News 10/16/20

Top News

Private equity firm JLL Partners acquires analytics solution vendor MedeAnalytics from Thoma Bravo, which acquired a majority stake in MedeAnalytics in 2015.

Reader Comments

From Chief Complaint: “Re: virtual exhibit halls. Your poll found that companies that paid to participate in a virtual conference’s exhibit hall didn’t find it worth the money or effort. I would be interested to hear from someone who has exhibited and can give their pros and cons, takeaways, what they would do differently, etc.” If you were in charge of a virtual exhibit at HIMSS, HLTH, CHC, etc., how about writing up your experience? I’ll make it anonymous if you’d like. Or if you aren’t motivated to put it in writing, I’ll interview you by phone (again, happily keeping you anonymous if you like). The poll results were interesting as a broad reaction, but it would be fun to get more firsthand insight. I haven’t heard much (any) buzz from Virtual HIMSS, so we’ll see how the even-larger RSNA does in  a few weeks, then attendees can for the first time keep eating Thanksgiving leftovers at home instead of bundling up for Chicago.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor CancerIQ. The Chicago-based company’s precision health platform enables providers to identify, evaluate, and manage entire patient populations based on individual genetic risk factors. By analyzing family history, running predictive risk models, and automating NCCN guidelines, CancerIQ empowers providers with the genetic expertise to prevent cancer, catch it early, and/or create personalized care plans. The platform has been rapidly adopted by some of the top health systems in the country and fully integrates with genetics laboratories, EHRs like Epic and Cerner, and specialty software vendors to streamline workflow, guide clinician decision-making, achieve cost savings, and most importantly, improve patient outcomes. CancerIQ is scaling the use of genetic testing to predict, preempt, and prevent disease. The company offers a toolkit for providers who want to quickly and effectively kick-start a telehealth-powered cancer genetic screening program. Thanks to CancerIQ for supporting HIStalk.

Here’s a video from the American Journal of Managed Care in which CancerIQ co-founder and CEO Feyi Olopade Ayodele, MBA describes how the company is making cancer genetic screening practical.

Listening: new from Sir Chloe, indie rockers from Bennington, Vermont. It’s kind of guitar-forward grungy pop with sweet singing, formed by singer Dana Foote two years ago as her senior-year thesis at Bennington College.  

Webinars

October 27 (Tuesday) noon ET. “Don’t Waste This Pandemic (From a Former Healthcare CEO).” Sponsor: Relatient. Presenter: Monica Reed, MD, MSc, former CEO, Celebration Health. Some healthcare organizations are trying to get back to the normalcy of 2019, but tomorrow’s leaders are accelerating even faster in 2020. Two- or three-year roadmaps were accomplished in six months, so what’s next? The presenter will describe how technology was changing before COVID-19, how the pandemic accelerated plans, what we can expect to see as a result, how leaders and providers can adapt, and what healthcare’s digital front door looks like going forward and how it can be leveraged.

October 28 (Wednesday) noon ET: “How to Build a Data-Driven Organization.” Sponsor: Newfire Global Partners. Presenters: Chris Donovan, CEO and founder, Adaptive Product Consulting; Harvard Pan, CTO, Diameter Health; Jason Sroka, chief analytics officer, SmartSense by Digi; Jaya Plmanabhan, data scientist and senior advisor, Newfire Global Partners; Nicole Hale, head of marketing services, Newfire Global Partners. The panel of data experts will discuss the opportunities that data can unlock and the challenges involved with becoming a data-driven organization. Attendees will learn why having a data strategy is important; how to collect, manage, and share data with internal and external audiences; and how to combat internal resistance to create a data-driven culture.

October 29 (Thursday) 1 ET. “How Presbyterian Healthcare Services Is Preparing for a Post-Pandemic Future Using Digital Care Tools.” Sponsor: Bright.md. Presenters: Ries Robinson, MD, SVP/chief innovation officer, Presbyterian Healthcare Services; Ray Costantini, MD, MBA, co-founder and CEO, Bright.md. Presbyterian Healthcare Services changed the way New Mexico patients access healthcare with its pres.today digital front door, which has given patients easy access to care during a global crisis. The health system’s digital care strategy goes beyond simply offering virtual visits and instead makes every episode of care — regardless of where it is delivered — better by streamlining clinical workflows and by directing patients to the most appropriate venue of care. The presenters will describe how Presbyterian has continued to meet patient needs during the pandemic, how it is deploying digital tools to tackle the combined COVID-19 and flu seasons, and how the health system is innovating care delivery to prepare for a post-pandemic future.

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

Acquisitions, Funding, Business, and Stock

Digital check-in vendor Clearwave acquires Odoro, which offers a similar product as well as patient scheduling.

Allscripts shares jumped 30% following news that it will sell CarePort Health to WellSky for $1.35 billion. MDRX shares have increased 2% in the past year versus the Nasdaq’s 46% gain, with the company’s market cap at $1.75 billion, of which CarePort Health and the cash it will generate obviously represent a surprisingly significant portion.

Shared decision-making platform vendor WiserCare raises $3.6 million, increasing its total to $9 million.

Philips is reportedly seeking a buyer for its Lifeline personal emergency response business. Philips acquired Lifeline for $750 million in January 2006, when Lifeline was generating $150 million in revenue with a 15% operating margin. 

Physician search and appointment scheduling platform vendor Zocdoc says that the lawsuit against the company filed by its former CEO for staging a “fraudulent coup” against him is without merit, it has boosted profit by moving from a flat subscription fee to a per-patient charge to providers, and it responded to COVID by launching video visits in April 2020 and a free video service in May. The company admits that it was in big financial trouble in 2015, adding that it couldn’t replace salespeople fast enough because of company culture problems. It hired a new CEO in November 2015 and says it has reinvented the Zocdoc around core values and a rejection of the “growth at all costs” mindset. The company has raised $226 million through a Series D round (almost none of that after 2015), and with this public mea culpa, seems to be looking for more investment action, maybe via one of those blank check SPACs that are suddenly all the rage.

Sales

• HHS’s Office of Women’s Health contracts with Premier for data and performance improvement methodology to address maternal health. Premier will bring at least 200 hospitals together in a Perinatal Collaborative to implement outcomes-proven best practices and care bundles.

People

Jay Colfer (Geniq) joins Medstreaming as CEO.

Quest Analytics hires Barbara Dumery, MS (Imprivata) as chief product officer.

MDLive promotes Mindy Heintskill, MBA to the newly created position of chief growth officer and hires Kristy Kaiser, MBA as chief product officer.

Healthcare automation technology vendor Olive hires Rohan D’Souza (KenSci) as EVP/GM of cybernetics; Mike Biselli, MA (Catalyst HTI) as VP of emerging technology partnerships; and Tony Brancato as VP of products for cybernetics.

Brian Norris, RN, MBA (OurHealth) joins employee health management company Marathon Health as SVP of population health.

NeoGenomics Laboratories hires David Brooks, MBA (Medlio) as VP of its informatics division, where he rejoins his Medlio co-founder Lori Mehen. 

Announcements and Implementations

Epic will use InterSystems IRIS Data Platform, a next-generation system that includes database management, interoperability, and analytics capabilities for data-intensive applications.

CliniComp will incorporate First Databank’s FDB MedKnowledge database into its EHR, where it will be used in ordering, conflict checking, documenting, and dispensing. It will also implement FDB Interoperability Module for medication reconciliation and interoperability with external systems such as automated dispensing cabinets.

Epic lists 314e’s Speki EHR help solution in its App Orchard.

Longtime Meditech user Milford Regional Medical Center (MA) goes live on Expanse. 

AMIA announces its 2021 fellows.

CloudWave expands its Meditech hosting to Puerto Rico and the Caribbean in partnership with IT services and telecommunications provider Neptuno.

Government and Politics

The Department of Defense says that private sector connectivity expanded significantly when DoD, the VA, and the Coast Guard connected to CommonWell last week.

CMS expands the list of telehealth services that Medicare will pay for during the pandemic.

COVID-19

CDC warns that small family gatherings are a growing source of coronavirus spread, reminding everyone that that mitigation is essential, especially with Thanksgiving coming up in which weather forces people indoors and cautious older family members will likely be exposed to younger and less-careful friends and relatives.

An investigative report published in Science, the journal of the American Association for the Advancement of Science, finds that White House Coronavirus Task Force Coordinator and former CDC employee Deborah Birx, MD drove the decision to abandon the CDC’s hospital data collection system and turn it over to private contactor TeleTracking. One CDC employee immediately quite because of the toxic atmosphere, others said the change was unnecessary because experienced staffers could reliably estimate totals even with missing data, and one texted to a colleague, “Birx has been on a months-long rampage against our data. Good f—ing luck getting the hospitals to clean up their data and update daily.” CDC employees told Science that she is largely responsible for the CDC’s credibility crisis because of her desire to please the White House and her lack of listening ability, noting that she had obtained data from every US hospital while running a CDC HIV/AIDS project and failed to understand why weekly data collection during a global crisis was any different. Birx says 98% of hospitals are reporting, but Science obtained an internal document indicating that only 24% are sending all of the data requested. TeleTracking’s system is also updated 3-4 days behind, struggles to report hospitals the share ID numbers, and consistently reports “nonsensical” numbers, such as 1,500 incidents in which it showed that a hospital had more occupied beds than its total beds.

WHO’s much-awaited Solidarity clinical trial finds that remdesivir does not improve survival rates of COVID-19 patients. The study of 11,266 hospitalized patients found that repurposed drugs such as remdesivir, hydroxychloroquine, lopinavir, and interferon had little effect on mortality or the need to ventilate patients. Remdesivir manufacturer Gilead Sciences says the conclusions of the report, which was made public before its publication, are not consistent with several other studies that showed remdesivir’s clinical benefit. A study published last week shows that use of the drug, which costs $2,340 per five-day course, was associated with a hospital stay reduction from 15 to 10 days with no mortality benefit.

Other

I’m fascinated by the bio of Darren Sommer, DO, MBA, MPH that I ran across. He’s founder and CEO of telemedicine hardware vendor Innovator Health, but his backstory is what caught my eye. He dropped out of college, joined the US Coast Guard at 19, completed EMT training, went back to school to earn an undergraduate degree and then a DO/MPH, then on the day after he finished his residency, joined the US Army’s 82nd Airborne Division, 2nd Brigade Combat Team and spent 15 months serving two tours in Afghanistan, where he also earned a Parachutist Badge and achieved the rank of major. He came home, earned an MBA at Duke and is now an Army Reserve lieutenant colonel along with his CEO job. I like these quotes:

• “The influence of the Airborne’s culture, which is to drop in behind enemy lines and find a way to succeed or expect to die, changes the way you face all challenges in life.I now meet every obstacle in my life with the expectation that failure is not an option.”
• “A hero is someone who does the right thing no matter the consequences. I worked with heroes every day. Some that I worked with received high accolades like the Silver Star or Purple Heart, but most of the heroes I worked with never even received a thank you. These were the soldiers that gave blood when we had a MASCAL [mass casualty], volunteered for patrols so their battle buddy could get rest, or risked their lives to ensure America stayed safe and Afghanistan could be free. This is why when you see a veteran, always thank them for their service. They have been a hero to someone.”
• “I plan to stay in [the Army reserves] another 10 years. I don’t look forward to the day when I can no longer wear the uniform and serve my country.”
• “It was my time in Afghanistan that really shaped my future. I was still a relatively inexperienced physician, and I was taking care of some very sick patients, in some very austere environments. Patients with conditions that I did not get exposed to in my civilian residency. The Army had an excellent communications infrastructure that allowed me to use technology to reach out to other physicians in Afghanistan, the US, and around the world. Their mentorship helped me to make better clinical decisions. It was my first exposure to telemedicine … [upon returning home to practice in a rural hospital] I kept asking myself why telemedicine wasn’t being used here in America like it was being used in Afghanistan.”
• “It took me a long time to realize the difference between failure and success was my effort.”
• “If you hear a horn honk at you while you are driving, it might be your driving, or it just might be them. When you hear a lot of horns honking at you, it is probably you.”

