Morning Headlines 1/18/21

More executive shakeup at Cerner: Two top leaders leaving Kansas City-based company

Cerner announces that Chief Client and Services Officer John Peterzalek and Chief Legal Officer Randy Sims will leave the company.

Ex-Obama official who helped fix botched healthcare.gov rollout to join Biden’s Covid-19 team

Former Acting CMS Administrator Andy Slavitt, who was previously CEO of OptumInsight and more recently founder of non-profit United States of Care, will take a temporary role as advisor the President-elect’s COVID team.

Fast-Growing Oncology Startup OncoLens Secures $7.25 Million Series A Funding

OncoLens, a software developer focused on care treatment planning for cancer patients, raises $7.25 million in a Series A funding round.

Monday Morning Update 1/18/21

Top News

Cerner announces that Chief Client and Services Officer John Peterzalek and Chief Legal Officer Randy Sims will leave the company. They will be replaced by Cerner Government Services President Travis Dalton and SVP of Cloud Strategy / Chief IP Officer Dan Devers, respectively.

Cerner Chairman and CEO Brent Shafer said in the internal announcement that the company’s annual client survey results require a greater sense of urgency in strengthening relationships, delivering on promises, innovating faster, and executing on strategies.

HIStalk Announcements and Requests

Most poll respondents don’t have a significant chunk of their net worth invested in health IT company ownership.

New poll to your right or here: For those who have worked for a company or healthcare organization that was acquired, how was your job afterward? I’ve mostly worked for big health systems that were the acquirer, which worked out well for me. My job also didn’t change much during my stint with a bottom-feeder vendor whose series of owners couldn’t wait to pawn it off on someone else like a gas station Christmas fruitcake, but only because (a) it wasn’t that great of a job to begin with; (b) I was somewhat safe as a clinical-technical subject matter expert who was happy to keep my head down while the mahogany row battles were being fought above me (literally and figuratively). My sense is that having your company acquired for unfavorable terms brands you with the collective stench of your previous employer’s failure, while those who actually captained the ship into the iceberg elbow women and children aside in fleeing for the corporate lifeboats.

The suddenly overused word that I’m sick of hearing: all forms of “lean,” including lean in, forward-leaning, left- or right-leaning, and leaning into. Unless you’re talking about someone who is unsteady on their feet, a carburetor, quality improvement, the director of “The Bridge on the River Kwai,” or that tower in Pisa, better word choices are available.

Webinars

January 28 (Thursday) 12:30 ET: “In Conversation: Advancing Women Leaders in Health IT.” Sponsor: Intelligent Medical Objects. Presenters: Tabitha Lieberman, SVP of clinical and revenue cycle applications, Providence St. Joseph Health; Ann Barnes, CEO, IMO; Deanna Towne, MBA, CIO, CORHIO; Amanda Heidemann, MD, CMIO, CMIO Services, LLC. IMO CEO Ann Barnes brings together a panel of female health executives for a results-oriented discussion on how managers and C-suite executives can address diversity and inclusion in their organizations. From STEM education to mentoring and networking, the “COVID effect” on women in the workplace, to matters of equity, there’s no better time to talk openly about these issues to help generate meaningful change in healthcare.

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

People

Former Acting CMS Administrator Andy Slavitt, who was previously CEO of OptumInsight and more recently founder of non-profit United States of Care, will take a temporary role as advisor the President-elect’s COVID team. That’s him accepting his “Healthcare IT Industry Figure of the Year” award at the final HIStalkapalooza in New Orleans in 2017, which was right after I interviewed him.

Announcements and Implementations

Healthcare development platform vendor Commure joins the Postman API Network, making its FHIR and authentication APIs available to healthcare developers. Clinical scenarios covered include telehealth, care team management, inpatient medical workflows, and capturing data with forms. Commure’s co-founder and executive chairman is investor Hemant Taneja, who started and sold Livongo, while its CEO is Brent Dover, who was president of Medicity and Health Catalyst. The company has raised $42 million in funding.

COVID-19

Saturday saw 126,139 people hospitalized with COVID-19 in the US, with 3,695 deaths. The death total will pass 400,000 early this week.

CDC says the more contagious B117 coronavirus variant will become the dominant strain in the US by March, which some experts predict will happen even sooner based on UK experience. In addition, the B1351 variant is probably already active in the US and may be resistant to at least one antibody therapy. Former FDA Commissioner Scott Gottlieb, MD says that new COVID-19 cases have likely peaked, but deaths and hospitalizations will continue to grow over the next few weeks as a lagging indicator. 

CDC reports that as of Friday, 12.3 million people have received COVID-19 vaccine first doses versus 31.2 million doses distributed, with less than 40% of available doses actually given.

Operation Warp Speed held CDC’s vaccine distribution plan for two months last summer, leaving state and local officials little time to implement mass vaccination programs. 

HHS imposes term limits on its top few dozen scientists at FDA and CDC, who would face reassignment every five years, in a rule that the new administration is likely to cancel.

Sponsor Updates

• OptimizeRx promotes Kennedy Whitney to marketing coordinator.
• D CEO and Dallas Innovates recognizes Phynd Technologies CEO Tom White as a finalist for their Start-Up Innovator of the Year award.
• KLAS Research recognizes Relatient as the highest rated patient engagement platform with 10 validated capabilities.
• Everest Group names Nordic a “Leader” in its “Healthcare IT Services Specialists PEAK Matrix Assessment 2021.”
• Spirion introduces its Customer Marketplace, an online hub for third-party data privacy and security integrations, applications, best practices, and training information.
• TriNetX will present during the Friends of the National Library of Medicine’s virtual workshop January 27 on real-world data and EHRs in clinical research.
• Well Health joins the Children’s Hospital Los Angeles’ KidsX digital accelerator as part of its initial cohort.

