Recent Articles:

Morning Headlines 11/28/23

November 27, 2023 Headlines No Comments

Ardent Health Services Reports Information Technology Security Incident

Ardent Health Services works to recover from a November 23 ransomware attack that forced it to take systems offline across its six-state network.

RepeatMD lands capital to grow its aesthetics and wellness booking business

Patient acquisition and retention software startup RepeatMD raises $40 million, bringing its total raised to $56 million.

Wyden, Merkley: USDA Invests $2.28 Million to Expand Health Care and Broadband Assistance in Rural Oregon

Senators Ron Wyden (D-OR) and Jeff Merkley (D-OR) will distribute a grant of $2.28 million to providers in five Oregon counties so that they can provide more virtual care.

Curbside Consult with Dr. Jayne 11/27/23

November 27, 2023 Dr. Jayne 3 Comments

image 

We’ve made it past the Thanksgiving holiday, and hopefully people were able to spend time with their loved ones and then have a little time on their own to de-stress before heading back to work.

Historically, this time of year brings out all kinds of family drama. Looking at the data from one of the practices I work with, over the past couple of years there have been upticks in the number of visits for anxiety and depression between mid-November and mid-January.

Although I avoided dinner time conversations about Medicare, one family gathering involved a conversation about hospital-affiliated primary care practices that are charging facility fees. Another covered the move of private equity organizations into the local care ecosystem, leading to decreased access as they cut providers from their rosters following acquisition. US healthcare is certainly in a dark spot, and patients are paying the price as they find it more difficult and more expensive to get the care they need.

Local pharmacies have been eager to step into this gap. However, one elderly relative discovered that it wasn’t as easy to get appropriate care as it should have been. She’s in her 80s and has multiple risk factors for severe disease from RSV infection, so she tried to make an appointment for the recently approved vaccine. She walked into a location of a nationwide retail pharmacy chain and was told she couldn’t get the vaccine without an appointment. However, per her recollection of the story, they wouldn’t make an appointment for her, instead telling her to call for one. She called and wound up in a phone tree system, which kept prompting her to choose a location despite the fact that she was standing in one. When she selected the prompt to speak to a representative, it continued to ring, but no one answered.

She went to another location, which refused to administer the vaccine because she didn’t have a prescription. I’m not sure if this was because the pharmacy didn’t have the appropriate standing order in place from their medical director, or if it was some kind of insurance issue, or if they didn’t want to do the counseling since the vaccine isn’t strictly recommended based on age but rather as a part of a shared clinical decision-making process.

Either way, she left without her vaccine and instead spoke to her primary care physician. It sounds like the primary physician isn’t keeping up with the literature, because he told her she didn’t need the vaccine because she “isn’t around babies,” which has nothing to do with the indications for the vaccine. It’s designed to reduce the burden for a disease that hospitalizes more than 60,000 older adults each year and results in up to 10,000 deaths among retirement-age adults each year.

I’m hoping that the EHR team at her primary care physician’s office ensures that the vaccine is added to health maintenance dashboards so that physicians who aren’t keeping current might be prompted to address the condition with their patients. Hopefully that hospital-affiliated organization will also be providing continuing education to ensure physicians are aware of current recommendations, since it’s foolish to assume that technology alone can solve a clinician knowledge gap.

But in the mean time, thinking about my family members, I was tempted to dig out a prescription pad and just write the order myself. I don’t practice medicine like that, though, so I provided some coaching to hopefully help the patient have a better conversation with her physician. In the mean time, I’ll be calling a couple of pharmacies to see if they have standing orders in place that would allow her to get the vaccine.

Is this a place where telehealth-only organizations might help patients that can’t get what they need? Probably not, since many of them won’t allow their clinicians to order injectable medications even if they are low risk, like vaccinations. At one telehealth organization where I worked during the height of the COVID pandemic, we weren’t even allowed to write letters that would have explained that patients were high risk and could receive priority vaccinations. Even though providers on those networks are usually independent contractors, they’re often constrained by group policies that prevent them from doing things that might otherwise be straightforward in a traditional medical practice.

Speaking of telehealth, a recent article in JAMA Network Open looked at how patients complete tests and referrals when those services are ordered as part of a telehealth visit compared to those ordered during in-person visits. The telehealth visits were delivered by providers at a large hospital-affiliated primary care practice and community health center in Boston during the time period between March 1, 2020 and December 31, 2021. The authors looked at colonoscopy orders, dermatology referrals for suspicious skin findings, and cardiac stress tests. They found that only 43% of orders placed during a telehealth visit were likely to be completed, compared to 58% of orders placed during in-person visits. Interestingly, 57% percent of orders placed without a visit (perhaps as a result of a non-visit telephone call, or a patient portal message) were completed.

The authors suspect that one reason for the discrepancy might be the absence of schedulers or medical assistants to help patients during telehealth visits, or the lack of follow up communications encouraging patients to close the loop on their orders. That doesn’t explain why the non-visit orders were completed as frequently as they were, however, unless schedulers were assisting those patients. I would be curious to look at completion rates for orders from third-party telehealth organizations. Some of them won’t even generate orders for patients because they have no way to get those orders to a performing facility near the patient. Others limit their orders to those that can be done as part of an employer wellness program, such as diabetes screening tests or cholesterol testing. Third parties are often worried about liability, and given the transactional nature of many visits, there isn’t a mechanism to follow up on abnormal test results or to easily communicate follow up instructions to patients.

As someone who has done a lot of process engineering work, these are the “people” and “process” parts of the equation, but I continue to see organizations that try to solve them with “technology” alone. I’d love to see more organizations put their money towards solving people and process problems, whether it’s integrating a checkout person or scheduler into a telehealth workflow or making it easier for patients to self-schedule certain tests and procedures or doing a better job of reminding patients of orders that aren’t completed. Certainly, technology is part of all of those solutions, but it’s not the only answer.

How is your organization making it easier for engaged patients to receive the services they need? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 11/27/23

November 26, 2023 Headlines No Comments

DOD’s EHR Deployment Nearly Complete

The Department of Defense completes the last of 23 MHS Genesis go-live waves.

BSA diverting ER patients after ‘potential security incident’ causes network outage

BSA Health System (TX) reverts to downtime procedures including ER diversion due to a Thanksgiving Day network outage.

Hackers accessed sensitive health data of more than 8 million Welltok patients

A notice filed by Virgin Pulse-owned Welltok says the personal information of 8.5 million people was exposed in a breach of its Moveit file transfer system, with affected customers including BCBS plans, Sutter Health, Stanford Health Care, and The Guthrie Clinic.

HHS’ Office for Civil Rights Settles HIPAA Investigation of St. Joseph’s Medical Center for Disclosure of Patients’ Protected Health Information to a News Reporter

Saint Joseph’s Medical Center (NY) pays $80,000 to settle HHS OCR charges that it provided photos and information of three patients in April 2020 to the Associated Press, which was writing an COVID-19 story, without the approval of the patients.

Monday Morning Update 11/27/23

November 26, 2023 News 10 Comments

Top News

image

The Department of Defense completes the last of 23 MHS Genesis go-live waves.

The military’s final Oracle Health implementation is scheduled for March 2024 at Lovell Federal Health Care Center, which it jointly operates with the VA.

DoD says that its teams are anxious to move on to optimization and applying analytics at the site and enterprise levels.