A former British cycling team doctor who has admitted to ordering banned substances claims that a hard drive failure prevents him from providing medical records data to the world governing cycling body. This is the third time he has claimed that a computer problem preventing him from complying with inquiries – he told authorities in 2011 that his laptop had been stolen, then last week said he destroyed his own laptop to prevent “Indian hackers” from accessing its data.

Sponsor Updates

• CentralReach will incorporate Change Healthcare’s RCM software and services into its EHR for autism-focused providers and educators.
• Health Data Movers publishes a new white paper, “Transplant Data Conversion: How We Make It Happen.”
• Healthfinch joins the Health Catalyst family.
• AI Tech Park interviews Saykara founder and CEO Harjinder Sandhu.
• Kyruus publishes the “2020 Patient Access Journey Report.”
• Coffeyville Regional Medical Center (KS) implements Meditech’s depression screening and suicide prevention toolkit.

Blog Posts

• 3 Things to Know About RCM (Experity)
• Introducing Brenda Ashley and Optimum CareerPath (Optimum Healthcare IT)
• Evolving the Cybersecurity Landscape (Fortified Health Security)
• You Need More Than a Scripting Engine to Monitor Citrix or VMware Horizon (Goliath Technologies)
• Multidisciplinary Collaboration: Healthcare’s Secret Weapon During Pandemic (Halo Health)
• Four Benefits of Automating Charge Note Reconciliation (Ingenious Med)
• Our Focus at AHIMA20: The Marriage of Prospective and Retrospective Audits (Hayes)
• Embracing Human Centered Design in Healthcare Digital Transformation (The HCI Group)
• Four Strategies Drive High-Value Healthcare Analytics for COVID-19 Recovery (Health Catalyst)
• It’s time to clinically integrate the healthcare supply chain (Infor)
• Four Benefits of Automating Charge Note Reconciliation (Ingenious Med)
• Tales and Tricks of Social Engineering 20 Years Ago and Today (Ingenious Med)
• How to Manage Change in a Dynamic Healthcare Environment (InterSystems)
• The Trends Defining Healthcare’s Next Normal. The Hospital Financial Model They Require (Loyale Healthcare)
• Build Community with Engagement (Medhost)
• Tracking COVID-19 Immunizations Relies on Accurate, Consistent Patient Identification (NextGate)

Contacts

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

EPtalk by Dr. Jayne 10/15/20

CMS has announced amended repayment terms for providers who received Medicare loans due to COVID-19. Repayment will begin one year from the issuance date of each provider’s (or supplier’s) advance payment. There is $106 billion in outstanding payments, which were intended to help bolster healthcare providers who had cash flow issues during the early stages of the pandemic. This is a positive development since they were originally scheduled to begin payback in August. Speaking with my friends who are independent physicians, they’re still struggling to get back to regular volumes and are worried about what things will be like once flu season hits.

Physicians across the country are still faced with shortages of personal protective equipment and aren’t equipped to manage COVID-positive patients in the office, so they often send them to the emergency department or local urgent care providers. If infections start to pick up, they’re going to be in the same place as they were last spring, if not worse. Providers who are still experiencing hardships can request an Extended Repayment Schedule that allows repayment over a three- to five-year period. In an interesting twist, CMS is also allowing recipients of the $175 billion in Provider Relief Funds to use those monies towards repaying the Medicare loans

St. Louis-based health system Ascension announced Monday that its 1,200 local employees will be able to work remotely permanently. The organization will be reviewing its local office footprint while supporting employees who have told leadership that they’re happy working remotely. Other local health systems are likely operating by the same playbook. Friends at BJC Healthcare mentioned that many remote IT and process improvement employees aren’t expected back in the office until June 2021. That gives the system plenty of time to evaluate their lease commitments and figure out where and how to shuffle the employees that eventually return in person.

From Non-Essential Travel: “Re: travel. Given the story of being in close confines with someone who flouted the rules, I’m curious whether you would recommend non-essential air travel to others at this time? Also curious whether your role, which brings you into more frequent contact with people who are COVID-19 positive, influences your decisions (i.e. you’re around it all day and have become accustomed to some level of risk). I know you discussed using air travel for important business reasons previously, but with so much conflicting information on what’s safe and what’s not, curious your take on the merits and risks of non-essential air travel at this time.” Good questions. I think that like everything else to do with this pandemic, the issue is one of weighing the pros and cons and finding the right comfort level with the decision. To be honest, for me this trip had significant elements related to mental health beyond just getting away.

I’ve been in a situation for six months now where I’ve been seeing twice (or sometimes more than twice) my usual patient volume within a 12-hour shift, which sometimes stretches to 13 or 14 hours to make sure all the patients are accommodated. My employer is extremely customer-focused, which creates a grueling environment for the staff. We don’t turn anyone away and we see all levels of acuity (at least until we can stabilize the patient while we call 911 and wait the heart-stopping 4 to 7 minutes for the fancy truck with the flashing lights to arrive). I’ve seen wounds and injuries that I haven’t seen since I worked in the big-city emergency department and have been expected to manage them until backup arrives. It’s gotten to the point where I know the ambulance-based paramedics by name.

When I finally make it home, I head straight to the shower, throw my work clothes in the washer, and then finally find dinner at 9:30 or 10 at night. The level of stress is pretty crazy, and some of us are left with few people with whom to commiserate. Non-medical friends and family members just cannot fathom what it’s like, although I’m not even in the worst of it by any stretch of the imagination.

Add that to the fact that we’re staring down the barrel of rising COVID numbers in my area, an extreme level of pushback against any kind of public health measures, and an impending flu season (which has already started for us) and I felt like if I didn’t get out of Dodge now I wouldn’t be able to do it for at least six or seven months.

The physician I met up with is much in the same position as I am. The reality of our dark thoughts led us to at least contemplate the fact that this is such a craptacular year that one never knows when one’s number might be up. I think a lot of people have forgotten (or didn’t realize) that back in March and April, physicians were updating their wills. That fear is still in the back of our heads, especially because we’re still seeing people who are deadly sick even though many in the US have returned to their normally scheduled programming, including leisure travel.

Bottom line: if not for this trip being an antidote to those dark thoughts, I would not have gone.

As someone who routinely encounters in the vicinity of 20 COVID-positive patients a day plus the other 40 to 60 who ultimately test negative, it’s nothing to throw on an N95 mask and some eyewear and hop on a plane with open middle seats (although I admit I fluid-restricted myself so I would have zero chance of needing to use the airplane lavatory, and did not eat or drink on the plane). Would I take my kids to Disney World just for fun? No way. Would I support someone making a trip to see a relative who might not be with them for much longer? Yes, with the right precautions.

I know the travel industry is hurting, along with many other sectors of the economy, but for the average person, I don’t know that the risk/benefit equation works out in favor of non-essential air travel. I’ve been wanting to make a non-essential trip to Boston to test-drive a custom musical instrument for nearly 10 months, and even though I could swab myself to meet the Massachusetts protocol and hop on a plane tomorrow (heaven knows I have enough unused airline tickets), I still haven’t done it.

The issue of the safety of air travel is certainly top of mind for many, and a recent article in the Journal of the American Medical Association looked at the topic. The comments on the article are interesting, and point out some level of conflict of interest among the authors that creates a shadow on their conclusion that the risk of contracting COVID during air travel is lower than that of being in an office, classroom, grocery story, or on a commuter train.

What do the rest of the road warriors out there think about air travel at this time? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 10/15/20

Clearwave Elevates the Patient Experience with the Acquisition of Odoro

Patient intake and eligibility verification vendor Clearwave acquires Odoro, a patient scheduling and engagement company, for an undisclosed amount.

Federal Electronic Health Record Connects With More Community Partners

The DoD, VA, and US Coast Guard add 15,000 facilities to their joint HIE after connecting to the CommonWell network, bringing the total number of connected facilities to 61,000.

Navina completes Seed investment round of $7 Million to solve the healthcare crisis using Artificial Intelligence, starting with primary care

Navina, an Israeli startup focused on using AI to help physicians better organize and assess patient data, raises a $7 million seed funding round led by Grove Ventures.

JLL Partners Announces Acquisition of MedeAnalytics

Confirming earlier reports, private equity firm JLL Partners acquires MedeAnalytics for an undisclosed amount.

Morning Headlines 10/14/20

WellSky® to Acquire CarePort Health from Allscripts® to Enhance Care Coordination Across Acute, Post-Acute Continuum

Allscripts will sell its CarePort Health care coordination business to WellSky for $1.35 billion.

HealthStream Acquires ShiftWizard, Expanding Its Nurse & Staff Scheduling Solutions for Healthcare Providers

Training and talent management platform vendor HealthStream acquires ShiftWizard, which offers systems for nurse and staff scheduling, productivity, and forecasting, for $32 million in cash.

Medical Undistancing Through Telemedicine: A Model Enabling Rapid Telemedicine Deployment in an Academic Health Center During the COVID-19 Pandemic

UC San Diego Health provides a “how to” model for rapidly deploying telemedicine, which includes roles and responsibilities, user technology support, a provider checklist for video visits, patient support, and billing and credentialing.

News 10/14/20

Top News

Providence forms Tegria, a healthcare services business comprised of nine companies that the health system has invested in or acquired. Providence SVP Anders Brown will lead the Seattle-based company’s team of 2,500. The companies involved are:

• Bluetree (Epic consulting)
• Engage (Meditech services)
• Navin, Haffty & Associates (Meditech consulting)
• Community Technologies (Epic Connect and services)
• MediRevv (hospital revenue cycle management)
• Acclara Solutions (hospital revenue cycle management)
• Medical Specialties Managers (ambulatory revenue cycle management)
• QuiviQ (machine learning for optimizing hospital operations)
• Lumedic (information exchange)

An executive of one of the companies says that they will continue to operate under their own names, which the announcement did not specifically say.

HIStalk Announcements and Requests

Thanks to the several folks who suggested ways that hiring a new journalism grad (a friend of a friend) as a paid intern might add value to HIStalk while enhancing her career prospects. I’ll be talking to her soon to learn more about her interests and capabilities and I’ll use the comments I received to give her an idea of the possibilities.

Listening: new from Bob Dylan. I’ve liked a few of his songs over the years and little else from his long career because I find his nasal, country-leaning vocal stylings distracting no matter how profound his lyrics. But at 79 years of age, “Murder Most Foul” sounds great and tells a story that doesn’t require a coffee shop study group to figure out, which might explain why the old, unreleased song became his first #1 pop hit and has earned 4.4 million YouTube views. It is simple yet effective in a Nick Cave meets Steven King poetic kind of way, mixing the Kennedy assassination with a bunch of random song titles. The time around 1963 was important in Dylan’s career as a 22-year-old – he released his first album followed by another that included “Blowin’ in the Wind,” he changed his name from Robert Zimmerman, and he recorded his first protest songs.