Blog Posts

• Inference Analytics Advanced Neural Network generates impressions based on radiologist findings (Nuance)
• American use of the EHR: What can we learn from others? (Nordic)
• Will 2021 be the Year of the Digital Health Platform? (PatientBond)
• When Plans Change: Lessons for Business Leaders from the Pandemic (PatientKeeper)
• Patient Simulators: Innovation Through Necessity (PMD)
• Five Issues Limiting the Vaccine Rollout – and How to Fix Them (Premier)
• The ABCs of healthcare IT (a vocab sheet) (Redox)
• The COVID-19 Vaccine Has Arrived: Here’s How Relatient is Helping (Relatient)
• A Nurse’s Greatest Fear, Part 2: Giving Clinicians Greater Insight & Improving Patient Safety Outside of the ICU (Capsule Technologies)
• 8 steps to take in the event of a data breach at your hospital (Spok)
• Thriving in a Virtual Work Environment (Summit Healthcare)
• Empowering Patients with Another Relationship They Can Count On (Surescripts)
• Interview / AI Research Insights (Visage Imaging)
• Revenue Cycle 101: Prior Authorization (Waystar)
• Beat the Heat: How to Fight Burnout in Your Rehab Therapy Practice (WebPT)

Contacts

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

Katie the Intern 1/15/21

Hi, HIStalk! I hope you’re well and that January is treating you just fine! I wanted to take the time to say thanks for reading my posts. I am learning fast!

This column is based on an interview with Natalia Southerland, MD from Brand New Med, PLLC. Dr. Southerland serves part-time at Crossover Health and is president of Brand New Med, PLLC in Texas.

I interviewed Dr. Southerland to discuss how primary care is changing, as well as how COVID-19 has impacted her as a provider. Dr. Southerland became a doctor to serve the underserved and to provide access to healthcare to everyone, particularly as an African American provider.

“Just trying to get people who are usually ignored by the system, trying to provide them quality care, has always been my goal,” Dr. Southerland said.

Dr. Southerland expanded her interest in medicine to wellness, as she is a sports-oriented and wellness-focused person and doctor. Initially interested in surgery, she focused her efforts on a more rounded approach to medicine alongside the ability to interact with patients, moving into family practice. She said inspiring people to take wellness into their own hands is important. She started Brand New Med to do just that.

“What was really missing for me was the ability to really spend time with people, and to really educate them about what was going on with them,” Dr. Southerland said. “I really wanted to serve people and get to the basis of chronic disease instead of just prescribing medication for chronic disease.”

Brand New Med combines a variety of wellness-centered treatments and services to inspire health protection and prevention. Movement and exercise, mental health and mindfulness work, sleep help, and relaxation are pivotal points in care that Brand New Med works towards. Dr. Southerland said that Brand New Med provides services that allow people to understand that they are more in control of their healthcare than they know.

Brand New Med had to adapt to COVID-19, just as primary care has also had to face the challenges the pandemic brought to light. Dr. Southerland said COVID has taken healthcare somewhere completely different than wellness. Healthcare is healthcare, she said, the treatment of illnesses. But wellness is the focus on feeling good, and that became harder to implement when a pandemic is looming over everyone’s head.

“I ended up actually moving my practice. My goal now is to help people really focus on the things that are going to keep them well,” Dr. Southerland said. “And putting together a program so people feel comfortable coming to the doctor not simply for sick visits, but for those visits that are going to keep them well.”

Providing wellness care virtually was a challenge, but learning how to adapt a wellness-centered healthcare space was not going to slow Dr. Southerland down. People were eager to do virtual visits, and the rare few took advantage of coming into a mostly empty office.

Dr. Southerland took this time to teach patients that if they have a particular medical condition, they can take charge of that at home. For example, a patient who has high blood pressure should keep a cuff at home and watch their pressure and learn to respond to it. Caring for patients from a virtual standpoint is easier when patients can gather information themselves at home, she said. Inspiring people to take control of their own healthcare will help the prevention of disease versus treatment of it become the new norm.

COVID-19 has changed the direction that both healthcare and healthcare IT are moving in general. Just as Brand New Med had to be moved and goals had to be changed, Dr. Southerland said the technology used to reach and treat patients was of utmost importance through the pandemic, and continues to be. Staying in contact with people through the pandemic was more important than ever, Dr. Southerland said.

“Using an EHR to send out mass messages to people, what information I got recently from the department of health, or information about where they get vaccines,” Dr. Southerland said. “Being able to contact them from that standpoint.”

Digitally contacting people is only one step in the evolution of primary care, as each day our internet-driven world becomes more entangled in the application of healthcare. Dr. Southerland believes there is catching up to be done in the healthcare IT industry, as she provided digital care during her time at the National Health Service back in 1995.

“It’s funny that COVID had to come to make it [digital care] the normal, or to make insurance feel that now it is OK to pay for it,” Dr. Southerland said. “I think this should become the new norm, and I think as we get better at making patients independent and giving them things that are going to help them help us diagnose them, then it is going to be better.”

The drawbacks to digital care are the obvious lack of physical examinations, but moving towards value-based, digital care can help build relationships in ways we might not have imagined. Dr. Southerland said a large part of the problem in moving towards value-based care is insurance payments, as doctors make more income when four people come into an office versus one person for an hour-long visit. But by moving to value-based care and instilling patient wellness, digital check-ins will become the new normal and new relationship between patients and providers.

