Readers Write: ViVE 2024: Enthusiasm Mixed with Caution Around Interoperability

ViVE 2024: Enthusiasm Mixed with Caution Around Interoperability
By John Blair, MD

A. John Blair III, MD is CEO of MedAllies of Fishkill, NY.

As a first-time attendee of digital healthcare conference ViVE, I wasn’t quite sure to expect prior to the 2024 event in Los Angeles. However, amidst all the inevitable talk of artificial intelligence and the massive chaos caused by the Change Healthcare saga, I found the event to be well conceived to maximize learning and networking with an efficient, upbeat approach. I enjoyed checking out presentations of all types on the floor, then was able to conveniently chat in meeting rooms with leaders of companies following sessions and panels, making the event a great opportunity to meet with people.

As a founder of a Qualified Health Information Network (QHIN), I attended the event to get a feel for the state of interoperability across the industry.

For the unfamiliar, QHINs were created under the Trusted Exchange Framework and Common Agreement (TEFCA), a federal regulation guided by the Office of the National Coordinator for Health Information Technology (ONC). A QHIN is a network of organizations working together to share data. QHINs will connect directly to each other to ensure interoperability between the networks they represent, with the goal of improving patient care through faster, more accurate data exchange.

QHINs achieved a major milestone in late 2023, when ONC announced that they had become operational. After completing the rigorous TEFCA onboarding process, we were one of five initially designated QHINs by the ONC. With QHINs now operational, I was enthusiastic to learn more about how the market is responding. With that, here are five major takeaways from ViVE.

• A focus on interoperability. The interoperability area of ViVE was terrific. There were continuous presentations and panels on one of three small stages that lent themselves to engaged and pertinent discussion. Also, because all the booths were interoperability companies, the interaction and discussions were rich and fruitful.
• QHINs spark a mix of enthusiasm and caution. As a representative of a recently designated QHIN, I was enthusiastically received everywhere, leading to informative and fruitful conversations. Although there is strong interest in and hope for TEFCA, understandable skepticism remains. There was a counterbalance between a high level of enthusiasm for TEFCA as a catalyst to significantly increase and improve interoperability to skepticism about the ability for a public-private effort of such magnitude to move much quickly.
• Privacy concerns. Individuals and organizations are concerned about privacy protections in TEFCA. Understandably, with all of the cybersecurity and privacy incidents happening, TEFCA’s massive scale has privacy and security professionals worried. However, those individuals close to the activity and process tend to agree that planning and adequate measures are taking place.
• Let me stand next to your FHIR. There is strong interest in TEFCA being a catalyst to move FHIR to scale. FHIR has made great progress and holds real promise, but achieving FHIR at national scale will be difficult. TEFCA is seen by many as the best way to address the challenge.
• Wanted: More use cases. Non-treatment use cases under TEFCA are needed, and the sooner the better. I had several conversations with individuals and companies interested in Individual Assess Services and Health Care Operations. They all want this to get live as soon as possible.

Perhaps the most relevant, concise remark I can make about ViVE is that I’m planning to attend next year. See you in Nashville.

HIStalk Interviews Jason Brown, CEO, MRO

Jason Brown, MBA is CEO of MRO of Norristown, PA.

Tell me about yourself and the company.

I have been in the healthcare technology space for almost 20 years. I have been working at the intersection of providers, payers, rev cycle, value-based care, and payment integrity, with an eye toward solutions that help take cost out of the healthcare system, move data, drive interoperability, and support value-based care.

At MRO, we think of the business as driving clinical data exchange among providers, payers, patients, and other third-party requesters at scale and driving health care interoperability across the ecosystem.

Is the term “release of information” still valid?

The business started in a document management style release of information. That’s still a core part of what we do and will continue to be. As we look at it, we are expanding out from that platform and taking perhaps a wider view of the opportunity. That opportunity is, how you make clinical data available on time, every time, to the right, credentialed user? The minimum necessary information available in the purpose fit format. 

Digital and release of information is a component of that, but not necessarily the totality of that. It is our core DNA where the company started and is still a big part of what we do. We built off of that capability and solution set to do a number of other things, and we will continue to advance those capabilities.

How has the demand for data exchange changed as providers captured more data electronically?

That’s a big part of the thesis that the demand for clinical data, in addition to claims data or maybe in replacement of claims data, continues to grow at a fast clip. The healthcare system places the burden on hospitals and providers to manage that clinical data and make sure that it gets to the right user, even though it sits in a bunch of different formats all over the place. 

As we see demand growing and complexity of data growing, there’s a great opportunity to be that middleware in between, partnering with providers, payers, other third parties — it could be pharmaceutical companies or patients themselves as legal requesters — to make sure that the minimum necessary data can get to the right place in the right format. On time, every time.

Life sciences companies seem to be the highest-profile data consumers, to the point that companies and provider groups have made a business of selling them data. How is that market progressing?

It is in an early stage.The appetite and demand from the pharma companies, life science companies, probably outstrips the supply or the ability to satisfy that data today. But there’s a lot of strides in interoperability, commercial models, etc. that is increasingly spinning up opportunities to be able to meet that demand, to do that in a secure way, do that in a way that is beneficial to the providers to allow them to participate in some of the economics, and then to make sure that we are ultimately helping to use the data that we have available to create the right type of pharmaceutical solutions for patients.

It’s early innings for sure, but that market has a long runway in front of it in terms of opportunities as we are able to meet that demand from life sciences companies.

What about data related to valued-based care, quality management, and care management?

I would say that is more mature than the life sciences market, but probably moving slower than all of us would hope. Part of the gating issue or pacing issue on more value-based care adoption is having that clinical data exchange between providers and payers. As you start to see a lot of the push and pull there, it is most acute in situations where there is some sort of value-based care relationship, where the provider needs to share data with the payer and vice versa so that they can both be successful in those risk-based relationships. 

That’s an area that has picked up a lot of traction for us over the last couple of years, but that market still is mid-innings. We would love to see it grow a lot faster, and I think it’s great for the overall healthcare system as well. As we enable more high fidelity, low latency, longitudinal clinical data to be available, I think you’ll see a step-function increase in value-based care arrangements, because both parties will feel that they can be successful in those relationships.

Does provider data still need a lot of cleanup and transformation to be understandable by the outside world?

That is certainly still the case. Strides have been made for sure. How you normalize standardized data, and in some cases tokenize it, to make it usable on the other end is still a big part of the healthcare value chain. Our solution set and capabilities is all about data extraction, digitization, ingestion, normalization, and standardization, and then you draw insights and intelligence from that. To make it useful, so that you can get it to whomever is requesting it in a format that they can consume it and have that data in a way that can drive the downstream insights and actions that you want to be able to power.

How is the market for patient registries that have been created or endorsed by professional and specialty societies?

That continues to be a very active market. It picked up a lot of traction over last 10 or 15 years. We have seen the evolution from value-based care type measures and quality reporting to now getting into some of the things we talked about earlier, which drive bigger clinical quality opportunities and opportunities with life sciences and pharma. That market is active and continuing to advance and innovate because they are sitting on large corpus of clinical data and deep clinical insights around certain specialties. Now they are looking at things in addition to their legacy work in value-based care around more quality stuff and partnering with life sciences firms in real-world data and real-world evidence.

Do you see company opportunities from using AI?

We are certainly digging into it now, looking at ways to leverage it across our entire book of business. We are actively developing a couple of AI solutions to power and automate parts of our workflow today that allow us to do more faster around quality insights, etc. We have big efforts around that. 

The other side of that coin is that of the vendors a company works with, all of them are developing AI solutions. We are actively working to evaluate those and understand how to move those into our workflows and into how we do things, whether that’s Microsoft Copilot, solutions from our telephony vendors, and even to back office systems such as HR and Salesforce. They all have different AI capabilities. 

We think it’s going to touch every part of our organization, not just the stuff that we can deliver to our clients and solutions that we can build, but also how we work with our vendors and automate different parts of our company. We are excited about that and are actively pursuing various initiatives right now. We have a lot of experience in different aspects of creating, running, and selling businesses in healthcare.

Is the business environment improving overall?

I think that the market is getting better and starting to normalize. People are a little bit more bullish about where the rate environment is going to be. We are heading into an election, and in any election cycle, healthcare tends to be on the ballot in some shape, form, or fashion. We keep an eye on all those things from a macro perspective. 

For our business more specifically, the tailwinds continue to be quite strong, as the demand for clinical data continues to grow at a pretty exceptional rate. That’s driven by a whole host of things, not the least of which is demographic factors. Ten thousand people age into Medicare every day, and a third or more of those go into Medicare Advantage. That’s a big tailwind for our business. Value-based care is big tailwind for our business. Demand for clinical data from sophisticated requestors, like life sciences, continues to be a tailwind for our business.  

Macro environment notwithstanding, we like all the trend lines of the need for clinical data to make healthcare decisions, treat patients, and drive better insights. We think that this is a long-term trend that will go unabated for at least a couple of decades.

What impact do you expect to see from the Change Healthcare cyberattack in terms of financing, healthcare policy, and antitrust concerns?

I’ll start with the last one because that will probably be the biggest. We now see where Change, United, and Optum touch every part of the healthcare system. This situation exposed the fragility of some of that and showed how connected some of these pieces are. Greater thought needs so be given to those aspects.

If you’re a provider, you have to think about who has your data and who you are connecting with. How do you make sure, as a provider or payer, that they have the highest standards of security, probably beyond HITRUST? We at MRO pride ourselves that we have been delivering secure, compliant data for 20-plus years, and we understand the sensitivity of that. Heightening those standards will increase. Every provider and payer will take a closer look, not that they weren’t before.

I also think about diversification, making sure that you don’t have all your eggs in one basket. That will have implications in how both providers and payers think about deploying technology and vendors. 

What are the key parts of the company’s near-term strategy?

We are in the early innings of a digital transformation. We want to continue to deploy technology across every part of our business. That will be a big part of our strategy.  We need to continue our client centricity and make sure that we are widening and deepening our relationships with our clients. We operate in a multi -sided network and need to make sure that we continue to deliver value to all sides of that network to continue to drive network effects across our business model.

HIStalk’s Guide to HIMSS24

AGFA Healthcare

Booth 1860

Join AGFA HealthCare at HIMSS 2024. Connect with industry experts and see firsthand how our Enterprise Imaging Platform can help reduce IT infrastructure, maximize efficiency while minimizing cost, improve delivery of patient care, and facilitate scalable growth. You’ll have the chance to explore our cutting-edge technologies that are shaping the future of healthcare imaging. Experience live demonstrations of our innovative solutions, like Streaming Client and Cloud Services showcasing how our Enterprise Imaging Platform collaboratively addresses the organization, IT, and growth hurdles your health systems face. Visit us at Booth #1860 to see why our XERO Viewer is Best in KLAS, Universal Viewer Category. To learn more about AGFA HealthCare’s participation at HIMSS, visit here to schedule an appointment with an enterprise imaging consultant.

Arcadia

Booth 3345

Contact: Drew Schaar, communications manager
drew.schaar@arcadia.io

Visit Arcadia at booth #3345 to learn how the right data infrastructure leads the way for healthcare innovation.

• Meet our team and get a one-on-one demonstration of Arcadia Analytics. You’ll walk away with a better understanding of how to harness the power of diverse data, advance global health outcomes, and drive strategic growth for your organization.
• Attend our general session, “From risky business to sustainable financial performance in value-based care,” on Tuesday, March 12 from 4:15 – 5:15 PM ET in room W330A. The Centers for Medicare & Medicaid Services (CMS) is radically changing how it reimburses risk-bearing organizations practicing value-based care as it marches toward its goal of getting every Medicare beneficiary on to a value-based care plan by 2030. These policy shifts place intense financial pressure on health systems, with many still recovering from the pandemic and facing higher operating costs, staffing challenges, and shrinking operating margins. This session will detail and analyze the most critical changes by CMS and provide health system leaders with actionable strategies powered by data analytics that can help achieve sustainable financial performance in value-based care.
• Attend byte-sized booth talks at various times in booth #3345. Learn from experts in data science and healthcare during short, informative sessions that will leave a lasting impression. Each session is 10–15 minutes and will get you inspired, excited, and eager to put these big ideas into practice. Q&A to follow presentations.
• Attend “sips and socks” happy hour on Tuesday, March 12 4:30 – 6:00 PM ET in booth #3345. Join Arcadia for happy hour to network with peers and snag a limited-edition pair of Arcadia socks.
• Attend “sips and socks” happy hour on Wednesday, March 13 4:30 – 6:00 PM ET in booth #3345.  Join Arcadia for happy hour to network with peers and snag a limited-edition pair of Arcadia socks.

