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Morning Headlines 9/22/21

September 21, 2021 Headlines Comments Off on Morning Headlines 9/22/21

AGS Health acquires AI-based clinical documentation and medical coding technology provider, EZDI

RCM vendor AGS Health acquires EZDI, a clinical documentation improvement, computer-assisted coding, and auditing business based in Louisville, KY.

What Our Latest Fundraise Means to the eVisit Team

Enterprise virtual care vendor EVisit raises $45 million in a Series B funding round.

Pager Secures $70M in Funding to Drive Expansion of Virtual Care in United States, Latin America and Worldwide

Virtual care navigation and collaboration software vendor Pager raises $70 million in a Series C funding round.

Comments Off on Morning Headlines 9/22/21

News 9/22/21

September 21, 2021 News 2 Comments

Top News

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Former Teladoc executive David Sides joins NextGen Healthcare as president and CEO. Sides spent 17 years as SVP of worldwide consulting at Cerner, and had a shorter, more recent stint as president and CEO of Streamline Health.


Webinars

October 6 (Wednesday) 2 ET. “Solving Patient Experience Challenges Through a Strong Digital Front Door.” Sponsor: Avtex. Presenters: Mike Pietig, VP of healthcare experience, Avtex; Jamey Shiels, MBA, VP of consumer experience, Advocate Aurora Health; Chad Thorpe, care ambassador, DispatchHealth. Patients expect healthcare providers to offer them the same digital experience they get when banking, shopping, and traveling. This webinar will describe how two leading healthcare providers created digital front doors that exceed patient expectations, improve patient outcomes, drive loyalty and acquisition, and future-proof their growth strategies in competitive markets.

October 6 (Wednesday) 1 ET.  “A New, Streamlined Approach to Documentation and Problem List Management in Cerner Millennium.” Sponsor: Intelligent Medical Objects. Presenters: Deepak Pillai, MD, physician informaticist, IMO; David Arco, product manager, IMO; Nicole Douglas, senior product marketing manager, IMO. The IMO Core CSmart app, which is available for Cerner Millennium in the Cerner code App Gallery, helps providers document with specificity, make problem lists more meaningful, and improve HCC coding. This webinar will review the challenges and bottlenecks of clinical documentation and problem list management and discuss how streamlined workflows within Cerner Millennium can help reduce clinician HIT burden.

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


Acquisitions, Funding, Business, and Stock

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RCM vendor AGS Health acquires EZDI, a clinical documentation improvement, computer-assisted coding, and auditing business based in Louisville, KY.

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Xealth raises $24 million in a Series B funding round led by Advocate Aurora Enterprises, bringing its total raised to $53 million. The Providence Health & Services spin-off has developed software to help providers find and prescribe digital health apps and programs.

Clearlake Capital Group launches the Vive Collective, a program to help foster and potentially invest in digital health companies. Clearlake’s portfolio includes Bamboo Health (the newly merged and rebranded PatientPing/Appriss Health), NThrive, and Symplr.

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Pager secures $70 million in financing. The company has developed virtual care navigation and collaboration software that it markets to providers, payers, and employers.

Surgical data analytics vendor Caresyntax adds $30 million to its $100 million Series C investment round, bringing the company’s total funding to $208 million.

Flywheel, a medical research data management company, raises $22 million in a Series C funding round led by 8VC. It has also acquired Radiologics, an imaging research data management and analytics business based in St. Louis.

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Enterprise virtual care vendor EVisit raises $45 million in a Series B funding round. The Arizona-based company plans to nearly double its workforce in the coming months.


People

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Jeff Gartland (Anthem) joins Relatient as CEO. He takes over from Michele Perry, who will become vice chairwoman.


Sales

  • The VA Puget Sound Health System’s Seattle Division will implement TransformativeMed’s Core Work Manager clinical decision support tools and diabetes module.
  • Dignity Health’s Yavapai Regional Medical Center (AZ) selects digital front door technology from Phunware.
  • Nicklaus Children’s Health System (FL) will deploy wayfinding technology from Gozio Health.

Announcements and Implementations

InterSystems announces GA of its Iris FHIR Accelerator Service for storing and retrieving FHIR data.

Methodist Le Bonheur Healthcare (TN) develops a remote patient monitoring program for COVID-19 patients using MD Revolution’s clinical experts and RevUp technology.

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SCL Health implements Nuance Dragon Ambient Experience automated clinical documentation software for its telehealth and in-person exams for cardiology, orthopedics, and primary care across its facilities in Colorado and Montana.


COVID-19

Ellkay resolves a software programming glitch that mistakenly inflated the state of Vermont’s COVID-19 case count by 109 and delayed the reporting of positive test results to 237 patients. Ellkay’s analysis also determined that the slow-down may have impacted reporting in several other states.

COVID-19 has overtaken the 1918 Spanish flu as the deadliest disease event in US history, with 675,400 Americans succumbing to the disease.

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Pfizer reports favorable results in its trial of a COVID-19 vaccine for 5 to 11 year-old children.


Other

Apple’s latest operating system gives Health app users the ability to share health data with their providers through EHRs. Six vendors are participating in the initial launch of the feature, first announced this summer, including Cerner and Allscripts. Pilots with several provider groups have shown the data-sharing feature to be well received by patients monitoring their blood pressure from home. 


Sponsor Updates

  • Arcadia CMO Rich Park, MD and VP of Enterprise Partnerships Anna Basevich will present at the NAACOS Fall 2021 Conference October 1.
  • CereCore has been recognized by Securance Consulting as a Best Practice Meditech Infrastructure as a Service provider for more than five years running.
  • Cerner releases a new podcast, “Moving from data connectivity to real provider usability.”
  • CHIME releases a new Digital Health Leaders Podcast, “A Conversation with William Hudson, SVP and CIO, John Muir Health.”
  • Bluetree, Cerner, Clearwater, Divurgent, Optimum Healthcare IT, Imprivata, Clearsense, and the HCI Group will sponsor CHIME Fall Forum October 27-30 in San Diego.
  • CloudWave Director of Sales Engineering Mike Donahue will present at the Meditech Users Network Conference September 23.
  • CEO Magazine features Meditech International CEO Charlotte Jackson.
  • Chris O’Brien Lifehouse has become the first hospital in Australia to upgrade to Meditech Expanse.
  • CarePort parent company WellSky announces that former CMS administrator Seema Verma has joined its Board of Directors.

Blog Posts


Contacts

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

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Morning Headlines 9/21/21

September 20, 2021 Headlines, News Comments Off on Morning Headlines 9/21/21

NextGen Healthcare Appoints David Sides President and Chief Executive Officer

NextGen Healthcare names David Sides (Teladoc Health) president and CEO.

Oncology Analytics Announces Rebrand to OncoHealth

Oncology analytics and benefits management vendor Oncology Analytics changes its name to OncoHealth.

iOS 15 will give doctors a window into Apple Health app data

Apple’s latest operating system gives Iphone users the ability to share health data with their providers via EHRs.

Comments Off on Morning Headlines 9/21/21

Curbside Consult with Dr. Jayne 9/20/21

September 20, 2021 Dr. Jayne 2 Comments

I was recently invited to join a physician forum centered on EHR optimization. It sounded like a great opportunity to share what I know about getting the most out of your EHR and to help colleagues who might not have access to clinical informaticists.

I decided to familiarize myself with the group by going through old posts and was surprised at how many physicians had posted questions that didn’t receive any responses. I felt bad for those docs, sending their questions into the wind without anyone answering. I wish I would have been there for many of them because it would have been easy to point people in the right direction at the time. Here are some of the main themes that we as tech enablers should be aware of:

First, despite what we might think at times, physicians often want to learn more about what they can do with their EHRs and want to be better users. However, they might not understand the resources that are available to them, even if they are free or included in the cost of their system. There were a number of highly specific questions about a particular EHR, such as “How do I document XYZ procedure in my EHR?” Those were the types of questions that most frequently went unanswered by the forum. In my experience as an EHR champion, they would have been easy questions to answer had the physician contacted the EHR vendor’s help desk or online help mechanisms.

