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EPtalk by Dr. Jayne 2/25/21

February 25, 2021 Dr. Jayne 4 Comments

Today’s web-based entertainment was courtesy of Nuance and its Dragon Ambient eXperience product. I’ve been keeping an eye on it since seeing it at HIMSS19.

Their demo at the time involved an orthopedic visit, which tends to be a lot more straightforward than most of the visits we have in primary care. I was hoping they would show a truly complicated visit and how the system could handle it. It was encouraging the host said they would be doing an “unscripted” demo based on attendee input through a Zoom poll with randomly generated options.

However, it quickly turned into the same old orthopedic visit that they typically show. They asked the audience to have input via poll on past medical history elements, but many of what we were given to choose from were just standard conditions like hypertension or an ACL repair.

I have yet to see a demo where the system can manage the real-world things we see in practice. Where is the history of “heart surgery” where the patient has no idea what was done or what the underlying diagnosis might have been? What about the problems that were more complex than injuring your ankle while walking your dog Lucky, which was the demo they actually showed? They showed the voice recognition streaming during the demo, and there were a number of elements where it wasn’t capturing exactly, so I was curious to see what the process would be to resolve those.

The command “Hey, Dragon, show me the x-ray” brought up an x-ray example with no patient identifiers, which failed my realism test. The physician also interpreted the x-ray before examining the patient, which is a no-no for many of us. The physician used a fair number of medical words, but didn’t really explain to the patient what those meant, including the anatomical names for the affected areas.

I wasn’t impressed by their simulated assessment and plan, which didn’t entirely follow the standard of care in that the patient was given a scheduled controlled substance for her ankle sprain, which most of us wouldn’t do until the patient failed other pain management strategies such as anti-inflammatories or acetaminophen, neither of which she said she had taken.

I know I tend to be critical since I’m a practicing physician, but it’s all part of credibility. It’s hard to find the messaging to be credible when they missed the clinical mark. Was it intentional, or did they not find it important to be clinically credible? Interestingly during the interview, the clinician ordered tramadol, but when the host reviewed the medication orders, the canned display on the back wall showed Tylenol, which maybe was an indicator that it was a little more unscripted than they planned. The final note did mention both Tylenol and tramadol, however.

They cut away to videos from physicians, including family physicians and orthopedic physicians, but they didn’t really show what this would look like in family medicine. I asked a pointed question via the Q&A chat about how the system would manage vague elements like I mentioned above. Not surprisingly, it was skipped. They did mention that they have a four-hour service level agreement for note turnaround, although they noted it can be shorter in the real world. As a physician who likes to have my notes done when I walk out of the room, that would take some getting used to. They did demonstrate how the system could filter out the conversational parts of the visit in order to create a concise note, which is promising. Still, I’d love to see how it handles a complex primary care visit.

Today’s patient-side entertainment was courtesy of my local hospital, which continued to underwhelm. I’m living the nightmare shared by a number of female healthcare providers who received the early rounds of the COVID-19 vaccines. Since it’s been two months, and statistics do what statistics do, one-sixth of us over a certain age have been due for an annual mammogram since receiving their vaccines. Both of the current vaccines tend to cause swollen lymph nodes, usually in the neck or underarm, and sometimes those nodes turn up on a mammogram. It’s a widespread enough issue that mammography centers are adding questions to their intake forms asking about vaccine status and which arm was used for the administration. The Society of Breast Imaging sees this as a big enough issue that it has recommended women delay screening mammograms until at least 4-6 weeks after receiving their last vaccination. However, for those of us who were due for screening prior to the recommendation, we are now chasing down rogue lymph nodes that could be due to the vaccine or to something more sinister, such as breast cancer or lymphoma.

I had a difficult enough time scheduling my follow-up ultrasound due to my clinical schedule and the limited appointment slots. Today’s actual appointment could have served as a case study of what not to do from a technology, operational, and clinical standpoint.

It started with patients reporting 15 minutes before their appointments as instructed, only to find that they had a single registrar who was taking names and instructing people to be seated until called. The problem: six patients and five chairs in a waiting room that had been stripped of furniture for social distancing. Patients were slowly called to the desk, where they were forced to fill out the usual clinical history form (completely from scratch, once again not pre-populated from the Epic system as it could have been) standing there in front of the registrar. This delayed additional check-ins and I’m sure was frustrating to patients.

Despite arriving early, I wasn’t called back until 10 minutes after my appointment time, where I was taken to a changing room that fed a sub-waiting room with an additional four patients (although there were five chairs, but this time we got to sit around with each other in flimsy gowns). Plus, instead of watching HGTV in the main waiting room, we were treated to a screen displaying a version of the imaging center’s tracking board, showing all the patients and their appointments and how backlogged they were. Although the names were truncated like we were flying standby, it felt like an invasion of privacy since we could see all the procedures scheduled for the day. There was a Windows popup on the screen that looked like an error or alert message, and although I couldn’t see the details, I wondered if we were really supposed to be seeing it.

After finally reaching the exam room, I was treated to a brusque sonographer who acted like I hadn’t followed appropriate prep instructions (despite having received none). I felt like reminding her that even though she does this a dozen times a day, each patient was enduring the harrowing experience of wondering if they have cancer or not, so they don’t need her attitude. It was clear she was having trouble getting the images she wanted, but she finally went to review them with the radiologist while leaving me draped on the table.

When the radiologist came in, she started spouting medical terminology and I’m hoping it was because somewhere my chart was flagged as a physician because as a “regular” patient I would have had no idea what she was talking about. I guess I’m also more sensitive to the patient’s comfort than she was, because I rarely have conversations with patients while they are draped and lying on the table. At a minimum, it would have been nice to sit up and have a conversation at eye level.

I don’t think I have unreasonably high expectations. They have been shaped by the way I was trained and how I’ve seen medicine practiced for the last two decades. But it seems they’ve substantially diverged from the post-COVID reality of healthcare in my city. Patient advocacy and patient empowerment are supposed to be major factors influencing how healthcare organizations operate, but apparently for some they’re little more than buzzwords.

The perfect cap on the day was when the sonographer walked me back to the changing room, where she told me to “enjoy the rest of your day.” As I looked at the faces of the other women in the sub-waiting room, knowing that their lives might be changed dramatically today, it didn’t seem like what patients might want to hear, especially knowing that some of them would go home to sit and wait for results. Perhaps “take care and thank you for choosing us as your healthcare team” might have been a better option.

Have you experienced a decline in patient services in the COVID era? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 2/25/21

February 24, 2021 Headlines Comments Off on Morning Headlines 2/25/21

High-End Medical Provider Let Ineligible People Skip COVID-19 Vaccine Line

One Medical comes under fire after leaked internal documents show that the membership-based primary care company has let ineligible patients – some with ties to company leadership – receive COVID-19 vaccinations before other, higher-risk groups.

Redox Market Momentum Leads to $45M in Series D Raise Led by Adams Street Partners

Healthcare API developer Redox raises $45 million in a Series D round that brings its total funding to $95 million.

Ontario Systems Continues Growth

Revenue recovery software vendor Ontario Systems acquires Pairity, which offers AI-based solutions for accounts receivable management.

Innovaccer Raises Series D at $1.3 Billion Valuation, Launches Innovaccer Health Cloud to Power the Future of Health

Innovaccer confirms a rumored funding round led by Tiger Global Management, bringing its total raised to $225 million.

Comments Off on Morning Headlines 2/25/21

HIStalk Interviews Michele Perry, CEO, Relatient

February 24, 2021 Interviews 1 Comment

Michele Perry, MBA is CEO of Relatient of Franklin, TN.

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Tell me about yourself and the company.

Relatient is the 2020 KLAS category leader in patient outreach and communication. The company is located right outside of Nashville, TN. We got our start with appointment reminders back in 2014. Since then, we have built an entire patient engagement platform to help medical offices manage all the major touchpoints in the outpatient journey. Our goal is to end phone tag in healthcare.

I’ve been Relatient’s CEO since 2017. We have been growing a lot and we are excited about where we are headed as a company and the work we are doing alongside the health systems, hospitals, and medical offices we serve to improve the patient experience.

How are providers using technology to manage COVID-19 vaccinations?

Medical providers are really grabbing hold of technology right now to solve the daily operational issues related to getting the COVID-19 vaccine distributed on a mass scale.

The first thing we started hearing from health systems like Med Center Health in Kentucky and Warren Clinic in Oklahoma was that they wanted to shoot for zero wasted doses. When they came to us with those conversations, they were most concerned about patient no-shows, because the first vaccine was Pfizer’s and the whole freezer situation meant that once a vial was thawed, mixed, and ready to use, it couldn’t be set aside for another day. A patient no-show could mean doses in the trash, and no one wanted that. After they set up their vaccine departments or clinics and locations, we configured some specific vaccine reminders to help get patients to both the initial appointment and the one following it 21 days later.

Health systems learned really fast that getting the vaccine schedule filled was a huge task. It takes a lot of people to work through lists of patients who qualify and get them booked. We had used our patient self-scheduling module for some customers earlier in the pandemic that wanted to let patients self-schedule for testing. We turned this on for customers who asked for help with vaccine scheduling and then made it available for new customers, too, turning it on very quickly un-integrated for immediate scheduling.

Some other things we’re seeing providers do include the use of messaging tools to send mass communication to their patients and their staff, like when a new phase of vaccinations opens up or a new vaccine clinic. We’ve seen them use short links to maps and directions in case patients are new to their organizations and utilize text messaging for one-to-one patient conversations so they can field questions and make schedule changes without the back and forth of playing phone tag with patients.

Why do patients fail to show up for their appointments and what are the best practices to reduce the no-show rate?

It’s interesting, because we are far enough into a world where appointment reminders are the norm that patients have come to rely on them to remember and plan for their appointments. Healthcare has come a long way in this, but COVID-19 introduced a new layer of complexities to patient schedules and the load of responsibilities patients are carrying. They’ve got kids at home all the time, they’re trying to work from home, they may no longer be close to the doctor’s office during the day because of this. We have heard from a lot of healthcare leaders over the past year that patients who were afraid to come in early on added to no-shows. It kind of all comes down to keeping communication open and clear so patients know that you are open and you’re a safe place to receive care. If something changes, do they have a telehealth option that can replace the in-person appointment?

The other key piece or best practice is the combination of communication methods and the ability for a patient to respond to a reminder. We’re patients ourselves and we get reminders from our own medical providers that either don’t ask for our confirmation or response or only allow a confirmation. If a patient has to call your office to cancel an appointment, they’re likely to hit the phone tree or get put on hold and hang up. This is where a lot of patient no-shows still come from, and there are well-established practices to avoid this.