Learn more and view a full schedule of Arcadia’s events at HIMSS24.

Availity

Booth 4181

Contact: Matt Schlossberg, director of PR
matt.schlossberg@availity.com
630.935.9136

Availity, the nation’s largest real-time health information network, will highlight the power of artificial intelligence (AI) and automation for health plans and provider organizations at HIMSS24. Featured solutions and focus areas at Availity booth #4181 and in Meeting Place MP166 include:

• Availity Lifeline. Availity is uniquely positioned to help health plans and providers in the wake of the Change Healthcare cybersecurity incident. Availity’s Lifeline support and resources are intended to enable health plans and providers to exchange critical electronic transactions during this period of disruption.
• Availity AuthAI, a scalable solution designed to automate and streamline the time-consuming and manual processes involved in prior authorizations using AI. During a recent implementation, a leading health plan automated more than 1 million prior authorization requests, authorizing 75% within 90 seconds with Availity AuthAI.
• Availity Essentials Pro Predictive Editing, a groundbreaking AI claims denial prediction tool that helps to identify potential denials prior to submission at the front-end of the provider’s submission workflow, allowing for timely corrections and smoother adjudication. The Predictive Editing tool flagged more than $828 million in denials with 97% precision in a proof-of-concept study of more than 100 million claims from two large health systems.
• Availity Essentials Pro Preservice Clearance ensures a seamless and error-free revenue cycle by addressing key components at the beginning, before the first patient interaction. Availity Essentials Pro Preservice Clearance includes authorizations for providers, coverage locator, and patient financial clearance features.
• Availity’s Trusted Partner Program, which enables partners access to exclusive content to power improved data flows and processes for claims status, coverage discovery, and API development.

Care.ai

Booth 3801

Contact: Lexi Lutz, marketing manager
lexi.lutz@care.ai
407.800.1937

Care.ai is revolutionizing healthcare with the world’s first and most advanced AI-powered Smart Care Facility Platform and healthcare’s leading Always-Aware Ambient Intelligent Sensors. Care.ai transforms physical environments into self-aware smart care spaces, increasing safety, efficiency, and quality of care in acute and post-acute settings while at the same time autonomously improving clinical and operational workflows and enabling new virtual models of care for Smart Care Teams, including Smart-From-The-Start Virtual Nursing solutions.

CereCore

Booth MP6280

Contact: Jillian Whitefield, business development manager
jillian.whitefield@CereCore.net
248.891.5557

CereCore provides IT services that make it easier for hospitals and healthcare systems to focus on supporting hospital operations and transforming healthcare through technology. We partner with clients to extend their team through comprehensive IT staffing and application support, technical professional and managed services, IT advisory services, and EHR consulting, because we know firsthand the power that integrated technology has on patient care and communities. Meaningful change happens with healthcare IT managed services. Schedule a meeting with us in #MP6280 and talk with experts in EHR implementations and optimization, managed services, support desk, and cybersecurity risk management.

Clearsense

Booth 1401

Contact: Larry Kaiser, chief marketing officer
lkaiser@clearsense.com
516.978.5487

Clearsense delivers tailored Platform as a Service (PaaS) offerings designed for health systems, health plans, and diverse industry stakeholders. The 1Clearsense Platform, combining cloud-based architecture with AI capabilities, is HITRUST-certified, providing comprehensive support for healthcare organizations in value-based care initiatives, data governance, archival, and access. This includes customized PaaS offerings catering to the specific needs of healthcare clients and stakeholders across the industry. Learn more at Clearsense.com.

Clearwater

Booth 1618

Contact: John Howlett, SVP and chief marketing officer
john.howlett@clearwatersecurity.com
773.636.6449

Rated both the top Cybersecurity Advisors & Consultants and the top Compliance and Risk Management Solution in Black Book Market Research LLC’s annual “State of the Healthcare Cybersecurity Industry” report, Clearwater helps organizations across the healthcare ecosystem move to a more secure, compliant, and resilient state so they can achieve their mission. The company provides a deep pool of experts across a broad range of cybersecurity, privacy, and compliance domains, purpose-built software that enables efficient identification and management of cybersecurity and compliance risks, and a tech-enabled, 24x7x365 Security Operations Center with managed threat detection and response capabilities. Stop by our booth in the Cybersecurity Command Center to learn about our innovations in Managed Security Services and maturity assessments and to receive a free copy of Clearwater Founder Bob Chaput’s new book “Enterprise Cyber Risk Management as a Value Creator”. Also, be sure to catch our presentation at 3:45 p.m. on March 12 in Theater B of the Cybersecurity Command Center when Clearwater CEO will discuss “Beyond CPGs: Advancing Your Cybersecurity Program Using Proven Practices and Standards”.

Clinical Architecture

Booth 2281

Contact: Jaime Lira, VP of marketing
jaime_lira@clinicalarchitecture.com
317.580.8400

[New This Year] Clinical Architecture in-booth Data Quality Theater. We will be featuring 13 educational sessions featuring industry thought leaders, clients and partners. Our esteemed speakers include Didi Davis, The Sequoia Project; Dr. Bill Gregg, HCA Healthcare; Michelle Dardis, MSN, MBA, The Joint Commission; Dr. Joe Bormel, Cognitive Medical Systems; Dr. Benjamin Hamlin, NCQA; Dr. Victor Lee, Clinical Architecture; Charlie Harp, CEO of Clinical Architecture, Jim Shalaby, PharmD, Elimu Informatics; Kelly Sager, Danaher– and many others. View the full list & register here.

CloudWave

Booth 2781

Contact: Christine Mellyn, VP of marketing
cmellyn@gocloudwave.com
508.251.8899

CloudWave, the expert in healthcare data security, provides cloud, cybersecurity, and managed services that deliver a multi-cloud approach to enable healthcare organizations to architect, integrate, manage, and protect a personalized solution using private cloud, public cloud, and cloud edge resources. The company is 100% focused on healthcare and delivers enterprise cloud services to more than 300 hospitals and healthcare organizations, supporting 140+ EHR, clinical, and enterprise applications. CloudWave’s OpSus cloud services provide managed hosting, end-to-end disaster recovery, systems management, cybersecurity, backup, and archiving services. Its Sensato Cybersecurity suite enables hospitals to implement a fully managed cybersecurity program to detect threats and respond to cybersecurity incidents in a fully integrated and easy to deploy holistic platform. All CloudWave services are fully supported by around-the-clock Network and Cybersecurity Tactical Operations Centers staffed by certified healthcare IT and cybersecurity professionals in the USA. For more information, visit www.gocloudwave.com. Stop by booth 2781 to learn more, and stay for one of our brief educational presentations for a chance to win Dell portable monitor!

DrFirst

Booth 1481

Contact: Erin Lease Hall, senior event manager
eleasehall@drfirst.com
216.650.7687

At this year’s HIMSS event, population health, regulatory compliance, and AI will be the hot topics. And while AI may be a new concept for many in healthcare, DrFirst has been safely translating free text and inferring missing data to streamline workflows and inform decision-making since 2015. It’s also being used to drive population health initiatives. Our Chief Medical Officer Colin Banas, MD, MHA, recently appeared with Wes Blakeslee, PhD, VP of population health, on the PopHealth Perspectives podcast to discuss the challenges in healthcare data management, the importance of semantic interoperability, and how clinical-grade AI can improve medication safety and patient outcomes. They’ll both be at HIMSS so this is your chance to get some face time. On the regulatory side, Nick Barger, PharmD, VP of product, is our go-to resource for new regulations from the CMS and ONC to improve e-prescribing, prior authorization, and more. Meet with any of these clinical workflow rock stars at booth #1481 to learn more.

ELLKAY

Booth 1547

Contact: Auna Emery, VP of marketing
Auna.Emery@ELLKAY.com
201.808.9504

ELLKAY is a recognized healthcare connectivity leader, serving as the single partner to healthcare organizations for their data management and interoperability solutions. ELLKAY empowers hospitals and health systems, diagnostic laboratories, healthcare IT vendors, payers, and other healthcare organizations with cutting-edge technologies and solutions. Since 2002, ELLKAY’s system capability arsenal has grown to over 58,000 practices connected and 750+ EHR/PM systems across 1,100+ versions.

ELLKAY’s innovative, cloud-based solutions address the challenges that our partners across all healthcare environments face. ELLKAY delivers bi-directional, standards-based connectivity to hundreds of sources with access to discrete and actionable data and provides tailored solutions to achieve your unique connectivity goals.

Visit Team ELLKAY at booth #1547 for demos, drinks, and data management:

Tea & Coffee Hour

• Tuesday, March 12, 10 a.m.-1 p.m.
• Women in Health ITea- Wednesday March 13, 9:30 a..m. – 2:30 p.m.
• Thursday, March 14, 9:30 a.m. – 12:30 p.m.

Happy Hour

• Tuesday March 12, 4-6 p.m.
• CommonWell Health Alliance – Wednesday, March 13, 4-6 p.m.

Elsevier

Booth 3048

Contact: Mary Ann Abbruzzo-White, SVP of global clinical solutions marketing
m.abbruzzo-white@elsevier.com
215.275.9091

Elsevier is committed to supporting clinicians, health leaders, educators, and students to overcome the challenges they face every day. We support healthcare professionals throughout their career journey from education to clinical practice and believe providing current, credible, accessible, evidence–based information can help empower clinicians to provide the best healthcare possible. Stop by our booth for the launch of ClinicalKey AI and learn how our new solution supports clinical decision making at the point-of-care by providing quick access to the latest evidence-based medical knowledge through conversational search.

FinThrive

Booth 4861

Contact: Jeffrey Becker, VP of portfolio marketing
Jeffrey.Becker@finthrive.com
978.289.0793

FinThrive is showcasing a number of new enhancements to its End-to-End RCM Platform at HIMSS’24, including a new intelligent prior authorization solution, continuous insurance Discover capabilities, and an end-to-end RCM analytics solution. Stop by to see what the future of RCM Platforms looks like.

Five9

We will be exhibiting with the Novelvox team at HIMSS.

Contact: Roni Jamesmeyer, senior marketing manager, healthcare
roni.jamesmeyer@five9.com
972.768.6554

Five9 is a HIPAA-compliant, healthcare cloud contact center solution that helps you real-time track and report on call volumes in patient access, scheduling, prescription refills, revenue cycle and more, all to increase your staff’s productivity. The Five9 Intelligent Cloud Contact Center is easily integrated with various back-end systems like electronic health records, acting as a control tower between them to provide digital engagement, analytics, workforce optimization, and AI to improve outcomes and deliver tangible business results.

Healthcare IT Leaders

Meeting Room MP6283

Contact: Rory Calnan, VP of sales
rory.calnan@healthcareitleaders.com
781.726.1009

Healthcare IT Leaders is a national leader in IT staffing, managed services, and consulting for healthcare systems. We provide strategy and talent for healthcare transformation across clinical, business, and operational systems. Areas of focus include EHR, ERP, HCM, WFM, RCM, Cloud, and Data where our consultants implement and optimize enterprise software solutions from leading vendors including Epic, Oracle Health, Workday, UKG, Oracle, Infor, SAP, Snowflake, AWS, Azure, GCP, and more.

