Katie the Intern 1/22/21

Hi, HIStalk! This week’s column is a Q&A with Kyna Fong, PhD, CEO and co-founder of Elation Health. This is the first column I’ve conducted in a written question and answer format. We touched on Elation Health, the evolution of primary care, COVID-19’s long-term impacts, and more. This column is a bit longer than usual, but I hope you find it to be an impactful and insightful read!

Dr. Fong’s journey with healthcare began at a young age, as her father served as a physician in Canada and the United States. As a teenager, Dr. Fong helped with in-house clinical services, which inspired her to become an assistant professor of economics at Stanford University. She and her brother then started Elation Health to deliver technology for independent primary care practices. 

Elation Health is a platform for primary care success, serving over 15,000 clinical users for their data management. The EHR is a collaborative, clinical-first system that supports physicians by managing clinical workflows, practice management, patient experience, and quality care. 

“Clinical-first is the radical idea that the quality of patient care matters and that supporting physicians is the path to that quality,” Dr. Fong said. “Our systems aren’t about upcoding, billing, and RVUs at the sacrifice of care. They’re about strengthening the patient-physician relationship and enhancing the craft of primary care.”

I asked Dr. Fong about technology that goes into running an EHR with a clinical-first outlook. Elation is a SaaS or cloud-based platform that relies on internet access. APIs (application programming Interface, noted) work behind the scenes to run data analytics and visualize information in real time. Dr. Fong said that Elation keeps the technology behind the scenes so users can focus on quality primary care. 

From Dr. Fong’s perspective, primary care and its evolution is the future of healthcare, and healthcare IT and holds the key to unlocking sustainable healthcare in the US. She cited studies that prove good patient-provider relationships lead to reduced healthcare costs and better livelihood. In this 2016 study, “Gordon and Beresin asserted that poor outcomes flow from an impaired doctor-patient relationship.” This understanding also leads to the conclusion that better healthcare relationships save time and money.

“That relationship drives reduced hospitalizations, less duplication of procedures, fewer medical errors, better prevention, increased chronic disease reversal, and more family involvement and trust in health decisions,” Dr. Fong said. 

The application of primary care is becoming more digital every day, growing at an exponential rate through telehealth’s application due to COVID-19. But not every area of the United States has been able to keep up with this digital move. Rural areas often have a higher population of underserved communities, and mom-and-pop healthcare practices are the only services available for miles. Dr. Fong says traditional EHR vendors require significant resources and technical support to successfully implement their services, and without large subsidies (which usually go to larger health systems), rural clinics struggle comparatively. Improving access and providership to underserved areas is important to assist rural practices in making the much-needed move to digital care. 

“These practices are so deeply invested in their communities,” Dr. Fong said. “Our goal is not only to see them survive, but to help them thrive, be recognized for high-quality patient care, and be paid what they deserve.” She believes that these underserved areas host tremendous opportunity for improvement, and with support, can begin to play catch-up in their digital development. I asked Dr. Fong what could be done to support rural areas and health systems in the switch to electronic records and how long would this take. 

In Elation and Dr. Fong’s experience, the answer lies in asking providers what they need and how they best tailor healthcare application to their communities. She said most rural providers and systems want “a healthcare structure that recognizes they are small businesses and not mini hospitals.” They want a system that reduces administrative burdens, offers purpose-built technology that is easy to develop and implement, makes data sharing and collaboration with larger systems easier, completes parity in pay for both in-person and digital / virtual healthcare in the pandemic, and offers support and pathways for moving to value-based care. 

The move to value-based care is also part of the problem in the evolution of primary care. Urban areas can sometimes have an easier time moving from FFS to VBC, but Dr. Fong tries not to see rural versus urban settings in this case. She views the challenge as being “more from the limited resources available to a small practice versus a large system, and the heavy financial and technical lift required of many health IT vendors’ legacy solutions to support alternative payment models.” Dr. Fong noted that smaller practices have a harder time getting the attention of payers to be able to invest in the shift to VBC. But for both large and small healthcare systems, monetary struggles and unmet incentives (such as reimbursement for VBC) can often hinder the move from a comfortable FFS model. 

As seen throughout the pandemic, the move to digital care can be done quickly and effectively. COVID-19 has in some ways leveled the playing field for the move towards value-based care. Primary care providers and their ability to practice have been supported by financial innovation to keep them afloat for their patients, Dr. Fong said. 

“We’ve seen big moves toward capitated and value-driven agreements for independent practices offered by payers across the country,” she observed. “The pandemic showed us starkly that the specialty-driven, fee-for-service model of healthcare fails to keep patients healthy when it really matters.”

Other surprising benefits of COVID-19’s presence have been technological advances and transitions. Movement to telehealth technology like Zoom and video-based platforms and the integration of these systems into EHRs were enhanced by the pandemic. This helped practices adopt new workflows to increase their treatment ability and reimbursement. She also said the shift towards telemedicine showed the world how quickly medicine can evolve when given the right incentives and support. 

“Primary care has a massive role to play in our national recovery from this pandemic in the years to come,” Dr. Fong said. 

Overall, the development of primary care is happening right before our eyes, she believes. Delivering the best possible outcome while also reducing cost of care are leading drivers in primary care’s evolution, and the pandemic has helped fuel that drive to make the switch faster and become a higher priority. Telemedicine, slowing the spread, and vaccine development are all just examples of the good that primary care does and glimpses into the future of its application. 

Lastly, Dr. Fong expressed her gratitude to those providers who have served the masses during this pandemic. “I see their sacrifice and their resilience, from practices in our community and my own dad’s clinic. Along with appreciation, they deserve support in helping build our country’s healthcare future.”

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That’s it, HIStalk! I’ve got some exciting ideas for some virtual interviews coming up, so if you have interest in watching 10-15 minute interviews or listening to some of my columns from a podcast POV, let me know! As always, I appreciate you and thank you for letting me learn about this industry. 

Katie The Intern

Email me or connect with me on Twitter.

Weekender 1/22/21

Weekly News Recap

• Micky Tripathi is named National Coordinator.
• The co-founder of The COVID Tracking Project says that the recently implemented HHS Protect COVID hospital status database is working well and urges the Biden administration to continue its use.
• Philips announces plans to acquire medical device integration vendor Capsule Technologies for $635 million in cash.
• ONC says it will invest $20 million in vaccine-related interoperability projects.
• An appeals court vacates MD Anderson’s $4.3 million civil money penalty for losing three unencrypted mobile devices that contained the PHI of 35,000 patients, challenging HHS’s ongoing interpretation of HIPAA requirements and its method of setting penalty amounts.
• Cerner replaces its chief client and services officer and chief legal officer and hires a CFO.

Best Reader Comments

I’ve been arguing with my health law friends that HHS and the conservative compliance lawyer mindset were wrong viewing HIPAA violations a some form of strict liability. I feel vindicated for now since I think the Fifth Circuit got this correct. 1. The technical requirements are met by simply not being negligent. You have implemented encryption? you make reasonable efforts to encrypt the data? Good enough. Perfection isn’t required. Doing more isn’t required. 2. Disclosure is an affirmative action, not merely just loss. It’s active. It’s participative. This construction fits nicely inside the framework. It also addresses the risk of loss to nation-state actors or those who are intent on stealing data. That’s not a punishable “disclosure” that’s a theft. 3. And I realize that HHS updated its penalty guidance, but this makes it very clear: outside some intentional acts, the penalties aren’t business-ending penalties. Yay for reasonableness of courts. (HIPAA Relieved)

The concept that that would not be considered a breach is mind boggling. I fully support the capriciousness but it shouldn’t be allowed to be pushed down to the staff level. In 2017 we all knew that we had to dictate it from an IT organization. (Jeremy)

Cerner Chairman and CEO Brent Shafer may wish to check out his own uCern “ideas” space to get a sense of how his peeps are doing on “strengthening relationships, delivering on promises, innovating faster, and executing on strategies.” There are loads of ideas that are no-brainers and/or have had significant support for many (5+) years, yet are not yet implemented or have been rejected as not on the road map. Other ideas point out serious safety risks, but are said to be working as designed (WAD), although they would be better termed WAHD (working as horribly designed). (CernerClient)

Watercooler Talk Tidbits

You as an HIStalk reader provided Ms. S’s elementary school class in Mississippi with 30 sets of individual, high-quality headphones in responding to her Donors Choose teacher grant request. She explains why she needed them: “Each year, I’ve bought headphones for my students completely out of pocket. The headphones which I get are usually a cheaper brand, which don’t tend to last long. I am so thankful for your support on this project! My students absolutely loved opening up the box and finding the beautiful headphones inside! Thank you for believing in us, and thank you for supporting our cause.”

California’s UCI Health will spend more than $1 billion to build 144-bed UCI Medical Center Irvine-Newport. That is $7 million per bed.

The state of Colorado dismantles a temporary COVID-19 hospital that was built in April 2020 inside Denver’s Colorado Convention Center, which the state leased for $60,000 per day for a year. None of its 2,000 beds were ever occupied.

A St. Louis TV station profiles 65-year-old pulmonologist Steven Brown, MD, who monitors 100 ICU patients per night – most of them on ventilators with COVID – from his living room as a physician with Mercy’s Virtual Care Center. He says it is hard to watch patients die remotely, in one case seeing four patients expire in a single hour.

A husband and wife who had been married for 70 years die together and within minutes of each other of COVID-19 in Riverside Methodist Hospital (OH), three days before their appointment to receive COVID-19 vaccine on would have been the husband’s 90th birthday. The family said in their obituary, “We are devastated to lose them both at the same time. But, we are blessed that they walked together, hand in hand, through the Gates of Heaven into Eternity, never having to face ‘Until Death Do Us Part.’”

A 29-year-old nurse who inspired her hospital co-workers by singing “Amazing Grace” after a 12-hour shift caring for COVID-19 patients – captured by a colleague in a video that went viral – sings it again in scrubs at the Lincoln Memorial Reflecting Pool to President-elect Biden and a national TV audience in the National COVID-19 Memorial. Lorie Marie Key, RN works for St. Mary Mercy Livonia Hospital (MI).

Acclaimed rapper-songwriter Lazarus encourages his fans to get COVID-19 vaccine, a recommendation that carries extra credibility because his other job is as Kamran Rashid Khan, DO, a Las Vegas family medicine physician.

