I mentioned in last week’s EPtalk my ongoing healthcare adventures with Big Health System. As a patient, the organization unfortunately continues to provide plenty of material for HIStalk.
It’s an interesting setup there, with the academic medical center and the non-academic hospitals not fully aligned. That leads to somewhat of a “let’s do it separately together” approach to not only the EHR, but operational and workflow elements, too.
The academic side of the house continued to have their act together. I had specifically requested that my skin biopsy be sent to the flagship hospital’s pathology department after hearing about a friend’s disastrous experience at one of the community hospitals. They didn’t disappoint. Pathology was turned around in less than 48 hours and I received a phone call from the dermatology office bright and early on Saturday morning. When I went to look at the report via the patient portal, not only was it there, but also present was a full copy of my visit note and not just the post-visit summary.
The community hospital where I was scheduled for my MRI continued to underwhelm. I showed up at 6:45 a.m. as requested. There was a backup of people waiting to enter the hospital at the COVID screening checkpoint. Based on the predominance of running shoes and scrub pants peeking out from long winter coats, I assumed that many of them were employees arriving for a 7 a.m. shift change.
It would have been useful for the facility to have separate lines for employees and patients to get people more quickly to where they needed to go. No one was standing six feet apart, but everyone was masked, so I guess that’s something. After finally making my way into the building. I noted that at least the line at the coffee kiosk was well spaced, so that was good.
I quickly found my way to the “imaging pavilion,” the name of which made me laugh since it looks like just another hallway branching off in the bowels of the mammoth complex. I’m sure the naming had something to do with fundraising, but a decade after its addition, it just seems silly. The hospital has grown up around it, and once you’re in that part, you still have to snake around to get to the particular area where your study will occur.
Despite my compliance with the pre-registration team’s phone call, they had no record that my file had been updated. I had to answer all the questions again, this time while yelling through Plexiglas to someone who acted like they couldn’t hear me despite the fact that my patient-facing work has made me very good at speaking clearly while wearing a mask. I had to sit for a full 15 minutes, which was annoying since I was the first patient of the day and had arrived at the time they specified. There was no explanation of the delay, and I was somewhat tortured by the overly-loud TV blaring a local morning show.
When I finally made it back to the MRI suite, I noted that they had turned the two curtained changing areas into a single larger one, presumably for distancing. They had rearranged a credenza and chair in the changing area, but unfortunately had not rearranged the herd of dust bunnies and leftover hair on the floor, which kind of grossed me out. I know that hospitals are running on razor-thin margins, but skimping on housekeeping services isn’t the answer.
As I finished changing, they brought in a second patient. That person was using the changing area while I was in the adjacent IV chair, so they got to listen to all kinds of personal questions that I was asked. Starting my IV was challenging, resulting in multiple attempts in which the second patient was the audience for the latter two.
I’ve had this study done numerous times and have never had someone right behind me like that. As a patient, it was unnerving. I don’t expect total privacy, but I do expect that they pace appropriately so that staff doesn’t feel rushed while they’re trying to complete satisfactory IV access.
I was greeted in the MRI room by the team member who was going to do my actual study. Turns out I recently cared for her daughter at the urgent care, so we had a bonding moment. Since this particular MRI study is face-down, they don’t make patients wear masks. We had a laugh when I handed my mask to her at the last minute — the MRI magnet was attracting the metal nose piece, and I felt for a brief second like I was in some weightless space movie as it floated upwards.
The rest of the procedure was uneventful, and I slept through it as planned. Any day the IV works right and you don’t get an arm full of contrast material is a good one. I headed home to await my results.
I usually get a call from the nurse coordinator who manages my program, but this time I got a call from the physician because they’re changing my follow-up protocol. She explained the situation and the next steps and promised to send the information through MyChart. The results arrived more than 24 hours later with this header:
Result Letter: Not Sent Error: The exam failed to generate a default result letter. Please review the exam information and select the correct result letter or contact your helpdesk for assistance.
Just what every patient wants to read, right? I don’t know if the issue was on the part of the radiologist or the physician who called me, but either way it’s a poor user experience and one that patients should not have to deal with. Fortunately, I’m a physician informaticist who understands what this means, but for other patients, it might have generated anxiety and phone calls.
I wonder if the institution explains to physicians how to prevent this, or what things need to look like on their side to make sure the patient gets the right letter. I have the notes I took during my phone call, but that’s it as far as commentary on the results. I also wonder what kind of user acceptance testing is done from the patient perspective, if any. I know of too many hospitals and health systems that never test the patient-side views.
I would be interested to hear how other organizations manage testing for scenarios like this, and whether they’re doing any post-visit quality checks to ensure it’s not a common occurrence. Have you seen this at your institution? Leave a comment or email me.
Ro considers going public via merger with a special purpose acquisition company in a deal that would value the online health, wellness, and prescription delivery company at $4 billion.
Digital health company Sharecare acquires AI solutions vendor Doc.ai. Terms were not disclosed.
Doc.ai had raised $41 million in two seed funding rounds.
Reports from late last week indicated that the deal was underway and that the combined companies will be taken public via a SPAC transaction at a valuation of $4 billion.
Reader Comments
From Library Carrel: “Re: IMedX. The national provider of medical transcription services to hundreds of hospitals had a malware / ransomware attack bring down the entire IMedX Express platform. Hospitals have been down since Monday 1/25 with no projected resolution.” IMedX’s rarely used Twitter account and its webpage do not mention the outage, but BJC’s most recent update at this writing says that IMedX remains down, although it says it’s working with “a vendor” to resolve an IMEdX problem. I’ve seen no mention anywhere else, so I can’t say if this is just a BJC problem or if the issue is IMedX’s problem. I messaged IMedX via their client support contact form Saturday afternoon, but haven’t heard back. IMedX has a lot of customers, so I would be surprised if it’s a national outage that nobody has mentioned on Twitter or websites, which would then suggest that it’s something specific to BJC.
From Cron Job: “Re: Olive. You don’t usually take on a vendor unless their is snake oil involved. What gives with this firm? Of course the EHR vendors would be more than happy if we didn’t use this or any other AI tool since they will have a product ‘soon.’” I have made no comments about Olive, although I have run some that readers submitted. I don’t have an opinion on Olive, other than it’s interesting that they sold check-in kiosks and patient matching solutions under their previous name CrossChx through 2018, then sold that business off to focus on an abandoned internal project that used screen-scraping and macros, with the renamed company claiming to offer “the Internet of healthcare” that will eliminate $1 trillion of healthcare costs. It’s up to the customer to figure out if it offers more than just the usual scripting tool to control other applications and whether it provides ROI. KLAS did an emerging technology profile on the company in September 2019, which I don’t remember reading, so it would be interesting to see how they stack it up against RPA competitors and how customers feel it’s working for them.
From J U Stice: “Re: Darena Solutions. Their so-called free promotion for BlueButtonPro is not really free. They are waiving implementation and subscription fees until 12/31/22. How about a little transparency?” Their FAQ is pretty clear on the terms and it is indeed free, just for a limited period (but nearly two years is a long time in free health IT land). They are gambling that customers who have gone to the trouble to implement their solution will find it worth keeping once the free period runs out, not the first vendor to make that offer.
From Hidden: “Re: HIMSS21 call for speakers. Closed months ago. Looks like you are confusing the open call for proposals for the extra-cost pre-conference symposia.” You are correct, thanks. The HIMSS21 website contains a “Call for Proposals” menu item under “Program,” but that is indeed is for just topic-specific, extra-cost symposia and forums. The general call was open from early October until early November, and those links now jump to the optional events call for proposals.
From Booth Carpet Eye Watering: “Re: HIMSS21. I haven’t heard of some of the companies that are featured exhibitors.” Me neither. We all know Athenahealth, BD, Epic, InterSystems, and possibly Updox, but the names Bravado Health, Podium, Surgical Directions, and Tegria are new to me. I also noticed that Cerner, Meditech, Allscripts, McKesson, IBM, and Microsoft aren’t on the exhibitor list when checking booth locations for the biggest companies.
From Lissome Waif: “Re: Baylor Scott & White. Some of the contractors the employees will be moving to are Atos, Citius Tech, and Health Catalyst.” Unverified.
From SPACMan: “Re: SPACs. With the SPAC craze picking up steam, when will HIStalk get itself acquired by one?” I’m picturing “The Unincorporated Man” science fiction novel that I haven’t actually read, in which every citizen is incorporated at birth with shares sold on the open market (maybe to pay their exorbitant L&D hospital bill), after which the person spends their life trying to finance a share buy-back to gain their emancipation from their owners. I am money-unmotivated and would rebel at creative oversight, so HIStalk will one day have an initially puzzling, then concerning home page that isn’t changing, at which point you will know that I have lost interest or died. Maybe it’s not the most amazing art, but it’s my art, and it will stay that way.