KeyCare

Booth 2288

Contact:Nancy Kavadas, VP of marketing
nancy@keycare.org
312.961.2018

KeyCare connects health systems to a network of virtual care providers working on KeyCare’s Epic-based EMR and telehealth platform. This partnership provides patients with convenient virtual care access, while easing the burden on health system providers. Health systems can start with virtual on-demand urgent care (24×7, 50-state coverage), and then can easily add other virtual health services based on their organizational needs. To learn more about KeyCare, visit www.keycare.org

Linus Health

Booth 4688

Contact: Laura Kusek, event and partner marketing manager
lkusek@linus.health
954.825.8389

Linus Health is a digital health company focused on early detection of Alzheimer’s and other dementias. We combine rich clinical expertise with cutting-edge neuroscience and AI to help providers spot and intervene on early signs of cognitive impairment – even those invisible to the human eye. Our digital cognitive assessment platform puts specialist-level insights about a patients cognitive function at providers’ fingertips in a matter of minutes. Visit our booth at HIMSS to learn more about the most accurate and sensitive digital cognitive assessments on the market, meet the team, and demo the product! Learn more at linushealth.com.

Medicomp Systems

Booth 4185

Contact: Jaimes Aita, director of business development and strategy
jaita@medicomp.com
703.803.8080

Clinical AI has healthcare abuzz. But how can you harness it to help make clinicians lives easier? Large language models (LLMs) are great at generating text, but clinicians need solutions to help them navigate compliance and quality reporting and complex billing requirements. The Quippe Clinical Intelligence Engine leverages LLM output, converts it into actionable data, and makes sense of it to help clinicians find what they need at the point of care to make their jobs easier. Meet with us at HIMSS booth 4185 to learn more about Medicomp’s clinical-grade AI solutions and Smart-on-FHIR apps for CQM compliance, HCC coding and risk adjustment, bi-directional interoperability, CDI and audit-readiness, point-of-care decision-making and more.

MEDITECH

Booth 2580

Contact: Rachel Wilkes, director of marketing
rwilkes@meditech.com
781.821.3000

Join MEDITECH at HIMSS 2024 for a comprehensive look at Expanse, the foundational EHR and cornerstone to a collaborative ecosystem. Expanse guides healthcare organizations through the complexities in healthcare today and prepares them for the changes of the future. Attendees visiting booth #2580 can talk with physician and nurse leaders about their experience with Expanse, including efficiency gains through greater mobility and enhanced care coordination. MEDITECH executives and product experts will also be showcasing many of the solutions that make MEDITECH the intelligent EHR, including our approach to AI, innovative care models, precision medicine, population health, interoperability, and more. You can also learn about our latest advancements, including Expanse Pathology, ambient listening, and our cloud-based patient portal.

Additional presentations to attend include: 

• On Wednesday, March 13, you won’t want to miss a captivating presentation with MEDITECH Executive Vice President & COO Helen Waters and Google Cloud, Global Director of Healthcare Strategy and Solutions Aashima Gupta at 1:15 p.m. at the Main Stage Theater – Hall A, Booth 381. Throughout their session, Radical Collaboration: MEDITECH, Google, and the Intelligent EHR, they’ll share their philosophy and approach to the strategic use of AI, ML, NLP, and other advanced cloud technologies. Learn about the breakthroughs they’ve already co-developed, projects currently underway, and the advances they expect to revolutionize diagnosis, treatment, and overall healthcare delivery.
• A Culturally Sensitive Approach to Acute Mental Health and Addiction Care on Tuesday, March 12 at 12 p.m., W330A, is a session led by Kelsey Sjaarda, CSW-PIP, Clinical Program Manager at the Link Community Triage Center, Avera McKennan Hospital & University Health Center. Learn about Avera’s Link Community Triage Center — a coalition of four organizations providing 24/7 care and support for individuals struggling with mental health crises and addiction, while reducing the number of custody holds by over 90%.
• Achieving a Collaborative Approach to Meaningful Interoperability Across Canada on Wednesday, March 13 at 2:30 p.m., W330A, is a panel discussion led by Peter Bak, PhD, CIO, Humber River Hospital and including panelists from MEDITECH and Health Gorilla. They will discuss Traverse Exchange Canada — an ambitious new data exchange network that has the potential to connect all participating healthcare organizations across Ontario and eventually Canada through a federated, query-based model. This connection is closing care gaps with more than 300 long-term care organizations across the province, to support more seamless care transitions.
• Empowering and Retaining Nurses to Improve Patient Experiences on Wednesday, March 13 at 2:30 p.m., W206A, is a session led by Sherri Hess, CNIO, Vice President, Nursing Informatics, HCA Healthcare. Hess will share insights and tactics surrounding post-pandemic nurse workforce challenges. Attendees will also participate in breakout groups to address three key questions about enhancing nurse satisfaction and building a culture of safety, the influence of technology on nurse experiences, and methods for assessing ongoing nurse satisfaction.
• MEDITECH will once again be participating in the HIMSS Interoperability Showcase – Hall A, Booth 3760. You can find us at Kiosk 71, where our Interoperability team, along with several of our partners, will share strategies on the latest interoperability standards, such as the Cancer Moonshot Initiative; our latest advancements in API development; and integration of key partner technologies such as ambient listening, precision medicine — including integrated pharmacogenomics as well as therapies and clinical trial matching — and patient engagement apps. You can also learn more about the deployment of our cloud-based Traverse Exchange Canada interoperability solution.
• MEDITECH will also participate in the CommonWell Health Alliance Clinical Scenario, presented multiple times a day in CommonWell’s booth, where we will highlight the benefits vendor collaboration has on patient outcomes.
• GenomOncology will be in the MEDITECH kiosk (Interoperability Showcase in Hall A, at the MEDITECH Booth (Booth 3760, Kiosk 71) from March 12 – 14, starting at 12:30 p.m. ET daily
• Finally, be sure to join us for a special Spotlight Presentation; Intelligent Interoperability, on March 13, at 11:15 a.m. where we will highlight strategies for leveraging EHR intelligence to ensure the right data gets to the right people at the right time. Stay tuned for an upcoming press release outlining further details on our Spotlight session and kiosk schedule.

Visit MEDITECH’s HIMSS 2024 event page for the latest updates and additional information, including session times and a special customer appreciation event.

MRO

Booth 3721

Contact: Stephanie Kindlick, senior director
skindlick@mrocorp.com
215.630.7786

MRO is accelerating the exchange of clinical data throughout the healthcare ecosystem on behalf of providers, payers and users of clinical data. By utilizing industry-leading solutions and incorporating the latest technology, MRO is helping providers, payers, and requesters of clinical data. With a 20-year legacy and as a 10-time KLAS winner, MRO brings a technology-driven mindset built upon a customer-first service foundation and a relentless focus on customer excellence. MRO connects over 250+ EHRs, 170,000+ NPIs, 35,000 practices, and more than 1,100 hospitals and health systems, while extracting more than 1.3 billion clinical records. Stop by booth #3721 and learn how MRO is solving for Quality & HEDIS Reporting; Payment, Government Audit & Prepay Claim Validation; Care, Utilization Management & Risk Adjustment; Care Gap Closure & Value-Based Care; Release of Information & Clinical Enablement. Talk to one of our representatives to enter our raffle for a $500 Brooks Brothers gift card! Join of of our Sessions!

• Tuesday, March 12, 1:15 – 1:35 p.m. Facilitating Seamless Clinical Data Exchange for Optimal Data Usability. Anthony Murray, Chief Interoperability Officer, MRO.
• Wednesday, March 13, 10:15 – 10:35 a.m. Streamlining Healthcare Data Exchange between Providers and Payers: CareFirst BlueCross BlueShield and Partner Experiences. Piyush Khanna, Vice President Clinical Services, CareFirst BlueCross BlueShield – Yana Ankudinova, Vice President Product Management, MRO

Redox

Contact: Andy Pung, director of sales
andy.pung@redoxengine.com
248.635.7130

Redox is the healthcare data platform that accelerates digital transformation for healthcare providers. We eliminate the burden of integration so IT teams can exchange data with any technology in just a fraction of the time and effort. They are freed from wrangling data, standing up interfaces, and constant rework and can instead focus on moving transformation forward. Presentations:

• Tuesday, March 12 11 a.m. How Redox powers hospital CXO decision making with real-time streaming into Databricks #2980 Databricks.
• Tuesday, March 12 1:30 p.m. AWS + Redox #1561 AWS.
• Wednesday, March 13 1 p.m. Snowflake + Redox #869 Snowflake.

Rhapsody

Booth 1933

Contact: Natalie Sevcik, director of communications and content
natalie.sevcik@rhapsody.health
816.651.5586

Are you headed to Orlando for HIMSS? Visit us in booth #1933 to learn how to improve data quality, focus more time and resources on your differentiators, and unlock value faster – all by partnering with a single vendor. Learn how health systems and digital health teams rely on Rhapsody to reduce the barriers to digital health innovation adoption by streamlining patient data access. Schedule a meeting with us.

Symplr

Booth 3921

Contact: Ann Joyal, VP of marketing communications
ajoyal@symplr.com
866.373.9725

Join us at HIMSS in booth #3921 for a fun golf experience, giveaways, purple donuts and a ”BIG Putt Prize” winner announced daily during happy hour. Connect with us, see a demo, and explore how AI and enterprise-wide healthcare operations can mean more time for caregivers and better outcomes. 2024 Best in KLAS winner. Meet our leaders and sign up for a demo. Rocking happy hours 4-6 p.m. daily. Symplr is the leader in enterprise-wide healthcare operations solutions, trusted by leaders for more than 30 years and in 97% of U.S. hospitals. Our proven solutions include provider data management, workforce management, compliance, quality & safety, and contract and supplier management. Learn more at www.symplr.com.

Tegria

MP107

Contact: Kristin O’Neill, senior director of external relations
kristin.oneill@tegria.com
617.319.5516

Join Tegria at HIMSS24! Schedule time to connect at Tegria’s Meeting Room, located at MP107! Our team of solution experts will be available onsite throughout the event, offering an excellent opportunity to address your latest challenges related to growth, experiences, and collaboration. Be sure to mark your calendar for a Tegria-sponsored learning session during the conference. Complete this form to schedule time with Tegria!

• Main Stage: Reaching Patient Experience Nirvana Requires Collaboration Wednesday, March 13 at 11:00 a.m. ET. Does your organization have a clear vision for your ideal patient experience? Join Tegria at the HIMSS Main Stage in Exhibit Hall A to explore the multifaceted nature of patient experience and the necessary actions to drive change. The presentation will underscore the crucial role of collaboration among clinicians, patients, and staff in shaping perceptions and outcomes. Don’t miss the opportunity to hear from Tegria’s Chief Medical Officer, Ray A. Gensinger, Jr., MD, and Peter Bonamici, VP of Revenue Cycle + Experience, as they discuss creating a healthcare ecosystem that benefits both patients and providers through improved access and elevated experiences.

TruBridge

Booth 4973

Contact: Molly Bauer, marketing operations manager
Molly.bauer@cpsi.com
208.669.0629

TruBridge connects providers, patients, and communities with innovative solutions to support financial and clinical solutions, creating real value in healthcare delivery. By offering technology-first solutions that address diverse communities’ needs, we promote equitable access to quality care and foster positive outcomes. Our industry-leading HFMA Peer Reviewed RCM suite provides visibility that enhances productivity and supports the financial health of organizations across care settings. We champion end-to-end, data-driven patient journeys that support value-based care and improve outcomes and patient satisfaction. We support efficient patient care with EHR products that integrate data between care settings. We clear the way for care.

TrustCommerce, a Sphere Company

Booth 1781

Contact: Ryne Natzke, chief revenue officer
rynen@spherecommerce.com
657.383.7967

TrustCommerce’s platform provides a comprehensive patient payment solution that has earned the trust of many of the country’s largest healthcare organizations. Here are three reasons to make a visit. Transform the way you process payments with TrustCommerce’s 20+ years of expertise in healthcare provider support. Experience secure and compliant payment processing, any time and anywhere,  all while being seamlessly connected to leading EHRs like Epic, Veradigm, and AthenaIDX. See our patient friendly digital payment experience that proudly supports digital wallets such as Google Pay, Apple Pay, and PayPal. Ask us how to integrate TrustCommerce payment solutions with your digital health software to drive revenue, reduce risk, and increase workflow efficiencies. Stop by for a sweet treat, enter for a chance to win a Pickleball Racket Set, catch a demo, and join the fun at booth #1781.