I’ve done consulting work for several of the vendors mentioned and they all have robust help desks and client support structures, and one has a lot of searchable hands-on videos that would have answered the questions. I can only guess that the physician didn’t know how to contact the vendor. Perhaps they are an employed physician and their organization’s internal help desk didn’t give them the assistance they needed, or maybe they’re part of a group where a managing partner or office manager tightly controls the information. I felt bad for them though, wondering if they ever found answers to their documentation questions.

Second, many of the physicians showed a high level of interest in ideas that went way beyond EHR optimization. One hot topic on the forum was that of bias in artificial intelligence. The discussion also covered ways that physicians could advocate to their institutions to try to minimize bias in their systems. Of course, this topic is likely much more relevant to those at academic medical centers rather than small primary care practices, but it certainly got a lot of conversation. Physicians care deeply about whether technical systems could be harming their patients and want to know more about predictive rules or algorithms that they might be presented with.

Third, the physicians were vocal about how vendors, including EHR and third-party vendors, might be using their patients’ data for profit. There was a near-universal lack of enthusiasm for cloud-based patient data being sold, whether it was for research or not. One particularly spirited discussion revolved around an EHR vendor who was alleged to have sold patient data to a nutrition and supplement vendor. Whether it’s explicitly allowed in a vendor contract or not, the physicians had negative feelings about anyone profiting off of their patients. There was particular opposition to the supplement vendor since supplements are not regulated by the US Food and Drug Administration. It’s also a $40 billion industry that causes a lot of confusion for patients and may require physicians to spend significant time on counseling and education, so I can see why they felt this way.

Overall, it looks like an interesting opportunity to be able to contribute, so I am looking forward to the next round of posts and seeing if I can be of assistance. Hopefully their moderators will be more flexible than those of a group I tried to participate in last year – I was kicked out of the group for “self-promotion” for mentioning that I worked for a chatbot vendor while answering a question about chatbots. Never mind the fact that I never mentioned the name of the company I was working for and didn’t try to solicit business, or that I was simply trying to establish credibility and provide transparency before giving a very specific answer to a question. It’s always interesting to see how these groups police themselves, so we’ll have to see how the new one runs.

Other than my foray into the physician forum, I spent most of the weekend heads-down on a big client project. They’re getting ready to go live with some new content this week and didn’t finish building it until Thursday afternoon. They had hired me to do their user acceptance testing so their crunch time became my crunch for the weekend.

Typically, I encourage organizations like theirs to have their actual end users participate in user acceptance testing, because only their end users know what their daily workflows look like. We all know that users are creative, and depending on the number of workarounds in a given system, they might not follow the prescribed workflows all the time if at all. I’m more than capable of testing the new content against the organization’s published best practice workflows, but even if everything passes my review, there is still a risk that they might have broken a workflow that they didn’t even know was in use.

“Document, document, document” is my middle name these days, so if things do go awry, I will have plenty of backup for the fact that I warned them that their plan was not ideal. So far, nearly everything I’ve tested has met the specifications although I’ve found some issues with the training materials and documentation that need to be addressed before go-live. They’re going to have the virtual equivalent of a fat stack of markups waiting for them when they arrive Monday morning, so I hope they had a restful weekend. I’m sure they’ll be throwing it back over the fence to me shortly thereafter, so I’m going to spend Monday resting up myself.

When’s the last time you had to work on a crunch time project? What’s your beverage of choice for all-nighters? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 9/20/21

September 19, 2021 Headlines 1 Comment

Feds charge 138, including doctors, with $1.4 billion in health-care fraud involving telemedicine, Covid, opioids

The Department of Justice files criminal charges against 138 defendants for their alleged participation in healthcare fraud schemes that generated $1.4 billion, the bulk of which involved telemedicine.

Cyberattackers Target Missouri Hospital At Epicenter Of COVID Outbreak, Post Patient Data

Hackers post stolen patient data online after launching a ransomware attack on Missouri Delta Medical Center.

Hinge Health Acquires the Most Advanced Computer Vision Technology for Tracking Human Motion

Digital physical therapy company Hinge Health acquires Wrnch, which has developed 3-D motion-tracking technology to capture full body movement.

Monday Morning Update 9/20/21

September 18, 2021 News 3 Comments

Top News

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Definitive Healthcare shares end the week at $48.99, up 81% from their IPO price Wednesday. The company’s valuation is $7 billion.


HIStalk Announcements and Requests

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Poll respondents value their vendor’s user group meeting more than any other conference, while HIMSS has twice the interest as HLTH. A couple of folks mentioned that they would have chosen CHIME Fall Forum if I had included it as a choice.

New poll to your right or here: Which technology will have the most impact on healthcare in the next five years? My list isn’t exhaustive, but it would have been a long poll otherwise.


Webinars

October 6 (Wednesday) 2 ET. “Solving Patient Experience Challenges Through a Strong Digital Front Door.” Sponsor: Avtex. Presenters: Mike Pietig, VP of healthcare experience, Avtex; Jamey Shiels, MBA, VP of consumer experience, Advocate Aurora Health; Chad Thorpe, care ambassador, DispatchHealth. Patients expect healthcare providers to offer them the same digital experience they get when banking, shopping, and traveling. This webinar will describe how two leading healthcare providers created digital front doors that exceed patient expectations, improve patient outcomes, drive loyalty and acquisition, and future-proof their growth strategies in competitive markets.

October 6 (Wednesday) 1 ET.  “A New, Streamlined Approach to Documentation and Problem List Management in Cerner Millennium.” Sponsor: Intelligent Medical Objects. Presenters: Deepak Pillai, MD, physician informaticist, IMO; David Arco, product manager, IMO; Nicole Douglas, senior product marketing manager, IMO. The IMO Core CSmart app, which is available for Cerner Millennium in the Cerner code App Gallery, helps providers document with specificity, make problem lists more meaningful, and improve HCC coding. This webinar will review the challenges and bottlenecks of clinical documentation and problem list management and discuss how streamlined workflows within Cerner Millennium can help reduce clinician HIT burden.

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


Sales

  • US Dermatology Partners chooses the RCxRules Revenue Cycle Engine to automate charge import and review.

People

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Aaron Miri, MD (Dell Medical School, UT Health Austin) joins Baptist Health (FL) as SVP / chief digital officer / CIO.

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Wellbe hires Darcey Nett (DotCom Therapy) as chief growth officer.

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David Finn, MA (CynergisTek) joins CHIME as VP of affiliated professional groups.

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Christopher Logan (VMware) joins Censinet as SVP / chief security officer.

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Methodist Le Bonheur Healthcare hires Patrick Woodard, MD, MHA (Renown Health) as VP/ chief digital officer.


Announcements and Implementations

In England, Royal Stoke University Hospital goes live with Vocera Badge in its ED.


Government and Politics

The Department of Justice files criminal charges against 138 defendants, 42 of them licensed medical professionals, for their alleged participation in healthcare fraud schemes that generated $1.4 billion. Telemedicine fraud contributed $1.1 billion of the total.


COVID-19

FDA’s vaccine advisory panel rejects the broad rollout of Pfizer vaccine booster shots, recommending their use only in patients who are over 65 or at high risk for infection. The panel said that despite White House plans to encourage booster shots for most people and Pfizer’s recommendation that they be approved, evidence shows that two shots protect people from hospitalization and death and that the goal should instead be to get more people vaccinated. FDA is not required to follow the committee’s recommendation and will announce its decision this week. The issue has raised opposing public viewpoints among FDA scientists who reviewed contradictory data from CDC, Pfizer, the government of Israel, and independent experts on whether a booster dose is needed.

St. Luke’s Health System (ID) won’t enforce its employee vaccination mandate because the state is under crisis standards of care and the health system can’t afford to lose employees.

The New York Times reports that the “nervous affluent” who can afford concierge medical services are having their COVID-19 antibody levels tested regularly even though experts warn that the number is mostly meaningless and the tests don’t measure the important T cell response. FDA doesn’t recommend such testing because the results may encourage some people to take fewer precautions. The article notes that concierge medicine providers are paid to do whatever the customer wants, even in the absence of medical evidence, while poor people have the opposite incentive in avoiding testing for fear that undesirable results could get them fired.