HIStalk Announcements and Requests
About 30% of the three-fourths of poll respondents who use Facebook have debated strangers on Facebook. Rob made a brilliant, pithy observation: “Pseudo-anonymous commenting systems offer the closest thing to public critique of mainstream viewpoints. Just because a great percentage of it it sounds Neanderthal-like does not mean it is bad — it just means you are noticing how dumb most people are for the first time.” I frequently wonder if Facebook users are representative of the percentage of people in real life who are angry, uninformed, or not terribly bright in general. I hold hope, without any evidence, that maybe Facebook just attracts and overrepresents people who have a lot of free time for reasons that appear obvious from their profiles.
New poll to your right or here: Which advance directive documents could your family or friends quickly find if you became medically unresponsive? The process takes quite a few steps: creating the documents, storing them somewhere accessible, making sure the people who will be watching over your care know that they exist and where to find them, and making sure those documents find their way to the hospital and chart. The next step is out of your hands – hoping staff remember don’t do something you don’t want, either from lack of coordination or their insistence on going all-in medically no matter the papers say.
I can’t claim that the results of my HIMSS21 poll are statistically valid given small sample size and unvetted respondents, but for what it’s worth if anything since a reader asked me to run it, it’s nearly an even split among vendors who registered to exhibit at HIMSS20 who plan to have a booth at HIMSS21. Nearly two-thirds of individual HIMSS20 registrants say they won’t attend HIMSS21. The big challenge is that COVID is eating up the clock and available bandwidth and we just don’t know if conferences will return to their longstanding status as must-see TV. The folks who liked HIMSS conferences when crowds were thin, booths were modest, and the after-hours social calendar wasn’t 10-deep with events may see the unlikely return to what it used to be.
Lorre wants me to tell you that she has a rare opening for the Top Spot Banner ad at the top of every HIStalk page. The previous occupant drew a few thousand clicks over a many-month run and the satisfaction of seeing their name first every time they read the site. Contact Lorre.
Welcome to new HIStalk Platinum Sponsor Ascom. The Morrisville, NC-based company – part of the global Ascom — is a communication solutions provider that focuses on mobile workflow to close digital information gaps to support making the best possible decisions. Hospital solutions to overcome poor communication include mobile workflow; noise reduction from device alerts; location services for finding staff, equipment, or patients; and staff security. Its Telligence system can function as a standalone nurse call system or a fully integrated, end-to-end patient response system that can provide access to key clinical content and capture information at the bedside, while TelliConnect Station supports automated staff check-in, efficient clinical workflows, quick charting, and medical device integration. The enterprise-grade, Android-powered Ascom Myco 3 smartphone is designed for healthcare professionals, equipped with a 5-inch Corning Gorilla Glass 3 display, noise and echo cancellation, barcode scanner, LED beacon, and a true hot-swap battery. Its Telecare IP supports senior living communities with caregiver contact, monitored active or passive check-ins, resident profiles, bed sensor integration, a help button, and wander management sensors that can automatically lock doors. Managing Director Kelly Feist, MBA is an industry long-timer who has held executive roles with Siemens, Eclipsys, Sunquest, and Philips. Thanks to Ascom for supporting HIStalk.
I found this brand new Ascom video on YouTube that provides an overview of how its solutions support a high-reliability ICU. It’s one of the most artistic, interesting product videos I’ve seen, a wordless model of “show, don’t tell” efficiency that says a lot in an entirely enjoyable 4.5 minutes.
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
I accidentally ran across last week’s earnings call transcript of Roper Technologies, whose healthcare holdings include Sunquest and Strata Decision. I was surprised that while Strata got a brief mention in the Friday call for its acquisition of EPSi, Sunquest wasn’t mentioned. That seems surprising since they used to talk about it quite a bit.
People
Mike Remmenga (CorroHealth) joins Central Logic as VP of client success.
Announcements and Implementations
Anthem launches Anthem Digital Incubator, which will help early-stage companies that are working on personalized healthcare apps. Participants will be able to use Anthem’s de-identified patient data to validate their technology. The Palo Alto-based organization will apparently report to VP of digital care delivery Kate Merton, who holds a PhD in pharmacology and toxicology and an MBA from Duke.
COVID-19
US case counts continued their sharp decline over the weekend. However, a new IHME forecast predicts that under the best-case scenario, another 200,000 Americans will die of COVID-19 in the next three months. The current death toll stands at 439,000.
CDC reports that 29.6 million COVID-19 vaccine doses have been administered of 50 million doses distributed (60%).
A CDC emergency order that takes effect Tuesday will require masks for passengers of airplanes, trains, subways, buses, taxis, and ride-shares. Transportation operators are assigned the responsibility of making passengers comply.
Former FDA Commissioner Scott Gottlieb, MD says that we now have three effective COVID-19 vaccines, including the Johnson & Johnson one that will be available soon, but FDA needs to streamline the regulatory process so that they can be updated quickly to address new variants, similar to software updates.
CDC’s $44 million, Deloitte-developed VAMS vaccination management system is being used by just nine states, even though it’s free to them, and one of those is moving away from it and another is looking for a replacement. Riverside Health System said it abandoned the system within a week of starting employee vaccination clinics because it was slow and prone to crashing, leading them to use Epic instead.
Massachusetts legislators call for the state to create a single vaccine registration portal and a 24/7 hotline that supports multiple languages. The current system requires looking up locations on a website, then clicking to external websites to sign up and search for appointments.
Florida will implement a statewide, ShareCare-powered vaccine appointment system in taking the program over from overwhelmed county public health departments. The state has also granted grocery story chain Publix – a donor to the governor’s political committee – exclusive rights to offer vaccinations in its pharmacies in some locations, raising concerns that the chain has few locations in poor areas. Florida’s surgeon general also issued an advisory that gives vaccination priority to state residents following a backlash from year-round residents who saw Northern tourists and visiting Canadians taking up all the available appointments.
New York City provides an example of the difficulty in ensuring vaccine equity. New York Presbyterian sets up a vaccination site in a Latino neighborhood, but white people traveled from other parts of the city and state and took most of the slots. A city councilman likens sign-up to “The Hunger Games,” where making an appointment requires a computer, Internet connectivity, and English speaking skills to navigate the required portal.
The mass vaccination site at LA’s Dodger Stadium shuts down for an hour when anti-vaccine protesters who organized a “scamdemic protest” block the entrance, extending the already hours-long wait to be vaccinated.
Sheriff’s deputies secure Legacy Salmon Creek Medical Center (WA) after anti-vaccine and COVID conspiracy theorists, some carrying weapons and gas masks, protest outside the ED that a 74-year-old woman inside was being medically kidnapped. She was being treated for a urinary tract infection and had asked to stay, but refused to be COVID tested or to wear a mask despite having a fever, so the hospital moved her to a quarantine area. Her daughter demanded to see her, refused to wear a mask, and then called 911 when she was not allowed in. A friend of the daughter live-streamed a call for supporters to overwhelm the sheriff’s office with calls demanding the woman’s discharge. Deputies pushed some protesters back out a door they had entered after it was opened to admit an unrelated person who was seeking care. The woman finally changed her mind and decided that she wanted to go home, so she was promptly discharged.
Sponsor Updates
The Sharp Index, in partnership with Medicomp Systems honor Saykara and Vocera with Sharp Index Awards in the category of “Best Health Tech Company to Reduce Physician Burnout.”
Arcadia announces that its healthcare customers have successfully begun nationwide, multilingual COVID-19 vaccination outreach campaigns using Arcadia’s analytics.
Nuance will participate in the virtual SVB Leerink Annual Global Healthcare Conference February 25-26, and in the virtual Morgan Stanley Technology, Media and Telecommunications March 1.
OptimizeRx names Nick Cassotis senior director of sales.
Netsmart releases a new CareThreads Podcast, “How Electronic Visit Verification Impacts Providers.”
CHIME names Nordic Chairman of the Board Bruce Cerullo a Healthcare Hero for his work during the COVID-19 pandemic.
Redox releases a new podcast, “Reproduction & Pediatrics pt 3: Dama Dipayana Co-founder & CEO of Manatee.”
Visage Imaging will sponsor the AI Hackathon during the virtual SIO 2021 February 5.
January 29, 2021Katie the InternComments Off on Katie the Intern 1/29/21
Hi, HIStalk! Hope you all are doing well. This column offers a different perspective, but speaks to working with IT and project management, surviving acquisitions, job termination, and how COVID-19 has paved this landscape of change. Hope you enjoy!
I spoke with Randy Burkert of Asheville, NC. He served until recently as manager of Mission Health’s Center for Innovation in Asheville. His early career was in engineering, but he moved to innovation work in 2013 to follow an interest in healthcare. While Randy did not work directly in IT, he described his job as working closely with stakeholders, IT resources, and tech companies.
Mission Health focuses on advanced medical care in western North Carolina. Randy used his experience with innovative processes, methodologies, and product development to manage the Center for Innovation. It worked to “promote and accelerate innovation opportunities that would have a transformational impact on our health system.”