Upfront Healthcare

Booth 2130

Contact: Margy Enright, VP brand strategy and experience
menright@upfronthealthcare.com
913.568.1520

Upfront is a mission-driven healthcare company delivering tangible outcomes to leading healthcare systems and provider groups. Its patient engagement platform makes each patient feel seen, guiding their care experience through personalized outreach. The backbone of the Upfront experience is its data engine, which analyzes clinical, sociodemographic, and patient-reported data. These insights, along with its advanced psychographic segmentation model, allow Upfront to individually activate patients to get the care they need while building a meaningful relationship between the patient and their health system. Upfront is rooted in partnership, leveraging best-in-class healthcare expertise to maximize the impact of technology and deliver a next-generation patient experience. To learn more, visit https://upfronthealthcare.com.

Visage Imaging

Booth 3913

Contact: Brad Levin, general manager of North America
blevin@visageimaging.com
540.454.9670

Visage Imaging is a global provider of enterprise imaging solutions that enable PACS replacement with local, regional and national scale. Visage 7 | CloudPACS is proven, providing a fast, clinically rich, and highly scalable growth platform deliverable entirely from the cloud. Be sure to check out our announcement next week to learn more about Visage’s exciting offerings at HIMSS 2024.

Waystar

Booth 2011

Contact: Valerie Jackson, trade show and events manager
valerie.jackson@waystar.com
801.874.6190

Waystar’s mission-critical software is purpose-built to simplify healthcare payments. With an enterprise-grade platform that processes over 4 billion healthcare payment transactions annually, Waystar strives to transform healthcare payments so providers can focus on what matters most: their patients and communities. Discover the way forward at waystar.com. As healthcare continues to evolve, your challenges do, too. Stop by booth #2011 for some premium giveaways or schedule a time to talk with us about how we can help you boost productivity, deliver better patient financial care, and bring in fuller, faster payments. Also join us on March 14 at 10 a.m. ET for a panel session in room W208C to hear Waystar and healthcare industry experts discuss how to build a unified revenue cycle strategy that boosts margins.

Wolters Kluwer Health

Booth 2927

Contact: Andre Rebelo, director of external communications
andre.rebelo@wolterskluwer.com
617.816.8596

See demonstrations of how Wolters Kluwer Health is helping healthcare organizations drive better outcomes in healthcare through market leading clinical decision support with GenAI, patient engagement, and drug referential solutions. On Tuesday, March 12 and Wednesday, March 13, experts will present in-booth sessions on how Wolters Kluwer is addressing today’s pressing challenges in healthcare: In “Supporting Primary Care Providers as they shoulder the burden of mental health,” Presenters discuss the shifting mental health landscape through the eyes of the primary care provider (PCP). By analyzing millions of clinician searches, UpToDate provides a unique glimpse into where clinicians struggle to serve patients in mental health matters and how clinical decision support can play a role. “AI Labs: Setting the standard for responsible point-of-care AI development” is a presentation of UpToDate’s approach to Clinical GenAI, prioritizing quality, safety, and transparency with AI Labs. Lastly, “The value of analytics: Understanding the needs of modern health systems for better clinical decision making” shifts the focus of today’s analytics to clinician insights to help drive better health outcomes.

Morning Headlines 3/6/24

‘Exit scam’ – hackers that hit UnitedHealth pull disappearing act

The BlackCat ransomware group appears to have shut down its infrastructure, leading some cybersecurity experts to predict that the hackers will begin operating under a new name.

HHS Statement Regarding the Cyberattack on Change Healthcare

HHS says that it has made clear that Change Healthcare owner UnitedHealth Group needs to do everything it can to ensure provider continuity of operations, and that it “is taking direct action” to support providers who are experiencing cash flow problems as a result of the downtime.

Whistleblower Accuses Aledade, Largest US Independent Primary Care Network, of Medicare Fraud

A whistleblower lawsuit accuses primary care practice network Aledade of rigging its coding software to overbill Medicare by inflating diagnoses to earn higher payments.

VA budget bill maintains EHR funding but imposes additional ‘reset’ oversight

Lawmakers propose a fiscal year 2024 budget package that includes $1.3 billion for the VA’s continued rollout of its Oracle Health EHR, with a contingency that 25% of that funding be tied to transparency with Congress about efforts to address ongoing performance issues.

News 3/6/24

Top News

Cybersecurity analysts surmise from underground forum chatter and evidence of a Bitcoin deposit that Change Healthcare may have paid a $24 million ransom to the BlackCat ransomware group on March 1.

They also point out that the ransomware group has made a remarkable comeback, given that the FBI took down its dark websites and issued decryption keys to victims last December.

HHS says that it has made clear that Change Healthcare owner UnitedHealth Group needs to do everything it can to ensure provider continuity of operations. It says it “is taking direct action” to support providers who are experiencing cash flow problems as a result of the downtime, including accelerated payments on a case-by-case basis.

HHS lists flexibilities that include help in switching claims clearinghouses; encouraging Medicare Advantage, Medicaid, and CHIP organizations to remove or relax prior authorization; and reminding Medicare Administrative Contractors that they must process paper claims from providers who need to file them.

Practice owner Christine Meyer, MD has provided commendable visibility into the outage’s provider impact:

• Optum claimed it would offer provider loans for 80% of historical claim submissions, but her practice was offered just $4,000 per month, or less than 1%.
• Banks are cold-calling to offer large lines of credit that include “ridiculous terms and strings.”
• Three RCM companies have offered to “take the pressure off” for fees ranging from 7% to 10%.
• One offered a not-free trial of an AI tool.
• A VC she had previously declined to sell her practice to is trying again.
• Asked if she would decline to accept UnitedHealth Group patients, she says she would consider it, but doesn’t want to abandon patients based on their insurer.

Reader Comments

From Mambo: “Re: Change Healthcare breach. Not widely reported is that healthcare entities have an obligation to inform patients of a breach, but have little idea how to determine which patients may have had data compromised. No one is sure where the line is.”

From HITGirl: “Re: Nuance. A bunch of layoffs today.” Unverified, but parent company Microsoft has been cutting headcount in some areas.

From HIMSS Question: “Re: HIMSS. How does it handle ethical breaches on their Davies awards? Do they have a way to report an ethical breach? Have any previous Davies award winners had to return their award due to fraud, lies, or fake data or reporting fake data? Anything similar for presenters at the HIMSS conference?”

Webinars

March 7 (Thursday) 1 ET. “Live Q&A: Waystar leaders answer provider questions on implementation, solutions + more” (this session will focus on ambulatory and other providers – a session specific to hospitals and health systems will be offered at 3 ET). Sponsor: Waystar. Presenters: Chris Schremser, CTO, Waystar; Laura Canzano, EVP provider and partner client experience, Waystar. Waystar leaders will explore how our secure, mission-critical software yields powerful results, like a 33% increase in staff productivity, while integrating with 530+ EHR/PM systems. We’ll talk through our smooth implementation process, which has earned us a 94% client satisfaction rate and a 74+ client NPS. And we’ll offer details about our hands-on support, which clients can reach in less than 11 seconds and which satisfies 96% of users. We’ll also explore how Waystar can accelerate implementation to alleviate disruption to your revenue cycle, all while helping you increase revenue and decrease manual efforts. For a limited time, Waystar is offering accelerated implementation for those experiencing disruptions due to data security.

March 27 (Wednesday) 3 ET. “Houston Methodist: Deploying clinical AI at scale for improved outcomes.” Sponsor: Health Data Analytics Institute. Presenters: Khurram Nasir, MD, MPH, chief of cardiovascular disease prevention and wellness, Houston Methodist DeBakey Heart & Vascular Center; Brenda Campbell, RN, senior consultant, HM Health System Innovations; Nassib Chamoun, MS, founder and CEO, HDAI. The presenters  will share how an interdisciplinary team collaborated to successfully use predictive models and a novel AI-driven approach to address post-discharge mortality. They will also describe how they expanded use of the platform to reduce clinician time spent digging through the EHR with a one-page risk profile, including codes extracted from notes using generative AI, and targeting their highest risk patients for extra attention. They will speak to how they overcame barriers to bringing AI at scale to support clinicians across the care continuum.

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

Acquisitions, Funding, Business, and Stock

Starfish Partners companies Direct Recruiters and Innova People will merge their healthcare and technology staffing divisions to create Innova Healthcare and Innova Tech staffing practices.

Kaiser Foundation Hospitals will lay off several dozen IT workers in California’s Bay Area, following a December 2023 layoff of 115 IT employees.

Scotland-based Craneware reports six-month results: revenue up 8% adjusted EPS $0.43 versus $0.41. CRW shares are up 37% in the past 12 months, valuing the company at $740 million.

Oracle Health reportedly laid off some number of employees this week, with insiders listing scrum masters, project managers, developers, and testers as affected.

Sales

• Morehouse School of Medicine (GA) selects ThinkAndor AI-powered remote patient monitoring technology from Andor Health.
• WebMD Ignite will integrate First Databank’s Meducation personalized medication instruction software with its Krames on FHIR patient education technology for prescribers.
• Amwell adds Suki’s voice-enabled digital assistant technology to its Converge virtual care software.
• Millennium Physician Group will implement WellSky’s technology and clinical services to improve patient outcomes.
• Intermountain Health will use Memora Health’s intelligent care enablement platform to implement new care delivery programs, initially focusing on cancer care.

People

David Finn, MA (CHIME) joins First Health Advisory as EVP of governance, risk, and compliance.

Bardavon Health Innovations promotes Alex Benson, MPA to CEO.

Geisinger names Terry Gilliland, MD, MS (Cogitativo) as president of Geisinger Health and its next CEO.

Announcements and Implementations

Christus Health (TX) implements Epic at six of its hospitals.

UVA Health Prince William Medical Center implements telehealth capabilities within its Level III NICU, enabling providers to virtually consult with pediatric specialists at UVA Health Children’s and families to stay connected with their newborns and care teams.

Orchid Wellness in Texas implements EHR, online appointment scheduling, and text-to-pay software from EClinicalWorks.

Government and Politics

A whistleblower lawsuit accuses primary care practice network Aledade of rigging its coding software to overbill Medicare by inflating diagnoses, such as coding anxiety as depression, to earn higher payments. The lawsuit claims that Medicare Advantage patients who were overweight were diagnosed with the higher-paying “morbid obesity” codes at 10 times the national average using coding guidance that was referred to as “Aledade gospel.” The suit was filed by Kushwinder Singh, MD, MHA, who served for a few months as a senior medical director for Aledade until he says the company fired him for raising fraud concerns. The investor-backed Aledade, which was recently valued at $3.5 billion, was co-founded in 2014 by former National Coordinator Farzad Mostashari, MD. Aledade EVP Mandy Cohen, MD, MPH left the company in last year after two years to become CDC director. The federal government has declined to join the case.

Lawmakers propose a fiscal year 2024 budget package that includes $1.3 billion for the VA’s continued rollout of its Oracle Health EHR, with a contingency that 25% of that funding be tied to transparency with Congress about efforts to address ongoing performance issues.

NASA’s Johnson Space Center issues an RFI for and EHR for its clinic, which serves astronaut, employees, and contractors. The clinic notes that its current EHR is housed on-premises and has significant dependencies on Microsoft BizTalk for interfacing.

The White House and the Biden Cancer Moonshot tout adoption of USCDI + Cancer to allow providers to share EHR information about cancer patients. Epic, Oracle, Ontada, Meditech, Flatiron, and ThymeCare have committed to adopting the core elements, while CVS Health and Athenahealth are working on it.

Privacy and Security

Lurie Children’s Hospital (IL) announces that it has restored its Epic EHR and other key systems. The hospital experienced a ransomware attack on January 31.

Other

Elliot Hospital (NH) launches a virtual ER service to help patients determine and receive an appropriate level of care and to alleviate capacity strain on its emergency room.

Guam Memorial Hospital Authority concludes that its clinicians have struggled to use its $5 million Medsphere CareVue EHR since it was purchased in October 2022 because the system was built for behavioral health rather than for use by acute care hospitals. GMH will issue an RFP for a replacement system that could cost $20 million to $60 million. 

