical data, which is informative for sure.

But what psychographics really gets to is the why and the how. It doesn’t focus on the historical. The historical can be informative, and there are certain things you can tell from a ZIP code or a salary that might impact payment ability, but really what the psychographics does is get behind the why and the how. This came out of Procter & Gamble and a number of high-quality, consumer-facing companies have used this for decades to segment consumers on a mass scale, as well as individual, and we can do both as well.

The classifier allows us to segment you with 91% accuracy. If we didn’t have that relationship, or if you were doing a marketing outreach to attract patients that you don’t know, we would take a national compiler’s database and append our model to it. That would be three times more accurate than chance on segmenting you properly, but it’s still not the number we get if you do the 12 questions.

Many people heard of psychographics in relation to Cambridge Analytica or Facebook collating a lot of data without user knowledge or permission to study their behaviors. Did these examples teach us that psychographics does or doesn’t work, especially in healthcare where the results would be used to improve the individual’s outcomes instead of trying to influence them for less-noble purposes?

I’ll start with the last piece of that. We believe in the health systems that we are working with. We believe in the payers. It’s really about activating positive behavior — making sure you take your medication, making sure you do your annual physical, or prompting you the best we can to get your colonoscopy. I think we would all agree that these are healthy behaviors. We’re not showing the data. In that case of Cambridge and Facebook, if the hospital did license the Facebook data — which we did at Tribune Company, for instance — that would still be separate data. That would go more to the social determinants of health datasets, and we could still use that and append psychographics to that.

To the first part of the question, part of our challenge with PatientBond has been awareness. Since I came in with the Series C investment round, we have been doing more on the outreach, more brand-building. We have started engaging with KLAS and Advisory Board and things like that. Frankly, the company didn’t have the budget to do it in the past. Half of our engagements are evangelizing, so a couple of calls will involve explaining the psychographics model, the history and genesis of that, how we get the data, what the clinical efficacy is, etc. 

Usually light bulbs start popping on. The client, the health system or payer, will start coming up with use cases. Could you do this? How do we operationalize it here? It’s a little bit of, I’ll say, free consulting and evangelizing. But once we get into a pilot mode, it pretty much takes care of itself. Then someone from the marketing or strategy group typically owns the project.

Absolutely awareness is still a challenge, but we’re working on that daily. There was a great paper put out by McKinsey about a month and a half ago that mentioned psychographics a number of times and the way they engage patients more effectively. That was unprompted by us. They found us and did the research and didn’t call us on it. Same with the Advisory Board. They put out a good case study with TriHealth and we were not contacted, but we were named. They both had some great results. So it really is about awareness.

Last year, of course, it was difficult to get mind share with the obvious situation at hand with the pandemic. This year is around awareness of PatientBond and the mission. It’s hard to say in healthcare IT. I was at Merge Healthcare and we had great products, but it’s hard to differentiate yourself. Most of the segments in healthcare are pretty crowded with vendors, but I can say there is no other company doing psychographic segmentation modeling and has our platform. 

There’s a lot of M&A on the AI side that do claims data analysis. Systems will recommend what they think would be the outcome based on historical, which is good stuff as well, but really nobody uses psychographics. A lot of the situations we are in are not competitive, but involve evangelizing and explaining in the first couple of calls.

Are health systems reluctant to apply marketing techniques to patient relationships that are more intimate than just consumer awareness campaigns? Or have their marketing folks not been involved and that will change with the new emphasis on consumerism as overseen by C-level executives?

I truly believe it’s the latter. It’s just coming of age. I’ve spent 10 years in healthcare and I can remember growing up that you didn’t see marketing from health systems, your doctor, or your hospital. I grew up around Northwestern Hospital and they didn’t advertise, but they do now. They have marketing budgets. They have data scientists.

That has evolved for the better. How to engage. How do people want to be communicated with, like text messaging versus email or IVR? Or, do you need to talk to a human being? We are informing them on how to best communicate.

That has been going on in CPG, consumer packaged goods, for 30 years. CPG used it effectively. Proctor & Gamble are masters at consumer marketing, but they don’t necessarily have the one-to-one relationships that can be built at health systems. You’re not as intimate when you’re buying Tide detergent, so when they are applying psychographics to something like Tide, it is more of a carpet bombing. They’ll profile an area and say, this area is over-indexed for priority jugglers, and here’s the messaging, here’s the labeling, and here’s what we need to do to resonate here.