Patients want self-scheduling and virtual waitlists more than just about any other technology. Has the pandemic affected adoption?

Definitely, and for a few reasons. Part of the increase in adoption has been resource constraints. Medical offices had to furlough employees, like many other industries. When they started to recover from that, they got hit with COVID-19 cases of their own and often found themselves short-staffed. The need for self-schedule and waitlists that can backfill last-minute cancelations is growing as there are fewer resources to do these things manually.

Additionally, Accenture recently reported that two-thirds of patients said they are likely to switch providers who don’t meet their expectations for handling COVID-19, and we know that patient access is a piece of these expectations. More than 30% of patient appointments are scheduled after normal clinic hours.

As I mentioned earlier, managing vaccine and testing schedules has also been a big burden to medical practices. Solutions that can lighten this burden and empower patients to self-select are win-win.

Can medical practices compete with the consumer-facing technology that is offered by urgent care centers, health systems, and chain drugstores?

Absolutely. Medical practices have the potential to offer the most personalized care if they can keep up with the innovation of larger organizations. They can do this with a cohesive digital strategy that works alongside and enhances their portal strategy. When solutions aimed at expanding access and convenience — like self-scheduling, two-way patient-practice conversations, and registration — are only available to portal users, a significant portion of a provider’s patient base never experiences those benefits.

Which health IT sectors will be the winners and losers in the next few years as COVID-19 becomes better controlled?

This is the winning question, right? COVID-19 won’t be a crisis forever, but some of the things we’ve learned during this time will stick around long term and we’re better for it.

Telehealth is one that is here to stay, but it won’t stay at the levels medical providers have used over the past year. Providers are now operating hybrid care models, where patient care is delivered in-person and via telehealth, so they need tools and workflows to help support this model of care delivery. I expect telehealth vendors to continue refining and expanding their technology as medical providers lean away from general video conference platforms that filled the immediate need early on.

The health IT sectors that help answer the question, “How do we get patients the right care, in the right place, at the right time” will be the winners. Interoperability will be a must as care becomes more dispersed, and digital communication tools and patient messaging will be crucial to helping patients navigate the journey.

You kind of hit on this already when you asked about consumer-facing technologies, but it’s key because patients are consumers, and these are the tools and kinds of access they’re looking for. My point is those technology sectors that require a lot of the patient — apps to download, portals to log into, additional accounts to create, and passwords to remember – will find less and less room over the next few years.

Morning Headlines 2/24/21

February 23, 2021 Headlines Comments Off on Morning Headlines 2/24/21

Our Care Studio pilot is expanding to more clinicians

Google Health expands the pilot of its EHR search and data presentation tool, which it has named Care Studio.

Enforcement Discretion Regarding Online or Web-Based Scheduling Applications for the Scheduling of Individual Appointments for COVID-19 Vaccination during the COVID-19 Nationwide Public Health Emergency

The HHS Office for Civil Rights won’t penalize certain potential HIPAA violators for their use of COVID-19 vaccine scheduling tools during the nationwide public health emergency.

DirectTrust Announces Implementation Guide for Event Notifications via the Direct Standard

DirectTrust publishes an implementation guide for sending ADT event notifications via the Direct Standard.

Comments Off on Morning Headlines 2/24/21

News 2/24/21

February 23, 2021 News 4 Comments

Top News

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Google Health expands the pilot of its EHR search and data presentation tool, which it has named Care Studio.

The system provides a centralized view and search capability of patient information that is stored one or more EHRs.

Ascension was the pilot site, for which Google earned the attention of Congress a year ago for how the company intends to use and protect patient information. Google has made assurances that it does not own patient data, doesn’t sell it, and won’t use it for advertising purposes.

Clinicians from unnamed sites in Nashville, TN and Jacksonville, FL will use an early release of Care Studio and provide feedback about its usability, usefulness, and workflow integration.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor RCxRules. The Burlington, VT-based company, founded in 2010, helps healthcare organizations succeed with both value-based care and fee-for-service billing models. Its unique, predictive rules engine ensures compliance with healthcare’s complex regulatory and reimbursement rules. Integrating with leading EMRs and PM systems, RCxRules software addresses issues before they affect revenue, delivering claims with the most accurate financial and HCC data — every time, guaranteed. Thanks to RCxRules for supporting HIStalk.


Listening: a grab bag of obscure 1960s psychedelia, which is mostly new to me. The naively optimistic flower children who formed forgotten bands 50-plus years ago are now dying off without fanfare. Little-known groups I’ve discovered: The Fallen Angels, Kaleidoscope, and The Peanut Butter Conspiracy (in addition to one of my all-time favorites and not obscure at all The Love). I am contemplating a foray into collecting LPs and 45s for the first time since I suspect a lot of this trippy vinyl is moldering in basement junk boxes and deserves better. It is sweetly sad to think of someone’s great-grandma passing away in her 80s without her family knowing that, if only for a few weeks, she was a sun-drenched Renaissance faire goddess with flowers in her hair, whose heartfelt, unskilled folkie crooning soundtracked the personal summer of love for thousands or millions of people who are struggling, as she did, to reconcile the sunny days of youthful exuberance and seeming immortality with the realization that the clock is running out. “Legacy” is an uncomfortable topic for me since I envy artists whose work will continue to be discovered and appreciated by new generations.

I ran across the best acronym-based group name ever, the Paediatric International Patient Safety and Quality Community, aka PIPSQC (“pipsqueak.”)

Odd grammatical quirk, almost entirely heard in 20-somethings: pointlessly expanding “thank you” to “thank you so much.”


Webinars

February 24 (Wednesday) 1 ET. “Maximizing the Value of Digital Initiatives with Enterprise Provider Data Management.” Sponsor: Phynd Technologies. Presenters: Tom White, founder and CEO, Phynd Technologies; Adam Cherrington, research director, KLAS Research. Health systems can derive great business value and competitive advantage by centrally managing their provider data. A clear roadmap and management solution can solve problems with fragmented data, workflows, and patient experiences and support operational efficiency and delivery of a remarkable patient experience. The presenters will describe common pitfalls in managing enterprise information and digital strategy in silos, how to align stakeholders to maximize the value of digital initiatives, and how leading health systems are using best-of-breed strategies to evolve provider data management.

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


Acquisitions, Funding, Business, and Stock

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Tech-enabled insurance startup Oscar Health plans to raise over $1 billion through its IPO, scheduled to take place next week. Like competitor Clover Health, the Alphabet-backed company has yet to show a profit, despite having raised $1.6 billion since launching in 2012. Analysts, however, are quick to predict a $6.7 billion valuation.

Precision medicine technology vendor Tempus will collaborate with Texas Oncology-owned Precision Health Informatics to advance clinical research and personalize patient care. Both are for-profit companies.


Sales

  • Jackson Hospital and Clinic (AL) will implement CPSI subsidiary TruBridge’s RCM software and services.
  • Mercy Iowa City selects Spok Go clinical communications software.

Announcements and Implementations

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Southeast Health (AL) implements Epic.

RxRevu develops SwiftMx, giving providers access to medical price transparency and coverage information via EHRs from vendors like Cerner.

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General Leonard Wood Army Community Hospital (MO) employees prepare to go live on Cerner as part of the DoD’s MHS Genesis Cerner roll out.

CommonSpirit Health uses VeeMed’s tele-ICU physician services across its Dignity Health and Catholic Health hospitals.

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Jupiter Medical Center implements Artifact Health’s mobile app for physician queries.

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A new KLAS report looks at the EHR experience of medium to large home health agencies, finding that MatrixCare Home Health leads the market, while Epic Dorothy follows closely as used mostly by health system-owned agencies. Homecare Homebase is widely used, but receives the lowest rating for quality of support. WellSky’s customers report lower satisfaction as the company grows and acquires, while users of Netsmart’s acquired products (Homecare Advisor and Homecare) say development has slowed as the company focuses on its MyUnity Enterprise platform.

DirectTrust publishes an implementation guide for sending ADT event notifications via the Direct Standard.


Government and Politics

TeleICU provider RemoteICU sues HHS for not allowing US-licensed physicians who live outside the US to bill Medicare for telehealth services.

In Canada, New Brunswick’s auditor general says that the province’s EHR rollout failed, where $21 million was spent on a system that fewer than half its physicians are using and that does not integrate with hospital systems. The New Brunswick Medical Society partnered with private company Accreon to create Velante to sell the software, then kept pumping money into the failing program and adding switchover subsidies until the exclusive deal ended in 2019. Velante is closing and the software vendor, Intrahealth Canada, will take over support.


COVID-19

J&J says it will ship 20 million doses of its single-shot vaccine in the US by the end of March if it receives FDA’s emergency use authorization, earlier than expected.


Other

HIMSS said early this month that it would provide more information on HIMSS21 on February 19. I didn’t see any specific announcement, but the FAQ now says that registration will open in early March. HIMSS will also run an extra-cost, single-day “CIO Summit” that will be followed by a “curated CIO experience” now that CHIME has pulled out. Exhibitor count is at 410 versus 1,300 at HIMSS19.

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St. Margaret’s Health-Spring Valley (IL) reverts to paper-based processes after its IT team discovers a data breach, forcing it to shut down all of its Web-based systems.

An AMA article touts the use of Xcertia app development guidelines — developed by AMA, HIMSS, and other groups — even though the Xcertia project was shut down in August 2020. HIMSS said at the time that the effort would continue with oversight by a HIMSS work group.


Sponsor Updates

  • AdvancedMD shares the product enhancements that will be made available during its Winter 2021 Release.
  • Black Book Market Research includes Impact Advisors among the top-rated RCM services and optimization consultants.
  • Cone Health (NC) expands its use of PatientPing’s real-time event notification software to include community providers.
  • PeriGen affirms that its technology supports the US Surgeon General’s call to action to improve management of maternal health.  
  • CereCore relocates its Nashville headquarters to, in the near future, better accommodate its workforce and partners.
  • Cerner releases a new podcast, “How diverse, community-based hospitals are a lifeline to saving clinical research.”
  • The Chartis Group publishes a new brief, “Partner with Purpose: How to Build a Winning Playbook to Guide Health System Partnership Strategy.”
  • Columbus CEO includes CoverMyMeds Senior Manager of Employee Engagement Lachandra Baker in its Future 50 initiative.
  • Wolters Kluwer Health highlights the top four challenges facing CMS Administrator nominee Chiquita Brooks-LaSure.
  • Quil becomes a HealthShare Exchange MarketStreet partner.
  • Medical Marketing & Media includes OptimizeRx SVP and Principal of Agency Channels Angelo Campano to its “40 Under 40” list.