HIStalk Announcements and Requests

image

Poll respondents aren’t optimistic that any of the usual suspects can disrupt healthcare, but they choose retailers as the best hope. I’m intrigued that they chose employers as the least likely given that they are footing much of the bill and have the only significant amount of clout, which they never seem to use.

New poll to your right or here: What is your single biggest frustration with your primary care provider? I’m allowing only one answer to hide the noise of problems that aren’t the main one.


Webinars

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


Acquisitions, Funding, Business, and Stock

London-based Phare Health, which offers medical coding tools, raises $3.1 million in a seed funding round.


Sales

  • Memorial Hermann Health System will implement Laudio’s worklfow automation tool for frontline leaders and has invested in the company.

Announcements and Implementations

image

Researchers develop a wireless acousto-mechanical system whose wearable sensors continuously transmit data about body movement sounds such as breathing, digestion, and cardiac activity.

image

London-based digital-first home healthcare provider Cera says it will provide 5 million care visits this winter to help address hospital capacity problems. Founder and CEO Ben Maruthappu, BM BCh. MPH was trained at London School of Hygeine and Tropical Medicine, University of Cambridge, Harvard, and University of Oxford.

A health official in China touts the country’s digital health success, listing online diagnosis and treatment, prescription services, fever clinic information, and hospital wait time.

image

A16z lists the jobs that AI could perform to reduce provider burnout and increase effectiveness, which it says should be supported by CMS in the form of increased payment for AI-assisted or augmented care (click the image to enlarge).


Privacy and Security

Saint Joseph’s Medical Center (NY) pays $80,000 to settle HHS OCR charges that it provided photos and information of three patients in April 2020 to the Associated Press for a COVID-19 story without their approval.

A notice filed by Virgin Pulse-owned Welltok says that the personal information of 8.5 million people was exposed in a breach of its Moveit file transfer system. Affected customers include BCBS plans, Sutter Health, Stanford Health Care, and The Guthrie Clinic. Virgin Pulse acquired the company in November 2021.


Other

Politico notes that a physician shortage will force the federal government to stitch together a primary care system that is delivered by nurses, physician assistants, and virtual visits, with no promise that people can get, much less keep, a regular doctor. Long appointment waits are sending sick people to the ED, urgent care, or pharmacy-located clinic where services are purely transactional with no promise of prevention or taking the patient’s personal or even medical history into account.

image

Cigna creates public outcry when it denies transplant coverage to a 47-year-old woman who was being prepped for a double lung transplant after being rushed to Vanderbilt University Medical Center when a matching donor had been found. VUMC sent her home and took her off the transplant waitlist. Cigna had previously approved the procedure, but found that the woman had the unapproved condition of terminal cancer. As is often the case, the insurer paid more attention to the bad press than to the patient and doctors in reversing its decision that it declared to have been an “error.” The patient now requires additional tests, the donor lungs are no longer available, and her only hope is to be placed back on the waitlist. Cigna got the black eye, while VUMC has drawn no public ire for declining to perform the transplant in the absence of Cigna’s willingness to pay.


Sponsor Updates

  • Health Data Movers appoints Curtis Cole, MD (Cornell University) to its board.
  • Through partnerships with Redox and Xealth, Tidepool develops EHR integrations for its diabetes data visualization software.
  • Five9 will present at the UBS Global Technology Conference November 29 in Phoenix and the Barclays Global Technology Conference December 7 in San Francisco.
  • Fortified Health Security names Kameron McNicholas senior SOC engineer.
  • Health Data Movers names Curtis Cole (Cornell University) to its Board of Directors.
  • Healthcare IT Leaders releases a new Leader to Leader Podcast, “Leading Through Growth and Change.”
  • Inovalon develops Converged Analytics Benchmarking to provide health plans with monthly determinations of their relevant national and state benchmarking for quality measurement and improvement initiatives.
  • InterSystems launches its HealthShare Health Connect Cloud solution in New Zealand.
  • A recently published study on brain health, “Using digital assessment technology to detect neuropsychological problems in primary care settings,” features Linus Health’s Core Cognitive Evaluation digital assessment technology.
  • Nordic names Claire Staple VP of strategy and country manager in Ireland.

Blog Posts


Contacts

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

Morning Headlines 11/23/23

November 22, 2023 Headlines No Comments

Tri-City Medical Center resumes nearly full operations after cybersecurity attack

Tri-City Medical Center (CA) resumes normal operations after a ransomware attack November 9 forced it to downtime procedures.

Company operating Nacogdoches Memorial Hospital files for bankruptcy

In Texas, Nacogdoches Memorial Hospital operating company Lion Star files for bankruptcy with debts of $10 million to $50 million owed to between 200 and 1,000 vendors, including $1 million owed to an EHR vendor.

Queensland Health fixes ieMR system crash after staff unable to login for hours

Queensland Health resolves an EHR log-in issue that had prevented users at its 24 facilities from accessing the Oracle Health system for several hours.

Morning Headlines 11/22/23

November 21, 2023 Headlines No Comments

Patient privacy fears as US spy tech firm Palantir wins £330m NHS contract

NHS England awards a consortium that includes Palantir and Accenture a five-year, $415 million contract to develop and operate the Federated Data Platform data-sharing platform across NHS trusts and care sites.

TCS Q3 to take $125 million hit on Epic Systems Corporation legal woes

Tata Consultancy Services will pay $140 million in punitive damages to Epic related to a 2014 case in which Epic accused TCS of downloading confidential material from UserWeb by having its employees pretend to be Epic customer consultants.

McWilliams School of Biomedical Informatics researchers awarded $31M in grants for medical artificial intelligence innovation research

Fifteen faculty members of UTHealth’s bioinformatics school are awarded $31 million in grants, $19 million of which came from NIH’s National Institute on Aging.

News 11/22/23

November 21, 2023 News 5 Comments

Top News

image

NHS England awards a consortium that includes Palantir and Accenture a five-year, $415 million contract to develop and operate the Federated Data Platform data-sharing platform across NHS trusts and care sites.

Medical groups and other watchdogs immediately expressed concern that a US firm that is best known for providing military and espionage software to the CIA and foreign governments will be handling sensitive patient information. They also noted that founder and chair Peter Thiel in on record as declaring that NHS “makes people sick” and should be privatized. He has also stated that NHS support by Britons is a form of “Stockholm syndrome.”

The contract, which follows extensive government lobbying by Palantir, does not include Scotland or Wales.

PLTR shares dropped on the news, valuing the company at $43 billion.


Reader Comments

image

From Ossifier: “Re: Forward Health’s CarePods. Maybe when they fail in the US and the company pivots once again, they can offload their unused pods to the French government.” France’s national railway will install appointment-only Loxamed telemedicine setups in 300 train stations that are located in medical deserts by 2028, which will feature on-site nurses who use connected medical equipment and sessions with virtual physicians, with services are billed to the national social security system. France’s physician union has objected strongly to the plan, saying that “There can be no good medicine that comes from the touch of a button, at a distance, from a doctor who does not know the patient.” Loxamed was formed in March 2020 by an equipment rental company to offer COVID-19 diagnosis and eventually vaccination. My take is that people could initiate their own telemedicine visits from home, so the advantage of this plan is the ability to be evaluated by an in-person nurse who can take vital signs and perform assessment before the remote physician takes over.