But with health systems, it is truly one to one. Once they are a member or patient client, it’s one to one, and we truly personalize it for each one. That’s a huge, huge upside and more productive.

I truly believe it is awareness. In none of the calls that I’ve been on in the past six months — and there have been a lot —  did the chief marketing or chief strategy officers not get it, not believe in it, or decide that “we’re good with what we’re doing.” It’s more of, this is really intriguing,. How would we operationalize this? How does this work with our CRM? How does it work with our EMR? There’s has been a lot of great commentary, feedback, and follow-on loops.

I would say it’s coming fast. We probably would have seen a bigger uptake last year but for the pandemic, but as hospitals get back to normal a little bit, it is all about treating the patient as if they have choices, which they do. Probably this year or maybe next year, people will be paying 50% out of pocket for their total healthcare costs. We’ve been talking about it for 10-15 years, but the patients will be in charge. They are starting to make decisions somewhat based on price, how they like doing business, and how they like the relationship. That has been evolving for a while, but it’s going to cross the 50% threshold here very soon, and patients will act like consumers. It’s coming and it’s going to come fast.

We’re seeing that increasing COVID-19 vaccine uptake isn’t a simple as informing people who are uninformed, so now we are trying to understand their beliefs and nudge them accordingly. Has that raised awareness that targeting patients who meet some criteria and hitting them with cookie-cutter messages probably won’t work?

That’s a great analogy. We surveyed 4,000 people with 400 questions around motivation for vaccination. We came out of that with a ton of data. It is coming to light right now that you can’t treat everybody the same. It’s not all about just being an anti-vaxxer. There are other motivations and other things you can point out, and it’s information. Some people need more information. Some need to have their clergy talk to them about it. It’s all starting to come out as we hit the wall. We predicted four months ago that we would hit the wall in June at about 65%. We were spot on. We had this great data built into the platform as how to basically get people who are close over the hump and off the fence.

We have been trying to get that data out there. The challenge is who ultimately is motivated and incentivized to get people who aren’t vaccinated to get vaccinated. Now it has become more of a public service. For health systems, it’s for the common good, but do they even have a relationship with people who aren’t vaccinated their community? Not always. Early on, employers were being hands off because it was a hot potato. It was hard for us, and it still is hard for us, to find a group that has the incentives to get behind this.

We are willing to share the data and share our insights on how we feel that you can move the needle on that. But that has been a challenge because there has been no ownership. The federal government is supportive of it, but other than making it free, there’s really not much else. To your comment, we are absolutely, definitely informed that you can’t treat everyone the same. You can’t have one billboard. That’s not going to resonate with all the groups.

What will the company’s strategy be over the next few years?

It’s about marketing awareness. We’ve tripled the go-to-market team, the sales team, in the first six months of the year. We’ll grow 100% this year, and I think we’ll continue that path. The really attractive piece for me coming in was that we have a somewhat “friends and family” board of directors. There’s really only one entity of professional money, which is First Trust, who has a legacy investment and is a great partner. The rest are family office and individual. It allows me to manage the company for growth and to see this thing through.

We have a huge runway ahead of us. I don’t have any investor pressure. There’s no timeline. We have enough of a platform, and it keeps growing weekly, that we can remain private and self-funded for eternity. Eventually we’ll come to a decision point in a couple of years about an IPO or something else, which is the natural evolution of an early-stage growth company, but the good piece for me was not having external pressure from traditional venture capital investors.

An HIT Moment With … Steve Shihadeh

July 28, 2021 Interviews 3 Comments

An HIT Moment With … is a quick interview with someone we find interesting. Steve Shihadeh is founder of Get-to-Market Health of Malvern, PA.


What advice are you giving clients about participating in HIMSS21 and HIMSS22?

I am very hopeful that HIMSS22 will return to a more normal trade show to meet the pent-up demand on both the vendor and provider side. 

With all of the COVID churn, mask debates, and travel challenges, we are advising clients who want to go to HIMSS21 to be surgical about their investment. By this, I mean that they should have a narrow list of who they want to visit and what they want to accomplish and generally be in and out in a day or so to keep expenses to a minimum. 

I get the sense that vendors are being cautious about investing, and a quick look at signups bear that out. If vendor attendance is light, I would have to guess that provider participation will be down significantly as well.

How are companies changing their marketing strategy?

