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Readers Write: Should Health Systems Become Banks?

May 15, 2023 Readers Write 2 Comments

Should Health Systems Become Banks?
By David Stievater

David Stievater, MBA is a partner with CWH Advisors of Boston, MA.


Are healthcare organizations expected to now run banks in addition to delivering patient care services? To help patients pay for their care, providers have become lenders, offering patients the equivalent of unsecured, zero-interest loans backed by hospital balance sheets. It should come as no surprise that with additional financial stress lingering from the COVID pandemic, providers are looking for additional funding sources and financing alternatives for their patients.

Overall US healthcare spending hit 18% of GDP in 2021, up from 5% in 1960. Total patient out-of-pocket spending, not including insurance premiums, totaled $433 billion, according to the latest numbers from CMS. The out-of-pocket dollars owed by patients has risen at twice the rate of US GDP growth since 1960. More and more, patients find they do not have the cash on hand to cover medical expenses.

The financial challenges facing patients are well documented. In 2021, the Federal Reserve Board reported that 17% of adults had major, unexpected medical expenses in the prior 12 months, with the median amount between $1,000 and $1,999. The same research also said that 23% of adults went without medical care due to an inability to pay. These types of findings are corroborated by other reports, including Synchrony Financial’s Lifetime of Healthcare Costs study in 2022 in which one in four individuals said they delayed a recommended procedure due to cost. The Synchrony study also indicated that when care was delayed due to cost, respondents ended up with additional medical issues 50% of the time.

Patients will benefit from more funding sources and options to reduce and eventually pay off balances owed to healthcare organizations.

Unlike other industries, providers generally bill patients after care is delivered. They carry the patient balance owed to them as a receivable, to be collected once insurance has calculated its portion. By billing after the fact, providers essentially make unsecured loans to patients.

Many decades ago, when the patient portion of provider revenues was relatively small, it was common for unpaid patient balances to simply be written off. It wasn’t worth the effort to pursue them. Providers did not tend to accumulate large unpaid patient balances on their books for long.

Over time, as the size and frequency of uncollected patient fees grew, provider organizations looked to new propensity-to-pay algorithms, early pay discounts, early out vendors, recourse financing, pre-service collection of co-pays, in-house payment plans, and other tactics to increase the yield on the amount owed by patients. Debt collectors were asked to pursue patients deemed able to pay. In some unfortunate cases, the most aggressive health systems have sued patients (including their own employees) to recover unpaid balances.

Provider executives say they work hard to balance compassion for patient circumstances with a desire to collect from patients who they believe can afford to pay at least some of what they owe. Additionally, they would prefer not to be in the lending game and tie up so much of their balance sheet with unpaid patient balances.

We estimate that 45-55% of a typical health system’s patient balance, after insurance (including full self-pay), is never collected and is converted to charity care, some other form of financial assistance, or written off as bad debt. Providers too will benefit from offering patients more options to fund their care and reduce and eventually pay off balances.

Our 2022 PatientPay study — which included 38 in-depth interviews with executives at health systems, hospitals, and large single/multi-specialty medical groups — indicated that providers will increasingly look outside their organization for solutions. One hospital CFO said that “a lot more people are going to finance their portion of what they owe,” Another revenue cycle executive said, “We are definitely going to provide more third-party financing options and less in-house over the next two years.” Overall, 61% of the executives said they expect to make greater use of third-party patient financing over the next 24 months.

Part of the impetus to look externally for payments solutions is that the COVID pandemic has made it harder for healthcare organizations to staff their revenue cycle operations. Still, much of the motivation to seek third-party assistance is simply the need to find more flexible payment and financing options for patients that free up the health system’s balance sheet.

The study noted that the biggest investments by large provider organizations are centered on creating a more retail-like payment experience for patients. COVID pushed more dollars here immediately in the form of contactless terminals and accelerated efforts around card-on-file and other portal-based technologies. Patients can expect improved communication via portal-driven emails, text to pay, and mobile applications.

Entrepreneurs are also putting their creative minds to work and generating new solutions to help providers match their patients with available financial assistance and philanthropic programs. Companies such as TailorMed/Vivor, Annexus Health (AssitPoint), RIP Medical Debt, and Atlas Health claim their approaches are generating meaningful ROI for providers.

Longer term, providers must focus on providing patients with an accurate estimate of their costs. This will enable them to collect the patient responsibility before care is delivered, without waiting for insurance adjudication and without turning their healthcare organization into a lender.

Morning Headlines 5/15/23

May 14, 2023 Headlines No Comments

Prognos Health Raises $23 Million

Real-world healthcare data marketplace operator Prognos Health raises $23 million in growth equity.

HC3: Sector Alert – Veeam Backup & Replication Latest Threat Actor Target

The Health Sector Cybersecurity Coordination Center warns organizations that hackers are exploiting vulnerabilities within Veeam Backup & Replication software.

Just-launched initiative aims to capitalize on Kansas City’s promise as a global leader in health tech, renews call for KC investment

Digital Health KC launches to encourage health technology professionals, especially those who worked for Cerner or other Kansas City-based companies, to return to the area.

Monday Morning Update 5/15/23

May 14, 2023 News No Comments

Top News


Real-world healthcare data marketplace operator Prognos Health raises $23 million in growth equity.

The company offers life sciences customers access to the integrated lab and health record data of 325 million de-identified patients.

The co-founders are Sundeep Bhan and Jason Bhan, MD.

HIStalk Announcements and Requests


Most poll respondents say their employers haven’t dialed back remote work options.

New poll to your right or here, inspired by Dr. Jayne’s XGM recap: What behavior of fellow conference education session attendees do you find most annoying? I am most bugged by those who charge the microphone during Q&A to deliver pontification that is poorly disguised as a question, which clears the room like someone yelling “fire” in a theater. If your insecurity doesn’t allow you to sit quietly while someone else holds the audience’s attention, then sign up as a presenter next time.

My best HIMSS23 takeaway was an first-timer’s appreciation for Chicago’s chicken Vesuvio, which I made at home this weekend with great success. It sounds unexciting on paper, but is brilliant.


Welcome to new HIStalk Platinum Sponsor Lucem Health. The Raleigh, NC-based company transforms the science of clinical AI into trusted point-of-care solutions that scale. With its comprehensive, AI-agnostic platform for building, operationalizing, and improving clinical AI solutions, Lucem Health brings the full power and potential of clinical AI from the lab to the front lines of healthcare, where it can help clinicians deliver better care, improve patient outcomes, and lower costs. The company envisions a world in which clinicians detect problems before they become life-threatening and patients get world class care, everywhere. Thanks to Lucem Health for supporting HIStalk.

I found this overview of Lucem Health on YouTube.


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

Acquisitions, Funding, Business, and Stock


Digital Health KC launches to encourage health technology people, especially those who worked for Cerner or other KC-based companies, to return to the area. The CEO is former Cerner executive Dick Flanigan.


  • Emory Healthcare will implement NeuroFlow to provide behavioral services in a collaborative care model with its primary care clinics.

Announcements and Implementations

Victoria, BC-based Island Health celebrates Canada’s National Nurse Week by honoring the nurses who are working to implement its Oracle Cerner EHR.

The senior director of the Collaboration to Harmonize Antimicrobial Registry Measures (CHARM), which analyzes the EHRs of participating organizations for current prescribing practices, says that up to 80% of outpatient antibiotic use is inappropriate, either because the drug isn’t needed or is ordered incorrectly.

Epic updates its Epic Research Data Tracker to publish every-other-week metric updates on respiratory illnesses and other topics using data from Cosmos, allowing continuous monitoring that is often beyond the capability of public health organizations.