Webinars

December 7 (Thursday) 2 ET. “Waystar + Epic Workflow 101: How to Maximize your Epic Investment.” Sponsor: Waystar. Presenters: Christine Fontaine, solution strategist, Waystar; Lori Anderson, channel partner director, Waystar; Ashley Rose, associate director of client consulting, Waystar. Many users are curious about enhancing their Epic environments, but how do you know which features your organization needs? During this session, you will be provided a proven process to help you evaluate Epic-related decisions, tangible examples of need versus want criteria, and concrete steps to extract full value from Epic workflows and environment.

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


Acquisitions, Funding, Business, and Stock

AstraZeneca launches Evinova, a separate business that will further scale digital health solutions that are already used by the pharmaceutical company; and develop and market digital products in the areas of clinical trials, remote patient monitoring, and therapeutics.

image

UpHealth will sell Cloudbreak Health and its Martti telehealth language interpretation services to private equity firm GTCR for $180 million. UpHealth is in the process of selling off or winding down certain service lines, with its focus now on its behavioral health business in Florida. Several UpHealth subsidiaries filed for Chapter 11 bankruptcy protection in September.

Novant Health (NC) will buy three South Carolina-based hospitals from Tenet Healthcare in a $2.4 billion deal that includes RCM services from Tenet subsidiary Conifer Health Solutions.

App-based chronic care company Vida Health raises $28.5 million, bringing its total raised to $216 million.

image

Clinical notes analysis startup Layer Health raises $4 million in seed funding. Its debut product, Distill, helps clinicians find and submit data to clinical registries. The company’s five co-founders all have MIT-related backgrounds in AI, machine learning, and computer science.

Likely sensing a vacuum since the departure of Cerner for greener Oracle pastures, non-profit Digital Health KC hopes to help launch or lure 20 digital health companies to the Kansas City area using $4 million in grants.


Sales

  • NYU Langone signs a $115 million contract with Philips for enterprise informatics, pathology, AI-powered diagnostic imaging, and patient information technologies; as well as its Capsule Medical Device Information Platform.
  • Oregon Health & Science University will implement Visage Imaging’s Visage 7 enterprise imaging software.
  • McAlester Regional Health Center (OK) selects Smart Analytics from Sixth Sense Intelligence.
  • Children’s National Hospital in Washington, DC will use IT infrastructure services and technology from Kyndryl.
  • The Florida Department of Children and Families will implement Juno Health’s behavioral health EHR at Florida State Hospital.
  • Teladoc Health will open a virtual ED in a rural, remote part of Canada’s Newfoundland Labrador Health Services under a two-year, $16 million contract in which the patient will first see an in-person clinician, then be diagnosed and treated virtually.

People

image

Joe Murad (WithMe Health) joins Vida Health as CEO.


Announcements and Implementations

image

Washington County Hospital and Clinics in Iowa goes live on Epic.

Fifteen faculty members of UTHealth’s bioinformatics school are awarded $31 million in grants. $19 million of which came from NIH’s National Institute on Aging.

image

Lincata launches an in-room hospital entertainment system that features patient engagement and health system marketing opportunities. The company’s executive board chair is industry long-timer Tom White, MBA, who is best known as co-founder and CEO of Phynd until the company was acquired by Symplr.


Government and Politics

Tata Consultancy Services will pay $140 million in punitive damages to Epic related to a 2014 case in which Epic accused TCS of downloading confidential material from UserWeb by having its employees pretend to be Epic customer consultants. The original award of $940 million has been reduced several times in court reviews. The US Supreme Court rejected TCS’s appeal of punitive damages on Monday, where the company argued that it had already paid $140 million in compensatory damages from the original award.

image

HHS OIG warns consumers that scammers are cold calling Medicare enrollees to obtain their Medicare ID, after which they are signed them up for phony remote patient monitoring services that are billed monthly from pharmacies or durable medical equipment companies.


Other

image

The South Eastern Health and Social Care Trust in Northern Ireland celebrates the birth of the first baby born with an Encompass digital health record. The trust went live on Epic November 9. The system will be rolled out to remaining trusts over the next 18 to 24 months.

An AvaSure study of virtual patient sitting technology versus in-person sitting at Providence finds that virtual sitting is correlated to lower levels of burnout.

image

KFF’s Bill of the Month involves a woman’s first prenatal checkup, during which the nurse suggested having the standard panel of blood tests drawn at an office down the hall for convenience. The office belongs to a hospital that is run by religious non-profits Texas Health Resources and AdventHealth, whose lab billed her insurance at hospital rates for $9,500. Anthem BCBS negotiated the price to $6,700 and paid $4,300, leaving the patient to owe $2,400 for standard blood chemistry and STI tests. The average price of a CBC in Texas is $6 in an independent lab and $58 in a hospital, while the hospital in this case billed her insurance $207. She spent 10 months trying to ask questions, during which the hospital sent her bill to collections and ignored complaints that she had filed with the state’s attorney general. The hospital responded only when KFF started asking questions for its story, after which it cancelled all charges that, as it turn out, had been incorrectly submitted as diagnostic rather than preventive, which BCBS would have covered even at the inflated prices. Experts contacted by KFF questioned how well insurers negotiate hospital contract prices.


Sponsor Updates

  • Baker Tilly publishes a new case study, “Healthcare organization tests technical security controls and internal security awareness training with phishing campaign.”
  • Bamboo Health adds discharge summaries to its Pings real-time care notifications platform.
  • Prisma Health integrates Artera’s patient communications platform with Gozio Health’s location-aware mobile engagement platform.  
  • The Northern Virginia Technology Council recognizes DrFirst as a top technology company for the fourth year in a row.

Blog Posts


Contacts

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

Morning Headlines 11/21/23

November 20, 2023 Headlines No Comments

Medmo Raises $9M in Funding

Medical imaging technology company Medmo, which matches patients with partner imaging centers, raises $9 million.

Reed Jobs’ Yosemite makes first digital health bet on Maia Oncology

Maia Oncology, a virtual primary care clinic for cancer patients, raises $4.25 million in seed funding.

AstraZeneca launches Evinova, a health-tech business to accelerate innovation across the life sciences sector, the delivery of clinical trials and better health outcomes

AstraZeneca’s new stand-alone Evinova business will develop and market digital products in the areas of clinical trials, remote patient monitoring, and digital therapeutics.

Curbside Consult with Dr. Jayne 11/20/23

November 20, 2023 Dr. Jayne 1 Comment

image 

The Centers for Disease Control and Prevention (CDC) has launched an initiative to tackle burnout in healthcare. The Impact Wellbeing initiative falls under the auspices of the National Institute for Occupational Safety and Health (NIOSH). According to the tagline on its website, it’s designed for “building a system where healthcare workers thrive.” It will provide “evidence-informed solutions” and resources to hospital leaders on avoiding burnout and promoting wellbeing for workers.

I was pleased to see that the website encourages hospitals to use materials from the Dr. Lorna Breen Heroes’ Foundation to address how hospitals can help staff address mental health needs without being penalized. Many hospitals and healthcare organizations still have questions on their employment and credentialing applications that stigmatize mental health conditions rather than supporting those that live with them.

As an example, one job for which I applied asked, “Have you ever been treated for a mental health condition?” with boxes to check yes or no, but no way to provide explanatory information. A better way to approach this is to ask whether the applicant has any current impairment that will prevent them from performing the duties of the position. There are plenty of mental health conditions that are episodic, and asking about past conditions that may be resolved hasn’t been shown to do anything but prevent people from honestly answering the questions.