Privacy advocates call for a review of Verilogue, a medical research firm that pays doctors to record conversations with their patients that de-identified and then provided to drug companies to fine tune drug marketing in working around clinician and patient objections. Verilogue, which is part of Publicis Groupe, paid doctors up to $2,500 per month to make the recordings with patient consent, and leaked records suggest that the company charged $135,000 for 50 visit recordings to drug companies that wanted to increase opioid sales.

Sponsor Updates

• TruBridge staff ring the Nasdaq opening bell in celebration of its corporate rebrand.
• Serviam Care Network will leverage Netsmart’s population health technology and expertise as part of its Higher Path Operating System for senior living operators.
• Leeds Teaching Hospital NHS Trust and Agfa HealthCare announce the launch of the real-world evaluation of Agfa’s Enterprise Imaging Rubee AI Package for Mammography.

Blog Posts

• Future-Proofing Healthcare: Long-Term Vision for EHR Optimization and Beyond (CereCore)
• Best Practices for Effective Patient Access Services (AGS Health)
• EHR usability: Critical failure in the industry, and the urgent need to respond (Altera Digital Health)
• How to balance high-quality care with rising costs (Arcadia)
• Working with LLMs Securely and Safely (Aridhia Informatics)
• From Crisis to Innovation: Unlocking the Path to True Digital Transformation (Divurgent)
• Prisma AI: Pioneering Value-based Care Through Advanced Interoperability (EClinicalWorks)

Contacts

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

Morning Headlines 3/5/24

Hackers Behind the Change Healthcare Ransomware Attack Just Received a $22 Million Payment

Cybersecurity analysts surmise from underground forum chatter and evidence of a Bitcoin deposit that Change Healthcare may have paid a $22 million ransom to the BlackCat ransomware group on March 1.

Direct Recruiters, Inc. and INNOVA People Merge to Launch Healthcare and Tech Staffing Divisions

Starfish Partners companies Direct Recruiters and Innova People will merge their healthcare and technology staffing divisions to create Innova Healthcare and Innova Tech staffing practices.

Cybersecurity Matter

Lurie Children’s Hospital (IL) announces that it has restored its Epic EHR and other key systems after a January 31 ransomware attack forced them offline.

Kaiser to Lay Off Dozens of Bay Area Employees

Kaiser Foundation Hospitals will lay off several dozen IT workers in California’s Bay Area.

Curbside Consult with Dr. Jayne 3/4/24

A number of my physician friends still work for independent medical practices, which is a bit surprising given recent market forces that have been challenging even for the most well run of them. Now that the Change Healthcare ransomware attack is approaching the two-week point, many are concerned that they are going to be in financial straits.

The first quarter of the year can be difficult for medical practices, especially if they have a large percentage of patients that are covered by high-deductible health plans. Those patients often avoid care until they reach their deductibles, which means volumes can be down in the practice. This tends to pick up towards the end of the calendar year, when patients have met those deductibles and are trying to squeeze in visits before the new year rolls around. 

Several of my friends were chatting about the inability to send claims to insurance companies and are worried about cash flow. I asked whether their business continuity insurance policies would cover the disruption and was surprised that more than half of them didn’t know if their practices even have that kind of insurance coverage. One would think that after coming out of a pandemic that significantly disrupted practices’ ability to function, groups would have looked into that if they didn’t already have coverage. Maybe the reliance on federal pandemic funds made them think they didn’t need to worry about it, but they are now wishing they did.

For those that outsource their revenue cycle management functions, they have been surprised by the lack of communication about the situation and what the third parties are doing to try to switch to other vendors. Some are wondering how they’re going to be able to make payroll and are trying to get short term loans to cover practice expenses. I’ve heard that a couple of local banks are stepping up to help out, but it sounds like national banks are less excited to be doing so. For lack of a better description, everyone is just scrambling at this point.

My current clinical practice pays me on a per-visit basis, regardless of a patient’s ability to pay or what insurance they might or might not have. That provides me a bit of a buffer from the Change Healthcare situation, although I know that the organization I work with is nervous about the situation. They’re committed to caring for patients and have a decent financial reserve, however, and I feel reassured that I’m unlikely to be benched like I was during the pandemic.

I’m exclusively seeing patients via telehealth these days, partly due to volume demands and partly due to my computer skills. I think my employers enjoy having someone who can power through visits, understands the need to set up their own favorites and defaults, and doesn’t complain about the EHR.

Patients have grown to rely on telehealth. The fact that we don’t know for sure what will happen with telehealth reimbursement is making a lot of organizations nervous. A little more than a week ago, 200 organizations signed on to a letter that asked the US Congress to take action to ensure that virtual care payments that were modified during the pandemic remain favorable. A couple dozen of these organizations were health systems, but among the rest were professional societies, patient advocacy organizations, virtual care companies, and tech giants such as Amazon. Big names signing on included Ascension, Intermountain Health, Johns Hopkins Medicine, Mass General Brigham, Michigan Medicine, Trinity Health, and UPMC.

The signers encourage Congress to take action now so that patients and care delivery organizations can plan and budget, rather than leaving them hanging until the eleventh hour as Congress tends to do. Organizations can be confident when they make investments in virtual and hybrid care models, which will be essential in managing workforce challenges. They also note the need for employers to be able to plan ahead for their health plan offerings for the coming year, which they can’t do if decisions aren’t made well before the traditional open enrollment periods that most employers have in November. Additional points made in the letter include:

• Patients have come to rely on telehealth, and ending payments will be detrimental to established care relationships.
• Safety net organizations have used telehealth to extend care, including community health centers and rural health clinics.
• Continued provision of mental health services via virtual care is essential.

I’m now in my seventh year as a practicing telehealth clinician, which is hard to believe when you think about it like that. It’s a skill that physicians of my training generation certainly weren’t trained to do, but we adapted quickly to it when our organizations decided to roll out programs. Those of us who were already seasoned definitely had an easier time during the pandemic. I was fortunate to be able to use a mature platform that hadn’t been cobbled together with Zoom, duct tape, and leftover Cat 5 cable.

I still chafe having to wear a white coat to perform telehealth visits, as required by my organization, but the annoyance of the scratchy polyester is outweighed by the fact that patients genuinely appreciate the flexibility of care even when I’m just providing advice and not sending out prescriptions.

I can’t think of any physicians I know who still perform house calls, but in many ways telehealth visits have become the house calls of the future. Especially when you can add technology like connected blood pressure cuffs, scales, and imaging devices, it goes along way towards what you could say was almost like being there. Now we just need to break down the payment barriers, and while we’re at it, I’d love to see our federal government find a way to break down the patchwork licensing restrictions in the US that keep me from seeing patients who live a couple dozen miles away from me but who are figuratively in a different world as far as me being able to care for them. My standard of care isn’t going to be different just because of where the patients live, but state medical boards sure try to convince people that it’s a real risk. It’s time for licensure reciprocity or a federal license.

I’m realistic enough to know that probably won’t happen before I retire, but a girl can dream.

What are the biggest priorities that our legislators should be tackling where healthcare is concerned? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 3/4/24

Change Healthcare cyberattack outage could persist for weeks, UnitedHealth Group executive suggests

Change Healthcare executives hint that the company’s ransomware-crippled data exchange systems could remain down for weeks, as the financial and operational impact on provides ripples throughout the industry.

WebMD Health Corp. Acquires Healthwise, Incorporated’s Operating Assets, Building on Leadership in Member and Patient Engagement Solutions

WebMD acquires the assets of Healthwise, the non-profit provider of patient educational resources.

State is taking an ‘important step’ for planned EHR, as key lawmaker moves to speed it up

The State Department’s Bureau of Medical Services is, after a 10-year delay, finally working towards digitizing its paper-based medical record-keeping system.

Larry Ellison’s Cancer Software Startup Project Ronin Is Closing

Project Ronin – which offered oncologists and their patients a platform to plan, personalize, and manage their care journey – shuts down after running out of money due to sales challenges.

Monday Morning Update 3/4/24

Top News

Change Healthcare executives hint that the company’s ransomware-crippled data exchange systems could remain down for weeks, as the financial and operational impact on provides ripples throughout the industry.

Parent company UnitedHealth Group has announced a loan program for providers who are unable to receive payments, although some of those providers say the available funding is too low to be useful to help their high-expense, low-margin businesses that are quickly running out of cash.

The company announced Friday that it has brought an alternate e-prescribing solution online.

Meanwhile, Aledade founder and CEO Farzad Mostashari, MD, ScM observes that had Change not been acquired by UnitedHealth for $13 billion in October 2022, Change would likely have already been forced into bankruptcy by the event, which started nearly two weeks ago.

When its systems are running, Change processes 15 billion healthcare transactions each year, impacting one out of three patient records.

Reader Comments

From MrCernerPizzaDriver: “Re: Children’s Minnesota. Announced internally that they are moving from Cerner to Epic, with go-live planned for fall 2026.” Unverified.

From Where Peeps At: “Re: HIMSS conference. What attendance do you predict?” I stopped doing that years ago because the way HIMSS counts heads is not transparent. It’s like a half-empty baseball ballpark that is claimed to be a sellout by the team, which has every incentive and counting method at its disposal to make itself look more popular than butts in seats would suggest. I wandered in the vast Nevada sunbake that was the COVID-delayed HIMSS21 in a futile search for my supposed 20,000 fellow attendees.

HIStalk Announcements and Requests

Two-thirds of poll respondents say that they or their employers have been affected by downtimes at AT&T or Change Healthcare.

New poll to your right or here: Does Epic operate as a monopoly in the health system market? Cheat sheet for what constitutes a monopoly: the only available producer, high market share, high barrier to entry, and can name their price since no close substitutes exist. That’s not the same as merely dominating the market, which means that my poll question is loaded, but I’m still curious who chooses the monopoly option.

Hello to former HIStalk sponsors who understandably had to tighten their belts over the past couple of years. Spring seems to have sprung, so bring your brand out of hibernation with my Welcome Back package for Platinum-level returning sponsors, which offers special recognition, a CEO interview, and bonus months for the first year. Contact Lorre.

Thanks to these companies that recently supported HIStalk. Click a logo for more information.

Webinars

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

Acquisitions, Funding, Business, and Stock

WebMD acquires the assets of Healthwise, the non-profit provider of patient educational resources. WebMD will move Healthwise’s offerings into its Ignite patient engagement solutions business, which will serve 50% of US hospitals post-acquisition. Healthwise will continue as a non-profit whose board will explore new ways the company can help people make better health decisions. Healthwise was formed in Boise, ID in 1975 by Don Kemper to distribute patient handbooks. Kemper, who retired in 2016, told the Idaho Statesman after the acquisition was announced, “We’re trying to look at the good work that we’ve done through the years and the recognition that the world is changing. It’s exceptional for our little independent nonprofit to last for 50 years.”

Project Ronin – which offered oncologists and their patients a platform to plan, personalize, and manage their care journey – shut down without notice on Friday, according to several former employees who said that the company ran out of money due to sales challenges. Oracle’s Larry Ellison was a co-founder and the primary financial backer of the San Mateo, CA-based company. I interviewed CEO Dave Hodgson and Chief Scientific Officer Christine Swisher, PhD last year. Ronin’s now-available 150 former employees include informaticists, data scientists, software engineers, and NLP scientists, providing a target-rich environment for companies who need their high-demand skills.

I was curious about CNBC’s headline that General Catalyst’s planned purchased of Summa Health “has Ohio community on edge,” wondering if they did a mass area survey or covered a protest march to reach the conclusion that the entire community is biting nails over the deal. It’s click bait, of course, the usually all-hat, no-cattle fake journalism in which the entire story was based on the skimpiest of sources:

• A DC-based health plan group says she’s excited to see if the change brings new approaches even though she’s not sure how it will work.
• A Tennessee-based health venture studio CEO says the idea makes people nervous, but he’s excited to see someone taking big swings.
• The article recycled quotes from elsewhere from the city’s mayor and a member of its city council, noting that 450 people have signed a petition to urge the health system to remain non-profit.
• Bottom line: 450 of the area’s 700,000 residents have signed a petition, and CNBC used 65 paragraphs to provide nothing conclusive or useful in mostly just citing old news from elsewhere.

People

Innsena promotes Britteny Matero to SVP and partner.