“A lot of our time was problem seeking,” Randy said. “We successfully identified significant, measurable problems that we needed to be solved, that healthcare needed to be solved, and we went out to solve them.”
Randy’s team worked with vendors to apply solutions to problems. We talked about stakeholders and working with IT teams during this process through the lens of supporting an innovative process. I had little understanding of what “stakeholder” meant and how that played a role in project management, so Randy explained.
“An internal stakeholder is anybody who can provide valuable information relevant to the project that you’re going to work on who in turn will be impacted by that project,” he said.
Identifying stakeholders in a project is a critical first step. As an example, Randy told me of a solution for patients who are injured in hospital falls. The hospital pays those bills, which are not reimbursed by insurance in most cases. A vendor came to the Center with technology to reduce falls for inpatients. Stakeholders were unit managers, nurse leads, and CEOs, along with IT managers. In the early days when Randy worked with IT developers, their focus was supporting operations rather than working on innovation projects.
The innovation department created a devoted group of IT members who worked on multiple projects and had vast knowledge of all things IT. This team acted as a liaison to pull in other resources when needed, Randy said, and that model worked well for the Center.
Much of Randy’s work at the Center was done before Mission Health was acquired by HCA Healthcare in 2019. Randy offered advice about surviving an acquisition.
His first idea is that every employee should have an idea of their worth to the central network of a business. They should make sure their value is tied to that central or core network, as even though healthcare offers several models for innovation, there are greater values in healthcare services, such as a doctor’s services or IT’s problem-solving tech.
In the midst of the pandemic, the Center for Innovation was dissolved. In Randy’s opinion, this was due to innovation not being at the forefront of what the health system’s goals were. He stressed that innovation is important, but operational excellence was of higher importance after the acquisition. Over time, this meant that the Center was no longer essential to the functioning of HCA.
“We were able to operate for a pretty long period of time, but we didn’t know where or how to fit in,” Randy said. “When COVID came along, the financial pressures were significant to the health system, and they were making some tough decisions to cut back anything that was not a core function.”
HCA centralized a lot of roles, including IT support functions. Mission Health was a non-profit, community-run hospital, and HCA Healthcare is a national, publicly traded company. Adapting was tough, Randy said, but the center held on until COVID-19 hit the world.
“Having a dedicated set of resources in an organization that focuses on and drives innovation is a much more effective model,” he said. But, support and dedication are required even at the top level for innovation to be successful. Until that is done, innovation will not be successful no matter where it is.
Because of COVID-19’s impact on the healthcare system, Randy’s position was terminated in October 2020. He is looking for a job in which he can apply his engineering, innovation, and management skillset. He believes that COVID-19 has shown leaders that innovation can help organizations prepare for future disasters. “Technologies that have been around or have been moderately tested or applied or used, such as virtual care, really accelerated,” Randy said. “It has now become the new standard.”
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TDLR; Katie the Intern spoke to a department manager of an innovation center about the importance of innovation and project management, acquisitions, and job termination.
That’s it for this week! I’ll back early February with my first virtual video interview / conversation. Until then, have a great one!
Athenahealth pays $18.25 million to settle federal False Claims Act allegations related to paying kickbacks to increase sales from 2014-2020.
GetWellNetwork acquires Docent Health.
Sharecare acquires Doc.ai.
ECRI lists its top 10 health technology challenges for 2021.
Symplr acquires Phynd.
Best Reader Comments
My take is that more public pricing will mostly affect hospitals that are undifferentiated and not capital efficient. So your-well branded academic system will still attract those with the ability to pay, your ruthlessly cost conscious commercial chain will actually benefit from the public knowing how much cheaper they are, and your community / rural hospital with decent volume already mostly gets the customer who has no other options. It ain’t fun for inefficient hospitals to close, but it also ain’t fun to be price gouged for medical care. (IANAL)
If you have to be short of something, you want to be short of vaccine. We can get more vaccine. I’m confident of that now. Now the converse: You are short of physicians. How long does it take to train a physician? How much money does it take to train a nurse or pharmacist? What are the hurdles you need to jump to open a new PH Office? It’s all difficult, costly, and there are years-long lead times. According to the Milken Institute, there were 133 experimental therapies as of April 2020. There were 49 in clinical trials. Holy cow! We will be up to our eyeballs in vaccines and treatments very soon. I’m guessing by summer 2021. And all those physicians, nurses, pharmacists, and public health offices will be waiting. They will scale up the vaccine rollout like crazy. (Brian Too)
Watercooler Talk Tidbits
A Mississippi man complains to the local TV station that a hospital wouldn’t let him in because he refused to wear a mask. He says he can’t breathe through a mask, wears a bandanna instead, and says he has a doctor’s note explaining his situation, but the hospital says he refused to wear any face covering even after they called his doctor, who said he should have no problem wearing a mask.
Stormont Vail Hospital (KS) defends giving its fundraising board members COVID-19 vaccine by saying that “our team members include our boards.”
Former Athenahealth CEO Jonathan Bush buys the Maine oceanfront home of former environmental lawyer and two-time candidate for governor Eliot Cutler in the most expensive home sale in the state in 2020 at $7.55 million. The 15,455 square foot home features a 5.5 acre oceanfront lot with 650 feet of shore frontage, gymnasium with sauna and steam rooms, heated pool, tennis court, a 4,000-bottle secured wine vault, and a four-bedroom guest house. It was originally listed at $11 million.
Employees of St. Mark’s Hospital (UT) launch a GoFundMe campaign to buy a car for ED environmental services worker and employee of the month Michael Piper, who showed up for his night shift on a freezing New Year’s Day when buses weren’t running after riding his bicycle 37 miles to work.
Athenahealth will pay $18.25 million to settle federal False Claims Act allegations that it paid kickbacks to increase sales of its products from January 2014 through September 2020.
SCP & CO Healthcare Acquisition Company, a health IT-focused SPAC, closes its initial offering for $230 million and will begin looking for one or more companies to absorb.
Athenahealth will pay $18.25 million to settle federal False Claims Act allegations that it paid kickbacks to increase sales of its products from January 2014 through September 2020.
The federal government says the company’s marketing programs:
Provided prospects with all-expense-paid sporting, entertainment, and recreational events, including luxury trips to the Masters Tournament and Kentucky Derby.
Paid customers up to $3,000 for each new physician who signed up after being identified by the customer as a prospect.
Entered into deals with companies that were retiring their health IT products (SOAPware was the biggest such arrangement) to refer their users to Athenahealth.
Reader Comments
From Dirty Martini: “Re: Olive. I interview with them just over a year ago for a solution architect position, which reviews tasks that are candidates for automation and then translates the requirements from the customer to the development. Nothing about their services involved AI and customers could do everything they were proposing with standard Epic enterprise functionality. It’s interesting to see how much they’ve grown, but I’m not confident they have actual AI or will have it in the near future.”
From Dripping Faucet: “Re: Baylor Scott & White. Stay tuned for outsourcing and layoffs.” The health system announced Monday that it will outsource or reassign 1,700 employees in hoping to save $600 million over five years. Two-thirds of those affected will be transferred to third-party partners, while 650 jobs will be eliminated with the possibility of retraining for different positions. The health system didn’t announce those third-party partners, but employees reported that one of them is Atos.
From Pondering Exhibitor: “Re: HIMSS21. Looks like there a lot of available spaces or those labeled ‘HIMSS’ on the show floor. Will you be doing an updated survey to ask vendors and attendees about their HIMSS21 plans? The deadline to cancel booth space is February 4.” That’s just a week away, so I’ll run a special poll now: For those who signed up for HIMSS20 as an attendee or exhibitor, what are your HIMSS21 plans? You can add a comment with an explanation of your decision after you vote. The floor plan shows 401 exhibitors, no keynotes have been announced, and the call for proposals runs until February 24, so it will be a leap of faith to commit without knowing who is presenting and exhibiting, not to mention that COVID limitations are hard to predict these days. I have heard nothing as a member or HIMSS20 registrant, but an exhibitor passed along a rumor today that HIMSS will make some kind announcement about HIMSS21 in the next three days, and given its quietness otherwise, it could be a significant one that will make my poll instantly obsolete.
HIStalk Announcements and Requests
Welcome to new HIStalk Platinum Sponsor Quil. The Philadelphia-based company, which is a joint venture between Independence Health Group and Comcast, is the digital health platform that offers personalized and interactive health journeys to consumers and their caregivers. Quil is committed to educating and engaging consumers, leading to better health experiences and better outcomes, at a lower cost. Quil serves patients, members, and their caregivers in partnership with their healthcare providers and health plans nationally. Thanks to Quil for supporting HIStalk.
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.
Emids acquires software development consulting firm Macadamian.
EHR-integrated patient-specific prescription pricing platform vendor RxRevu raises $7 million in a Series B funding round, increasing its total to $28 million.
Investors are reportedly discussing executing a deal in which consumer health information platform Sharecare would be merged with AI vendor Doc.ai with the combined companies then being taken public at a valuation of $4 billion.