Blog Posts


Contacts

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

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Morning Headlines 2/23/21

February 22, 2021 Headlines Comments Off on Morning Headlines 2/23/21

Alphabet-backed Oscar Health eyes as much as $6.7 billion IPO valuation

Tech-enabled insurance startup Oscar Health hopes to raise over $1 billion through its IPO early next month.

St. Margaret’s Health – Spring Valley breached by cyber security attack

St. Margaret’s Health-Spring Valley (IL) reverts to paper-based processes after its IT team discovered a data breach over the weekend and shut down all of its Web-based systems.

Conversion Labs Begins Trading Under New Company Name, LifeMD, and Ticker Symbol, LFMD

Conversion Labs rebrands to LifeMD to reflect its transition to direct-to-consumer telemedicine and online prescription delivery.

Comments Off on Morning Headlines 2/23/21

Curbside Consult with Dr. Jayne 2/22/21

February 22, 2021 Dr. Jayne 1 Comment

I’m not sure if I’ve ever met Nordic Chief Medical Officer Craig Joseph, MD in person, but he’s definitely on my list of “people I’d like to have a cocktail with” at some point. His Twitter posts @CraigJoseph always have interesting tidbits, such as a recent white paper from ECRI’s Partnership for Health IT Patient Safety. He notes, “Lots of smart people with clinical and EHR vendor chops outline specific actions to consider.”

I checked out the paper, titled “Optimizing Health IT for Safe Integration of Behavioral Health and Primary Care.” It resonated with me because this is an issue I’ve had to deal with for years – navigating the intersection of those two disciplines while trying to coordinate care while maintaining privacy. Many organizations, including some of my current clients, choose to keep primary care and behavioral health records siloed. This results in fragmentation of care and lack of understanding around whole-person factors that drive both physical and mental health.

It lays out clear reasons why primary care and behavioral health need to be integrated:

  • 80% of behavioral health patients will visit a primary care provider (PCP) at least annually.
  • 50% of behavioral health disorders are treated in primary care settings.
  • 48% of appointments for psychotropic medications are with non-psychiatrist PCPs.
  • 67% of people with behavioral health disorders don’t get behavioral health treatment.
  • 30-50% of patients referred from PCPs to outpatient behavioral health don’t keep their first appointment.
  • Two-thirds of PCPs report being unable to access outpatient behavioral healthcare for their patients.

Additional barriers for mental healthcare access include provider shortages, health plan barriers, and coverage issues. In my major metropolitan area, we recently opened a dedicated mental health emergency department unit that is staffed full time by specialist providers. The community accepted it readily because we know we don’t do the best job for patients needing non-medical services who present to other care venues, such as the emergency department or urgent care facilities.

Even for health systems or provider-side organizations that want to try to integrate the behavioral health and primary care realms, EHRs aren’t always supportive. Psychiatry notes, therapy notes, and documentation from social workers are often kept under separate access where the primary medical team can’t see them. Especially when we’re dealing with medical conditions that can have significant behavioral components, it would be useful to be able to see all the information about the patient. The white paper does a nice job explaining different levels of integration, from “coordinated” care to that which is “co-located” to fully “integrated” care. Right now, many primary care practices are struggling to deliver even minimally coordinated care.

One of the major participants in the creation of the paper was the HIMSS Electronic Health Record Association (EHRA). I have some experience with EHRA from a past life and know many of the members of the project’s working group to be knowledgeable individuals with a deep understanding of EHRs and care delivery. EHRA has a code of conduct for EHR and health IT developers that addresses the need for collaboration described in the paper.

However, working as someone outside of an EHR vendor, I’ve found it nearly impossible to access the materials that we relied on when I was on the vendor side. This forces those of us who work on homegrown or in-house systems to re-invent the wheel trying to determine best practice as we develop our technology. Since this is a partnership with ECRI and this paper exists, I take that as positive signs. Still, non-commercial developers are going to have to do a lot of figuring out on their own unless there are maneuvers to standardize at the federal or payer levels.

The paper talks about standardizing screening and documentation tools so that data is consistent across an enterprise. Although this would be good, many patients may receive their care across multiple organizations. I cared for a patient the other day who receives medical care primarily through a county health clinic because she doesn’t have health insurance, but receives a telehealth benefit from her employer, so she’s using that for urgent care services and psychotherapy. She came to our urgent care because she needed stitches and we have an affordable self-pay program. Given the vast differences in the systems used by those entities coupled with the relative immaturity of our state’s HIE, there’s no way there will be coordination any time soon.

There are also legal barriers to sharing of data under both HIPAA and 42 CFR Part 2, especially around sensitive health information. Many organizations find these restrictions daunting and either don’t have the wherewithal or the manpower to try to tackle them, especially while simultaneously coping with a pandemic and the generalized dysfunction of healthcare delivery in the US. Patients also struggle to understand the protections and restrictions and become frustrated when we try to explain why we have to ask the patient to summarize their care because we can’t access the information that we need without recreating the proverbial wheel.

The document has some great appendices, including a literature review and tables of evidence used during its creation. The summaries of EHR challenges and existing workarounds were fascinating case studies in dysfunction: lack of integration between the EHR and tablet devices used for patient-completed screeners and surveys; copy and paste to add the same note to the PCP and behavioral health EHRs; printing and scanning of medication lists from the behavioral health EHR to the medical one; and more. My favorite is “Reliance on patient or clinical recall for inaccessible clinical information – providers describe this as ‘flying blind.’”

Due to my employer’s lack of integration with our state HIE or nearby health systems, I’ve been flying blind for the last six years, except for when patients use their phones to access MyChart and then hand them over. That’s been useful in a number of medical situations, but I have to admit I’ve never seen psychiatry notes or therapy notes in any of those encounters, and I usually can’t see a full medication list history to know what’s been tried in the past — only current medications are typically displayed.

The paper also contains pages of recommendation tables, some of which push back on ONC, CMS, and other agencies to provide easily accessible standards for developers to use when creating documentation. It also calls on ONC to drive adoption and implementation guidance for APIs to improve integration. There is also a bid for the federal government to incentivize patient care organizations to implement standardized tools. There’s a great swim-lane diagram of an ideal IT-enabled workflow for safe integration. It will be interesting to look back at this paper in a couple of years and see how far we’ve come or whether we’re still living in the land of siloed documentation.

Has your organization done work to support integration of primary care and behavioral health? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Interviews Lissy Hu, MD, CEO, CarePort Health

February 22, 2021 Interviews Comments Off on HIStalk Interviews Lissy Hu, MD, CEO, CarePort Health

Lissy Hu, MD, MBA is co-founder and CEO of CarePort Health, powered by WellSky, of Boston, MA.

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Tell me about yourself and the company.

I’m a physician by background. CarePort connects hospitals with post-discharge providers, such as nursing homes, home health agencies, hospice, community-based providers, and all of the services that patients need after a hospital stay.

What activity are you seeing around hospitals sending ADT notifications to the patient’s other providers now that the deadline is getting close?

We’ve spent the last couple of years helping hospitals and post-acute care providers navigate that initial transition from the hospital into post-acute. Instead of a fact-based or manual process, where the discharge planner at the hospital picks up the phone and calls around to all the different nursing homes in the area asking if they have a bed, we have a network of hospitals and post-acute providers on our platform that can send these referrals electronically and that can communicate back and forth.

Over the last two years, we’ve seen more interest in closing that loop or that round trip. For the ADT piece that you referred to, not just how to get patients out of the hospital efficiently and share information back and forth in that transition, but being able to understand, when a patient lands in a skilled nursing facility, how long they are there, especially if a patient then goes back into the ED or gets admitted. We are seeing a new level of collaboration between acute and post-acute, especially as folks are starting to realize the importance of post-acute and how much that drives outcomes, both from a cost and quality standpoint.

We’ve learned that open hospital beds aren’t managed like a grid, where COVID-19 patients are moved between hospitals based on individual hospital capacity and clinical capability. Are hospitals showing an interest in sharing open bed information with each other?

On the bed availability piece, you are right. There’s not a centralized information piece out there, and we are seeing more interest in wanting that level of visibility. We are seeing it not only on the hospital side, I would say, but interestingly, on the post-acute side as well.

One of the things that has been so interesting about COVID-19 and the pandemic is that we sit in the middle, in terms of the hospital and the post-acute. We see the impact on both sides. Even in April and March of last year when things were really kicking off in the New York area, what we were seeing was that the hospital capacity and their capacity to take patients is very much tied to their ability to discharge patients into that next level of care, in terms of that post-acute.

People will start to see that it’s not just about the hospital bed — it’s around capacity and that flow across the entire continuum. New York hospitals were having a hard time getting their patients out of the hospital and into post-acutes, because a lot of these post-acute providers changed their admissions policy with COVID-19 in their vulnerable population. That hesitation to take on new patients backed things up from the hospital. What I’ve been encouraging our customers to think about is that visibility into the hospital beds is helpful and it’s necessary, but you also need to think about that next step. Where does that patient go? Because it is a pipe that’s connected.

We also saw in New York a high number of nursing home deaths that were possibly caused by forcing them to accept their residents back into the facility following discharge from a COVID-19 hospital stay. How will that situation change permanently and will technology play a part?

That highlights two things. First, the interdependency between hospitals and post-acute providers. It also highlighted to a lot of people the dual roles that nursing homes play in our society.

On the one hand, they are residential facilities for the elderly, the vulnerable, and those who can’t be in their own homes, so they are these long-term care settings. On the other hand, we rely on them as post-acute settings, where folks who have gotten a hip or knee replacement or are recovering from surgery go for a couple of weeks, almost like a step-down unit, to recover, to rehab before moving on to home with home health or back into the community. That was the challenge of New York and really all across the country — we need places for people to recover that aren’t the hospital.

At the same time, these facilities traditionally have been these residential facilities for the elderly and the vulnerable. How do we balance that? Does that get split apart? The role that technology can play is facilitating that transition as much as you can with high-quality information. In our products, we looked at facilities that could take COVID-19 patients, that had a separate wing, isolation wings, and a separate admissions processes. We tag those in our system so that the discharge planner at the hospital will know. We transmitted COVID-19 results that were pending from the hospital to the post-acute care provider.

Those were all COVID-specific changes that we did in part because we had to help our customers, but also because the market is moving to increased interoperability between the hospital and the post-acute care providers. There is a need to share more and more information, especially as we are seeing sicker and sicker patients going into post-acute because of length-of-stay pressures in the hospital.