Webinars

October 27 (Tuesday) noon ET. “Don’t Waste This Pandemic (From a Former Healthcare CEO).” Sponsor: Relatient. Presenter: Monica Reed, MD, MSc, former CEO, Celebration Health. Some healthcare organizations are trying to get back to the normalcy of 2019, but tomorrow’s leaders are accelerating even faster in 2020. Two- or three-year roadmaps were accomplished in six months, so what’s next? The presenter will describe how technology was changing before COVID-19, how the pandemic accelerated plans, what we can expect to see as a result, how leaders and providers can adapt, and what healthcare’s digital front door looks like going forward and how it can be leveraged.

October 28 (Wednesday) noon ET: “How to Build a Data-Driven Organization.” Sponsor: Newfire Global Partners. Presenters: Chris Donovan, CEO and founder, Adaptive Product Consulting; Harvard Pan, CTO, Diameter Health; Jason Sroka, chief analytics officer, SmartSense by Digi; Jaya Plmanabhan, data scientist and senior advisor, Newfire Global Partners; Nicole Hale, head of marketing services, Newfire Global Partners. The panel of data experts will discuss the opportunities that data can unlock and the challenges involved with becoming a data-driven organization. Attendees will learn why having a data strategy is important; how to collect, manage, and share data with internal and external audiences; and how to combat internal resistance to create a data-driven culture.

October 29 (Thursday) 1 ET. “How Presbyterian Healthcare Services Is Preparing for a Post-Pandemic Future Using Digital Care Tools.” Sponsor: Bright.md. Presenters: Ries Robinson, MD, SVP/chief innovation officer, Presbyterian Healthcare Services; Ray Costantini, MD, MBA, co-founder and CEO, Bright.md. Presbyterian Healthcare Services changed the way New Mexico patients access healthcare with its pres.today digital front door, which has given patients easy access to care during a global crisis. The health system’s digital care strategy goes beyond simply offering virtual visits and instead makes every episode of care — regardless of where it is delivered — better by streamlining clinical workflows and by directing patients to the most appropriate venue of care. The presenters will describe how Presbyterian has continued to meet patient needs during the pandemic, how it is deploying digital tools to tackle the combined COVID-19 and flu seasons, and how the health system is innovating care delivery to prepare for a post-pandemic future.

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

Acquisitions, Funding, Business, and Stock

Allscripts will sell its CarePort Health care coordination business to WellSky for $1.35 billion. I interviewed CarePort Health co-founder and CEO Lissy Hu, MD in May 2020.

Training and talent management platform vendor HealthStream acquires ShiftWizard, which offers systems for nurse and staff scheduling, productivity, and forecasting, for $32 million in cash.

In Australia, NSW Health begins accepting bids for a statewide, cloud-based health IT system that it hopes to have in place by 2026. The single system will replace nine EHRs from Cerner and Orion Health; several patient administration systems from Cerner and DXC; and laboratory information systems from Cerner, Citadel, and Integrated Software Solutions.

Israel-based Nym Health raises $16.5 million to expand its automated hospital coding and billing technology beyond the 40 providers it already serves in the US.

I’m a new fan of health IT guy Kevin O’Leary, MBA, JD for his shockingly insightful analysis of the $3.7 billion valuation of Medicare Advantage startup Clover, which emphasizes its PCP contracting tool called Clover Assistant. Clover is going public via a Special Purpose Acquisition Company (SPAC), a shell company that is formed to raise capital through an IPO while avoiding some SEC reporting. It’s a fascinating read, with this spoiler offered in the second sentence: “It’s obviously a great exit for everyone associated with Clover, but you’ll have to forgive me if I’m a bit befuddled that a 3-star Medicare Advantage plan with an MLR of 98.8% in 2019 and ~57,000 lives is somehow being valued at $3.7 billion (roughly equaling $65k per life covered).” He also notes that the company has been fined by CMS for misleading marketing, withheld payments to labs in hoping to force them to provide detailed patient data, and laid off 25% of its headcount in admitting that it needed more people who understand healthcare. The CEO previously ran a chain of hospitals best known for going out of network with all insurance and increasing prices to the point that one was the most expensive in the US in 2013, earning him and his investors $150 million in management fees.

Sales

• UAB Medicine will offer tele-ICU services from Advanced ICU Care.

People

Darin Ryder (UF Health) joins Continuum Health IT as EVP of client services.

Announcements and Implementations

Through its Mayo Clinic Platform, Mayo Clinic (MN) and Safe Health Group establish Safe Health Systems to improve access to efficient, affordable virtual treatment for common conditions using the SAFE digital health platform. Initial efforts have focused on enabling COVID-19 testing and app-based health status verification for employees and students, and will expand to testing for STDs and common conditions.

Imprivata develops a touchless version of PatientSecure, a biometric palm scanner healthcare organizations can use to correctly identify patients and match them to their medical records.

Non-profit public trust The Commons Project partners with LabCorp to make test results, including COVID-19 screening, available on the CommonHealth Android app. It makes Apple Health type functionality available to the vast majority of the world’s mobile phone users whose devices run Android rather than IOS. I’m surprised they misspelled “Immunizations” in the app as depicted on the Google Play screen shot.

A new KLAS report on implementation consulting finds that S&P Consultants, Impact Advisors, Cumberland, and Ettain Health (formerly known as Leidos Health) are strong in Cerner projects. Health systems whose Epic implementations are complex give high marks to Impact Advisors, Nordic, and Optimum Healthcare IT. Engage tops the list tops the list of firms that provide strategic and technical expertise for Meditech projects, which also includes its fellow Tegria company of Navin, Haffty & Associates.

Government and Politics

ONC publishes a questionnaire for EHR users that would allow it to publish product comparisons. However, ONC notes that the questionnaire was developed using Cures Act funding, no money was appropriated to do anything with the tool after its development, and ONC has no plans to use it. They also note other potential problems, which would seem to have been obvious before ONC handed taxpayer money over to the contractors who happily did pointless work in designing a survey that no EHR user could ever complete accurately:

• Only the happiest and least-happy customers submit reviews.
• QA methods would need to screen for duplicate responses, incomplete submissions, and outlier responses.
• No method was designed to ensure that users and the EHR they claim they use are valid.
• The user’s evaluation may reflect their own organization’s customization or deployment rather than the design of the base product.
• The more detailed the questions, the harder it is for a single respondent to answer them all since they span everything from clinical usability to contractual terms.
• Voluntary participation is unlikely to generate good results.

COVID-19

Use of masks in New Zealand as a coronavirus mitigation measure reduced its flu case count over its April to August winter to just six, saving an estimated 1,500 lives.

Surgeon, author, and Johns Hopkins Bloomberg School of Public Health professor Martin Makary, MD, MPH says in a USA Today opinion piece that a top national priority should be to support at-home COVID-19 testing using telemedicine to avoid sending potentially infected people out in public. He advocates having trained professionals supervise a patient’s at-home testing in a virtual visit, then having an app send the de-identified information to a national tracking database. The federal government is starting distribution of 100 million Abbott BinaxNow kits this week.

Former FDA Commissioner Scott Gottlieb, MD says that antibody treatments for COVID-19 will need to be rationed given the current infection rate that will require up to 400,000 doses per month.

Brown University’s medical school and Lifespan develop MyCOVIDRisk, which allows people to specify their location, describe their plans for the day, and understand how much risk is involved and how they can reduce it. A two-person, 45 minute lunch in my area with no masks creates a small risk, with the site concluding that it’s a good idea for my mental health, while a two-hour hair appointment for Mrs. HIStalk in a salon with eight unmasked people creates a high risk. A subtle point is that the site is optimistic and helpful rather than just doling out gloom and doom that will force users into the false binary choice of doing whatever they want versus locking themselves in their homes.

Public health departments and colleges are struggling to perform contact tracing because students aren’t sure whether to put their home address or their campus address on COVID testing forms. Students are also less likely to answer phone calls from an unknown number to verify their location. The address issue also affects campus outbreak counts since some cases are being sent to their home addresses, especially if the student didn’t specifically identify themselves as attending college, and those addresses may be in a different state.

A New York Times opinion piece says “the medical cavalry is coming” and says that coronavirus optimism is warranted for these reasons:

• Experts say that the pandemic will end here sooner than expected, possibly by mid-2021.
• Americans have been mostly cooperative with shutdowns, distancing, and mask requirements despite high-profile exceptions.
• Every COVID-19 survivor and vaccine recipient  breaks another chain in the transmission.
• The percentage of people who die of the infection has fallen dramatically as older Americans exercise more caution, nursing homes improve their protections, and hospitals use treatment techniques such as proning and ventilator avoidance.
• At least two vaccines will likely be approved by early January, and despite distribution challenges, enough doses should be available vaccinate every American by June.

Other

Stat looks at how population health analytics software inadvertently adds racial bias in identifying patients who should receive more involved care, which happens because those platforms use medical spending data as a proxy for health need. White patients are scored up to four times higher for preventive care that similar marginalized patients because they have had more tests and visits. The article notes that the algorithms deliver the promised benefit — reduced hospitalizations and cost — but don’t consider that the data of black patients includes the effects of racism, lower incomes, less insurance coverage, and fewer provider choices.

UC San Diego Health provides a “how to” model for rapidly deploying telemedicine, which includes roles and responsibilities, user technology support, a provider checklist for video visits, patient support, and billing and credentialing.

In Australia, a health district will review the case of a woman who died of gastrointestinal rupture after arriving by ambulance at Gulgong Multi-Purpose Service, which no longer employs doctors. The hospital decided in June to use telehealth services instead. The family, which didn’t find out until the next day that the woman died without a physician being present, says it is reasonable to expect that ambulance-transported patients will see a doctor in person.

Sponsor Updates

• AGS Health will present during AHIMA’s virtual conference October 15 and 16.
• OptimizeRx expects Q3 revenue to increase 100% to $10 million.
• Ryan Engle (TT Capital Partners) and Navid Farzad (Frist Cressey Ventures) join Audacious Inquiry’s Board of Directors.
• Change Healthcare offers tips for interviewing virtually as part of its new Candidate Corner series.
• Clinical Architecture releases a new Informonster Podcast, “The Architecture of Intolerance: Discussing How Healthcare IT Documents Substance Intolerances and Allergies.”
• HIMSS SoCal features CloudWave President and COO Erik Littlejohn.
• Dimensional Insight congratulates customer Konza on its HHS grant, which the HIE will use to establish better connectivity with local public health agencies.
• Cerner Chairman and CEO Brent Shafer announces new offerings at its virtual Cerner Health Conference: Unite (usability), Discover (intelligence-integrated products), and social disparity dashboards.
• In England, Cerner will work with Induction Healthcare Group to develop patient engagement offerings for NHS facilities.
• Spok welcomes more than 550 attendees this week to its Connect 20 Virtual conference.