SCP & CO Healthcare Acquisition Company, a health IT-focused SPAC, closes its initial offering for $230 million and will begin looking for one or more companies to absorb.
NextGen Healthcare reports Q3 results: revenue up 3%, adjusted EPS $0.26 versus $0.23, beating Wall Street expectations for both. NXGN shares are up 59% in the past year versus the Nasdaq’s 45% gain, valuing the company at $1.5 billion.
The Cincinnati business paper profiles clinical collaboration platform vendor Halo Health, which just announced new financing and the hiring of its first chief marketing officer and CTO.
Sales
The state of West Virginia will use Everbridge’s COVID-19 Shield Vaccine Distribution – an extension of its critical event management system — to coordinate vaccine distribution and schedule appointments.
UNC Health chooses Medicom Health’s Epic-integrated Rx Savings Assistant solution to notify prescribers of pharma discounts and free trials for their patients.
People
4Medica hires Cynthia McIntyre (IBM Watson Health) as SVP of sales and marketing.
Children’s therapy provider The Theraplay Family of Companies names Fran Spivak, MS, RN (Strive Health) as VP of IT.
Verily hires Preston Simons, MBA (Simons & Associates) as CIO.
Announcements and Implementations
Optimum Healthcare IT will offer its CareerPath health IT apprenticeship program at University of Colorado Denver, giving students three months of health IT training, then hiring them on after completion.
Darena Solutions offers a free version of its BlueButtonPro solution for meeting Cures Act interoperability and patient access requirements.
A new KLAS report on quality management solutions — which includes quality and regulatory reporting, performance improvement and benchmarking, and patient safety and risk – finds that Naunce and Medisolv lead in overall performance, while Conduent users are dissatisfied and the company has backed away from its Juvo product and is again developing the Midas platform. IBM Watson Health has the lowest “would buy again” percentage as users report lack of innovation and the feeling that the company has forgotten them. Premier scores well for advanced users but is seen as being expensive, while Vizient users like its peer-hospital comparison but think the product is cumbersome.
A Black Book population health management poll of hospitals, practices, and payers finds that most expect to spend more for systems and integration, while one-third expect the government to offer incentives for providers who participate in information blocking rule fixes. Some of the PHM system vendors that score tops in customer satisfaction and loyalty are Azara Healthcare, Inovalon, I2I Population Health, Cerner, Datarobot, Casenet Trucare, and Epic MyChart.
Government and Politics
Oki Mek, recently promoted to HHS’s first chief AI officer, shares its AI plan, in which it defines its role as an AI regulator, investor, convener, and catalyst.
The state of Oklahoma rejects a protest from non-profit HIE MyHealth Access Network, whose $19.9 million software bid for a statewide HIE was turned down in favor of $49.8 million offer from Orion Health.
CACI wins a $96 million US Army task order to test, train, and deploy its MC4 battlefield EHR.
COVID-19
CDC reports that 26 million COVID-19 vaccine doses have been administered of 48 million distributed (54%).
A KHN report says that information about who has been given COVID-19 vaccine is only as good as the US’s 64 unconnected vaccine registries, which is to say not good at all since many immunization records are missing race, ethnicity, or occupation that might be useful in monitoring progress.
Seattle’s Overlake Medical Center & Clinics is chastised by the governor for emailing 100 big donors with a link to sign up for invitation-only COVID-19 vaccination even though its public-facing scheduling site showed no available appointments. The email said that the hospital had reserved 500 openings over a week and contained an access code for access. The hospital apologized and said the invitation was a quick fix that followed last week’s eligibility expansion to anyone 65 or over, with the demand that followed overloading its scheduling system. The hospital says it simply contacted the people whose email addresses were on file as an efficient way to open up slots that couldn’t be moved easily to the new scheduling system.
California will turn over its struggling COVID-19 vaccination program to Blue Shield of California, which will oversee distribution and most likely replace the state’s complex vaccine eligibility rules with age-based ones that aren’t dictated by where the individual lives or the jobs they hold. Governor Gavin Newsom had challenged state residents to hold him accountable for administering 1 million doses in 10 days, but two weeks later, found that coding errors and lags in reporting made it impossible to even know how many doses have been administered.
North Carolina’s state hospital association complains to the governor that the state’s Accenture-developed COVID Vaccine Management System is burdensome and ineffective, creating bottlenecks in vaccine delivery. The system, which will cost $7 million through May, does not provide vaccination scheduling or text message reminders as the state’s contract requires. One hospital says it takes 8.5 minutes to upload the data of a single patient, while another reports that a 1,000-shot clinic requires 5-6 nurses to perform data entry for two days afterward since the system requires entry of 14 fields that are required by the federal government and another seven that the state added.
Salesforce announces Vaccine Cloud, which helps government agencies, healthcare organizations, and others deploy and manage their vaccine programs. Provider functionality includes inventory management, staff training, payment, and community communication for notifications and second-shot reminders.
The New York Times columnist Ezra Klein asks public health experts how to prepare for a 50% jump in COVID-19 contagiousness six weeks now because of the B117 variant, which could kill up to 300,000 more Americans:
Increase the use of genomic sequencing to see how and where the virus is mutating.
Don’t reopen restaurants and bars just because recent numbers are coming down.
Avoid total lockdowns and instead get the FDA to speed up approval of rapid, at-home tests.
CDC should give direct guidance on what kinds of masks to wear in various situations and the government should consider distributing high-quality masks.
Other
ECRI lists its top 10 health technology hazards for 2021:
Managing medical devices that are marketed under FDA’s Emergency Use Authorization.
Order entry mistakes caused by accepting partial names of drugs. ECRI recommends populating search fields only after the first five letters of the name have been entered.
Revisit the quick rollout of telehealth to consider patient technology inequalities, user training, integration with other systems, and determining which patients are well suited for telehealth visits.
Review imported N95 masks, especially KN95 masks from China, because they sometimes fail to provide the claimed level of protection.
Avoid the use of consumer-grade monitoring devices in the acute care environment wherever possible, including pulse oximeters, blood pressure cuffs, and glucose monitors.
Review the capabilities and use of UV disinfection devices, which are not usually regulated by FDA.
Assess the capability of medical device vendors to manage the third-party software they use.
Conduct a risk-benefit analysis of AI functionality to make sure that the data a system was trained on is representative of the organization’s population.
Avoid remote operation of medical devices whenever possible in trying to conserve PPE, which can lead to less-frequent patient observation, placing devices where staff can’t see or hear them, and creating tripping hazards from hallway placement.
Employ QA measures and clinician approval of 3D-printed devices.
Sponsor Updates
WellSky-owned CarePort’s Interop interoperability solution is made available in Epic App Orchard to satisfy CMS’s April 30, 2021 Conditions of Participation requirement that hospitals notify a patient’s other providers of ADT activity.
The HCI Group VP of Provider Delivery Will Conaway celebrates two years on the Forbes Technology Council.
MHS will integrate its CareProminence platform with the Healthwise Care Management Solution for health education.
LexisNexis Risk Solutions wins CyberSecured Awards from Security Today in the categories of fraud protection and threat intelligence.
Cerner receives a fourth consecutive perfect score in the yearly Corporate Equality Index.
Optimum Healthcare IT and the University of Colorado Denver partner to offer recent college graduates an apprenticeship pathway to high-paying healthcare IT jobs.
Ellkay features Meditech’s Helen Waters in its Women in Health IT series.
In response to my recent piece about hospital price transparency, Jenn clued me in about Turquoise Health and their pricing website. It’s still in beta and doesn’t have data for my area yet, but comparisons for a neighboring state were pretty easy to understand. It looks like they’re still building their insurance rate database, but their cash-pay display was clear.
A reader also sent some thoughts about the whole transparency situation. He notes that based on some vendor-side experiences, a large number of hospitals seem to be deliberately dragging their feet and don’t want to be the first in their market to show what’s behind the curtain. Either that, or they’re not able to meet all the requirements since many of them assumed that the rule would be killed or further delayed. He notes, “Many will presumably quietly delay until HHS starts embarrassing some folks with bad PR and the compliance / penalty process.”
He goes further to note that the online tool I mentioned in my piece isn’t compliant, since “the Rule requires that a consumer be able to access the pricing info for all contracted payers WITHOUT providing any identifying information or agreeing to anything.” He agrees that third-party aggregators (presumably like Turquoise Health above) will take the machine-readable files and create the equivalent of “Travelocity for Hospital Prices.” I think that’s going to be the best approach that will benefit consumers from an experience perspective, but agree with him that the behind-the-scenes benefit will be when plans and networks and benefits brokers can see the information and use it to drive pricing negotiations.
My reader predicts that price transparency will ultimately lead to hospital closures, as hospitals will no longer be able to “cross-subsidize underfunded services with high commercial rates.” I always love hearing from readers and understanding what’s going on in different parts of the country and this was a great discussion. Rather than watching hospitals close, I’m hoping that health systems will take this as a wakeup call and begin to help lobby for better public health infrastructure and more public funding for early prevention, screening, and treatments so that we can push back against the chronic diseases that are driving healthcare expenditures.