Your product helps hospitals and families select a skilled nursing facility, with CMS star ratings being one factor. Were those ratings predictive of which SNFs had a lot of COVID-19 deaths, and will consumers look at different criteria after the pandemic is controlled?

The biggest change we’ve seen is a shift away from facility-based care towards more home-based care. There have always been patients who clearly need to go to a facility, or who clearly can go home. But in the middle ground of patients are those jump ball patients that could go home, but maybe they are just sick enough or frail enough that they need to go to a facility. We’ve seen a lot of this shift, where patients who might have gone to a facility in the past are now going home.

The other change is that going home instead of to a facility is a more difficult discharge. When you go to a facility, you’ve got your dialysis, you’ve got your infusion, you’ve got your nursing care. All of that is set up for you. When you go home, the discharge planner has to set up all of those pieces a la carte.

We saw hospital admissions go down, so we were expecting referral volume to go down. We found that when we looked at 2020, our referral volume went up by almost 20%, even though total admissions to hospitals were down. I think a lot of that can be explained because of the complexity of setting patients up at home and the need to set up more and more services. A lot of people are saying that COVID probably accelerated some of that, but that trend of more patients opting to go home was already there.

That was a  roundabout answer to your question about whether patients are picking facilities differently. The shift to home was probably the number one trend that we saw. But in terms of patients picking facilities differently, I think people are paying more and more attention to the quality of nursing homes. COVID highlighted some of the problems with those ratings that a lot of folks in the industry have already raised. I hope this will push CMS for more transparency, more data on the quality of these nursing homes. Right now, for example, they are considering adding COVID-19 vaccination rates of staff and patients to that rating. That is an excellent idea, given what we know about the vulnerability of that patient population. 

Overall, it has pushed patients and their families to consider that choice with wanting more information and better information. Hopefully that pressure from patients and their families will give us even more transparency than what we have today.

WellSky said when it acquired CarePort that it would invest significantly to expand CarePort’s capabilities. What changes do you expect to see?

Luckily when we went through this process of parting from Allscripts and choosing our next home, we had a choice, which is important. When we spoke with WellSky and we talked about our shared vision, I wanted to be very specific around what that meant, rather than amorphous corporate jargon about synergies. I was impressed with WellSky because they had been thoughtful about the process. Given the price that they paid, it makes sense that they were thoughtful, speaking in the realities of the world. 

Specifically, in terms of the benefits to our customers, there were probably three things that we looked at and valued. The first is, as we are seeing more of a shift towards home-based care, our clients are asking us to connect more and more with these home-based providers. WellSky is in one in four home health agencies in the US. Being able to add those agencies to our network, both as referral partners and to add visibility in terms of that ADT and deeper clinical data, was valuable out of the gate for our customers.

The second piece was that WellSky has a network that goes beyond home health and delivering medical services into the home. They have a huge network in the social determinants of health space. Again, as we are seeing more of a shift home, there are more concerns around how the patient is going to get their meal. How do we think about the non-medical parts of their care that we can support in their home? That was another piece that the WellSky network added for our customers.

The third piece was funding. The deal closed on December 31, 2020. We started the year with 200 people and we are already in the process of trying to hire 50 more people to our team.

You’ve said that you want CarePort to be a place where smart women want to work. How do you make that happen?

It all starts with the culture that you build. When I was in business school and in medical school — and I’m almost embarrassed to admit, even when I was taking classes on corporate culture and team dynamics — those soft classes almost felt less important in some ways than the finance and accounting classes. The hard business classes, if you will. I have to say that my biggest learning in these last eight or nine years since I founded CarePort is that it’s the opposite. Team building, figuring out how to manage, figuring out how to set up a positive culture where women are valued, where you enable everyone to speak up — that’s the hardest part about building a company.

At our scale, the lesson that I’ve learned is that it’s not even just about you and maybe the senior people in the team. You have to be hiring people at the manager level, at the director level, all down through the org, to make sure that those managers embody the competencies that they need to meet the roles and responsibility of that job, but the right culture and the right attitudes as well. That’s how you build a culture at scale. It’s not just from the leader, the CEO, the founder, the visionary. You have to staff in your company at all levels with people who want a positive working environment for women, who value the contributions of women, and who understand some of the complexities and challenges that women face. When you’re building a company and trying to recruit, all those things are difficult to prioritize. But really, that’s how you bake this into your DNA. You have to find people at all levels who embody that.

How did you protect that goal while being acquired twice?

You have to be thoughtful about why you’re doing the acquisition. To be fair, some companies just don’t have that choice. For us, luckily, we’ve always had optionality, because we’ve been doing well and we’ve had supportive backers, first from venture capital, then Allscripts. For me, when I evaluated an acquisition and whether we should do it versus do nothing and continue on our current path — because that was always an option that was available to us — there are two lenses that I always thought about. One is, do I see a tangible benefit to the customer? If the answer is no or it’s amorphous, then immediately we shut the conversation down. Because ultimately, if it’s not good for the customer, it’s not good for the business, end, period, stop.

But the second lens, once you get through that hurdle, is, is it good for the team? What is the feel of the culture of the other organization? What is their leadership like? What is that working environment? Is it a place where I could see my team thriving? Because as a founder, some of these people have been with me since the very, very beginning. They left higher-paying jobs with more security, they had families, and they came to a startup where there was none of those guarantees. I feel a tremendous responsibility to my team to make sure that they are taken care of and that my customers are taken care of. Not every company has this choice, but because I’m still here, because we’ve been doing well, because we have this choice, I wanted to optimize around both of those fronts and I was able to.

Do you have any final thoughts?

I’m excited about the future of acute and post-acute care. We have seen even more so than when we last talked, given the changes caused by COVID-19, the interdependency between acute and post-acute. In the next couple of years, I’m seeing payers become more involved in that relationship as well, as payers are trying to think about post-acute and think about how to work with post-acute. Those are some of the things that I’m excited about. Also, having patients who are more engaged, who have more data available to them. Those things will be important for patients who need post acute-care, a number that will only increase.

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Morning Headlines 2/22/21

February 21, 2021 Headlines Comments Off on Morning Headlines 2/22/21

Des Moines University telehealth center could create hundreds of jobs

Des Moines University, in partnership with a local health system, will develop a $4 million telehealth training center that will create 678 jobs.

Spok Reports 2020 Fourth Quarter and Full Year Operating Results

Spok reports Q4 results: revenue down 5%, EPS $-$2.44 versus -$0.50.

New Columbus, Ohio Insurtech Company, Circulo, Raises $50M to Disrupt Medicaid

Columbus-based Medicaid Managed Care insurer Circulo raises $50 million in funding and announces that it will use software from Olive and share its CEO Sean Lane.

Comments Off on Morning Headlines 2/22/21

Monday Morning Update 2/22/21

February 21, 2021 News 2 Comments

Top News

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The Wall Street Journal reports that IBM is considering selling IBM Watson Health.

Observers estimate that IBM Watson Health has $1 billion in annual revenue, but loses money.

The grab bag of acquired businesses that may be sold off to private equity or in one or more SPAC mergers include Merge Healthcare, Phytel, and Truven Health Analytics. IBM spent billions on the acquisitions that one of its former executives called a “bet the ranch” move that followed Watson’s game show win on “Jeopardy!”

IBM’s new CEO hopes to catch up to rivals in cloud computing after IBM paid $34 billion to acquire Red Hat in mid-2019.


Reader Comments

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From Jeff: “Re: Change Healthcare acquisition by UHG/OptumInsight. Ronald Hirsch, MD of R1 RCM says consensus is that UHG will modify the criteria to their advantage, resulting in fewer patients meeting criteria for inpatient admission and therefore being held in an outpatient observation status.”

From GeddyAlexNeil: “Re: Change Healthcare acquisition by UHG/OptumInsight. I’ve worked at Optum, McKesson, and GE. This combination seems either brilliant or a total mismatch. In the Bill Miller era when I worked there, Optum was generally pretty good in their acquisition hit rate (Catarmaran, Alere, Humedica, and MedExpress). There’s also been some that at the time were well thought out, but the market shifted and/or they miscalculated (Picis). My opinion was they they have a thoughtful approach and historically done a good job integrating the new company into the fold, unlike McKesson. New leadership is here, however. Change is a behemoth saddled with the likes of HealthQuest (yes, it is still around at Emory and AU Medical Center), but first and foremost, it is almost impossible to send a claim today that doesn’t travel through the Change clearinghouse at some point. There has to be value that Optum sees in owning the EDI infrastructure that is Change. The Optum as we know it today was built on the back of the clinical services in the fringe (homecare, urgent care) and the PBM business. This was Ingenix, the code book company and the company whose electronic version of codes were built under the hood of every EMR/PM system in the country before it was Optum. Above all else, Optum is the sister company of one of the top payers that providers love to hate. And if I’m not mistaken, Optum is now larger than its insurer sister by several billion. Optum also represents a disproportionally large percentage of UHS quarterly earnings.”

From The Nazz: “Re: apps are dead. I would say at least that modern web technology makes possible to deliver the same functionality via a web page.” I’ve ditched other apps than the Washington Post one. Accuweather inexplicably decided to make its app landscape mode only on the IPad, so I replaced it with The Weather Channel but really don’t need either. I use Amazon’s website over the app at times since the IPad app won’t let you buy Kindle books. I like the Kindle app for reading books, the Walmart app for online grocery ordering, Waze for driving, and the Sonos app for playing music literally every day, but it’s a bunch of seldom-used icons after those. I think people are right that patients don’t need or want specific apps – MyChart is amazing on the browser and I’m fine with the Walgreens web page instead of their app. All I need is password management and rarely speech recognition and IOS provides those (LastPass is great on the desktop, but speech recognition isn’t as convenient there).


HIStalk Announcements and Requests

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External electronic records weren’t reviewed in just over half the most recent encounters of poll respondents, although they would not have been useful in about two-thirds of those visits anyway.

New poll to your right or here: Which of your local care providers has earned your most positive brand perception? How that brand perception was created – by experience or otherwise – is up to you, as is the distinction among types of services offered. It would probably be the hospital-owned practices for me even though I’m happy with my direct primary care physician as well — it’s just that the former has spent a lot more energy and money to create a brand image than my one-woman physician practice.


Webinars

February 24 (Wednesday) 1 ET. “Maximizing the Value of Digital Initiatives with Enterprise Provider Data Management.” Sponsor: Phynd Technologies. Presenters: Tom White, founder and CEO, Phynd Technologies; Adam Cherrington, research director, KLAS Research. Health systems can derive great business value and competitive advantage by centrally managing their provider data. A clear roadmap and management solution can solve problems with fragmented data, workflows, and patient experiences and support operational efficiency and delivery of a remarkable patient experience. The presenters will describe common pitfalls in managing enterprise information and digital strategy in silos, how to align stakeholders to maximize the value of digital initiatives, and how leading health systems are using best-of-breed strategies to evolve provider data management.