John Snow Labs posts demos of AI-powered models that can summarize clinical text, medical journal articles, consumer medical questions, and radiology reports.

Privacy and Security

HHS’s cybersecurity center warns that Veeam Backup and Replication software contains a vulnerability that hackers are exploiting.



In England, the mother of a 19-year-old patient whose hand was bruised significantly during a blood draw shows the hospital a photo of the nurse watching soccer on his phone as he stuck her. The trust says the nurse was on break and decided to treat the patient anyway, which the mother says isn’t true. However, the trust adds that it will be more diligent about staff members using phones at work.

Sponsor Updates

  • Netsmart customers celebrate key milestones at the company’s CONNECTIONS2023 conference in Washington, DC.
  • Meditech recognizes the Institute for Health Metrics as their data collaborator to support and accelerate health equity at hospitals across the country.
  • Surescripts releases a new episode of its There’s a Better Way Podcast, “Getting to Interoperability 2.0 with ONC’s Micky Tripathi.”
  • Netsmart will integrate Findhelp’s closed-loop referral solution with its CareFabric platform.
  • Magellan Healthcare details the success it has seen with NeuroFlow’s integrated behavioral healthcare solutions.
  • Nordic will present at the AMIA 2023 Clinical Informatics Conference May 24 in Chicago.
  • PerfectServe honors over 200 outstanding nurses in its third annual Nurses of Note Awards program.
  • Tegria will exhibit at the MUSE Inspire Conference June 7-10 in Denver.
  • Zynx Health parent company Hearst Health names Stanford Medicine the winner of the Hearst Health Prize in partnership with the UCLA Center for SMART Health.

Blog Posts


Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
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Morning Headlines 5/12/23

May 11, 2023 Headlines 1 Comment

Amino Health Secures $80 Million in Financing to Accelerate Growth and Product Innovation

Amino Health, whose platform guides members to cost-effective providers, raises $80 million in financing.

Lavita AI Raises $5M Seed Financing to Launch the First Patient-Driven Health Information Marketplace to Accelerate Life Sciences Innovation

Lavita, whose health data marketplace platform allows people to control and monetize their digital health information for purposes such as clinical trials recruitment, raises $5 million in seed funding.

Richmond University Medical Center suffers ransomware attack; unclear if patient info compromised

Richmond University Medical Center (NY) works to recover from a ransomware attack that has caused network outages for the last week.

Meta punts pixel tool responsibility, says privacy fault is on providers

Meta files a motion to dismiss a class action lawsuit that accuses the company of privacy violations for sharing the medical data of users with advertisers via its Facebook Pixel website tracking tool.

News 5/12/23

May 11, 2023 News 1 Comment

Top News


London-based, digital-first primary care operator Babylon Health will take itself private, 18 months after it went public in a SPAC merger that the CEO says was a “big mistake.”

The company just reported Q1 results: revenue up 17%, EPS –$2.53 versus –$1.71, with shares falling 84% in the past two days on the news.

BBLN shares have lost more than 99% of their value since trading began on October 22, 2001, with the market capitalization of the one-time high flyer sliding from $4 billion to $30 million.

HIStalk Announcements and Requests


Welcome to new HIStalk Platinum Sponsor Amenities. The Dallas-based company helps health systems grow top-line revenues and earn scalable ROI. Its Digital Membership Platform is a suite of e-commerce tools designed explicitly to: (1) Acquire new patients: Verify identity and register new patients with full EMR and patient portal accounts in under 30 seconds, with just one question. That means zero data entry, photo uploads, or duplicate accounts. (2) Upgrade tools (i.e., MyChart). Improve the design, usability, and conversion rate of critical revenue drivers like provider search, provider profiles, appointment scheduling, and proxy management. Additionally, aggregate and promote same-day care options in one simple place and maximize the visibility and usage of all access options.(3) Win patient loyalty. Create memberships designed explicitly to help keep patients in network. Build personalized experiences for members (i.e., health plan, ACO, D2E, MA, or other VBC groups) with custom networks, care options, vendor services, pricing, and more. Or, better yet, offer highly unique and market-tested features like a financial package that includes “no surprise billing” guarantee, transparent pricing, affordability scores on providers, and more. You may well know CEO Aasim Saeed, MD, MPA, who launched the company in 2021 after serving as VP of digital health for Baylor Scott & White Health. Thanks to Amenities for supporting HIStalk.

A wise company has taken advantage of my “Small Booth Special” first-year sponsorship discount for non-sponsors that occupied a 10×20 or smaller HIMSS23 booth. Get with Lorre by June 1 to shed the small-booth stigma and enjoy the same ad size as everyone else, a prime location that isn’t just a waypoint on the way to the bathrooms, and a 365-day audience of heavy hitters instead of those looking for a quiet part of the exhibit hall to make phone calls.


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

Acquisitions, Funding, Business, and Stock


National medical group Envision Healthcare is planning to file Chapter 11 bankruptcy as it struggles with $7 billion in debt, high labor costs, and federal legislation that has limited the company’s key business model element of surprise medical billing. KKR, which took the company private in 2018 in a $10 billion deal, will likely lose its entire investment.

Amino Health, whose platform guides members to cost-effective providers, raises $80 million in financing. The company previously pivoted from direct-to-consumer sales to focus on self-insured employers, health plans, and third-party administrators.

Lavita, whose health data marketplace platform allows people to control and monetize their digital health information for purposes such as clinical trials recruitment, raises $5 million in seed funding.

Business Insider lists the digital health market predictions of several healthcare bankers, which include:

  • Behavioral health care companies will consolidate by merging.
  • Companies that sell to employers will need to consolidate to improve their clinical models in an environment where companies are reducing their vendor count.
  • Companies that will address healthcare labor shortages with AI will be attractive to buyers if they can prove ROI.
  • Companies that address value-based care will continue to draw funding and interest.
  • Startups that are struggling to reduce costs or raise money will need to consolidate to find a path to profitability, and private equity firms will sell some of their holdings even at less-attractive valuations.
  • M&A, rather than IPOs or funding rounds, will dominate digital health.
  • The digital health market will make a comeback within a year and well-capitalized firms are already targeting acquisitions, especially of companies that can use data to reduce waste and administrative complexity, automate standard protocols, and increase health system productivity.


  • Center for Minimally Invasive Neurosurgery chooses EClinicalWorks and Healow.
  • Victoria, Australia’s health department will implement Altera Digital Health’s DbMotion for a statewide HIE.



Henry Archibong, MS (Inovalon) joins HealthMark Group as head of interoperability and innovation.


Scott Jones, MBA (ConnectiveRx) joins Equiva Health as COO.


Athenahealth hires George Hamilton, MBA (UnitedHealth Group) as chief corporate strategy and development officer.

Announcements and Implementations

Medhost launches an interoperability solution that meets ONC’s expanded requirements with an AWS data store, FHIR APIs, and common interfaces.

A small study finds that radiologists of all experience levels who use AI-supported mammography systems are prone to “automation bias,” in which they accept the technology’s assessment even when it is wrong.

A group of 21 Ontario hospitals launches the Ontario EHub HIE with technology and services from Oracle Health.

Government and Politics

The COVID-19 Public Health Emergency officially ended at end of day Thursday. US COVID-19 deaths are at 1.1 million and continue increasing at more than 1,000 per week.


CHIME asks people to email and tweet members of Congress asking them to repeal the Section 510 funding ban on creating a unique patient identifier.