Blog Posts

• 314e Corporation launches “Speki” EHR Help (314e)
• Top 5 Concerns Driving Your Contactless Check-In Initiatives (Access)
• Impressive research by Agfa RSNA R&E Grant recipient (Agfa HealthCare)
• US News & World Report Analytics: Showcase Your Successes (Bluetree)
• Patient Event Notification CoPs: Understanding the Regulatory Landscape (CarePort Health)
• A Full Virtual Care Strategy is More Than Telehealth: Achieve Outcomes, Scale, and ROI with Deviceless Remote Patient Monitoring (CareSignal)
• ServiceNow Workflows: Best Practices for Maximizing Your Investment (CereCore)
• Improving Healthcare Access and Orchestration by Aligning Providers and Health Systems (Central Logic)
• Cerner’s Commitment to Innovative and Cost-Effective Associate Health Care (Cerner)
• Navigating Cybersecurity Challenges in Healthcare (ChartLogic)
• Recent Spike in Healthcare Breach Reports Due to Blackbaud Ransomware Attack (CI Security)
• 9th Annual Rock Health Summit 2020: Delivering Digital-First Collaborative Care for Vulnerable Populations (Collective Medical)
• Beyond the Coat: CoverMyMeds Pharmacists Share Their “Why” (CoverMyMeds)
• CMS: Home Care-Related MA Benefits are Booming (Dina)
• Online Doctor’s Appointment Booking Made Easy (EClinicalWorks)

Contacts

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

Morning Headlines 10/13/20

Providence combines 9 existing investments to form new healthcare services company Tegria

Providence forms Tegria, a healthcare services business comprised of nine companies the health system has invested in or acquired.

Nym Health raises $16.5 million for its auditable machine learning tools for automating hospital billing

Israel-based Nym Health raises $16.5 million to expand its automated hospital billing technology to providers in the US.

Health care SaaS startup plans McKinney expansion with new grant funding

McKinney, TX-based MyTelemedicine will use a regional economic grant to relocate and expand its headquarters within the city, as well as triple its staff over the next three years.

Mayo Clinic and Safe Health Systems launch new health and connected diagnostics platform to lower costs and streamline access to care

Through its Mayo Clinic Platform initiative, Mayo Clinic and Safe Health Group establish Safe Health Systems to improve access to efficient, affordable virtual treatment for common conditions using proprietary technology.

Curbside Consult with Dr. Jayne 10/12/30

I’ve returned from my brief sojourn in the desert. Unfortunately, on my outbound flight, I had my first exposure to a passenger behaving badly.

The last couple of times I’ve been on a plane have been smooth, but this one was marred by a man who wouldn’t keep his mask on his nose. It wasn’t a case of the mask not fitting right with resulting slip. He would wait until the flight attendant walked by, then intentionally lower his mask. He had already been a problem at boarding, when he planted himself in the exit row and took his mask off entirely, claiming he was “hot,” but put it back on when confronted.

After being counseled by multiple flight attendants, he finally complied when they told him he’d have to give up his exit row seat and move to the front of the plane with them. If you’re hale and hearty enough to fly coast to coast, you should be able to wear a mask.

It was fantastic to be in a part of the country where they’re taking COVID seriously. Nearly everywhere we went, people were universally masked and businesses were deadly serious about customers keeping their masks covering their noses and mouths. My community at home is doing unfortunate things, such as having unsanctioned homecoming dances with numbers of attendees that not only exceed county guidelines, but are entirely unmasked. I wish the parents organizing these events could come spend a day in our clinic and see how many families we deal with whose lives are disrupted after the fact by these events, and see how hard the staff works trying to deal with it all. As a physician dealing with COVID all day, it’s grating to see people who don’t understand personal responsibility and how their actions can impact the lives of others.

The small town I was visiting has reimagined their downtown area to promote outdoor dining and distanced socializing, blocking off streets and expanding the footprint for restaurants to serve in-person customers. Given our relatively self-isolating outdoor activities, most of our meals were of the “pull it out of your backpack” variety, but it was nice to get out and do some people-watching on the day we ventured into town.

If you’re going to blow your day’s calories on a single item, I highly recommend a shake that comes accessorized with not only whipped cream, but a donut. I saw some sassy boots while window shopping, but refrained from looking further until I have somewhere interesting to wear them. Of course, I could always stroll around my house in them, but it’s just not the same.

My wingwoman on this trip is a surgeon, and given the types of cases she usually does, she hasn’t been doing much telehealth work. She works for a large integrated delivery network where after-hours care is handled by triage nurses, so she was fascinated by the fact that I could log onto my favorite telehealth vendor’s site and have a waiting room full of patients who wanted to speak with a random physician at all hours of the night. I only saw a handful of virtual patients, and only when I received escalation text messages that the patients had been waiting a long time due to a shortage of available providers licensed in one of my states. She comes from a totally different world where the patient population is somewhat captive, so she found the potential fragmentation in care a little unnerving.

There’s still a lot lacking as far as interoperability between telehealth vendors and the rest of the teams that care for the patients they serve. At best, the patient’s local physicians receive a PDF document or a copy of the patient’s care plan. At worst, they receive nothing. In order for third-party telehealth platforms to be a robust part of patients’ ongoing care, they’re going to have to reach a level of interoperability that’s on par with the capabilities of certified EHR systems used by those other providers. They’re also going to have to execute on those capabilities. I know those vendors (and their shareholders and investors) don’t want to hear about the amount of money it’s going to take for that to happen, but it’s the right thing to do for the patient.

For me to be an effective telehealth urgent care physician, I need an current copy of the patient’s medication list and problem list, not just what they recall or what they might have picked from the top of a dynamic picklist because they were in a hurry. I need to have a better picture of whether a patient is compliant or not, and what their local care team has been doing or what they might have already been thinking regarding next steps for a given condition that might impact my short-term care plan. Whether I get that data from a provider’s EHR or some kind of API integration direction with the patient doesn’t make that much of a difference to me, as long as the data is there and comes through in a usable form. For the platforms I practice on, I’m betting it will be months to years before we reach those capabilities unless something changes drastically in the interim.

It will probably be a while before I practice any telehealth since I have quite a few in-person clinical shifts coming up to make up for my time away. I’m pleased to say that my flight home was uneventful, with most passengers sleeping. I think my exit row companion and I were the only ones with our lights on, and he appeared to be working most of the flight just like I was. Seeing a fellow road warrior type back in his natural habitat made me smile.

I’m cautiously optimistic that we can continue to put systems in place that allow people to travel or otherwise move about more freely than they have been, assuming they (or their companies) can afford to do so. However, flu season is just over the horizon, so it will be interesting to see if things stabilize or if we have more challenging days ahead of us.

What’s your over/under prediction for the upcoming US flu season? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Interviews Harjinder Sandhu, CEO, Saykara

Harjinder Sandhu, PhD is founder and CEO of Saykara of Seattle, WA.

Tell me about yourself and the company.

I’ve been working on artificial intelligence in healthcare for about 20 years, starting before it was cool to call it artificial intelligence. I transitioned from a role as a professor of computer science into entrepreneurship. A friend and I co-founded a company doing speech recognition and natural language processing in healthcare. We sold that company to Nuance Communications and I spent several years as the VP and chief technologist in Nuance’s healthcare division.

I founded Saykara a few years ago with the idea that doctors should be able to focus on seeing patients and that we can build AI systems that can capture what they say and automatically enter the pertinent data into the chart. That’s what Kara, our virtual assistant, does.

Healthcare encounters involve a complex, two-way conversation with minimal guidelines, structure, and length. What technology advances allow turning that conversation into encounter documentation whose accuracy is high enough to avoid manual cleanup afterward?

Two things. One is that we started out using a “human in the loop” model, which means that behind the AI is a person who will make sure that the system gets it right. Doctors get a good experience from Day One because the AI picks up a lot, but then humans not only help correct it, but also teach it.

The second thing we do is on the AI side. AI is advancing at a very rapid rate and our goal is to get to a solution that is purely autonomous, without any human in the loop. We are doing that by teaching our system how to recognize specific clinical pathways that are the subject of what the doctors are actually doing with their patients and start interpreting along those pathways. That helps a lot in terms of figuring out what the system should key in on at any given encounter.

How is that use of behind-the-scenes humans to correct and teach the system different from just hiring scribes?

In the short term, it may look very similar to the end user, where they get a clinical note or an order put into the EHR. In the longer term, as the system gets better and better, we can provide that same service at a much lower cost, but also go well beyond what a scribe would be able to do. Our system is learning to predict what’s happening in an encounter, to put specific nudges in front of physicians, and then along the way, we capture everything in the form of discrete data. We are able to populate and construct data in a way that is virtually impossible for people to do without a lot of effort and cost.

What does a typical patient encounter look like to a provider using your system?

There is no “one size fits all” for all providers. Different providers use the system very differently. But a typical experience would be that during the encounter, the physician turns on Kara on their IPhone app. They walk in, turn the app on to start listening, and then they just interact with their patient.

A lot of providers like doing what we call reflective summarization to make sure that the system captures the right things. They will speak, either during the encounter or afterward, to tell Kara, here are the key points that came up in this conversation or the things I did in the physical exam or in the assessment plan. They let the system key in on all of those things and make sure those are the core of what gets documented.

How does EHR integration work to get the information into the chart?

That varies a lot by EHR. Some EHRs are not geared towards capturing anything more than a blob of text as if it were from a clinical note. Others have granular APIs that allow you to take specific parts of what is being communicated and populate it, uploading diagnoses or other information that needs to go into registries. We find that the integration experience varies a lot, but we capture on our side as much detailed data as we can, then push into the EHR as much as the EHR is able to consume in the form of APIs.

What do users cite as the biggest benefit?

The biggest thing that our physicians say is that it eliminates pajama time. That’s the biggest thing that users want. Physicians are spending hours in the evenings trying to close their charts. We eliminate that almost across the board for all of our users.

Physicians like the idea that whatever they’ve done in that encounter, they can rely on the system to create very accurate rendition. Because we have humans behind the scenes helping the system and making sure it got it right, physicians get accustomed to the fact that the system creates very accurate information. They can mentally offload what they are doing and then move on to that next patient.

How long does it take from the first time a physician turns on the system until they feel that it is benefitting them?

Most of the time, it’s on the first day. A provider either types during the encounter, which draws their attention away from the patient, or they spend their evening time trying to close that chart. Their first note on the first day they start using the system will be highly accurate. Providers literally tell us, “This changed my life on Day One.” Largely because, all of a sudden, they found that they weren’t sitting there typing during that encounter or that evening they went home and they didn’t have those charts to do.

The value is very, very fast. And of course, behind the scenes, the AI is learning and getting better and more autonomous over time. That part takes time, but the immediate value for that physician is on Day One.

Having spent time at Nuance, how would you compare Kara to their ambient intelligence product?

Ultimately, we are trying to solve the same problem. The proof is what is happening behind the scenes and how intelligent the systems are getting behind the scenes, because Nuance also uses human scribes behind the scenes. We started four years ago at Saykara trying to solve the hard NLP problems to get the systems to be fully autonomous. We are on the cusp of releasing models that are going to be fully autonomous for specific pathways. The real distinctions are coming in the next little while.

Otherwise, doctors are oblivious to what happens behind the scenes. They just see a note that comes back to them.

We are training our system to do a lot more than clinical notes, such as clinical guidelines, coding, providing nudges, and predicting what is about to happen in that encounter. We are starting to put some of that in front of physicians, and you’ll start seeing those differences.

Since the clinician isn’t aware of how much of the final result was delivered by the AI or the scribe, is it the company rather than the user that will get the benefit of moving toward better-trained AI?

It’s a bit of both, actually. Certainly we benefit as the system becomes more autonomous, but there’s a huge benefit for the providers. I look forward to a point where they can see what the system is doing in real time, and we are starting to put some of those things in front of the physician. They can see guidelines and what information they need to capture during this particular encounter to cover it. Physicians are asking about those kinds of things.

The system is learning to interpret these encounters. We can teach it to figure out for the subjective part when the patient says “shoulder pain” to consider what questions the physician would typically ask a patient about shoulder pain, or the kinds of responses that a patient might give.The system is gearing up to be able to communicate directly to the patient to collective the subjective information before the encounter begins, which will offload work from the physician. Ultimately, that subjective information is really the patient’s voice, and it’s coming from them anyway.