Unfortunately, that approach will erode the profits of hospitals and payers, and some people feel it smacks of “socialism” and we’ll see politics and economics forcing public health into the back seat again and again despite the fact that strong public health measures make good economic sense long-term. The resignations of public health officials across the country due to their COVID-fighting stances has been disheartening. I hope we’ve seen as much of that as we’re going to see for a while. I’ve enjoyed seeing Dr. Anthony Fauci smile again this week, though, so I’ll stay hopeful.
I had another round of healthcare adventures with Big Health System this week. The first was for a physician appointment with their academic faculty dermatology practice. I received my appointment reminder in Epic and completed the online check-in process, which was seamless. I was surprised that they’re not doing any virtual waiting room strategies and that I had to physically come to the office to check in and sit in the waiting room, which is very different than what my practice does. At least the wait was brief and I was impressed by the documentation of the cleaning protocol that was posted on the exam room door. Since this was a dermatology practice, they also had signage explaining how they do a full skin exam in the time of COVID and to keep my mask on — the physician would tell me when to take my mask off and reminded me not to talk when my mask was off.
The second encounter was an unsatisfactory pre-registration phone call prior to an upcoming MRI. Apparently, my data in the system journeyed through a portal to another time and reverted to values from 2018. I just had another radiology study at the same facility less than five months ago, when I updated everything on a lovely paper form that I assume would have been uploaded. Somehow today they had my employer from 2018 listed and the wrong emergency contact. Having been in the CMIO trenches there, I asked what system the registration agent was working from, since they still use another system for some financials and Epic for clinical. She said she was working in both systems, but the data in question was not in Epic. Apparently, they don’t have a bidirectional interface, or no one updated the information provided back in August, or both, so I got to do it all over again over the phone with someone who wasn’t that interested in my responses and wasn’t really paying attention.
She also went through the same COVID screening questions I had just answered an hour earlier, and I asked her to verify that I was flagged in Epic as an emergency doc since this was an issue during some previous visits. She actually admitted that she really didn’t look at the screen because she’s just so used to asking the same questions over and over. When I clarified that yes, I’m regularly exposed to COVID in my work, she replied, “So, you currently have COVID?” and I had to explain again. Here’s hoping she was actually doing what she said she was doing and updating their revenue cycle platform rather than just going through the motions, because I don’t want to have to update everything again at my radiology visit at the crack of dawn on Friday. These were the kinds of issues I enjoyed fixing when I worked there – making the patient experience seamless. I wonder if anyone there even knows it’s messed up, and if they do, whether they really care.
I’m not exactly looking forward to having my molecules magnetically spun, but it is what it is when you’re playing the early cancer detection game. Usually I schedule the test first thing in the morning when I’m tired so I can sleep through it, which the technicians find hilarious since “no one ever sleeps through an MRI due to the noise.” Maybe they just don’t scan enough sleep-deprived urgent care docs to have a good sample size. I figure the first appointment of the day is also good for COVID-prevention purposes.
What’s your strategy for being a patient in the time of COVID? Leave a comment or email me.
Sources say Falcon Acquisition Corp. is in talks to merge with digital health and wellness company Sharecare and startup Doc.ai in a deal that would take the newly combined business public at a $4 billion valuation.
Equality Health, which manages a network of value-based, tech-enabled primary care practices, secures funding from General Atlantic and acquires consulting firm Daraja Services.
Baylor Scott & White Health, the largest not-for-profit health system in Texas, announces another round of layoffs that will see two-thirds of affected workers transferred to third-parties that handle IT, RCM, and other support services.
HHS seeks approval to make its July switchover in hospital COVID-19 reporting systems permanent, which would make the TeleTracking-developed system the standard in replacing CDC’s National Healthcare Safety Network.
Provider management, credentialing, and payer enrollment technology vendor Symplr acquires Phynd Technologies, which offers provider data management software.
The acquisition price was not disclosed. Phynd had raised $11.4 million in funding through a year-ago Series B round.
Symplr parent company Clearlake Capital Group had considered selling the company last July at a valuation of up to $2 billion.
The Phynd acquisition is Symplr’s sixth since Clearlake took ownership in 2018.
Reader Comments
From Long-Time Fan: “Re: Olive. I’ve been bombarded with ads for the company in news feeds, social media, and now a giant billboard. I’m astounded by the scale of their customer and recruitment campaigns and their ability to attract venture capital, but the company seems kind of fluffy and ambiguous. The most specific service I can understand is a claims scrubber, which is nothing earth-shattering. I thought you might jump on the case with an interview or something.” I suspect that an interview would not be fruitful, although I’m willing to talk with CEO Sean Lane, who has a stellar military background but no healthcare experience that I can find. They list a bunch of healthcare customers like Yale New Haven, Centura, and MedStar, so if you work there and have personally seen Olive’s impact and potential whether good or bad, tell me and I’ll keep both you and your employer anonymous.
HIStalk Announcements and Requests
Welcome to new HIStalk Platinum Sponsor LexisNexis Health Care. The Alpharetta, GA-based company helps providers meet interoperability goals and gives patients more control of their health data. It offers the most robust and accurate provider, patient, and member data in the industry. It helps improve patient engagement and outcomes through proprietary linking, claims analytics, SDOH data, and predictive science. The company’s identity access management platform helps protect patient identities and prevent fraud. Thanks to LexisNexis Health Care for supporting HIStalk.
I found this LexisNexis Health Care video that explains best practices for creating a Social Determinants of Health program.
I lose thankfully few HIStalk sponsors, and most of those defections involve companies that have been successfully acquired by another sponsor (I admire this even though it’s depressing losing sponsors). I still fret over the others, who sometimes leave for good reasons (“we don’t have any money”) or bad reasons (the new marketing rep assigned to us has zero industry knowledge and has never heard of HIStalk but wants to look decisive by cancelling). Here’s a win-win for these pre-HIMSS21 times where we’re all just making it up as we go — if your company last sponsored more than a year ago, I’ll spiff you some extra months on your first comeback year. Contact me.
Webinars
January 28 (Thursday) 12:30 ET: “In Conversation: Advancing Women Leaders in Health IT.” Sponsor: Intelligent Medical Objects. Presenters: Tabitha Lieberman, SVP of clinical and revenue cycle applications, Providence St. Joseph Health; Ann Barnes, CEO, IMO; Deanna Towne, MBA, CIO, CORHIO; Amanda Heidemann, MD, CMIO, CMIO Services, LLC. IMO CEO Ann Barnes brings together a panel of female health executives for a results-oriented discussion on how managers and C-suite executives can address diversity and inclusion in their organizations. From STEM education to mentoring and networking, the “COVID effect” on women in the workplace, to matters of equity, there’s no better time to talk openly about these issues to help generate meaningful change in healthcare.
Previous webinars are on our YouTube channel. Contact Lorre to present your own.
Acquisitions, Funding, Business, and Stock
Health IT, supply chain, and consulting company Medsphere acquires Marketware, a developer of relationship management software and analytics for healthcare organizations. Marketware CEO Alex Obbard came to the company from patient relationship management vendor Solutionreach.
OptimizeRx, whose communications platform connects life sciences companies, physicians, and patients, expects Q4 revenue to increase 117% to $16 million.
Sales
RML Specialty Hospital (IL) selects Engage to provide cloud hosting for its upcoming implementation of Meditech Expanse.
The MetroHealth System will implement Montreal-based Tactio Health Group’s CareSimple remote patient monitoring solution, integrated with Epic.
People
Fern Health, which offers employers a digital platform for chronic back and joint pain, hires Brad Lawson, MBA (Marshalsea Health) as CEO. He replaces Travis Bond, who has joined dementia risk prediction technology vendor Altoida as CEO.
The Chartis Group promotes Catharine Wilder to VP of practice operations.
Interlace Health (fka FormFast) promotes Allison Reichenbach to president.
Lumeon names Tom Zajac as executive chair of its board.
Announcements and Implementations
Consulting firm ReMedi Health Solutions assists a Northeastern health system with a virtual Cerner go live across 23 facilities.
Halifax Health (FL) implements Pure Storage’s FlashArray to ensure the stability of its Meditech system during natural disasters.
The AMA’s technology development subsidiary AMA Innovations and Onyx Technology will develop a FHIR-based messaging solution to connect providers and social care networks, which it will enter in an HHS social care referral challenge.
A new CoverMyMeds report finds that 65% of patients have been impacted by the pandemic, 36% skipped medications and treatments to pay other bills, and more than 40% either diverted payments for essential items for prescriptions or stretched their prescriptions by taking fewer or smaller doses than were prescribed. Most asked their provider about price and affordability options and 43% checked a pharmacy price comparison app when a prescription cost more than they expected.
SOC Telemed launches a TelePulmonology consultation service through its Telemed IQ on-demand telemedicine platform..
