Recent Articles:

Morning Headlines 7/5/22

July 4, 2022 Headlines No Comments

IT outages across Norton Healthcare

Norton Healthcare (KY) attributes ongoing computer connectivity issues to an unspecified hardware problem that began on July 1.

Ria Health Secures $18 Million Series A to Scale Online Alcohol Use Disorder Treatment

Virtual alcohol addiction treatment provider Ria Health raises $18 million in a Series A funding round led by SV Health Investors.

Government to approve €86m electronic records system at new national children’s hospital

In Ireland, the government approves the purchase of an EHR for a new national children’s hospital from an unspecified vendor with a strong track record of global implementations.

Morning Headlines 7/1/22

June 30, 2022 Headlines No Comments

HealthMark Group Announces a Series of Strategic Acquisitions to Elevate Their Release of Information Portfolio

Patient engagement and release-of-information technology vendor HealthMark Group acquires Acton Corporation, its third ROI acquisition in 15 months.

Francisco Partners Completes Acquisition of IBM’s Healthcare Data and Analytics Assets; Launches Healthcare Data Company Merative

Francisco Partners launches Merative, a new healthcare data company that leverages the IBM Watson Health data and analytics assets acquired by the investment firm earlier this year.

Sensible Care Raises $13M Series A to Advance Quality-of-Care for Teletherapy Services

Online mental healthcare company Sensible Care raises $13 million in a Series A funding round led by Volition Capital.

News 7/1/22

June 30, 2022 News 2 Comments

Top News

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A NEJM perspective piece says that today’s care delivery policies and technologies sacrifice the “solution shop” work of doctors (solving patient problems and building patient trust) for “production line” work (approving prescription refills, entering orders, completing preventive screenings).

It notes that most of the patient visit can be consumed by clinicians completing EHR checkboxes, entering orders, manually completing prior authorization requests, and managing inbox messages.

It also observes that since it’s easier to measure the production line work in the EHR, quality metrics represent those tasks disproportionately.

The article also says that healthcare financial resources have moved away from direct patient care to tech companies, data aggregators, drug and insurance companies, and performance measurement subcontractors, as insurers and pharmacies automated their practices to meet more complex billing requirements while leaving doctors with more production line work.

The authors conclude that the solution and production work streams be designed to match worker skills, supported by policies and workflow.

The physician who sent the article my way says that the “workflow versus thoughtflow” challenge requires a major reengineering of physician processes to allow either (a) lower-level staff to do them where appropriate; or (b) the physician to perform them while still addressing higher-level thinking tasks. 


Webinars

July 12 (Tuesday) 1 ET. “Digital Data Stewardship for Trusted, High-Quality Data Exchange.” Sponsor: Clinical Architecture. Presenter: Carol Graham, MS, RN, product manager, Clinical Architecture. Organizations face challenges in ensuring that the patient data they received and send is consistent, accurate, and usable. Use cases include receiving multi-source data across health information networks with variation in formats and content; merging and de-duplicating provider, payer, and research data; uplifting legacy data for current use cases and formats; and normalizing and formatting data for public health surveillance, quality measure reporting, and providing directly to the patient. This webinar will cover Pivot, a comprehensive Digital Data Steward solution that orchestrates format harmonization, content (vocabulary) normalization, de-duplication, and data quality validation into a single solution.

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


Acquisitions, Funding, Business, and Stock

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Patient engagement and release-of-information technology vendor HealthMark Group acquires Acton Corporation, its third ROI acquisition in 15 months.


Sales

  • In England, East Suffolk and North Essex and West Suffolk trusts choose Sectra for digital pathology.
  • NHS Scotland names Citadel Health as supplier of its Laboratory Information Management System framework.

People

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Kyruus hires Paul Merrild MBA (Sound Physicians) to the newly created position of president.

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CloudWave promotes Mike Donahue to VP of client services.

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Former Kareo CEO Dan Rodrigues takes the CEO role at Tebra, the company he co-founded when Kareo merged with PatientPop last year.


Privacy and Security

Baton Rouge General is forced to chart on paper due to a Tuesday cyberattack.


Other

Funniest news of the week: the federal government fines accounting firm Ernst & Young $100 million for failing to act on reports that many of its employees were cheating on their CPA exams. The best part – the section they were cheating on was ethics. Those involved say they were short on after-work study time or had already failed the exam multiple times.


Sponsor Updates

  • California State University, Dominguez Hills becomes the seventh higher education institution to join Optimum Healthcare IT’s CareerPath program, which offers students who are interested in a healthcare IT career a two-phase training program that includes a digital health certification program that was co-developed with CHIME followed by application-specific technical tracks.
  • Visage Imaging joins the Amazon Web Services Partner Network as an Advanced Technology Partner.
  • Premier honors The Breakaway, an Indiana recovery home for women battling addiction, with its Monroe E. Trout Premier Cares Award and a $100,000 prize.
  • West Monroe publishes a new report, “Understanding Major Trends in Healthcare M&A and Investment.”
  • The HIT Like a Girl Podcast features EVisit Chief Strategy Officer Juli Stover.
  • FDB hires Jaelyn Ibarra as a research associate.
  • GHX congratulates customer Spectrum Health on earning the 2022 Top Supply Chain Projects Award from Supply & Demand Chain Executive.

Blog Posts


Contacts

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

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EPtalk by Dr. Jayne 6/30/22

June 30, 2022 Dr. Jayne No Comments

I’m still in the woods. We have had good weather, so I’m grateful. I ended up sharing some of the first aid duties with one of my favorite nurses. The camp has a new policy about how we document medications that are given the participants and there’s a bit of redundancy to it. One of the volunteers was complaining, but the nurse mentioned the EHR that she uses in her hospital and the fact that she’s used to documenting the same thing in multiple places. I literally laughed out loud. I’m sure the other volunteers thought I was suffering from the campsite psychosis that typically develops late in the week, but it made my morning.

I hopped on a work call to help with some testing in the production environment. In the software world, companies sometimes refer to “eating their own dog food,” while one of the other volunteers who is a software engineer said that his company refers to it is “drinking their own champagne.” I hadn’t heard that one before, but I like it, although it’s pretty presumptuous to assume that what you’re releasing is top shelf. I’ve used plenty of software that’s closer to Three Buck Chuck than it is to Dom Perignon.

My organization is bringing up some new features and has a solid plan for the go-live, so while we were troubleshooting a small issue, we were talking about past go-live experiences. We collectively decided that intensive care unit go-lives are the most nerve wracking, although those on the labor and delivery unit are a close second. One of the major challenges with changes to the system for L&D is that you have to be able to immediately document on a patient who didn’t exist just moments before, and for whom you have no information. It’s similar to managing a John Doe patient in the emergency department, although the odds of having a John Doe during a go-live are significant smaller than having new babies arrive.

After more than two years dealing with the COVID-19 pandemic, hopefully EHR developers and those who support ambulatory clinics will be able to swiftly make the changes they need to combat the growing monkeypox outbreak. More than 50,000 doses are being shipped to states with the highest case rates, which means that systems need to be updated to document their administration. I’ve worked with a couple of niche EHRs where the vaccines are hard coded or difficult to configure, so I hope the clinics that receive the doses have systems that make it easy to capture such important patient care information. Plans are in place to distribute more than 1.25 million doses in coming months. I hope we can get ahead of the problem rather than be in reactive mode like we were for COVID.

This article caught my eye, noting that half of public databases in the US misuse gender and sex terminology. This is one of my pet peeves. I’ve worked with vendors who do a good job understanding the difference between the two and those that don’t. The authors looked at 75 databases used in biomedical research and also looked at journals to see if they had author guidelines that addressed these factors. Understanding sex and gender is important to better quantify the ways in which sex and gender drive clinical outcomes.