In Case You Missed It

• News 1/22/21
• EPtalk by Dr. Jayne 1/21/21
• News 1/20/21
• HIStalk Interviews Marilee Benson, President, Zen Healthcare IT
• Curbside Consult with Dr. Jayne 1/18/21
• Monday Morning Update 1/18/21
• Katie the Intern 1/15/21

Get Involved

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

Morning Headlines 1/22/21

Pieces Acquires Bowtie Business Intelligence to Fuel Continued Growth and Fulfill Data-Driven Mission of Creating Healthier Communities

Healthcare outcomes and community service connection vendor Pieces acquires Bowtie Business Intelligence, which offers a data management platform.

Healthcare tech-focused SPAC Compute Health Acquisition files for a $750 million IPO

Compute Health Acquisition, a SPAC that will focus on healthcare technology, files for a $750 million IPO that will value the company at around $1 billion.

Hillrom Announces Planned Acquisition Of Bardy Diagnostics, Inc.

Hillrom will acquire ambulatory ECG monitoring vendor Bardy Diagnostics for $375 million in cash.

MPulse Mobile Acquires The Big Know

Healthcare conversational AI vendor MPulse Mobile acquires health video course developer The Big Know.

News 1/22/21

Top News

The Biden administration chooses Micky Tripathi, PhD, MPP as National Coordinator for Health Information Technology. He replaces Don Rucker, MD, MS, MBA, who was named national coordinator in April 2017.

Tripathi was chief alliance officer for Arcadia, which last year acquired the assets of the closed Massachusetts EHealth Collaborative, of which Tripathi served as CEO for 15 years.

Tripathi has resigned from the boards of Datica, HL7 FHIR Foundation, CommonWell, and The Sequoia Project.

Reader Comments

From Rad Idea: “Re: PACS. Mach7 (which acquired Client Outlook and its eUnity viewer last year) won the enterprise viewing RFP from Trinity Health this past November, with an option to add VNA, diagnostic viewer, and worklist. It’s a big deal since Trinity does 60% more studies than the big academic radiology heavyweights.” Thanks. Australia-based Mach7, which restructured and fired its CEO a couple of years ago in a cost-cutting effort, has an impressive roster of big customers. Trinity signed a seven-year, $5 million contract for its enterprise viewer in November. Shares in M7T, which trade on the ASX, value the company at $313 million.

From PEI: “Re: Nano-X. Ever run across them? I’ve heard some interesting stories and wondered about your thoughts.” The technology explanations of Israel-based Nano-X goes way over my head, but it involves low-cost and portable diagnostic imaging, which has yet to earn FDA approval. The chairman and CEO apparently invented wireless phone charging. NNOX did its IPO in August 20 and shares are up 166% since, valuing the company at $2.7 billion. Fun reading of the “interesting stories” variety (but of unverified validity) is the analysis of fraud chasers Citron Research, which calls the company “Theranos 2.0” with just 20-odd employees and “nothing more than a science project with a simple rendering, minimal R&D, fake customers, no FDA approval, and fraudulent claims that are beyond the realm of possibility.” Perhaps readers have more information to contribute.

HIStalk Announcements and Requests

Dr. Jayne’s office chair write-up spurred me to long-deferred action to replace my old, cheap Office Depot model, whose defective height-adjusting mechanism made it a poor man’s carnival drop tower ride. I was happy to find a local office furniture store that buys used chairs from closed or relocated businesses, refurbishes them, then sells them cheap with a one-year warranty. My new chair is a fully tricked out Herman Miller Celle that came from a closed Blue Cross Blue Shield office that turned in 1,000 of them. The retail price is $750, so $199 seemed like a bargain. I didn’t realize how un-ergonomic and cheap-feeling my old chair was until I sat in a decent, highly adjustable one where my back actually touches the chair.

Listening: new soul / R&B from Grammy winners Black Pumas, which I ran across before finding that they played virtually at the inauguration this week.

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

HealthStream will acquire policy management technology vendor ComplyAlign for $2 million in cash.

Text chat-based telehealth vendor K Health raises $132 million in a Series E funding round that values the company at over $1 billion. K Health offers unlimited online doctor chats for $9 per month, also offering pediatrics in 15 states and single urgent care visits for $19. Co-founder and CEO Allon Bloch, MBA previously started several online businesses, none of them related to healthcare.

UnitedHealth Group reports Q3 results: revenue up 8% to $65.1 billion with Optum as its biggest percentage contributor, EPS $2.51 versus $3.90, beating estimates for both. The company said in the earnings call that its OptumCare business will add another 10,000 employed and affiliated physicians to its existing 50,000 in 2021. It expects the combination of its acquired Change Healthcare and OptumInsight to allow it to introduce evidenced-based criteria into clinician workflow.

Healthcare outcomes and community service connection vendor Pieces acquires Bowtie Business Intelligence, which offers a data management platform.

Compute Health Acquisition, a SPAC that will focus on healthcare technology, files for a $750 million IPO that will value the company at around $1 billion. The company is led by Intel Chairman Omar Ishrak, PhD, who was formerly CEO of Medtronic. Medtronic is interested in buying 1.5 million shares in the company, he says.

Hillrom will acquire ambulatory ECG monitoring vendor Bardy Diagnostics for $375 million in cash.

Healthcare conversational AI vendor MPulse Mobile acquires health video course developer The Big Know.

Sales

• Community Care Plan chooses CareSignal’s Deviceless Remote Monitoring program to send self-management text messages to its Medicaid members.
• New York State Office of Mental Health chooses Cerner’s hosted revenue cycle management solutions in a 10-year contract that covers 23 inpatient and 155 outpatient facilities.

People

Cerner hires Mark Erceg (Tiffany & Company) as VP/CFO. He replaces Marc Naughton, whose departure was announced last fall. Cerner’s entire executive team has now been replaced since Brent Shafer was hired as chairman and CEO in January 2018, with the exception of Don Trigg, who was then president of Cerner Health Ventures and is now president of Cerner.

David Tavares, founder and CEO of alarm and event notification vendor Connexall, died last week at 73.

Announcements and Implementations

Jvion launches its COVID Vaccination Prioritization Index, which helps public health officials determine which areas need more vaccines based on an AI-powered analysis of each community’s makeup. I randomly chose Roane County WV, which is high priority as explained in the graphic above.

AI researchers from Facebook work with NYU Langone Health to develop software that analyzes chest x-rays to predict if COVID-19 patients will deteriorate or require oxygen. The researchers say their models are research solutions rather than products and will make them open source to allow hospitals to tune them using their own data.

The local TV station covers how SSM Health Saint Louis University Hospital allows the family members of patients to send photos electronically to their in-room entertainment system. The video doesn’t mention the interactive patient system vendor that does the heavy lifting, but freeze-framing the video shows that it’s PCare.

Government and Politics

Implementation of HHS’s December 10 rule that reduces the time providers have to give patients copies of their records will be delayed for 60 days in a Biden administration review of all recent HHS actions.

HHS OCR will not impose HIPAA penalties related to use of online scheduling to make COVID-19 vaccination appointments.

COVID-19

The COVID Tracking Project shows 122,700 people hospitalized in the US, with the trend continuing down. Deaths hit a daily record 4,409 as the US total increased to 406,000.

CDC shows as of Wednesday that 16.5 million COVID-19 vaccine doses have been administered of 36 million distributed (46%).

Amazon offers in a letter sent to President Biden to use its operations, IT, and communications to help get people vaccinated.

Experts question the COVID-19 vaccination plan of Washington, D.C. – which is already struggling with vaccine distribution problems – to open up priority slots to anyone who is overweight, which would be more than half of the district’s residents. An obesity researcher says that “it’s not much of of a discriminator any more if you define a co-morbidity as something that almost everybody has.” The city will also use the honor system in requiring those showing up for a vaccine to answer two questions – are you a resident, and do you have at least one priority chronic condition – with no proof required.

The White House publishes its 200-page national COVID-19 strategy, in which the federal government will:

• Provide expert-led, science-based public briefings and CDC-led communication and guidance.
• Give states more support and funding to “convert vaccines into vaccinations.”
• Expand vaccine production and purchasing.
• End the policy of holding back second doses and encourage states to move quickly through the priority groups.
• Create as many vaccination venues as are needed, including federally run centers in stadiums and conference centers, drugstores, VA hospitals, physician office, hospitals, urgent care centers, and mobile clinics.
• Compensate providers fairly for administering the vaccine, expanding the FMAP to 100% for Medicaid enrollees and assigning CMS to review whether payment rates are appropriate.
• Strengthen the federal government’s approach to vaccination data collection.
• Have CDC and FDA perform real-time safety monitoring of vaccines through expanded systems.
• Expand provider scope-of-practice laws and waive licensing requirements to meet community workforce needs.
• Require masks and distancing within federal buildings and lands and require mask-wearing on planes, trains, and other public transportation.
• Develop a COVID-19 treatment discovery and development plan.
• Establish a US Public Health Jobs Corps to provide 100,000 contact tracers, community health workers, and public health nurses.
• Provide technical help with the use of technology and data to guide response.
• Invoke the Defense Production Act to fix supply problems with vaccination and testing supplies and PPE.
• Implement a national strategy to support the safe reopening of schools, with most K-8 schools to be open within 100 days, including Congress-approved funding.
• Provide emergency funds to help hard-hit childcare providers remain open and to support higher education operation.
• Restore the US’s participation in the World Health Organization.

Other

The non-profit, Tulsa-based MyHealth Access Network protests the state’s selection of Orion Health to provide a statewide HIE platform for $49.8 million, which is nearly $30 million more than its own bid. ONC warned the state in a January 6 email that scrapping MyHealth and starting over was a bad idea. MyHealth bid $106.6 million on December 30, 2019, then lowered its price nine months later to $41.7 million when the state asked for its best and final offer, then lowered its price again to $19.9 million. The federal government will pay 90% of the cost.

I mentioned that health IT long-timer Amy Gleason had a big role in the successful implementation of HHS’s COVID hospital data reporting system as part of the US Digital Service. She invites other industry folks to join the group. I’m fantasizing about how cool it must be to casually name-drop “The White House” as a current or previous employer when meeting someone.