Other

Guardians accessed more than half the patient portal accounts of patients aged 13-18 years in an study of three children’s hospitals. Natural language processing was used to determine how many outboard portal messages were sent by guardians, as evidenced by referring to the child in the third person or containing phrases such as “my daughter.” The authors note that federal and state regulations require that a mechanism be provided to share information with adolescents without the knowledge of their guardians, but effectiveness is limited by these challenges: (a) institutions may not always configure the portal account correctly; (b) adolescents and their parents may not understand the portal’s design; (c) adolescents may voluntarily share their log-in with guardians; and (d) guardians may coerce the adolescent to provide portal access or may use their credentials without permission. They also note that limitations of NLP analysis, as well as inability to detect access in which guardians didn’t send messages, means that actual numbers are probably higher. They suggest that the perspectives of adolescents and guardians be studied to determine how they impact confidentiality.

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A UCSF review of national Epic data finds that patient-to-physician messages jumped as the pandemic began and remained at high levels through the January 2021 review period. Twitter comments pondered whether forced use of MyChart to participate in virtual visits drove the increase or whether virtual visits themselves result in more patient messages. It seems that quite a few interesting studies could be performed – the number of messages that were sent just before virtual visits, the number sent immediately after (suggesting that some need was unmet by the virtual visit), the number sent by first-time portal users, message count compared to the number of active portal users, the number of messages sent by patients of varying acuity or chronic condition levels, and message time of day that might indicate access problems.


Sponsor Updates

  • ChartSpan publishes a new white paper, “Follow the Money: Medicare’s New Gold Mine is Chronic Care Management.”
  • Nuance launches its AI-powered, cloud-based PowerScribe One radiology reporting platform and MPower Clinical Analytics in Australia and New Zealand.
  • OptimizeRx names Andy D’Silva SVP of corporate finance.
  • Netsmart has been inducted into the Kansas City Business Journal’s Hall of Champions after being recognized as a Champion of Business for three consecutive years.
  • EClinicalWorks releases a new podcast, “Caring is Sharing (Data) at Innova Primary Care.”
  • CHIME applauds the FTC’s actions to secure consumer health data.
  • Pure Storage appoints Operator Collective founder Mallun Yen to its Board of Directors.
  • RxRevu founder Carm Huntress will present “Staying True to Your Values During Massive Growth” on October 6 as part of Den Startup Week.
  • SOC Telemed announces that David Fletcher will become interim CFO upon the departure of Chris Knibb at the end of the year.
  • Spok Holdings postpones its Investor Day Program due to an ongoing strategic alternatives review process.
  • Summit Healthcare publishes a new client success story, “Doctors Community Hospital Continues Partnership with Summit Healthcare Post-Epic Migration.”
  • University of Alabama at Birmingham researchers feature their use of the TriNetX Research Network in “Advancing clinical research and population health with real-world data.”
  • West Monroe will invest $250 million in the expansion of its digital consulting services.
  • Zynx Health celebrates its 25th anniversary.

Blog Posts


Contacts

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

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Weekender 9/17/21

September 17, 2021 Weekender Comments Off on Weekender 9/17/21

weekender 


Weekly News Recap

  • Commure’s latest funding rounds reportedly value the healthcare data exchange platform vendor at $3.5 billion.
  • FTC warns digital health app developers that they must notify consumers if their health information is exposed.
  • Definitive Healthcare shares soar after the company’s IPO Wednesday.
  • DOJ says a now-closed analytics company allowed insurers to overcharge Medicare Advantage by mining EHRs to create new diagnoses months after the fact.
  • Zane Burke joins Quantum Health as CEO.
  • Symplr announces its intention to acquire Halo Health.
  • The VA reportedly issues a $1 billion RFP for remote patient monitoring.
  • Two of the three researchers who developed the SAFER Guides for EHR safety call for vendors and ONC to share responsibility.

Best Reader Comments

The thing that caught my eye from the Aaron Martin article was the quote about health tech companies compared to health systems. Talking about Apple and Amazon or whatever is how you get CEOs to pay attention to you, because CEOs eat up those business book-style quotes from Jeff Bezos. Big tech companies aren’t interested in changing healthcare, but they have so much cash that it is coming out their ears, so they’ll try whatever. Healthcare services companies with tech dressing are the ones who are really taking a run at traditional payers and providers. (IANAL)

[At Epic] it was pretty imperative that if you were supporting a go-live at a customer you did not implement at, that you were careful not to mention unimplemented features to end users since those decisions were made at a higher level than a frontline nurse, for example. That doesn’t mean we just ignored these findings – there were mechanisms to bring these requests back to implementation / technical support teams, which were then laddered up to customer leadership to assess and prioritize. (HITPM)


Watercooler Talk Tidbits

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Readers funded the Donor Choose teacher grant request of Ms. M in Alabama, who asked for STEM kits for her elementary school class. She reported in February, “It has been amazing to see students happy and excited to come to school at 6:30 a.m.! Many students who attend before-school care were not excited to be there so early. These materials have made a huge impact. They are excited and learning so much both before school and after school. When students saw the materials, they were shocked and could not believe these materials were for them. They have explored, worked together, had amazing conversations, and have become problem solvers. Second grade students are now mentoring younger students using these resources. This is an amazing benefit that I did not plan. They are investigating and using collaborative conversations and posing their own problems and working toward solutions. Thank you for your willingness to support students!”

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A Louisiana man who became impatient that a hospital wasn’t seeing him quickly enough following a car accident steals an EMS ambulance that is parked outside, drives it to another hospital to seek care where he was also not seen promptly, then is pursued by police officers in a 10-mile chase down Interstate 10. He was arrested inside the office of his primary care physician, where he had driven the ambulance and hit a parked car before going in.

A VA hospital anesthesia department employee tweets a screenshot of a 72-year-old veteran’s pre-op note to mock his government-paid penile implant surgery. The DC hospital hasn’t said that it has fired the employee, but indicated that their medical records access has been revoked.

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Conway Regional Health System (AR) requires employees who claim a religious exemption to mandatory COVID-19 vaccination to attest that they won’t use the many other products that are derived from fetal cells.

A Nevada man’s 100-day, $2 million COVID-19 hospital stay leaves him with a bill for $80,000 of insurer-denied payments because the doctors who treated him were out of network. Dignity Health says it can’t get involved in disputes between insurance companies and its contracted intensivist company.

Lewis County Health System, a small hospital in upstate New York, will stop delivering babies now that six of its 18 maternity department employees have refused mandatory COVID-19 vaccination and another seven haven’t said either way. The conservative county has one of the lowest vaccination rates in the state at 44% and 30 of the hospital’s 464 employees have already quit ahead of the September 27 vaccination deadline. The hospital says its plans could change if it can hire agency nurses or if a legal challenge against its vaccination policy is successful.


In Case You Missed It


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Comments Off on Weekender 9/17/21

Morning Headlines 9/17/21

September 16, 2021 Headlines Comments Off on Morning Headlines 9/17/21

Cured Raises $10M Series A; Launches Next Generation Healthcare Digital Marketing & CRM Solutions

Health system digital marketing and CRM vendor Cured raises $10 million in a Series A funding round.

Digital health startup Commure just hit a $3.5 billion valuation as it raises fresh cash to unlock healthcare data

Healthcare data exchange technology vendor Commure has reportedly raised $500 million in funding through a Series D round, valuing the company at $3.5 billion.

Statement of the Commission On Breaches by Health Apps and Other Connected Devices

The Federal Trade Commission issues a notification that health app vendors must notify consumers if their health information is exposed.

Comments Off on Morning Headlines 9/17/21

News 9/17/21

September 16, 2021 News 2 Comments

Top News

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Shares of healthcare commercial data and analytics vendor Definitive Healthcare open at 38% above its IPO price on Wednesday and close for the day up 59%, valuing the company at $4 billion. DH shares rose another 9% Thursday.


Webinars

October 6 (Wednesday) 2 ET. “Solving Patient Experience Challenges Through a Strong Digital Front Door.” Sponsor: Avtex. Presenters: Mike Pietig, VP of healthcare experience, Avtex; Jamey Shiels, MBA, VP of consumer experience, Advocate Aurora Health; Chad Thorpe, care ambassador, DispatchHealth. Patients expect healthcare providers to offer them the same digital experience they get when banking, shopping, and traveling. This webinar will describe how two leading healthcare providers created digital front doors that exceed patient expectations, improve patient outcomes, drive loyalty and acquisition, and future-proof their growth strategies in competitive markets.