With in-person trade shows effectively non-existent since March 2020 — by the way, every client we have talked to has felt that the virtual shows were a bust — companies have adapted marketing significantly to keep their businesses vital.

A few clients have upped their webinar game with real thought leadership and way more nuanced selling than in the past.

I continue to be impressed by how much mileage our clients are getting out of social. They are making use of multiple channels and keeping it edgy and interesting. The really sophisticated companies are getting participation across their employee base, which is greatly amplifying their messaging.

We have participated with our clients in a number of focus groups, and while you don’t get the reach of large-scale events, you certainly get to go way deeper. It seems like picking the right attendees and having a solid structure to the events reaps the most reward.,

How has the sales process changed post-pandemic?

Value prop, value prop, value prop. With in-person meetings dramatically reduced in both number and time allowed on site, companies need to more than ever translate their bells and whistles into things that matter to the client. How exactly does it save money? How exactly does it positively impact clinical workflow and outcomes? How exactly does my taking a meeting with you help my organization dig out of this COVID hole?

What are the most important things you look at when asked to perform due diligence for a potential health IT investment or acquisition?

Value prop, value prop, value prop. Just kidding, but not really. Investors get this more than anyone and want to deeply understand a company’s storyline and associated ROI. Investors at different stages – seed, venture, growth equity, private equity, strategic — will have different expectations, but they all need to understand how you truly differentiate and how you truly help a provider with a key challenge.

What clues will the HIMSS21 exhibit hall provide about the direction of the health IT market and the companies in it?

The health tech market is coming back red hot, in my opinion. The pandemic has broken the status quo and providers are finding new ways to use technology and new problems it can solve. Hopefully HIMSS21, albeit with a lighter attendance than in the past, gives us a glimpse at how companies have responded to the many opportunities presented by the COVID crisis.

Morning Headlines 7/28/21

July 27, 2021 Headlines No Comments

Nordic Capital in Talks to Buy Health Tech Firm Inovalon

Bloomberg reports that Europe-based private equity investor Nordic Capital is in talks to acquire health data analytics vendor Inovalon.

New tool for early identification of COVID-19 surges

Kaiser Permanente develops a COVID-19 HotSpotting Score to help providers predict COVID-19 surges up to six weeks ahead of time.

Teladoc stock drops after telemedicine company reports wider quarterly loss

Teladoc shares drop 7% in after-hours trading after the company reported a greater-than-expected Q2 loss of $133.8 million.

News 7/28/21

July 27, 2021 News 2 Comments

Top News


British health IT company System C acquires medication management vendor WellSky International from parent company WellSky Corp.

WellSky International will change its name to CareFlow Medicines Management and operate as a division of System C, which primarily serves NHS trusts.

WellSky International, the former JAC and Mediware Information Systems BV, took that name in mid-2019 following the 2018 renaming of then-parent company Mediware to WellSky.

Reader Comments


From Essential Oils: “Re: McLeod Health, SC. Replacing Cerner with Epic.” Verified, according to a health system announcement. The health system chose Cerner Millennium in late 2016 to replace Cerner / SMS Invision and Soarian. The first of McLeod’s seven hospitals went live on Millennium in early 2019 and the rollouts continued through at least early 2020, so that was a short stay. The health system says that the move to Millennium was the largest project in the health system’s history.

From Nanner Puddin: “Re: HIMSS21. My company has zero confirmed face-to-face meetings versus our requirement of having five booked at least two weeks before the conference, so we have decided against attending.”

From New to the Startup World: “Re: EHR. I recently started working at one of those telehealth disruptor type Silicon Valley startups after many years in health IT. I laughed so hard I nearly fell out of my chair when I heard they are planning to build their own EHR. I don’t see how they can get by without a certified EHR and I don’t see how it makes sense to build one purely for internal use. Amy I the crazy one? Does anyone still build their own EHR? Can you get by without a certified EHR? Oh, also note that the company does not have any staff with EHR experience.” I used to argue that non-traditional providers that don’t deal with insurance could gain competitive advantage by building their own EHR-lite that is centered around patients and providers, basically more like a CRM (although for that purpose, maybe an actual CRM would be the best option). A few investor-backed primary care companies that tried that failed, although most likely for other reasons. The Silicon Valley argument for building would be Uber or other company whose entire physical and business presence is a seemingly simple app that is powered by a lot of hidden computing power. A smart, aggressive, well-funded, and disruptive telehealth provider might convince me that a custom-developed EHR is essential, but hopefully they at least keep integration in mind since we’ve learned that even telehealth companies with their own providers can’t exist responsibly in a medical silo.