“Moving to value-based care is valuable, but value-based care has to be couched into where you actually spend time with the patient to do what you need to do or have the ability to educate the patient in a way that the patient is actually going to become an independent healthcare provider and not dependent on the healthcare system,” Dr. Southerland said. “That relationship of not going back and forth, that has to be established.”

Dr. Southerland and I also talked about technologies that have helped her provide care during the pandemic, and where she hopes that tech will go. She mentioned the importance and ease of having a good EHR, and the ability for an EHR to change over time. Having communications, appointment making, video visits, payments and more all in the same place has been extremely beneficial throughout the pandemic, she said.

Other improving and useful technologies include wearable apps for monitoring blood sugars and other information will also be the future of helpful tech, Dr. Southerland said. Proactive care versus reactive care will benefit patients and providers alike, and technology can and will continue to help fill those gaps.

“Anything that is going to help the patient provide us with more information to diagnose and treat or to follow their condition is going to be a lot more helpful,” Dr. Southerland summarized. Any technology that allows for interaction with the patient, or allows group visits, etc. will be the future of primary care.

That is it today, HIStalk!

Katie The Intern

__________

TLDR: Dr. Natalia Southerland of Brand New Med, PLLC talks services and how COVID-19 impacted primary care in general. She believes moving towards value-based care is important but instilling overall patient wellness will help VBC become the new normal. “Really helping people to change their behavior is what is going to change the course of not just chronic disease, but primary care as well.”

Weekender 1/15/21

Weekly News Recap

• Health and technology leaders, including Epic and Cerner, announce their participation in the Vaccination Credential Initiative, which hopes to provide patients with digital proof of their COVID-19 vaccination.
• QGenda acquires Shift Admin.
• Walgreens announces plans to develop an extensive customer engagement, care integration, and health marketplace platform.
• Flo settles FTC charges that it shared the ovulation data of 100 million users with Facebook, Google, and other companies while telling them it was keeping that information private.
• AdventHealth says its replacement of Cerner, Athenahealth, and Homecare Homebase will cost $660 million.
• Federal prosecutors say that Theranos destroyed its laboratory information system database that it had hoped to use to prove fraud and use of unreliable tests.
• ONC releases United States Core Data for Interoperability Draft Version 2 for public comment.
• Central Logic acquires Acuity Link.
• Tech-enabled Medicare Advantage insurer Clover Health begins trading on the Nasdaq in a reverse merger with a SPAC that values the company at $7 billion.

Best Reader Comments

It’s kind of absurd that you’re talking about robotic process automation as an innovation. Using computers to automate navigation and administration of our bloated regulatory structures is not innovation. It doesn’t help patients or improve care in any way. It only helps organizations improve their bottom line. The best innovation we could unleash would be to adopt a single payer healthcare system. Innovation should be focused on improving care, not doing paperwork. (Elizabeth H. H. Holmes)

In my opinion, workflow design (and of course system design) questions are often difficult conceptual problems, and they take a good deal of focused thought to come up with a sensible answer. Confounding the problem is the fact that a good design, once clearly laid out, is deceptively easy to follow and understand, leading to the mistaken idea that it was equally easy to come up with. Thus people don’t generally have an adequate appreciation for the task of design. Thus they sometimes aren’t prepared to devote the time and focus actually required. As my high-school English teacher used to tell us: “Anyone can take a simple problem and make it complicated. It takes a genius to take a complicated problem and make it… anyone? anyone?” (Clustered)

Watercooler Talk Tidbits

Readers funded the Donors Choose teacher grant request of Ms. K in Illinois, who asked for several books for her elementary school class. She reports, “These books have been such a wonderful addition to our classroom library. They are so popular that I cannot keep them on the shelves and students eagerly wait for their classmates to finish the next book in the series. While it previously felt like a struggle to get some of my students to read, now, nearly every student in my class is found reading whenever they get a chance. When students finish their work before others, they take out their book and read. When students need to take a short break from instruction, they take out their book and read. When students go home at the end of the day, they take out their book and read. These books have made such a positive change to our classroom, and it would not have happened without your help.”

Microsoft patents a “Black Mirror”-like process of turning data about a person – even a dead one – into a chatbot that includes a 3D rendering, a voice, and the trained ability to converse like that person.

The family of a nursing home patient who was allowed to install a security camera in his room to monitor his care captures him dying after his oxygen cannula dislodges. The footage shows the 80-year-old patient, who was infected with COVID-19, gasping for air just after 4 a.m. after not being checked for nearly four hours and with a nurse call button that was draped over the bed railing where he couldn’t reach it. His daughter noticed his situation, but her calls to the facility were not answered and nobody came to its door when she frantically showed up in person.

Two Chicago-area broadcasters launch a podcast that covers the history of Edgewater Hospital, which was built as a high-end facility in 1929 for patients like Frank Sinatra, was the birthplace of Hillary Clinton and serial killer John Wayne Gacy, and then was closed in 2001 after its management company and some of its doctors were caught running a massive fraud scheme. The hospital became a popular destination for urban explorers who found the interior to be intact from the moment the doors were closed until it was mostly torn down in 2017.

A new nurse in North Carolina has photos taken with her 98-year-old great-grandmother, who graduated from nursing school in 1942.

The director of performance improvement at Ascension St. John Medical Center runs 46 miles from another Ascension hospital in a 10-hour tribute to “nurses and the marathon they run every day.” Wyatt Hockmeyer gave out 85 medals to healthcare workers in the two hospitals on behalf of Medals4Mettle, which awards medals that have been donated by endurance athletes to those who are fighting serious illness.