For those who need a quick review, “sex” refers to biological attributes such as anatomy, chromosomes, hormone levels, and gene expression. “Gender” refers to expressions, identities, social roles, and behaviors. I hope that the software vendors who continue to use these values interchangeably will eventually get it in gear.

I’m keeping it short this week since I need to get back to my camp duties. It’s been great to see how the participants are already growing and learning new things. The group I ate breakfast with this morning made my day. Since they knew that I was their assigned adult, they cooked my pancakes in the shape of a J. When you have the chance to work with people who have that level of commitment to caring for others, it gives you hope for the next generation.

Email Dr. Jayne.

Morning Headlines 6/30/22

June 29, 2022 Headlines No Comments

Socially Determined Closes $26M Series B Financing to Set the Standard for Propelling Successful Health Equity and SDOH Initiatives

Socially Determined, a healthcare analytics company focused on social determinants of health, has raised $26 million in a Series B investment round.

WebMD Health Corp. Acquires Mercury Healthcare, Building on Leadership in Patient Engagement Solutions

WebMD will acquire patient engagement and analytics vendor Mercury Healthcare for an undisclosed sum.

Regard serves as a ‘medical co-pilot’ for busy physicians

Regard will use $15.3 million in new Series A funding to build out its AI-powered diagnosis software capable of mining patient data found within EHRs.

Evolent Health to Acquire IPG

Population health management and analytics vendor Evolent Health will acquire musculoskeletal-focused surgical management company IPG for $375 million.

HIStalk Interviews Brian Robertson, CEO, VisiQuate

June 29, 2022 Interviews No Comments

Brian Robertson, MHSA is founder, chairman, and CEO of VisiQuate of Santa Rosa, CA.

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Tell me about yourself and the company.

I’m 30 years in and a data geek at the core. I started helping the provider industry achieve yield improvement from the revenue cycle 30 years ago, initially at a consultant that had a boutique. That turned into a company called MedeAnalytics. It was taking the application of what you learned in consulting walking the halls of the hospital. People were interested in visualizing what was going on in the enterprise. MedeAnalytics was focused on that and still is. 

I departed in 2009 and started VisiQuate, fundamentally doing the same thing, although my passion grew from targeted point solutions to a broader data platform for the revenue cycle as opposed to having too many point solutions. We deliver that as a service-enabled technology, because we are doing the data aggregation and processing.

I am trying to the help CFO, the VP of revenue cycle, and their staff do two things. Drive yield improvement, but also those data signals can also tell you where there’s redundancy and where automation — more buzzwords, such as AI, machine learning, RPA, all of those things – create a tremendous opportunity to take waste and process inefficiency out of the revenue cycle. My passion remains. The bots have arrived and we’re helping clients get things done through intelligent bots.

What has changed the most in analytics and technology since you started the company?

There’s a nice tipping point, in my view. Let’s just go back five years. We started our initiative for AI and built a chatbot, essentially Alexa or Siri for the revenue cycle. You could say, “Ana, what’s going on with Medicare bad debt, or what’s going on with Aetna, payer code 1234?” That then evolved to looking at deep data signals on where there is redundancy. Clients would say, “We have to start automating things. We are growing to so many people growing through acquisition. I have 1,200 revenue cycle FTEs, the company is growing, and the CFO wants us to maintain 1,200.”

We started to lean into that. For those years it was pilot projects, proof of concepts, interest. Everybody knew it was something you should do. COVID arrives, we’re all working from home, and you look at getting people at the home. Then some labor shortages, some problems with the sheer volume of accounts that need to be processed every day. The conversation went from “nice to have, we should do that” to “what can we automate?” We are in COVID hangover, but many folks are still at home. Many of our clients tell us, and we see it in the data, that they are having problems. Largely in the back office, where it’s hard to find FTEs that are doing account follow-up call center type activities. The line you hear is, “Target pays more than I can pay the most senior collector.”

We are addressing that shortage by using one lens of insights that is driving yield improvement. Who’s paying and who’s not paying? Where are there under payments? Where are their denials? Those types of things. But now we are training the data signals to also look for redundancy, where any kind of revenue cycle FTE is doing the same thing. Filling out a payer downgrade appeal form, and they do it 15 times in their day. And you say, we have all the data, what if we automate that? Oh yeah, I could work more accounts.

Our approach, instead of pure robotic process automation, is what Gartner and others call intelligent or cognitive process automation. Because we are letting Ana, which is our AI analyst, first go do the discovery, companionate smart people to say, we have a lot of redundancy here, here, and there. They say that qualitatively. Then we say, let’s go look at the data, let’s look for that redundancy, and then let’s do one bot at a time.

We are trying to focus on smart bots, leverage the Pareto principle, get people excited about automation, get them familiar with it, do one and go to the next, and make sure you maintain them. You hear sentiment like “Bots break. Bots are brittle.” Yes, they are. But so is the contract management system, where you have to update tables, profiles, and dictionaries. It just has to be built into the service model.

We are advanced analytics versus BI and reporting. Insights can focus on where to automate. That’s where we are passionate and getting some nice traction.

How does a health system that has revenue cycle opportunities decide whether to bring in outside help, outsource, or invest in technology?

When we are talking to clients, we can walk in and say, “Here’s what we can do, You push the data to us, we’ll take care of all the heavy lifting. You’ll be on the assembly line.” Many clients have already invested in bots and RPA or they are about to, or they’ve got a consultant. We try to be compatible and complimentary in all the things that we do. I hate to use Lego blocks as a metaphor, but I don’t have e better one. Whether it’s APIs or just containers, all the techy stuff, we try to make all of our offerings plug and play. Because half the time it’s fully outsourced to us, and half the time we’re working with a combination of the VP of revenue cycle and CIO and should complement their initiative.

For example, if they have bought or made an investment in UiPath, Automation Anywhere, or tools like that, they have existing licenses. You say, great, let’s leverage them, Our cognitive bot Ana is benefiting from crowdsourced data across many, many clients. That’s the cognitive brain that lets us do that part. For the carpentry of building the bot, if you have programmers and you want to do that, it’s like we’re doing the architecture. We can do carpentry or you can do carpentry. We try to be plug and play friendly, because if you don’t, then you are leaving market opportunity on the table.

How has hospital consolidation into larger health systems impacted the capability for revenue cycle management to scale?

I’m famous for saying that you can end every sentence in healthcare with dot, dot, dot. It depends. We have seen all of the above. Some grow through acquisition, and maybe there’s two-thirds on one platform like Epic. They have robust, capitalized product development dollars. IT shops that have actual software developers, an architect, a true world class DBA are the shops we tend to be complementary to. They have some existing investment. Other shops are resource constrained and are just keeping the lights on in many cases.

People will say things like, they’re an Epic shop, or they’re a Cerner shop. I would say that they have chosen Epic to be their vendor of choice for the HIS and system of record, but they are on Epic, Cerner, Meditech, and Allscripts and they are moving across a five-year journey to centralize Epic. Many times, clients think that we are the bridge. We are still giving a consolidated view of the enterprise, because we take feeds from all those systems and give the CFO, the VP of revenue cycle, and the case manager their dashboards. Everybody gets the intelligence that they need and we normalize that data.