Sponsor Updates

• Everbridge launches its enhanced Public Warning System.
• Experity adds distribution phase information to its state-by-state COVID vaccine plan tracker.
• The HCI Group hires Blake Richardville as a business development executive, and Eli Lemkin as an account executive.
• Kyruus adds online consumer scheduling for COVID-19 vaccine visits to its patient access platform.
• Lumeon publishes the “US Patient Access Leadership Report 2020/21.”
• Medicomp Systems sponsors the awards section of the Physician Burnout Symposium through January 29.
• Meditech customer Northeastern Vermont connects the full birth experience with Expanse Labor and Delivery.

Blog Posts

• 4 Predictions for Diabetes Management and Technology in 2021 (Glytec)
• Secure Text Messaging Benefits Extend Beyond EPHI Protection (Halo Health)
• The 2021 Healthcare Financial Forecast: What to Expect, How to Prepare (Health Catalyst)
• Cooking and Consulting with Joe – Week 1 – Mustard Crusted Salmon (Health Data Movers)
• Digital Programs Let You Enroll More Patients in Cardiac Rehab (Healthwise)
• 2020 ushered in the era of the “Payvider” (Infor)
• Shifting Mindsets for Population Health (Intelligent Medical Objects)
• Transform Situational Awareness into Hospital Efficiency (LiveProcess)
• Parallels between HIPAA and 21st Century Cures Act (Medhost)
• 3 Things to Know About ONC’s Project US@ (NextGate)

Contacts

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

EPtalk by Dr. Jayne 1/21/21

I took time out this week to listen to the tolling of the funeral bell at the Washington National Cathedral. The bell tolled 400 times, once for every 1,000 COVID deaths in the United States. The 12-ton bell creates a deep and somber tone, intended to help mourn but also celebrate the lives of the lost. The recording was accompanied by video of the paper doves that form the Les Colombes installation by artist Michael Pendry, which is located in the Cathedral’s nave. It’s likely that we’ll see another 150,000 deaths by summer unless something changes significantly.

To the relief of many, Inauguration Day passed without any serious incidents, with the new US president getting straight to the business of trying to manage the COVID pandemic. I’m interested to see if the tone at the Centers for Medicare & Medicaid Services changes, since nearly every email that I’ve received over the last several years had a headline or opening paragraph celebrating the administration’s accomplishments. I suspect the new leadership may be a little more humble, and hopefully they’re getting the right kinds of leaders in place to help steer the massive bureaucracy to a more functional and productive place.

Many healthcare organizations are holding their collective breath to see if there will be major changes to policy or additional federal funds targeted towards vaccine administration. From people I’ve spoken to who have boots on the ground across the country, administration continues to be chaotic. We’ve finally been able to get my family members scheduled — they range in age from 75 to 95 — but it remains to be seen whether there will be vaccines shipped and available for their scheduled appointments.

Speaking of vaccinations, two Michigan marijuana dispensaries are offering free joints to customers who are vaccinated for COVID-19. The Detroit Free Press reports on the “Pot for Shots” campaign and its attempt at “blunting the curve.” The participating locations are Greenhouse in Walled Lake and UBaked Cannabis of Burton. You have to love a business name that clearly defines the brand.

Back to the realm of healthcare IT, I had a chance to catch up with a friend this week. We were bouncing ideas around as far as what sectors of the market might actually be heating up. Although most of my friends on the vendor side say that none of their prospects or clients is in a buying mood, there are indications that there will be money to be made. Intel Chairman Omar Ishrak is building a $1 billion war chest for a special purpose acquisition company IPO to target health technology deals. Prior to Intel, he was at Medtronic, so he’s not a stranger to the marketplace. Goldman Sachs Group Inc. is putting together the IPO. It seems that lately we’ve been hearing a lot about SPACs and I suspect this will be one to watch.

I enjoyed reading the recent blog penned by my long-term crush Farzad Mostashari. Aledade’s premise is that primary care is the foundation of an effective health system, and that it must be strengthened if we are to deliver better patient care and lower healthcare costs. Since 2014, the company has expanded to 27 states.

The blog notes that shared savings payments have been a way for primary care practices to stay afloat while fee-for-service payments have dropped due to decreased volumes during the pandemic. Aledade hopes to grow that savings from $50 million last year, doubling it this year and tripling it for the next. Investors are taking note, resulting in a $100 million funding increase that will drive an ambitious agenda that includes a 50-state growth strategy, expanded remote patient monitoring, predictive analytics, continuation of telehealth, and upgrades to Aledade’s software. It’s exciting to watch a truly mission-driven company do well, and I wish them continued success.

The Office for Civil Rights of the US Department of Health & Human Services will not be imposing penalties for potential HIPAA violations when healthcare organizations use online or web-based scheduling applications as long as they are “used in good faith and only for the limited purpose of scheduling individual appointments for COVID-19 vaccinations during the COVID-19 nationwide public health emergency.” That’s good, because my employer was one of the potential violators. In order to try to rapidly schedule employees for the 300 doses of vaccine that we received (which had to be given within 36 hours of receipt, since it had already been thawing at another health system) they used the Calendly platform. The so-called “enforcement action” does not include appointment scheduling systems that connect directly to the EHR, but encourages healthcare providers and their business associates to continue to guard the security of protected health information.

HIMSS announces a new recognition program, the HIMSS Changemaker in Health Awards. The award recognizes “inspiring senior healthcare executives who rigorously challenge the status quo in their journey to build a brighter health future.” Recipients will be determined by peer voting and will receive a “symbol of recognition” as well as coverage in HIMSS publications and seminars. They also must agree to contribute to HIMSS content including articles, podcast interviews, and participation in webinars. I was surprised to see that candidates can nominate themselves. If you know someone who is making change, or think you’re hitting it out of the park yourself, nominations are open through February 16.

In COVID news, the internet is full of cures and treatments that haven’t necessarily been proven. I’m interested in further research on this one, which purports that chemical compounds found in dark chocolate may interfere with COVID virus replication. Researchers at North Carolina State University are continuing to investigate, although they note that no human trials have been conducted yet. I’ve already got at least one reason to want to visit the Carolinas, so I’m happy to volunteer as a research subject.

If you’ve been holding off on travel due to COVID, what’s the first place you’d like to visit? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 1/21/21

K Health Launches ‘K for Parents’ Pediatric Care and Raises $132M Series E

Chat-based telemedicine company K Health raises $132 million in a Series E funding round.

Administration Unveils Senior Tech and Acquisition Leaders

Former Arcadia Chief Alliance Officer Micky Tripathi will serve as the national coordinator for health IT.

CareXM Announces Acquisition of TouchPointCare

Nurse triage and telemedicine company CareXM acquires remote patient monitoring vendor TouchPointCare.

Signify Health Files Registration Statement for Proposed Initial Public Offering

Clinical, behavioral, and social care coordination company Signify Health files paperwork with the SEC to go public on the New York Stock Exchange.

HealthStream buys policy management software firm

Training and talent management platform vendor HealthStream acquires ComplyAlign, a cloud-based policy management software vendor, for $2 million.

Morning Headlines 1/20/21

America’s Most Reliable Pandemic Data Are Now at Risk

The co-founder of The COVID Tracking Project urges the new administration to continue using the HHS Protect system instead of switching back to the CDC’s National Health Safety Network hospital reporting database.

Philips to expand its leadership in patient care management solutions for the hospital with the acquisition of Capsule Technologies, Inc.

Philips will acquire medical device integration vendor Capsule Technologies for $635 million in cash.

HHS Awards Funds to Expand Immunization Information Sharing Collaboration

ONC will invest $20 million in projects related to helping communities share COVID-19 vaccine-related data, and supporting immunization-related collaborations between HIEs.

Aledade Raises $100 Million Series D to Help More Primary Care Practices Thrive in Value-Based Care

ACO operator Aledade raises $100 million in a funding round that increases its total to $294 million and values the company at over $2 billion.

News 1/20/21

Top News

The co-founder of The COVID Tracking Project outlines the success of HHS’s fast switchover last summer from the CDC’s National Health Safety Network hospital reporting database to the TeleTracking-developed HHS Protect.

The article in The Atlantic urges the new administration to continue using the HHS system instead of switching back to NHSN.

Many observers assumed that the government made the change to marginalize CDC and to make its COVID-19 response appear to be more effective, but the author says The Covid Tracking Project’s investigation found no evidence of “cooking the books.”

Some points:

• CDC approved the reporting change, contrary to media reports saying its scientists were blindsided by the White House.
• NHSN is an old system that was jury-rigged to collect COVID-19 hospital data. Leidos maintains the system under a $60 million contract. Adding urgently needed data collection fields was taking weeks.
• HHS Protect’s data was all over the place at first, as hospitals worked to make the switch. Its reports now match those that states submit and have eliminated NHSN’s odd data swings and unexplained variability.
• By the end of 2020, 96% of hospitals were reporting their data to the new system every day.
• The system has been enhanced to include metadata, staff shortage details, and hospital-level capacity data to show where health systems are overwhelmed.
• The COVID Tracking Project concludes that the system has “enormous potential to be the federal numbers we’ve always wanted” and urges the new administration to keep using it.

The leader of the development team was health IT veteran Amy Gleason of the White House’s inter-agency United States Digital Service, which was created by the Obama administration to bring private industry technologists into government. She is credited with making the system production-worthy and fixing data issues. She has previously worked for CareSync, Allscripts, MediNotes, Bond Technologies, and Misys Healthcare.

Reader Comments

From Bone Spur: “Re: podcast. My list of good and bad ones. ” As a hardcore radio and TV channel-flipper, I don’t have the attention span to spend 15 minutes listening to what I could read in 15 seconds (or abandon in five). Maybe I would feel differently for something funny or dramatic where getting to the point isn’t the primary objective, but not news, opinion, or freeform yakking. My perception is that industry leaders who are busy holding jobs of responsibility — the folks I might find interesting enough to listen to — mostly aren’t screwing around doing podcasts and YouTube videos. Industry podcasts remind me of “King of Comedy,” the Scorsese-De Niro cult film that I watched the other night in which aspiring comedian Rupert Pupkin wows an imaginary TV audience from a talk show set that he built in his mother’s basement. Still, I figure that Katie the Intern might need more video production on her journalism resume, so I’ve suggested that she do some video interviews. Plus Pupkin actually did become a star in the movie’s darkly predictive ending, so you never know.