A new CHIME-KLAS white paper on EHR interoperability finds that deep interoperability is progressing but still too low and most vendors have improved their ability to connect with outside EHRs. However, cost remains the most frequently identified provider barrier, especially in smaller health systems. The highest-valued interoperability method is public HIE, but that is followed closely by national networks and direct messaging. Use of FHIR APIs still lags proprietary APIs and mostly involves customers of big EHR vendors using them to exchange patient records and to support clinician and patient tools. Respondents identified deeper patient-record exchange and population health as the most-needed use cases in the next 2-3 years.
COVID-19
HHS seeks approval make its July switchover in hospital COVID-19 reporting systems permanent, which would make the TeleTracking-developed system the standard in replacing CDC’s National Healthcare Safety Network.
Several industries and companies are developing vaccination passport apps without national or international coordination, leading to the possibility that an individual might need to install and maintain several for specific purposes. Questions are also coming up about how to get electronic vaccination information into those systems without the possibility of fraud since the only official patient record in the US is a handwritten paper card.
Philadelphia’s health department ends its partnership with Philly Fighting COVID, the overseer of its largest vaccination site, after discovering that its registration website is operated by a recently formed for-profit arm whose privacy policy does not precluded disclosing the information of those who sign up. The site says the information entered by users – 60,000 of them so far – is shared with the city’s Health Department, which denies involvement with the site. Philly Fighting Covid originally performed COVID-19 testing, but quickly shut those locations down and cancelled appointments when it was chosen to administer vaccine. The organization was reported to have given shots to anyone who signed up regardless of their assigned priority. A nurse claims that the CEO of both organizations, 22-year-old Drexel graduate student Andrei Doroshin who has no healthcare experience, took vaccine vials offsite to administer to private individuals, while a vaccination site volunteer said teenaged students were vaccinating each other and taking photos as the clinic ended. Doroshin also lists himself a filmmaker, an executive with a cell therapy company, a resort developer, and manager of an investment company.
CDC Director Rochelle Walensky, MD, MPH says that the federal government doesn’t know many doses of COVID-19 vaccine it has on hand, leaving state health officials to work blind in setting up vaccination sites, scheduling staff coverage, and issuing appointments without knowing how many doses they will receive.
A VA study finds that the mortality rate of COVID-19 patients in the ICU doubled when the unit was overloaded with coronavirus patients.
Google will donate $150 million to help promote COVID-19 vaccine education and equitable distribution, and will incorporate vaccination clinic locations and details in its Search and Maps tools starting with Arizona, Louisiana, Mississippi, and Texas.
The CEO of casino operator Great Canadian Gaming Corp. resigns after he and his wife were caught flying to Yukon Territory, skipping the mandatory self-isolation, and posing as motel workers so they could jump the COVID-19 vaccine line.
Other
A longtime resident of Tiny Township in Ontario makes a $5 million donation to its Georgian Bay Hospital, $1 million of which will be used to upgrade the hospital’s record-keeping to Meditech Expanse.
Corporate therapists say that remote workers who use social media-resembling tools like Slack all day exhibit the same “mix of hyper-engagement and lack of empathy” as they might on Facebook. Company cultures are being lost as remote workers use company time and tools to argue politics, bully each other, ignore requirements to turn on their webcams during video calls, confront management, and spend their day chatting constantly in ways that might alienate older workers who were not raised sharing their whole lives electronically. Employment lawyers urge employers not to let use of online tools get out of hand to avoid lawsuits, offended co-workers, or unfair performance reviews.
Sponsor Updates
Healthcare Growth Partners advises Symplr in its acquisition of Phynd Technologies.
The UpTech Report features Saykara CEO Harjinder Sandhu.
Agfa HealthCare releases a new case study focused on enterprise imaging’s role in personalized, end-to-end care for cancer patients at IFO in Rome, Italy.
CereCore recognizes 13 team members with its annual Rock Solid Award.
NEJM Catalyst features the Arizona Surge Line and its innovative use of Central Logic technology to coordinate public health services across the state.
Cerner donates 100 laptops to Kansas City students.
Change Healthcare releases a new podcast, “The Policy Connection: Healthcare Policy and the Road Ahead for States.”
Clinical Architecture names Morgan Johnson to its Team Services group.
Hunt Scanlon includes Direct Recruiters on its list of “Top 40 Cyber Technology Search Firms.”
Divurgent releases a new podcast, “The Integration of Music Therapy in Biotechnology.”
Former health IT executive Tom Zajac joins Lumeon’s Board of Directors as executive chairman.
SOC Telemed adds tele-pulmonology consulting services to its Telemed IQ platform.
CoverMyMeds publishes the “2021 Medication Access Report.”
Wolters Kluwer Health launches Lippincott Connect, an interactive digital medical textbook.
Health IT, supply chain, and consulting company Medsphere acquires Marketware, a developer of relationship management software and analytics for healthcare organizations.
Google will donate $150 million to help promote COVID-19 vaccine education and equitable distribution, and will incorporate vaccination clinic locations and details in its Search and Maps tools.
Lewisville, Texas-based Post Acute Analytics will use a Series B funding round to expand its management team and further develop its AI-powered analytics for care coordination in the post-acute space.
January 25, 2021Readers WriteComments Off on Readers Write: How COVID-19 is Driving Innovation in our Behavioral Health System
How COVID-19 is Driving Innovation in our Behavioral Health System By Eric Meier
Eric Meier, MBA is CEO of Owl Insights of Portland, OR.
Our nation was facing a behavioral health (BH) crisis even before the COVID-19 pandemic. According to the National Institutes of Health, 51.5 million American adults were living with a diagnosable mental illness in 2019, with fewer than half having received treatment in the previous year. Interestingly, the Commonwealth Fund reports that as of mid-November, 2020, “states with the lowest infection rates per capita are Medicaid expansion states, where there is better access to care and providers.” Non-expansion states were suffering the highest rates per capita. This highlights one of the biggest issues in BH: lack of access.
Now enter COVID-19 and the crisis has escalated exponentially. In a July 2020 poll conducted by Kaiser Family Foundation, 54% of all adults in the US said the pandemic had negatively impacted their mental health. This is up from 32% from just four months earlier. A survey by the CDC supports this finding. It reports that the number of adults in the US suffering from an anxiety or depressive disorder has quadrupled since before the pandemic. Experts now predict that the economic fallout from COVID-19 may cause tens of thousands of additional deaths by suicide or drug abuse in the years to come. In an article published by The Kennedy Forum, former US Representative Patrick J. Kennedy warns that the pandemic has unleashed “a new wave of mental health and substance use disorders in the US.”
Times of crisis often highlight weaknesses in existing systems. An article published by Harvard Business Publishing says, “The places where things could be done better or more efficiently become glaringly obvious. All of a sudden, opportunities for innovation are staring us in the face.” Telehealth is a prime example. The rollout of social distancing requirements was one of the first challenges brought about by the pandemic. Providers scrambled to implement virtual care technology and associated processes in order to keep themselves, their staff, and their patients safe. Because of recent surges, telehealth is still in use. But not all telehealth solutions are the same. To be effective, providers need more than just a video app, especially when treating individuals with BH whose conditions are often more complex than individuals with non-BH conditions where screening and triage are more straightforward.
This is where innovative BH technology shines, by helping providers perform systematic screening via integrative telehealth solutions across all BH conditions, allowing them to proactively identify, diagnose, and treat those at risk through evidence-based practices. Providers can better match treatment to each patient’s unique symptoms, medical history, social determinants of health, and comorbidities. Not only does this produce improved outcomes, it also helps reduce gaps in care and provides more efficient care pathways.
How innovative BH technology improves the effectiveness of remote care:
Provides actionable, evidence-based outcomes data within the telehealth session.
Collects patient outcomes in advance of a telehealth visit to target treatment.
Supports telehealth billing by providing clinical documentation.
Screens patients and their care team members before or during telehealth visits.
Provides access to additional distress and anxiety measures relevant to the BH impact of COVID-19.
Remotely identifies patients who are not responding, deteriorating, and require immediate intervention.
Innovative BH telehealth technology gives providers the ability to easily screen, track, analyze, and guide treatment while enabling patient reported outcome measures (PROMs) and enhancing clinical confidence.
COVID-19 has had a devastating impact on all populations across our country and experts agree that the mental and economic fallout could last for years to come. Now that mass vaccinations are underway, we can finally see the light at the end of the pandemic tunnel. Healthcare systems and community organizations must act now to implement technology solutions that can help scale resources to meet the urgent needs of a quickly expanding population living with BH conditions. The bottom line is that we would be greatly remiss to allow ourselves to revert to the “old normal” of pre-pandemic BH. This is our chance to make lasting change and innovation will lead the way.
Comments Off on Readers Write: How COVID-19 is Driving Innovation in our Behavioral Health System
Many of my healthcare IT colleagues are deeply involved in their organizations’ COVID vaccine administration efforts. They’re involved in creating pre-registration and wait list systems, running analytics to determine who should be invited to receive a vaccine next, managing outreach efforts, then scheduling those patients. It’s a massive effort that, like many IT projects, can be subject to external disruptions.