In looking at some of the other materials on the site, as well as interviews with NIOSH staff that appeared in the media at the time of the announcement, it feels like the organization’s leadership understands that talking about resiliency or offering wellness programs doesn’t scratch the surface where employee mistreatment is concerned. Healthcare workers encounter bullying, harassment, and moral injury on a daily basis and those elements need to be addressed as part of an overall solution.

The initiative also encourages the leadership of healthcare delivery organizations to involve those affected in the process of defining the issues and solving them. I don’t know when it became a revolutionary idea to talk to people in order to understand their needs, but I’m happy to see recognition of the idea featuring prominently in the campaign. Organizers can use the NIOSH Worker Well-Bring Questionnaire to better understand where their workers are across domains that include policies, culture, environment, personal health, and home/community factors.

Although I appreciate that the focus of the campaign is on hospitals since they’re such a critical part of our healthcare infrastructure, I’d like to see these elements addressed in other care delivery sites, such as urgent care centers. There are 14,000 urgent care centers in the US, and according to data provided by the Urgent Care Association, more than 25% of adults visited an urgent care center in the last year.

Unfortunately, the level of regulation for those facilities varies from state to state, and in talking to physician colleagues, abuses are becoming more common as private equity companies expand in the industry. For a while, we saw a lot of emergency department physicians leave those environments to go to the relatively slower pace of urgent care. However, as the complexity of patients presenting to urgent care rises, and the number of patients physicians are expected to see each hour increases, we’re seeing physicians leave those environments as well.

Given the reliance by hospitals on nurses to deliver patient care, there’s a lot of push by nursing organizations to improve things. Since urgent cares use many more non-nurse caregivers — such as medical assistants, emergency medical technicians, and unlicensed patient care technicians — to deliver care at a lower cost, there aren’t many advocacy organizations looking out for those workers.

Quite a few urgent care centers are physician owned and operate more under a private practice model than an emergency care model, so that adds another element to the problem. In my area, a local multi-site urgent care center recently closed after the physician owner was arrested, leaving staff and patients in the lurch. Other organizations have struggled to absorb those visit volumes in the face of their own staffing shortages, and it’s been a bit of a mess.

Meanwhile, capable physicians sit on the sidelines because they’re not willing to go back to abusive environments. At my former clinical employer, nearly all the physician employees left when the private equity company that acquired it started tightening the screws to squeeze out more profit. I know at least six of us who would return from our early retirements if the working conditions were less atrocious.

In speaking with colleagues across the country, this experience is in no way unique. One local urgent care chain classifies its physicians as hourly employees, but pays a “shift rate” that requires them to stay until all patients have left without additional pay for the additional time. I’m not sure how that’s legal under state labor laws, but they’ve gotten away with it for a number of years. On the other hand, it might be one explanation for why they have locations that are mothballed because they can’t staff them.

I admit I didn’t read every single word on the CDC website for the program and didn’t follow every link, but I didn’t see any mention of how organizations need to do more to believe workers when they complain or how to take action when issues are reported. There is still a culture at many organizations of just saying “it is what it is” or “suck it up” when employees report exploitive practices. People are suffering from compassion fatigue, which can lead to lack of empathy and may contribute to workplace bullying if left unchecked.

At one local hospital, nurses scheduled for 12-hour overnight shifts routinely have to stay for 14 or 15 hours due to staffing issues. I guarantee that situation is not doing much for morale or burnout prevention. Even among healthcare workers, I hear comments like “you chose healthcare, what did you expect?” which doesn’t help solve the issue. I have a handful of non-medical friends who understand what we go through, but when medical folks can’t even support each other, how can we expect outsiders to understand what we’re going through?

It will be interesting to follow the progress of the initiative over time and to see how many organizations are using the tools and trying to drive positive change vs. just paying lip service to the idea.

If you’re a care delivery organization leader, had you heard of the initiative before today? What steps are you taking to drive change? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 11/20/23

November 19, 2023 Headlines No Comments

Over 80 St. Louis NextGen Healthcare workers to be laid off

NextGen Healthcare files WARN documents indicating that it will lay off 84 employees in St.Louis in the first months of next year.

Novant Health to acquire three hospitals from Tenet Healthcare

Novant Health (NC) will acquire three South Carolina-based hospitals from Tenet Healthcare in a $2.4 billion deal that includes RCM services from Tenet subsidiary Conifer Health Solutions.

Aya Healthcare Acquires Winnow AI, a Data Science Driven Platform to Recruit Passive Physicians

Digital staffing platform vendor Aya Healthcare acquires Winnow AI, which identifies physicians who are open to new positions and relocation who match open roles.

GTCR to Acquire Cloudbreak Health

Private equity firm GTCR will acquire telehealth language interpretation services company Cloudbreak Health from UpHealth for $180 million.

Monday Morning Update 11/20/23

November 18, 2023 News 1 Comment

Top News

image

NextGen Healthcare files WARN documents indicating that it will lay off 84 employees it St.Louis in the first months of next year.

Meanwhile, executives who are cashing in on the November 10 sale of the company to private equity firm Thoma Bravo by selling shares include President and CEO David Sides ($15 million), CFO James Arnold ($12 million), and board member Srinivas Velamoor ($9 million).


Reader Comments

From AnInteropGuy: “Re: Veradigm. Continues to miss their filing deadlines and met with NASDAQ about the delisting situation — no news on how they will rule — but they have not been able to restate any of the questioned quarters. Leadership continues to say ‘very close’ but the remains substantially quiet on what the timeline looks like. Their last claim in September was that they would file by early November ahead of the NASDAQ meeting. That was before the announcement of the delisting notice so they had been made aware that they were facing delisting. They are still trying to gather contracts, payments, etc for the previous quarters and years — now apparently reaching all the way back to 2015.” A final SEC de-listing hearing was held on Thursday, but the decision hasn’t been announced. I don’t know the extent of accounting work that is required, but it seems strange that a publicly traded company whose shares are about to be de-listed can’t muster the resources, as other firms have done, to meet ASC 606 revenue recognition requirements. As a skeptic, I wonder if other motivations may be in play.

From Epson: “Re: Forward Health’s CarePod. I’m interested in predictions.” OK, here’s mine: (a) the company will deploy less than 250 devices versus its 3,200 goal; (b) issues with maintenance, limitations of the clinical model it was developed around, and lack of member loyalty will stall rollouts and raise questions about the viability of that business; and (c) Forward will try yet another pivot and the CarePods will move from malls to landfills given that no other company would have a use for them. I could be wrong, but Forward Health’s core business doesn’t seem to be sound enough to warrant gadgetary distraction, not to mention that as an N-of-one analysis I can’t see myself paying for such a service as described.


HIStalk Announcements and Requests

image

Poll respondents report seeing diminished influence across many of the newly established C-level technology roles within healthcare systems. What’s your experience with these positions being eliminated or downgraded? A LinkedIn wizard could probably find examples.

New poll to your right or here: Who is most likely to disrupt the US healthcare system to benefit patients?


Five Easy Ways You Can Support HIStalk

  1. Join my spam-free mailing list to be first in the know.
  2. Connect and follow on LinkedIn and join Dann’s 4,000-member HIStalk Fan Club so I can follow your company and job news.
  3. Mention HIStalk to your colleagues and vendors or send me a testimonial about its value to you.
  4. Share news, rumors, and intriguing insights.
  5. Consider being interviewed, particularly if you’re a frontline worker or researcher.