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

Philips will acquire medical device integration vendor Capsule Technologies for $635 million in cash.

Accountable care organization operator Aledade, which was co-founded by former National Coordinator Farzad Mostashari, MD in 2014, raises $100 million in funding round that increases its total to $294 million and values the company at over $2 billion.

Conversa Health, which offers a virtual care and triage platform, expands its Series B funding round to $20 million

Newfire Global Partners will launch an office in Kuala Lumpur, Malaysia next month that will provide around-the-clock technical operations to clients in healthcare and other critical industries.

Sales

• The State of Pennsylvania selects Aunt Bertha to help it build a statewide resource and referral portal for healthcare and social services.
• Yale New Haven Health System (CT) will work with Gozio Health to develop an app with wayfinding, patient portal, and virtual care features.
• Behavioral health provider Springstone (KY) will use VisiQuate’s RCM software and consulting services.

People

GetWellNetwork promotes Nikia Bergan to president.

John Ward (Atos North America Healthcare) joins Divurgent as CFO.

Karen Marhefka (Impact Advisors) joins RWJBarnabas Health and Rutgers Health as deputy CIO and VP of IT for their combined medical group in New Jersey.

CI Security promotes Kristoffer Turner to VP of security operations for its Critical Insight Security Operations Centers, and hires Steve Sedlock (EPSi) as chief revenue officer.

Christine Boyle, who held marketing executive roles in Oncology Analytics, Get-to-Market Health, Caradigm, Microsoft, and Sentillion, died of cancer on January 9. She was 50.

Announcements and Implementations

University of Arkansas for Medical Sciences regional campuses implement Epic.

UnitedHealthcare launches a virtual primary care service for employers powered by Amwell. The payer had attempted before COVID to offer telemedicine services through its network of primary care practices, but found physician uptake slow due to reimbursement issues.

East Orange General Hospital (NJ) rolls out bedside tablets from PadInMotion for patient education, entertainment, and care team messaging.

Government and Politics

ONC will invest $20 million in projects related to helping communities share vaccine-related data, and supporting immunization-related collaborations between HIEs.

A reader who is a nationally recognized provider-side HIPAA expert (I’m leaving them anonymous) called out a recent court decision about MD Anderson, which they say will change how entities look at HIPAA breaches, enforcement, and penalties. Here’s the summary:

• An appeals court last week vacated MD Anderson’s $4.3 million HHS OCR civil money penalty that was imposed in 2017 following three lost device incidents in 2012 and 2013. The unencrypted mobile devices contained the information of 35,000 patients.
• The court ruled that the penalty was “arbitrary, capricious, and contrary to law” in questioning how HHS OCR interprets HIPAA violations and sets penalty amounts.
• The ruling noted that MD Anderson had provided IronKey technology to encrypt PHI on mobile devices and the training to use it, but employees had not enabled it on the lost laptop and two USB drives. The court said that HIPAA requires only that covered entities “implement a mechanism to encrypt,” also noting that the health system’s IT user agreement requires employees to enable the provided encryption.
• The court also questioned whether information has been “disclosed” to an outside entity, as HIPAA defines, when it is stolen or lost. It said, “It defies reason to say an entity affirmatively acts to disclose information when someone steals it” and that the word “information” means that someone has been “informed” by it, which hasn’t been proven just because devices can’t be located.
• The court’s conclusion, which HHS could contest, is that losing unprotected PHI is not disclosure and likely isn’t an enforceable action under HIPAA.

COVID-19

Monday’s US COVID numbers: 123,848 hospitalized, 1,393 deaths, as the numbers trend sharply down but with potential underreporting due to the MLK holiday. It’s just a short break in any case, experts warn, as the more contagious B117 coronavirus variant spreads. The US crossed the 400,000 death mark Tuesday and the incoming CDC director predicts 500,000 by mid-February.

CDC hasn’t updated its vaccination numbers since Friday morning. Meanwhile, Florida reports that 45,000 people are already overdue for their second shot.

Lumeon announces GA of its COVID-19 Vaccination Campaign Management software featuring automated patient outreach, self-scheduling, and surveys.

Sponsor Updates

• In Australia, InterSystems TrakCare and Launceston General Hospital become the first to support the new ISBT 128 blood labeling standard with a digital interface to the National Blood Authority’s BloodNet online ordering and inventory management system.
• CNBC’s Squawk Box features Change Healthcare and the Vaccination Credential Initiative.
• The Chartis Group promotes Brian Spendley to principal in its strategy and private equity advisory practices.
• Clinical Architecture releases a new Informonster Podcast, “CommonWell Health Alliance and the Mission to Bring People and Data Together.”

Blog Posts

• Tips for Making EHR Digital Learning More Productive (314e)
• COVID-19 vaccinations: Ability helps providers get paid (Ability Network)
• Top 3 Healthcare IT Trends of 2021 (Optimum Healthcare IT)
• AdvancedMD launches Hub, customer community portal (AdvancedMD)
• Bluetree Network, a Tegria Company, Honored as One of the Best Places to Work in 2021, a Glassdoor Employees’ Choice Award Winner (Bluetree)
• Leveraging Technology to Power Improved Outcomes in Acute and Post-Acute Care (CarePort Health)
• Three Ways Health IT Project Kickoff Meetings Fall Short (CereCore)
• Honoring the Legacy of Martin Luther King Jr. (Cerner)
• How Providers Can Keep Their Focus During the COVID Era (EClinicalWorks)

Contacts

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

Morning Headlines 1/19/21

CloudMD Closes Acquisition of Medical Confidence Inc., a Revolutionary, Technology-based, Healthcare Navigation Platform for Enterprise Clients

Canadian health IT vendor CloudMD acquires Medical Confidence, a developer of healthcare navigation software aimed at helping employees more easily find and access specialists.

Femwell Group Health Announces Strategic Investment from LightBay Capital

Miami-based management services organization Femwell Group Health secures a minority investment from LightBay Capital.

Commure Joins the Postman API Network to Bridge the Gap Between Clinical Knowledge and Developer Efficiency in Healthcare

Healthcare development platform vendor Commure joins the Postman API Network, making its FHIR and authentication APIs available to healthcare developers.

HIStalk Interviews Marilee Benson, President, Zen Healthcare IT

Marilee Benson, MBA is president of Zen Healthcare IT of Costa Mesa, CA.

Tell me about yourself and the company.

My husband Jim and I founded Zen after spending 25 years in healthcare IT. Our goal from that experience was to simplify interoperability, because we had learned how difficult it can be. Zen is our second company in healthcare IT. We sold the first one to WebMD in 1999. We’re one of those rare couples who love to work together and we thrive doing it. A lot of people think we’re crazy, but we love it.

The best part about Zen is that we’re made up of some of the best and brightest people who work in healthcare interoperability. We have a good mix of more experienced folks who have gray hair and the younger up-and-comers. That mix of experience and innovative new ideas is important when working on the kinds of problems that we work on every day.They are smart and dedicated, and we are laser focused on giving our clients the best possible experience. You will frequently hear our clients say that we are their favorite vendor to work with, and for us, that’s one of the most important aspects of what we do. We don’t take that for granted and we work hard to make that a reality.

What kinds of interoperability projects are customers working on?

We’ve certainly seen in the last year or so a big increase in the National Trusted Exchange-type implementations, such as IHE exchange and federated query and response. We’ve also seen an increase in FHIR-related projects, although typically we’re translating FHIR to the older standards. We may do a FHIR to IHE translation, or FHIR to proprietary API.

I’m excited about where we’re headed with FHIR and more API-based exchange, but we might also pick up a flat file and turn that into HL7. That represents where we are with interoperability today – it’s just extraordinarily complex. We have new emerging standards, but the old standards don’t die. That’s our challenge.

What impact are you seeing from ONC and the Cures act?

That will drive better adoption of API-based exchange, but we will need middleware tools that help bridge the gap from where we are today to where we are trying to go. Beyond the technical side, ONC is focused on information blocking, and its rulemaking process is helping push the business side, which is often the bigger problem. We can come up with technical solutions, but we need to have people on both sides of the transaction who are willing to share that data.

The other area is patient access. That has tremendous potential, but there’s been a lot of fear, uncertainty, and doubt for healthcare organizations to open up for better patient access to data. 

I’m excited about the business drivers that hopefully will once and for all ensure that sharing data is the standard way that healthcare is delivered, as opposed to that project that everyone’s always trying to work on, but never quite gets there.

What happened to the debate a couple of years ago about how vendors will approve who can connect to their systems via APIs, who owns the data, and who makes money from its exchange?

The information blocking rules are helping us get over that problem. I agree with you 100% that it has been a huge problem. It takes time to change people’s minds. But if you aren’t engaging in API exchange of information and opening up, both at a vendor level as well as in healthcare organization level, you’re going to have some explaining to do. You will need to have good reasons why you’re not doing it. That will apply a lot of pressure.

The other thing that will help is the tension that we have between the HIPAA minimum necessary standard versus information blocking. We are starting to get some direction from ONC around not letting minimum necessary be the reason that people aren’t exchanging data and clarifying some of those rules to address some of the legal concerns.

What unusual examples of interoperability have you seen?

We absolutely get to work on some pretty creative projects. Some of those things might include just moving data around within an individual organization’s suite of applications. We often think of data leaving the four walls and going over to another stakeholder. But often organizations are having trouble even moving data around within their own systems to leverage the data they are collecting to create a positive impact on patient outcomes. For example, you might pull data out of an EHR and several other systems and create a dashboard for certain types of patients, such as chronically ill patients. Those are fun projects to work on.

We also do a lot of work supporting health information exchanges across the country, and we’ve seen a lot of opportunity for health information exchanges to make a difference. For example, in the time of COVID, you can leverage the fact that you’ve got a data aggregator regionally that can help providers more quickly see whether, for example, a COVID test has been ordered and what the result was. That will obviously be extended to understanding the vaccine administration process and how we’re doing as a population. So the diversity of use cases for health information exchange is extraordinary.

We also have many great analytics vendors and analytics tools, but many of them still struggle with getting the data. So a lot of our work is in that area, helping get data into a format so that the analytics vendors can take that in and use that data for improved population health.

One theory of why Haven shut down was that it was starved of data by health systems that saw the company and its owners as adversaries. Are companies from outside of health IT surprised that they can’t get data that they thought would be readily available?