A lot of our advanced analytics is leveraging embedded wisdom across a lot of years. That’s the part we’re always making sure that they take advantage of. I can also sit down with folks if they’re intellectually honest and say, “I know you have invested in licenses and all that, I can show you a TCO calculator, and it would be hard to compete with our benefit of scale. Because we have a massive cloud store, our return on terabyte is going to probably have a benefit of scale that you can’t compete with. We have over 400 hospitals, and we do this every day. Whether it’s the private cloud or it’s running daily ETL, personalizing dashboards — because in healthcare, it’s hard to be a cookie cutter solution, things change too much – we are very malleable in all of our solutions, and to be malleable, you’re supporting them every day.” We tell clients, if you want to do this portion, let’s make sure we’ll consult with you, what’s the maintenance, what’s your maintenance plan. Because these are the hours it takes to keep all the lights on. Data action versus reporting is not for the faint of heart. You have to be a little bit crazy and you have to have done your 10,000 hours.

What do health systems gain from using workforce performance analytics?

One of the most exciting things that I’m passionate about came from a client. The hospital side of the house and the physician side of the house  were very different in how they did incentive compensation. They were using tools out of PeopleSoft and traditional systems like Kronos to not only get time and attendance, but try to have quality performance scores. They would take a random sample of transactions. For example, if you were a patient access clerk, there was a threshold of errors. You can’t miss the Social Security number, the subscriber ID, the really important information required to get a claim paid. It was saying that you have to be at this threshold, and if you’re at this threshold, you’re eligible for points in monthly giveaways in the fishbowl, or you’re eligible in some shops for incentive comp.

It started there, and we started getting deeper into the quality scores, because that particular client got us excited about the notion of gamification. Shops that can’t do incentive pay can do point systems and badges, like a Fitbit. People love bragging rights, to go in the lunchroom and announce, “Hey, did you see I got the badge? I improved my patient accounting collections 3% over last week.” The attaboys and attagirls and things that come from gamification really started to move the needle.

We took time and attendance and added measures of quality that people would usually do through an audit. We automated that audit, so instead of looking at 15 accounts, do a score, and see which threshold they are at, we took all their Boolean logic and automated it. They ended up with something that is similar to RVUs. We called it a PVU, Performance Value Unit. It’s multi-variable calculus on, what does their time and attendance record look like? What does their quality score look like? Some people do things like training, so what is their ongoing training and CEUs? It’s more holistic than grading somebody’s paper on pure time and attendance and leveraging the Hawthorne effect in a positive way.

Where do you see the company going in the next few years?

I expect, and we see this in the market, that our revenue mix will shift from 80% insights business and advanced analytics to 80-20 or maybe 60-40, where the 40% will be intelligent process automation. It will be us tackling administrative waste in the revenue cycle in a way that’s compelling and delivers an ROI. Right now we deliver an ROI by improving cash flow, bad debt, and underpayments and the like. I think that because the need is so great, our ROI will now be a combination of analytics and the results of automation, taking out the waste and also upskilling the revenue cycle folks to be directionally headed to being knowledge workers.

Morning Headlines 6/29/22

June 28, 2022 Headlines No Comments

The Promise of Digital Health: Then, Now, and the Future

The National Academy of Medicine publishes a paper titled “The Promise of Digital Health: Then, Now, and the Future” whose authors are digital health household names that include Amy Abernethy, Patti Brennan, Atul Butte, Judy Faulkner, John Halamka, Kevin Johnson, Don Rucker, and Eric Topol.

ITC Administrative Law Judge Finds Apple Infringed AliveCor’s Patented Technology

A trade court judge rules that Apple infringed on AliveCor’s atrial fibrillation detection technology, a decision that if affirmed by the International Trade Commission, could force Apple to stop selling Watch in the US or to remove the disputed technology.

New Data Analytics Can Predict Patient Outcomes and Improve Care – Here’s How

Hartford HealthCare (CT) spins out H2O, a cloud-based predictive analytics company focused on offering providers insight into patient length of stay, and patient flow through the emergency department and during surgery.

News 6/29/22

June 28, 2022 News 9 Comments

Top News

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The National Academy of Medicine publishes a paper titled “The Promise of Digital Health: Then, Now, and the Future” whose authors are digital health household names that include Amy Abernethy, Patti Brennan, Atul Butte, Judy Faulkner, John Halamka, Kevin Johnson, Don Rucker, and Eric Topol. Points:

  • US health policies and health system investments are misaligned with WHO’s definition of health as incorporating physical, mental, and social well-being, not just the absence of disease.
  • Digital health has done little to improve care effectiveness, efficiency, equity, and continuity of care, as inpatient data is largely sequestered and difficult to integrate due to a lack of data standards.
  • The promise of real-time generation of evidence to fuel a learning health system exists only in a few pilot projects.
  • Potential uses of digital innovation include advancing diagnosis and treatment, ensuring care continuity, managing patients offsite via telemedicine, partnering with individuals for self-management, and reducing errors and waste.
  • Digital health measured the impact of COVID-19 by race, economic states, and underserved populations and has the potential to identify, measure, and modify the root sources of illness.
  • Social determinants of health, which cause up to 15% of premature deaths, need to be considered as in-scope by providers and health systems, as supported by the collection and integration of SDoH into EHRs and mobile apps. The risk of algorithmic bias should be considered, however, such as stigmatizing no-show patients who struggle with employment and childcare issues.
  • Digital health can also contribute to the understanding of environmental factors, such as air pollution and climate change.
  • Behavioral interventions, such as weight management programs, often don’t work, and digital programs that claim otherwise are usually not supported by evidence and weren’t produced by experts in health behavior change.
  • AI/ML as applied to genetic, genomic, and medical history data could provide near real-time feedback to individuals using a voice assistant as a “digital health coach.”
  • Architecture should focus on the individual, embed equity and transparency, and realign health system payments around outcomes and value.

Reader Comments

From Das Kapital: “Re: slow news days. I’m disappointed when there’s not much news to read in HIStalk.” That’s a feature, not a bug. Unlike most news sites, I have no incentive to pad out the good stuff with junk to draw clicks or increase time-on-page numbers. My gift to you on those slow news days is time that you can reallocate.

Meanwhile, that’s a reminder for me to offer the annual Summer Doldrums first-year, extra-months deal for new sponsors. If your company is failing to reach decision-makers; was surprised to learn that your since-departed junior marketing person ignored our renewal emails and got you cancelled; or is a small startup, Lorre can hook you up. You get a year’s worth of exposure for less than what some companies spend on Starbucks for conference booth staff.

From Oracle of Secrets: “Re: Oracle Cerner (still feels weird to write that). Larry’s reading of marketing mumbo jumbo about quality and cost improvements with the acquisition wasn’t convincing.” You should assume until proven otherwise that Oracle’s entire interest in buying Cerner is (a) to boost sales of Oracle’s existing products, especially cloud services, by getting (or making) Cerner users replace anything from Oracle’s big tech competitors Microsoft, Google, Amazon, etc.; (b) to sell more Oracle products such as ERP into the Cerner market; (c) to gain access to a supply of de-identified patient data that can be used from everything from AI training to selling on the open market; and (d) to get a bit closer to massive healthcare spending in both the US and elsewhere. Oracle may do great work in healthcare, but market precedents aren’t encouraging. It will be interesting to see how hard Oracle upsells into the Cerner client base and whether that drives clients to Epic, which by the way already offers a lot of what Larry was extolling. Readers, what is your experience with Oracle as a vendor?


HIStalk Announcements and Requests

Listening: Turnstile, Baltimore-based, high-energy punkish rockers who I found accidentally who then made a big splash at Glastonbury this week. They kind of remind me of Rage Against the Machine, but they can take an enjoyable hard turn from scrapping with throngs of on-stage mosh pit divers to playing thoughtful melodies.