July 28 (Wednesday) 1 ET. “Stop running from your problem (list): Strategies for streamlining the EHR’s front page.” Sponsor: Intelligent Medical Objects. Presenters: Amanda Heidemann, MD, CMIO, CMIO Services LLC; James Thompson, MD, physician informaticist, IMO. How can clinicians mitigate the longstanding EHR problem list challenges of outdated or duplicative entries, rigid displays, and limited native EHR capabilities? The presenters will describe how to analyze current problems, create a problem list governance strategy, and measure improvement progress.

On-Demand Webinars:

Key Differences: Value Based Care vs. Fee-For-Service.” Part 1 of a three-part series. Sponsor: Net Health. Presenters: Bill Winkenwerder, MD, chairman, CitiusTech; Josh Pickus, CEO, Net Health. Dr. Bill Winkenwerder, former assistant secretary of defense for health affairs for the US Department of Defense, shares his unique perspective on the future of value-based care (VBC) systems in the public sector and how VBC differs from fee-for-service models in the private sector. This Part 1 webinar covers which aspects of the fee-for-service health system payment model look the most different compared to fully value-based systems (clinical, back-office, analytics, etc.)

Current Innovation and Development in Value-Based Care.” Part 2 of a three-part series. Sponsor: Net Health. Presenters: Bill Winkenwerder, MD, chairman, CitiusTech; Josh Pickus, CEO, Net Health. Dr. Bill Winkenwerder, former assistant secretary of defense for health affairs for the US Department of Defense, shares his unique perspective on the future of value-based care (VBC) systems in the public sector and how VBC differs from fee-for-service models in the private sector. This Part 2 webinar discusses what health systems should know about the transition to value-based care, including macro versus micro shifts.

Future of Value-Based Care: Predictive Analytics, Technology, Policy.” Part 3 of a three-part series. Sponsor: Net Health. Presenters: Bill Winkenwerder, MD, chairman, CitiusTech; Josh Pickus, CEO, Net Health. Dr. Bill Winkenwerder, former assistant secretary of defense for health affairs for the US Department of Defense, shares his unique perspective on the future of value-based care (VBC) systems in the public sector and how VBC differs from fee-for-service models in the private sector. This Part 3 webinar discusses the role analytics will play in the shift to value-based care and how financial and clinical ROIs for analytics-oriented products must differ when applied to FFS and VBC models.

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

Acquisitions, Funding, Business, and Stock


Bloomberg reports that Europe-based private equity investor Nordic Capital is in talks to acquire health data analytics vendor Inovalon. Since going public in 2015, Inovalon has acquired Avalere Health, Ability Network, Complex Care Solutions, and Creehan & Company. INOV shares rose 70% in the past 12 months, valuing the company at $6 billion.


  • CPSI will integrate Medicomp’s Quippe Clinical Data Engine with its acute and post-acute EHR products.
  • Adventist Health (CA) selects GetWellNetwork’s full line of digital patient engagement technologies.
  • In Australia, South West Alliance of Rural Health and Barwon Health will deploy the InterSystems Iris for Health data extraction and analysis software.
  • LTC ACO will implement PatientPing’s real-time care notification and coordination software across more than 700 member facilities.
  • Marshfield Clinic Research Institute (WI) joins TriNetX’s global health research network.
  • The ACT Health Directorate in Australia will use Capsule’s device integration technology to connect medical devices with its new Epic system, set to go live in September.
  • Everest Rehabilitation Hospitals will implement WellSky’s rehabilitation software, including its EHR, across its facilities in Texas, Arkansas, Ohio, and Florida.
  • LifeBridge Health (MD) selects Intelerad’s cloud-based medical imaging managed services.
  • University Hospitals (OH) will launch its Hospital at Home program using Edgility technology.
  • HealthLinc will use Greenway Health’s telehealth solution.



Siv Raman, MD (Lumilla) joins 314e as chief product officer.

Announcements and Implementations


Infor announces GA of its FHIR Server for improved data storage and exchange based on the FHIR standard.


Ochsner Health (LA) adds ActX’s genomic decision support to its Epic system.


UnityPoint Health develops social services referral software using technology from Aunt Bertha.