October 6 (Wednesday) 1 ET.  “A New, Streamlined Approach to Documentation and Problem List Management in Cerner Millennium.” Sponsor: Intelligent Medical Objects. Presenters: Deepak Pillai, MD, physician informaticist, IMO; David Arco, product manager, IMO; Nicole Douglas, senior product marketing manager, IMO. The IMO Core CSmart app, which is available for Cerner Millennium in the Cerner code App Gallery, helps providers document with specificity, make problem lists more meaningful, and improve HCC coding. This webinar will review the challenges and bottlenecks of clinical documentation and problem list management and discuss how streamlined workflows within Cerner Millennium can help reduce clinician HIT burden.

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


Acquisitions, Funding, Business, and Stock

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Health system digital marketing and CRM vendor Cured raises $10 million in a Series A funding round. The company’s founding team members all spent time at Epic.

Biopharma solutions vendor Syneos Health acquires StudyKIK, which offers tech-enabled clinical trials recruitment and operation tools.

Healthcare data exchange technology vendor Commure has reportedly raised $500 million in funding through a Series D round, valuing the company at $3.5 billion. 


Sales

  • Gloucestershire Hospitals NHS Foundation Trust selects Hyland Healthcare’s OnBase content services platform.

People

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Healthcare benefits navigation and care coordination platform vendor Quantum Health hires Zane Burke (Livongo) as CEO and board member.

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Peter Embí, MD, MS (Regenstrief Institute) joins Vanderbilt University Medical Center as chair of its biomedical informatics department. He will also hold the title of senior VP for research and innovation.

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AdaptX hires Lisa Counsell, RN (Imprivata) as chief commercial officer.


Announcements and Implementations

Intermountain Healthcare and SCL Health sign a letter of intent to merge into a 33-hospital, $14 billion system.

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Penn Presbyterian Medical Center goes live on the PCare Ambulatory digital health and patient engagement system that was jointly developed by PCare and Quil. The system suggests next best action with personalized videos, articles, check-ins, and reminders for therapy, also supporting the participation of family and friends.

The first hospital goes live on a service from Ob Hospitalist Group  and SOC Telemed in which patients receive 24/7 onsite care from OBHG’s physicians and have access to SOC Telemed’s maternal-fetal medicine physicians.

The ProMedica health system launches its Healthcare Redefined Initiative, which includes social determinants of health, senior care, programs specific to its individual markets, and an innovation program.


Government and Politics

The Federal Trade Commission issues a notification that health app vendors must notify consumers if their health information is exposed. FTC, clarifying its Breach Notification Rule, says companies that aren’t covered entities under HIPAA are still accountable when sensitive health information is exposed. It also notes that sharing covered information without the individual’s permission constitutes a breach. FTC says the apps that are mostly likely to be affected by the update are those that track diseases, diagnoses, treatment, medications, fitness, fertility, sleep, mental health, and diet.

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The Department of Justice files a fraud complaint against a New York health insurance plan and its analytics company for overcharging Medicare Advantage. The now-closed data mining company DxID, owned by Independent Health Association of Buffalo, analyzed electronic medical records to find missed diagnoses to boost the insurer’s risk score. Another health plan that hired DxID to increase revenue billed $30 million new claims, many of which were not valid or supported by the medical record, such as depression and renal failure. The company pitched its services by requiring no upfront payments and instead taking 20% of paid claims worth tens of millions of dollars, which the whistleblower’s lawsuit described as “trolling patient medical records to gin up, in many cases, new diagnoses exclusively from information derived from impermissible sources.” Independent Health closed the company in June 2021.

A 55-year old Louisiana doctor who has claimed to have been a hired assassin and Medellin Cartel leader at 16 is charged with writing opioid prescriptions totaling 1 million doses for cash, resulting in $5 million in fraudulent insurance billings. Adrian Talbot, MD, JD operated a clinic but didn’t work there because he had a full-time VA job, so he left pre-filled, pre-signed prescriptions for employees to sell without examining the recipient. He self-published a bizarre book a few months back in which he says he’s working on a cure for Alzheimer’s.

FDA reorganizes its IT functions into the Office of Digital Transformation, with newly promoted Vid Desai serving as CEO with a budget of $750 million and staff of 2,500.


COVID-19

FDA meets this week to decide whether to approve the use of COVID-19 booster doses even as two of its top vaccine officials join a group of global scientists who say in a Lancet article that boosters aren’t needed. FDA is also facing pressure to approve doses for children.

The US hits a grim milestone as one of every 500 residents has died of COVID-19.

A KHN review finds that 26 states have permanently curtailed public health authority since the pandemic began. The most common actions were to prohibit mandate masks or quarantines and to ban COVID-19 vaccine mandates or proof of vaccination.

The New York Times finds that India’s government forced its scientists to downplay the possibility of a COVID-19 outbreak that eventually killed hundreds of thousands of people, suppressing and even falsifying data to support the re-election of Prime Minister Narendra Modi. A scientist who was reprimanded for his less-rosy predictions says, “Science is being used as a political weapon to forward the government narrative rather than help people.” A recent study estimates India’s COVID-deaths at 3 million, 10 times the official government number.

Idaho, which has one of the lowest rates for COVID-19 vaccination, implements Crisis Standards of Care statewide as hospitals are overwhelmed with COVID-19 patients.


Other

Financial Times reports that Houston Methodist hospitals are using Alexa-type voice assistant commands from Amazon Web Services in a prototype OR of the future. The system announces steps that need to be completed and records the results in the EHR. It also records audio of the procedure, with the patient’s permission, that it analyzes to present treatment options.

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Vanderbilt Clinical Informatics Center and its director Adam Wright, PhD publish an annual report covering its first year. A key project was its burnout reduction project Clickbusters, which evaluates Epic Best Practice Advisories to remove those that clinicians find unhelpful.


Sponsor Updates

  • LexisNexis human resources employees volunteer with Trees Atlanta.
  • First Databank publishes research led by two of their pharmacists that further refutes the concept of iodine allergies.
  • Gyant publishes a new case study, “Christus Health Launched Virtual Assistant Supporting Vaccinations Across Four States.”
  • Health Data Movers names Marissa Lewis (Invo HealthCare) and Peter Squire (Centauri Health Solutions) account managers.
  • Healthcare Growth Partners advises Symplr in its acquisition of Halo Health.
  • InterSystems will exhibit at the Hack MIT event September 18-19 in Cambridge, MA.
  • Jvion drives adoption of prescriptive intelligence and clinical intelligence with peer-reviewed results, platform integrations, and SDOH solutions.

Blog Posts


Contacts

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

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EPtalk by Dr. Jayne 9/16/21

September 16, 2021 Dr. Jayne 7 Comments

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This was a rough week on a number of fronts, and I had to resort to some pastry therapy. I wasn’t sure what to think about sopapilla cheesecake initially, but it made my house smell amazing. I’m a big fan of butter, but I think it’s actually possible this recipe had too much, if that could even be a thing. Now to wait for three hours for it to chill, and then I’ll be able to give the final verdict.

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The best thing about the week was hearing from my friends at the Office of the National Coordinator for Health Information Technology, in response to my earlier post covering topics such as information blocking, the 21st Century Cures Act, and patients’ access to their notes. They brought up some really good points in response to the post and I wanted to share them, since there are some good clarifications as well as links to resources, FAQs, and more.

Hi Dr. Jayne,

Your August 23 post was shared with ONC and we want to share some information that we hope will be helpful to your readers. Some general resources that might be helpful to your readers are:

Regarding some of the specific issues raised in your post:

Re: Open Notes

  • The ONC Cures Act Rule does not specifically point to “Open Notes,” which is a branded industry initiative.
  • However, the rule does require availability of electronic health information (EHI), which includes notes. From April 5, 2021 through October 5, 2022, the definition of EHI is limited to eight note types, but it expands to include more notes thereafter.