Also, for companies that have 2023 marketing funds to spend, we can bill you now and you can send your ad and materials later when you are ready. You get a full 365 days of sponsorship starting when your ad is posted. I’m mentioning this because Lorre has received the question several times this week.


Webinars

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


Acquisitions, Funding, Business, and Stock

image

Digital staffing platform vendor Aya Healthcare acquires Winnow AI, which identifies physicians who are open to new positions and relocation who match open roles.

Mass General Hospital and Brigham and Women’s announce that they cannot accept new primary care patients because their appointment waitlists are months long.

Children’s Hospital of Philadelphia, Stanford Health Care, and Children’s Medical Center of Dallas implement Wolters Kluwer’s Ovid Synthesis for evidence-based practice workflow applications.

Open AI’s board fires high-profile co-founder and CEO Sam Altman for unspecified reasons in a surprise announcement that wasn’t shared in advance with investors such as Microsoft, which owns 49% of the company. The rumored issue was product safety versus profit and Altman’s work to raise funds to create AI hardware companies outside of OpenAI’s non-profit oversight. Greg Brockman, co-founder, president, and board chair, was removed from the company’s board and then resigned. Several senior scientists also quit. The blowback has reportedly convinced the board to negotiate for Altman’s return, although he says he’s not that interested and would require significant governance changes to return. Meanwhile, the action that has likely cost Open AI much of its $80 billion valuation and the confidence of developers who use its products has also resulted in speculation that Altman and the other departed executives will immediately start a competing company, along with speculation that Microsoft should save OpenAI by buying the rest of it.


People

image

Lynsi Garvin, MSN, RN (Google Health) joins Intermountain Health as associate chief clinical information officer.

image

Adrienne Morrell (SCAN Health Plan) joins MRO Corp. as VP of governmental affairs.


Announcements and Implementations

Oracle will hold a one-day health summit on February 13 in Nashville, where the company is significantly expanding.

image

A new report from Center for Connected Medicine at UPMC finds that the patient engagement potential of health system-owned ambulatory pharmacies is being threatened by drug chains and technology firms that offer more convenient and innovative services and digital tools. Top operational challenges are 340B limitations and staffing issues, while the biggest consumer issue is lack of physical accessibility due to location, lack of transportation, and limited hours of operation. Top tools include delivery service and text-based refill reminders, while telepharmacy kiosks and self-pickup lockers have low interest.


Government and Politics

Memorial Hermann Health System and Texas Attorney General Ken Paxton settle the AG’s investigation into reports that its patient portal could not be accessed by the parents of patients aged 13 to 17. Texas law gives parents and legal guardians the right to access the medical records of their children except in specific circumstances where the child can indicate that they don’t want their information shared. The health system agreed to provide better instructions for accessing family records on its patient portal and also cited its planned migration to Epic.


Other

Federal Trade Commission Chair Lina Khan, JD says that she has used ChatGPT to contest questionable medical bills. She didn’t say how she used it specifically, but ChatGPT suggests that it can provided detailed breakdown of charges, explain how insurance applies, identify discrepancies, offer negotiation tips, and draft appeal letters.

image

The Madison paper covers Nurse Disrupted, which offers a virtual nursing platform. The founder and CEO of the eight-employee company is Bre Loughlin, MS, RN, a former bedside nurse and Epic executive.


Sponsor Updates

  • Vyne Medical publishes a case study titled “Cloud Fax Reduces IT Burden for Large Health System.”
  • Mobile Heartbeat publishes a new customer success story featuring Henry Mayo Newhall Hospital.
  • Lucem Health will incorporate AccurKardia’s ECG interpretation software into its Reveal solution to identify high-risk patients.
  • NTT Data publishes a new report, “Innovation Index: How North American Organizations are Achieving Growth, Value, and High Performance.”
  • Nordic releases a new Designing for Health Podcast, “Interview with Margaret Lozovatsky, MD.”
  • PerfectServe congratulates customers Elmhurst Hospital, Beverly Hospital, and UNC Health Rex on receiving 24 consecutive “A” grades for safety from The Leapfrog Group.
  • SmartSense by Digi’s second annual Live23 user conference sees a 300% increase in attendance year over year.

Blog Posts


Contacts

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

Morning Headlines 11/17/23

November 16, 2023 Headlines 1 Comment

VA still has ‘significant concerns’ as Oracle works to get EHR modernization back on track

VA CIO Kurt DelBene tells a House committee that despite improvements, he has “significant concerns” about Oracle Health related to new incidents, failing to meet standards, end user responsiveness, and workflow.

AAPC Expands Its Technology Solutions Portfolio with the Acquisition of Semantic Health

RCM organization AAPC acquires Semantic Health, a Toronto-based startup specializing in AI-powered coding and auditing software.

3M Healthcare Spinoff Gets a Name: Solventum

The healthcare business that 3M will spin off in the first half of 2024 will be named Solventum.

News 11/17/23

November 16, 2023 News 6 Comments

Top News

image

VA CIO Kurt DelBene tells a House committee that despite improvements, he has “significant concerns” about Oracle Health related to new incidents, failing to meet standards, end user responsiveness, and workflow.

On the positive side, the VA has had no complete system outages in six months.

Also from the hearing:

  • Rep. Matt Rosendale (R-MT) cited a KLAS survey of VA employees in which only 26% said the EHR is available when they need it, leading him to question whether the VA’s help desk makes it too hard for employees to report problems.
  • Deputy CIO Laura Prietula, MS, EdD  blamed VA-approved customization of the base Oracle Health platform for its implementation struggle compared to the private sector. She added that the VA is now trying to reverse that customization and go back to out-of-the-box functionality.
  • Rosendale cited a report saying that it will take Oracle Health 15 more years to match VistA’s functionality. Prietula responded that she doesn’t think it will take that long.
  • Rosendale says that Oracle “hold themselves out as the experts in this field” but the VA’s VistA has 99.9% uptime and “it’s baffling that anyone could pay billions of dollars and set a lower standard.”
  • Rosendale noted that the committee invited Oracle EVP Mike Sicilia to attend the hearing, but he didn’t attend or send an alternate.

Reader Comments

image

From Chip Ludd: “Re: CarePod. Serious Silicon Valley Kool-Aid is being slurped by anyone who thinks this will work.” The likelihood of success for this clinician-less health app kiosk in malls has two dimensions – whether it’s a viable business (which I doubt) or if it’s a medical breakthrough (which I’m sure isn’t the case). My reactions:

  • HealthSpot went bankrupt in early 2016 after failing to gain traction for a similar offering even after installing its gadgets at the facilities of its partners Cleveland Clinic and Rite Aid. Higi offers a national network of free Smart Health Stations, but it was acquired for nearly nothing in early 2022 by Babylon Health, whose share price is also approaching near-nothingness. And everybody remembers the endlessly hyped but modestly featured Scanadu Scout tricorder-like device, whose 2017 shutdown after an 18-month study led some to call it Scamadu.
  • Memberships cost $99 per month, and don’t include in-person clinic access. Insurance is not accepted.
  • Customers still have to drive to a physical location, although finding a parking space at a dying mall shouldn’t be a problem.
  • I would be hesitant about having my orifices penetrated by a machine that has a single, non-licensed attendant who will probably be so bored between breakdowns and reboots that they’ll hang out at Cinnabon.
  • I assume that the company will need to navigate a regulatory maze in performing scans and blood draws using self-developed equipment that operates without clinician oversight.
  • The company is investor-hungry, so it adds the obligatory AI connection – the box will perform AI searches of medical literature and generate a care plan that clinicians review. I’m not sure most of primary and preventive care requires real-time literature review.
  • The gadget is a pivot for the company, whose core business is running a few clinic locations that they like to compare Apple Stores.
  • The functions the technology can assess are limited compared to what a skilled human can perform in a real examination. Only so many sensors and algorithms are available and approved.
  • The target audience seems to be young, worried well people who prefer faceless machines and tons of prevention-focused data or congratulatory test results to interacting with a clinician. That actually is a pretty good business model. Reviews for the company’s in-person clinics are almost all from customers in their 20s and early 30s.
  • Forward attracted a fresh $100 million from investors, but this is an entirely different, capital intensive, and less-certain business mode than its actual operating business of running clinics.
  • From a societal health perspective, convincing people that running app tests in a mall is equal or better to seeing an actual clinician is not a positive accomplishment, nor is a system that cares so little about consumerism and preventive health that people flee to the healthcare equivalent of a photo booth in front of a defunct Sears.