I assume all of us HIMSS members received an email today pitching Accelerate, a HIMSS-developed app that hopes to connect users, HIMSS-designated thought leaders, and HIMSS exhibitors and content. Mostly so far it seems to push Healthcare IT News articles into a news feed. HIMSS apparently formed a new company called One OpCo, LLC to support the app and apparently hopes to sell it to “enterprises, organizations, and associations interested in getting access to their members.” HIMSS uses Accelerate name for innovation-related products, including what used to be called VentureConnect. The app tracks a ton of user data, according to app store privacy details. I don’t see me launching the app a second time since I rarely find HIMSS-generated content useful and my experience is that healthcare IT folks aren’t interested in contributing content and participating in discussions.



From Tuesday afternoon’s CDC press conference:

  • Fully vaccinated people are now advised to wear masks when indoors in areas where spread is extensive.
  • Teachers and students are urged to wear masks indoors regardless of vaccination status.
  • The Delta variant makes up 83% of new cases and most transmission is occurring in low-vaccination areas, which includes most counties in Arkansas, Louisiana, Missouri, Mississippi, Alabama, and Florida.
  • It appears that some people who have been vaccinated can spread the Delta variant, which wasn’t common with previous strains.
  • CDC Director Rochelle Walensky, MD, MPH said that coronavirus is “just a few mutations potentially away” from becoming resistant to COVID-19 vaccines.


Penn Medicine (PA) will launch the Center for Applied Health Informatics to develop best practices for data projects across its health system and foster informatics leadership. Initial projects will focus on telehealth expansion and COVID-19 response efforts. Collaborators will include Information Services, the Center for Health Care Innovation, and the EHR Transformation team, among others.


Kaiser Permanente develops a COVID-19 HotSpotting Score to help providers predict COVID-19 surges up to six weeks ahead of time. The predictive modeling tool’s estimates, which incorporate variables like COVID-19 test rates, inpatient and clinic data, and call center and patient email data, strongly correlated with COVID-19 hospital activity during the last half of 2020.

Sponsor Updates


  • Cerner receives an award from the Missouri House of Representatives commending its mass vaccination efforts during Operation Safe.
  • CloudWave and Vital Images will partner to deliver enterprise imaging as a cloud-based service.
  • Audacious Inquiry and the Georgia Hospital Association announce that hospital participation in GA Notify, powered by Audacious Inquiry’s Exposure Notification Service, has tripled over the past six months.
  • Optimum Healthcare IT publishes a video titled “Optimum CareerPath: A Different Approach to Building a Team.”
  • Mach7 Technologies has received the Frost & Sullivan Global Enterprise Imaging Solutions Product Leadership Award, has been recognized by Industry Tech Insights magazine as one of its Top 10 Companies Revolutionizing Healthcare in 2021, and has been named one of the Top 20 Most Promising Workflow Solution Providers by CIO Review magazine.

Blog Posts


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Morning Headlines 7/27/21

July 26, 2021 Headlines No Comments

Penn Medicine Launching Center for Applied Health Informatics

Penn Medicine (PA) will launch the Center for Applied Health Informatics to develop best practices for data projects across its health system and foster informatics leadership.

Epic’s AI algorithms, shielded from scrutiny by a corporate firewall, are delivering inaccurate information on seriously ill patients

STAT sheds light on an Epic program that incentivizes customers to use its algorithms, one of which – sepsis prediction – has been found to not work as well as advertised.

Komodo Health Acquires Breakaway Partners to Improve Patient Access to Effective Therapies

De-identified patient data and analytics company Komodo Health acquires Breakaway Partners, which offers market access analytics.

Curbside Consult with Dr. Jayne 7/26/21

July 26, 2021 Dr. Jayne 2 Comments


I learned a valuable lesson in procrastination today, as I delayed writing until after I had an unfortunate encounter with a cheese knife. It was a classic blunder because I was in a hurry, and now I get to figure out how to type with fewer digits because I forgot how much finger lacerations hurt. It’s a good thing I’m not seeing patients in person right now because proper hand hygiene would certainly be a challenge. Public service announcement: don’t cut toward yourself, folks.

I should be practicing music in preparation for a recording that’s due soon, but that’s not going to happen. In the meantime, I’m recuperating by catching up on my journal articles and some light Netflix watching, which I almost never get to do. One of the first articles to catch my eye is timely given the state of burnout among my healthcare colleagues. It deals with the evaluation of resident physicians as to their level of “grit” and its association with wellness outcomes. The personality trait of grit is defined as “perseverance and passion for long-term goals.” Grit has been associated with conscientious behavior and higher levels of hope. In healthcare, those with higher grit scores have been associated with lower burnout scores.