I talked to a HIMSS insider about recent changes there. Notes from our chat, with the usual disclaimer that this is one non-anonymous person’s opinions and observations that have not been confirmed:

  • Some employees felt that HIMSS22 was an awkward conference, with low HIMSS employee morale and a lack of visibility of President and CEO Hal Wolf. Turnover increased immediately before and after the conference.
  • Some regional events that should have been popular have been cancelled due to lack of sponsoring vendors. HIMSS laid off around 50 people, most of them in the events area, a few weeks ago.
  • Hal’s vision was a Netflix or New York Times type subscription model for HIMSS, where people could buy a basic subscription and pay extra for add-ons.
  • Hal runs HIMSS more like a for-profit business than his predecessor Steve Lieber, with a quick, confusing switch of tactics from a non-profit and the hiring on of quite a few of Hal’s former for-profit company colleagues.
  • HIMSS wasn’t prepared for the buzz of the ViVE conference and “mouths dropped” internally upon seeing the energy it drew. HIMSS didn’t send anyone to scout ViVE, but saw recaps and photos from the brightly colored, fun conference with interesting people on stage in Miami. The industry’s aggravation level with HIMSS was high, making it the perfect time to start a competing conference. Still, HIMSS isn’t making major changes, just strategizing to increase HIMSS23 registration numbers and streamline the entry process for the “45 minute PowerPoints in windowless rooms” educational format.
  • HIMSS had previously tried something similar to HLTH and ViVE by buying Health 2.0 to get a younger and hipper crowd and to tap into investors, but “wrung the life out of it” by making it into a mini-HIMSS that suffered from “death by committee.”
  • The sale of HIMSS Analytics was “shocking” since that business had given HIMSS a way to understand health IT as an influencer rather than just a cheerleader.
  • HIMSS Accelerate was the “jump the shark” moment as HIMSS tried to push members where they wanted them instead of where those members actually wanted to be. It was supposed to change the way that HIMSS does business, but people don’t need or want another social media platform. Accelerate use is negligible outside of HIMSS employees.

Webinars

July 12 (Tuesday) 1 ET. “Digital Data Stewardship for Trusted, High-Quality Data Exchange.” Sponsor: Clinical Architecture. Presenter: Carol Graham, MS, RN, product manager, Clinical Architecture. Organizations face challenges in ensuring that the patient data they received and send is consistent, accurate, and usable. Use cases include receiving multi-source data across health information networks with variation in formats and content; merging and de-duplicating provider, payer, and research data; uplifting legacy data for current use cases and formats; and normalizing and formatting data for public health surveillance, quality measure reporting, and providing directly to the patient. This webinar will cover Pivot, a comprehensive Digital Data Steward solution that orchestrates format harmonization, content (vocabulary) normalization, de-duplication, and data quality validation into a single solution.

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


Acquisitions, Funding, Business, and Stock

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A trade court judge rules that Apple infringed on AliveCor’s atrial fibrillation detection technology, a decision that if affirmed by the International Trade Commission, could force Apple to stop selling Watch in the US or to remove the disputed technology.

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PicnicHealth raises $60 million in a Series C investment round, bringing its total funding to over $100 million. The San Francisco-based startup uses de-identified patient data culled from its PHR offering to build datasets for research.

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App-enabled at-home and point-of-care testing company Cue Health will reportedly lay off 170 employees, citing economic hardships and a shrinking market for COVID-19 testing. The company had signed testing contracts with the NBA, MLB, and HHS, among others, during the height of the pandemic.

Hartford HealthCare (CT) spins out H2O, a cloud-based predictive analytics company focused on offering providers insight into patient length of stay, and patient flow through the emergency department and during surgery. The software, developed in collaboration with MIT professor Dimitris Bertsimas, PhD, will be offered commercially by the end of the year.


People

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R1 RCM names former Cloudmed CEO Lee Rivas, MBA president. R1 finalized its acquisition of the RCM software vendor last week.

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Hackensack Meridian Health (NJ) names Sameer Sethi (Bon Secours Mercy Health) SVP and chief data and analytics officer.


Announcements and Implementations

Olive announces GA of its Autonomous Revenue Cycle, a group of solutions designed to help providers automate time-consuming, revenue-related administrative tasks.

Trinity Health of New England partners with virtual lactation platform vendor Nest Collaborative to offer virtual breastfeeding support for families who give birth at the health system’s three birthing hospitals, generally paid for by health insurance.

TriHealth says that integrating Tempus oncology genomic testing workflows with Epic helped identify available clinical trials, recommend an FDA-approved treatment, improved genetic counseling, alerted clinicians when appropriate new treatments became available for existing diagnoses, and made clinician ordering easier.

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Yale researchers develop an EHR-embedded software tool to help ED doctors initiate buprenorphine treatment for opioid abuse.


Government and Politics

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The Government Accountability Office recommends that HHS develop a way for covered entities to offer feedback on the breach reporting process. Hacking and IT incidents have increased by 843% since 2015, while unauthorized access and disclosures have increased by 43%.


Other

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An Insider investigation of virtual mental health startup Cerebral finds that the company ran itself without regard to clinical standards until the federal government intervened. The report says that the company took on patients it should not have, assigned them to clinicians — mostly nurse practitioners — and other employees who lacked training and oversight, pushed those clinicians to issue prescriptions to 95% of patients, and placed the licenses of its clinicians at risk via its policies and its disregard for state regulations. Insiders say Cerebral’s clinicians sometimes ignored the company’s requirement that they check prescription drug monitoring databases before prescribing controlled substances. Cerebral is being investigated by the DEA, DOJ, and FTC, while health insurers and pharmacies have cut ties. The company at one time had 210,000 active patients and 4,500 employees, with plans to expand to 10,000 employees by the end of this year as it planned to expand into weight loss.

A study concludes that most digital health startups have low levels of clinical robustness, as evidenced by few regulatory filings, clinical trials, and data shared publicly.


Sponsor Updates

  • Agfa HealthCare further develops enterprise imaging workflows for the Yorkshire Imaging Collaborative and South Yorkshire & Bassetlaw regions in England.
  • Everest Group’s RCM Operations Peak Matric Report names AGS Health a Star Performer and Leader for growth, innovation, and positive impact on the healthcare market.
  • Baker Tilly donates $10,000 to Camp Good Mourning as part of its Wishes grant program.
  • BDO publishes a new insight, “Minimizing Revenue Loss Due to Inpatient Status Downgrades.”
  • Clearwater hires Alka Kumar (HealthWorks) as a compliance and privacy consultant.
  • Optimum Healthcare IT hires Kenneth Martin (Elliot Hospital) as application team manager within its managed services team.
  • Divurgent names Kristal Wittman director of digital health.
  • AGS Health is again named a Leader and Star Performer in Revenue Cycle Management (RCM) Operations by Everest Group.
  • Enlace Health will present at the World Forum Bundled Payments Conference July 14 in Chicago.
  • The American Society of Nephrology has entered into a publishing agreement with Wolters Kluwer Health to publish Journal of the American Society of Nephrology, Clinical Journal of the American Society of Nephrology, and Kidney360.

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Morning Headlines 6/28/22

June 27, 2022 Headlines No Comments

PicnicHealth raises a $60m Series C to expand patient-centered real-world data

PicnicHealth, which uses patient-reported data to build datasets for research, raises $60 million in a Series C investment round that brings its total funding to over $100 million.

Nomad Health Raises $105 Million to Expand to New Specialties and Address Healthcare Staffing Crisis

Nomad Health will use $105 million in new funding to expand its online healthcare jobs marketplace beyond travel nursing to include physical therapists, and laboratory and ultrasound technicians.

Siemens to buy U.S. software company Brightly in $1.58 bln deal

Siemens will acquire maintenance asset management software Brightly, whose solutions are used in hospitals, offices, schools, and factories, for $1.6 billion.