Privacy and Security

Meta files a motion to dismiss a class action lawsuit that accuses the company of privacy violations for sharing the medical data of users with advertisers via its Facebook Pixel website tracking tool. Meta says it’s the website developer’s job to understand how the technology works and to decide which information to send to advertisers.


ProPublica notes that federal law requires insurers to share claims-related documents with the insured person and offers a form for requesting the information. The file can include notes, phone call audio, and internal correspondence that was involved with deciding whether to pay a claim.

In Canada’s Prince Edward Island, a family physician is closing his practice because of burnout that he says was caused by the province’s dysfunctional EHR. Thor Christensen, MD touts the value of electronic records, but says the Telus system is inefficient, is unconnected to the systems other providers, and has forced him to take on technology and billing tasks that eat up his evening hours. The 39-year-old doctor says that issuing a prescription takes up to five minutes versus 15 seconds on paper. PEI chose the Telus Health system in February 2021 as the island’s single EHR.


Bizarre: a 23-year-old Snapchat influencer expects to make $5 million per month from her $1-per-minute “digital girlfriend” voice chatbot, which was created from her YouTube videos and ChatGPT.

Sponsor Updates

  • Black Book Research announces the top comprehensive RCM solutions for laboratories and ancillaries based on the feedback of 2,663 healthcare and medical users.
  • joins The Leapfrog Group’s Innovators for Leapfrog collaborative as a charter member.
  • EClinicalWorks releases a new podcast, “Experience a More Efficient EMR with V12.”
  • Technology executive Philip Pead joins WebPT’s board.
  • Surescripts publishes a new podcast titled “Talking the Future of Pharmacy with Rina Shah.”
  • Direct Recruiters Inc. promotes Aaron Kutz, Shayla Jastrzebski, and Kim Jaber to partner.
  • Divurgent partners with HIMSS as a preferred digital health technology partner.
  • Healthcare Triangle will present at the 2023 MUSE Inspire Conference June 9-10 in Denver.
  • Konza National Network will present at WEDI’s virtual Annual Spring Conference May 24.
  • Nordic posts Episode 205 of its DocTalk podcast titled “Decentralized care supports the health of older adults,”
  • Jon Lauck joins Rhapsody’s board as chair.

Blog Posts


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

EPtalk by Dr. Jayne 5/11/23

May 11, 2023 Dr. Jayne 3 Comments


I’ve been in Wisconsin this week attending the first week of Epic’s annual XGM, or Xpert Group Meeting. Although there’s always a lot of chatter about the fabled User Group Meeting in late summer, I hadn’t heard of XGM until a couple of years ago. I’ve spent the majority of my clinical informatics career working with other EHR platforms (McKesson Horizon, anyone?) and had only interacted with Epic in an end-user capacity previously, but this has been my favorite of the Epic conferences so far. XGM is split across two weeks.

This week seemed more clinical in nature, with the more technical sessions following next week.  Although I’m confident that I could learn plenty at either, this is the one that worked best with my schedule, and it’s been jam-packed. Unlike some of my experiences at HIMSS, I’ve been surrounded by thought-provoking presentations that have a lot of applicability to my ongoing work, and I’ve met lots of people who are beyond energized about working in the industry. 

Some random thoughts. Epic requires you to attest to being fully vaccinated as a condition of registering for the conference. For those of us who came home from HIMSS with the plague, I appreciate it. I’ve seen a number of people who are wearing masks, including plenty of staffers. It seems prudent when you are interacting with large numbers of people, because there are plenty of circulating viruses other than COVID that I wouldn’t want to bring home to my family, and interacting with a couple of thousand people from across the country and around the world is a risk factor. I saw a couple of N-95 masks on people’s elbows or clipped to their backpacks, which isn’t doing anyone much good, but there were quite a few being worn properly as well. Distancing was possible in most of the sessions, and although mealtimes were busy, there was the option to take a carry-out box outside except for the day when it was raining.

The sessions that have been the most packed include those on clinical decision support and Epic’s Cosmos database, which includes de-identified data from millions of patients. Telehealth sessions were also popular, as were those on optimizing clinical alerts. It feels like a lot of attendees are serious about making sure that their technology investments are generating value for clinicians and making sure that patients are being included as beneficiaries of those efforts as well as clinicians and other end users.

As far as the sessions themselves, the Epic moderators run a pretty tight ship, keeping sessions on time. They’re also good at making sure that audience members who are asking questions remember to use a microphone so that the session recordings include all the questions. Of course, there are still some people who don’t want to wait for a microphone and jump right in, but the presenters were good at addressing those, too. As with any conference, there are always audience members who confuse the Q&A portion with their own personal story time, but it seemed less than what I have encountered recently at other conferences I’ve attended.

Even the “attendees behaving badly” weren’t that bad, although I was ready to throttle the person I’ll call “crinkly bag guy” who seemed to have everything in his messenger bag double-shrouded in cellophane, resulting in a tremendous amount of noise every time he looked for something, which was often during the 40 minutes we were together. His nearest neighbor even shushed him librarian-style. There was also the guy who spilled coffee on the bus (and also on himself) because he put his partially full coffee cup in the side pocket of his backpack.

Generally, though, everyone was pleasant and patient with any lines or crowded situations, which made the entire meeting feel smooth. The weather was fantastic Tuesday and Wednesday and I was able to get out and stroll the campus and have some random interactions with other attendees who were doing the same thing. The continued campus construction was a common topic, as was the legendary Epic culinary department. Highlights of the menu included the spinach-asiago breakfast tart as well as a chocolate cake that was enrobed in a delightfully crispy coating.

A couple of presenters got into the ChatGPT spirit, with one using the tool to write the introduction to his presentation and another asking it to detail some thoughts about the future of patient experience. I took what felt like a million pages of notes, trying to capture every useful thing I heard. Many of the client presentations dealt with issues that are common no matter what EHR platform you use, and I’m surprised that they’re still being discussed. This includes such advice as “put the things you want used most often at the top of a menu and the things you want used least at the bottom of the menu” which can make a huge difference for providers being able to order common tests as efficiently as possible. It can also make a difference when you’re trying to steer patient behavior, such as encouraging them to use a refill request workflow or an appointment scheduling workflow rather than just defaulting everything to a message to their primary care physician.

Reducing the continued increased in post-pandemic patient portal messages was a common theme, with several clients sharing their strategies as well as Epic giving information on its features to support their efforts.

Speaking of features, one non-technical feature that I’ve only seen at Epic conferences is the inclusion of local and regional businesses for attendees to shop in between sessions. Several Wisconsin-based businesses were featured, including one that had handmade soap and gift items, gift boxes, everything badger-themed, and local snacks. There were also chocolatiers and creameries selling a variety of cheese, snacks, honey, sweet and savory pecans, truffles, and more. This is on top of the Epic shop, where attendees could pick up themed t-shirts, notebooks, jackets, water bottles, and other items that are offered at cost. The conference also knocked it out of the park from a sustainability standpoint by having dedicated recycling and trash bins everywhere you turned, but also by including recycling instructions on the standard slides that played in the meeting rooms between sessions.



The Epic campus is known for its quirky art. The piece that gave me the most delight on this trip was this planter that appeared to have microscopes mounted on it. Instead, the eyepiece revealed a kaleidoscopic view of the plants that changed as the planter was spun, reminding the viewer that what you see is not always exactly as others see it. This will be important to remember as I bring back a virtual treasure trove of presentations of cool things that work at other institutions but might not work at my own or might be beyond what my own users are ready to experience at the moment. I met some new people who will be great to bounce ideas off of down the road as well as some who can commiserate with the challenges I run into on a regular basis.