The article looks specifically at the association of grit scores in surgical residents with burnout, thoughts of leaving the program, and thoughts of suicide. Researchers tested residents following the 2018 American Board of Surgery In-Training Examination. Where previous studies looked at data for residents in a single institution, this approach allowed them to look at nearly all clinically active surgical residents. Although the scores varied between programs, they found that residents with higher grit scores were less likely to have burnout, thoughts of quitting, or thoughts of suicide. It also confirmed that residents overall continue to have unacceptable levels of burnout, suicidal thoughts, and thoughts about leaving their training programs.

Fast-forward a couple of years and we have a situation where physicians and other healthcare providers around the world have been pushed to the brink. Many of them are working hours that are similar to what they worked in residency or their training programs, except now they’re responsible for these larger patient loads and sicker patients rather than being in training. It’s a heavy burden to bear and this week I saw four more of my colleagues resign from medicine. Mentally it seems worse, I think, because the patients are often in the situations that they are in by choice – by refusal to vaccinate, wear a mask, or practice social distancing. It’s hard to manage the cognitive dissonance around putting yourself at risk caring for others who didn’t take basic precautions.

As a clinical informaticist, I’ve learned to tread lightly around physicians and other care team members who are stressed. It’s important to know what else has been going on in their days before figuring out the best approach to training them or working with them in meetings. For example, did the OB/GYN on the committee just come out of a disastrous delivery, and that’s why they are disengaged or sound angry? Was it a difficult day in clinic? Lately, it seems like all the practicing physicians with whom I work are stressed every single day, which makes it hard to take projects forward when you need their input. I’m seeing many more canceled and rescheduled meetings and lots of schedule juggling. I’m having to think of entirely different ways to work with some of my end users while they struggle to balance all of the different pressures that they are under.

Lately it seems like they never get a break. The younger clinicians seem particularly stressed because school is starting soon. Most of them have planned for their children to attend in-person school, and the thought that our local COVID case numbers might change that is pushing them to the brink. It’s hard to get people to want to engage with you around designing order sets or evaluating potential clinical workflows when they are worried about childcare. We’ve seen a drop-off in participation in some of our committees and work groups as well. It seems people are just not willing to spend any more time at the workplace than they absolutely have to.

It doesn’t seem like video calls are the answer due to a tremendous amount of Zoom fatigue. We are having to think outside the box on how to engage people while also respecting their need for work/life balance. It’s important that we have good representation from different types of users with different types of needs, so we’re going to have to figure it out.

As clinical users become more stressed by patient care activities, they have less tolerance for misbehaving technical systems. What used to be small annoyances that users would ignore now seem to be more disruptive. If the EHR is running slow or there are any performance lags, it causes much more angst. Any buffer of resilience has been completely eroded over the last year. Most of the clinical organizations I work with have placed new non-essential tech initiatives on hold in order to give their budgets some breathing room, and it’s probably a good thing because it also gives their personnel some breathing room. For those that are moving ahead with big projects, I’m making sure they think about how they’re going to best support their users through the transitions.

I’m curious how other organizations are coping with the stresses of our new healthcare normal. Maybe there are some change leadership Jedi tricks that I haven’t learned yet that would be of benefit. Or perhaps the solution is to just slow down and give people some breathing room so that they can focus on patient care and self-care. Or maybe there are no good answers, and we just have to continue putting one foot in front of the other each day and hope for the best.

How gritty are your clinicians, and will they be able to rebound? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Interviews Vik Krishnan, GM, Intrado Digital Workflows

July 26, 2021 Interviews No Comments

Vik Krishnan, MBA is general manager of the Intrado Digital Workflows business of Intrado Life and Safety.


Tell me about yourself and the company.

I live in Boston with my wonderful wife and three children. I studied biomedical engineering at the University of Pennsylvania, then earned my MBA from Harvard Business School. I entered the digital health market 12 years ago through a company I founded. I have the probably unique distinction of having run two of the businesses in the market today that offer something similar to Intrado HouseCalls in terms of patient engagement.

Intrado’s HouseCalls business is a market share leader by far in automating mass patient engagement workflows. We serve 17,000 healthcare providers, including 400 of the largest hospitals that are using Epic and hundreds that are using Cerner.