Haven was on my list of least-surprising news. I use HIStalk as my primary source of news, and when I saw your headline, I said, OK, that’s not a surprise. The problem is multifaceted. There’s the problem of the sharing of the data, and hopefully some of the new rules will help with that. But then there’s also the quality of the data. Even if you can get the data, there is a tremendous amount of work to be done to be able to leverage that data effectively from an analytics and population health point of view. Some of been around for a long time and we as an industry must do better at fixing them.

That includes patient identity and provider identity. Those are key pieces of information in a healthcare message, yet we struggle as an industry to manage them, using expensive tools that have a lot of management and maintenance. The industry is talking about these problems, but we still have a lot of work to do to fix them.

Does bringing in someone else’s data involve constant monitoring for inconsistent editing and storing of what seem like straightforward elements, such as blood pressure?

It has gotten better, but we still have a lot of work to do. ONC recently announced an effort around things like address normalization, which is great, but it sets you back on your heels to realize we’re talking about something as fundamental as that. Some of the clinical data normalization has gotten better with the evolution of the standards. FHIR in particular is doing a good job of being more specific in terms of the sharing of targeted clinical data.

How has the pandemic changed interoperability demand?

The two big things that we saw happening in the spring of last year were public health reporting, particularly with lab results, and telehealth. Telehealth was a big growth area for us last year.

I was a bit surprised that we had as much work to do in the public health side as we did. You might assume that we have public health registries, so data must be flowing, but in reality, there was a lot of work that had to be done. Many of the health information exchanges across the country were helping scale lab reporting, particularly to the public health agencies.

Integrating telehealth with hospital systems and provider EMR systems was a big area. I’m hopeful that telehealth is an area that we’ve proven has a has a bigger role to play in future healthcare delivery in the future and it isn’t just a blip. From an access to care perspective, telehealth has an important role to play.

Tracking pandemic-related hospital status, cases, deaths, and vaccination status is being done in some cases with primitive technology such as emailed worksheets and probably even fax machines. Are you finding that you have electronic provider data that those entities need that they can’t process electronically?

That is absolutely a problem. We do more work at the state level than the federal level, but it was surprising that even in states like California we had problems with the lab registry. Now we’re having trouble with the immunization side, where the right systems are not in place. This is an absolutely critical area that we have to invest in over the next several years. We simply cannot afford to not have that public health reporting infrastructure be modern and ready to tackle the next healthcare crisis that comes along.

Is it easier now that hospitals are using a reduced number of EHRs and other systems?

We still have a lot of ambulatory vendors even with consolidation. I’ve seen that vendor landscape pendulum swing in 32 years in healthcare IT and 40 years in healthcare, but the most important thing we need to do is make sure that our data sources are broader than just what’s happening in a hospital setting. We need better data from long-term care facilities and ambulatory care facilities. Behavioral health has been a big challenge in terms of effective health information exchange. We have a number of initiatives that address those issues, working with some of our HIE partners. If you look at the community and who is really impacting a healthcare consumer, it is a very diverse group of folks, including a lot of social service agencies. All of that data is critical for improving outcomes, particularly with those communities that need it the most.

After all those  years in the industry, what aspects of it are you enthusiastic about?

We are entering a golden age. We are overcoming some of the last hurdles, from a business perspective. Even though I complain about the proliferation of standards, the positive side of that is it gives us an awful lot of tools in the toolbox to address specific healthcare workflows and use cases. We have a lot of talent coming in from an engineering, a lot of younger folks coming into this part of the space who enjoy problem solving. I’m really excited, and while I realize there are problems that have been around for a long time, we have a lot of great minds working on them. There have also been a lot of advances on the infrastructure side that give people options. We are going to be able to accomplish more in the next five years than we’ve accomplished in the last 20.

Do you have any final thoughts?

Zen has been a pretty well-kept secret for years. To help fuel our growth over the next couple of years, we’re going to be working hard this year to share some of our clients’ successes as a testimony to the value that we bring to our clients and to the industry. We’re going to continue to grow and evolve our solutions to keep up with what’s happening in the industry, with a continued focus on FHIR, API, and National Trusted Exchange. But the most important thing we’re going to be doing is continuing that laser focus on making interoperability easier for clients so that they can stay focused on what they do best. Our best day is when one of our clients makes a difference in the life of their patients or in the healthcare consumer. In the last year, that has never been more important. It’s an exciting time to be in this business and we will continue doing the best we can for our customers every day.

Curbside Consult with Dr. Jayne 1/18/21

It’s finally time for price transparency, with hospitals now being required to disclose their contracted prices on their websites. I decided to see how difficult it would be to find out the potential pricing for my local hospital, and also to compare it to recent Explanation of Benefit (EOB) documents from a couple of friends and family members.

I first went to the hospital website. Of course there wasn’t any kind of notice about the availability of the new data, so had to guess where it might be filed. Clicking on “Billing and Financial Assistance” took me to a health system website, and after scrolling two full screens, I found an “Understanding Your Costs” header. Under that, I could select either a customized cost estimate or the “General Estimate Tool – Shoppable Services.” A description under that link noted: “Under 2020 pricing transparency guidelines from the federal government, this tool allows you to view your costs for the most frequently used hospital services.” I knew I was at the right place.

From there, I had to again select my hospital and agree to Terms and Conditions for the tool. Next, I had to select my insurance. My my plan was unfortunately not listed on the pick list, so the system instructed me to call to speak to a financial specialist. I backtracked and just selected Cigna since I have a general working knowledge of how their plans work.

I was next asked to select whether I was choosing an inpatient or outpatient procedure. Although the system defined these strictly as “staying overnight in the hospital” versus “not planning to stay overnight,” as a physician I know there are nuances to this. When I had my emergency gall bladder surgery, I spent the night on an inpatient unit, but my visit was billed as outpatient since I was admitted less than 23 hours. Patients aren’t going to know or understand this, nor should they be expected to do so.

After that, I was asked to choose a popular procedure. I’m not sure I would have chosen the word “popular” when building this user interface. Medical procedures are rarely popular, and perhaps “common” would be a better word.

Bouncing back and forth between the inpatient and outpatient lists, I quickly determined that the system wouldn’t let me match combinations that went with the EOB documents I had. These involved my outpatient gallbladder removal, an outpatient hysterectomy, and an outpatient hip replacement (for which this particular facility is renowned). Instead, I went with the colonoscopy, although my EOB was from an ambulatory surgery center rather than the hospital. From there, I had to input my insurance benefits, including deductible, how much I’ve met for the year, my out of pocket maximum, and whether I had met it. I also needed to know my co-pay and co-insurance for the procedure. Most patients aren’t going to have this at their fingertips.

The system told me I’d be responsible for $20 for my colonoscopy, which I know isn’t remotely accurate. I played around with the “my insurance benefits” screen and could make the numbers go up and down depending on what I put as a deductible. At no point did it tell me what the contracted charge was for the procedure, only an estimate of my patient responsibility. I went back and plugged in “uninsured” for my coverage and was able to get an estimate of costs for a diagnostic colonoscopy with biopsy, which ranged from $1,286 to $3,744, with a median of $1,575. There was no explanation whether the numbers being provided reflected only the facility fee or whether they included any other fees, such as pathology. Again, I wouldn’t expect patients to know that there are going to be multiple fees from multiple sources, so they are still likely in for some sticker shock.

Other things I learned: the system thinks a cardiac catheterization costs $141,636, which is grossly inaccurate. Based on the codes and descriptions displayed, I think they confused it with a cardiac valve replacement. Patients wouldn’t know that. The only chest x-ray on the list was a one-view, which isn’t typically done for outpatients. The hospital charge for that one view was four times what my urgent care charges for both the technical and professional components. The markup for a CT scan of the abdomen and pelvis was also four times higher. I guess those big fancy marble lobbies have to be paid for one way or another. The facility fee for a hospital outpatient clinic visit was $169 and that doesn’t even include seeing the physician. An emergency department visit ranges from $2,190 to $7,573, with a median of $3,310. That definitely underscores the benefit to patients who see us at the urgent care versus going to the hospital for urgent issues.

I ran through the various procedures at a couple of the other hospitals in the health system and found that even an as uninsured patient, I could receive some procedures for dramatically less by driving 20 miles, assuming the data was accurate. The $1,800 CT scan became $900 at the hospital that is in a somewhat economically depressed part of town. However, the mysterious cardiac cath/valve procedure jumped to $171,625 at that facility. The procedure jumped to $209,451 at the system’s flagship academic medical center hospital.

Although the push for price transparency was certainly a hot topic when it was initially proposed, it quickly became a battle between the patient advocacy factions and the hospital lobbyists. From my N=1 analysis, I’m not sure patients are any better off using the tool than using other available data or even a simple Google search. The data provided was too vague to be used for real decision making.

If I was really price shopping a major surgical procedure, I would want to call and talk with the system’s staff to see if they could put together a better estimate. One would also need to research all the ancillary costs, such as laboratory, anesthesia, in-procedure radiology, pathology, etc. Don’t get me wrong, this is a step in the right direction, but we just need to realize it’s a baby step.

Have you looked at price transparency for your institution or neighboring hospitals? What did you think? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 1/18/21

More executive shakeup at Cerner: Two top leaders leaving Kansas City-based company

Cerner announces that Chief Client and Services Officer John Peterzalek and Chief Legal Officer Randy Sims will leave the company.

Ex-Obama official who helped fix botched healthcare.gov rollout to join Biden’s Covid-19 team

Former Acting CMS Administrator Andy Slavitt, who was previously CEO of OptumInsight and more recently founder of non-profit United States of Care, will take a temporary role as advisor the President-elect’s COVID team.

Fast-Growing Oncology Startup OncoLens Secures $7.25 Million Series A Funding

OncoLens, a software developer focused on care treatment planning for cancer patients, raises $7.25 million in a Series A funding round.

Monday Morning Update 1/18/21

Top News

Cerner announces that Chief Client and Services Officer John Peterzalek and Chief Legal Officer Randy Sims will leave the company. They will be replaced by Cerner Government Services President Travis Dalton and SVP of Cloud Strategy / Chief IP Officer Dan Devers, respectively.

Cerner Chairman and CEO Brent Shafer said in the internal announcement that the company’s annual client survey results require a greater sense of urgency in strengthening relationships, delivering on promises, innovating faster, and executing on strategies.