In Case You Missed It

• News 1/15/21
• EPtalk by Dr. Jayne 1/14/21
• Readers Write: Healthcare Must Embrace Innovation Beyond the Pandemic
• HIStalk Interviews Brian Schmitz, CEO, Clinect Healthcare
• News 1/13/21
• Curbside Consult with Dr. Jayne 1/11/21
• HIStalk Interviews Drex DeFord, Healthcare Strategist, CI Security
• Monday Morning Update 1/11/21
• Katie the Intern 1/8/21

Get Involved

• Sponsor
• Report a news item or rumor (anonymous or not)
• Sign up for email updates
• Connect on LinkedIn
• Contact Mr. H

Morning Headlines 1/15/21

Broad Coalition of Health and Technology Industry Leaders Announce Vaccination Credential Initiative to Accelerate Digital Access to COVID-19 Vaccination Records

Health and technology leaders announce the Vaccination Credential Initiative, which hopes to provide digital access to COVID-19 vaccination records using the open SMART Health Cards specification.

Healthcare Specific AI Platform Lumiata Raises Series B Funding

Lumiata – which applies AI to 120 million patient records to predict patient outcomes, clinical costs, and risks for providers and payers – raises $14 million in a Series B funding round.

Healthtech firm Accolade is buying telemedicine start-up 2nd.MD for $460 million, sources say

Health benefits navigation company Accolade acquires 2nd.MD for $460 million to offer its users easier access to second opinions.

QGenda Acquires Shift Admin

Provider and resource scheduling system vendor QGenda acquires Shift Admin, which offers shift-based specialty scheduling for emergency medicine, urgent care, and hospital medicine.

News 1/15/21

Top News

Health and technology leaders announce the Vaccination Credential Initiative, which hopes to provide digital access to COVID-19 vaccination records using the open SMART Health Cards specification.

Individuals could obtain an encrypted digital copy of their immunization credentials to store in a digital wallet or could receive a paper form containing a QR code.

The goal of the initiative is to connect to The Commons Project Foundation’s CommonPass, which is being used for travel and return-to-work vaccine verification.

Participants include CARIN Alliance, Cerner, Change Healthcare, The Commons Project Foundation, Epic, Evernorth, Mayo Clinic, Microsoft, Mitre, Oracle, Safe Health, and Salesforce.

Reader Comments

From Assign Me Up: “Re: email updates. Please enroll me at this new address and remove the old one.” I’ve been remiss in not providing self-service email signup instruction reminders in many months, so here’s a refresher:

• Sign up for updates here or using the “Subscribe to updates” menu option under Contact (desktop format) or the “Get email updates” menu option (mobile format).
• Watch for the verification email that follows since it may end up on your spam folder and you’ll receive no further emails unless you confirm this one.
• Review your email rules, whitelist, company email server setup, etc. if you aren’t receiving the emails you signed up for. The automatic sending of the emails is highly reliable, but the receiving of them is much less so and is not something I can control (spam tools have eliminated the reliability and timeliness of email delivery, unfortunately).
• Unsubscribe your old address by clicking the ‘”unsubscribe” link that is at the bottom of each email. Or, do nothing since your inactive old address will cancel itself even if you do nothing.
• Reminder: I do absolutely nothing with the email addresses, so all you’ll get as a result of signing up is a notice that I’ve posted something new. I collect only the actual email address itself, don’t use those addresses for anything else, and don’t make them available to others.

From Clog Queen: “Re: HIStalkapalooza shoe contest. I think that in these challenging times (don’t all emails start with that phrase these days?) you should do a virtual version.” Certainly the shoe contest would virtualize better than most conference components since judges would just need to review photos, perform their deliberations, then announce the winners. I bet closets are full of low-mileage yet stylish zapatos since they add no value to a Zoom call.

From Dunning Notice: “Re: HIMSS21. Are you doing a booth this year, assuming the conference goes on?” No. It’s been nice in the past to have a place to say hello to readers on the show floor, but it’s not worth the several thousand dollars that a microscopic 10×10 foot space costs when I have nothing to sell that would offset that personal expense. I’ll probably (not certainly as of yet) be treading the thick exhibit hall carpet as a paying attendee, using my HIMSS20 registration rollover, if HIMSS21 happens. Thank goodness I ended HIStalkapalooza in its 10th iteration at HIMSS17 since I would have faced financial Armageddon otherwise from the cancelled HIMSS20.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor PatientBond. The Salt Lake City company applies consumer insights and innovative technologies to digital patient engagement. Its Digital Health Platform uses a proprietary psychographic segmentation model that allows health systems, urgent care facilities, and medical practices to personalize messaging and digital channels to each individual’s motivations and preferences, supporting market share growth (patient acquisition and loyalty, service line marketing, and social reputation management);  improved patient outcomes (closing care gaps, improving medication adherence, and automating care coordination); and increased patient payments (reminders, online payments, digital statements, and card-on-file messaging). The cloud-based, API-driven platform requires no training, no software to install, and offers easy integration with most CRM, EMR, and PM systems. Discover which of its five psychographic segments you fit in as a patient by answering a 12-question survey. Thanks to PatientBond for supporting HIStalk.

Thanks to the 2,000 folks who completed my once-yearly reader survey. Resultant factoids:

• 94% of respondents say they have a higher appreciation for companies they read about in HIStalk, while 82% have a higher appreciation for HIStalk sponsors.
• 94% say that reading HIStalk helped them perform their job better in 2020, which is a relief since that’s my most-valued metric.
• I’ve emailed the winners of $50 Amazon gift cards who were randomly drawn from participants. Thanks to all who completed the survey.