Dental practices have offered just about every form of patient engagement technology for years. Why did it take practices and hospitals so much longer?

If you think about the longer tail of healthcare providers, small physician practices and dental practices, there is no disguising the revenue impact in a given week or in a given month of even a slight variation in patient volumes. A dental clinic is going to feel that. They may even go under with a couple of bad months. That’s probably why they were quicker to adopt. Also, any smaller institution in any market, including healthcare, is usually more willing to have a quicker and more simple sales cycle. There are more levels in the decision and more integration into the solution and the current systems at a larger healthcare provider.

All of those factors will come into play. I think that they have gotten there now, though, but you are right, it has taken longer.

What do patients gain as a benefit when you integrate a patient engagement platform with an EHR like Cerner or Epic?

We have to understand patient preferences. Certainly they vary by demographic type, and age, but essentially what a patient is looking for is a seamless experience. Surveys find that 90% of patients want automated patient engagement communications. Nearly 70% say that they want more communications and reminders that help them be compliant with their own healthcare needs and their own requirements.

What they don’t want to do is get a reminder — for example, about an appointment — and then realize that the scheduled time doesn’t work for them, but the only available follow-up action is to call the contact center. That’s a laborious process, not just for appointments, but for a recall campaign, for example. If somebody knows that they need to schedule an annual wellness visit, but now they have to call in and wait, that’s a challenge and a burden that can ultimately disengage the patient from the process.

What a patient would like — and this can only be achieved through deep integration with the EHR – is to solve that workflow through SMS. If the appointment I have tomorrow doesn’t work, why can I not just reschedule that through SMS through real-time integration with the EHR? If I know I need a colonoscopy and I’ve been reminded of it effectively, that’s great and I want to schedule it, too. Why can’t I just do that in an automatic way without talking to a human being?

Last point on this. This matters a lot for underserved communities as well, because there are a variety of differences to consider there. Some of those differences are around a preference that studies suggest for using SMS versus phone call and email. Some of it is around language. If a platform can use over 100 languages, you are more likely to deliver the patient experience that somebody wants if English is not their native language. That will improve communication health and patient satisfaction.

How do you capture the categories into which a given patient falls, such as those with a preferred communication method, a limit to how many messages they want to receive, or those who want to opt out entirely?

That is done effectively through both a solution philosophy and a support philosophy. The solution philosophy needs to be to use the hospital or health system’s EHR as the single source of truth. If the hospital or health system is using the EHR as a single source of truth, these toggles, these preferences, this information will be in there. It’s just waiting to be used.

Then the next step is a solution philosophy that leverages that data, integrates through real time like we do through APIs into the system, and is empowers that system and that hospital to get the most out of their EHR. Any hospital CIO or CMIO will tell you that they want the EHR to be the single source of truth. It’s harder to do that when many other solutions on the market don’t integrate through API as the way we do and instead use HL7. This creates a parallel EHR-like system of data and rules that live outside of the EHR.

That makes it more complex. It makes it harder for the hospital to manage this and these insights on the patients and their preferences. It also exposes the hospital and health systems — going a little off-topic here, but it’s important to mention — to data breaches and other risks. You use the EHR as a single source of truth, and you help through support the hospital or health system to do that. That’s ultimately how you achieve what I just described in my previous answer.

Everybody’s buzzword is “digital front door.” Do health systems that haven’t solved longstanding patient pain points – employee friendliness, parking and wayfinding, and accurate billing – create digital expectations that their physical reality can’t match?

We see a lot of hospitals navigating what seems like a simple concept. Digital front door seems like a specific concept, just like patient engagement seems like a specific concept, but ultimately it involves a more comprehensive solution with lots of departments and stakeholders at the hospital involved. We typically see hospitals and health systems find this process, both front door and digital engagement, to be complex and difficult.

The concept of digital front door can encompass many things. It could encompass what the website looks like. Is there a chat bot or web bot on the website? That’s for inbound. Patient engagement is often thought about as being outbound, but the way we think about it is two way. We want to facilitate, and we do, two-way patient interactions. Sometimes these will be around something specific that is happening. We want to inform a patient about an annual wellness visit, the need to get a mammogram, or something pre-post-procedure, appointment, or thereafter. But sometimes these things will be inbound. It’s not because of something the hospital wants, it’s because of something the patient is seeking. They may be on the hospital’s website, for example, and want to be able to take an action that doesn’t involve calling the hospital contact center.