Sometimes companies that offer a physician-targeted product struggle with creating a marketing and sales organization that can reach out to an endless number of practices to make sales. Who is your target customer and how will you reach them?

We get users across all tiers of the healthcare ecosystem, from large health systems all the way down to small group practices. I would say the sweet spot for us today is really large specialty groups. That’s where we find rapid uptake and a great deal of success. Within the large health systems, we find specific physician groups reaching out, particularly in primary care, for example, where burnout is a big issue. And then of course the small group practices.

From a marketing perspective, we’ve focused our efforts on reaching out with a message of, “We solve the problem of burnout.” A lot of the sales effort ends up being directed at the large specialty groups, but we get a lot of the health systems and the small groups coming along just because they feel that message and they want solutions for their physicians.

I appreciate your transparency in describing how humans are involved in your offering since some companies, especially those who yearn for a tech company valuation, market a proprietary black box that performs magic. Are companies trying too hard to get AI to do everything instead of accepting that it could be brought to market faster and less expensively by just shooting for 90% and letting humans lend a helping hand?

It depends on the area that AI is being applied in. When it comes to conversational AI, by which I mean listening and interpreting conversation, that’s an extraordinarily difficult AI challenge. We are making pretty substantial strides in that right now, but there are areas where you can apply AI where the AI systems can actually do a pretty good job without needing any kind of human power. But certainly in this space today, we are just at the infancy of NLP.

NLP has been around for a long time. I’ve been working on it for 20 years. But I would say just in the last year, we’ve seen so many gains just within our own system and across what’s happening in the industry outside of healthcare, even in NLP. But where I can see over the next couple of years, a lot of these solutions, our solutions, are going to be completely autonomous. But right now, that’s the right fit for this space today. For other industries, other applications of AI, it may or may not be. You  have to pick and choose the strategy used for what you’re trying to do.

Where does the technology and the company go over the next 3-5 years?

I often use the analogy of driverless vehicles. Ten years ago, people thought autonomous vehicles were a distant future, and nobody gave it much thought. Suddenly we wake up one day and there are autonomous vehicles on the road. They have drivers behind the wheels, but the vehicles are starting to drive themselves. Now you can go a pretty long distance without actually touching the wheel.

I look at AI in healthcare in that same kind of way, where we have the human in the loop. The AI is learning from what those humans behind the scenes are doing, but what is more interesting is that it is learning from what the doctors themselves are doing. If you put a camera on a doctor’s shoulder, connect it to a really intelligent system, and tell it to watch what the doctor is doing — how they’re interacting with the patient, what kinds of questions they are asking, what they do in their physical exam — and connect this to the EHR whose data the physician is using to make their decisions, you are building, over the long term, an intelligent system that can actually understand medicine. 

The scribing part of what we’re doing is just the cusp, the tip of the iceberg. The more important and more interesting trend is that, over the next 3-5 years, these systems will actually start understanding the process of providing care to patient. We will be able to supplement and assist doctors in ways that we haven’t really thought about today. That’s the part that I get excited about.

Do you have any final thoughts?

We are extremely early in the AI revolution in healthcare. Really, it hasn’t been a revolution. We are augmenting processes in healthcare, making them more efficient, and making physicians happy. Not just us, but other companies in this space. But what we’ve seen with AI technology in other industries is that it reaches an inflection point, where the AI begins evolving much faster and starts being able to do more in a short span of time than people would have imagined possible. I think we are almost at that inflection point in a lot of processes within healthcare. We will see, over the next couple of years, incredible disruption to the business of healthcare, and in a good way.

A core part of that is natural language processing.  So much of healthcare, so much of medicine, is communicated by voice. When you can do a really great job of interpreting and understanding what’s being communicated, what never actually makes it into the medical record or doesn’t make it into the medical record in a systematic, discrete way, you’re able to understand how to communicate with doctors on their own terms. Not in the way that you as a interface designer want doctors to interface with your system, but the way the doctors would naturally interact with other doctors or with a patient. You can interact with them in those terms. You can interact with patients on their own terms as well. That revolution is going to create a new platform and new capabilities that we can only start dreaming of today.

Morning Headlines 10/12/20

Internal Talkspace memo illustrates challenge of delivering virtual mental health services in 50 states

Online texting-only mental therapy provider Talkspace, frustrated by state-by-state therapist licensing that has limited therapist availability during pandemic-driven high demand, tells its independent contractor providers that the company will pay any fines that result from their serving patients who are located in states where they aren’t licensed.

Lux Capital’s SPAC Lux Health Tech Acquisition files for a $300 million IPO

Formed by Lux Capital, blank-check company Lux Health Tech Acquisition prepares for an IPO that it estimates will raise $300 million.

NSW Health goes to market for statewide single digital health record

In Australia, NSW Health begins accepting bids for a statewide health IT system that it will use to replace multiple systems from multiple vendors by 2026.

Monday Morning Update 10/12/20

Top News

Online texting-only mental therapy provider Talkspace, frustrated by state-by-state therapist licensing that has limited therapist availability during pandemic-driven high demand, tells its independent contractor providers that the company will pay any fines that result from their serving patients who are located in states where they aren’t licensed.

Emergency waivers have allowed therapists to serve patients who are located in states where the therapist isn’t licensed, but penalties will be reinstated when the waivers expire.

Legal experts warn that unlicensed practice is a crime in some states. They also note that any licensing board actions will remain on their record permanently regardless of who pays.

Health IT attorney Nathaniel Lacktman summarizes, “This is an enterprise-wide aggressive growth play in lieu of getting licensure. When a company uses the waivers to blitzscale its patient base, it needs a plan for what to do when those waivers end.” Competitors have addressed the issue by creating licensure teams and covering some or all of the cost of obtaining new state licenses.

A recent New York Times report says Talkspace’s startup culture conflicts with mental health concerns, noting its obsession with using patient data for purposes that sometimes lapses into marketing. It gave burner phones to employees and asked them to write five-star app store reviews to improve its lackluster scores. Therapists complained that it added a button to its app that allows clients to demand quick responses and and having their pay reduced if they don’t respond several times daily.

Another licensure issue unrelated to Talkspace is that patients are moving or taking extended vacations during the pandemic without necessarily notifying their virtual therapist, which creates legal exposure if the therapist unknowingly conducts sessions with a regular patient who has temporarily or permanently relocated to a state in which the therapist is not licensed.

HIStalk Announcements and Requests

The most valued use of LinkedIn among 386 poll respondents is for casually checking credentials or finding out what colleagues are up to, with few using it as a businessperson’s Facebook in reading the news feed, reading or posting articles, or messaging. Some commenters commendably use it to help others make connections, such as passing along recruiter pitches or leaving a recommendation for a former colleague who has lost their job.

New poll to your right or here: What factors have caused you to leave a recently presented webinar or to stop paying attention? Feel free click the poll’s Comments link to explain the factors that make a webinar interesting and valuable to you. We require companies that have us produce their webinar to do a rehearsal that we record and review, but many times they ignore our advice, usually because (a) marketing people are reluctant to coach the presenter; (b) they believe time is too short to make improvements; or (c) the box to be checked is to present a webinar, not necessarily to make it as good as it can be. Still, our experience is that a knowledgeable, qualified presenter who earnestly provides useful information that delivers what the write-up promises will usually do very well regardless of any other issues.

A friend of a friend just graduated college with a journalism degree, which wasn’t exactly a hot employment ticket even before COVID. I’m thinking about hiring her as a paid remote intern in some fashion, assuming she is interested in learning about health IT and thinks she could gain something useful working in my decidedly non-traditional way. Help me out here – how could a fresh journalism graduate best add value to HIStalk while simultaneously becoming better prepared for the job market? Let me know what you think. I would be doing it as a giving back kind of thing, but it would be nice to user her talents wisely and make her more employable in the process.

Prospective new sponsors: read the media kit, contact Lorre, and get the rest of 2020 free and all of 2021, including HIMSS21.

Welcome to new HIStalk Platinum Sponsor Change Healthcare. The Nashville-based organization is a leading independent healthcare technology company that is focused on insights, innovation, and accelerating the transformation of the US healthcare system through the power of the Change Healthcare Platform. It provides data and analytics-driven solutions to improve clinical, financial, administrative, and patient engagement outcomes, with specific offerings in end-to-end revenue cycle management, enterprise medical imaging, payment accuracy, and patient experience. Thanks to Change Healthcare for supporting HIStalk.

I found this Change Healthcare explainer video on YouTube.

Webinars

October 28 (Wednesday) noon ET: “How to Build a Data-Driven Organization.” Sponsor: Newfire Global Partners. Presenters: Chris Donovan, CEO and founder, Adaptive Product Consulting; Harvard Pan, CTO, Diameter Health; Jason Sroka, chief analytics officer, SmartSense by Digi; Jaya Plmanabhan, data scientist and senior advisor, Newfire Global Partners; Nicole Hale, head of marketing services, Newfire Global Partners. The panel of data experts will discuss the opportunities that data can unlock and the challenges involved with becoming a data-driven organization. Attendees will learn why having a data strategy is important; how to collect, manage, and share data with internal and external audiences; and how to combat internal resistance to create a data-driven culture.

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

Announcements and Implementations

Canada’s Trillium Health Partners goes live on Epic.

COVID-19

COVID-19 cases and hospitalizations have increased significantly in the past few weeks, with the lagging indicator of daily deaths likely to follow. Acceleration is almost certain as cooler weather sends people indoors. Europe is seeing the same trends. Experts have long feared a second wave given the seasonality that is exhibited by most respiratory infections and coronaviruses, such as in flu season where cases pick up in late fall and peak in January and February.

A CDC review of COVID-19 spread in Arizona finds that cases shot up after the state reopened, but stabilized and then decreased sharply when control measures were implemented.

The Wall Street Journal explains the behavioral challenge in which young people have the most COVID-19 infections, but the older people they spread it to make up most of the deaths.

Companies and schools in the UK are reportedly telling employees to turn off the NHS test and trace app or to remove it from their phones, apparently fearing that their workers will receive warnings that tell them to isolate. One of the companies that told employees to shut the app down at work is GlaxoSmithKline, which is working on COVID-19 vaccine.

HHS Assistant Secretary and pediatrician Admiral Brett Giroir, MD orders Nevada to end its recent ban on two rapid coronavirus testing systems that the federal government provides, saying that false positives are to be expected and that the decision “can only be based on a lack of knowledge or bias.” Federal guidance says states can’t block the use of tests that have been approved by the FDA for testing people in congregate settings. The two test manufacturers issued statements saying they were pleased with Giroir’s order.

Other

A study finds that physician organizations that are affiliated with health systems deliver about the same level of quality care to high-need Medicare patients as independent practices. Aldedade CEO Farzad Mostashari, MD, MSc notes that the Rand researchers seem to have tried and failed to find ways to game the results to make higher-cost health system practices look better, even when trying to bolster the “our patients are sicker” argument that the study did not support.

Security experts find that Dr Lal PathLabs, one of India’s largest lab operators, failed to secure its daily testing logs that were stored as Excel worksheets on Amazon Web Services. The company fixed the problem, but did not respond to the researcher who told them about it.