Webinars

January 28 (Thursday) 12:30 ET: “In Conversation: Advancing Women Leaders in Health IT.” Sponsor: Intelligent Medical Objects. Presenters: Tabitha Lieberman, SVP of clinical and revenue cycle applications, Providence St. Joseph Health; Ann Barnes, CEO, IMO; Deanna Towne, MBA, CIO, CORHIO; Amanda Heidemann, MD, CMIO, CMIO Services, LLC. IMO CEO Ann Barnes brings together a panel of female health executives for a results-oriented discussion on how managers and C-suite executives can address diversity and inclusion in their organizations. From STEM education to mentoring and networking, the “COVID effect” on women in the workplace, to matters of equity, there’s no better time to talk openly about these issues to help generate meaningful change in healthcare.

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

Acquisitions, Funding, Business, and Stock

Provider and resource scheduling system vendor QGenda acquires Shift Admin, which offers shift-based specialty scheduling for emergency medicine, urgent care, and hospital medicine.

Signify Research says the EHR market in Europe and EMEA in 2020 was better than in the US, which declined due to COVID-related financial challenges. It also notes that consolidation is picking up in Europe, with Dedalus acquiring Agfa’s HCIS business, CompuGroup Medical buying parts of Cerner’s non-Millennium assets, and the merger of big Nordics vendors Tieto and EVRY.

Lumiata — which applies AI to 120 million patients records to predict patient outcomes, clinical costs, and risks for providers and payers – raises $14 million in a Series B funding round.

Cerner says in its J.P. Morgan Healthcare Conference investor presentation that it will create a billion-dollar data business in selling de-identified patient data as real-world evidence to drug companies, partly driven by its $375 million cash acquisition last month of Kantar Health.

Walgreens says in its J.P. Morgan Healthcare Conference presentation that it will create a tech-enabled healthcare startup as a “company within a company” that will offer a customer engagement platform, a personalization engine, a care integration platform, and a health marketplace. The company says that neither a digital-only nor a physical-only platform can be successful. It will partner with best-in-class companies as an integrator. The company said in Q&A that it expects to be part of the care team in offering patients real-time information for managing conditions and recommending medication changes to doctors, enabled by the increasing scope of pharmacist practice in some states. Walgreens has seen a 40% jump in pharmacist involvement with medication therapy management. It adds that a patient with multiple chronic conditions is forced to log into multiple apps, a process that it intends to simplify.

NextGen Healthcare’s J.P. Morgan Healthcare deck highlights its December 2019 acquisition of telehealth platform vendor Otto Health for a reported $22 million, after which its virtual visits have increased by 68%, active user count has jumped from 300 to 13,000, and contracted annual recurring revenue has increased from $200,000 to $9 million.

Sales

• Virginia Department of Behavioral Health and Developmental Services chooses Cerner’s EHR for four additional behavioral health facilities. 
• Konica Minolta Japan will use InterSystems IRIS for Health and its HL7 FHIR interoperability capability to connect its devices with other systems, such as the EHR.

Announcements and Implementations

Healthwise announces five Digital Health Programs – for diabetes, cardiac rehab, colonoscopy and endoscopy, orthopedics, and pregnancy and newborn – that allow providers to send education and reminders and receive individual and aggregated analytics to monitor patient progress.

Meditech offers a short-form Quick Vaccination solution that allows hospitals to administer COVID-19 vaccine at high-volume locations and transmit vaccine data to state systems.

Specialty EHR vendor Modernizing Medicine acquires Exscribe, which offers an orthopedics EHR.

A new KLAS report on structured reporting in cardiology finds that Change Healthcare and IBM Watson Health lead in adoption, Epic saw the biggest adoption increase but Cupid still requires a lot of work and is missing some functionality, and customers of Lumedx are frustrated with poor training, support, and development.

Government and Politics

Flo Health settles FTC charges that its Flo Period & Ovulation Tracker app shared user information with Facebook, Google, and other companies while assuring users that it would keep their information private. The company will have its privacy practices independently reviewed and will get user consent before sharing user data. Some members of FTC’s panel dissented parts of the settlement, saying that FTC should have charged Flo with violating the Health Breach Notification Rule that would have required notifying individual users, while Commissioner Noah Joshua Phillips issued a statement saying that simply requiring a company to notify users isn’t worth much if those users have no remedial actions available to them.

A Department of Defense annual review of its MHS Genesis Cerner implementation (thanks to reader Vaporware? for sending the link) finds that:

• MHS Genesis “is not operationally suitable because training remains unsatisfactory, dissemination of system change information is inadequate, and usability problems persist.”
• The system is operationally effective for basic operations in conventional clinics, but not for some specialty clinics and business areas.
• Performance scores increased from 45% of tested performance measures to 78%, with improvements needed in medical readiness, provider referrals, business intelligence, billing, coding, and reporting.
• System usability improved from “unacceptable” to “marginal-low.”
• The project has 158 open high-priority issues.
• Information exchange with required external systems was “sporadic, and the data were sometimes inaccurate and complete.” AHLTA-housed patient allergies, meds, and immunizations didn’t transfer to Cerner 13% of the time and care was sometimes delayed because of the manual reconciliation that was required.
• Cybersecurity experts found the system to be “not survivable in the complex, cyber-contested environment of a major medical facility.”
• Testing has not yet been performed to determine if the system can sustain the expected number of users at full deployment.

COVID-19

US COVID-19 hospitalization numbers dropped a bit on Wednesday, with 130,383 people in hospital beds with COVID. Daily deaths were also below record numbers at 4,022. Hard-hit UK and Ireland, which have high B117 variant activity, also showed a sharply reduced number of cases. CDC reports that 11 million vaccine doses have been administered of 31 million distributed, leaving two-thirds of them sitting unused.