I’m sad that I’ll miss the second week but trust that my team will bring back lots of other ideas.

What’s the best idea you’ve picked up at a conference in the last year? Leave a message or email me.

Email Dr. Jayne.

Morning Headlines 5/11/23

May 10, 2023 Headlines 1 Comment

Shares in Babylon fall sharply on news of moves to take private

London-based virtual care vendor Babylon Health will revert to a privately-run company as part of a debt restructuring plan and new funding arrangement with Albacore Capital.

VA Pharmacists Don’t Trust new EHR System, Survey Finds

VA pharmacists surveyed by the House Veterans’ Affairs Technology Modernization Subcommittee say they don’t trust the new Oracle Cerner system in use at their facilities, causing them to work in a constant state of hypervigilance.

Norton Healthcare Network Update

Norton Healthcare (KY) works to restore systems impacted earlier this week by a cyberattack on its computer network.

Healthcare AI News 5/10/23


AI-powered drug discovery could represent a $50 billion opportunity for big pharma according to a Bloomberg article, which notes that one drug company paid $4 billion for drug that was developed by a startup in just six months. The psoriasis drug is expected to generate up to $3.7 billion in annual sales.

Microsoft eliminates the waitlist for the AI version of its Bing search engine, adds persistent chats and visual capabilities, and announces third-party plug-in capability.


Microsoft expands access to the preview version of Microsoft 365 Copilot, which adds AI capability to the whiteboard function of Teams, integrates the DALL-E image generator into PowerPoint, offers writing suggestions from within Outlook, helps users create lists and generate ideas in OneNote, and creates a learning plan in Viva Learning.


AI drug discovery platform vendor Insilico Medicine offers a free course on using its PandaOmics generative AI tool for disease modeling and target discovery.

Salt Lake City-based AI drug discovery company Recursion, which has five products in Phase 1 or later studies, acquires two competitors.

The CEO of Databricks says that the best way to invest in AI is to think of it as a gold rush, in which you want to be the company selling picks and shovels to gold-seekers. He also recommends investing in companies that control proprietary data, such as from medical records.

Lucem Health, a portfolio company of Mayo Clinic Platform that turns AI advancements into point-of-care solutions, raises $7.7 million in a Series A funding round.


Researchers apply AI to early, large-scale diagnosis of pancreatic cancer, projecting that analyzing the EHR data of one million people could identify 70 who are highest risk who have not been diagnosed with the aggressive cancer.


An Atlantic article warns that ChatGPT is following a similar trajectory as mostly-forgotten IBM Watson, whose over-publicized rush to commercialization left it with little market visibility as it ended up being used to automate mundane, back-end B2B tools. The article dismisses IBM’s failed Watson oncology work with Memorial Sloan Kettering and MD Anderson Cancer Center as “a swole Clippy fed on enterprise data and techno-optimism, [that] could barely read doctors’ handwriting, let alone disrupt oncology.” The author says that ChatGPT, like Watson, is being commercialized to create “banal consumer and enterprise software” that is invisible to users.


A BMJ Global Health analysis piece calls for regulation of AI and a moratorium on self-improving artificial general intelligence, saying that AI poses threats to health and well-being.

Former VA Secretary David Shulkin, MD lists “25 Ways Generative AI Will Change Healthcare” that include specific companies:

  • Ibex – improve diagnostic accuracy from pathology.
  • Galileo – patient navigation of health and treatment options.
  • Cadence and Kaii – remote patient monitoring.
  • Google Health and Babylon Health – improved diagnosis using electronic patient records.
  • Saama – drug discovery.
  • Dexcare – access to care.
  • Indegene and Edocate – new methods of interactive medical education.
  • Cedar – billing.
  • TriNetX and MD Clone – clinical trial design.
  • Theator – surgical learning systems.
  • Eleos – analysis of behavioral health session to improve outcomes.
  • CareJourney, Datavant, and Voiceitt – reducing disparities and addressing disabilities.
  • Aldoc – early intervention using unstructured data and image analysis.
  • Ixlayer and TytoCare – point-of-care testing.
  • Sparta Science – identifying fall risk.


In a preview of how ChatGPT might find its way into health system digital front doors to improve access, Expedia is testing a chat-based trip planner, while a Zillow add-on allows conversational access to its real estate listings.


UPMC CTO Chris Carmody says that the health system is working on AI chatbots that can answer patient questions about insurance coverage, but adds that the goal is to support rather than replace healthcare professionals.

A Tennessee radiologist writes 16 research papers in four months, five of which were published in journals, using ChatGPT.


An ED doctor uses ChatGPT to perform roleplay that teaches doctors how to break bad news to patients. ChatGPT provided the scenarios and feedback.

Resources and Tools

  • Holly – sends weekly lists of LinkedIn candidates for open positions and engages them in conversation to book interviews.
  • EvidenceHunt – performs advanced searches of PubMed entries.
  • Law ChatGPT – creates legal documents from user prompts and templates.


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

Readers Write: Rural Hospitals Need Federal Assistance to Strengthen IT Security Posture

May 10, 2023 Readers Write No Comments

Rural Hospitals Need Federal Assistance to Strengthen IT Security Posture
By Kate Pierce

Kate Pierce, MSMIITA is senior virtual information security officer and executive director of the Subsidy program of Fortified Health Security of Franklin, TN.


The majority of my career in healthcare IT has been dedicated to working for a small and rural hospital, leveraging technology advancements to improve patient care and to keep those systems safe from cyberattacks. I spent 21 years with North Country Hospital in Vermont, starting as a systems analyst and working my way up to chief information officer and chief information security officer.

Growing up in a rural community in northeast Vermont, I have a deep understanding of the challenges faced by smaller hospitals, especially those in rural settings. I also understand how vital these organizations are to the communities they serve.

When I was asked to testify before the US Senate’s Homeland Security and Governmental Affairs Committee on the challenges that small and rural hospitals face in managing an effective cybersecurity program, as well as barriers to adequate funding and human capital constraints, it was an honor to do so, as this is a topic near and dear to my heart.

Even without the cybersecurity challenges, rural hospitals are experiencing unprecedented staffing and budget constraints. More than 40% operate in the red, and nearly one in three is at risk of closure. When it’s a daily challenge to deal with basic healthcare delivery while managing higher labor costs and shrinking margins, cybersecurity isn’t a top priority for most hospital executives.

Anyone who has ever worked in a hospital knows that change is constant. However, a cyberattack is among the most disruptive and devastating events that can occur within a healthcare environment. A 2021 study by the federal Cybersecurity and Infrastructure Security Agency (CISA) found that hospitals hit by ransomware often experience additional stressors that can be correlated with higher patient mortality rates.

This can happen at any facility, but criminals shifted their focus to attacking small and rural hospitals in 2022. Even though a successful attack against a smaller facility may yield less patient data or a lower ransom to release data, the reality is that they are often easier to breach and invariably connected to larger facilities.

When an urban or suburban hospital is hit with a cyberattack, it may inconvenience patients, but they often have other care options nearby. That’s not the case for rural hospitals. The nearest facility may be 40+ miles away, which doesn’t make it feasible to simply divert patients. Even if patients are diverted, nearby facilities can become overwhelmed, creating a cascading crisis throughout the community.

The stakes couldn’t be higher, as evidenced by a 2019 attack on an Alabama hospital that knocked out the hospital’s IT systems for three weeks and is believed to have resulted in the nation’s first fatality attributed to ransomware. According to the lawsuit, patient monitors were offline while the plaintiff was in labor, leading to insufficient monitoring of a fetus that was born unresponsive with the umbilical cord wrapped around the baby’s neck. Although the child was resuscitated, brain damage occurred, and the infant died nine months later.  In a recent 2022 attack, a rural Washington State hospital was so overwhelmed that an ER nurse called 911 for help.