Also interesting is that the company’s clinics have mediocre reviews from their $149-per-month members, with comments like these making you wonder if investors are watching the company’s member retention rate (independent PCPs, especially direct primary care docs, everything you need for your marketing plan is right here):

  • There’s no way to talk to a real human being on the phone, it’s all done through chat, and often the people I were chatting with didn’t understand the issue I was trying to explain to them. Wait times to see a doctor are horrendous, usually longer than 2 weeks. The app that they offer is mediocre and is much worse than record keeping systems used by other medical providers.
  • Slow followup on things like bloodwork and other tests. Billing issues. Inconsistencies on providers & quality of care/advice. 10 out of 10 do not recommend.
  • Tone def. Limited communication channels – no one available on phone. Virtual experience – not in person. They define your health priorities and disregard the health priorities that are important to you. They do not solicit your medical records – they rely on the patient to share that information. Not data backed guidance. The app is not intuitive – very poor user experience
  • At my 1 year checkup recently, all that happened was collection of lab blood by staff and a report on my app without any guidance from my doctor. Fortunately, things are going well for me, but I would like to keep that going. I am looking for more of a partner in healthcare instead of a monitor.
  • Initially had potential yet with physician turnover, outsourced labor and a lack of continuity in records and communication you are no better off than dealing with the typical primary care physician. Save yourself the money and perhaps try a different concierge-like medicine platform.
  • I had a membership for several years and always had frustrations, mostly about the doctors and their poor advice. Eventually though I got tired of not getting prompt replies and having physicians change repeatedly, the new ones never seeming to bother with reading your history. They contradict each other. It really doesn’t feel safe. For example, they can’t administer the Covid vaccine. They can’t handle simple things like annual skin cancer exams. They take pictures of your moles and send them to someone. They have to send you to a specialist outside of their system for EVERYTHING.

From Dockside: “Re: BJC. I work there and the CEO aid in a town hall this week that the merger with Saint Luke’s in Kansas City is set to close on January 1, 2024. For now, the systems will operate as BJC HealthCare in eastern Missouri and Saint Luke’s Health System in western Missouri.” Unverified, but previously rumored as planned “by the end of the year” The merger would create a 28-hospital, $10 billion health system. I think they’re both running Epic.


HIStalk Announcements and Requests

I’m noting with grammarian interest the sudden pervasiveness of the word “lovely,” which I actually kind of like despite (or maybe because of) its time capsule images of grannies sipping tea pinkies-up on lace doilies. I hereby propose the resurrection of the similarly aged “splendid.”


Webinars

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


Acquisitions, Funding, Business, and Stock

Primary care chain Forward Health raises $100 million in growth capital to roll out CarePod, which it calls “the world’s first AI doctor’s office” for members who pay $99 per month for access to the app-equipped kiosks that will be installed in retail locations.

The estates of two deceased individuals sue UnitedHealth Group (UHG), alleging its AI algorithms, which came from its acquisition of NaviHealth in 2020, deny necessary care to Medicare Advantage seniors. The complaint highlights a 90% error rate in the AI system when its decisions are challenged, with the plaintiffs alleging that UHG’s Medicare Advantage patients receive substandard care compared to traditional Medicare patients.

The healthcare business that 3M will spin off in the first half of 2024 will be named Solventum.


Sales

  • University of Miami Health System chooses Aidoc to identify and triage abnormalities in patient images.
  • Lee Health (FL) will offer virtual urgent care from KeyCare, which patients can launch from MyChart.

People

image

Elation Health hires Tom Natt (ConnectRN) as chief growth officer.

image

Greg Tracy. MS joins Wondr Health (ResMed) as CTO.

image

VCU Health hires Jeffrey Kim, MD (Loma Linda University Health) as CMIO.


Announcements and Implementations

image

Rimidi will provide its remote patient monitoring technology to Atlanta-based non-profit Brighter Day Health Foundation, which will offer RPM and chronic condition management services to underserved communities from local churches. Rimidi CEO Lucienne Ide, MD, PhD founded the company in 2011, and before her medical training, served as a signals analyst for the National Security Agency.

California health and social data-sharing organization Connecting for Better Health restructures as a non-profit and announces its initial board of directors.

Sectra will integrate its enterprise imaging diagnostic application for radiology with GE HealthCare’s AW Family Advanced Visualization applications.

image

A new KLAS report on patient engagement finds that patient portals, patient surveys, and telehealth are widely adopted and health systems are moving on to implement provider search and patient self-scheduling. Two-thirds of respondents say their plans involve their EHR vendor, either alone or with third-party solutions, with 58% of Epic-using respondents and nearly as many Meditech customers saying that the vendor aligns with their plans, while one-third of Oracle Health’s customers say the same. Technologies most mentioned for consolidation are virtual care and patient communications.


Privacy and Security

Mail order pharmacy fulfillment vendor Truepill files a breach notice that the information of 2.4 million people was exposed in an August cyberattack.  


Other

image

Snips from the Digital Health Most Wired 2023 survey:

  • Health system IT budgets have stabilized, with most returning to pre-pandemic levels and likely to increase as they acquire technology to address labor shortages, wage inflation, and reduced margins.
  • They are looking for solutions that offer a clear, measurable ROI.
  • The average Digital Health Most Wired score has increased steadily from 63% in 2019 to 77% in 2023.
  • An ever-increasing amount of stored data has increased use of advanced analytics, although often involving multiple vendor solutions across locations and departments, with limited integration.
  • End users need to improve their understanding of how to use data, but scaling education programs is hard as systems rapidly evolve.
  • Health systems are trying to integrate data from patient-wearable devices into their EHR.
  • The role of the CIO is becoming complex as cybersecurity, innovation, and analytics require leadership that may or may not fall under the CIO’s oversight.
  • Few large health systems place cybersecurity under the CIO, as 90% of them have a CISO or other VP-level position.

image

Mark Cuban disagrees with a tweet that says Big Tech won’t disrupt healthcare, offering a detailed response that I’ll summarize:

  • Tech companies that claim to “optimize” the system are improving only its rent-seeking aspects.
  • Healthcare consolidation has used lack of transparency to “extract rents everywhere and anywhere they can” so that nobody can see who pays how much.
  • PBMs and insurers add complexity and are not needed given the ability for employers to contract directly with providers, adding that “is it really insurance if they do everything possible not to pay claims?”
  • Providers know that contracts, pricing, and network games that big insurers play are ruining the quality and cost of care, but they are too scared to speak up.
  • Employer CEOs don’t understand that they are enabling the status quo by working with incumbents, but they are finally realizing the need to change for financial and employee wellness reasons.

image

UCLA sues Mattel for reneging on its 2017 pledge to donate $49 million to its children’s hospital, claiming that the toymaker is instead offering a few million dollars plus a bunch of toys. UCLA wants the full $49 million plus damages, but Mattel says the donation was earmarked for adding a new tower to UCLA Mattel Children’s Hospital that UCLA decided not to build.