Re: Types of notes

  • As noted above, eight specific types of notes are included in the EHI definition through October 5, 2022, and more notes are required thereafter.
  • During the current period of the more narrow EHI definition, note types are determined by the content and function of the notes, not by the names assigned by any particular organization or vendor.

Re: Health care providers subject to the rule

  • The regulations apply to an array of health care providers, including hospitals and ambulatory physicians (as well as health information networks/exchanges and developers of ONC-certified health IT).
  • We have a resource that providers may find helpful in assessing whether the regulations apply to them (Health Care Provider Fact Sheet).

Re: Exception for harm

  • There is indeed a Preventing Harm Exception
  • However, it does require an individualized determination of risk of harm and a reasonable belief that the exception is needed to substantially reduce an individual patient’s risk of harm or, as applicable, another individual’s risk of harm

Re: EHR certification

Re: Scope of medical record

  • The regulations focus on EHI, the scope of which is initially more narrow, as described above.
  • EHI is the electronic portion of health information that would be included in the Designated Record Set (DRS). The DRS is defined by HIPAA regulations and includes any information in the record used to make decisions about individuals.

Finally, we’re making every effort to help the industry with this transition. Let us know how we can help!

Thanks!

ONC

I appreciate their input and the open lines of communication. It’s always good to know that the powers that be are reading and are willing to help us better understand the work that we’re all trying to do together.

I got a chuckle out of a headline in an email that talked about Epic looking to grow its Twitter presence after noticing that its customers use the platform “quite a lot.” The Wisconsin State Journal reports that Epic has created a Twitter account for its new website, epicshare.org, which is designed for client organizations to share ideas and receive information from the vendor. The site also features a “Hey Judy” page that shares “Thoughts and Stories from Judy.” So far, @EpicShares has 215 followers, yours truly included. It will be interested to see how the software giant fares on Twitter since this is its first foray into that social media space.

I was curious about a quote from Leela Vaughn, Epic senior executive, regarding patient use the site. Vaughn noted that “Anybody can be reading these and showing them to their doctor” and that the site was written in a way where they “really worked hard on getting rid of the jargon” so that it could be useful “to people who aren’t super tech savvy.” Physicians already have to worry enough about patients who take the “ask your doctor” advice seriously for every TV commercial they see for a new drug – I can’t imagine what physicians will think when their patients come in and begin quoting things that they read on an EHR vendor website. For one, the vast majority of physicians are not attuned to what Epic is doing as a company – they’re just trying to keep their heads down and see patients, while surviving the pandemic. I’d be curious to see what others think about this approach.

Mr. H previously mentioned the MyMountSinai app, designed to offer patients additional features that aren’t available in their Epic MyChart mobile app. One of the features that is included is the ability to upload COVID-19 vaccine cards. It would be interesting to know if the app allows the data from those vaccine cards to populate the patient’s medical record and function in the same way that vaccine data would function had the vaccines been natively documented in the health system’s record. I have multiple physicians on different instances of MyChart and it still surprises me that they don’t recognize each other’s data. For example, one system continually prompts me for vaccines and services that are documented in the other record, even though I know they have the capability to recognize those care elements behind the scenes. That’s the kind of information blocking we need to get rid of at the patient level, and doing so would make things easier for both patients and providers. The app also includes the ability to schedule visits with new providers and wayfinding assistance for some of its facilities.

Sobering statistics: 1 in 500 people in the US have died of COVID-19. As of Tuesday, more than 663,000 people have been lost to the disease. I remember the early days of the pandemic when we hoped that interventions might cap the deaths at 60,000 or 70,000 and how horrified we were at those numbers. Now we’re exceeding that by a factor of 10 and plenty of people don’t bat an eye. Every one of those casualties was something to someone – a mother, father, sibling, grandparent, friend, or neighbor. As a physician, I’m tired of hearing from people that this is no big deal, or that people didn’t really die “from” COVID-19 they just died “with” it, etc. Frankly, your healthcare teams no longer want to hear it. It’s exhausting and it just needs to stop.

Email Dr. Jayne.

Morning Headlines 9/16/21

September 15, 2021 Headlines Comments Off on Morning Headlines 9/16/21

Healthcare Industry Leader Zane Burke Joins Quantum Health as CEO

Former Cerner president and Livongo CEO Zane Burke joins consumer-focused care coordination and navigation company Quantum Health as CEO.

This Startup Raised $100 Million To Turbocharge Women’s Health

Women’s healthcare provider Tia raises $100 million in a Series B funding round led by Lone Pine Capital.

Definitive Healthcare stock soars out of the gate, opening 38% above IPO price

Healthcare market intelligence company Definitive Healthcare raises $420 million in its IPO.

Comments Off on Morning Headlines 9/16/21

Morning Headlines 9/15/21

September 14, 2021 Headlines Comments Off on Morning Headlines 9/15/21

Symplr to acquire Halo Health

Healthcare governance systems vendor Symplr will acquire clinician digital communications vendor Halo Health.

SymphonyRM Becomes Actium Health

Patient engagement and activation company SymphonyRM rebrands to Actium Health.

Zelis to Acquire Healthcare Transparency Leader Sapphire Digital

Healthcare payments platform vendor Zelis will acquire provider search and transparency website Sapphire Digital.

Indy-based Future Health ESG Corp. goes public, the latest in a flurry of SPACs to hit Wall Street

HC1 founder, chairman, and CEO Brad Bostic launches a $200 million SPAC that hopes to merge with a healthcare data science company.

Comments Off on Morning Headlines 9/15/21

News 9/15/21

September 14, 2021 News 5 Comments

Top News

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Healthcare governance systems vendor Symplr will acquire clinician digital communications vendor Halo Health.

Previous Symplr acquisitions include HealthcareSource HR, SpinFusion, The Patient Safety Company, Vistar Technologies, Hayes, TractManager, IntelliSoft, API Healthcare, CBR Associates, Cactus Software, and Phynd.

Clearlake Capital acquired Symplr in late 2018.


Reader Comments

From Inquiring CIO: “Re: HIMSS attendee lists. I’m tired of companies using them to mine sales leads. I’ve emailed HIMSS, but haven’t received a reply. I’m not sure where companies are getting the contact info of conference registrants, but it’s a deterrent to attending.” Inquiring CIO forwarded two emails, both of which contain scammy elements. Email #1 is from someone offering to sell a list of 45,678 HIMSS20 attendees (an oddly linear number series which technically should  be zero given that the conference was cancelled) for $1,999. Email #2 is from a business development guy in India-based company who used “HIMSS conference” in their subject line and content to make a technology sales pitch. The company was not a HIMSS exhibitor. I emailed the originator, but as I expected, received no reply. I contacted HIMSS, which reiterated that (a) it doesn’t sell attendee lists, and anyone who offers one is lying and probably is just dumping a bunch of old, inaccurate industry lists together and claiming they came from an official source; and (b) while HIMSS rents attendee lists to exhibitors for short-term use immediately before and after a conference, the company in Email #2 was not an exhibitor (I pondered the irony that perhaps Company #2 bought their list from Company #1). HIMSS says its legal team would love to have a conversation with Company #2 about its use of the HIMSS name if Inquiring CIO approves.


Webinars

September 16 (Thursday) 1 ET. “Patient Acquisition and Retention: The Future of Omnichannel Virtual Assistants.” Sponsor: Orbita. Presenters: Harris Hunt, SVP growth product, Cancer Treatment Centers of America; Patty Riskind, MBA, CEO, Orbita; Nathan Treloar, MSc, co-founder and COO, Orbita. Consumers want the same digital healthcare experience from healthcare that they get in online shopping, banking, and booking reservations, and the pandemic has ramped up the patient and provider need for frictionless access to healthcare resources and services. Health systems can improve patient acquisition and retention with the help of omnichannel virtual assistants that engage and delight. Discover how to open and enhance healthcare’s digital front door to offer care that goes beyond expectations.