HIStalk Announcements and Requests

Most poll respondents don’t have a significant chunk of their net worth invested in health IT company ownership.

New poll to your right or here: For those who have worked for a company or healthcare organization that was acquired, how was your job afterward? I’ve mostly worked for big health systems that were the acquirer, which worked out well for me. My job also didn’t change much during my stint with a bottom-feeder vendor whose series of owners couldn’t wait to pawn it off on someone else like a gas station Christmas fruitcake, but only because (a) it wasn’t that great of a job to begin with; (b) I was somewhat safe as a clinical-technical subject matter expert who was happy to keep my head down while the mahogany row battles were being fought above me (literally and figuratively). My sense is that having your company acquired for unfavorable terms brands you with the collective stench of your previous employer’s failure, while those who actually captained the ship into the iceberg elbow women and children aside in fleeing for the corporate lifeboats.

The suddenly overused word that I’m sick of hearing: all forms of “lean,” including lean in, forward-leaning, left- or right-leaning, and leaning into. Unless you’re talking about someone who is unsteady on their feet, a carburetor, quality improvement, the director of “The Bridge on the River Kwai,” or that tower in Pisa, better word choices are available.

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.

People

Former Acting CMS Administrator Andy Slavitt, who was previously CEO of OptumInsight and more recently founder of non-profit United States of Care, will take a temporary role as advisor the President-elect’s COVID team. That’s him accepting his “Healthcare IT Industry Figure of the Year” award at the final HIStalkapalooza in New Orleans in 2017, which was right after I interviewed him.

Announcements and Implementations

Healthcare development platform vendor Commure joins the Postman API Network, making its FHIR and authentication APIs available to healthcare developers. Clinical scenarios covered include telehealth, care team management, inpatient medical workflows, and capturing data with forms. Commure’s co-founder and executive chairman is investor Hemant Taneja, who started and sold Livongo, while its CEO is Brent Dover, who was president of Medicity and Health Catalyst. The company has raised $42 million in funding.

COVID-19

Saturday saw 126,139 people hospitalized with COVID-19 in the US, with 3,695 deaths. The death total will pass 400,000 early this week.

CDC says the more contagious B117 coronavirus variant will become the dominant strain in the US by March, which some experts predict will happen even sooner based on UK experience. In addition, the B1351 variant is probably already active in the US and may be resistant to at least one antibody therapy. Former FDA Commissioner Scott Gottlieb, MD says that new COVID-19 cases have likely peaked, but deaths and hospitalizations will continue to grow over the next few weeks as a lagging indicator. 

CDC reports that as of Friday, 12.3 million people have received COVID-19 vaccine first doses versus 31.2 million doses distributed, with less than 40% of available doses actually given.

Operation Warp Speed held CDC’s vaccine distribution plan for two months last summer, leaving state and local officials little time to implement mass vaccination programs. 

HHS imposes term limits on its top few dozen scientists at FDA and CDC, who would face reassignment every five years, in a rule that the new administration is likely to cancel.

Sponsor Updates

• OptimizeRx promotes Kennedy Whitney to marketing coordinator.
• D CEO and Dallas Innovates recognizes Phynd Technologies CEO Tom White as a finalist for their Start-Up Innovator of the Year award.
• KLAS Research recognizes Relatient as the highest rated patient engagement platform with 10 validated capabilities.
• Everest Group names Nordic a “Leader” in its “Healthcare IT Services Specialists PEAK Matrix Assessment 2021.”
• Spirion introduces its Customer Marketplace, an online hub for third-party data privacy and security integrations, applications, best practices, and training information.
• TriNetX will present during the Friends of the National Library of Medicine’s virtual workshop January 27 on real-world data and EHRs in clinical research.
• Well Health joins the Children’s Hospital Los Angeles’ KidsX digital accelerator as part of its initial cohort.

Blog Posts

• Inference Analytics Advanced Neural Network generates impressions based on radiologist findings (Nuance)
• American use of the EHR: What can we learn from others? (Nordic)
• Will 2021 be the Year of the Digital Health Platform? (PatientBond)
• When Plans Change: Lessons for Business Leaders from the Pandemic (PatientKeeper)
• Patient Simulators: Innovation Through Necessity (PMD)
• Five Issues Limiting the Vaccine Rollout – and How to Fix Them (Premier)
• The ABCs of healthcare IT (a vocab sheet) (Redox)
• The COVID-19 Vaccine Has Arrived: Here’s How Relatient is Helping (Relatient)
• A Nurse’s Greatest Fear, Part 2: Giving Clinicians Greater Insight & Improving Patient Safety Outside of the ICU (Capsule Technologies)
• 8 steps to take in the event of a data breach at your hospital (Spok)
• Thriving in a Virtual Work Environment (Summit Healthcare)
• Empowering Patients with Another Relationship They Can Count On (Surescripts)
• Interview / AI Research Insights (Visage Imaging)
• Revenue Cycle 101: Prior Authorization (Waystar)
• Beat the Heat: How to Fight Burnout in Your Rehab Therapy Practice (WebPT)

Contacts

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

Katie the Intern 1/15/21

Hi, HIStalk! I hope you’re well and that January is treating you just fine! I wanted to take the time to say thanks for reading my posts. I am learning fast!

This column is based on an interview with Natalia Southerland, MD from Brand New Med, PLLC. Dr. Southerland serves part-time at Crossover Health and is president of Brand New Med, PLLC in Texas.

I interviewed Dr. Southerland to discuss how primary care is changing, as well as how COVID-19 has impacted her as a provider. Dr. Southerland became a doctor to serve the underserved and to provide access to healthcare to everyone, particularly as an African American provider.

“Just trying to get people who are usually ignored by the system, trying to provide them quality care, has always been my goal,” Dr. Southerland said.

Dr. Southerland expanded her interest in medicine to wellness, as she is a sports-oriented and wellness-focused person and doctor. Initially interested in surgery, she focused her efforts on a more rounded approach to medicine alongside the ability to interact with patients, moving into family practice. She said inspiring people to take wellness into their own hands is important. She started Brand New Med to do just that.

“What was really missing for me was the ability to really spend time with people, and to really educate them about what was going on with them,” Dr. Southerland said. “I really wanted to serve people and get to the basis of chronic disease instead of just prescribing medication for chronic disease.”

Brand New Med combines a variety of wellness-centered treatments and services to inspire health protection and prevention. Movement and exercise, mental health and mindfulness work, sleep help, and relaxation are pivotal points in care that Brand New Med works towards. Dr. Southerland said that Brand New Med provides services that allow people to understand that they are more in control of their healthcare than they know.

Brand New Med had to adapt to COVID-19, just as primary care has also had to face the challenges the pandemic brought to light. Dr. Southerland said COVID has taken healthcare somewhere completely different than wellness. Healthcare is healthcare, she said, the treatment of illnesses. But wellness is the focus on feeling good, and that became harder to implement when a pandemic is looming over everyone’s head.

“I ended up actually moving my practice. My goal now is to help people really focus on the things that are going to keep them well,” Dr. Southerland said. “And putting together a program so people feel comfortable coming to the doctor not simply for sick visits, but for those visits that are going to keep them well.”

Providing wellness care virtually was a challenge, but learning how to adapt a wellness-centered healthcare space was not going to slow Dr. Southerland down. People were eager to do virtual visits, and the rare few took advantage of coming into a mostly empty office.

Dr. Southerland took this time to teach patients that if they have a particular medical condition, they can take charge of that at home. For example, a patient who has high blood pressure should keep a cuff at home and watch their pressure and learn to respond to it. Caring for patients from a virtual standpoint is easier when patients can gather information themselves at home, she said. Inspiring people to take control of their own healthcare will help the prevention of disease versus treatment of it become the new norm.

COVID-19 has changed the direction that both healthcare and healthcare IT are moving in general. Just as Brand New Med had to be moved and goals had to be changed, Dr. Southerland said the technology used to reach and treat patients was of utmost importance through the pandemic, and continues to be. Staying in contact with people through the pandemic was more important than ever, Dr. Southerland said.

“Using an EHR to send out mass messages to people, what information I got recently from the department of health, or information about where they get vaccines,” Dr. Southerland said. “Being able to contact them from that standpoint.”

Digitally contacting people is only one step in the evolution of primary care, as each day our internet-driven world becomes more entangled in the application of healthcare. Dr. Southerland believes there is catching up to be done in the healthcare IT industry, as she provided digital care during her time at the National Health Service back in 1995.

“It’s funny that COVID had to come to make it [digital care] the normal, or to make insurance feel that now it is OK to pay for it,” Dr. Southerland said. “I think this should become the new norm, and I think as we get better at making patients independent and giving them things that are going to help them help us diagnose them, then it is going to be better.”

The drawbacks to digital care are the obvious lack of physical examinations, but moving towards value-based, digital care can help build relationships in ways we might not have imagined. Dr. Southerland said a large part of the problem in moving towards value-based care is insurance payments, as doctors make more income when four people come into an office versus one person for an hour-long visit. But by moving to value-based care and instilling patient wellness, digital check-ins will become the new normal and new relationship between patients and providers.

“Moving to value-based care is valuable, but value-based care has to be couched into where you actually spend time with the patient to do what you need to do or have the ability to educate the patient in a way that the patient is actually going to become an independent healthcare provider and not dependent on the healthcare system,” Dr. Southerland said. “That relationship of not going back and forth, that has to be established.”

Dr. Southerland and I also talked about technologies that have helped her provide care during the pandemic, and where she hopes that tech will go. She mentioned the importance and ease of having a good EHR, and the ability for an EHR to change over time. Having communications, appointment making, video visits, payments and more all in the same place has been extremely beneficial throughout the pandemic, she said.

Other improving and useful technologies include wearable apps for monitoring blood sugars and other information will also be the future of helpful tech, Dr. Southerland said. Proactive care versus reactive care will benefit patients and providers alike, and technology can and will continue to help fill those gaps.

“Anything that is going to help the patient provide us with more information to diagnose and treat or to follow their condition is going to be a lot more helpful,” Dr. Southerland summarized. Any technology that allows for interaction with the patient, or allows group visits, etc. will be the future of primary care.

That is it today, HIStalk!