The COVID Tracking Project warns that it will no longer report “recovered” patient numbers since not all states report that number and the term “recovered” has no standard definition and thus is reported in different ways by individual states. It also notes that many people who have had COVID-19 still don’t consider themselves to be free of symptoms.

CDC will require all travelers who are entering the US – including US residents — to show either (a) their negative coronavirus test results from within the previous three days; or (b) proof that they have recovered from COVID-19. Airlines will be instructed to not allow boarding to any passengers who cannot provide the documentation.

China locks down 22 million residents of several cities following a COVID-19 outbreak. The entire country of 1.4 billion people is reporting 109 new cases per day, while the US has that many new cases every four minutes with one-fourth of China’s population.

A Public Health England pre-print study finds that people who have already had COVID-19 are 83% less likely to get it again and are probably protected for at least five months.The researchers note that nobody knows if they can still spread infection to others.

People from Canada and Argentina are traveling on private jets to Florida to get COVID-19 vaccine, taking advantage of the state’s policy to vaccinate anyone over age 64 regardless of residency.

Stormont Vail Health disables its employee COVID-19 vaccine sign-up site after discovering that outsiders were able to sign up for shots using links that employees had shared with them. The hospital will now require those who are being vaccinated to show their badges, which it wasn’t doing before.

The former president and CEO of Canada’s London Health Sciences Centre sues the hospital for $2 million, claiming that he was fired this week for making five trips to the US despite Canada’s ban on non-essential travel across the border. Paul Woods, who is a Canadian citizen who holds permanent resident status in the US, says the hospital’s chief counsel approved his request to visit his daughter and his fiancée in Michigan as long as he self-isolated afterward. The hospital’s board chair resigned the day after the lawsuit was filed, admitting no wrongdoing.

Other

AdventHealth’s replacement of Cerner, Athenahealth, and Homecare Homebase with Epic will cost $370 million in capital cost plus $290 million in operating cost, according to its J.P. Morgan Healthcare Conference presentation. AdventHealth, the former Adventist Health System, says Its first go-live will be in Q4 of this year and the last will be finished a year later. The Florida-based system has 50 hospital campuses in nine states, 2,300 employed physicians, 80,000 employees, and $12.5 billion in annual revenue.

Prosecutors say that Theranos destroyed the SQL database of its laboratory information system when it closed its New Jersey facility in 2018, making its patient records unavailable for use in the federal government’s fraud case. The company paid a firm that was run by an associate of former Theranos COO Sunny Balwani $10 million over seven years to administer the database. Theranos provided the government with three versions of the backup before the company shut down, but all of them were encrypted with a password that everyone involved claims they have forgotten. Prosecutors hoped to use the database to prove their claims that tests offered by Theranos were unreliable, including one thyroid test whose failure rate was over 50%. The government also asked the court to deny the motion by former Theranos CEO Elizabeth Holmes to exclude what she calls “anecdotal” test results since the company destroyed the database while under subpoena.

A public hospital in China becomes the first to bill a patient using its blockchain-based invoicing system, which allows patients to review their medical and billing records on their phones. 

HIMSS21’s home of Las Vegas, which has the highest unemployment rate of major US metro areas at 11.5%, is taking another hit this week with the move of the Consumer Electronics Show to a virtual format. CES was supposed to be the first event in the $1 billion expansion of the Las Vegas Convention Center, which remains unused. CES expects its show to return in 2022, but most likely in a partially digital form.

Talk about positive patient ID: Denver police arrest the wrong woman for burglary after being told their suspect was an inpatient at St. Joseph’s Hospital, which they confused with Denver Health, where they arrested patient Sarah Cook in her hospital bed. Cook, who is a nurse, spent two nights in jail until police checked surveillance footage and realized that the brown-haired Cook wasn’t the blonde suspect they were seeking. The police department apologized, the officers were suspended for 10 days for failing to positively identify Cook before arresting her, and Cook is suing the police department.

Sponsor Updates

• The United States Park Police and the District of Columbia government will use Everbridge software to provide subscribers with safety, weather, traffic, event, and emergency alerts leading up to and during the presidential inauguration.
• Experity offers updates on state-based COVID-19 vaccine provider enrollment information.
• The HCI Group Chief Digital Officer Ed Marx will speak at the HIMSS Dallas/Forth Worth Chapter’s Annual C-Suite Panel January 29.
• Konica Minolta Japan selects InterSystems IRIS for Health for rapid, FHIR-based data integration for imaging devices.
• Nordic is named a leader in Everest Group’s Healthcare IT Services Specialists PEAK Matrix Assessment 2021.
• Ten health system customers of Kyruus are using its COVID-19 vaccine scheduling capabilities and have booked 100,000 appointments in the first month.
• The local paper profiles the way in which a Medical University of South Carolina student used Jvion’s technology to find patients at risk for COVID complications.
• Meditech offers customers access to its complimentary Quick Vaccination solution to reduce the burden of COVID-19 mass vaccination distribution.