September 16 (Thursday) 1 ET. “ICD-10-CM 2022 Updates and Regulatory Readiness.” Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, VP global clinical services, IMO; Theresa Rihanek, MHA, RHIA, mapping manager, IMO; Julie Glasgow, MD, clinical terminologist, IMO. IMO’s top coding professionals and thought leaders will discuss the coding changes in the yearly update to allow your organization to prepare for a smooth transition and avoid negative impacts to the bottom line. The presenters will review new, revised, and deleted codes; highlight revisions to ICD-10-CM index and tabular; discuss changes within Official Coding Guidelines, and review modifier changes.

October 6 (Wednesday) 2 ET. “Solving Patient Experience Challenges Through a Strong Digital Front Door.” Sponsor: Avtex. Presenters: Mike Pietig, VP of healthcare experience, Avtex; Jamey Shiels, MBA, VP of consumer experience, Advocate Aurora Health; Chad Thorpe, care ambassador, DispatchHealth. Patients expect healthcare providers to offer them the same digital experience they get when banking, shopping, and traveling. This webinar will describe how two leading healthcare providers created digital front doors that exceed patient expectations, improve patient outcomes, drive loyalty and acquisition, and future-proof their growth strategies in competitive markets.

October 6 (Wednesday) 1 ET.  “A New, Streamlined Approach to Documentation and Problem List Management in Cerner Millennium.” Sponsor: Intelligent Medical Objects. Presenters: Deepak Pillai, MD, physician informaticist, IMO; David Arco, product manager, IMO; Nicole Douglas, senior product marketing manager, IMO. The IMO Core CSmart app, which is available for Cerner Millennium in the Cerner code App Gallery, helps providers document with specificity, make problem lists more meaningful, and improve HCC coding. This webinar will review the challenges and bottlenecks of clinical documentation and problem list management and discuss how streamlined workflows within Cerner Millennium can help reduce clinician HIT burden.

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


Acquisitions, Funding, Business, and Stock

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Patient engagement and activation company SymphonyRM rebrands to Actium Health.

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App-based house call and telemedicine company Remedy pivots and rebrands as CareHive, which offers telemedicine, digital front door services, analytics, and clinical navigation. Remedy laid off 82 employees last November, many of whom were hired during the previous summer’s peak of COVID-19 patients. Remedy Chief Medical Officer Ronald Dixon, MD has been promoted to CEO of the new company.

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Edifecs acquires Talix, which has developed a natural language processing-enabled risk adjustment coding, retrieval, and analytics platform for providers and payers.

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Digital maternity care software vendor Babyscripts raises $12 million in a Series B funding round.

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Healthcare payments platform vendor Zelis will acquire provider search and transparency website Sapphire Digital.

HC1 founder, chairman, and CEO Brad Bostic launches a $200 million SPAC that hopes to merge with a healthcare data science company.


Sales

  • Legacy Health (OR) selects Simplifi 797 automated cleanroom compliance technology from Wolters Kluwer Health.
  • Oroville Hospital (CA) will implement CliniComp’s fetal surveillance and fetal mobile technologies.
  • Saina Health integrates Sphere’s healthcare payments and security software with its InstaHealth medical record portal for multiple family members.
  • Health Choice Network chooses Epic for its 44 safety net organizations in 16 states in a $400 million deal.

People

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CitiusTech names Atul Soneja (Infosys) president of operations.

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UC San Diego Health promotes CIO Christopher Longhurst, MD to chief medical officer and chief digital officer.

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Verato promotes Arti Pandit to chief customer experience officer and names Mark Erwich (Imprivata) chief marketing officer.

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B. Well Connected Health hires Gary Johnson (Atlas Health) as VP of marketing and Romy Carlson, MBA (League Inc.) as VP of partnerships.


Announcements and Implementations

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Divurgent develops a Concierge Scheduling Application that gives end users the ability to schedule one-on-one personalization sessions as part of their EHR training.

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Powell Valley Healthcare (WY) goes live on Cerner.

Cincinnati Children’s Hospital Medical Center develops real-time data-sharing software for medical teams and case workers that will be commercialized by Cordata Healthcare Innovations.

EHealth Exchange will award up to $550,000 in grants and incentives to its participants or eligible applicants that are innovating in the exchange of health information or establishing new technical advancements in connectivity.

Leidos will use Nuance’s Mix conversational AI development platform to create digital patient engagement solutions for health systems and federal healthcare agencies. Nuance Mix allows organizations to create conversational experiences for interactive voice response and chatbot systems.


Government and Politics

Bloomberg reports that the VA has issued an RFP for a $1 billion remote patient monitoring – home telehealth contract.


Privacy and Security

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In Canada, The Ottawa Hospital apologizes to 391 employees for a software error that caused their names to be visible on an email that was sent to unvaccinated employees ahead of the October 5 mandatory vaccination date.

Children’s Hospital & Medical Center (NE) will pay $80,000 and take corrective actions to settle potential HIPAA violations related to its failure to provide timely access to all of a patient’s medical records despite multiple requests.


Sponsor Updates

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  • CereCore sponsors the American College of Healthcare Executives – Middle Tennessee Chapter’s annual golf outing benefitting Mercy Community Healthcare.
  • The Tech Trek Podcast features Well Health CTO Thor Clark.
  • Impact Advisors publishes a white paper titled “Achieving Sustainable Value from ERP.”
  • Agfa HealthCare achieves the new European Medical Device Regulation certification of its Class IIa Enterprise Imaging and Xero Viewer solutions.
  • The Data Masters Podcast features Arcadia Chief Product Officer Nick Stepro, “The Role Empathy Plays in Data Visualization.”
  • Clearwater founder and Executive Chairman Bob Chaput publishes a new book, “Stop the Cyber Bleeding: What Healthcare Executives and Board Members Must Know About Enterprise Cyber Risk Management.”
  • CoverMyMeds Pod Lead Eda Erkal and Kitchen Manager, Campus Operations Shey Jin join the Leadership Columbus Signature Program Class of 2022.
  • Kyruus expands its ProviderMatch online scheduling platform to allow consumers to self-book diagnostic and preventive care appointments, and customers to offer online booking for COVID-19 booster shots.
  • OptimizeRx adds a Therapy Initiation Workflow to its point-of-care medication prescription platform.

Blog Posts


Contacts

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

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HIStalk Interviews Steve Cagle, CEO, Clearwater

September 14, 2021 Interviews 1 Comment

Steve Cagle, MBA is CEO of Clearwater of Nashville, TN.

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Tell me about yourself and the company.

I’ve been with Clearwater for about three and a half years. My background is all healthcare, over 20 years working in a number of healthcare-related firms building businesses. At Clearwater, our mission is to help our healthcare customers protect their patients and their data to help them be compliant and to develop capabilities that allow them to be more effective and efficient at the business of cybersecurity, which is becoming extremely difficult in today’s age.

We talk about pandemic fatigue. Are we experiencing cybersecurity fatigue?

We as an industry had to pivot quickly to work-from-home for employees and in patient care and patient delivery. That involved a lot of new technologies and deploying those quickly. At the same time, threat actors recognized the enormous opportunity to target the healthcare industry. The data is so valuable, and the historic underinvestment in cybersecurity, more so through the pandemic, made it a juicy target. 

There may be a bit of fatigue with regard to what we’re seeing with ransomware, unfortunately. We will have to continue to understand that, because we are probably still at the beginning of where we need from a maturity perspective in healthcare.

Has the cybersecurity significance of employee behavior changed, especially with regard to ransomware?

It’s very significant. Cybersecurity is not just about the tools that we have in place. It’s really about the people and the organization. It’s about establishing a culture where everybody in the organization understands they have a role in keeping their information safe and being vigilant. We have to continue to remind people through training and not just rely on tools. Security processes become important as well.

The top healthcare cyberattack threats remain centered around ransomware and email phishing. That’s an important part of how we need to deal with the problem.

What is the maturity level of tools that can prevent that single employee click from bringing down the enterprise?

Unfortunately, there is no silver bullet. There are some important controls that all organizations should put in place from a baseline perspective. We hear a lot about multi-factor authentication, encryption, having good protection on endpoints, and identity access management. A number of security practices should be employed. But every organization needs to have a thorough assessment and analysis of their specific risks. 

When we talk about risks, we’re talking about vulnerabilities based on the specific information systems that they use in their organization and threats and the threat actors that could exploit those vulnerabilities. We have to assess the effectiveness of those tools and other types of controls, administrative controls, physical controls. How effective are those controls in preventing that threat from exploiting that vulnerability?