Katie The Intern

__________

TLDR: Dr. Natalia Southerland of Brand New Med, PLLC talks services and how COVID-19 impacted primary care in general. She believes moving towards value-based care is important but instilling overall patient wellness will help VBC become the new normal. “Really helping people to change their behavior is what is going to change the course of not just chronic disease, but primary care as well.”

Weekender 1/15/21

Weekly News Recap

• Health and technology leaders, including Epic and Cerner, announce their participation in the Vaccination Credential Initiative, which hopes to provide patients with digital proof of their COVID-19 vaccination.
• QGenda acquires Shift Admin.
• Walgreens announces plans to develop an extensive customer engagement, care integration, and health marketplace platform.
• Flo settles FTC charges that it shared the ovulation data of 100 million users with Facebook, Google, and other companies while telling them it was keeping that information private.
• AdventHealth says its replacement of Cerner, Athenahealth, and Homecare Homebase will cost $660 million.
• Federal prosecutors say that Theranos destroyed its laboratory information system database that it had hoped to use to prove fraud and use of unreliable tests.
• ONC releases United States Core Data for Interoperability Draft Version 2 for public comment.
• Central Logic acquires Acuity Link.
• Tech-enabled Medicare Advantage insurer Clover Health begins trading on the Nasdaq in a reverse merger with a SPAC that values the company at $7 billion.

Best Reader Comments

It’s kind of absurd that you’re talking about robotic process automation as an innovation. Using computers to automate navigation and administration of our bloated regulatory structures is not innovation. It doesn’t help patients or improve care in any way. It only helps organizations improve their bottom line. The best innovation we could unleash would be to adopt a single payer healthcare system. Innovation should be focused on improving care, not doing paperwork. (Elizabeth H. H. Holmes)

In my opinion, workflow design (and of course system design) questions are often difficult conceptual problems, and they take a good deal of focused thought to come up with a sensible answer. Confounding the problem is the fact that a good design, once clearly laid out, is deceptively easy to follow and understand, leading to the mistaken idea that it was equally easy to come up with. Thus people don’t generally have an adequate appreciation for the task of design. Thus they sometimes aren’t prepared to devote the time and focus actually required. As my high-school English teacher used to tell us: “Anyone can take a simple problem and make it complicated. It takes a genius to take a complicated problem and make it… anyone? anyone?” (Clustered)

Watercooler Talk Tidbits

Readers funded the Donors Choose teacher grant request of Ms. K in Illinois, who asked for several books for her elementary school class. She reports, “These books have been such a wonderful addition to our classroom library. They are so popular that I cannot keep them on the shelves and students eagerly wait for their classmates to finish the next book in the series. While it previously felt like a struggle to get some of my students to read, now, nearly every student in my class is found reading whenever they get a chance. When students finish their work before others, they take out their book and read. When students need to take a short break from instruction, they take out their book and read. When students go home at the end of the day, they take out their book and read. These books have made such a positive change to our classroom, and it would not have happened without your help.”

Microsoft patents a “Black Mirror”-like process of turning data about a person – even a dead one – into a chatbot that includes a 3D rendering, a voice, and the trained ability to converse like that person.

The family of a nursing home patient who was allowed to install a security camera in his room to monitor his care captures him dying after his oxygen cannula dislodges. The footage shows the 80-year-old patient, who was infected with COVID-19, gasping for air just after 4 a.m. after not being checked for nearly four hours and with a nurse call button that was draped over the bed railing where he couldn’t reach it. His daughter noticed his situation, but her calls to the facility were not answered and nobody came to its door when she frantically showed up in person.

Two Chicago-area broadcasters launch a podcast that covers the history of Edgewater Hospital, which was built as a high-end facility in 1929 for patients like Frank Sinatra, was the birthplace of Hillary Clinton and serial killer John Wayne Gacy, and then was closed in 2001 after its management company and some of its doctors were caught running a massive fraud scheme. The hospital became a popular destination for urban explorers who found the interior to be intact from the moment the doors were closed until it was mostly torn down in 2017.

A new nurse in North Carolina has photos taken with her 98-year-old great-grandmother, who graduated from nursing school in 1942.

The director of performance improvement at Ascension St. John Medical Center runs 46 miles from another Ascension hospital in a 10-hour tribute to “nurses and the marathon they run every day.” Wyatt Hockmeyer gave out 85 medals to healthcare workers in the two hospitals on behalf of Medals4Mettle, which awards medals that have been donated by endurance athletes to those who are fighting serious illness.

In Case You Missed It

• News 1/15/21
• EPtalk by Dr. Jayne 1/14/21
• Readers Write: Healthcare Must Embrace Innovation Beyond the Pandemic
• HIStalk Interviews Brian Schmitz, CEO, Clinect Healthcare
• News 1/13/21
• Curbside Consult with Dr. Jayne 1/11/21
• HIStalk Interviews Drex DeFord, Healthcare Strategist, CI Security
• Monday Morning Update 1/11/21
• Katie the Intern 1/8/21

Get Involved

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

Morning Headlines 1/15/21

Broad Coalition of Health and Technology Industry Leaders Announce Vaccination Credential Initiative to Accelerate Digital Access to COVID-19 Vaccination Records

Health and technology leaders announce the Vaccination Credential Initiative, which hopes to provide digital access to COVID-19 vaccination records using the open SMART Health Cards specification.

Healthcare Specific AI Platform Lumiata Raises Series B Funding

Lumiata – which applies AI to 120 million patient records to predict patient outcomes, clinical costs, and risks for providers and payers – raises $14 million in a Series B funding round.

Healthtech firm Accolade is buying telemedicine start-up 2nd.MD for $460 million, sources say

Health benefits navigation company Accolade acquires 2nd.MD for $460 million to offer its users easier access to second opinions.

QGenda Acquires Shift Admin

Provider and resource scheduling system vendor QGenda acquires Shift Admin, which offers shift-based specialty scheduling for emergency medicine, urgent care, and hospital medicine.

News 1/15/21

Top News

Health and technology leaders announce the Vaccination Credential Initiative, which hopes to provide digital access to COVID-19 vaccination records using the open SMART Health Cards specification.

Individuals could obtain an encrypted digital copy of their immunization credentials to store in a digital wallet or could receive a paper form containing a QR code.

The goal of the initiative is to connect to The Commons Project Foundation’s CommonPass, which is being used for travel and return-to-work vaccine verification.

Participants include CARIN Alliance, Cerner, Change Healthcare, The Commons Project Foundation, Epic, Evernorth, Mayo Clinic, Microsoft, Mitre, Oracle, Safe Health, and Salesforce.

Reader Comments

From Assign Me Up: “Re: email updates. Please enroll me at this new address and remove the old one.” I’ve been remiss in not providing self-service email signup instruction reminders in many months, so here’s a refresher:

• Sign up for updates here or using the “Subscribe to updates” menu option under Contact (desktop format) or the “Get email updates” menu option (mobile format).
• Watch for the verification email that follows since it may end up on your spam folder and you’ll receive no further emails unless you confirm this one.
• Review your email rules, whitelist, company email server setup, etc. if you aren’t receiving the emails you signed up for. The automatic sending of the emails is highly reliable, but the receiving of them is much less so and is not something I can control (spam tools have eliminated the reliability and timeliness of email delivery, unfortunately).
• Unsubscribe your old address by clicking the ‘”unsubscribe” link that is at the bottom of each email. Or, do nothing since your inactive old address will cancel itself even if you do nothing.
• Reminder: I do absolutely nothing with the email addresses, so all you’ll get as a result of signing up is a notice that I’ve posted something new. I collect only the actual email address itself, don’t use those addresses for anything else, and don’t make them available to others.

From Clog Queen: “Re: HIStalkapalooza shoe contest. I think that in these challenging times (don’t all emails start with that phrase these days?) you should do a virtual version.” Certainly the shoe contest would virtualize better than most conference components since judges would just need to review photos, perform their deliberations, then announce the winners. I bet closets are full of low-mileage yet stylish zapatos since they add no value to a Zoom call.

From Dunning Notice: “Re: HIMSS21. Are you doing a booth this year, assuming the conference goes on?” No. It’s been nice in the past to have a place to say hello to readers on the show floor, but it’s not worth the several thousand dollars that a microscopic 10×10 foot space costs when I have nothing to sell that would offset that personal expense. I’ll probably (not certainly as of yet) be treading the thick exhibit hall carpet as a paying attendee, using my HIMSS20 registration rollover, if HIMSS21 happens. Thank goodness I ended HIStalkapalooza in its 10th iteration at HIMSS17 since I would have faced financial Armageddon otherwise from the cancelled HIMSS20.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor PatientBond. The Salt Lake City company applies consumer insights and innovative technologies to digital patient engagement. Its Digital Health Platform uses a proprietary psychographic segmentation model that allows health systems, urgent care facilities, and medical practices to personalize messaging and digital channels to each individual’s motivations and preferences, supporting market share growth (patient acquisition and loyalty, service line marketing, and social reputation management);  improved patient outcomes (closing care gaps, improving medication adherence, and automating care coordination); and increased patient payments (reminders, online payments, digital statements, and card-on-file messaging). The cloud-based, API-driven platform requires no training, no software to install, and offers easy integration with most CRM, EMR, and PM systems. Discover which of its five psychographic segments you fit in as a patient by answering a 12-question survey. Thanks to PatientBond for supporting HIStalk.

Thanks to the 2,000 folks who completed my once-yearly reader survey. Resultant factoids:

• 94% of respondents say they have a higher appreciation for companies they read about in HIStalk, while 82% have a higher appreciation for HIStalk sponsors.
• 94% say that reading HIStalk helped them perform their job better in 2020, which is a relief since that’s my most-valued metric.
• I’ve emailed the winners of $50 Amazon gift cards who were randomly drawn from participants. Thanks to all who completed the survey.

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

Provider and resource scheduling system vendor QGenda acquires Shift Admin, which offers shift-based specialty scheduling for emergency medicine, urgent care, and hospital medicine.

Signify Research says the EHR market in Europe and EMEA in 2020 was better than in the US, which declined due to COVID-related financial challenges. It also notes that consolidation is picking up in Europe, with Dedalus acquiring Agfa’s HCIS business, CompuGroup Medical buying parts of Cerner’s non-Millennium assets, and the merger of big Nordics vendors Tieto and EVRY.