The urgency of improving the security posture of these small and rural facilities continues to escalate every year.

As the sophistication of cyberattacks continues to grow, the federal government should be stepping in to help secure these hospitals and keep patient data safe. As I testified to the Senate committee, implementing these four measures could improve the state of cybersecurity for our small and rural hospitals.

First, we must move beyond guidance and recommendations and create minimum standards for cybersecurity that all healthcare organizations must follow. These standards must be reasonable, effective, achievable, and continually evolving as cybersecurity requirements change over time.

Based on the items outlined in the Health Industry Cybersecurity Practices (HICP) document, recommendations can be grouped into five basic categories:

  • Email security and protection
  • Access management
  • Asset management
  • Network management
  • Incident response

Simply put, regulators must spend less time suggesting and more time providing concrete solutions.

Second, we cannot leave our small and rural hospitals behind. We must create funding opportunities to allow all hospitals to meet the standards. Options include:

  • Subsidies, which have found success among rural hospitals in other initiatives
  • Grants, which may prove more difficult as smaller hospitals often don’t have grant-writing resources
  • Incentives for small and rural hospitals to enhance security, a “Meaningful Security” type program modeled on Meaningful Use
  • Enhancements in Medicare and Medicaid payments for eligible facilities, with hospitals showing how additional funds were used to boost cybersecurity

Third, we need better coordination of government cyber efforts for healthcare. While the guidance and services from government are appreciated, there is often a knowledge gap regarding the unique healthcare challenges that must be considered when applying cyber best practices in this sector. Due to time and budget constraints, many rural hospitals find it challenging to access or use available resources, so coordination must be streamlined to be effective.

Fourth, the federal government should establish a cyber disaster relief program, much like the assistance provided by the Federal Emergency Management Agency (FEMA). Such a program would provide this vulnerable sector with valuable resources in the event of attack, assist organizations in their recovery process, and increase the likelihood that hospitals could keep their doors open following a cyber-attack.

Overall hospital operating margins have been in negative territory for the past 12 months, according to a February hospital report from Kaufman Hall, and margins have decreased year over year for the past eight months. Operating margins are often higher for larger facilities that have outpatient clinics and more ancillary services than a smaller hospital can offer.

Adding to the challenging complexities, nearly 700 healthcare data breaches of 500 or more records occurred in 2022, according to the Office for Civil Rights. While the number of breaches is basically flat, the number of breached records topped 51 million for the first time, apart from the anomalous 2015, when just two breaches exposed 90 million records. Cyber insurance rates also continue to increase, with insurers demanding more monitoring and detection technologies that smaller facilities may not have if facilities can obtain insurance at all.

Because healthcare records are so valuable, hackers aren’t going to stop. Small and rural hospitals need help to protect their systems and patients, and these simple measures are a sensible path forward.

Readers Write: Turning Data into Action to Address Social Determinants of Health

May 10, 2023 Readers Write 2 Comments

Turning Data into Action to Address Social Determinants of Health
By George Dealy

George Dealy, MS is VP of healthcare applications of Dimensional Insight of Burlington, MA.


Social determinants of health (SDOH) are widely recognized as critical factors that influence the health outcomes of individuals and communities. SDOH refers to the various environmental, economic, and social factors that impact a person’s health, including food and housing insecurity, social isolation, and lack of reliable transportation options.

While most people are aware of SDOH, they often struggle with how to derive meaningful insights from the available data. Therefore, it is essential to explore practical ways to turn data into action to address SDOH and reduce health disparities.

Failing to address social determinants of health can have dire consequences, particularly for underserved populations. CDC data shows that certain populations, such as minority groups, are disproportionately impacted by SDOH. The health outcomes of these groups are often comparable to those in third-world countries.

One of the most striking examples of this is the maternal and infant mortality rates among certain minority populations. For instance, maternal and infant mortality rates are significantly higher among African American women than among other racial and ethnic groups in the United States. Addressing social determinants is a critical step in reducing these disparities and improving overall population health. This highlights the need to use data related to SDOH for actionable change.

One practical way to address SDOH is to use data and analytics. It’s first important to know where to find data related to SDOH. The data can be obtained from various sources, including national surveys, government agencies, and community organizations. One such resource is the US Census Bureau American Community Survey, which provides valuable data on community demographics, including economic and social characteristics at the neighborhood level. As SDOH information is very geographically specific, data at this level can help identify specific needs and target interventions more precisely. Another important resource is the US Agriculture Department’s Food Desert Map, which helps to identify communities where residents lack access to healthy food options.

Additionally, many non-profit organizations aggregate data from various sources into information resources. These resources include the County Health Rankings Project, run by the University of Wisconsin and the Robert Wood Johnson Foundation, and Community Commons, which is a collection of tools and resources for democratizing data related to advancing equitable community health and well-being. These data-centric resources can empower healthcare providers and policymakers with the necessary insights into the needs of the community and identify potential solutions.

The next step is to analyze the data to identify trends to better understand the specific challenges that a community is facing in relation to SDOH. One practical approach is to use technology to analyze and visualize the data. This can help identify trends and patterns more efficiently and communicate findings in a clear and compelling way.

Leveraging data on SDOH can help in the development of targeted interventions tailored to address the specific needs of each community, such as expanding access to healthy food options or improving transportation services. For instance, data mapping tools can identify areas with high rates of poverty and food insecurity, with this information then used to target interventions in those areas. Predictive analytics can forecast potential health risks based on social and economic factors. The use of data and analytics can be a powerful way to identify trends related to SDOH, develop appropriate interventions, and measure their effectiveness.

Improving population health requires a comprehensive understanding and focus on social determinants of health. While healthcare plays a crucial role, it is only one piece of the puzzle. Addressing SDOH requires a practical and collaborative approach that involves analyzing data, leveraging available resources, and recognizing the dire consequences of inaction. By turning insights into action, we can make meaningful progress in improving the health outcomes of communities, particularly among minority populations, and ensure that every citizen has access to the care they need and deserve.

Morning Headlines 5/10/23

May 9, 2023 Headlines No Comments

Aegis Ventures and Northwell Holdings Launch Optain, an Advanced AI Company That Uses Photos of the Eye to Detect and Prevent Early Stage Disease

Ascertain, a joint venture between Aegis Ventures and Northwell Holdings, invests $12 million to launch Optain, an AI-enabled company focused on early disease detection and prevention via retinal imaging.

Lucem Health Announces Series A Funding Round

Clinical AI development startup Lucem Health raises $7.7 million in a Series A funding round led by Mayo Clinic, Mercy, and Grainger Management.

My Health Record modernisation to cost $429m

Australia will spend $290 million in a two-year project to modernize its My Health Record system, which will include a new national repository and increased connection to GPs and pharmacies.

News 5/10/23

May 9, 2023 News 2 Comments

Top News


Hackers breach the systems of NextGen Healthcare and access the information of one million patients, according to a filed breach report.

The company says that its cloud-based NextGen Office EHR/PM was accessed using stolen credentials between March 29 and April 14, 2023.

NextGen was also breached in a ransomware attack in January 2023.

Reader Comments

From Sundowner: “Re: Oracle Cerner’s Helix molecular diagnostics platform. I hear that they are sunsetting it. Can you confirm?” I’ve heard this from multiple readers. I’ve asked an Oracle media contact to clarify, but haven’t heard back.