Cue Health to Lay Off 170 People

App-enabled at-home and point-of-care testing company Cue Health, which went public last year at a nearly $2.5 billion valuation, will reportedly lay off 170 employees.

Readers Write: Payers Are Approaching a Moment of Reckoning on Fraud, Waste, and Abuse

June 27, 2022 Readers Write 4 Comments

Payers Are Approaching a Moment of Reckoning on Fraud, Waste, and Abuse
By Ketan Patel, MD

Ketan Patel, MD is chief medical officer of SyTrue of Stateline, NV.

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Payers are poised to face a new operating environment with significantly more scrutiny over fraud, waste, and abuse (FWA) in the wake of COVID-19.

Two years ago, the federal government created the Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) program to beef up audits of MA insurers. For 2022, CMS also doubled its budget for fraud, waste, and abuse (FWA) investigations, and the Department of Justice just announced charges against 21 defendants accused of various healthcare fraud schemes involving the COVID-19 pandemic. Meanwhile, payers are working to reconcile billions of dollars in COVID-related medical expenses and correctly identify risk for the surging number of long COVID patients.

These factors have converged to generate significant potential headwinds for payers and will create the following two new realities:

  • Payers will be forced to sift through increasingly huge volumes of clinical records to identify potential fraud and waste, as well as confirm bill accuracy to properly compensate providers.
  • At the same time, as we head into the third year of the pandemic, payers will uncover an unprecedented amount of FWA related to COVID-19.

How successfully payers manage these challenges will be determined by their ability to replace time-consuming and expensive manual processes with artificial-intelligence-based tools that comb patient records to identify potential fraud, assess patient and population risk, and confirm payment accuracy.

In the past, payers depended on expensive and time-consuming chart reviews to find and extract key unstructured data from patient records, such as information that reveals the need (or lack thereof) for a patient to undergo various COVID-related tests. More recently, though, payers have turned to natural language processing (NLP) as an alternative to manual chart reviews. NLP is an AI-based technology that enables computers to “read” and understand text by simulating humans’ ability to interpret language, but without the limitations of human bias and fatigue.

With NLP, payers can retrospectively analyze longitudinal health data to find a particular piece of clinical information about a single patient or identify subsets within populations that require further exploration. Given today’s environment of increased FWA scrutiny, NLP is poised to play an increasingly important part in helping payers pinpoint instances of FWA.

The following are three ways payers can leverage NLP to improve FWA detection:

  1. Detect patterns. In cases of FWA, there is often a pattern of repeatability in the data, such as a large number of patients meeting the same prior authorization requirements. NLP helps payers detect these patterns that lack the natural variability found in legitimate patient records.
  2. Identify outliers. In the same respect, NLP can help payers spot unusual data that may be representative of fraud, such as expensive tests for which there is no medical necessity. With its ability to accurately analyze unstructured data to identify anomalies within records, NLP can quickly verify the presence, or lack of, critical data.
  3. Improve scale. While even the most hard-working humans possess limitations on their ability to perform a high amount of chart reviews in a narrow timeframe, NLP automates the process, enabling substantial improvements in scalability. Because some complex medical records may consist of thousands of pages, NLP can drive significant savings in time and money in reviews.

For payers, the time to prepare for increased FWA scrutiny is now.

HIStalk Interviews Jeff Brandes, CEO, Azara Healthcare

June 27, 2022 Interviews 1 Comment

Jeff Brandes is president and CEO of Azara Healthcare of Burlington, MA.

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Tell me about yourself and the company.

I am a serial entrepreneur who has dabbled in all sorts of areas of technology. About 10 years ago, I came upon an opportunity in healthcare. At the time, I truly didn’t know the difference between Medicare and Medicaid, but I was heavily schooled by our initial partners as we started Azara. Here we are 12 years later and I can speak the lingo and I actually think I might even have a bit of credibility. Azara provides population health, primarily to safety net clinics, Federally Qualified Health Centers, and others who are serving the underserved.

The argument could be made that value-based care is the superior healthcare delivery model, yet patients are usually part of a federally supported program who are seen as underserved or disadvantaged. What are we learning about value-based care that can change the healthcare system?

The Federally Qualified Health Centers in general, depending of course on the state that they reside in, have mostly been fee-for-service with some shared savings and some upside. But because they are held accountable for quality metrics and improvements to maintain their status with HRSA, they have started to place an infrastructure that looks just like what is needed for value-based care into place. Looking at quality. Looking at high-cost events like readmissions. With both the cost aspect in mind, but clearly if someone’s going back to the hospital, they need more care or they need different kinds of care and it’s all in the effort of improving the patient’s health.

How is technology being used to identify those patients who need the most specific care?

We have learned a lot over the past few years. We started by automating things that we were doing already, in particular, billing. US-based EHRs are all centered around billing for services. But through that, we have collected a vast amount of data on our patients and are now just starting to find ways to unlock that data and make sense of it.

But as we do it, what we are learning is that it doesn’t matter how good the reports are and how good the information on the reports is if you can’t get that information to the right point in the workflow of the clinician or the provider where it’s easy for them to see and digest. You can’t make an impact on the patient. What we are starting to see, and what we will see in the years going forward, is more and more emphasis into how to get the right information that we already have to the right place at the right time.

There’s a significant amount of patient responsibility involved in participating in these programs since they need to be engaged, receptive, and perhaps educated about the concept. Does technology help in that way as well?

Technology helps us identify which patients are complying and are engaging a lot sooner potentially than waiting until they come in their next visit and they’ve gained 10 pounds and say they only take their meds once in a while. Using technology, we can at least identify some of those things. If they’re not picking up their prescriptions, it’s unlikely that they’re taking them. We can use things like that to get a bit ahead of the problem instead of waiting six months or a year, or for an emergency room visit, to realize that the patient is not engaging the way we had hoped or the way we had talked to them about.

They may be skipping doses because they can’t afford the prescription. How do you draw a line around delivering value-based care versus the social services that may be required for the patient to do what they need to do?

There are technology aspects and programmatic aspects of it. Of course, there’s just being in tune with it. The vast majority of our clients, the ones who are in the safety net, are very in tune with the patient’s social needs, screening for those and finding their patients affordable means to get the medications and other services that they need. First is identifying the need and then having access to the programs that can fulfill that need. Definitely medications is an obvious example, and there are programs to get medications in the hands of those who can’t afford it.

But when you start to expand the scope of those needs around housing and access to quality food in caring for patients, all of a sudden you need programs like Medicaid and Medicare to be a little more flexible in how those benefits can be delivered. Because it may not be a drug they need, but enough money to buy high-quality fruits and vegetables instead of processed food. Definitely we are hearing and we are seeing our clients look more and more for that flexibility in caring for the total patient in order to address their medical needs.

Capturing social determinants of health is becoming common, but what is the role of providers to help address them?

My perspective is a little biased because I believe that my customers in the safety net are a good bit ahead on this, but it doesn’t just affect patients at Federally Qualified Health Centers. My first experience with how being in tune with social factors and social determinants of health was an interesting one. In talking to a clinician, they talked about having a flag to tell them that the patient had unstable housing or was homeless. The patient presents themself with a run of the mill tonsillitis or some type of infection that requires antibiotics. Just by knowing and recognizing that that patient is homeless, you’re going to look at the available meds, antibiotics in this case, that you could prescribe. If you know they are homeless, you’re going to choose the one that doesn’t require refrigeration. Even though the refrigerated one may be the best one, you’re going to choose one that you know the patient is capable of hanging onto and taking effectively to cure that infection, versus something if it required refrigeration would get thrown away or likely not provide the intended effect. That was my first experience at how recognizing these factors and working with them could really change the way the clinician and the care team delivered their care to be more effective.