One of our local health systems just went through a massive cancellation of vaccination appointments after they received fewer doses from the state than they anticipated. The sheer volume of appointments that had to be canceled and rescheduled created havoc. As their API-driven chatbot was reaching out to patients to offer them new appointments, it was creating temporary locks on the appointment slots that were being offered, which is standard when you’re doing scheduling outreach. However, the magnified consequence of trying to reschedule thousands of patients at once prevented the call center from being able to reschedule anyone else, including patient-facing healthcare providers who were needing to also reschedule after missing vaccine appointments while awaiting negative COVID tests.
The answer to the latter problem became decidedly low-tech, with the system standing up a temporary walk-in vaccine clinic to accommodate the healthcare providers with its remaining available doses. A Google Doc was used to keep track of the employees who were approved to come to the clinic and what time they planned to come, so that the vaccination team could coordinate with the call center to ensure that the correct number of doses were available real time. Since they weren’t running the public-facing vaccine clinic, they had a surplus of workers who could handle the manual scheduling, but the fact that the situation arose at all shows how much difficulty the US is having with the last mile of vaccine distribution.
With recent stories about vaccine spoilage due to temperature issues, those running the vaccination operations could learn from their IT colleagues. A Veterans Affairs hospital in Boston recently had a freezer failure from multiple contributing causes. First, a pipe burst leading to a water leak in the building, which led to the arrival of a cleaning crew who had to move a freezer to get to some standing water. The power cord for the freezer apparently wasn’t properly secured to the freezer, causing it to disconnect. Then the freezer’s alarm system didn’t function properly, which coupled with the lack of daily monitoring, led to the loss of 1,900 doses of vaccine.
The VA is still investigating why the alarm failed, but proper daily human monitoring could have saved the vaccines since the freezer was unplugged for several days before being discovered. Any small-practice primary care physician who has had to maintain thousands of dollars of vaccine inventory knows that even though you have thermometers with alarms, you still need to have someone check the logs daily and document the ranges. It’s shocking that a larger organization that is responsible for such a precious commodity didn’t have the right processes in place. However, based on some of the IT failures I’ve seen over the last several years, I’m not surprised.
Many healthcare organizations have complex automated backup systems and sophisticated disaster recovery systems that promise a rapid fail-over to sustain clinical operations. However, they may not test them often enough, and some organizations don’t test them at all. We’ve all heard horror stories of clients who went to restore from a backup, only to find that the backup contained no data or was corrupted in some way.
We’ve also encountered the unforeseen. Early in my career, a car that was involved in a police chase crashed into our hospital’s data center, which led to a small fire, which led to discharge of the fire suppression system and a complete shutdown of the building. There was a failure of the network switches that should have rerouted everyone to the disaster recovery site as well, which led to a multi-hour outage since no one could get in there to see if they could switch things manually since the building was now a crime scene. I’m sure “what if the building becomes a crime scene” was never in the minds of those who designed the downtime policies and systems, but you can bet it’s on the checklist for my consulting clients.
Organizations may also be missing physical safeguards that are needed for their systems to be effective, like the VA hospital’s freezer was missing a couple of screws that could have prevented the vaccine loss. I worked with a client not too long ago that thought they were creating nightly backups of their system. They were using removable hard drives as the media. An employee would come in every morning and disconnect the drive, place it in a manila envelope with the date, then pull the oldest backup drive and connect it to the system. They failed to lock the door to the data room consistently, however, resulting in the disappearance of the box full of envelopes and drives.
As I tell these stories, I feel a bit like a Monday-morning quarterback. However, except for the crime scene part, the preventive maneuvers for these situations are already well documented. HIPAA requires a Security Risk Assessment where covered entities must look at physical, administrative, and technical safeguards for protected health information. Participation in federal and state vaccine programs requires signing agreements on vaccine storage and accountability. Although there were technical failures in the situations above, the human error component is strong as well.
This story out of Boston isn’t the only vaccine loss story out there. Much larger losses were recently documented in Maine and Michigan. The COVID vaccine is such a scarce commodity. If I were in charge of an organization that was a vaccinator, you can bet that I would have daily touch points with the leaders involved to ensure accountability and that systems were in place to approach zero waste. Every dose that doesn’t go to someone who wants it is a tragedy in the making.
My parents and elderly relatives are scheduled for vaccines over the next two weeks. I’m crossing my fingers that they don’t get caught in one of these situations. Based on the horrors I see in my clinical role, I’ll be holding my breath to some degree until everyone in my family is fully vaccinated.
How does your organization approach disaster recovery planning? Do you have plans in place if you need to execute a massive rescheduling operation if vaccines are lost or delayed? Leave a comment or email me.
I’m a pediatric cardiac anesthesiologist at Arnold Palmer Hospital for Children in Orlando, Florida. I take care of babies and children that have congenital heart defects when they have heart surgery and any other type of surgery.
How is the Ease app that you developed being used?
It has been quite a remarkable journey for us. We created this from the need that, as anesthesiologists, we are the last person to take family members to surgery and away from their loved ones. We thought it was pretty barbaric the way that families are being ignored, whether they were just getting a phone call once in a while or maybe never when their kids or their adult loved ones were off to surgery, or had a board that they were looking at that didn’t tell any information.
The app is used universally in any location. We made it nimble and user-friendly for not only the families, but also the nurses. It fits in well with their clinical workflow and with the physician’s workflow. It has become an efficient way for us to communicate. You could be communicating with a loved one while I’m talking to you right now — via text or even a photo or a video or something like that — and it wouldn’t disrupt your workflow. We wanted to bring in the modern way of communicating from our world into a HIPAA compliant and secure way to do it in healthcare.
You see that moment on TV or in movies where the surgeon dramatically enters the waiting room full of anxious family members. How is the mindset different for the surgical team when they have the ability, and maybe then the responsibility, to provide regular updates to family members who may not be in the same city or even the same country?
We are all so connected now, whether it’s online or otherwise, that we are ready for instant information and instant gratification with knowing what is happening with our loved ones. We can track our package from Amazon, so why can’t we track our loved one’s progress and know what’s going on?
When you talk about the care team, there are two aspects. There’s the surgeon and anesthesiologists, then the nurses. Vocera Ease is the modern way of communicating. It is a non-disruptive and it doesn’t bother their workflow. A nurse is used to taking essentially a snapshot or a barcode on the patient’s wristband and scanning it and getting a medication. We created the app to be the same way, so that whenever the patient or the nurse wants to send a communication, they scan a wristband and send off the message. That could be from the surgery or medical floor, because the program is now in the ICUs, medical floors, radiology, the cath lab, and obviously surgery, where it was born.
It’s a non-disruptive way for the nurses to communicate. Previously, if they were able, they would have to stop what they were doing, get on a phone, and call the families. Sometimes they answer, sometimes they don’t. Then have a two-way conversation, which can be disruptive. The surgeon might go out to the waiting room and the families aren’t even there.
You alluded to the fact that we have so many loved ones in other states and other locations who can’t be there. The great thing about Vocera Ease is that it sends one-way messages from the clinicians out to the family members that give them a step-by-step story of what happened, whether it’s on the floor, in the ICU, overnight, or in surgery. It is a remarkable way to communicate and increases efficiency. When those surgeons go out to the waiting room, the families already know what happened, so it’s a short, efficient conversation. The surgeon can move on to whatever is next in their busy schedule.
Do the messages go beyond simply “we’re starting anesthesia” or “we have made the first incision?” I can see where it might be dangerous to convey conclusions early in a procedure.
We reflect milestones. Let’s say your wife or your loved one needs surgery. First, there’s the emotional impact of, “Oh my gosh, they’re going to have this.” Then the surgeon will tell you in their office or wherever preoperatively, “These are the steps of what’s going to happen as it happens.” The day of surgery, you meet your anesthesiologist, who tells you, “This is what I’m going to do. I’m going to take you there. I’m going to give you some IV medicine and get you off to sleep,” et cetera. The patient and family members have a vague idea of what there is, and that vague idea can become fearful when you don’t understand, you don’t see what’s happening, and you don’t have that checklist of what’s happening.
Ease allows them to receive these one-way communications, such as “The patient is in the operating room” with maybe a little picture with a thumbs-up before they fall asleep. Then we will send them, “The patient is safely under anesthesia. Bill is now prepped and ready for surgery and Dr. So-and-So is about to walk in.” When Dr. So-and-So is scrubbed and over the drapes, we might take a little picture of him about ready to start. Then if it’s an orthopedic procedure, we might take a picture of an x-ray and say, “This is the fractured hip. This is what’s going to be repaired.” Then we can show after the fact that the implant is in place and the repair is in place. They have a vivid understanding of what’s happening as it’s happening.
Does Ease offer advantages over consumer video tools such as FaceTime to help families communicate with their loved one who they can’t visit because of COVID precautions?