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


Acquisitions, Funding, Business, and Stock

Business Insider reports that Walmart has changed its 2018 plan to spend $3 billion to open 4,000 clinics by 2029, with new company teams now focusing on e-commerce as it has opened just 20 clinics in more of an experiment than a commitment.

Spok reports Q4 results: revenue down 5%, EPS $-$2.44 versus -$0.50.

Just-formed, Columbus-based Medicaid Managed Care insurer Circulo raises $50 million in funding and announces that it will use software from Olive and share its CEO Sean Lane.


Sales

  • Mon Health System (WV) chooses PatientMatters IntelliAdvisor consulting services to direct its pre-access service center.

People

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Seattle Children’s promotes Eric Tham, MD, MS to interim SVP of its research institute.

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WellStar Health System hires Hank Capps, MD (Novant Health) as EVP / chief information and digital officer.


Announcements and Implementations

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A KLAS review of ERP implementation firms finds that among software vendors, Workday offers strong software knowledge but falls short on guidance, while Infor’s improvements have significantly improved the client experience. The large number of recent Workday implementations has led to shortage of experienced resources across all firms, including Workday itself. Among consulting firms, Accenture and Huron stand out, while Deloitte and KPMG get mixed reviews from customers. Less-complex implementations are managed well by Avaap, Bails, and ROI Healthcare Solutions, while Chartis Group and Impact Advisors are newer to ERP work but are showing early success. Healthcare IT Leaders earns the highest score of ERP staffing firms.


COVID-19

US COVID-19 deaths will cross the 500,000 mark early this week. All major metrics are sharply down. The count of hospitalized patients dropped below 59,000, about the same as at the worst point in the spring and summer surges.

Researchers find from re-examining  originally submitted FDA vaccine data that both the Pfizer and Moderna products have first-dose efficacy of 92%, suggesting that the best use of the available vaccine supply would be to get first doses into as many people as possible, then worry about second doses later, to cut the time to reach herd immunity in half.

New research published in The Lance finds that the Oxford / AstraZeneca COVID-19 vaccine is more effective when the second dose is given 12 or more weeks after the first dose versus the usual four weeks.

Israel rolls out its “green passport” program in which gyms, theaters, hotels, concert halls, and synagogues will partially reopen only to people who have either been vaccinated for COVID-19 or who have recovered from previous infection and thus are not eligible to receive the vaccine. People can download the Health Ministry’s app, then create passport certificate with a QR code. The data sources will apparently be the Health Ministry’s vaccination records and treatment records from the country’s HMOs.

A nine-month follow-up study of COVID-19 patients, most of them with mild disease, finds that 30% had persistent symptoms, most commonly fatigue and loss of sense of smell or taste.

CDC Director Rochelle Walensky, MD, MPH says that schools can safely open regardless of the degree of community spread of coronavirus as long as they require masks and distancing among students and staff.


Other

An AMIA study finds that its 2009 policy meeting underestimated the degree of EHR-caused burnout while overestimating the impact of HITECH-powered identify theft and fraud alerting. Most of the recommendations from that meeting have resulted in little, if any, action.

Adventist Health says its CommonWell to Carequality connection has allowed it to exchange patient information with 340 health systems, sending 8 million documents and receiving 44 million.


Sponsor Updates

  • CareSignal publishes a case study titled “Remote Monitoring to Support Members’ Chronic and Behavioral Health.”
  • OptimizeRx will present at the virtual SVB Leerink 10th Annual Global Healthcare Conference February 25.
  • Nordic publishes a new white paper, “2021 E/M Updates: EHR Workflow and Operational Considerations.”
  • PatientPing’s national network of ACOs earns over $260 million in savings under the Next Generation ACO model.
  • Pure Storage updates its flagship Purity software for FlashBlade and FlashArray to accelerate Windows applications, deliver ransomware protection across file, block, and native cloud-based apps; and make hybrid storage for departmental and data center workloads obsolete with a third-generation FlashArray//C all-QLC platform.
  • Redox releases a new podcast, “The PCC Takeover.”
  • Health Catalyst seeks speaker and showcase proposals for its virtual Healthcare Analytics Summit September 21-23.
  • ReMedi Health Solutions works with the Houston Food Bank to provide over 2,000 meals to the Houston community.
  • Sectra publishes a new case study, “One for all – native support for automated breast ultrasound in Sectra’s expanded breast imaging PACS.”
  • TriNetX publishes a new case study, “TriNetX Helps Cuyahoga County’s MetroHealth System in Ohio Strive for Clinical Research Leadership Through Data Sharing.”
  • Sam Hupert, MD CEO of Visage Imaging parent company Pro Medicus, shares his thoughts on the company’s 2020-21 final results.

Blog Posts


Contacts

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

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Weekender 2/19/21

February 19, 2021 Weekender 1 Comment

weekender 


Weekly News Recap

  • Intelerad acquires Lumedx.
  • IBM considers selling IBM Watson Health.
  • Former Nuance CEO Paul Ricci joins Qualifacts as president and CEO.
  • Zocdoc receives $150 million in growth financing.
  • Innovaccer is valued at $1 billion based on a reported new investment.
  • Dexcom launches a venture capital fund.
  • Sharecare’s SPAC deal values the company at $4 billion.
  • GAO recommends that the VA stop its Cerner implementation until critical issues are resolved.

Best Reader Comments

“Apps are dead.” I’m curious what healthcare readers think about that comment. (Matt Ethington)

Syringa Hospital. Why in the world is a board involved in this level of operations? They should only be approving, or not, the CEO’s financial outlay for the acquisition. If the CEO can’t get the leadership team on the same page, the board has another, bigger problem. (Jamey)

There are probably less than 100 employees at this hospital. There just aren’t that many management staff above line managers. The board is probably composed of community leaders who may have some experience in the area either in IT or just organization in general. It isn’t easy running 15 bed rural hospitals on shoestring budgets. (IANAL)

The developer’s opinion and the comment represent the age-old battle between developer’s who view the system as “working as designed” and the users who are just trying to make an appointment. In this case, I’m betting the specification did not mention that users should not be able to make multiple appointments for the same dose. The developers either missed the difference between the two doses or just let anyone make as many appointments as possible. Clearly the system was not working as required. I loved the comment it allowed our technical folks who don’t normally interface with customers the opportunity to do that … what a rewarding experience. (AllHatNoCattle)

Agree that if the clinician isn’t checking the transcription, then that is on them. With the number of scribes and “speech processors” out there, I have yet to find one that is much above 95% per word accuracy — the more complicated the word, the lower the accuracy. With a word count of 171, which eight were recorded incorrectly in this missive? (AnInteropGuy)

For the “lung cancer” versus “tongue cancer” mistake, I’d think that something suggesting the correct diagnosis could have helped. “Note indicates lung cancer, lung cancer not documented as patient diagnosis.” No idea how difficult that would be to not trigger on false positives, but it could help fill out a patient’s problem list and medical history. (AI what?)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. D in Kentucky, who asked for online instruction resources for home using during “COVID days.” She reports, “My class is very grateful to receive this generous gift. I have become a full-time virtual teacher with more than 50 students. These supplies have helped lessen the cost of that I would have had to purchase for my students.”

I read most news on my tablet and find myself avoiding the Washington Post even though I subscribe to it because I despise the app’s layout, navigation options, and inability to view reader comments. Not to mention that there’s no way to forward an article to my email so I can remember to mention it in HIStalk. I found a better way — place the browser link on the IPad’s home screen and skip the app. The navigation is better, “send to” works, comments display, and it feels a lot more like something worth paying for.

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The New York Times covers the thousands of medical school graduates who aren’t chosen for the limited number of US medical residency slots, leaving them with an average of $200,000 in student loans and no ability to work as a doctor. The US has at least 10,000 such graduates, many of them Americans who went to medical schools in the Caribbean or other countries whose chances of landing a residency are about 50%. Medical schools have increased their enrollment, but residency positions — which are funded by CMS – remain capped. Experts say the offshore medical schools that recruit American students sometimes overstate the history of their graduates being matched and thus eventually employed.

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Hospitals in Texas are collecting buckets of rainwater and using portable toilets as storm-related water shortages affect even the largest facilities. Patients are being double-roomed and boarded in hallways, dialysis patients are showing up in hospital EDs because dialysis centers are closed, patients who are ready for discharge can’t leave, and hospital employees are sleeping over because they can’t get home. Hospitals are also seeing patients with carbon monoxide poisoning due to improper use of generators and heaters. About 100 hospitals in southeast Texas declared an internal disaster in hoping to avoid receiving new patients by ambulance. Meanwhile, the CFO of a natural gas company owned by billionaire Dallas Cowboys owner Jerry Jones giddily tells investors with Enron-level greed and indifference to the misery of others that the weather “is like hitting the jackpot” as the company is selling natural gas “at super premium prices.”

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New York-born Indian-American actress, film maker, and former physician Lakshmi Devy, MD serves as the writer, director, and lead actor in “When the Music Changes,” which address rape and assault. She previously made “Daro Mat” (which translates to “Don’t Be Afraid,”) a short film that is available on YouTube.

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Missouri Baptist Medical Center COVID-19 ICU nurse, family nurse practitioner, and first-time mother Mandi Tuhro, RN, MSN describes the challenges of watching patients die, trying to find time to pump breast milk, feeding her son overnight, and dealing with the fact that at 30 years old, “there’s not a single facet of my life right now that I’m not needed, and that is a heavy feeling.”

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Clark County, Indiana health officer and Colts fan Eric Yazel, MD writes a letter to the team’s general manager every year to offer his service as quarterback. He’s perhaps not the perfect candidate, as he admits to the GM: “A less visionary GM might be given pause by my age (44),  mediocre BMI, and relative lack of any athletic experience.” The GM called him back this year just to be nice, but Yazel ignored the call because it came from a Houston area code and “I thought it was the Texans calling. I will listen to some other options, but I am not going inter-division.”


In Case You Missed It


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Morning Headlines 2/19/21

February 18, 2021 Headlines Comments Off on Morning Headlines 2/19/21

Leading Imaging Software Company Intelerad Medical Systems Announces Acquisition of LUMEDX

Imaging vendor Intelerad acquires Lumedx, which offers cardiovascular information systems and analytics.

Carevive Closes Oversubscribed $18M Series C Equity Raise

Cancer care management software vendor Carevive raises $18 million in a Series C funding round.