What are the constraints in recommending and arranging those services?

The majority of our customers are in the safety net. They are community health centers, and many of them function in the true nature of the word “community,” where they provide the medical care, but they have long established relationships with food banks, shelters, and social service agencies that can help fill these gaps. Do new challenges present themselves every day? Of course, they do. But I think they’re pretty adept at handling it.

I think what they’re optimistic about is that now that the broader world is recognizing the social factors and some of the disparities and starting to put funding and services in that direction, they are well positioned to be able to align their patients to take advantage of those services better today than they were yesterday.

What is the role of text messaging?

In our experience and with our clients, text messaging is extremely effective in the populations that our clients are serving. I’ll speak for myself. Getting text messages for my doctor is quite effective, and in some cases, maybe a little too effective, where I want to turn them off because there’s so many of them. But when I go back to the kind of programs we run and with our clients using texting, there are a lot of ways you can configure a texting campaign, especially around childhood well visits, immunizations, and cancer screenings that you’re automatically due for when you hit a certain age.

We wanted to work with our partners and our customers to make these things really, really simple to execute. From our perspective as a population health company, we know magically when you turn 45 and you’re due for a colorectal cancer screen. We don’t need someone to generate that list. We can build that list every week of who turned 45 and is due. We can see the record. We can kick off that campaign to message them to schedule an appointment. A week later, we can look and see if they’ve taken that action. If they’ve not, we can send them a second, gentle reminder. In fact, a week later, we can send them a third reminder and ask them if they care to schedule an appointment or if they are going to ignore this, etc. We can get some feedback through texting.

All of this runs in the background. No human has to go pull these lists every week look at who took the action and who didn’t. Every new week there’s a new group of patients that turn 45 and are due. It’s combining the text messaging with effective patient identification and automation to make this stuff just happen in the background so that no one at the practice has to handle it day in and day out.

What impact did the pandemic have on your clients?

I think the number one thing they walked away with, besides the confidence that they know how to treat patients even under some of the worst circumstances and keep things moving forward, is the importance of data and information. We had been in this business long before the pandemic hit, but all of a sudden that need for accurate data and the accuracy of it just bubbled up to the executive suite fast and loudly. We had clients for years whose quality staff and operational staff were engaged with Azara and all all of a sudden we were hearing from executive directors.

We were watching a lot of the disparities that we’ve read about in the pandemic, or as the pandemic unfolded. We were watching it in real data how it disproportionally affected those that were black and brown, and how that compared to the population within the practices that we were already serving. As these practices rolled out telehealth, we saw who had access to telehealth, who took advantage of it, and what those disparities were. It’s one thing to go with anecdotes, whether it’s to the state house, the Feds, or to your payers. It’s another thing to go with real numbers and fact. To come back to your question, it heightened the need for accurate and easily available information.

What will be important to the company over the next few years?

To us, the most important thing is to support our clients on their journey to value-based care. They are in different states and in different spots along that journey. Everyone is concerned about improving quality and making the patient better, and we should never forget that there’s a patient behind every number. No matter how good the data is, if there’s not someone out there to take action with it, it doesn’t make an impact. But getting the data, making it available for that journey, whether it’s quality, cost, or risk utilization. All of them play a part. More and more, the requirements are going to be how to get it to the right place at the right time in the workflow so it’s very easy for that provider to know what to do when they’re with the patient, whatever type of provider it is.

Curbside Consult with Dr. Jayne 6/27/22

June 27, 2022 Dr. Jayne 2 Comments

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It’s that time of year, when I typically take a week off to volunteer at one of the nation’s premier summer camps. It’s always an adventure. I’m hoping that despite COVID surges in the area that we have what we previously would have considered a “normal” summer camp experience. Of course, there will be masks indoors when we are in close quarters, but there will be plenty of time to run around in the great outdoors and for the campers to have fun with their friends.

It’s been a scorcher across large parts of the US over the last couple of weeks. I’m hoping for at least a little break so that I don’t have to spend the week treating heat exhaustion, headaches, and dehydration. I’d much rather be teaching fire building, knots, lashings, and wilderness survival skills.

Although the camp offers most of the traditional activities like fishing, swimming, canoeing, kayaking, archery, and various other shooting sports, it also offers some great STEM (science, technology, engineering, and math) options. Welding is available, as are programs in movie making, game design, electronics, and geocaching. There is something for everyone. Usually the best part of the day is dinner, where an adult sits with each table of campers and gets to ask questions about their day and what they liked best.

I always get some interesting questions about what I do in my real life. The staff knows I’m a physician, but they also know I do something with computers on the side. Almost every adult has used a patient portal by this point, so I use that as a way of explaining the kind of work I do and how we help physicians make better use of information and that we help patients have a better experience. There are usually a lot of questions about what kinds of things we can do as telehealth physicians.

Although this camp is old school as far as facilities, I’ve worked with camps in the past that have remote examination setups that really deliver as far as telehealth infrastructure. Given the fact that this particular property is about 30 minutes from a very capable rural hospital, I’m not surprised that they opt to send campers into town if they need more than what we can offer on site.

Since I’m in the middle of a major project, I’ve got my wi-fi hotspot at the ready in case I need to join any calls (courtesy of my public library, which lets you check them out for a couple of weeks at a time). However, for the first time in a long time, I’m working with an extremely capable team, and I would be surprised if I hear from them. There might be something that they need that requires a physician credential to accomplish, but it’s nice to know that they’ve got my back and I can actually take time off without worrying that I’ll walk into a disaster when I return.

I’m sure that some of the people on the team think I’m a little loopy to do this kind of thing for fun, but at least one of my co-workers has made me promise to take pictures of a couple of things I’ve talked about, so I hope I can deliver. I’m just hoping this year is better than the experience I had a couple of years ago, when I ended up with a squirrel leaping from a tree to my head when I least expected it. Honestly, not having a squirrel in your hair seems a low bar when you think about it.

As a consultant, some of my major areas of work included change leadership and teambuilding. I have to say, although I have had plenty of formal training in those disciplines, some of the best training I have had has been in outdoor programs like this one. A very wise man once said, “A week of camp life is worth six months of theoretical teaching in the meeting room.” Having done this for many years, I have to agree. It’s extremely gratifying to see young people learn new skills and discover that they are more capable than they ever thought. This generation of campers has had a couple of summers of COVID-related modifications, and many of these experiences will be new to them. They will be challenged to try things outside of their comfort zones and will be allowed to fail in a safe and supportive environment. They will also probably get sunburned and get lots of mosquito bites because they’re pre-teens and teens and they won’t heed our warnings, but those too will be growth experiences.

For some of the oldest campers who come back year after year, I’ve worked with them since 5th grade and they’re now high school seniors. They’ve had phenomenal growth emotionally and mentally (and also physically, since most of the eldest tower above me). It’s been a pleasure seeing them take leadership roles and I enjoy seeing how the youngest campers look up to them and start to envision what they might look like in a few years. Many of last year’s graduating class headed into tech fields, and one of my older campers from many years ago is now applying to medical school. I hope that as they head to college and into the real world that they take the problem-solving skills that they learned at summer camp with them and figure out how to apply them, not only to the challenges of today, but to what we might run into tomorrow.

If there’s anything we’ve learned since 2020, it’s that life can always throw you a curve ball and we have to figure out how to rise to the occasion. Although I’m looking forward to a week relatively off the grid, I know I’ll come back energized and ready to get back to work (even though my body will be tired). Being around young people with so much potential and so much eagerness to learn always delivers a spark.