From Tootie: “Re: Sentara. Another $1M down the drain. They must have used the same firm Intermountain did. Perhaps health systems should rethink adding to their already bloated C-suites. I mean how many marketing, digital, experience, etc., ‘leaders’ do they really need to come up with this stuff? I have interns who can crank out better options than this in an hour. Maybe hospitals really do need ChatGPT.” Sentara claims to possess a newfound focus on overall health in renaming itself to Sentara Health, also announcing plans to rename its health plans under Sentara Health Plans. The president and CEO claims that the slightly new name will make healthcare simple, seamless, personal, and more affordable, apparently anxious to break free of being held back all these years by the omission of “health” in its name. Oddly, the organization says people should just keep calling it “Sentara” when talking about it. Interestingly, Sentara’s first hospital under its old name was called Retreat for the Sick, which seems most accurate and least gimmicky. The ever-growing health system chose the Sentara name in 1987 following a consultant’s recommendation to pick a meaningless name that it could copyright. It has since (expensively) gone through the usual hospital evolution of trendy names – Sentara Health System, Sentara Healthcare, Sentara, and now Sentara Health. Despite their emphasis on “health,” they still make most of their money from “healthcare.” I consulted with ChatGPT, which opines that spending all that money when Sentara is already well known as a healthcare organization might be silly, not to mention that business name changes usually involve shortening a name rather than making it longer.

HIStalk Announcements and Requests

That big banner spot at the top of every HIStalk page is available after years of being fully booked, so get in touch if your company is interested.


Welcome to new HIStalk Platinum Sponsor Waystar. Healthcare payments are too complex for providers and patients. It’s time to simplify. Waystar’s technology is the way to make healthcare payments more human, helping your team prioritize care, improve margins, and give patients more clarity and trust. Waystar provides market-leading technology that simplifies and unifies healthcare payments. Its cloud-based platform streamlines workflows and improves financials for healthcare providers of all kinds, and brings more transparency to the patient financial experience. The Waystar platform is used by more than 450,000 providers, 750 health systems and hospitals, and 5,000 health plans and integrates with all major HIS and practice management systems. Thanks to Waystar for supporting HIStalk.


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

Acquisitions, Funding, Business, and Stock


Premier Inc. is evaluating strategic alternatives that could involve selling some or all of the company. PINC shares – which rose 6% on the announcement — are down 28% in the past 12 months versus the Nasdaq’s 1% gain, valuing the company at $3 billion. The company said in its most recent earnings call in February 2023 that it would realign its Remitra invoice and payment platform business due to slower-than-expected adoption. It noted that its group purchasing business was being affected by lower provider utilization, reduced pricing and demand for pandemic-related categories, and provider use of previously stockpiled supplies. Premier has implemented a cost savings plan that included layoffs.

The New York Times looks at the rapid pace at which big corporations such as CVS Health and Amazon are acquiring primary care practices, especially those that serve Medicare Advantage patients. Seven in 10 doctors are employed by either a health system or a corporation, and while those owners tout cost savings and care coordination, experts warn that profit-seeking behavior will increase overall costs and frustrate patients and providers with gatekeeping functions such as prior authorization. The at-risk shared cost saving structure of Medicare Advantage allows primary care doctors to be paid up to $14,000 per year to manage a single patient instead of a few hundred dollars per visit.


  • Australia’s Northern Health contracts for Agfa’s enterprise imaging solution for radiology.
  • Weirton Medical Center (WV) will implement Oracle Cerner in a $65 million project. The hospital sued Cerner in 2017 over problems with its $30 million implementation in 2013 of Siemens Health Services Soarian. Cerner acquired that company in early 2015. The hospital said Cerner executives told them that they had inherited an unprofitable deal, after which Cerner failed to keep the promises Siemens had made.
  • Nashville General Hospital (TN) will implement RLDatix solutions for governance, risk, compliance, and workforce management.



Jackson Healthcare promotes Brad Chason to SVP of IT.


Edifecs hires Chris Lance, MBA (Evolent Health) as chief product officer.


Medicus promotes Tony Niemotka to EVP of community health.

Announcements and Implementations

Medhost’s Medteam Solutions services business launches a managed IT services program that includes infrastructure management, network administration, and desktop support.

Harrison County Community Hospital (MO) goes live on Meditech Expanse’s patient portal, while Pinckneyville Community Hospital implements the full Meditech Expanse system.

Northwell Health provides $500,000 in funding each of to two employee-proposed innovation projects: (a) an AI-enabled solution to navigate cancer patients to care and clinical trials; and (b) a trigeminal nerve stimulator to help in recovery of acute ischemic stroke.

Australia will spend $290 million in a two-year project to modernize its My Health Record system, which will include a new national repository and increased connection to GPs and pharmacies. The health minister describes the system, which was implemented as a personally controlled EHR in 2012, as “a pretty outdated, clunky, PDF format system.”


A new KLAS report on interactive patient systems – which include patient care coordination, BYOD integration, non-clinical service requests, room controls, feedback surveys digital door signs, digital whiteboards, and in-room telehealth – finds that PCare earns the top performance score of 93.2. Vibe Health by EVideon is broadly evaluated in all areas except BYOD integration, while Epic, Sonifi Health, and Oneview Healthcare are rarely seen as complete solutions.

Government and Politics


The VA tells the technology modernization committee of the House Committee on Veterans’ Affairs that while Oracle Cerner is improving its pharmacy software, the changes are “small and incremental”and need to be sped up. Oracle EVP Mike Sicilia says that Cerner had provided the VA with an “unacceptable” timeline of three years to fix problems involving integration of Medication Manager Retail to PowerChart to support the VA’s role as both prescriber and prescription filler. Sicilia did not mention his previous commitment for Oracle to rewrite the pharmacy system by April 2023. Committee chair Rep. Matt Rosendale (R-MT) closed the hearing by saying that, “The worst thing the VA could do is  to continue down this dead-end road perpetuating the same failed strategy” and says that he expects to see the VA “disentangle itself from this monopoly” by next week’s contract renegotiation deadline, urging the VA to “cut their losses and move on” because Oracle is unlikely to be able to resolve existing problems quickly enough to meet the VA’s needs.

Privacy and Security


A study finds that one hospital’s ransomware attack disrupts other local EDs, leading the authors to recommend that cyberattacks be treated as disasters with coordinated planning and response efforts. The authors found that the EDs of hospitals that were not part of the cyberattack saw resulting jumps in patient census, ambulance arrivals, waiting room times, patients who left without being seen, and length of stay as the affected hospital recovered its systems.



Northwell Health sues a former Long Island Jewish Medical Center morgue attendant who allegedly posted autopsy videos on her Instagram and TikTok accounts under the name “Autopsy Bae.” Hospital administrators confronted Quantaise Sharpton, who expressed no remorse for being an “influencer” with 20,000 followers who monetizes morgue “content.” She also claimed that her intention was to inspire her followers to pursue mortician and autopsy careers.

Sponsor Updates

  • Clinical Architecture releases its “2023 Healthcare Data Quality Report,” highlighting the impact that data quality has on patient care and organization performance.
  • Black Book Research announces that Netsmart has swept the post-acute health technology platform ratings for highest customer satisfaction in its annual client experience polling of 20 top vendors.
  • Access publishes a new patient e-signature case study, “Northern Regional Hospital: Creating a Better Experience for Healthcare Workers and Patients.”
  • AdvancedMD publishes a new e-book, “The Current State of Telehealth in Ambulatory Care.”
  • Arrive Health publishes a new white paper, “The Terrifying Truth About America’s Healthcare Affordability Crisis.”
  • Availity wins the platinum-level Healthiest Companies Award from the First Coast Worksite Wellness Council.
  • Baker Tilly publishes a new case study, “Medical products provider undergoes PMO assessment to prioritize initiatives and improve technology landscape.”
  • ChartSpan and Illinois Primary Health Care Association partner for better health outcomes in Illinois.
  • CTG releases a new episode of its This Week Health Podcast featuring Managing Director of Health Solutions in North America Tanya Johnson.