IBM Explores Sale of IBM Watson Health

Sources say IBM is considering selling its IBM Watson Health business, which includes Merge Healthcare, Phytel, and Truven Health Analytics.

Olive founder Sean Lane raises $50M to start Medicaid managed care company

Olive CEO Sean Lane will soon launch Circulo, a managed care company that will leverage Olive’s AI, automation, and data analytics.

Google to open first Minnesota office to advance Mayo Clinic cloud partnership

Google will open an office in Rochester, MN to better facilitate its work with Mayo Clinic, which includes projects related to engineering, AI, and machine learning.

Comments Off on Morning Headlines 2/19/21

News 2/19/21

February 18, 2021 News 3 Comments

Top News

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Imaging vendor Intelerad acquires Lumedx, which offers cardiovascular information systems and analytics. 


Reader Comments

From Editorial Ed: “Re: job seekers. You should publish every week or two a list of people who let you know that they are out of work and looking for health IT jobs. Just use a table format limiting it to name, last job and company, position being sought, and a link to their LinkedIn profile.” I’m not opposed to the idea, although I have a lot of readers and it might get out of hand.

From Pondering Partnership: “Re: Change Healthcare – Optum Insight merger. Would like to see a survey of your readers about whether they see this as positive or negative, why, and whether they will stop doing business with either company.” I got no responses when I asked previously, so here’s one last chance for customers of either company to weigh in by contacting me with their anonymous thoughts.  


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor Healthcare IT Leaders. The Alpharetta, GA-based company is a national leader in IT workforce solutions, connecting healthcare organizations with experienced technology talent for implementation services, project management, consulting, and full-time hiring. Areas of focus include EMR, ERP, WFM, RCM, and CRM. KLAS #1 rated for Business Services (Best in KLAS 2020) and highly-KLAS rated for HIT implementation and staffing, the company has ranked on the Inc. 5000 five consecutive years and has been named a Best Place to Work by the Atlanta Business Chronicle and one of America’s Best Professional Recruiting Firms by Forbes. Its COVID-19 practice, Healthy Returns, offers comprehensive onsite COVID-19 testing, contact tracing, and vaccination support. Thanks to Healthcare IT Leaders for supporting HIStalk.


My latest widespread but puzzling new conversational grammar quirk: people who say something like “customers ask what does our product do” instead of “customers ask what our product does.” I started hearing that kind of sentence construction recently and it has spread to probably 80% of such usage. 


Webinars

February 24 (Wednesday) 1 ET. “Maximizing the Value of Digital Initiatives with Enterprise Provider Data Management.” Sponsor: Phynd Technologies. Presenters: Tom White, founder and CEO, Phynd Technologies; Adam Cherrington, research director, KLAS Research. Health systems can derive great business value and competitive advantage by centrally managing their provider data. A clear roadmap and management solution can solve problems with fragmented data, workflows, and patient experiences and support operational efficiency and delivery of a remarkable patient experience. The presenters will describe common pitfalls in managing enterprise information and digital strategy in silos, how to align stakeholders to maximize the value of digital initiatives, and how leading health systems are using best-of-breed strategies to evolve provider data management.

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


Acquisitions, Funding, Business, and Stock

Cancer care management software vendor Carevive raises $18 million in a Series C funding round. 


Sales

  • Several counties in Florida go live on Everbridge’s vaccine distribution solution and the state of West Virginia will use the system to coordinate vaccinations through a pharmacy chain.
  • Nine hospitals choose CloudWave’s Opsus Cloud for hosting and disaster recovery services, while another 10 have engaged the company to build local data center cloud edge platforms.
  • Tift Regional Medical Center (GA) chooses Wolters Kluwer Health’s POC Advisor for sepsis detection and treatment.

People

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Nathaniel Weiss, former CEO of LiveProcess and Standard Molecular, launches VelloHealth, which offers real-time care coordination software for serious mental illness.

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Gretchen Tegethoff, MSIST (CoverMyMeds) joins Ellkay as regional vice president of strategic relationships.

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Paul Ricci — who retired from Nuance in 2018 and then took an interim CEO role at SOC Telemed until the company went public via a SPAC in October 2020 – is named CEO of behavioral health EHR vendor Qualifacts. He replaces David Klements, who remains on the board.

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Law firm McGuireWoods expands its digital health team by hiring three partners: Jonathan Ishee, JD, MPH, MS (Vorys, Sater, Seymour, and Pease); Janice Walker-Suchyta, JD (Seyfarth Shaw); and Andrea Linna, JD (Honigman). McGuireWoods deals with corporate transactions and private equity deals. Ishee earned an MS in health informatics in 2004 and is an assistant professor of biomedical informatics at UTHealth in Houston.

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Cardiologist, inventor, and Nobel Peace Prize antiwar activist Bernard Lown, MD dies at 99. He co-invented the defibrillator, created one of the first cardiac ICUs, formed a non-profit group that launched a satellite to deliver medical training to doctors in Africa and Asia, and created the Lown Institute that ranks hospitals on their civic leadership, inclusivity, avoidance of overuse, and pay equity.


Announcements and Implementations

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Capsule Technologies releases its Generation 3 Vitals Plus patient monitoring and clinical documentation solution in its Medical Device Information Platform. It allows hospitals to perform continuous monitoring and remote clinical surveillance outside the ICU. Philips acquired Capsule last month for $635 million.

TriNetX adds COVID-19 vaccination data to its platform and real-world data set, which will allow researchers to perform their own studies of de-identified EHR patient data to look at comorbidities, reinfection, and outcomes.

CarePort will use the provider directory of MedAllies to allow users to comply with CMS’s ADT notification Condition of Participation.

Particle Health announces a FHIR API that will allow developers to create products that can search the information of 270 million patients.

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Amwell releases Hospital TV 100, a kit that turns existing hospital TVs into telehealth endpoints. Intermountain Healthcare has deployed 1,200 of the units.

The Consumer Technology Association launches an ANSI-accredited standard for the use of AI in healthcare, which consists only of definitions for a few dozen terms such as “algorithm” and “big data” as agreed on by 50 big-name organizations and companies.


COVID-19

CDC reports that 56 million COVID-19 vaccine doses have been administered of 72 million delivered (78%) and 15 million people have received both doses.

CDC will spend $200 million to increase the number of coronavirus samples that are genetically sequenced as surveillance for the spread of variants.

Former FDA Commissioner Scott Gottlieb, MD predicts a less-active COVID-19 spring and summer because infections and vaccinations have raised protective immunity to 40%.

Overall US life expectancy dropped by a full year in the first half of 2020, while that of the black population was reduced by 2.7 years. The life expectancy of black Americans is now six years less than that of whites.

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The Los Angeles Times features its owner – billionaire Patrick Soon-Shiong, whose NantWorks conglomerate owns ImmunoBio, which is developing a coronavirus vaccine – as the host of a video series that covers COVID-19. One of his interviewees is a South African geneticist who is an ImmuneBio partner, which was not disclosed in the discussion, as they discussed the logistical shortcomings of existing vaccines. NantWorks also owns health IT vendor NantHealth.

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KHN reports the plight of the rural 25-bed St. James Parish Hospital in Louisiana, which does not have an ICU and at times cannot find a hospital closer than 600 miles away that will accept a transfer. The hospital has seen 70% of its employees decline COVID-19 vaccination

Johnson & Johnson, the world’s largest healthcare company, will have only a few million COVID-19 vaccine doses available in the next few weeks when FDA could approve its use. The US government paid the company $1 billion to develop the vaccine in exchange for 100 million doses after having given it $456 million in March, but J&J says that most of the promised first-half doses won’t be available until June. The company’s vaccine requires one dose instead of two and can be stored in refrigerators rather than in freezers.

Mount Sinai Health System (NY) halts its use of convalescent plasma to treat COVID-19 patients, saying that it has shown no clinical benefit in repeated clinical trials.

The state of Iowa cancels its contract with Microsoft for a COVID-19 vaccination appointment system, deciding that it would be to hard to combine the several existing systems that are being used by health departments and pharmacies.

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A man in England is offered COVID-19 vaccine early after his doctor’s office enters his height incorrectly as 6.2 centimeters instead of 6 feet 2 inches.


Other

France’s president, Emmanuel Macron, announces a $600 million program to improve cybersecurity in the public and private sector, saying that two recent hospital ransomware attacks show how serious the threat is.

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The CEO of Medicare Advantage insurer Clover Health – which is facing reviews by the Department of Justice and the SEC as well as short-seller pressure – unleashes a profanity-filled tirade against a Forbes reporter who wrote an article whose headline he didn’t like. Vivek Garipalli became a paper billionaire when Clover went public via a SPAC last month, valuing the company at nearly $4 billion. Clover offers physicians its Clover Assistant to manage patient care, paying them a fee of $200 every time the software is used during a patient visit. The money-losing company, which operates in some counties of seven states, did not report prior to going public that it is the subject of a Department of Justice False Claims Act investigation for improperly inducing patient referrals. Clover’s board includes folks who have a health IT connection – Flatiron Health co-founder and former CEO Nathaniel Turner and former Allscripts and Livongo executive Lee Shapiro.

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Kaiser Family Foundation uses Epic Health Research Network to find that hospital admissions dropped to a low of 69% of expected admissions in the first week of April 2020, but have remained at above 90% since June 2020, leaving the full-year reduction in admissions at 8.5%. Non-COVID-19 hospitalizations started dropping again with November 2020’s COVID-19 surge, suggesting that people are deferring or forgoing care, possibly because of hospital capacity constraints. Fewer care-seekers boosted the gross margins of insurers, as their medical loss ratios were lower. 

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In observation of the death of Bernard Lown, MD this week, here are the Lown Institute’s 2020 Shkreli Awards from last month for egregious healthcare profiteering and dysfunction, in the spirit of pharma bro and federal inmate Martin Shkreli:

  1. Private equity-owned physician staffing companies spent millions to squash surprise billing legislation while cutting physician pay and accepting $60 million in CARES Act interest-free loans.
  2. Hucksters, some of them physicians, pushed fake COVID-19 cures.
  3. Connecticut internet Steven Murphy, MD offered to run public COVID-19 testing sites for several towns, then billed the insurance of patients for large panels of tests for other infections at an estimated cost of up to $2,000 per person.
  4. Hospitals punished their clinicians who wore masks, claiming they didn’t need them and would scare patients.
  5. Brigham and Women’s CEO Elizabeth Nabel, MD wrote an op-ed defending high drug prices while not disclosing that Moderna paid her nearly $500,000 in 2019 for serving on it board, after which she sold $8.5 million of the vaccine maker’s stock.
  6. Executives of the four big drug companies that developed COVID-19 vaccines declined to participate in a WHO program to share information to develop and distribute treatments, vaccines, and diagnostics.
  7. Nursing homes failed to protect their residents from COVID-19.
  8. Four California health systems refused to accept transfers of poorly insured COVID-19 patients even though they had available beds.
  9. Moderna, which had 100% of its $1 billion in COVID-19 vaccine development costs covered by the US government, set the highest price of all companies that offer a vaccine.
  10. FEMA’s PPE task force airlifted PPE in from other countries, but instead of distributing it to states, gave it to six private medical supply companies to sell to the highest bidders.