Sponsor Updates

image

  • CHIME gives its 2023 collaboration award to Ellkay and Signature Healthcare. 
  • Eric Sellari joins Health Data Movers as account manager.
  • Biofourmis and HealthXL publish a report titled “Unlocking the Value of Digital Measures in Drug Development.”
  • Ascom Americas names Kim Hendrix, RN regional director, Healthcare Alliance.
  • The Outcomes Rocket Podcast features Availity AuthAI CTO Rob Laumeyer, “We Can’t Make Healthcare Error-Free, But We Can Make the Errors More Traceable.”
  • AvaSure publishes a new guide, “AI Powered Enhancements for Your Virtual Care Workflow.”
  • Nordic releases a new episode of its “In Network” podcast titled “Designing for Health: Interview with Margaret Lozovatsky, MD.”
  • Bamboo Health will exhibit at the Medicare Star Ratings Summer December 6-8 in Orlando.
  • Bardavon joins the National Safety Council’s TechHub Marketplace.
  • Recent KLAS reports recognize Care.ai’s virtual care solutions based on the company’s expert staff, premium hardware, and advanced AI features.
  • The This Week in Pharmacy Podcast features CereCore Physician Consultant Charles Bell, DO and CereCore Manager Andrea Corner, PharmD, “Pharmacists and Physicians Refining the EHR.”
  • Clinical Architecture releases a new Informonster Podcast, “Documentation in the OR with AORN.”
  • KLAS Research’s 2023 Data & Analytics Platforms Performance Report names Dimensional Insight a top performer.
  • Divurgent releases a new Vurge Podcast, “Exploring the Power of Data and Analytics in Healthcare.”
  • EClinicalWorks announces that Moreno Valley Physician Associates (CA) has successfully implemented its new AI assistant tools.
  • First Databank receives the American Medical Informatics Association’s Silver Corporate Partner Award for its contributions to the association and the field of informatics.
  • FinThrive relocates its corporate headquarters to Plano, Texas.

Blog Posts


Contacts

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

EPtalk by Dr. Jayne 11/16/23

November 16, 2023 Dr. Jayne 2 Comments

As a frontline physician who has dealt with my share of angry patients, I’m always worried that one of them will follow me home from work or show up at my house. I’m vigilant about my personal information and make sure that it’s difficult to find me through real estate or other public records.

Recently Doximity announced a free service called DocDefender that can help physicians remove their personal information from public websites. I decided to give it a whirl. I initially tried to find it through my Doximity account, but wasn’t successful. A web search took me to the right site, but I had to go through an email authentication process to get started. From there, the system started scanning and found my information on 17 out of 35 targeted websites.

The removal process is supposed to begin automatically with results in two to 60 days. I should be receiving regular updates on the removal process, so I’ll provide updates in the coming weeks. It’s also supposed to provide periodic checks to identify new listings, so we’ll see how that goes.

While I was digging around my Doximity account, I stumbled upon Doximity GPT, which is described as “A medical writing assistant that can compose patient education, recommendation letters, grant proposals, ortho poetry – basically any writing task you can think of.” I found the idea of ortho poetry to be intriguing but not compelling, so I asked it to write a haiku about clinical informatics instead. It did not disappoint:

Data flows like streams,
In clinical realms it gleams,
Healing in light beams.

Telehealth organizations across the US are jumping into the weight loss business, making it easier for patients to obtain prescriptions for costly injectable medications, although their ability to jump through the hoops imposed by payers is highly variable. Employers are starting to try to control costs, and Mayo Clinic’s employee health plan has announced that it will cap weight loss medication expenditures at $20,000 per patient as a lifetime maximum. Since some of the medications run up to $900 per month, for patients who are already in treatment, we’re going to see what is essentially an unregulated, uncontrolled clinical trial where time and financial means will be influencing outcomes. The caps don’t go into effect for patients using the drugs for diabetes, which creates a strange “chicken or the egg” situation where prevention or risk reduction isn’t covered but treatment of disease is.

This is largely the result of our payment system, where everyone is trying to control costs for their attributed patients, but doesn’t have the means to take advantage of long-term savings. For example, let’s look at an obese 55-year-old patient with pre-diabetes. If they can achieve weight loss, they likely reduce their chances of developing diabetes, which saves money down the line. When you look at the costs of diabetes care or the complications of diabetes, those expenses would likely occur in 10 to 15 years, when Medicare might be paying them as opposed to commercial insurers.

There’s no incentive for a commercial payer to absorb the cost today in order to realize the savings down the road, because the patient won’t be on their books then, and might not even be on the books in a year or a month, if they work for a healthcare IT company that includes them in a reduction in force as we’ve seen plenty of recently. The math just doesn’t work, but inability to get treatments that could improve quality of life and reduce disease burden is a reality for so many patients today.

Mayo Clinic is just following the example of other healthcare employers that have dropped coverage, including Hennepin Healthcare, Ascension, and the University of Texas System in Austin. All of those popped up in a web search as being in the same situation. My crystal ball predicts that many more organizations will be changing coverage over the coming months unless the prices of the drug come down or there’s evidence of a way they could save money by covering it.

This week included my regularly scheduled annual visit to Big Medical Center for follow-up imaging and a consultation with my care team. I received the email reminder of my visit and confirmed it by completing the electronic check-in process the same day the reminder came out. The next day, I received a phone call, right in the middle of typical dinner hours, asking me to again confirm the appointment. However, I had to listen to a minute and a half of recordings about parking and arrival times before I could confirm. They should have told us to allow an extra 20 minutes to deal with the parking and construction situation, because it was rough and I barely made it to my appointment on time. Good thing they didn’t check my blood pressure because I’m sure it was up there.

I was seeing a new provider at this visit, since they’ve changed how the department runs. I wasn’t impressed by the fact that she had a bunch of handwritten paper notes about me, or that she didn’t use the EHR at all during our visit. It would have been one thing if her notes were accurate, but they weren’t, as I discovered when she tried to offer me genetic testing that I’ve already had.

We discussed the existing results, which I wonder if she missed because they’re scanned into the EHR as opposed to being discrete data, and she relied on my memory to tell her what testing I had completed. From there it was off to the imaging department, only to be told that they’re not doing real-time results anymore, which is one of the reasons I use this facility. Results will come to me via the patient portal in a few days, which I suppose is adequate, but the availability of real-time results was one of the reasons I tolerated the long drive and the general hassle of using this facility.

As a last bit of frustration, they used to schedule your follow up at the checkout desk, and they don’t do that any more. The new process is a bit bumpy and I had to wait for the clerk to write the appropriate phone number on a sticky note so I can call back and self-schedule. At a minimum, someone needs to make a half-sheet handout they can give patients that includes all the pertinent information. In the time it took her to write it down, she could have scheduled the appointment since it’s for a year out and my calendar is wide open. I wonder how many patients will be lost to follow up this way, as those sticky notes disappear into purses and tote bags.