Optimum Healthcare IT hires Allie Messimer (Abra) as EVP of enterprise application services.

Healthcare IT Leaders hires Steven Cardenas, MBA (DMCA) as SVP of government relations. He spent 23 years in the US Air Force, retiring as colonel.

Ed Roberts, PhD, a former MIT Sloan management professor and co-founder of Meditech, died February 27. He was 88.

Privacy and Security

Lurie Children’s Hospital has been mostly offline for a month from a ransomware attack, and now the hackers who are responsible are offering to sell its data for $3.4 million. The screenshot is from cybercrime expert Alexander Leslie.

Other

Christine Meyer, MD describes how the Change Healthcare cyberattack has impacted her practice:

• They are submitting claims individually via paper and payer portals, but expect cash flow to dry up within two weeks.
• Once that happens, staff and essential services will be cut, leaving phones unanswered and referrals and refill requests unprocessed.
• Practice hours will be cut back, with same-day and walk-in appointments eliminated, sending patients to overloaded EDs.
• She says that Optum’s loan offer is $4,000 per month versus her payroll of $350,000 per month.
• A commenter notes that it’s nice for parent UnitedHealth Group that while patients will get turned away because of the Change downtime, UHG will still be collecting their insurance premiums without paying claims.

An unintended consequence of requiring hospitals to post their prices: Mount Sinai is strong-arming UnitedHealthcare for a 50% rate increase after the health system used the public transparency data to find that competitors are paid more.

Sponsor Updates

• QGenda employees serve breakfast at Children’s Healthcare of Atlanta.
• PerfectServe opens nominations for its 2024 Nurses of Note awards program.

Blog Posts

• Beyond the logo: The healthcare executive’s guide to creating genuine healthcare technology partnerships (Notable)
• Specialty Medication Technology can Empower Providers and Reduce Admin Burden (RxLightning)
• 4 common challenges for hospital contact centers in 2024 (Spok)
• Faster Meds, Enhanced Care: How One Specialty Pharmacy Makes a Difference (Surescripts)
• Valued Communication with Vendor Relationships (Symplr)
• 5 strategies to reduce future cybersecurity threats in the healthcare revenue (Waystar)

Contacts

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

Morning Headlines 3/1/24

AHA Letter to HHS on Implications of Change Healthcare Cyberattack

The American Hospital Association asks HHS for help with the Change Healthcare attack, requesting better communication and transparency from Change, help with payments that will be delayed, pausing of citations related to wait times, enforcement discretion for the lack of ability to create good faith estimates, and added flexibility in e-prescribing regulations.

Trinity Capital Inc. Provides $25 Million Growth Capital to Moxe Health

Healthcare interoperability vendor Moxe Health receives $25 million in growth capital.

Salvo Health raises $5M to expand GI Provider Enablement for Wraparound Care

Virtual gastrointestinal clinic Salvo Health raises $5 million, bringing its total raised to $15.5 million.

The Sequoia Project and HL7 Enter Strategic Collaboration to Advance FHIR Implementations Nationwide

The Sequoia Project and HL7 will collaborate to accelerate the adoption of FHIR standards in the US.

News 3/1/24

Top News

A ransomware group claims that its cyberattack against Change Healthcare yielded 8 terabytes of data from every provider that sends data to Change, including medical records, insurance records, and data from active military service members. The group quickly removed its post, raising speculation that the company might be negotiating a ransom payment.

CommonWell uses Change technology and has disabled its network as a precaution.

Meanwhile, the American Hospital Association asks HHS for help with the Change Healthcare attack, requesting better communication and transparency from Change, help with payments that will be delayed, pausing of citations related to wait times, enforcement discretion for the lack of ability to create good faith estimates, and added flexibility in e-prescribing regulations.

MGMA lists the problems its medical group members are experiencing due to the Change Healthcare disruption:

• Claims cannot be submitted.
• Prior authorization requests cannot be submitted.
• Patient eligibility can’t be checked.
• Health plan payments cannot be received.
• Prescriptions and lab orders cannot be transmitted electronically.
• Medical groups don’t carry reserves year-over-year due to tax consequences, so they are running short on working capital due to their inability to bill and be paid.

Reader Comments

From EHRMusing: “Re: Epic. I’m interested in your thoughts on this article that examines whether it’s a monopoly.” The Forbes article – which was pretty good except for spelling Judy Faulkner’s name wrong – makes these points:

• Epic holds a 36% market share of US hospitals, short of the usual monopoly definition of 50%.
• The company’s aggressive IP protections, such as non-competes and controlling who can work on a client’s Epic team, could be construed as monopolistic behavior.
• Epic increases third-party costs by limiting developer access, and controls access to its ecosystem via its new Showroom third-party marketplace.
• The nature of buying Epic gives more influence to health system CIOs and thus Epic.
• Epic pre-empts competition by announcing products before their release and by publishing a “Products You Can Replace With Epic” guide.
• Epic plays a positive role in filtering “innovation noise” from flaky startups, gives health systems a single point of contact, and has been around for 45 years with no involvement by outside investors.
• The article didn’t mention other important monopoly factors – a high barrier to entry, the ability to set prices above competitive levels, and lack of substitutes, all of which apply to Epic.
• My opinion is that the IP concerns are valid, but otherwise Epic grew because if offers a better product for the academic health systems where it enjoys a high market share. Monopolistic behavior requires intention, and I don’t think Epic intentionally stifles competition in unsavory ways. The market voluntarily accepted its offerings as superior, and if CIOs preferred Epic because of the cool factor and future job prospects, that’s not Epic’s fault.
• Most amazing to me is that the fresh-from-college kids that Epic sends to prestigious health systems earn the full attention of C-level executives who buy into Epic’s way of running health systems, which is either a tribute to Epic or a criticism of those highly paid executives who let a software vendor tell them how to run their business.

From HisTalk2Fan: “Re: Teladoc results. Any comments? Do you think the company will survive long term?” My thoughts:

• TDOC shares are down 46% since the company’s IPO in mid-2015, and even worse, are down 95% over the past three years. Share price dropped 25% on the most recent earnings report, with the company blaming macroeconomic conditions rather than its own missteps. Shares in competitor Amwell have tanked equally dramatically, suggesting that the problem is that virtual visit demand didn’t stick once the pandemic eased.
• The company has reported just one profitable quarter in 32 earnings reports.
• Everybody knows that the company wildly overpaid for Livongo in October 2020, as experienced investor Glen Tullman hypnotized Teladoc CEO Jason Gorevic – who had no CEO experience prior to Teladoc – into buying Livongo for a staggering $18.5 billion, stoking Gorevic’s ambition to become a mini-Glen level industry player in a swing (and a miss) for the fences. Teladoc announced vague plans to spend the proceeds of temporarily popular COVID virtual visits to expand beyond telehealth, which based on dramatically falling telehealth demand, might have been the right idea, but certainly the wrong execution. 
• Gorevic somehow kept his job and at least provided the overhyped healthcare startup market with a cautionary tale about irrational exuberance. Teladoc filed a $13.7 billion loss from the acquisition just two years later, and the company’s bragging about its $37 billion value has quieted down now that the whole package is worth just $2.5 billion.
• Meanwhile, last week’s earnings report showed a 46% fall in telehealth visits as Gorevic warned of a well-penetrated market and low single-digit growth for US virtual care products. He also announced plans to expand into weight management and pediatrics while characterizing its virtual care business as a “very stable asset” despite obvious evidence to the contrary.
• BetterHelp, which was about the only good news for the company in previous quarters, failed to meet expectations for revenue and margins.
• I assume the company will survive in some form, but its heyday – if it ever had one – is long past, and they are left with rounds of cost-cutting and trying to shoo away the circling vultures.

From Nomenclaturist: “Re: health system mergers. Why do you usually call them acquisitions?” A merger implies that two companies will combine to do business as a newly formed company, which is rarely the case with health systems. If Health System A and Health System B announce that they will merge and will operate under the Health System A name, then I assume that Health System A is the acquirer and the “merger of equals” characterization is to avoid making the acquired system feel inferior (which they obviously are or they wouldn’t be selling out). I also look to see which company provides the CEO and if one of the health systems will assume the liabilities of the other. 

HIStalk Announcements and Requests

I’ve been away and mostly offline for several days, and the fact that you didn’t notice is a tribute to Jenn, who happily follows my doggedly exacting but sometimes quirky writing rules so that the “product” does not vary in my absence. It was fun to enjoy HIStalk as a reader and to find nothing to second guess about the news items she chose or the way she worded them. In fact, Jenn could probably have outdone me today since I’m recovering from a bug.

This is the final call for sponsors to tell me about their HIMSS24 plans for my guide.

Some folks seem surprised that Billy Idol was good at ViVE. Not me, since I saw him years ago when House of Blues Las Vegas comped me a ticket to his show when I was scouting for HIStalkapalooza there. I figured that the spiky, sneering, nearly septuagenarian Billy hadn’t made waves in 40 years and even then in the now-defunct genre of angry Brit punk, but he put on a good show to a self-selected audience who prefer listening to music from their college-aged years.

Webinars

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

Acquisitions, Funding, Business, and Stock

The Washington Post says that since Amazon’s acquisition of One Medical — the parent company of Medicare-focused Iora Health, which operates in nine metro areas – the business now known as One Medical Seniors has shortened appointments, laid off clinicians, pushed virtual visits to reduce in-person ones, and eliminated much of Iora’s legendary personal interaction and care coordination, all under the usual corporate excuse-making as necessary to “position One Medical for long-term, sustainable success.” The report also notes that Amazon will be challenged to scale One Medical by offering Prime members a discount because of the its limited geographic coverage. The company has implemented a call center and AI chatbot triage to manage an increased number of telehealth visits. Business Insider reported a couple of weeks ago that Amazon has talked about spinning off the former Iora Health business to reduce One Medical’s projected loss of $342 million this year.

Columbus-based Redi Health, which offers digital pharma support to patients with chronic conditions, raises $14 million in Series B funding. Co-founder and CEO Luke Buchanan came from CoverMyMeds.

Healthcare interoperability vendor Moxe Health receives $25 million in growth capital. CEO Dan Wilson founded the company in 2012 after several years at Epic.

Northwell Health announces plans to acquire Nuvance Health, which would create a 28-hospital system with $18 billion in annual revenue. 

The federal government launches an antitrust investigation into UnitedHealth Group, with an apparent focus on the relationship between its insurance business and the healthcare services business of its subsidiary Optum, which is the largest employer of physicians in the US. The justice department previously challenged the company’s $13 billion acquisition of Change Healthcare in 2022, but lost. Change Healthcare’s ransomware attack that has brought US healthcare to its knees is making a good case for the feds.

Online vanity drug prescribing company Hims & Hers Health reports Q4 results: revenue up 65%, EPS $0.01 versus –$0.05, becoming on of the first digital health companies (if that’s what you call it) to show a profit. The company says that new services for weight loss, mental health, and dermatology could each deliver $100 million in revenue starting next year. The company seems excited about the launch of its compounded Hard Mints chewable version of erectile dysfunction drugs.

People

Rhapsody hires Jitin Asnaani, MBA (Health Gorilla) as chief product officer.

Beth Gall (Mantra Health) joins Rainfall Health as VP of sales.

Mark Gee (WellSky) joins Medecision as chief revenue officer.

Former Estes Park Health (CO) CIO Gary Hall, who retired in September 2023, is running for town mayor.

Announcements and Implementations

The Sequoia Project and HL7 will collaborate to accelerate the adoption of FHIR standards in the US. Their initial focus will be on:

• Scalable registration, authorization, and authentication.
• Interoperable digital identity and patient matching.
• Hybrid / intermediary exchange.
• Consent at scale.

Highmark Health will use Epic’s Payer Platform running on Google Cloud to glean insights that can be used to inform consumers of the next best actions. The company says that more than half of its 7 million members are attributed to an Epic-using provider, allowing it to close care gaps automatically.

Several health systems and vendors begin beta testing Hippocratic AI’s healthcare-built LLM, with priority areas being chronic care management, post-discharge follow-up, social determinants of health surveys, health risk assessments, and pre-operative outreach. I was amused to see that the company’s dozen unlabeled photos of healthcare professionals are almost certainly generated by AI in the “dogfooding” style, as verified by Is It AI that places the AI-generated odds at 99.27%.