Blog Posts


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

Morning Headlines 5/9/23

May 8, 2023 Headlines No Comments

NextGen Healthcare says hackers accessed personal data of more than 1 million patients

NextGen notifies over 1 million patients of a data breach in which hackers stole personal information by gaining access to its NextGen Office EHR and practice management software using stolen customer credentials.

Healthcare firm Premier explores strategic alternatives

Premier shares rise on the news that it has formed a special committee to consider strategic alternatives including a sale of part or all of the company, partnership opportunities, or recapitalization.

CareCloud Reports First Quarter 2023 Results

CareCloud attributes a 15% drop in Q1 revenue to a dip in professional services revenue, the absence of COVID-related RCM services, and customer migrations away from Meridian Medical Management, which CareCloud acquired in 2020.

Curbside Consult with Dr. Jayne 5/8/23

May 8, 2023 Dr. Jayne No Comments

I’m back in the air this week with some weekend travel, which I don’t usually do. My flight was nearly all vacation travelers. The boarding process started with someone spilling his coffee all over the exit row, which led to a string of urgent maintenance issues and caused confusion and delay. Since he soaked nearly all of the seat belts in the exit row, those had to be changed out. Additionally, the flotation devices under the seats also had to be checked. Meanwhile, no one was able to board into that row or adjacent rows while the spill was being addressed, causing a lot of grumbling.

I’ve seen so many spills and messes at the airport and on planes due to Starbucks and fast food cups that it’s a miracle there aren’t more delays than they are. I don’t understand how people think they’re going to board with a roller bag, a shoulder bag, and a non-secured beverage and expect everything to turn out OK. I also see a lot of impractical shoes, which isn’t going to help anyone in the case of an emergency. I think most people never think of the fact that they might have to emergently exit a plane, but as someone with an interest in disaster preparedness, I’m always ready to deploy that exit door and head out in my trusty running shoes.

One of my projects for the day involves helping a former client. They reached out to me earlier in the week about a custom application that I installed for them way back in 2011, and I was frankly surprised to learn that it was still chugging along. It was designed to help with routing of laboratory results, and it sounds like its simplicity is what led to it still being in service more than a decade later. Since it was a custom build, the client opted at the time for a no-frills approach with a straightforward user interface. I figured they would have retired it long ago as they transitioned from a dedicated ambulatory EHR to an enterprise application, but apparently they continued to use it for some non-employed private practice clients who had steadfastly refused to migrate to the enterprise platform. The last of those physicians is retiring at the end of June and they were looking for advice on how to wind down his laboratory feeds as he transitions out of practice.

As a consultant, I’ve helped with a number of practice and provider “disengagement” processes over the years, so I was able to dust off some existing documentation and point them in the right direction to manage some of the non-application tasks that need to be addressed before they shut it down. Although they were more worried about what to do about the technical infrastructure, I let them know that the issue will largely resolve itself once the lab vendors stop feeding information. Fortunately, the physician is a subspecialist who orders very few laboratories and has been good at tracking outstanding orders, so the odds of a rogue result needing management in the practice’s final days are slim to none.

I enjoyed catching up with the analyst who was tasked with winding down the practice from the information technology side since I had worked with him when we initially configured the system. It’s rare to see someone continue to support a one-off application like that for the duration that they had with this one, but it was fun to talk about where the industry has gone in the years that have passed since we were both relatively new to the clinical informatics world.

My other project for the day is finishing a sorely overdue library book. I’ve had a lot going on in both my professional and personal lives and the amount of time I’ve had for those kinds of pursuits has been largely non-existent. Fortunately, my library has a no-fine policy, but I feel bad about keeping this book out of circulation, especially since someone has now put a hold request on it.

Since I’m spending the rest of the weekend in a hotel, it’s not like I can work on household projects, putter in the yard, do laundry, switch out the winter clothes in my closet for summer ones, or do any of the dozen other projects that are looming. I’ve got some downtime at my destination later in the week and I hope to see some of the sights and do a little shopping, so it will be a good change from my normal routine. Sometimes it’s good to just change things up, so we’ll see what the rest of the week brings.

I’m also still recovering from the respiratory funk that I picked up at HIMSS. Although it wasn’t COVID, it has put a dent in my activities, and I’m realizing that I don’t bounce back like I used to. Even though I no longer work in person in the emergency department or in a high-acuity, high-volume urgent care situation like I did during the height of the COVID pandemic, I feel like those experiences have taken months if not years off my life. I’ve watched nearly everyone I worked with during that time leave frontline healthcare roles, so I know I’m not alone in feeling like the experience was a turning point.

Some of my former colleagues have moved on to subspecialty positions that have more predictable working hours, but others have left clinical medicine entirely. When COVID started, we all promised to see each other “on the other side,” but several were lost along the way, including one to suicide. Thinking about them reminds me how important it is to savor every day even if you don’t feel well or if it’s particularly stressful. It’s also a good reminder of how we need to look after each other because you never know what’s going on in the parts of someone’s life that you don’t see.

Once the business component of this trip ends, I’ll be zipping home to get ready for some family functions. I’ve also got an upcoming girls’ trip that I need to plan, so hopefully I can knock a big chunk of that out on the flight home as long as wi-fi cooperates and we don’t have any major in-flight issues. After June, I can finally enjoy some long-needed R&R.

How do you spend your travel time? Is it full of catch-up tasks, or do you manage to find time for yourself? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 5/8/23

May 7, 2023 Headlines No Comments

Constellation Software hit by cyber attack, some personal information stolen

The ALPHV group of ransomware hackers say they have breached Constellation Software, whose software groups include healthcare-focused Harris Computer, and are threatening to publicly post 1 TB of its data if it fails to pay the ransom.

Zyter Health and Casenet TruCare Introduce New Brand, Representing the Organization’s Continued Dedication to Value-Based Care

Home health, telehealth, and remote patient monitoring company Zyter Health rebrands to Zyter|TruCare after acquiring Casenet and its TruCare care management software solutions from Centene in 2021.

Mayo Clinic Platform expands its distributed data network to partner to globally transform patient care

Mayo Clinic Platform extends its Connect de-identified clinical data network to University Health Network in Canada, Sheba Medical Center in Israel, and Hospital Israelita Albert Einstein in Brazil.

Monday Morning Update 5/8/23

May 7, 2023 News 1 Comment

Top News


UC San Diego Health will use a $22 million donation to create a mission control center for digital medical data.

The health system notes that many systems issue constant streams of potentially useful data, which requires experts and AI to isolate the elements and trends that would be immediately useful to caregivers.

The donation and the plan to develop the center were announced in February 2023. They were explained further in last week’s Innovation in Digital Health symposium.

HIStalk Announcements and Requests


I’m relieved that poll results suggest that I’m not the only one who has zero interest in sitting through videos and podcasts that were made at HIMSS23. I’m feigning anticipation of the educational session recordings, but I know from past years that my interest drops off quickly in the weeks it takes for them to be posted.