As a final insult, when I returned to the parking garage, the car next to me had parked over the line to the point where I couldn’t get into my car. Fortunately, I’m spry enough to do the gymnastics needed to climb in the passenger side and crawl over the console, but I’m betting a good portion of those visiting a world-renowned cancer center might not have the ability to do so. Still, I’m glad it happened to me and not someone who just finished a treatment or who just received life-altering news, so I’ll view it as my good turn for the day.

After I got home and decompressed from the experience, I walked to the mailbox and found a fundraising solicitation from the organization. I’m no stranger to the concept of so-called “grateful patient” fundraising, but the timing on the solicitation gave me an idea. What if I challenged them to fix their messed up processes in exchange for a sizable donation? I’m sure I could solicit patients and family members to participate, as well as physician colleagues who don’t want their patients to be frustrated by the care delivery experience. I’d even throw in some complimentary consulting services to sweeten the deal.

What are the simple things that facilities could do to improve the patient experience? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 11/16/23

November 15, 2023 Headlines No Comments

Forward Raises $100M and Announces Forward CarePod

Primary care provider Forward Health announces CarePod, a self-contained, unstaffed “doctor in a box” that is available to members who pay $99 per month to access AI-powered apps that perform screening and create care plans.

UnitedHealthcare’s broken AI denied seniors’ medical claims, lawsuit alleges

The estates of two deceased men sue UnitedHealth Group, claiming that the company uses an algorithm to override physician assessments in denying care to its Medicare Advantage enrollees.

Aranscia Acquires YouScript from Invitae

Precision diagnostics vendor Aranscia acquires select assets of the YouScript personalized medication management platform from digital medical genetics company Invitae.

Health Disinformation Use Case Highlighting the Urgent Need for Artificial Intelligence Vigilance

Researchers find that ChatGPT can rapidly and effortlessly create medical disinformation blog posts about vaccines and vaping, including impressive but fake patient and clinician testimonials and literature citations.

Healthcare AI News 11/15/23

November 15, 2023 Healthcare AI News 1 Comment

News

image

The estates of two deceased men sue UnitedHealth Group, claiming that the company uses AI algorithms to deny care to seniors who are enrolled in its Medicare Advantage plans. The complaint says that the AI system that UHG gained in its 2020 acquisition of NaviHealth has a 90% error rate and creates generic care recommendations that are used to override physician assessments of medical necessity, placing the Medicare Advantage patients at a disadvantage compared to traditional Medicare. A previous report found that patients who were entitled to up to 100 days in a nursing home following hospital discharge were usually cut off within 14 days by UHG.

image

Elsevier and OpenEvidence create an early access version of ClinicalKey AI, which allows doctors to enter patient information that is matched against Elsevier’s medical journal data to help them make clinical decisions. OpenEvidence’s original system is available for demonstration.

OpenAI pauses new signups for ChatGPT Plus due to a user surge following the company’s November 6 DevDay. The company also acknowledges that it is working on GPT-5, which will require more public and proprietary data sets.


Business

The CEO of an AI-powered robotics company says that the factors that made ChatGPT successful – training on a vast and diverse dataset and aligning the model’s response with what humans find useful – are being applied to AI robots that can understand their surroundings, make decisions, and adapt to changing circumstances. He predicts widespread deployment of robots that can perform object manipulation in 2024.

image

University of Miami Health System will use Aidoc’s technology system-wide  to identify and triage abnormalities in patient scans. The Israel-based company offers 13 FDA-cleared algorithms. The CEO is a former AI leader in the Israeli Air Force and co-founded the company with military peers one year after discharge.

image

Montreal-based Pathway, which provides evidence-based responses to clinician queries, raises $5 million in seed funding.


Research

Researchers in Australia refer to large language models that have limited guardrails as “weapons of mass disinformation” in a JAMA Internal Medicine article, where they describe using ChatGPT to create 102 disinformation blog posts about vaccines and vaping. Creation of the posts that totaled 17,000 words, which included fake patient and clinician testimonials and scientific-looking references, took just over one hour. Additional OpenAI tools contributed realistic images and a deep-fake video.

AI outperformed tissue biopsies in grading the aggressiveness of retroperitoneal sarcoma, which could potentially spare low-risk patients from unnecessary treatments and tests.

image

Tech-heavy medical practice operator Forward Health develops a standalone, app-powered  medical station it calls the CarePod, which it hopes to place in malls and office buildings where members will pay $99 per month for access. Founder and former Google computer scientist Adrian Aoun, who says “I don’t even believe a doctor’s office should exist,” hopes to turn healthcare into a product rather than a service. CarePods are powered by a large language model that uses medical research data to create care plans. The company just raised a $100 million Series E round and hopes to launch 25 CarePods initially and scale to 3,200 within one year. Aoun says he hopes to enhance the machines to perform open heart surgery within the next 20 years.


Other

image

AI expert Mark Hinkle builds a GPT into which users can upload PDFs of their health insurance plan options during open enrollment, then ask ChatGPT specific questions and have it compare plans.

image

A Nebraska oncology research nurse’s lung cancer is detected by Methodist Hospital’s AI-powered LungGPS, a Medtronic system that double checks radiology images and reports for incidental nodules. She was X-rayed for pain in her left side, but LungGPS noted nodules on the other side, with the early detection allowing her stage 1 lung cancer to be cured via surgery. LungGPS caught 26 patients with undetected cancer in 2022 and 15 so far this year.


Contacts

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

Morning Headlines 11/15/23

November 14, 2023 Headlines No Comments

Henry Schein Reports Third-Quarter 2023 Financial Results and Updates Full-Year Guidance

The medical supply vendor misses estimates for both revenue and earnings and lowers guidance even though the quarter was over before its October cyberattack.

UnitedHealth pushed employees to follow an algorithm to cut off Medicare patients’ rehab care

The company reportedly threatened to fire employees who failed to hit targets to limit the rehab care of Medicare Advantage patients to an algorithm-predicted appropriate number of days.

The Next WebMD: An LLM as Your Front Door to Healthcare

A16Z predicts that the model of Googling symptoms and then asking a medical friend or relative could be replaced by AI chatbots that could refer people to a marketplace of services offered for sale, giving the LLM company control of revenue streams worth billions.

AristaMD and Sitka Form Single Company, Secure Series C of $16.5M for the Expansion of Specialty Care Access via Electronic and Video Consultation Services

EConsult and referral management solution provider AristaMD acquires Sitka, which offers a platform for primary care providers to request video consultations from specialists.

Text Ads


RECENT COMMENTS

  1. Honestly, I autocorrected "62 Ventures" as "62 Vultures", and I considered posting snark about same! Is that on me? Is…

  2. $20 million to improve behavioral HIT? That's like 1/7th of a typical Epic install in one hospital. Seems like symbolic…

  3. Regarding the Particle Health - Epic Carequality Drama - it's important to note that most existing national networks separate out…

  4. Re: Tullman/62 Ventures Given his track record for acquiring companies, bungling day-to-day operations and then somehow selling to an unwitting…

  5. Was not the struggle of Teladoc foreseeable with the acquisition of Livongo?

Founding Sponsors


 

Platinum Sponsors


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Gold Sponsors


 

 

 

 

 

 

 

 

 

RSS Webinars

  • An error has occurred, which probably means the feed is down. Try again later.