Who’s ready for some basketry, rock climbing, and whittling? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 6/27/22

June 26, 2022 Headlines No Comments

Biden signs VA health record modernization transparency act into law

The White House signs the VA Electronic Health Record Transparency Act of 2021, which requires the VA to report the costs of its EHR modernization project to congressional committees each quarter.

Myriad Genetics Teams Up with Epic to Make Genetic Testing Accessible to More Patients with Electronic Health Record (EHR) Integration

Myriad Genetics will integrate its provider genetic test ordering and resulting program with Epic.

Hybrid-care Physical Therapy Platform Kins Announces $7.2M in Total Seed Funding to Accelerate Innovation in Care Delivery

Virtual and in-home physical therapy provider Kins raises $4 million in seed funding from W Health Ventures.

Monday Morning Update 6/27/22

June 26, 2022 News 1 Comment

Top News

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The White House signs the VA Electronic Health Record Transparency Act of 2021, which requires the VA to report the costs of its EHR modernization project to congressional committees each quarter. The report will also include a breakout of project funding sources.

The VA must also submit quality, performance, safety, and value metrics, along with a list of patient safety reports, incidents, alerts, or disclosures.


HIStalk Announcements and Requests

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Poll respondents are skeptical that Oracle’s acquisition of Cerner will improve cost or quality.

New poll to your right or here: How important to you personally is telehealth today versus in 2019? I realized while posing the question is that it hasn’t changed for me – I’ve yet to have a telehealth visit, although I wouldn’t be opposed to it as an alternative to the physician office visits that I rarely require.

I’m surprised to see pundits who confidently state that Larry Ellison is CEO of Oracle, a position he hasn’t held since 2014.

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The need is evident.


Webinars

July 12 (Tuesday) 1 ET. “Digital Data Stewardship for Trusted, High-Quality Data Exchange.” Sponsor: Clinical Architecture. Presenter: Carol Graham, MS, RN, product manager, Clinical Architecture. Organizations face challenges in ensuring that the patient data they received and send is consistent, accurate, and usable. Use cases include receiving multi-source data across health information networks with variation in formats and content; merging and de-duplicating provider, payer, and research data; uplifting legacy data for current use cases and formats; and normalizing and formatting data for public health surveillance, quality measure reporting, and providing directly to the patient. This webinar will cover Pivot, a comprehensive Digital Data Steward solution that orchestrates format harmonization, content (vocabulary) normalization, de-duplication, and data quality validation into a single solution.

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


Acquisitions, Funding, Business, and Stock

Myriad Genetics will integrate its provider genetic test ordering and resulting program with Epic.

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Healthcare Triangle launches a digital front door app for users of Epic’s MyChart.


Sales


People

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Healthcare Growth Partners hires Brooks McElveen, MS (New Capital Partners) as VP.


Announcements and Implementations

Microsoft will collaborate with Volpara Health Technologies on AI-powered detection and quantification of breast arterial calcification.

PerfectServe will further develop its cloud-based call center solution.

Baker Tilly and MedeAnalytics develop Service Line Data Signs, an easy-to-use analytics solution for supply and pharmacy expenses.


Other

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CHOP SVP/CIO Shakeeb Akhter recaps the health system’s recent conversion from Ascom phones to Epic communications, including secure messaging, Voalte voice calling, and Rover alerts and alarms.


Sponsor Updates

  • OptimizeRx extends the reach of its omni-channel medication adherence platform through a partnership with pharma marketing technology company Equals 5.
  • Pivot Point Consulting promotes Nicole Gerten to senior operations specialist.
  • Protenus has received the highest overall performance score for its drug diversion surveillance solution in the recent KLAS Drug Diversion Monitoring report.
  • Symplr announces the winners of its 2022 Lean Human Capital Elite Honor Roll program.
  • Premier has named Henry Ford Health the winner of the 2022 Premier Alliance Excellence Award.
  • TigerConnect and its Critical Alert business have announced that Mount Nittany Health nurse Jodie McClure, RN has won its Nurses at the Heart of Healthcare contest.
  • VisiQuate expands its Payer Action Center to help providers reclaim millions in unpaid claims.
  • The following HIStalk Sponsors will exhibit at HFMA through June 29 in Denver: AGS Health, Arrive Health, Availity, Change Healthcare, Experian Health, Iodine Software, Nym Health, Olive, Optum, Oracle Cerner, Premier, Tegria, VisiQuate.

Blog Posts


Contacts

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

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Morning Headlines 6/24/22

June 23, 2022 Headlines No Comments

Asimily Announces Strategic Investment from MemorialCare Innovation Fund to Further its Innovation in IoT Device Security and Risk Management

MemorialCare’s innovation fund makes an unspecified investment in IoT security vendor Asimily.

Digital health startup Ro just slashed 18% of its staff months after hitting a $7 billion valuation. We got the CEO’s full note explaining the layoffs.

Ro, which offers telehealth visits for ED, hair loss, skin care, and fertility, reportedly lays off 18% of its headcount on Thursday, four months after reaching a paper valuation of $7 billion.

Medallion Raises $35 Million in Series C Funding Fueled by Significant Revenue Growth Over Past Six Months

Provider licensing and credentialing software company Medallion raises $35 million in a Series C investment round, bringing its total funding to $85 million.

News 6/24/22

June 23, 2022 News 6 Comments

Top News

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MemorialCare’s innovation fund makes an unspecified investment in IoT security vendor Asimily.


Reader Comments

From Pointy Solution: “Re: Cures Act vendor requirements. NextGen, at least, is reaching out to customers about their responsibilities.” NextGen reminds its customers via email that the Cures Act prohibits EHR vendors from enforcing “gag clauses” and reiterates that its customers are free to communicate about system usability, interoperability, security, and user experience regardless of what their contracts do or don’t say (the company says it does not believe that any of its agreements contain gag clauses). I’m not sure if such customer communication is required, but regardless, nice job by NextGen.


Webinars

July 12 (Tuesday) 1 ET. “Digital Data Stewardship for Trusted, High-Quality Data Exchange.” Sponsor: Clinical Architecture. Presenter: Carol Graham, MS, RN, product manager, Clinical Architecture. Organizations face challenges in ensuring that the patient data they received and send is consistent, accurate, and usable. Use cases include receiving multi-source data across health information networks with variation in formats and content; merging and de-duplicating provider, payer, and research data; uplifting legacy data for current use cases and formats; and normalizing and formatting data for public health surveillance, quality measure reporting, and providing directly to the patient. This webinar will cover Pivot, a comprehensive Digital Data Steward solution that orchestrates format harmonization, content (vocabulary) normalization, de-duplication, and data quality validation into a single solution.

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


Acquisitions, Funding, Business, and Stock

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Ro, which offers telehealth visits for ED, hair loss, skin care, and fertility, joins an ever-lengthening list of formerly high-valuation digital health startups that are laying off employees. Business Insider reports that the company laid off 18% of its headcount on Thursday, four months after reaching a paper valuation of $7 billion.


Sales

  • Intermountain Healthcare goes live on Gyant’s asynchronous e-visit system Async, which provides AI-powered clinical assessment within the health system’s My Health+ app and routes patients to an asynchronous visit when appropriate.
  • Urgent care provider Innovative Care goes live on Nym Health’s medical coding technology for revenue cycle management.

People

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Signify Health hires Paymon Farazi, MBA (Tausight) as chief product officer.

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InstaMed, a JP Morgan Company, promotes Jeff Lin to president.


Announcements and Implementations

Global Healthcare Exchange launches a digital solution to support health systems capture, review, and report vaccination information.

Change Healthcare releases a patient engagement solution that incorporates its revenue cycle management capabilities with Luma Health’s patient engagement software.