Sponsor Updates

  • OmniSys uses Virtustream’s Enterprise Cloud and XStreamCare Services to ensure its pharmacy customers can meet the demands of COVID-19 vaccine management.
  • WellSpan Health (PA) expands its Nuance Dragon Ambient Experience deployment to improve care access and patient and provider experiences.
  • SymphonyRM names former Intermountain Healthcare CIO Marc Probst to its board.
  • Healthcare Growth Partners advised Symplr on its acquisition of Phynd Technologies, which closed earlier this week.
  • In the UK, InterSystems makes COVID-19 vaccination appointment scheduling available through its TrakCare system.
  • Loyale Healthcare publishes a new industry analysis, “Growth in Healthcare Spending will Decelerate Post-COVID: How Hospitals Should Plan.”
  • Meditech publishes a new case study, “NMC Health decreases antibiotic use through Meditech’s Antimicrobial Stewardship Toolkit.”

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EPtalk by Dr. Jayne 2/18/21

February 18, 2021 Dr. Jayne 6 Comments

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I had a moment of excitement in my pre-HIMSS planning when a friend clued me in to reasonable rates at The Palazzo. I’m happy to be rebooked somewhere that is attached to the meeting facility so I don’t have to melt in the August heat on the way to the show. The HIMSS room reservation system shows that the resort fees are optional this year,  which is great for those of us who never get to experience the “resort” component since we’re frantically trying to see everything possible then write it up before collapsing every night. I also had a thrill when I came across this ad featuring a vintage booth babe. I’m a sucker for opera length gloves and a dramatic up-do, so it certainly got my attention.

People always ask what kinds of things I’m interested in looking at when I attend HIMSS. Smart glasses are back on my radar. It’s been years since Google Glass came and went, but I’ve seen two articles in the past week that featured some variation on smart glasses. Specific use cases include helping a remote clinician better visualize a patient during a telehealth consultation or using the glasses to deliver diagnostic information from AI-powered clinical support systems.

One of the articles noted the potential for patient-side wearables to capture clinical information for later review by the care team. There’s always a lot of talk about wearables, but I haven’t seen a tremendous body of evidence that they can significantly drive clinical outcomes. We’ll have to see what companies bring to the table come August.

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The American Medical Informatics Association issues a call for proposals for the AMIA 2021 Annual Symposium, to be held October 30-November 3 in San Diego. A quick scan of the website showed they are currently planning for a live event “with a limited component of live streaming.” It goes on to note that the AMIA board will make a decision in June if this needs to change. For those interested in presenting, submissions are due March 10.

Although I read a number of journals regularly, I enjoy JAMIA because of its focus on informatics issues. One recent submission looks at gender representation in US biomedical informatics leadership and recognition within the biomedical informatics community. The authors assessed data on AMIA members, academic program directors, clinical informatics fellowships, AMIA leaders, and AMIA awardees. Not surprisingly, men were more often in leadership positions, including 75% of academic informatics programs, 83% of clinical informatics fellowships, and 57% of AMIA leadership roles. Men also received 64% of awards.

I’ve worked with a number of informatics organizations and have seen significant differences in how they approach the creation of a diverse workforce. While some hope it will happen by chance, others work quite intentionally to provide opportunities for groups that are traditionally underrepresented in technical fields. I recently met with a group of women informatics leaders and learned about their strategies for recruiting diverse teams. We certainly can benefit from broader perspectives.I look forward to seeing what those numbers look like in five or 10 years.

JAMIA publishes a study that examines the impact of after-work EHR use and clerical work on burnout among clinical faculty. Specifically, they looked at faculty across Mount Sinai Health System, with 43% of eligible faculty members participating. They concluded that spending more than 90 minutes on EHR work outside the workday and performing more than one hour of clerical work per day are associated with burnout. The findings were independent of demographic characteristics and clinical work hours.

I’ve spent a good chunk of my career trying to help organizations improve their workflows and am always gratified to see an organization that cares about how technology is impacting workers. Unfortunately, many groups don’t see this as a priority or are happy to watch their clinicians absorb increasing amounts of non-clinical work.

Challenges with personal protective equipment are once again in the news, as healthcare organizations have been saddled with millions of counterfeit N95 respirators. Impacted organizations include Cleveland Clinic, the Washington State Hospital Association, Jersey Shore University Medical Center, and Hennepin County Medical Center in Minneapolis.

I was discussing this article on a local physician forum and ended up talking with a local academic faculty member who couldn’t believe that community hospitals and private organizations are still struggling to provide adequate PPE. My clinical employer provides a limited number of N95 respirators to our team and makes their use inconvenient by only stocking them at a single location, requiring people to travel on their days off to pick up a new supply and to rotate that supply over an extended number of days. Some of us are providing our own respirators to avoid reuse, but the counterfeit issue is still a concern. Co-workers who don’t go through the steps are still being diagnosed with COVID-19 despite vaccination.

I have friends who are nurses at community hospitals that sometimes receive N95s only once a week since they’re not on dedicated COVID units. Others have to beg supervisors to replace their PPE when straps break, or they become wet from wear. It’s a tragedy that we are still dealing with this a year into the pandemic. I can’t help but think that if the Centers for Disease Control made N95s mandatory for patient care encounters that we would stop seeing healthcare workers being infected. Employers would be forced to raise their game and to support those employees who want the highest level of protection. But as long as they say that surgical masks are an OK alternative, we’ll continue to see cases.

Fortunately, I have enough masks to make it through the end of my current clinical situation, since I’ve officially tendered my resignation. The fact that I made the right choice was confirmed a few days later when the organization announced some fundamental changes that will significantly alter how the business operates. It will be interesting to see how many people jump ship. I was asked not to reveal my resignation to staff until a couple of weeks before I actually leave, so for all I know, there could be others in the same position. It should make for an interesting couple of months. In the mean time, I’m looking forward to having a break from work-related COVID while I figure out my next move.

The Washington Post reports that Europe’s oldest person, a 117-year-old French nun, has survived COVID-19. Lucile Randon, who took the name of Sister Andre in 1944, was diagnosed on January 16. She was born on February 11, 1904, which means she also lived through the 1918 pandemic. Her birthday celebration was slated to include foie gras, capon with mushrooms, and red wine. Best wishes to Sister Andre for an uneventful 2021.

Email Dr. Jayne.

Morning Headlines 2/18/21

February 17, 2021 Headlines Comments Off on Morning Headlines 2/18/21

MedPilot Acquired by Vytalize Health

Medicare ACO-focused practice management company Vytalize Health acquires patient financial engagement startup MedPilot.

Former Nuance CEO takes over at Qualifacts

Paul Ricci (SOC Telemed) has joined Qualifacts as president and CEO.

Derek A. Pickell appointed Chief Executive Officer, CompuGroup Medical US

CompuGroup Medical US names industry long-timer Derek Pickell as CEO.

Comments Off on Morning Headlines 2/18/21

Readers Write: CMS: Unlocking Data for Patients

February 17, 2021 Readers Write Comments Off on Readers Write: CMS: Unlocking Data for Patients

CMS: Unlocking Data for Patients
By Nassib Chamoun

Nassib Chamoun, MS is founder, president, and CEO at Health Data Analytics Institute of Dedham, MA.

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The digitization of medicine over the last decade has driven exponential growth in the quantity of medical data, measured in the digital footprints of billions of care events each year. Yet this data explosion has made little difference for patients, who still struggle to access, understand, and share their medical data.

Several barriers have kept patients from the benefits of their data. A lack of commonly accepted and consistently implemented software standards inhibits access to silos of data generated by providers, insurers, and electronic health record vendors. Patients also lack tools for accessing and understanding their data.

Encouragingly, each of these barriers is now crumbling as years of effort by industry, entrepreneurs, and government are beginning to bear fruit.

The Centers for Medicare and Medicaid Services (CMS) has created MyMedicare.gov, which connects 40 million Medicare fee-for-service beneficiaries to any medical claim in the last three years that CMS has paid on their behalf. Although the site provides beneficiaries with valuable information, individual patient records can run to hundreds of pages,  an overwhelming user experience. Equally important, MyMedicare.gov contains patient records only for the last three years.

In recognizing the need for a better patient experience, CMS released Blue Button 2.0, an open Applications Programming Interface (API) that allows developers to build apps to help patients access their medical information and decide which apps – if any – can access their personal data.

CMS is further catalyzing this ecosystem of developers and users with its Interoperability and Patient Access Rule, released in May 2020, whereby millions of people covered by commercial insurance, Medicaid, and Medicare Advantage plans will soon have access to their medical histories. While enforcement is somewhat delayed due to the COVID-19 pandemic, the CMS rule also expands the types of information available by requiring healthcare providers and electronic health record vendors to give patients access to certain clinical information, such as lab values, through the third-party applications of their choice.

Blue Button 2.0 and the Carin Alliance (a non-profit devoted to enabling consumers and their authorized caregivers to access more of their digital health information with less friction) are enabling dozens of third-party apps to extract data from large documents and reformat it in a way that lets users and their caregivers quickly understand their medical histories and conditions.

These apps focus primarily on assembling health information from a variety of sources and presenting it more simply to patients. Other tools offer advanced analytics, including highly personalized risk information, to help patients make more data-enhanced healthcare choices.

For example, a patient in her 80s could ascertain the probability of requiring hospitalization from heart disease in the next 12 months and plan accordingly. In the future, risk profiles may also be combined with data from real-time monitoring tools, such as smart watches and smart speakers, to provide more customized insights and enable deeper, more impactful conversations between clinicians and patients.

What’s exciting is that the combined initiatives of open standards, improved data access, and a thriving app ecosystem have established the foundation for sustained innovation. Add an inrush of entrepreneurial talent and venture capital investment and we will likely see numerous new software innovations that accelerate the transformation of huge quantities of difficult-to-use data into usable insights for patients.

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HIStalk Interviews Jon-Michial Carter, CEO, ChartSpan

February 17, 2021 Interviews 4 Comments

Jon-Michial Carter is co-founder and CEO of ChartSpan of Greenville, SC.