Sponsor Updates

• HIStalk Sponsors exhibiting at the virtual Cerner Health Conference October 13-14 include Access, Elsevier, Ensocare, Fortified Health Security, Healthwise, Intelligent Medical Objects, Imprivata, Kyruus, Nuance, and Surescripts.
• Carroll County Memorial Hospital celebrates 10 years of partnership with Cerner CommunityWorks.
• Netsmart welcomed more than 3,000 providers and professionals to its 13th annual Connections conference earlier this month.
• OpenText makes electronic signature accessible to organizations of every size.
• Dina will sponsor HLTH VRTL 2020 on October 12-16 and will be part of the Matter Startup Showcase on October 16.
• Ernst & Young recognizes TriNetX CEO Gadi Lachman as an Entrepreneur of the Year in its 2020 New England program.

Blog Posts

• Beyond the Digital Front Door: The Digital House (Phynd)
• Going online with your go-live (Nuance)
• Are you at risk of losing customers to a competitor during Medicare annual enrollment? (OmniSys)
• E-Signature: Why offering customers more choice is vital (OpenText)
• A Look at the 2019 Medicare Shared Savings Program: Results, Findings & Changes to Come (PatientPing)
• The Healthcare Cybersecurity Threat Landscape (Pivot Point Consulting)
• Rapid Critical Result Reporting with Clinical Communication Technology (PerfectServe)
• PMD: So Much More Than Secure Messaging (PMD)
• The New Rules of Margin Improvement (Premier)
• Pure is 11 Years Old: Let’s Celebrate the Decade to Come (Pure Storage)
• Public Health Resources for Telehealth Companies: a quick look (Redox)
• Healthcare under attack: How backup systems make or break your response to ransomware (Spirion)
• The state of healthcare communications: 2020 report (Spok)
• A Faxless Future: Dare We Dream? (Surescripts)
• How to Become a Preferred Provider with Payers (WebPT

Contacts

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

Weekender 10/9/20

Weekly News Recap

• Apple releases Health Records on the IPhone for users in the UK and Canada.
• Dignity Health’s St. Joseph’s Hospital and Medical Center (AZ) will pay $160,000 for failing to provide a patient with a copy of their medical records.
• Harris adds Australia to its operating areas with its acquisition of Meridian Health Informatics.
• Universal Health Services completes part of its recovery from a cyberattack.
• Four health IT companies are acquired by private equity firm The Carlyle Group and will operate under the single brand of CorroHealth.
• HHS issues a second $10 million contract to TeleTracking Technologies for its HHS Protect COVID-19 hospital data collection system
• Clinical trials software vendor EResearch Technology is hit by a ransomware attack.
• Meditech will end its status as an SEC public reporting company by de-registering its shares to go private.

Best Reader Comments

[On Hims-style telemedicine] The reason it costs so much is because he sees a physician who the health system has to pay a couple hundred grand a year and the health system itself has high overhead (rent, administration, etc.) that it needs to bring in revenue to cover. Medicare for all isn’t going to change that cost equation unless it puts substantial downward pressure on physician compensation. Hims has got it worked out where they have low labor costs for a variety of reasons and they’ve got low overhead besides marketing spend. Why can’t someone replicate that for prescription renewals or other routine, almost secretarial care? (IANAL)

Treating depression or anxiety isn’t just a matter of writing a quick script. The same is true of virtually any legitimate prescribing. If a drug is sufficiently powerful to work in treating a clinical condition, then it’s also likely to have some potential for side effects, interactions with other drugs, or be problematic depending on the patient’s underlying health conditions. Making those determinations and identifying whether the patient is best served by medication and/or psychotherapy, isn’t a 5 minute process nor is it best served by seeing a different person for 5 minutes every year. (MedicareForAll)

Traditional doctors are way too expensive to be handling these issues for the young and low income. People might get suboptimal treatment via episodic care, but paying out the nose for every little thing harms people in its own way. We can’t choose the option that protects health system incomes over patient incomes every time. Americans just do not have the money. Sometimes paying a lot less for care that is a little lower quality is what people want. (Associate CIO)

Watercooler Talk Tidbits

Readers funded the Donors Choose teacher grant request of Ms. R in Pennsylvania, who asked for a history book series for her third grade class. She reported in early March, “When I told my students that we were getting new books, a huge cheer went up in the classroom! When I told them what books we were getting, they were even more excited! The students have been reading our new books since they were delivered to the room, and you can tell how much they love them. After reading a book, students have the opportunity to share their book with other students. This gives students a chance to practice their summarizing skills (as they tell others about their book) and their persuasive skills (as they convince others to read the book). But most importantly, it gives them a chance to share their love of a book and give others a chance to enjoy the book as well.”

I took advantage of some great third-party matching to fully fund these Donors Choose projects, courtesy of funds from my Anonymous Vendor Executive:

• Math manipulatives, calculators, and whiteboards for Ms. C’s high school geometry class in Blountsville, AL.
• A second monitor for remote learning instruction for Ms. M’s high school class in Belfast, ME.
• Seating, supplies, educational toys, and arts and crafts supplies for Ms. D’s special education class in Scranton, AR.
• An Apple TV for remote learning streaming for Ms. E’s second grade class in Los Angeles, CA.
• Hands-on math tools for Ms. K’s special education class in Tucson, AZ.
• A document camera for Ms. V’s fourth grade class in Los Angeles, CA.
• Laptop and phone stands and calendar and weather charts for the elementary school class of first-year teacher Ms. S in Houston, TX
• Books and reading materials for Ms. A’s elementary school class in Los Angeles, CA.
• Reading circle carpet and learning activities for Ms. G’s kindergarten class in Houston, TX

Doctors of osteopathic medicine — whose DO credential allows them to practice identically to their allopathic (MD) peers – worry that political arguing over the hospital treatment rendered to President Trump by Sean Conley, DO has caused some to question why the president isn’t being treated by a “real doctor.” Some people confuse DOs with chiropractors because they receive extensive extra training in the musculoskeletal system (75% of whom don’t use it in their practice) and focus on preventive medicine, and in fact MD training is moving more toward that of DOs in its newfound emphasis on prevention and holistic medicine. It gets more complicated for foreign-trained doctors, whose diploma may show MBBS, MBChB, BMED, BMBS, or other credential that is equivalent to an MD, some of whom misstate their LinkedIn credential as having earned an MD degree from a school that does not issue that credential. I’ve read that surgeons in the UK are addressed as Mr., Miss, Ms. or Mrs., which is interesting, and I’ve seen quite a few health industry folk in the US append “Dr.” in front of their names for possessing degrees that are not only non-medical, but in some cases are from unaccredited schools or were conferred as honorary degrees, where using the “Dr.” title is just plain wrong. And of course it is never correct to bookend the social title with the professional credential, in the form of “Dr. John Smith, MD.”

The Denver Broncos honor five of their cheerleaders who are healthcare workers in their day jobs, among them an ED nurse practitioner, a physical therapist, and a trauma nurse.

A traveling nurse who spent two months on the COVID front lines in New Jersey this spring donates a kidney to a one-year-old boy.

The China-based manufacturer of a $200 Bluetooth-controlled male chastity belt sex toy responds to a reported security flaw — in which hackers could lock every one of the devices worldwide or steal user information — by suggesting that users could break the device open with a screwdriver if needed. One of the security researchers wasn’t enthused at that prospect, saying, “The forceful use of a screwdriver in close proximity to a very sensitive area of the anatomy seems very unwise,” which might be explained by the company’s tagline, “love hurts.”

In Case You Missed It

• News 10/9/20
• EPtalk by Dr. Jayne 10/8/20
• News 10/7/20
• Curbside Consult with Dr. Jayne 10/5/20
• Readers Write: TechQuity: Influencing Health Literacy, Equity, and Disparities in Spanish-Speaking Communities
• Monday Morning Update 10/5/20

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• Contact Mr. H

Morning Headlines 10/9/20

Health Records on iPhone available today in the UK and Canada

Apple makes Health Records available to IPhone users in the UK and Canada in its first expansion outside the US.

Datavant Raises $40 Million in Series B Financing to Expand Open Health Data Ecosystem

Healthcare data de-identification vendor Datavant – whose clients include 70 academic medical centers and 100 health technology and data companies — raises $40 million in a Series B funding round, increasing its total to $83 million.

Lark Health Raises $55 Million Series C to Bring A.I.-Driven Chronic Conditions Care to More People

Health coaching app vendor Lark Health raises $55 million in a Series C funding round and $15 million in a venture debt credit facility, increasing its total to $100 million.

News 10/9/20

Top News

Apple makes Health Records available to IPhone users in the UK and Canada in its first expansion outside the US.

Health Records has been integrated with Cerner, Epic, Allscripts, and InterSystems.

HIStalk Announcements and Requests

Listening: Van Halen, reminding myself how good the band was as the late EVH’s Frankenstrat howled and growled through my favorite tracks like “Ain’t Talking About Love,” “Panama,” and “You Really Got Me.” It’s easy to understand why he disliked the uber-annoying but occasionally entertaining David Lee Roth, who kept me from being a big Van Halen fan, but Eddie’s rationale was at least partly musical – he thought Roth’s vocals distracted from his guitar playing similar to someone singing over a Beethoven symphony.

Webinars

October 28 (Wednesday) noon ET: “How to Build a Data-Driven Organization.” Sponsor: Newfire Global Partners. Presenters: Chris Donovan, CEO and founder, Adaptive Product Consulting; Harvard Pan, CTO, Diameter Health; Jason Sroka, chief analytics officer, SmartSense by Digi; Jaya Plmanabhan, data scientist and senior advisor, Newfire Global Partners; Nicole Hale, head of marketing services, Newfire Global Partners. The panel of data experts will discuss the opportunities that data can unlock and the challenges involved with becoming a data-driven organization. Attendees will learn why having a data strategy is important; how to collect, manage, and share data with internal and external audiences; and how to combat internal resistance to create a data-driven culture.

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

Acquisitions, Funding, Business, and Stock

Health coaching app vendor Lark Health raises $55 million in a Series C funding round and $15 million in a venture debt credit facility, increasing its total to $100 million.

Prescription delivery company ScriptDrop raises $15 million in a Series A funding round, increasing its total to $27 million. Founder and CEO Amanda Epp, a veteran of CoverMyMeds, started the Columbus-based company in 2017 and reports a 220% increase in revenue so far in 2020 due to the pandemic. The company charges $8 for same-day delivery of prescriptions to patients who are located within five miles of the participating pharmacy. Drivers are the employees of partner courier companies rather than its own.

Healthcare data de-identification vendor Datavant – whose clients include 70 academic medical centers and 100 health technology and data companies — raises $40 million in a Series B funding round, increasing its total to $83 million.

Mental health telemedicine company Cerebral raises $35 million in Series A funding, proceeds from which will fund an expansion to all 50 states and development of a mobile app.

Avail Medsystems, which offers a surgery telemedicine system that allows OR teams to access external expertise, raises $100 million in Series B funding,

Building sensor vendor Lumenix acquires the prototype of the AI-powered handwashing monitoring system AIMS from Boston Children’s Hospital.

Google renames its G Suite business software package as Google Workspace, also adding video chatting capability to the document editing window and improving integration among Gmail, Docs, Sheets, and Calendar to better compete with Microsoft Office 365. The system was called Google Apps for Business until mid-2016. The basic business plan costs $6 per user per month.

Greenway Health announces availability of Greenway Telehealth.

Sales

• Intermountain Healthcare chooses Vynca for Cerner-integrated access to advance care planning documents for clinicians, patients, and caregivers.
• Prevea Health will implement the financial planning and analysis platform of Syntellis Performance Solutions, formerly known as Kaufman Hall Software. 

People

Audacious Inquiry hires Edwin Miller, MBA (Aledade) as chief product officer; Sunil Chandran, MBA (FranConnect) as CTO; and Marie Crump, MsC (Mymee) as chief marketing officer.