Blog Posts

• Build vs. Buy: Insulin Dosing Software (Glytec)
• Value-Based Care: A 2021 Priority (Halo Health)
• Why Data-Driven Healthcare is the Best Defense Against COVID-19 (Health Catalyst)
• Why Virtual Diabetes Programs Should Be the New Normal (Healthwise)
• COVID-19 has created additional digital identity management challenges in healthcare, Imprivata survey reveals (Imprivata)
• Save the dates: 2021 code system updates at-a-glance (Intelligent Medical Objects)
• Advancing digital health solutions beyond the pandemic (Meditech)
• 2020 Year End Review: Our Most Accessed Patient Experience Resources (Kyruus)
• How COVID-19 Has Changed Healthcare (Optimum Healthcare IT)
• Haven Shuts Down But Disruption Thrives (Loyale Healthcare)
• More Than Just Compliance, EPrescribing Can Reduce Opioid Misuse and Overdose Deaths (Medhost)
• Department of Health and Human Services Extends Public Health Emergency (MWTherapy)
• Top Trends Shaping the IT Industry in 2021 (Newfire Global Partners)

Contacts

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

EPtalk by Dr. Jayne 1/14/21

I’ve been knee-deep in the Consumer Electronics Show the last couple of days. It’s a treasure trove of things you expected to see (smart home accessories, high-tech vacuum cleaners) and some you didn’t (high-tech sex accessories). Still, I’ve seen some cool things, and although some are not 100% healthcare related, they appear to have the potential to deliver solid benefits.

• Abbott predictably showcased its Navica mobile app, which pairs with its BinaxNow COVID-19 antigen testing cards. Its FreeStyle Libre 2 continuous glucose monitoring system may not have received top billing, but could be a game-changer for diabetes patients age 4 and up.
• Ampere offers the Shower Power hydropower Bluetooth shower speaker. It recharges via the water flow and is made of recycled ocean plastic. It’s pricey at $100, but the idea of having your own mini-generator to keep tunes playing is kind of cool.
• Butterfly showed off its handheld ultrasound units that integrate with smartphones for a portable and accessible experience. This would be great for organizations that don’t want to spend the money on traditional ultrasound machines or that need to be able to deploy on the go. I was disappointed to see that some features are only available for IOS devices since Android clearly dominates the world market.
• PenguinSmart offers individualized online speech and language therapy support for pediatric patients. It claims to be the first remote / teletherapy solution to serve developmentally delayed patients who have speech and language needs.
• Samsung offers an AI-powered JetBot 90 robotic vacuum which “identifies messes” and avoids them. Anyone who has ever experienced a pet-related “poopocalypse” with their Roomba knows what a nightmare this can be. Pricing is expected to be upwards of $900, but depending on how bad you’re scarred from past events, it might be worth it.
• Steri-Write is a UV-C sterilization unit that cleans and dispenses ink pens for patients or the public. An article on the device was published in the American Journal of Infection Control in 2020 and the device itself is pretty slick. It’s got a slot on the top for the pen to enter the machine, then it travels on serpentine belts while exposed to UV light. A hands-free dispenser finishes the process. Since our office has the front desk team sanitizing pens with wipes and constantly managing them throughout the office, it would save time and resources.
• Welldoc offers app-driven solutions for management of multiple chronic conditions, including diabetes, hypertension, heart failure, prediabetes, and behavioral health diagnoses. It reportedly can integrate data sets from payers, employers, and providers, but information on the actual solution was light unless you wanted to talk to a rep.

Other offerings include an AI-powered toothbrush (Philips Sonicare) that adjusts intensity based on user-applied pressure and has its own app to track effectiveness. There was also Heatbox: The Self-Heating Lunchbox, but honestly I’d rather have a self-chilling martini shaker that I could stick in the side pocket of my backpack for those particularly challenging days. Med:na from Medipresso is a DNA-driven solution that matches consumers with tea capsules based on their profiles. Not sure about the evidence-based background on that, but I bet someone will buy it. One thing I might consider buying is the Sniffy Personal Dog Trainer App, which is desperately needed by my neighbor since I get to hear her annoying dog barking outside my office window on a daily basis.

Procter & Gamble also featured a smart toothbrush, the Oral B iO. Its companion app provides feedback on brushing and offers tips for improving technique. I always love hearing German engineers discuss things like magnetic drive in the context of a “surprisingly enjoyable brushing experience.” Its AI brushing algorithms were trained with thousands of brushing sessions in the company’s labs.

I wanted to look at wearables and Garmin didn’t really have anything that caught my eye from a running and walking standpoint. Omron showcased its HeartGuide wearable blood pressure monitor that links with its HeartAdvisor app for BP, activity, and sleep monitoring. It also presented its VitalSight remote patient monitoring solution. MySize Inc. won the buzzword bingo challenge with its sensor-based measurement technology that allows for shoppers to have a contactless fit and style experience. They won by using “AI, Big Data, and Machine Learning” in a single sentence.

CES generated about 10x the email I usually receive prior to a HIMSS conference, and it shows no signs of letting up. I flipped through all the promotional emails I received, but if I couldn’t figure out what you were presenting, I didn’t do any further investigation.

The ones that were the easiest to figure out were those with COVID in the pitch. Their offerings were often straightforward, such as thermal scanners and social distancing accessories. Several vendors offered smart masks with various fans, filters, and monitors. Others weren’t COVID related but were clearly identified, such as Nexvoo’s ergonomic office chair with health monitor app. I’ll stick with my Ikea chair (which honestly is the best office chair I’ve ever had) for now.

If I had some advice to offer to the marketing teams that create the email, it would be to at least tell the reader something about the offering. For example, a company I’m already familiar with touted its “AI Powered Platform for Pandemic Response,” but the tagline didn’t really tell me anything, and it was frustrating to try to dig through press releases to see what the new or updated solution really offers. For example, Rise Gardens hit it out of the park with a single sentence describing their modular, WiFi-connected and app-guided indoor hydroponic garden for home use. I knew in less than a second that I wanted to check it out. Font and readability are also important in emails – if your font is unreadably small, everything you have to say is unfortunately a no-go.