We see complex RFP processes. We see hospitals engaging consulting firms to solve these problems. I certainly have recommendations on how to solve these problems, but I want to acknowledge it is a complex process and decision that is difficult for hospital decision-makers to navigate.

Is it possible to address all these patient needs, including pre- and post-procedure instructions and communication with the patient’s family, through a single technology or vendor?

It is. This is an important concept to mention. We see an evolution underway right now in the market in terms of how hospitals and health systems are viewing patient engagement. Virtually all understand that they need to send SMS reminders, for example, about appointments and related communications. Many today still view those particular use cases as point solutions, or value may be measured, for example, through no-show rates or through transactional pricing.

Some, to your point, have understood that they need a patient engagement platform, not a point solution. More broadly, a solution, a platform that is not just solving any one of those things, but that integrates, for example, in real time, not just with their EHR, but with other systems like the contact center. One that truly automates a wide range of two-way patient engagement workflows.

When you think about making a solution decision versus a platform decision,vit can be a more complex decision. But the ROI for that platform will be measured by increased revenue delivered, decreased operational costs that the hospital has to bear, and increased community health and patient satisfaction. Some hospitals and health systems are going through that process, and that frankly is the solution that we provide. Those are the types of customers that we serve and the needs we try to solve, but that’s how you get there, and that’s the difference between the solution and the platform.

To what degree are hospitals using patient-reported outcomes, such as automating a daily inquiry about the patient’s pain, medication effectiveness, or mobility?

Let’s talk about a mass notification solution and then a patient engagement platform and what the difference is.

Let’s say a hospital has a mass notification system to inform patients about the need to have an annual wellness visit. They have some success rates. Great. They get some revenue and community health has improved. Nice job.

Now if they have a patient engagement platform that truly integrates in real time, it can automatically identify which patients need to be informed about an annual wellness visit. It can drive those interactions, but it can also capture those patients, for example, who say, “I actually declined, I don’t want to have an annual wellness visit.” You can record that information and report it in real time back to the EHR.

At some point, that patient will come in and  talk to a physician, maybe their PCP, about something else. The PCP, through a platform — not just a mass notification system — will have that information in the EHR that will allow them to know the decision the patient made and have a conversation with them about why they made that decision. This is about holistic care, which ultimately drives patient satisfaction and improves community health. Doing that actually also improves the hospital’s satisfaction scores and care quality scores, just knowing why if somebody didn’t want to do something, why that was and what happened after.

Do health systems and practices do a good job of not overwhelming patients with poorly designed or poorly targeted messages?

For our solution, we adopted a concept of augmented intelligence. You can broadcast every message to every patient about everything, which will probably create the dissatisfaction and disengagement that you just described. You can also ask a patient to go log in somewhere to a portal, download an app, and go log in there and get whatever information that the hospital wants the patient to get. Every study shows that if you ask a patient to log in somewhere, they’re less inclined to do it. They probably don’t know their login and they will never get that message. The message may not even be tailored to them.

An augmented intelligence patient engagement platform integrated into the EHR knows when a patient needs to hear what and when. Once one of those automated workflows is set up by hospital staff, it runs. It can be monitored and reported on, but it doesn’t need to be manually managed. A platform like that will reach out to patients about the right thing at the right time and collect responses. That makes it more tailored, more personalized, and ultimately more effective.

What changes do you expect to see in your business over the next few years?

We have adopted a process of continual innovation. The biggest hump to get over — and we are increasingly doing this in our new logo deals and also our customer base —  is that it’s not a point solution that you need. What you’re getting from us now and what you need to adopt from us now is a true augmented intelligence patient engagement platform.

But once they make that leap, and many of our customers already have made that leap with us, then it is not hard after that to continue to add new workflows that increase automation and ultimately help healthcare providers, hospitals, and health systems do three things — increase their revenue, decrease their operational burden and costs, and improve community health and delight patients and increase their satisfaction. Once the customers we serve and the customers that we are adding are over that hump, they will continually add more and more automated workflows that we are delivering.

Do you have any final thoughts?

I’ve described the concept of a point solution and a platform. While we excel at delivering some of those point solutions, our mission in this business is to offer the platform. If a healthcare provider in your audience is interested in a true platform that digitally transforms their organization and does what I’ve described, I would urge them to reach out to Intrado or to me personally.

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