New poll to your right or here: Has your employer cut back on remote work in the past year? I drew the ire of several readers in July 2022 when I said this:

Economic and industry conditions have put bosses back in charge and they know that they need to manage costs while fretting less that their employees might flee to greener pastures … I bet many executives agree with me that you can’t build and maintain a great company when employees are doing task work in their living rooms … I expect companies to compromise by offering a hybrid model of 1-2 offsite work days per week or maybe going with a permanent four-day workweek.

GLP-1 weight loss drugs such as Wegovy and Ozempic are fascinating, especially as they negatively affect the work of physicians. Insurers don’t want to pay for them, so they are adding bureaucratic measures to impede demand, such as prior authorization and documentation proving that less expensive alternatives were tried and failed. Second, patients who cannot afford to pay $800 to $1,500 per month will pressure their doctors to falsely diagnose them with diabetes so their insurance will pay, which could land the doctors in trouble in the absence of supporting clinical documentation. The US is a weight loss drug dream market of overweight people (two-thirds of the population), lobbyist-friendly politicians, and unregulated drug pricing, and while these drugs might improve an individual’s health, our system of frequent job and insurance changes doesn’t reward employers and insurers who spend money today to save someone else on healthcare expenses years from now. And we like drugs better than behavioral changes, as the now-shuttered Jenny Craig can attest.


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

Acquisitions, Funding, Business, and Stock

Shares of the Global X Telemedicine and Digital Health ETF were unchanged over the past month versus the SP& 500’s 1% gain. They are down 25% since inception in July 2020 versus the S&P’s 26% gain. Top holdings are Masimo, Doximity, Alibaba, JD Health, and DexCom. 

Minnesota’s largest employer, Mayo Clinic, threatens to redirect billions of its investment dollars to other states in protest of two bills that would: (a) set a maximum patient-to-nurse staffing ratio; and (b) create a Health Care Affordability Board that would set healthcare spending growth targets, enhance provider transparency, and explore alternative payment programs.


image image

Nym promotes Or Peles to CEO. He replaces co-founder Amihai Neiderman, who will remain on the company’s board.

Announcements and Implementations

Redox announces its reimagined product portfolio: Nexus (integration); Nexus Lite (a lightweight, self-service offering); Access (connection to Carequality and DirectTrust); Chroma (a Verato-powered EMPI); and Nova (transform legacy standards to FHIR using existing provider integrations and libraries).


Toronto’s Women’s College Hospital incorporates Indigenous healing and wellness practices into Epic.


A new KLAS report on hospice software finds that MatrixCare and WellSky are ranked highest for independent hospices, while Epic Comfort is top ranked overall by its hospital-owned hospice users.

Government and Politics

The Senate Finance Committee wants to hold health plans accountable for “ghost networks,” citing a secret shopper study by Senate staffers in which only 18% could get an appointment with a mental health provider that was listed by 12 Medicare Advantage plans. Another audit of MA plans found that 73% of dermatologists who were listed as in-network providers could not be booked for an appointment due to duplicate entries or a change in plans they accept. 

Kell West Regional Hospital, which was one of just four hospitals that CMS fined for failing to comply with its price transparency rule, will appeal the $117,000 fine because it has successfully met CMS requirements after a company it had hired failed to deliver.

Privacy and Security

The ALPHV group of ransomware hackers say they have breached Constellation Software, whose software groups include healthcare-focused Harris Computer, and are threatening to publicly post 1 TB of its data if it fails to pay the ransom. Constellation, which has acquired 500 software companies since 1995, says it has restored its infrastructure and none of the IT systems of its companies was affected. An ALPHV ransomware attack took down the Colonial Pipeline in May 2021, triggering panic buying that caused gasoline shortages in the eastern US even though the company paid the demanded $4.4 million almost immediately. 


Don Detmer, MD, MA and Andrew Gettinger, MD list essential EHR reforms for the this decade in a JAMA viewpoint article in which they also advocate use of technology such as ambient voice recognition, AI, and cloud-based medication and allergy lists.:

  • Develop a national patient identifier as HIPAA originally mandated.
  • Remove administrative and regulatory content from clinical time. CMS should replace check-the-box documentation by deriving quality measures from existing documentation.
  • Include patient-entered information in the EHR.
  • Reinvent the clinical note to become prospective and to encourage less documentation instead of more. Ban copy-paste and copy-forward functions.

Scan Health President and CEO Sachin Jain, MD, MBA says in a Forbes opinion piece that health systems have “an epidemic of inauthenticity and superficial execution” as much-publicized projects are never scaled beyond pilots or limited deployment, broken care processes are hidden, and regression to the mean is presented as evidence of impact. He adds that we have normalized inauthenticity as being good salesmanship, as people are selling their ideas and building their brands despite lack of real impact, which will eventually breed cynicism and burnout. 


Danielle Ofri, MD, PhD observes “The Curious Side Effects of Medical Transparency” in a New Yorker essay, where she ponders how her practice has changed due to Cures Act requirements that patients be given access to clinician documentation:

  • She worries that patients will become alarmed if she records her differential diagnosis correctly and they see serious but unlikely possible diagnoses that she is ruling out.
  • She cites experts who question whether transparency should be its own ideal or whether it should be compared with other ways to deliver the same end result.
  • Seniors whose technology is managed by their adult children have asked her to keep some prescriptions private, and having multiple family members accessing the patient’s portal can make it hard to determine whether communications are going to them directly or to detect when patient records are being accessed by people who are harming them.
  • The use of multi-test lab panels almost ensures that every patient will get a slightly out-of-range result that will be highlighted as abnormal, or the results of tests whose result can’t be expressed as a simple yes or no.
  • She spends time every day managing a flood of patient questions about new test results and is forced to try to answer urgent questions quickly without having completed basic legwork.

Sponsor Updates


  • Wolters Kluwer Health staff in Waltham, MA clean up the banks of the Charles River as part of its Green is Green initiative.
  • Drug Store News recognizes OmniSys XiFin Pharmacy Solutions for the second time with its annual Retail Excellence Award – Technology and Automation.
  • An OptimizeRx physician survey finds that they are receiving life sciences product information from a variety of channels, but with gaps, and with a need for more information about treatment eligibility, affordability, and access.
  • Sectra releases a new episode of its Let’s Talk Enterprise Imaging Podcast, “Beyond the technology – how Sectra provides end-to-end SaaS security.”
  • Black Book Research names Andor Health to the top spot in virtual care collaboration solutions based on a survey of nearly 1,000 health system executives.
  • KLAS awards Ellkay its Points of Light award, recognizing the company’s payer-provider collaboration efforts via bi-directional connectivity. 
  • National Medical Care Company in Saudi Arabia selects Wolters Kluwer Health’s UpToDate, UpToDate Advanced, and Medi-Span solutions.
  • First Databank VP of Clinical Network Services Lathe Bigler will present at the NCPDP 2023 Annual Technology & Business Conference May 9 in Scottsdale, AZ.

Blog Posts


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

Morning Headlines 5/5/23

May 4, 2023 Headlines No Comments

Pediatric Mental Health Provider Brightline Cuts 20% of Its Workforce for the Second Time in 6 Months

Virtual youth and family mental health provider Brightline lays off 20% of its employees on top of the 20% that it let go in November 2022.

Inbox Health Raises $22.5 Million Series B

RCM vendor Inbox Health raises $22.5 million in a Series B funding round, bringing its total raised to $43 million since launching in 2017.

WA gov invests $100m in electronic medical record rollout

The Western Australian government will allocate $100 million towards the first phase of an enterprise EHR roll out, beginning with Perth Children’s Hospital and Sir Charles Gairdner Hospital.

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