Ease is literally created for something like what the pandemic has brought about, which is communication with people who are unable to be in the hospital. The operating room or the ICU are isolated areas don’t offer much access and don’t have a lot of information coming out of them. Now the entire hospital has become like those areas with COVID and visitor access restrictions. We have put Ease in these locations and added — beyond one-way communication via text, pictures, and videos — a FaceTime or video chat feature, where there can be two-way interaction.
Ease is HIPAA compliant and HITRUST certified. We set the standard for what security should be in this kind of communication, and we were the first to be able to do it. We are proud of what we were and how we could position our solution to help families out during this time of crisis. Out of necessity, hospitals started using Zoom, WhatsApp, and all these non-secure ways of messaging that they never would have done in an era outside of the pandemic. With Ease, they can do that safely and securely.
What IT technologies do you find most impactful or useful to your practice?
It depends on the problem that you are trying to solve. When it comes to communication, which is what we were focused on, anesthesiologists are in the perfect position to solve this communication issue from the operating room. I have to balance the patient’s safety, making sure that the environment for the surgeon is correct for them. I even talk to the nurses a lot to communicate how we send the family about this, that, or the other to let them know what’s going on. It’s quarterbacking everything to give the surgeon the right environment so that they can operate and do what they need to do. In that milieu, I think it was perfect for us to — my partner and I, Dr. Hamish Munro — to come up with the Ease solution for solving the communication problem and using healthcare IT in that way.
We have many health IT initiatives that we are using now in the operating room, whether they be just simple things like timeouts and keeping track of things. The EMR has become such a useful tool to help us with that. But this one problem with communication wasn’t solved until we brought our solution on board.
You created a health IT product and company and then successfully sold them. Will you get involved in other health IT projects?
I would love to be involved in something like that. We created a team. My partner Dr. Munro and I came up with the idea together. Then my brother Patrick became the CEO of our company. He has an MBA, a background in IT, and was an administrator at a hospital before that. These talents came together. We created a team that can foster new ideas.
With my background in medicine, that would be an amazing thing to see. I don’t have any idea just yet, but I love thinking about different solutions we can find, thinking about problems with the environmental impact of hospitals and how we can help that. That’s where my brain is going, but we’ll see where it goes. It’s an exciting time to help find solutions to problems that have been around for a long time, or that are just starting to come to the surface.
Are you still involved with the product under Vocera?
Yes. I’m a clinical consultant for them and I help them out with anything that they need with regards to the platform.
Do you have any final thoughts?
In the journey we’ve had with what is now Vocera Ease, from eight years ago to today, it was about finding a strong problem and then putting the components together to find a solution for it. One-way communication via text, video, and pictures is the perfect way to communicate outside of healthcare because it’s non-disruptive and gets things out there, so how do we go about this? Let’s go read about HIPAA. Let’s go read about HITRUST. How do we create apps? Everybody downloads apps, everybody knows how to text.
From there, you start creating the solution to the problem, as opposed to creating the solution and then trying to find a problem to fix. It was created from a place of empathy, from a place of need. We saw these poor family members struggling when they weren’t with their kids who were in the NICU for a long time or they were in surgery. It’s important to find that strong problem and then hopefully an elegant solution to fix that problem.
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ONC opens a challenge project to create realistic patient data for the open source Synthea synthetic health data engine.
Synthea creates simulated lifelong health records that can be used by developers and researchers to support patient-centered outcomes research while they are waiting for access to real clinical data.
Up to six winners will be chosen for prizes of $10,000 to $50,000.
Reader Comments
From Maybe Going: “Re: HIMSS21. No registration page yet?” The conference site says that registration will open in January. The latest entry on the “Conference News & Announcements” page is from five months ago. We are just over six months away from the scheduled start of HIMSS21. HIMSS22 is scheduled for seven months later in March 2022 in Orlando.
HIStalk Announcements and Requests
Most poll respondents who have worked for an acquired company say their jobs got worse afterward.
New poll to your right or here: Have you argued with, criticized, or publicly disagreed with someone on Facebook who you have never met personally? Background: I don’t understand the perceived benefit of arguing publicly online and I can’t identify with how someone’s political or social beliefs can be so defining to their self-worth that they need defend them to faceless strangers, but Facebook fight-picking seems to be everybody’s favorite pastime. Mrs. HIStalk sometimes gets worked up over some clearly stupid or trolling comment and wants to respond, but I always provide my unsolicited advice: (a) you’ve never had your mind changed by a stranger’s Facebook comment and neither has anyone else; and (b) do you really want to spar with some keyboard warrior who can find our address from your name? I would consider social media to be a place for thoughtful discussion only if (a) everybody had to register with one and only one account using their validated name and address; and (b) I could click any comment to mute the author permanently.
I’m puzzled at why I’ve seen the city of “St. Louis” – its legal name – spelled out several times in the last week or two as “Saint Louis” by folks whose tendency seems to be to erroneously shorten rather than lengthen words (“Saint Louis University” is correct only because it is named after the actual saint and not the city). The city’s pronunciation is equally vexing – it should be “loo-EEE” given that it was named by French speakers who were referring to their king, whose delight would probably be diminished upon hearing that ‘Murcans mispronounce his name as LOO_us. Even the state’s name is illogically converted by some residents to Missou-ruh. It’s interesting that we choose names from other languages, but then mispronounce them intentionally or otherwise to make them uniquely ours (see Texas, just north of “I see an X so I’m saying an X” Mexico).
It’s a slow-to-no news day compared to the usual HIMSS-focused seasonal burst of PR activity. Enjoy the few minutes you will save as a result.
Webinars
January 28 (Thursday) 12:30 ET: “In Conversation: Advancing Women Leaders in Health IT.” Sponsor: Intelligent Medical Objects. Presenters: Tabitha Lieberman, SVP of clinical and revenue cycle applications, Providence St. Joseph Health; Ann Barnes, CEO, IMO; Deanna Towne, MBA, CIO, CORHIO; Amanda Heidemann, MD, CMIO, CMIO Services, LLC. IMO CEO Ann Barnes brings together a panel of female health executives for a results-oriented discussion on how managers and C-suite executives can address diversity and inclusion in their organizations. From STEM education to mentoring and networking, the “COVID effect” on women in the workplace, to matters of equity, there’s no better time to talk openly about these issues to help generate meaningful change in healthcare.
Previous webinars are on our YouTube channel. Contact Lorre to present your own.
Announcements and Implementations
Eighteen hospitals of Steward Health Care complete their virtual implementation of a regionally shared Meditech Expanse EHR.
Divurgent launches a Virtual Patient Support Solution to help providers manage COVID-19 vaccination scheduling calls.
A Mass General / Harvard Medical School study that was performed using real-world data from the TriNetX global health research network finds that people who have autoimmune or immune-suppressing rheumatic conditions are less likely to experience severe COVID-19 outcomes. The authors, who reviewed the de-identified information of 8,500 patients, also noted that the death risk to those patients remains substantial at 5-6% within 30 days of diagnosis.
Beverly Knight Children’s Hospital goes live on Vocera Ease for connecting parents with their NNICU babies. Employees applied for and received a Pampers Bright Beginnings NICU Connectivity Grant to fund the project.
COVID-19
Sunday’s COVID-19 hospitalizations in the US dropped to 110,628, new deaths to 1,940, and new cases the lowest other than on Christmas Day since December 1 at 142,949. The numbers are likely retreating after holiday-caused spikes, but the lull may be temporary as the B117 variant increases in prevalence. The US death count is at 417,000.
CDC reports that 20.5 million COVID-19 vaccine doses have been administered of 41.4 million distributed (50%). The federal government says that vaccine availability won’t improve until April due to manufacturing capacity, so experts urge the government focus on fixing state and local vaccination center problems that can’t even get existing limited supplies into arms.
The New York Times warns that the US should learn from Britain’s experience of hospitals becoming overwhelmed with patients, partly driven by the more contagious B117 coronavirus variant. One example is overloaded liquid oxygen pipes, caused by the use of high-flow oxygen for COVID-19 patients in trying to avoid the use of ventilators. The article also notes that hospitals have been reluctant to delay elective procedures, causing staff burnout, and quotes doctors who worry about how COVID survivors can be rehabilitated.
Sponsor Updates
OptimizeRx will present at the B. Riley Securities 2021 Vision Day Virtual Conference January 28.
PatientPing publishes a new white paper, “CMS Direct Contracting: Preparing for the New Model & How to Succeed with Real-Time Data.”
Arcadia congratulates Micky Tripathi on his new leadership role as National Coordinator for Health Information Technology with the Department of Health and Human Services.
TrustRadius has recognized Pure Storage’s FlashArray for Best Customer Support and Best Usability.
Relatient publishes a new case study, “The Warren Clinic Leverages Epic and Relatient to Distribute COVID-19 Vaccines.”
Spirion will host a series of virtual events January 26-28 in support of Data Privacy Day.
MD Tech Review names Zen Healthcare IT a “Top Healthcare Interoperability Solution Provider of 2020.”
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