Keysight announces an AI/ML network validation and optimization solution. 

Elsevier Health launches ClinicalKey AI, which provides clinicians with a personalized conversational search interface for medical literature that incorporates patient context and provides linked citations.

A study finds that 58% of the NeuroFlow users who were flagged via NLP as as having possible suicidal ideation would not have been identified otherwise.

A new KLAS report on home health technology finds that Homecare Homebase has a wide lead in market share, but Netsmart, WellSky, and ResMed have good market share among mostly smaller clients. Most often considered are Homecare Homebase, MatrixCare, and Epic.

Privacy and Security

The White House issues an executive order to protect the sensitive personal data of Americans – including personal health and genomic data — from “exploitation by countries of concern.” It focuses on commercial data brokers that can sell information to other countries, potentially raising privacy, counterintelligence, and blackmail concerns.

Other

The American Prospect describes what happened when Steward Health acquired Rockledge Regional Medical Center (FL):

• The CEO of Wuesthoff Health System, the two-hospital nonprofit that owned Rockledge, sold out to Health Management Associates, which earned his C-suite a $10.6 million golden parachute, after which the hospital was then sold to Community Health Systems and then sold again to Steward, who used money from the medical properties trust that bought Steward’s real estate. 
• Steward immediately sold the hospital’s hospice center and home health business and outsourced entire departments.
• Nurses report that the hospital runs short of medical supplies and has had medical equipment repossessed. The hospital has been sued by dozens of vendors for non-payment.
• Five of the hospital’s nine elevators have been out of service for a year.
• The company balked at paying exterminators $1 million to remove 5,000 bats from the facility whose guano backed up hospital sinks and pipes.
• Steward stopped showing up at legal proceedings after the Boston paper noted that the company was $1.4 billion in the red when founder and CEO Ralph de la Torre bought himself a $40 million yacht and the Globe exposed the flight records of the company-owned jet that showed trips to Corfu, Santorini, and Antigua.
• Despite all of its problems, the hospital passed its Joint Commission survey and earned an A grade from the Leapfrog Group. Former employees said that the only thing Steward is good at is hiding problems from inspectors.
• Negative company news hasn’t been run in Florida, leading some to predict that the chain is trying to morph into a Florida-only system as state legislators look the other way and lean on news outlets to do the same.

Sponsor Updates

• Censinet publishes its “2024 Healthcare Cybersecurity Benchmarking Study.”
• Lucem Health incorporates Ryght’s generative AI capabilities into its AI SolutionOps platform.
• Arcadia releases its next-generation data platform powered by an open lakehouse architecture.
• Odessa General Surgery Robotics (TX) adds Sunoh.ai medical AI scribe capabilities to its EClinicalWorks EHR.
• Symplr releases the results of its “State of Healthcare Supply Chain Survey.”
• HealthMark Group adds Credo Health’s PreDx record retrieval technology to its Request Manager medical records software.
• AvaSure selects Oracle Cloud to power its AI-enabled virtual care platform.
• Black Book Research’s latest analysis recognizes Netsmart as the top-performing provider in geriatric medicine EHR and practice management software.
• Net Health publishes findings from a new study, “What’s Delaying Advanced Analytics Adoption in Healthcare?”
• FinThrive releases a new episode of its Healthcare Rethink Podcast, “Take a Deep Breath … Virtual Healthcare is Here!”
• Healthcare IT Leaders CEO Ben Hilmes will chair the Kansas City Light the Night Corporate Walk in support of the Leukemia & Lymphoma Society.
• Inovalon will exhibit at Rise National March 17-19 in Nashville.
• Konza National Network publishes its 2023 Annual Impact Report.
• Medhost releases a new customer testimonial featuring Freestone Medical Center in Texas.
• Meditech announces that the Rotherham Hospital is at the forefront of patient data-sharing with the integration of GP Connect.
• MRO will exhibit at the Minnesota HFMA’s HLAMN Winter Conference March 5-6 in St. Paul.

Blog Posts

• An untapped opportunity for today’s telehealth developers: Clinical content (Wolters Kluwer Health)
• Change Healthcare (Optum) Outage FAQs (Experity)
• Medicaid Waivers by State: Findhelp and New York (Findhelp)
• Navigating the Healthcare Staffing Shortage with People-First Technology (FinThrive)
• Prioritize Your Contact Center Cybersecurity Methods (Five9)
• We Answered “The Healthcare AI Question No One Wants to Answer” (Lucem Health)
• The push and the pull: an interoperability update (Meditech)
• Extend the Reach of Your Hospital’s EHR with Clinical Communication and Collaboration (Mobile Heartbeat)
• Unlocking Specialty EHRs: Take a User-Centric Approach to Wound Care (Net Health)

Contacts

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

EPtalk by Dr. Jayne 2/29/24

Lots of folks around the virtual water cooler are talking about the ransomware attack that has brought Change Healthcare to its knees. In addition to negatively impacting financial transaction, the trickledown effects are preventing patients from getting needed medication refills at the pharmacy.

The BlackCat gang claims that they took 6 TB of data, including clinical, payment, and claims files as well as patient demographic data. This includes data on active US military personnel. Spokespeople for parent company UnitedHealth Group have stated that 90% of affected pharmacies have switched to new processes to get the prescriptions moving. You can follow along on a dedicated status page.

From Phi Beta: “Re: healthcare financial departments. Are in full battle mode with claims authorizations and eligibility all off line due to Change Healthcare / Optum cyberattack. I’m hearing Duke Medicine cannot send out any claims. The financial costs for US healthcare entities are going to be massive. No one seems to be telling that story.” Now that the outage has gone as long as it has, I think people are starting to have those conversations. The impact of this will be staggering and cause everything from tsunami-size waves to ripples through revenue cycle processes for the next year.

Several people have sent me fun and sassy pics from ViVE, which were much appreciated since I’m hanging out at home in chilly weather rather than partying it up in LA. Roving reporters indicated that the Billy Idol concert was “shockingly good.” I did get annoyed by the repeated emails from ViVE asking if I had “FOMO.” By definition, can you still have “fear of missing out” when you are actually missing out? Inquiring minds want to know.

Even though many of us in the industry have followed the VA and US Department of Defense IT projects closely due to their sheer size and visibility, the fact that I have active duty military personnel in my family makes it even more interesting to me. I was intrigued by the reports that the EHR transition had slowed down recruiting and onboarding and wanted to know exactly why. Having used both systems in the past, it didn’t make sense to me that switching from one system to the other would have made such a huge difference in workflow or click counts that it would delay entry. Additionally, there were reports that after the new system went live, twice as many recruits were disqualified. That didn’t make sense at all, unless the new system had totally different parameters than the old one.

After doing some digging, reading a lot of articles, and confirming with military personnel, I finally understand. Although the EHR is involved, it’s really not the cause. It’s the sheer volume of records that reviewers are now having to address compared to what they had before. In the legacy workflow, reviewers had access self-reported patient histories coupled with a relatively small number of medical records for each recruit. In the new system, health information exchange technology is used to pull much larger volumes of data about individuals. Although some branches of the military have refused to comment on it, an Air Force spokesperson did provide information to National Review, which confirmed that higher numbers of records are revealing more disqualifying conditions, which then need to be investigated and evaluated.

Previously, 81% of all Air Force applicants passed on their initial screening during fiscal year 2021, but after reviewers had greater access to patient data, that number dropped to 69% in 2022 and eventually to 58% in 2023. Increased access to data led to increased time needed for review, and until additional reviewers were added to help catch up, there was a lag. I’m not sure how failure to staff up in the face of a significant increase in workload can be attributed to the EHR rather than to lack of understanding of the time needed to review records coupled with poor capacity management. It’s always easier to blame the technology than it is to hold management accountable, I suppose.

A UK coroner’s classification of a young woman’s death as “preventable” has landed the EHR in trouble. The 31-year-old patient died from a pulmonary embolism after presenting the day before at the hospital. The coroner’s inquest confirmed that staff identified the diagnosis, but there were “errors and delays” in administering the correct treatment on an appropriate timeline. The hospital’s new emergency department EHR was named as a contributor, noting that it lacked clear and color-coded indicators for patients who needed urgent care, which had been present in the legacy system. Instead, the Cerner system has symbols next to patient names that had to be clicked to indicate the acuity of care rather than the acuity being immediately apparent. The coroner noted that there had been clinician complaints that went unresolved after the transition to the new system. The hospital has 56 days to respond to a demand for action. When we implement healthcare technology, we have user acceptance testing for a reason. Let this be a warning to people who don’t listen to the users or overrule their findings.

From Less-than-happy Hybrid: “Re: return to work. I feel like a ping pong ball going back and forth between the annoyances of working in the office and my Zen home office setup. In the office, my entire group was moved to a different floor that is nothing but cubes. I can’t even see if other people are here, and since none of us have actual cube assignments I don’t know where to find people if I wanted to collaborate. There are no lockers or storage cabinets. so I’m stuck hauling my stuff home at the end of every day, which isn’t an employee satisfier. There’s also a cheapo battery-powered clock on the wall whose ticking is making me crazy. It may not survive the morning. I also just heard a very distinctive sound coming from across the aisle and confirmed that some guy was brushing his teeth. At his desk. I’m so glad we’re building all this culture.” Other readers have weighed in with annoyances with remote colleagues, including attendees who are consistently doing school drop-offs or pickups during standing calls, yet will not admit that the call is scheduled at a bad time and should be moved. I’ve worked with people like that and it’s maddening since you know that they are not paying attention and are possibly placing themselves and their children at risk driving while on calls. One reader shared some photos of backgrounds they’ve seen on calls, including messy unmade beds, sinks piled high with dishes, and inappropriate artwork in the background. I use a lot of platforms and every one of them has an option to use digital backgrounds or at least blur the background, so there’s no excuse for appearing to be in an unprofessional environment even if you are indeed in the middle of one.

Email Dr. Jayne.

Morning Headlines 2/29/24

Redi Health nabs $14M for patient medication support

Medication adherence and patient engagement app startup Redi Health raises $14 million in a Series B funding round.

Ransomware gang claims they stole 6TB of Change Healthcare data

The BlackCat ransomware group says it has stolen 6 terabytes of data from Change Healthcare’s network, including product source code.

CHI RPM Transforms as VitalCare Sync, Revolutionizing Remote Patient Monitoring with Decades of Clinical Expertise

Pennsylvania-based Cognitive Healthcare International RPM rebrands to VitalCare Sync.

Healthcare AI News 2/28/24

News

Hartford HealthCare creates the Center for AI Innovation in Healthcare and launches Holistic Hospital Optimization, a startup company that will help hospitals optimize patient flow and operations.

A survey that was commissioned by Amazon Web Services finds that US healthcare employees and employers expect AI to deliver a 44% improvement in labor productivity, with potential uses in fraud detection, quality assurance, medical imaging review, and improving communication.

Highmark Health will use Epic’s Payer Platform running on Google Cloud to glean insights that can be used to inform consumers of the next best actions. The company says that more than half of its 7 million members are attributed to an Epic-using provider, allowing it to close care gaps automatically.

The VA says that 40 of the 100 AI use cases that it has identified are being used in the field.

Google CEO Sundar Pichai says that the company has taken its Gemini image generation feature offline for further testing after reports that it created offensive and biased results. Critics noted that the tool seemed exhibit liberal bias, such as creating an image of “a founding father of America” as black and Native American men.

Business

AI-powered clinical documentation tools vendor Abridge raises $150 million in a Series C funding round, valuing the six-year-old company at $850 million.

Research

Vanderbilt University Medical Center uses ChatGPT to analyze the medical literature to find existing drugs that could be repurposed for treating Alzheimer’s disease. The results were then applied to VUMC’s patient data and the All of Us Research Program to identify three drugs that may hold promise – losartan, metformin, and simvastatin.

Other

Scientists warn that while it’s possible to recreate a deceased loved one based on their emails and other writings, that could harm mental health, as it would impede the natural grieving process and create dependence on the technology to the exclusion of forming new relationships.