American College of Medical Informatics names Harvard Medical School biomedical informatics professor and department chair Isaac “Zak” Kohane, MD, PhD as its Morris F. Collen Award of Excellence winner for 2020.

Announcements and Implementations

314e launches Speki, an EHR-embedded application help product that users invoke with a context-aware hot button that triggers micro-learning videos, tip sheets, and other documents that guide the user through completing the task at hand. The company will offer integration with EHRs such as those offered by Epic, Cerner, and EClinicalWorks.

Nephrology Associates goes live on Saykara’s  mobile AI voice assistant to automate physician charting.

UK patients can access information from providers who use InterSystems TrakCare via the Apple Health app, with integration with HealthShare to follow.

Epic will integrate Lyft ride-hailing into its product, allowing hospital staff to book transportation for patients.

Medicare and Medicaid technology vendor Centauri Health Solutions releases a pricing transparency solution for Epic that allows customers to comply with CMS price list publishing requirements that take effect on January 1, 2021. It offers similar products for non-Epic users.

A Central Logic-commissioned independent survey of health system executives finds that 96% will address patient leakage as one of their priorities this year, but only 31% report having the tools they need to keep patients within their networks.

Government and Politics

Dignity Health’s St. Joseph’s Hospital and Medical Center (AZ) will pay $160,000 to settle federal charges that it violated HIPAA’s right-of-access provision. The hospital ignored a mother’s request for copies of her son’s medical records, finally delivering them 22 months later and only after OCR got involved.

COVID-19

Most states are seeing a rise in coronavirus infection and nine have set seven-day records, with Wisconsin being among the worst in doubling case counts in the past month. The US has seen 212,000 deaths in 7.6 million cases, with both numbers representing about 20% of the world’s total. 

Nevada orders state nursing homes to stop using quick COVID-19 antigen tests from Quidel and Becton Dickinson for routine screening due to a high number of false-positive results. Both companies claimed zero false positives in their application for FDA’s Emergency Use Authorization. Experts note that FDA’s authorization for the tests cover only those people who are in their first five days of showing symptoms – they were not evaluated for screening people who don’t have symptoms. HHS required routine testing of residents and staff in late August, including those who don’t have symptoms. National testing czar Adm. Brett Giroir responded by saying that the use of antigen tests is acceptable for nursing homes despite lack of FDA authorization given the cost, delays, and material shortages in conducting PCR tests, also noting that it isn’t unusual for false positives to outnumber true positives in areas that have low coronavirus activity.

Regeneron applies for FDA’s Emergency Use Authorization for the antibody mixture that was administered to President Trump. The company says that initial supplies will be limited to 50,000 patients, but it will produce 300,000 courses of therapy within a few months and 250,000 doses per month sometime next year. Regeneron’s agreement with the federal government calls for the first 300,000 doses to be provided at no cost. Eli Lilly is also seeking authorization for its antibody product.

Moderna won’t enforce its coronavirus vaccine patents while the pandemic is underway and will license them to others afterward, explaining that “we’re not interesting in using that IP to decrease the number of vaccines available in a pandemic.”

NEJM’s editors say in its first-ever editorial involving a political candidate in its 208 years of existence that the Trump administration has “taken a crisis and turned it into a tragedy” in being “dangerously incompetent” in its COVID-19 response, urging Americans to vote them out of office.

JAMA Network profiles a clinic whose “plain old phone calls” made up 75% of appointments during the area’s COVID-19 lockdown, with none of them involving video apps such as FaceTime. Lack of technology, comfort with its use, lack of broadband availability, and work or family conflicts leave phone calls remaining as a vital tool for vulnerable populations, for which physicians would like to see temporary reimbursement made permanent.

Other

Epic confirms to a Northwestern University news site that 45% of its employees have returned to on-campus work. (note: the 43,000 employee number is obviously a mistake and should have been 4,300).

Sponsor Updates

• Healthcare Growth Partners advised Ontellus in its acquisition of Intertel and MasterTrace.
• Wolters Kluwer and Meditech join forces to deliver integrated healthcare solutions across the Middle East and Africa.
• MDLive Institute publishes a new report showing changes in consumer attitudes toward telehealth and corresponding behaviors since the start of the pandemic.
• Elsevier launches Transition to Practice, a virtual learning and support platform for new nurses.
• Ingenious Med adds missing clinical documentation identification functionality to its Charge Note Reconciliation.
• First Databank Health network partner Hearst Health and the Jefferson College of Population Health honor Nationwide Children’s Hospital’s Healthy Neighborhoods Health Families program as the winner of the 2020 Hearst Health Prize.
• CHIME’s Digital Health Leaders Podcast features The HCI Group’s CEO Ricky Caplin.
• Health Data Movers publishes a new white paper, “Patient Monitor Deployments: How We Make It Happen.”
• Spirion wins an Outstanding Information Security Company award for securing the information of work-from-home and another for most valuable corporate response for providing meals to restaurant staff during the COVID-19 lockdown.
• Ingenious Med introduces new Charge Note Reconciliation capabilities, including automatically identifying missing clinical documentation and charges.
• Healthcare organizations using InterSystems TrakCare in the UK can now offer patients a secure way to access medical data using Apple’s Health Records app.
• Jvion CMIO John Frownfelter contributes to “Intelligence Based Medicine” by Anthony Chang.

Blog Posts

• The Role of Industry in COVID-19 Pandemic Glycemic Management (Glytec)
• How I Use Goliath to Monitor & Troubleshoot Citrix Daily (Goliath Technologies)
• Three Considerations for 2020 Healthcare IT Planning (Healthcare Triangle)
• Leading Digital Transformation in Health Care Requires Specialized Skills (HCTec)
• Top 5 Concerns Driving Your Contactless Check-In Initiatives (Access)
• The Heatlhcare Analytics Summit: Top Data Discoveries and Insights from HAS 20 Virtual (Health Catalyst)
• Reaching Our “Silent Seniors” During COVID-19 (Healthwise)
• Get digital identity right with the Imprivata Digital Identity Framework for Healthcare (Impact Advisors)
• Connecting people, finances, and supplies with patient care (Infor)
• The Benefits of Virtual EHR Training (Optimum Healthcare IT)
• The Year of the Nurse: In conversation with Whitney Mannion (Intelligent Medical Objects)
• Patients Love Virtual Health. Digital Financial Engagement Makes It Better. (Loyale Healthcare)
• Medhost Prepares Community Hospitals for Price Transparency (Medhost)
• A matter of trust: Reflections on Meditech’s 2020 Physician and CIO Forum (Meditech)
• 7 Ways to Increase Your PT Practice’s Social Media Presence (MWTherapy)

Contacts

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

EPtalk by Dr. Jayne 10/8/20

I’ve helped numerous organizations with EHR system selection over the years, so I’m always skeptical when vendors or others report outcomes that can only be described as too good to be true. I always feel vindicated when I get to the bottom or an article and find some tidbit that I might have otherwise missed if I skimmed.

Such was the case with a recent write-up about FastMed Urgent Care implementing Epic. Although FastMed may technically be the first independent urgent care operator to take Epic live, they partnered with HonorHealth in Arizona. It’s unclear what level of partnership is present – is it a joint venture, a resource sharing agreement, or some kind of licensing deal?

The write-up morphs from a report about FastMed into a write-up about a July KLAS report where vendors were rated on their COVID responses. It goes on to quote an anonymous Epic client who says that the efficiency gained using Epic has allowed them to go from seeing 300-400 patients daily to about 1,000. If you weren’t reading carefully, you might think this was about FastMed.

It caught my eye because for an urgent care to make that dramatic leap in volumes, it would require changes in many more systems beyond the EHR, such as staffing, facilities, supply chain, and more. When actually considering information like that, it’s also important to understand the timeframe for that kind of ramp up. It’s unclear why they even included the KLAS report in the piece, but just another example of the sloppy writing that’s out there and why prospects and customers need to remain vigilant.

From Dancing Queen: “Re: resigned employees. I sat on a 1:1 call earlier this week, waiting for someone who ultimately no-showed. There was no response to outreach on Slack or email, and no out-of-office message. Turns out he gave notice around Labor Day and his last day was almost a week ago. This was a C-suite person with an administrative assistant. Why would anyone think it’s OK to leave meetings on the calendar and not notify anyone of his departure?” Unfortunately, not caring about the time of other people seems to be the new normal. I personally experience no-shows all the time, as well as people who arrive late with no notification and no apology. One company I work with has a serious issue with people just ignoring emails. Especially in the world of virtual officing, people need to revisit the ideas of common courtesy and respectful behaviors. I understand companies not doing blast notifications when people leave, but there’s no excuse for not putting on an out-of-office message that directs people to someone who is assuming responsibility for that person’s work. In one past life, we would see a little “x” in the Outlook directory in front of people who had left, but that doesn’t help if you’re an external stakeholder, vendor, or consultant.

Telehealth has become a key part of the care team for many patients and providers, but organizations are still struggling with patient acceptance and technology glitches. Some patients seem to be more receptive than others, for example, those who had difficulty traveling to see a distant specialist or those who have difficulty taking time away from work for appointments. Others may not have the technology needed to do a visit well or may be uncomfortable discussing certain issues at home versus in the privacy of the physician’s exam room.

Now that the initial pandemic-driven pressures for telehealth services have slowed, organizations are starting to rethink their strategies. Maybe they have outgrown the quick and dirty solutions they initially deployed, or maybe they’ve realized that the vendor they chose didn’t offer all the features they need to be successful.

Organizations that are trying to move beyond the urgent care and immediate care constructs are looking for more robust technology that includes elements like remote monitoring or enhanced triage abilities that help streamline the physician portion of the visit. One consistent request I’ve heard in talking with CMIO friends is the ability to have multi-party conversations, such as with the patient and children or caregivers who may be remote not only due to distance, but due to potential quarantine or isolation. Having everyone virtually on the same page can cut down on the post-visit interactions that providers sometimes have to conduct to make sure everyone has the same information.

Others are looking for solutions that will allow multiple providers, such as a multidisciplinary care team, to see the patient at once. These integrated teams are often used for pediatric patients with complex medical problems that require follow up from a variety of subspecialists, to avoid having families travel multiple times to tertiary care centers. This is also important for patients who need translation and interpretation services.

EHR integration is also an ask, especially for those that implemented lightweight, standalone systems. Providers don’t like having to use multiple systems and screens to access data and document while they’re seeing the patient. It will be interesting to see what the provider-based telehealth market does over the next year, as well as how things turn out for direct-to-consumer applications.

Since no one hangs out in the actual physician lounge anymore (thanks, COVID), we’ve moved to virtual forums to try to stay connected. I’m part of multiple physician and provider groups that are trying to keep each other updated on not only COVID-related happenings, but other healthcare issues, while trying to bolster our communal morale. One of the hottest topics recently has been the future availability of a vaccine for the novel coronavirus and speculation on how complicated the process will be for its distribution. We’ve been collectively pleased that vaccine manufacturers seem to be holding the line against political pressures for a premature release and that CEOs have frankly contradicted the White House’s claim that manufacturers were pushing back against FDA guidelines.