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Tell me about yourself and the company.

ChartSpan was founded in 2013. We were focused on driving patient engagement. Almost everything that happens in healthcare is built and designed for providers, with patients having the ultimate end experience. As chronic care management began to evolve in 2015, we realized — as a company that was very much focused on the patient experience — that this was an area that we would excel in. We started small. My brother and I and one other person founded the company. Within five years, we became the largest provider of chronic care management solutions in the country based on active monthly enrolled patient population.

I come from the technology world as an operator with deep experience in finance operations and sales. My brother, in contrast, was a 20-year practicing clinician. We made a great partnership in that he focused on the clinical side of things and I focused on the operational side of things. It has been a big reason that we have been successful.

How many providers, and what kinds, are offering CCM, and how many of them engage companies like yours for outside help?

Chronic care management is a Medicare program where providers are encouraged to telephonically and/or electronically engage with patients on a monthly basis. You engage with patients on the patient’s terms. You go to them when it’s convenient and you go to them when they’re at home.

The thought is that if a patient has two or more chronic conditions, and they are not yet high acuity, they are not a candidate for case management. We preventatively reach out to them every month. The data shows that we dramatically improve outcomes and reduce costs for those patients. You want to get those patients when they are low risk or rising risk, not when they become high utilizers of the system. That’s the entire focus of chronic care management. If you look at the CMS claims data, it is delivering extraordinary results.

In regards to what type of providers utilize the service, initially it was focused almost entirely on primary care, internal medicine, and geriatrics. That began to expand over the last couple of years. There are few specialty areas that we don’t have as customers providing chronic care management services to their patients.

How do practices market CCM to their patients to convince them to sign up and pay their part of the cost?

With COVID, a lot of Medicare patients are hesitant to go out in public, much less sit in a waiting room with other sick patients. We have seen a 30% increase in enrollments from our legacy customer patients. That’s encouraging, because the value for the patient is convenience. Our job as a turnkey service provider for our physicians and providers is not to practice medicine. That’s what they do. We act as an extension of the provider, dealing with the low-level care coordination activities that are so important to prevent the exacerbation of a patient’s chronic conditions.

For instance, we assist in making sure that they have appointments, that they have transportation to get to those appointments, and that they’re getting their medication refills. We assist them in having those medications delivered, or get transportation to get across town, to get to the pharmacy to get them. We make sure that we have the provider’s care instructions and that we understand exactly what the care goals are for that patient and are, reinforcing those and making sure that the provider’s instructions are being followed.

We have a bi-directional feed with our clients. We are extracting the CCDA out of the EHR. We are agnostic and work with every single EHR in the country. Then we push back our clinical data set wherever they want it in their EHR, whether that’s in a particular file or discretely in a patient record. On the billing side, we do the same thing. We push the billing to the billing department, to the practice management system, so that it’s easy to build those E&M encounters once we have had a compliant engagement with a patient on any particular month.

What issues do providers have when they do CCM on their own?

I have met with hundreds of practices and health systems that have attempted to do chronic care management on their own. I have never met one that was profitable. I have never met one that was able to achieve the volume of enrollment or revenue that they had hoped for. 

Here’s why. Everybody with a nurse and a spreadsheet thinks they can do chronic care management, and they are wrong. The clinical encounter is the most predictable part of CCM, but it’s not the hardest part. The hardest parts are all the operational complexities in the periphery. It includes enrollment. By the way, clinicians are traditionally terrible at enrollment. Compelling patients to be in the program. It’s solicitous in nature, and it’s almost uncomfortable. I know, because in the early days, we tried to have clinicians do enrollment and it was a miserable failure.

Enrollment is hard because 85% of your patients have a co-pay. You have to be articulate about defining what the value is in the program. You need data feeds that show you who the primary and secondary insurer are so you know what the co-pay and financial obligations are for the patient. That alone is one of the most difficult operational processes that you have to deliver with chronic care management.

But there’s many more. You are constantly doing data reconciliation. You have millions of patients churning into Medicare and millions churning out of Medicare every day. Churn is the name of the game. If you don’t know, from a data perspective and from a business process perspective, how to manage the daily churn that occurs in a Medicare program, you shouldn’t get into this business.

That stretches way beyond the clinical encounter. You’ll never get to the clinical encounter if you’re not doing your data reconciliation, churn management, patient marketing, enrollment, quality assurance, and billing support services. The clinical encounter is the depth of what most health systems think about when they think about chronic care management, and they are terrific at the clinical encounter. If that was all there was, then we would have a lot more people doing it and they would be a lot more successful. The problem is all the other operational components around the clinical encounter. Few people understand how to master that.

These Medicare patients with multiple chronic conditions probably have multiple active providers. Who decides which of them provide CCM services to that patients and what happens when the patient changes providers?

Being compliant requires that you consent the patient, and that must be documented. Once the patient has given consent to the provider, then that provider is the chronic care management provider of record. No other provider can come in unless the patient unenrolls and then gives consent to the next provider.

What are the best practices of performing CCM and the Annual Wellness Visit remotely?

From a CCM perspective, we do telephonic, and then we rolled out a multimodal approach last year, and it has been extremely successful. I would say 20% of our engagements on any given month are through SMS text messaging. There’s a fallacy in thinking that portals and apps are the way to go. Those are dead. Apps are dead. You don’t make patients go to your proprietary software to have an encounter. You go to where the patient is.

There are only two places that they ubiquitously are, on their phone and on their phone — telephonically on their phone and texting on their phone. We go to where the patient is. That’s why our engagement rates are off the charts. You don’t want to force them to have to open your app and enter their username and password. We have seen, through Meaningful Use, single-digit engagement rates for View, Download, and Transmit healthcare records. Our focus is doing what’s convenient for the patient.

That started telephonically, and now we’ve extended that to SMS text messaging. A patient has to opt in and give consent. We do it in a secure, encrypted, HIPAA-compliant way. But as Boomers age into Medicare, that youngest cohort in Medicare has a preference for texting versus telephonic engagement. It’s important that we go to where patients want us to go in regards to how they want to engage and communicate.

Does that dispel the notion that older patients are less interested than younger ones in using their phones to help manage their affairs, including healthcare?

Differentiate between phone and what we often think of as a computer. As we age, more and more of us are more comfortable with computers and using smartphones. We certainly see lower engagement levels around technology for older Americans. Data I saw last week shows that smartphone usage in 80-plus people is dramatically lower than 65-plus among ChartSpan’s cohort. It’s still a problem, and it’s a real problem, but it’s becoming less so over time as more and more people age into Medicare. Those people are coming from a world where they had to be able to manage digital tools like smartphones and computers.

You’re focused on a specific Medicare-paid service that CMS could change. How do you position the company accordingly?

We have been working hard on legislation that would remove the barrier of a co-pay. CMS released retrospective claims analysis for two years of CCM billing and it was eye-opening. It showed that for a patient who has been in the program for a year, taxpayers and Medicare save $74 per patient per month. After the reimbursement, they save 41 cents on the dollar, roughly $31 net. Keep this in perspective. There are 63 million Medicare and Medicare Advantage patients, and CMS says 68% are eligible for a CCM program. That’s 43 million patients. Take 43 million times $31 a month and you’ve just cut billions of dollars a year in spending that goes back to Medicare and taxpayers.

Congress is paying attention. There is a bill, H.R. 3436, that we have been working hard on over the last couple of years. We are trying to get this pushed through Congress and we think it has a decent chance this year. It would remove the co-pay. Why are we tripping over pennies to get the dollars? Why are we going to charge a patient $8 when taxpayers save $74? Let’s just save the $66 and move from hundreds of thousands of patients enrolled to millions, and let’s focus on improving at scale outcomes for patients and reducing costs.

We spent the first part of our company’s history focused on one thing, and that was chronic care management. We were deliberate in that. We said until we are truly the best in the world at what we do, we’re not going to expand into any other offering. I don’t know that you ever wake up and look in a mirror, and say, “I’m the best.” But we feel like, certainly from a size standpoint, that we are the largest, and we certainly think we’re the best.

We looked at other opportunities where we could grow the business. Our customers told us over and over that we should focus on Annual Wellness Visits. I didn’t understand that. An AWV seems so simple — a self-reported, 10-minute questionnaire by a patient. There’s no co-pay. How in the world are four out of five Medicare patients walking into the doctor’s office multiple times a year and never getting one of these done? If you look at any ACO, it’s one of their core operational components to do AWVs. It saves, on average, nearly 6% in cost on an annual basis for a typical Medicare patient.

What we figured out was that it had nothing to do with the questionnaire. It had to do with the fact that there was poor technology and poor processes around how AWVs are done. Again, according to claims data, only 19% of Medicare and Medicare Advantage patients got an AWV last year. When we studied that, we saw that there’s a 41% no-show rate for AWV appointments. Candidly, patients come to the doctor when they’re sick, not when they want to prevent something. So if you are scheduling preventative care appointments, you’re going to lose a ton of money in no-shows.

We designed a SaaS-based product that turns a sick visit into a well visit. When the patient comes to the doctor’s office, they’re predisposed while in the waiting room to fill out paperwork. Seize that moment. Give them a ChartSpan AWV. In 10 minutes, they will complete that AWV, which doesn’t interrupt the workflow of the provider and doesn’t put a burden on the practice. They hand it to the front desk. That patient report is either printed or emailed to the patient and the provider report is uploaded into the EHR.

What we also realized around AWVs is that the questionnaire is simple. The thing that’s largely ignored around AWVs is the upstream and downstream data component around that. When I say upstream, I mean that there’s not an AWV in the country that’s checking the HETS database in real time to even know if that patient is eligible. Furthermore, if you’re missing demographic data as so many patients are, there’s no query system that reconciles that missing data and prompts, in real time, the front desk to say, “Hey, we’re missing a Medicare ID,” or, “We’ve got a change of name.” Fix it and then hit the HETS database in real time so that you actually know if that patient is eligible and which AWV code they’re eligible for. We built all that.

On the downside, the real value of an AWV is the aggregate care gap identification data that comes from an AWV. Quality managers are having to figure out, how do I port that into my population health system? How do I make sense of this? We spent a lot of time investing and building the backend data that allows a quality manager to go in and say, “Of all the AWVs today, this week, this month, this year, where do I have care gaps for fall risk assessments?” or whatever the quality measure may be. That data then needs to become actionable at the patient level. We built that as well. It’s a really sophisticated AWV product and we are really proud of it. We don’t think there’s anybody in the marketplace who has anything like what we have.

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