Wolters Kluwer, Health and Laerdal Medical launch a VSim for Nursing simulation training course area for advanced medical-surgical and critical care scenarios.

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Optum develops a laboratory benefit solution to reduce unnecessary lab testing, which it saves could save health plans $3 billion per year.

WellSky-owned CarePort expands its care coordination data connections to 17 HIES and data sources.

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KLAS says that Oracle Cerner’s go-forward RCM product RevElate won’t necessarily solve the company’s high-profile revenue cycle problems, as customer experience with implementation and training of its underlying Soarian Financials product has been mixed. Customers say that Soarian Financials is a solid system that drives good outcomes despite usability issues, but requires more add-on products than expected, has exposed customers to more nickel-and-diming since Cerner acquired the product in 2015, and won’t solve Oracle Cerner’s challenges of hiring and keeping employees who can facilitate successful outcomes.  


Other

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North Carolina’s state treasurer says that pandemic-related federal hospital funding was a “huge wealth transfer to wealthy hospital systems,” noting that the state’s seven dominant health systems saw profits swell to $5.3 billion last year. Treasurer Dale Folwell – who notes that Atrium Health collected $719 million in provider relieve funds and then merged with a competitor, while Duke Health’s profit margin jumped from 11% in 2019 to 41% last year – says that big health systems “have turned into stock market, private equity, and real estate development firms” that “disguise themselves as non-profits.”

A KHN article ponders whether a small town is better off with a bad hospital than having none at all, describing two rural Missouri hospitals that were bought by a private equity-backed firm that collected federal relief money, hired directors with little hospital experience, stopped paying their bills, missed paychecks, ran out of supplies, and racked up a long list of CMS deficiencies before closing the hospitals 18 months after buying them. Noble Health Corporation, which operated Audrain Community Hospital and Callaway Community Hospitals, announced on March 18 that it would limit services and divert ambulances temporarily because of an unspecified IT issue with RCM and EHR systems that it said was causing cash flow problems, then locked the doors for good six days later.


Sponsor Updates

  • The Health Information Resource Center recognizes Healthwise with seven Digital Health Awards for its medical illustrations and health education videos.
  • FDB hires Christopher Marks (State Farm) as information security officer.
  • Jinuper Networks publishes an information sheet titled “Revolutionize the Network for Modern Healthcare.”
  • CarePort, a WellSky company, has expanded its data connections to 17 HIEs and data sources across the country to provide enhanced visibility into a growing number of providers and increased care coordination capabilities.
  • LexisNexis Risk Solutions publishes a new interoperability report, “Assessing the Evolution of Health Data Exchange.”
  • Medicomp Systems releases a new Tell Me Where It Hurts Podcast, “On Innovation with Dr. Nick van Terheyden.”

Blog Posts


Contacts

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

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EPtalk by Dr. Jayne 6/23/22

June 23, 2022 Dr. Jayne 2 Comments

I wrote recently about hospital shootings and the other unsafe situations that healthcare workers are encountering with greater frequency. We can add another hazard to the list. Earlier in the week, batteries exploded in a Milwaukee hospital parking garage, injuring two people. The incident, which occurred at Aurora St. Luke’s Medical Center, is attributed to an acid spill in a container that was holding recycled batteries. Unanticipated combustion is a thing, and it just goes to show that regardless of how well you think you’ve planned or prepared, there’s always something that has the potential to surprise you.

I’ve read a lot of articles about how physicians should manage their social media profiles, but I haven’t seen too much on how they should manage their non-work-related TV appearances. Amar Shere MD, a cardiology fellow at Saint Louis University School of Medicine, was selected to complete on the NBC show “Dancing With Myself.” Shere appeared in his white coat, but was cut after the fourth round. He has used TikTok to share his dance skills along with patient education and eating tips. He’s also a fitness instructor with an interested in promoting heart health in the community. Kudos to Dr. Shere for putting himself out there, and I hope his patients enjoy his care as much as it sounds like he enjoys delivering it.

Many physicians are watching carefully to see what happens to telehealth provider Cerebral as it has come under fire for deceptive business practices and poor patient care. I’ve seen a number of patients in the brick-and-mortar urgent care world who were trying to get refills on their prescriptions after being denied ongoing treatment due to billing disputes. Cerebral is accused of pushing patients to take controlled substances in an effort to increase patient loyalty. The company used flexibility in telehealth rules to prescribe highly regulated medications without any in-person care. Pharmacies were seeing so many prescriptions they stopped filling orders from the company and flagged its business practices for scrutiny.

Cerebral is no longer starting new courses of therapy with controlled substances and patients who are already under treatment have to transition to other drugs or different providers by mid- October. Given the severe shortage of physicians willing to take over these prescriptions, my clinical employers included, it’s going to be rough for patients who are trying to figure out how to continue treatment. The company has been removed from insurance networks and patients are left holding the bag while they go on waitlists for psychiatrists and call from urgent care to urgent care looking for anyone willing to give a 30-day prescription.

Speaking of brick-and-mortar urgent care practices, I’ve been receiving harassing emails and phone calls from a particular insurance company as they try to recredential me to deliver care at an organization where I haven’t practiced for more than a year. Apparently, their calls and emails to my former employers weren’t managed in a timely fashion (not surprising given the overall turnover in the organization), so they decided to contact me personally. They tracked down personal email addresses that I never would have used on a credentialing application and also used several emails associated with the LLC that I use for my consulting business (but never for clinical care). I finally convinced someone to understand that I don’t want to be recredentialed so they can stop trying, but it took several phone calls and quite a bit of frustration. Supposedly they’ve been trying to reach me for months to see if I wanted to remain on the plan. You’d think they’d be able to look at their own claims data and see that I haven’t submitted anything in a year, but that would require coordination within the organization. I’m less than thrilled that they spent patients’ premium dollars exploring my personal websites, but I guess they consider it trying to be engaged with their providers.

Monkeypox has arrived in my state and medical misinformation is running rampant. I’ve seen comments on local news articles suggesting that transmission is limited to certain sexual behaviors, complete with links to bogus articles blaming this “scourge” on immorality. News flash from infectious disease specialists – monkeypox is spread through contact with body fluids, monkeypox sores, contaminated clothing or bedding items, and through respiratory droplets. It’s been a long two and a half years dealing with patients who have decided that social media is more believable than their own physicians, and I sure wish we could mandate public health and hygiene classes in schools. The World Health Organization plans to rename the disease to reduce stigma and racism, but unfortunately people’s attitudes aren’t going to be easy to adjust.

I just finished reading the novel “Hamnet” by Maggie O’Farrell. It’s a fictionalized account of the life of William Shakespeare’s son, who died at age 11 at 1596. The book’s subtitle clearly says it’s “A Novel of the Plague” and there’s an underlying story about the child’s mother being a healer and her encounters with the medical establishment of the times as the bubonic plague reaches her family. My book club has a way of selecting less-than-cheery readings at times, but I enjoyed the book and found it to be a relatively quick read. Within a day or two of finishing it, I came across an article that summarizes findings about the origin of the Black Death, which ravaged Europe for hundreds of years. Researchers propose that the Black Death began in the late 1330s in North Kyrgyzstan, based on analysis of DNA extracted from skeletons found in the region.

I wonder what historians in the future will say about our current pandemic when they’re looking back at us. They’ll probably think we were similar to what modern medicine thinks about medieval “plague doctors” who wore bird-beaked masks stuffed with herbs as a way to ward off disease. Hopefully, our next book club selection is a little lighter read, but I’m always looking for summer reading suggestions whether I have the ability to make them truly a beach read or not.

What’s on your summer reading list? Leave a comment or email me.

Email Dr. Jayne.

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