Manufacturers have plenty of skin in the game and can’t afford to rush a vaccine to market only to have it go wrong in the field. We’ve all seen those examples of drugs released without adequate testing (Vioxx, anyone?) that have come back to haunt patients, providers, and manufacturers alike. As a front-line provider, the decision to take an available vaccine is not insignificant. FiveThirtyEight put together some thoughts from vaccine professionals on how we might know when a vaccine can be trusted. Here are the best nuggets:

• Don’t get your vaccine advice from politicians or pharmaceutical companies.
• Trust independent scientists and medical professionals.
• Look at information from FDA reviews.
• Be skeptical of anything released before year-end.
• Trust experts who are straightforward about the limitations of potential vaccines.

No one wants to get back to normal more than the healthcare providers who are in the trenches dealing with COVID and its fallout. Everyone is tired in a thousand different ways. Our hope is that people will learn to wear masks properly and consistently, that people will be vaccinated when a safe and effective one is approved and available, and that everyone will show patience and grace while all this is going on.

What’s the best example of grace under pressure you’ve seen during the pandemic? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 10/8/20

Audacious Inquiry Expands Leadership Team and Board of Directors

Transitions of care software vendor Audacious Inquiry secures growth equity financing from lead investor TTCP and bolsters its C-suite with three new executives.

UCSF, Fortanix, Intel, and Microsoft Azure Utilize Privacy-Preserving Analytics to Accelerate AI in Healthcare

UC San Francisco’s Center for Digital Health Innovation partners with Intel, Microsoft Azure, and confidential computing vendor Fortanix to develop technology dedicated to the development and validation of clinical algorithms.

Cerebral Raises $35 Million to Expand Online Mental Health Care to All 50 States

Membership-based mental health telemedicine and prescription delivery startup Cerebral raises $35 million in a Series A funding round, which it will use to expand its services to all 50 states by the end of the year.

Avail Medsystems Raises $100 Million in Series B Funding Led by D1 Capital to Meet Demand for Procedural Telemedicine™ Technology for the Operating Room

Avail Medsystems, which specializes in telemedicine software for the operating room, raises $100 million in a Series B round led by D1 Capital Partners.

Morning Headlines 10/7/20

Harris moves into Australia with the acquisition of Meridian Health Informatics

Harris acquires Australia-based Meridian Health Informatics, which offers maternity and clinical solutions.

Columbus health IT startup PriorAuthNow raises $10M

Prior authorization software startup PriorAuthNow raises $10 million, bringing its total raised to $32 million since launching in 2014.

Clover Health, a Next-Generation Medicare Advantage Insurer, Announces Plans to Become Publicly-traded via Merger with Social Capital Hedosophia

Medicare insurance plan operator Clover Health will go public through a merger with Social Capital Hedosophia Holdings, giving it a valuation of $3.7 billion.

Abridge, now and in the future: Announcing new product changes and our latest round of funding.

Consumer-facing healthcare encounter software startup Abridge formally launches with a $15 million Series A funding round led by Union Square Ventures and UPMC.

Statement from Universal Health Services

Universal Health Services confirms it has completed the recovery process for servers at its corporate data center, and that all of its US-based inpatient facilities have been reconnected.

News 10/7/20

Top News

Harris acquires Australia-based Meridian Health Informatics, which offers maternity and clinical solutions.

Harris says its strategic growth plan calls for more acquisitions in Australia.

Canada-based N. Harris Computer Corporation, which operates as Harris under Constellation Software, operates 18 acquired health IT brands that include Amazing Charts, Iatric Systems, IMDSoft, Picis, and QuadraMed.

Reader Comments

From Pointy Skull: “Re: health IT podcasts and video versions of podcasts. Can you review this one?” I could, but I’m a written word, short attention span kind of guy who values conciseness and weeding out pointless fluff and would thus vastly prefer a skimmable transcript or excerpted high points (if, indeed there were any). Podcasts and videos are fine for entertainment or where a picture is worth 1,000 words, but just watching an undisciplined and / or un-insightful presenter rambling away on a screen drives me crazy. But then again, I’m often critical of industry folk whose books, presentations, or writings seem to fall short on either effort or ability.

From Usurious Rates: “Re: Hims and other vanity prescription-writing companies. Are they telehealth?” They don’t seem like it to me. Companies that sell prescription-only products related to hormones, sex, hair, or skincare by hiring doctors as prescription-writing robots are just exploiting human weaknesses — impatience, vanity, and embarrassment — in allowing customers eschew actual medical advice in favor of getting a quick prescription for whatever they’ve decided they want. I bet 98% of people who are “evaluated” by these sites end up with a prescription that creates no harm, raising the question of why the drug is prescription-only in the first place. I’m really skeptical about Hims getting into the anxiety and depression telehealth business.

HIStalk Announcements and Requests

RIP rock legend Eddie Van Halen, who died of cancer Tuesday morning at 65.

Webinars

October 28 (Wednesday) noon ET: “How to Build a Data-Driven Organization.” Sponsor: Newfire Global Partners. Presenters: Chris Donovan, CEO and founder, Adaptive Product Consulting; Harvard Pan, CTO, Diameter Health; Jason Sroka, chief analytics officer, SmartSense by Digi; Jaya Plmanabhan, data scientist and senior advisor, Newfire Global Partners; Nicole Hale, head of marketing services, Newfire Global Partners. The panel of data experts will discuss the opportunities that data can unlock and the challenges involved with becoming a data-driven organization. Attendees will learn why having a data strategy is important; how to collect, manage, and share data with internal and external audiences; and how to combat internal resistance to create a data-driven culture.

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

Acquisitions, Funding, Business, and Stock

Rock Health’s latest analysis shows that 2020 is already the largest funding year ever for digital health, with $4 billion invested in startups during Q3, for a total thus far of $9.4 billion. On-demand healthcare services like telemedicine, prescription delivery, and at-home urgent care have seen the most attention, with 48 deals totaling $2 billion.

Medicare insurance plan operator Clover Health will go public through a merger with Social Capital Hedosophia Holdings, giving it a valuation of $3.7 billion. The company, which also offers clinical decision support software, inked a deal with Walmart Health last week to offer its Medicare Advantage plans to patients in Georgia.

Sales

• The Chesapeake Regional Information System for our Patients (CRISP), Maryland’s statewide HIE, selects patient engagement technology — including secure access to COVID-19 testing results — from Get Real Health.

People

Remote patient monitoring company WithMyDoc hires Frank Astor, MD (Naples Community Hospital Healthcare System) as chief medical officer.

Shandy Guharoy (Evolent Health) joins healthcare and social services referral software vendor Unite Us as CTO.

Announcements and Implementations

New Jersey Urology becomes the first large, independent urology group to implement Epic.

San Luis Valley Health (CO) implements Meditech with consulting help from Engage.

Phelps Health (MO) rolls out Epic.

A new KLAS report on team-shared mobile devices for nurses and other care team members finds that hospitals like the IPhone because it is solid and integrates will with Epic, Meditech, and Mobile Heartbeat; the ruggedized Zebra TC51-HC is heavy and expensive but allows hot-swapping batteries and can be used for barcode scanning and taking photos; and the Vocera Smartbadge has very strong software and security that is used primarily for push-to-talk conversations and texting. Spectralink and Ascom have not been able to regain the market share they lost from their early devices that were heavy and featured small screens.

Government and Politics

Defense Health Agency Director Lieutenant General Ron Place congratulates sites in California and Nevada on their MHS Genesis go-lives, part of the DoD’s Wave Nellis launch in late September. The next wave of go-lives – the department’s third – will happen next month.

COVID-19

The White House rejects the FDA’s higher standards for the safety and effectiveness of a COVID-19 vaccine after it says drug companies complained and the new standards would delay release until after Election Day. FDA says it has not heard those concerns from drug companies and all but one of the companies in the vaccine race have expressed their support for FDA’s guidance in the interest of bolstering public confidence. Pfizer’s CEO went on record Tuesday morning as saying the company has not discussed FDA’s guidelines with the White House. FDA says it will move ahead with the stricter standards. UPDATE: the Wall Street Journal reported Tuesday afternoon that the White House has dropped its objections and will sign off on FDA’s toughened guidelines that call for companies to monitor recipients for two months before requesting FDA’s Emergency Use Authorization.

CDC republishes its previously withdrawn warning that coronavirus can spread via airborne droplets at distances greater than six feet and linger in the air for minutes or hours, especially in poorly ventilated areas. It stresses, however, that most spread occurs from close contact with someone who is infected. The information was accidentally published to CDC’s website a few weeks ago before it had been approved and was then removed.

The White House will not perform contact tracing on attendees of the Rose Garden celebration 10 days ago that has infected at least eight people. Meanwhile, New Jersey health officials scramble to perform contact tracing of the 206 people who attended President Trump’s fundraiser at his golf club there on Thursday, for whom the Republican National Committee provided only email addresses without phone numbers or physical addresses. That event was held after White House aide Hope Hicks had tested positive, meaning everyone who had been in close contact with her for more than 15 minutes should have been self-isolating for 14 days.

Public Health England’s use of Microsoft Excel for COVID-19 test results compilation causes 16,000 cases to go unreported. PHE’s developers chose the old .XLS file format (which was replaced by .XLSX in 2007) for converting the CSV files of commercial labs, unaware that its limit of 65,536 rows would allow a single file to truncate rows after hitting around 1,400 cases.

Salesforce announces Work.com for Vaccines, and end-to-end vaccine management system for governments and healthcare organizations that includes a public health command center, inventory management, appointment scheduling, outcome monitoring, and public health notifications.

Other

Universal Health Services confirms it has completed the recovery process for servers at its corporate data center, and that all of its US-based inpatient facilities have been reconnected. The company was the victim of a cyberattack last week that impacted all 250 of its US facilities.

A former New York City hospital IT employee is sentenced to 30 months in prison for installing a keylogger program on the computers of 70 workers, most of them female, to steal the login credentials for password-protected personal accounts, photos, documents, and tax records. The unnamed hospital spent $350,000 to remediate the resulting network damage.

Sponsor Updates

• The local news features CI Security’s Drex Deford’s analysis of the Universal Healthcare Systems breach.
• Frost & Sullivan recognizes CoverMyMeds with its 2020 North American Product Leadership Award for Prior Authorization Solutions.
• TransformativeMed will combine its clinical communication and collaboration software with clinical decision support from Crossings Healthcare Solutions.
• Business Group on Health honors Cerner with its Helen Darling Award for Excellence in Health Care Value and Innovation.
• Elsevier Senior Director for Scientific Services for R&D Solutions Matthew Clark wins bronze in the VHA Innovation Ecosystem and precision FDA COVID-19 Risk Factor Modeling Challenge.
• Everbridge announces the 4^th Annual Critical Event Management Impact Awards recognized the innovative use of its technology for mitigating the impact of COVID-19 and other crises in 2020.
• Registration is now open for Experity’s Virtual User Experience half-day conference on October 15.

Blog Posts

• Interoperability for the 21st Century Cures Act Era (314e)
• All claims management isn’t created equal: what you should know (Ability Network)
• Reflections on the History of the Patient Unified Lookup System for Emergencies (PULSE) (Audacious Inquiry)
• The Impact of COVID-19 on Hospital Readmissions (CarePort Health)
• Meditech Patient Portal: Are you missing out on engagement tools you already own? (CereCore)
• Leveraging Real-Time Data to Reduce Unnecessary ED Utilization (Collective Medical)
• Community Partnerships Enrich Student Learning (CoverMyMeds)
• Reflections on the Virtual St. Jude Walk/Run Boston 2020 (Dimensional Insight)
• Cerner is Advancing the Health Care Data Revolution (Cerner)
• Meet the Dina Team at HLTH! (Dina)
• Surviving COVID-19: Telehealth and Beyond (EClinicalWorks)

Contacts

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