Another lawyer gets in trouble for using ChatGPT, as a law firm partner bills the court for $113,500 at the ChatGPT-recommended rate of $550 per hour. The judge halved the bill, saying that using ChatGPT to calculate the firm’s fee without submitting supporting detail is “utterly and unusually unpersuasive.”  

Contacts

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

Readers Write: Reframing Healthcare at Home

Reframing Healthcare at Home
By Philip Parks, MD, MPH

Philip Parks, MD, MPH is partner and senior advisor at CWH Advisors of Boston, MA.

What is in store for 2024 for healthcare at home? The organizations that will be successful will make progress rethinking healthcare and reframing both the problems we are solving and how we are solving them.

Whether we think about healthcare from the perspective of a patient, caregiver, payer, healthcare provider, or technology provider, it is undeniable that three types of healthcare experiences are here to stay:

1. Facility-based care. In-person care in facilities has an important place for the highest acuity clinical needs and when facility infrastructure is required;
2. Virtual care. Virtual care, ranging from episodic care to primary care to mental health care, may be the best and most effective way to meet patients’ needs and wants.
3. Care in the home. Virtual or in-person care (or a combination of the two) ranging from hospital home, primary care, specialty care, home health, hospice services, to in-home health evaluations for prevention and wellness.

However, the US healthcare system remains largely organized around facilities, even though the mega trends demand otherwise – aging populations with chronic conditions, adoption of technology, rising costs to support facility infrastructure, and healthcare provider staffing challenges. Therefore, many of the challenges that must be solved for moving care to the home are a work in progress. Often adoption and utilization have not been achieved to the extent needed.

While delineating care models by the site of care is practical for reimbursement and delivery of care, we are evolving to a world where patients just need care they need at the right time. The emerging concept and an example of reframing is that care can be thought of as always being on or continuous care being proactively enabled to address prevention, monitoring of treatment or care plans, navigation, and guiding the next best action for patients, caregivers, and providers.

How we accomplish this type of care in the US health system is, shall we say, a wicked hard problem that is being shaped by health and technology policies for standards information sharing (e.g., passing of TEFCA in December 2023), vertical integration (via acquisitions and/or partnerships) of providers, payers, platforms for care beyond facilities’ walls, and continued incremental innovations in care delivery models.

An often-underemphasized discipline is logistics related to healthcare in the home, especially, high acuity care in the home (or hospital-at-home) where nearly 20 types of services, supply, and staffing resources must come together on a daily basis to serve the clinical need of the patient. Factors to consider include timeliness, complexity, safety, quality, and the management and use of clinical and non-clinical data. We need more impactful partnerships between entities that bring together more integrated solutions with more value to impacting total costs of care, better use of data to directly inform evidence-based decisions and actions, and that reduce friction for patients and providers.

Five must- have tenets of a framework for healthcare services in the home should include:

1. Access. Requires making the intending action easier for patients, awareness of services, mechanism for reimbursement, efficient and cost-effective logistics, 24/7 navigation, appropriate staffing, and technology enablement support by data capture and documentation. Some examples to rethink include logistics and processes: waste disposal, reimbursement – attribution to combined service providers, technology – integration with mainstream EHRs, clinician staff that can travel, cancer care in the home, and clinically appropriate 911 diversion.
2. Engagement. A mix of human touch and empathetically designed and implemented technology; very simply, engagement is the trigger for action for human behavior. Engagement must result in activation of motivation and often is a prompt of some type that is educational, motivational, or oriented toward a desired identity of being healthy. Examples of effective marketing campaigns include making the intended action by the patient or member easier by empathetically addressing “what is in it for the patient and or caregiver”. Patient and caregiver voice is critical to getting this right.
3. Actions. These are the evidence-based behaviors by the provider and the behaviors of the patient (and caregiver) to participate in self-care or provided care. An example of options for home care is direct to consumer campaigns for colorectal cancer screening, which provide information based on the member or patient’s preferences and risk for colorectal cancer and in some cases can be done at home.
4. Adherence. Repeated behaviors related to self-care and active participation in provided care. Critical for adherence are literacy, knowledge, motivation, and ability. Making the repeated action as easy and simple as possible is critical. Examples of effective adherence strategies at home include enlisting the caregiver to reinforce self-care, using technology enabled reminders to prompt good habits, and ensuring that resupply of medications and supplies are automated when possible and medically necessary.
5. Health outcomes are a function of proactively creating access to all people and populations, proactively engaging with education and motivation that must lead to action on the part of patients. Adherence or repeatable actions result in outcomes.

Care at home may be the best site to conduct early screenings and pick up on other factors that wouldn’t necessarily happen in traditional settings. Also, with some diseases, the time period of screening and early detection may be much faster when screening can occur at home. For example, for individuals at average risk for colorectal cancer, samples can be collected in the home and mailed in for evaluation.

These tenets are the most important attributes which must be part of patient-centered design of services in the home. Obsessing over the healthcare and lived experiences of patients, caregivers, and their healthcare provider team members is paramount.

Reframing healthcare at home offers immense potential benefits related to quality of care, decreased costs and improved outcomes, elimination of silos across the continuum of care, and high satisfaction for patients, caregivers, and providers. Perhaps one of the most actionable ways for determinants of health to be identified and addressed is through continuous engagement and support to patients via care navigation, coordination, and the provision of clinical and non-clinical services in the home.

Readers Write: HTI-1: A Step Towards Demystifying AI in Healthcare

HTI-1: A Step Towards Demystifying AI in Healthcare
By Ryan Parker

Ryan Parker is a consultant and healthcare informatics graduate student. 

The integration of artificial intelligence (AI) in healthcare has been a double-edged sword, offering the potential for revolutionary advancements in patient care while simultaneously posing significant challenges related to data transparency, algorithmic bias, and the elusive nature of AI decision-making processes. The Office of the National Coordinator for Health Information Technology (ONC)’s latest regulatory effort, the Health Data, Technology, and Interoperability: Certification Program Updates, Algorithm Transparency, and Information Sharing (HTI-1), attempts to address these challenges head on. However, the question remains: Is it enough to solve AI’s most pressing issues in healthcare?

The challenges of implementing AI in healthcare extend beyond the technical sphere, often rooted in what I call “the human problem with artificial intelligence.” This encompasses issues like incomplete or biased datasets, unconscious biases leading to unintended outcomes, and the notorious “black box” problem where the reasoning behind AI decisions remains opaque. While the HTI-1 final rule aims to tackle these issues, its scope and impact merit a closer examination.

A significant hurdle in AI implementation is the siloed nature of patient data across the US healthcare system. This fragmentation hampers the development of AI models by limiting access to comprehensive datasets necessary for training. Although HTI-1 does not directly address data silos, you can see how this final rule aligns with ONC initiatives like the Trusted Exchange Framework and Common Agreement (TEFCA), aiming to foster a more interconnected health information landscape.

The problem of algorithmic bias and unintended outcomes—referred to as the “alignment problem” —is acknowledged tangentially in HTI-1. While the rule doesn’t mandate specific measures to eradicate biases, it underscores the importance of transparency and accountability in AI development and deployment. This approach suggests a recognition of the systemic nature of biases within AI algorithms but leaves the responsibility for addressing these issues largely in the hands of developers and implementers.

Perhaps the most significant contribution of HTI-1 is its attempt to illuminate the black box of AI decision-making. By identifying 31 source attributes that must be accessible to end-users—ranging from input variables and the purpose of the intervention to external validation processes—the ONC aims to increase transparency. This initiative is crucial, as studies have shown that healthcare providers are often reluctant to trust AI systems that lack explainability, regardless of the potential benefits.

The emphasis on transparency aligns with the sentiment expressed by Christian (2020), who noted that “the most powerful models on the whole are the least intelligible,” and Ehsani (2022), who highlighted the significant risk perceived by healthcare providers when faced with unexplainable systems.

It’s important to note that HTI-1 does not create a requirement for health systems to implement any specific technology related to decision support interventions (DSIs). Instead, it sets a framework for how AI should be integrated and evaluated within certified healthcare solutions. This approach allows for flexibility and innovation but also places the onus on health systems and developers to navigate the complexities of AI integration responsibly.

As Borgstadt et al. (2022) aptly put, the implementation of machine learning algorithms supporting clinician workflow can enhance the quality of care and provider experience, ultimately leading to improved patient outcomes. However, the journey toward fully harnessing AI’s potential in healthcare is fraught with challenges that require ongoing attention, intention, and effort. At the end of the day, HTI-1 is offering a new tool to healthcare providers, the real impact of which can only be determined by themselves.

Readers Write: Transforming Nursing Education: Seizing the Opportunity for AI and Technology Advancements

Transforming Nursing Education: Seizing the Opportunity for AI and Technology Advancements
By Julie Stegman

Julie Stegman is vice president of the Health Learning and Practice business at Wolters Kluwer Health of Waltham, MA.

In the ever-evolving landscape of healthcare, the nursing profession stands at a critical juncture. The nursing shortage is a pressing concern, and nursing education faces the challenge of preparing students for the day-to-day demands of clinical practice. The intersection of these challenges presents unique opportunities for the integration of artificial intelligence (AI) and other cutting-edge technologies, like virtual reality (VR), in nursing education to usher in a new era of learning and proficiency.

Nursing students find themselves navigating a learning environment that is vastly different from their earlier educational experiences. The transition from K-12 to nursing school is marked by an overwhelming amount of reading from textbooks, a lack of hands-on clinical practice, and the pressure to perform in a high-acuity clinical setting. Consequently, a staggering 37% of nurses who are under 25 said they were planning to leave their current role in the next six months, contributing to the broader nursing shortage.

Nursing schools are grappling with a lot right now, from how to best train practice-ready graduates and fill faculty openings while also reassessing their teaching methodologies. The goal is clear: combat unsafe practices, graduate clinically confident and competent nurses, and enhance retention rates. The need for innovation in nursing education is more critical than ever.

2024 is poised to witness a paradigm shift in nursing education, driven by the integration of AI. Embedded thoughtfully, AI holds the promise of streamlining educational workflows, alleviating the burden on faculty, and enhancing the learning experience for students.

AI offers a solution to the demanding workload faced by educators. By using AI algorithms, faculty members can efficiently assess student knowledge, allowing educators to focus on refining the delivery of content, fostering critical thinking, and providing personalized guidance.

For students, AI provides access to trusted learning materials in a conversational format, making information more accessible and digestible. Educational companies, recognizing the time constraints and expectations of modern students, are early adopters of AI to engage learners and provide personalized study resources.

The convergence of the nursing shortage and the evolving landscape of education creates a unique opportunity for the integration of AI in nursing education. The transformative potential of AI, coupled with innovations like VR and multimedia, can reshape the way nurses are trained and prepared for clinical practice.

At this critical juncture, nursing schools must seize the opportunity to embrace technology and ensure the next generation of nurses is not only clinically competent, but also well equipped to navigate the complexities of modern healthcare. The integration of AI in nursing education is not merely a technological advancement; it is a crucial step towards building a resilient and proficient nursing workforce for the future.

The nursing profession is witnessing a significant exodus of younger nurses, with approximately 15% of those with fewer than 10 years of experience expected to leave the workforce in the next five years. To combat this trend, nursing schools must adapt and incorporate technology to meet the needs of the current generation of learners. Doing so will allow students to be exposed to more lifelike scenarios, helping ease the transition to patient care.

Innovations like VR and virtual simulation can offer a bridge between theoretical learning and real-life clinical practice. Traditional simulation labs often limit students due to the need to share learning experiences. VR technology, on the other hand, enables multiple students to engage in realistic training simultaneously, enhancing the quality of the learning experience.

Combined with AI, these advanced virtual tools can better prepare students for real-world clinical scenarios without risking real patient harm. A startling statistic reveals that only 9% of new graduates are considered within an acceptable range of providing safe patient care, emphasizing the urgency for better clinical preparation. Bringing together VR simulation and testing leveraging AI for personalized learning can play a pivotal role in bridging this gap. This way of teaching and learning allows nursing students to gain practical experience, ensuring they enter the workforce with the skills and confidence needed for safe and effective patient care.