Lumiata — which applies AI to 120 million patients records to predict patient outcomes, clinical costs, and risks for providers and payers – raises $14 million in a Series B funding round.

Cerner says in its J.P. Morgan Healthcare Conference investor presentation that it will create a billion-dollar data business in selling de-identified patient data as real-world evidence to drug companies, partly driven by its $375 million cash acquisition last month of Kantar Health.

Walgreens says in its J.P. Morgan Healthcare Conference presentation that it will create a tech-enabled healthcare startup as a “company within a company” that will offer a customer engagement platform, a personalization engine, a care integration platform, and a health marketplace. The company says that neither a digital-only nor a physical-only platform can be successful. It will partner with best-in-class companies as an integrator. The company said in Q&A that it expects to be part of the care team in offering patients real-time information for managing conditions and recommending medication changes to doctors, enabled by the increasing scope of pharmacist practice in some states. Walgreens has seen a 40% jump in pharmacist involvement with medication therapy management. It adds that a patient with multiple chronic conditions is forced to log into multiple apps, a process that it intends to simplify.

NextGen Healthcare’s J.P. Morgan Healthcare deck highlights its December 2019 acquisition of telehealth platform vendor Otto Health for a reported $22 million, after which its virtual visits have increased by 68%, active user count has jumped from 300 to 13,000, and contracted annual recurring revenue has increased from $200,000 to $9 million.

Sales

• Virginia Department of Behavioral Health and Developmental Services chooses Cerner’s EHR for four additional behavioral health facilities. 
• Konica Minolta Japan will use InterSystems IRIS for Health and its HL7 FHIR interoperability capability to connect its devices with other systems, such as the EHR.

Announcements and Implementations

Healthwise announces five Digital Health Programs – for diabetes, cardiac rehab, colonoscopy and endoscopy, orthopedics, and pregnancy and newborn – that allow providers to send education and reminders and receive individual and aggregated analytics to monitor patient progress.

Meditech offers a short-form Quick Vaccination solution that allows hospitals to administer COVID-19 vaccine at high-volume locations and transmit vaccine data to state systems.

Specialty EHR vendor Modernizing Medicine acquires Exscribe, which offers an orthopedics EHR.

A new KLAS report on structured reporting in cardiology finds that Change Healthcare and IBM Watson Health lead in adoption, Epic saw the biggest adoption increase but Cupid still requires a lot of work and is missing some functionality, and customers of Lumedx are frustrated with poor training, support, and development.

Government and Politics

Flo Health settles FTC charges that its Flo Period & Ovulation Tracker app shared user information with Facebook, Google, and other companies while assuring users that it would keep their information private. The company will have its privacy practices independently reviewed and will get user consent before sharing user data. Some members of FTC’s panel dissented parts of the settlement, saying that FTC should have charged Flo with violating the Health Breach Notification Rule that would have required notifying individual users, while Commissioner Noah Joshua Phillips issued a statement saying that simply requiring a company to notify users isn’t worth much if those users have no remedial actions available to them.

A Department of Defense annual review of its MHS Genesis Cerner implementation (thanks to reader Vaporware? for sending the link) finds that:

• MHS Genesis “is not operationally suitable because training remains unsatisfactory, dissemination of system change information is inadequate, and usability problems persist.”
• The system is operationally effective for basic operations in conventional clinics, but not for some specialty clinics and business areas.
• Performance scores increased from 45% of tested performance measures to 78%, with improvements needed in medical readiness, provider referrals, business intelligence, billing, coding, and reporting.
• System usability improved from “unacceptable” to “marginal-low.”
• The project has 158 open high-priority issues.
• Information exchange with required external systems was “sporadic, and the data were sometimes inaccurate and complete.” AHLTA-housed patient allergies, meds, and immunizations didn’t transfer to Cerner 13% of the time and care was sometimes delayed because of the manual reconciliation that was required.
• Cybersecurity experts found the system to be “not survivable in the complex, cyber-contested environment of a major medical facility.”
• Testing has not yet been performed to determine if the system can sustain the expected number of users at full deployment.

COVID-19

US COVID-19 hospitalization numbers dropped a bit on Wednesday, with 130,383 people in hospital beds with COVID. Daily deaths were also below record numbers at 4,022. Hard-hit UK and Ireland, which have high B117 variant activity, also showed a sharply reduced number of cases. CDC reports that 11 million vaccine doses have been administered of 31 million distributed, leaving two-thirds of them sitting unused.

The COVID Tracking Project warns that it will no longer report “recovered” patient numbers since not all states report that number and the term “recovered” has no standard definition and thus is reported in different ways by individual states. It also notes that many people who have had COVID-19 still don’t consider themselves to be free of symptoms.

CDC will require all travelers who are entering the US – including US residents — to show either (a) their negative coronavirus test results from within the previous three days; or (b) proof that they have recovered from COVID-19. Airlines will be instructed to not allow boarding to any passengers who cannot provide the documentation.

China locks down 22 million residents of several cities following a COVID-19 outbreak. The entire country of 1.4 billion people is reporting 109 new cases per day, while the US has that many new cases every four minutes with one-fourth of China’s population.

A Public Health England pre-print study finds that people who have already had COVID-19 are 83% less likely to get it again and are probably protected for at least five months.The researchers note that nobody knows if they can still spread infection to others.

People from Canada and Argentina are traveling on private jets to Florida to get COVID-19 vaccine, taking advantage of the state’s policy to vaccinate anyone over age 64 regardless of residency.

Stormont Vail Health disables its employee COVID-19 vaccine sign-up site after discovering that outsiders were able to sign up for shots using links that employees had shared with them. The hospital will now require those who are being vaccinated to show their badges, which it wasn’t doing before.

The former president and CEO of Canada’s London Health Sciences Centre sues the hospital for $2 million, claiming that he was fired this week for making five trips to the US despite Canada’s ban on non-essential travel across the border. Paul Woods, who is a Canadian citizen who holds permanent resident status in the US, says the hospital’s chief counsel approved his request to visit his daughter and his fiancée in Michigan as long as he self-isolated afterward. The hospital’s board chair resigned the day after the lawsuit was filed, admitting no wrongdoing.

Other

AdventHealth’s replacement of Cerner, Athenahealth, and Homecare Homebase with Epic will cost $370 million in capital cost plus $290 million in operating cost, according to its J.P. Morgan Healthcare Conference presentation. AdventHealth, the former Adventist Health System, says Its first go-live will be in Q4 of this year and the last will be finished a year later. The Florida-based system has 50 hospital campuses in nine states, 2,300 employed physicians, 80,000 employees, and $12.5 billion in annual revenue.

Prosecutors say that Theranos destroyed the SQL database of its laboratory information system when it closed its New Jersey facility in 2018, making its patient records unavailable for use in the federal government’s fraud case. The company paid a firm that was run by an associate of former Theranos COO Sunny Balwani $10 million over seven years to administer the database. Theranos provided the government with three versions of the backup before the company shut down, but all of them were encrypted with a password that everyone involved claims they have forgotten. Prosecutors hoped to use the database to prove their claims that tests offered by Theranos were unreliable, including one thyroid test whose failure rate was over 50%. The government also asked the court to deny the motion by former Theranos CEO Elizabeth Holmes to exclude what she calls “anecdotal” test results since the company destroyed the database while under subpoena.

A public hospital in China becomes the first to bill a patient using its blockchain-based invoicing system, which allows patients to review their medical and billing records on their phones. 

HIMSS21’s home of Las Vegas, which has the highest unemployment rate of major US metro areas at 11.5%, is taking another hit this week with the move of the Consumer Electronics Show to a virtual format. CES was supposed to be the first event in the $1 billion expansion of the Las Vegas Convention Center, which remains unused. CES expects its show to return in 2022, but most likely in a partially digital form.

Talk about positive patient ID: Denver police arrest the wrong woman for burglary after being told their suspect was an inpatient at St. Joseph’s Hospital, which they confused with Denver Health, where they arrested patient Sarah Cook in her hospital bed. Cook, who is a nurse, spent two nights in jail until police checked surveillance footage and realized that the brown-haired Cook wasn’t the blonde suspect they were seeking. The police department apologized, the officers were suspended for 10 days for failing to positively identify Cook before arresting her, and Cook is suing the police department.

Sponsor Updates

• The United States Park Police and the District of Columbia government will use Everbridge software to provide subscribers with safety, weather, traffic, event, and emergency alerts leading up to and during the presidential inauguration.
• Experity offers updates on state-based COVID-19 vaccine provider enrollment information.
• The HCI Group Chief Digital Officer Ed Marx will speak at the HIMSS Dallas/Forth Worth Chapter’s Annual C-Suite Panel January 29.
• Konica Minolta Japan selects InterSystems IRIS for Health for rapid, FHIR-based data integration for imaging devices.
• Nordic is named a leader in Everest Group’s Healthcare IT Services Specialists PEAK Matrix Assessment 2021.
• Ten health system customers of Kyruus are using its COVID-19 vaccine scheduling capabilities and have booked 100,000 appointments in the first month.
• The local paper profiles the way in which a Medical University of South Carolina student used Jvion’s technology to find patients at risk for COVID complications.
• Meditech offers customers access to its complimentary Quick Vaccination solution to reduce the burden of COVID-19 mass vaccination distribution.

Blog Posts

• Build vs. Buy: Insulin Dosing Software (Glytec)
• Value-Based Care: A 2021 Priority (Halo Health)
• Why Data-Driven Healthcare is the Best Defense Against COVID-19 (Health Catalyst)
• Why Virtual Diabetes Programs Should Be the New Normal (Healthwise)
• COVID-19 has created additional digital identity management challenges in healthcare, Imprivata survey reveals (Imprivata)
• Save the dates: 2021 code system updates at-a-glance (Intelligent Medical Objects)
• Advancing digital health solutions beyond the pandemic (Meditech)
• 2020 Year End Review: Our Most Accessed Patient Experience Resources (Kyruus)
• How COVID-19 Has Changed Healthcare (Optimum Healthcare IT)
• Haven Shuts Down But Disruption Thrives (Loyale Healthcare)
• More Than Just Compliance, EPrescribing Can Reduce Opioid Misuse and Overdose Deaths (Medhost)
• Department of Health and Human Services Extends Public Health Emergency (MWTherapy)
• Top Trends Shaping the IT Industry in 2021 (Newfire Global Partners)

Contacts

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