We also have to think about not only the likelihood of an event being successful, but also what the impact would be to our organization. That’s a risk discussion, because when you think about what you’re going to do in your organization to optimize security, it’s about your risk tolerance. Everybody’s risk tolerance is going to be a little bit different. There’s no way that we are ever going to eliminate risk completely, but we can make better decisions about where we’re spending our limited resources and our limited time by understanding, through a risk analysis, where those risks are and what we can do about them.

Health systems have recently reported some huge costs from ransomware attacks. How do they tailor what they can afford versus the possibility of huge losses due to downtime?

University of Vermont is a great example and Scripps Health incurred about $112 million in lost revenue and other expenses. What stood out there was that their insurance covered only covered a fraction of that. That was the same for University of Vermont, if I’m not mistaken. There was a time where we would hear, “We have insurance and we can cover that if we need to.” But it’s not just about the financial aspects — it’s about patient safety, it’s about brand and reputation, it’s about mission to provide safe and effective care. When you hear about health systems diverting ambulances to other hospitals, you’re talking about precious minutes where those patients who need emergent care aren’t getting that care as quickly as they could be.

There is a cost perspective. Those costs are getting to be more expensive. Insurance premiums are going up – we are hearing more than 50%. We are hearing from CFOs about limits on what will actually be covered in terms of their insurance policies and needing potentially to buy multiple insurance policies. Insurers are becoming more prescriptive when it comes to specific security controls that are in place, and the security questionnaires are getting to be more extensive.

Certainly we need to look at all those implications. For many healthcare organizations, there has been historically an under-investment relative to what we see in other industries. At the same time, healthcare is going through this digital transformation. We are deploying all these new technologies. We will need the appropriate amount of investment in security as well to ensure that we can keep our applications secure and keep patients and patient data safe.

What can health systems do about the risk introduced by their business associates and vendors?

Through the first half of the year, somewhere around 40-plus percent of healthcare breaches resulted from business associates, third-party vendors, or other third parties that have electronic protected health information that was entrusted to them by a covered entity, a provider or a payer. Healthcare is shifting to cloud, using third-party service providers, generating a lot more data, and sharing and accessing that data from many more endpoints. As we continue on that journey, the threat landscape and the vulnerabilities that are created through that type of model are going to increase.

Every covered entity under HIPAA needs to ensure that they have a business associate agreement with their third parties, but that’s really not enough. We are seeing healthcare providers and healthcare payers turn up the dial in terms of what they expect from third parties, from their vendors, and from anybody that wants to do business with them who is going to receive that electronic protected health information or other sensitive data. It is still the covered entity’s responsibility to ensure that data is being protected.

What role will the federal government play in health system cybersecurity?

There have been some good efforts, public and private partnerships. The Cybersecurity Act of 2015 resulted in the establishment of the 405(d), the cybersecurity working group and task force. They recently came out with a good best practices guide that has, for small, medium and large organizations, the top 10 cybersecurity practices that can be used as a baseline. That’s been a great effort that is supported by 150 or 200 members. In January of this past year, there was legislation H.R. 7898, which basically said that healthcare organizations that are implementing or have implemented best practices — which include the NIST Cybersecurity Framework or 405(d) best practices — should not necessarily have a safe harbor, but should be looked at a little bit differently from regulators when it comes to audits or potential fines and penalties after a breach.

We have had some good momentum coming into the year. We’ve seen some good activity from the Biden Administration to work with private industry and to some communication that we’ve seen suggests that there will be more support. The recent executive order that required additional security practices and controls to be in place from government contractors hopefully will also transcend to the healthcare industry. Obviously there’s a lot of technology providers out there that support the VA, for example. 

There’s some good movement there. We would like to see more. The healthcare industry just lacks resources, dollars, and people. Those are things that the government can do to support healthcare, as a critical infrastructure industry, to respond to the challenge.

What developments will see in healthcare cybersecurity over the next few years?

The challenge of cybersecurity will continue to be more complex. That’s a result of the increased adoption of new technology and the vulnerabilities that come along with that. For the future, organizations have to develop core competencies in cybersecurity and in risk management in particular as part of cybersecurity. They have to get good at identifying, prioritizing, and responding to risk, and doing that in a methodical way and a programmatic way.

We are already seeing a lot of movement at the board and leadership levels, conversations that weren’t there before, when cybersecurity was considered to be an IT problem. It’s not an IT problem, it’s a business problem, and it could potentially be one of the largest risks to the overall organization.

Morning Headlines 9/14/21

September 13, 2021 Headlines Comments Off on Morning Headlines 9/14/21

After layoffs and pivot, Austin health care startup reemerges as CareHive

App-based house call and telemedicine company Remedy pivots and rebrands as CareHive, a digital health company that offers telemedicine, digital front door services, analytics, and clinical navigation.

Babyscripts secures $12M to roll out its virtual maternity care model

Digital maternity care software vendor Babyscripts raises $12 million in a Series B funding round led by MemorialCare Innovation Fund.

Edifecs Announces Acquisition of Talix

Edifecs acquires Talix, which has developed a natural language processing-enabled risk adjustment coding, retrieval, and analytics platform.

Comments Off on Morning Headlines 9/14/21

HIStalk Interviews Coby Skonord, CEO, Ideawake

September 13, 2021 Interviews Comments Off on HIStalk Interviews Coby Skonord, CEO, Ideawake

Coby Skonord is co-founder and CEO of Ideawake of Milwaukee, WI.

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Tell me about yourself and the company.

Ideawake helps large healthcare systems or providers create a highly engaging experience to capture, evaluate, and implement ideas from frontline employees. The biggest customers we work with in the healthcare space are UnityPoint, Advocate Aurora, and Sanford Health.

To what degree are health systems underusing their workforce as a source of ideas for innovation and improvement?

We are seeing a large uptick in getting better utilization of frontline staff, especially once they implement our system. A lot of the time when we come in, there’s a large underutilization, because things they tried in the past, like running one-off contests, didn’t work all that well. A lot of the time, systems are built on top of SharePoint or another solution that’s already internal. Since you don’t run these often inside of the system, things will fall through the cracks and you don’t get the results that you want. There’s no action plan after the fact. 

Once we come in, we see much better utilization. It’s easy to get started, but it takes a couple of cycles of running these challenges to get a lot more adoption across the large swaths of the organization. We normally like to start pretty small.

How much does using a technology platform democratize the process to avoid having the highest-ranking person choose their favorite idea?

One hundred percent. You hit on a great point. The best ideas to improve patient experience and process come from those who are closest to the patient every day. To your point, we democratize the process of capturing ideas. We do this in a couple of ways, but it empowers anyone at the front lines of the organization, regardless of role or title, to make their voice heard based upon the quality of their idea versus their job title.

What kinds of ideas are health systems looking for?

It’s all over the board. About half of our use cases, or challenges as we call them, are around continuous improvement. General process improvement within the system ties a lot to quality improvement programs. That’s pretty much exclusively how Sanford Health, as an example, uses the system.

You can also go to the other end of the spectrum, which would be product innovation or solutioning, which is split pretty evenly. How might we better attract millennials? How could we reduce patient anxiety before, during, and after care takes place? We’ve seen challenges that focus on solutions to better enable the aging in place trend that’s happening in the market.

The challenges focus on the major categories of healthcare trends that are being talked about from a consulting perspective. What trends will affect us? Then, putting those in the  form of a question and asking frontline staff for input on them.

Is this a way for health system executives to avoid paying consultants to simply talk to their employees and then report back a summary of what they said?

I like to say that we are more fun than consultants. The system is gamified. Users earn points as they submit ideas. There’s a leaderboard and you can offer prizes. Unlike having consultants interview employees, we create a transparent experience that allows for peer-based recognition. Employees can like each other’s ideas.They can track their idea from when it’s submitted to when it’s decided upon and ultimately implemented. You complete the loop of, hey, I gave input and something came out of it.

Health system executives sometimes solicit employee input on such decisions as choosing an IT system or how to implement it, but then override the frontline employee vote. How do health systems handle cases where a popular idea isn’t considered workable?

We do our own primary research. It’s important to complete the loop and to make sure that there’s transparency around where ideas go and why. We did a survey of 700 employees throughout the continental US, who told us that the number one reason that people who had ideas stopped sharing them – 20% of respondents – was because they didn’t hear feedback on where a previous idea they shared went and why it went there.

As far as prioritization, certain ideas that flow to the top from the frontline staff might not be workable for several reasons. But we have a transparent prioritization process where leadership who reviews the top ideas can say why something will or won’t work. That is communicated back to frontline staff automatically.

How do health systems decide who they want to participate and then encourage them to do so?

Our philosophy is the more, the merrier. We believe in the wisdom of crowds and the power of large numbers when you have the ability to sift through the ideas automatically using our technology. Our rule of thumb is if you’re under 5,000 participants when you get started, you can target that entire population. If we go over 5,000 or you have a complex network with a lot of locations that span several states, we’ll normally roll it out to a specific service line across several locations, or do it in a region and then expand out from that. But overall, we believe that everybody has ideas to improve quality of care and outcomes, so we try to make sure that everybody is involved.

Would the best prospect be a health system that has a track record of innovation, or should they just have a general interest or a specific idea to try?

Most health systems have some type of quality program in place. We see the easiest way to get started is making that quality improvement process more collaborative. Many health systems, regardless of their organizational makeup or culture, have that baked into the culture. We can help significantly improve the results. 

From there, looking at the innovative side of things. Innovation is happening in healthcare all over the place. If you don’t innovate, you will be left behind. Look at Blockbuster to Netflix, taxi cabs to Uber, or Amazon Care. Where primary care is getting disrupted now is on the fringe, but events and trends will continue. Health systems will have to be innovative and center their overall care model around the patient, continuously getting that patient input and feedback. If your culture doesn’t support it yet, then the best place to start is quality. But if you hear words around patient-centric care, and investment is going on around patient-centric care, we would be a great fit.

Are for-profit companies interested in paying health systems to participate in product evaluation or development?

We haven’t seen too much of that yet. In my past life, with the inception of the company, we were doing something similar that was entrepreneur focused versus enterprise focused. What we see most commonly now is an enterprise reaching out with an open call to startups for solutions, instead of just focusing internally on employee ideas.

Do health systems invite patients to be part of the process?

We are seeing the first iteration of that right now. It has been talked about for a long time. There’s a hesitancy to go directly to the patient or to replace some of the things that are in place currently, but it is something that we are starting to see. We should have our first rollout to those in early 2022. We just need to work through some obstacles such as security and compliance and making sure there are no concerns about HIPAA. When you go internal to employees, there’s a lot less concern. Sometimes there is more of a fear about working with patients, but we have the technology to do fully anonymized feedback.

What is the future of health system innovation?

Employee engagement and employee experience were already critical, but with COVID-related attrition rates, retention strategies are becoming even more important. Our system is being leaned upon more because of the need to engage employees and empowering them with a voice. That trend will grow. Most health systems think that their culture doesn’t support innovation, but every culture inside or outside of healthcare can support it. It’s a matter of where you start it. There will always be a leader in a region who will support the initiative. The sooner that leaders realize that, and more and more are realizing it now, the easier it will be to bring innovation and patient-centered care into the mainstream.

Comments Off on HIStalk Interviews Coby Skonord, CEO, Ideawake

Curbside Consult with Dr. Jayne 9/13/21

September 13, 2021 Dr. Jayne 8 Comments

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As a family physician at heart, I’m always looking for ways to help my clients meet their patients where they are, whether it’s through designing communications strategies, enabling patient-centered care platforms, or delivering more effective and culturally competent care. I was interested to see an article in the Journal of the American Medical Association that looked at whether emoji could improve communication between patients and their care teams. The initial thinking is that using emoji might help patients communicate symptoms and concerns.

On initially launching into the article, I was concerned about a potential of the approach. People don’t always have a common frame of reference for what emoji are supposed to depict. I recall one older family member who thought for quite some time that a certain brown and somewhat pointy emoji was a chocolate kiss rather than something more scatological in nature. Upon further reading, the authors suggest that various medical disciplines should have their own unique sets of icons as well as using healthcare-specific emoji. The idea is that using icons can make communication more accessible for children with developing language skills, people who speak languages other than English, and patients with communication challenges.

The authors propose using emoji as part of a method of point-and-tap communication that could be used quickly, as well as to augment hospital discharge instructions that patients and families often find confusing. They see emoji as powerful because they are standardized, universal, and familiar even though some users might have a bit of a learning curve as I noted previously. I was surprised by some of the data in the article, including an estimate that five billion emoji are used each day on Facebook and Facebook Messenger alone. Curation of emoji is managed by the nonprofit Unicode Consortium and there are over 3,500 emoji in the Unicode Standard.

The article went through a history of some of the existing emoji that could be considered useful in medicine, including the basic body parts such as ear, hand, leg, and foot. Additional “medical” emoji didn’t come into play until 2015 and those included the syringe and pill, followed a year later by male and female health workers. I used the opportunity to put my new phone through its paces and was only able to find the latter two by searching for “health” and the little stethoscopes around their necks are so microscopically tiny that I admit I had to use reading glasses to see them.

In 2017, Apple collaborated with the American Council of the Blind, the Cerebral Palsy Foundation, and the National Association of the Deaf to add various emoji, including the mechanical arm and leg (which I have on my new phone) and the hearing aid and white cane (which I do not). Several others were introduced in 2019 including the stethoscope, blood drop, bone, tooth, and microbe. The authors worked in conjunction with the United Kingdom’s National Health Service to introduce the anatomical heart and lung emoji, which I have as well.

Several other emoji are under consideration and are pictured in the article, including: intestines, leg cast, stomach, spine, liver/gallbladder, kidneys, pack of pills, bag of blood ready for transfusion, IV fluids, CT scanner, EKG tracing, crutches, a weekly pill dispenser, and one I couldn’t identify. I had overlooked the description for the graphic and it turns out that the one I couldn’t identify was supposed to be a scale, and the one I thought was a coronavirus was actually supposed to be a white blood cell. Maybe those emoji aren’t as standardized and familiar as the authors think they might be.

The authors hope to advocate for a “more comprehensive and cohesive set of emoji” but are also researching how the healthcare community could better leverage an expanded set of medical emoji. There’s certainly precedent for using icon-based systems like the Wong-Baker FACES Pain Rating Scale for helping patients quantify the intensity of pain they’re experiencing. The authors note, though, that many visual analog scales like the Wong-Baker scale are trademarked, but emoji are open source.

The last proposed benefit that the authors specifically call out is that related to advancing telemedicine. They propose that using emoji to describe symptoms via online messages can be helpful. As a practicing telemedicine physician, I’d have to say the devil would be in the details as far as how much information you could obtain via emoji and whether it would make it more challenging than eliciting the information during a focused interview. They note that there are challenges with using emoji, including patients without access to technology, those who are not facile users, and overall low health literacy that would preclude the use of anatomical emoji.

Speaking of anatomy, the article taught me something I didn’t know. Emoji skin tones are based on the Fitzpatrick pigmentary phototype skin classification system, which reflects how much melanin is present in different skin, how sensitive it is to UV light, and the relative risk of skin cancer.

The authors conclude by calling on the healthcare community to “take the lead by formalizing a unified perspective on emoji relevant to the field, including important gaps and solutions.” Given the pressures faced by healthcare providers right now, I’m not sure that evolving a representative set of emoji is at the top of anyone’s priority list, but it’s certainly something to think about in the context of overall communication with patients, caregivers, and colleagues.

We’ve come a long way as communications have evolved from voice pagers to numeric ones and then from alphanumeric pagers to emoji. I think I can safely predict that the ways in which we communicate will continue to evolve over the next several decades. As they do, I hope they become more efficient and reliable as well as having improved abilities to convey information. Maybe a few years from now, instead of lamenting the performance of our voice-to-text, we’ll be talking about using voice-to-emoji or maybe even some modalities we haven’t thought of.

What do you think about expanding the use of emoji in the delivery of healthcare? Leave a comment or email me.

Email Dr. Jayne.

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