Home bathrooms were a hot topic at both Kohler and Toto – touch-free commodes and faucets for the home were featured as a COVID-related solution. Bidet functionality was also prominent, especially with greater awareness of their existence following the Great TP Shortage of 2020. They’re also handy for postpartum and postoperative patients, but a good number of people might not have experienced either of those situations.

I have to admit I was captivated by Kohler’s Stillness Bath, which it describes as “an immersive bathing experience that uses light, water, steam, and aroma to transport you away from the everyday” and to simulate Japanese forest bathing. I’m definitely starting a list of things to purchase if I ever win the lottery.

The CES digital venue continues to remain open through the weekend, so I’ll still be hard at work plugging away through all the emails and the vendors I flagged to visit. Did anyone else attend? What did you think? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 1/14/21

Modernizing Medicine Announces Acquisition of Orthopedic Healthcare Technology Company, Exscribe, Inc.

Modernizing Medicine acquires orthopedics-focused EHR vendor Exscribe.

Developer of Popular Women’s Fertility-Tracking App Settles FTC Allegations that It Misled Consumers About the Disclosure of their Health Data

Period and ovulation tracking app developer Flo Health settles allegations by the FTC that it shared user data with third party marketing and analytics firms without user consent.

Mental health tech firm NeuroFlow raises $20M Series B, led by one of its customers

Mental health monitoring software startup NeuroFlow raises $20 million in a Series B round led by customer Magellan Health.

Readers Write: Healthcare Must Embrace Innovation Beyond the Pandemic

Healthcare Must Embrace Innovation Beyond the Pandemic
By Niko Skievaski

Niko Skievaski, MA is co-founder and president of Redox of Madison, WI.

It’s been said that necessity is the mother of invention. However, I’d say 2020 created a permutation of the adage, especially for healthcare: Necessity is the mother of adoption. The COVID-19 pandemic forced healthcare’s hand to embrace technologies that had been used sparingly, if at all, by many providers. While this sudden burst of adoption was positive, the pandemic showed that years of putting off innovation left many healthcare organizations unprepared to smoothly transition into the use of new technology.

The question is this. Will the innovation adoption momentum continue, or is this newfound appetite for tech solutions a bridge over the troubled water of the pandemic? The optimist and realist in me don’t always agree, but, in this case, they’re on the same page. I believe we’re headed toward not only embracing healthcare innovation, but also establishing a foundation to get ahead of demand. Let’s take a closer look.

How we got here

Few healthcare providers would argue against innovation, but tech implementation has typically been viewed as nice to have, as opposed to need to have. Cost, time, resistance to change, and administrative red tape are just a few of the big reasons a healthcare organization might have avoided adopting a particular technology.

However, some healthcare systems, like Providence St. Joseph, have taken a different approach, and had made huge bets on technology and partnerships in the years leading up to the pandemic. Such organizations have looked for experts outside of healthcare and targeted tech executives from Fortune 500 companies, developed innovative apps and funded startups, and created the necessary infrastructure that positioned them to operate in healthcare’s sudden new reality. Once the pandemic hit, these organizations only had to refine what was already in place, as opposed to scrambling to build from scratch.

Such foresight has proven extremely beneficial for practices transitioning to telehealth, as evidenced in a recent conversation I had with David Elkin, MDiv, PhD, founder and executive director of the Center for Advancement of Youth at University of Mississippi Medical Center. Dr. Elkin pointed out that videoconferencing has also allowed mental health providers to maintain regular visits with patients, which has been especially critical given the immeasurable emotional stress many patients are experiencing during the pandemic, especially those in underserved communities.

Many healthcare providers weren’t as prepared, and they found the pivot to telehealth challenging. That’s why, in March, the Health and Human Services Office for Civil Rights loosened telehealth privacy restrictions to allow customer-facing platforms such as Zoom, Google Hangouts, and FaceTime to be used for telehealth visits. Enforcement of potential HIPAA penalties was suspended for healthcare providers using what the announcement called “everyday communications technologies” to serve patients during the pandemic. Additionally, the Centers for Medicare and Medicaid Services expanded services to include telehealth.

This opened up the opportunity for many doctors to start offering video visits and telehealth visits, and, during the last week of March 2020, telehealth appointments increased 154% compared to the same period in 2019. The Zooms of the world served as an appropriate, quick fix to an emergency situation, but they aren’t likely to be viable, long-term telehealth solutions.

The pandemic also exposed the outdated nature of many legacy solutions, like EHRs. Many EHR systems struggled to quickly digest and share new data with disparate systems, as healthcare organizations experienced a dramatic increase in daily patient visits. Given the many benefits of interoperability during a pandemic, the burdensome interop approaches of many EHR systems were never clearer.

The lesson: Many healthcare organizations are realizing that staying ahead of the tech curve is a necessity, and they will take the steps required to integrate innovation.

The path moving forward

The sudden adoption of technology served healthcare well during the pandemic, as it addressed an immediate need. However, long-term success requires a new approach for how innovation will make the patient’s role easier and more in line with the expectations of living in a digital world.

Expanding telehealth services should be a top priority, especially for providers with patients in underserved and rural communities. It’s also time to refine the patient and provider digital experience. Using the mental health example from earlier, Dr. Elkin points out that there are aspects of an in-person visit that don’t currently translate via video, such as subtle movements and gestures that can offer deeper insight into a patient’s feelings. Reexamining the areas where telehealth falls a little short can help create a richer experience for the patient and empower providers to provide the most comprehensive care possible.

This doesn’t mean that such decisions are easy or inexpensive. However, organizations must create an environment where the innovators (software developers) can easily build and deploy the tools required to enhance telehealth capabilities. If rolled out in the spirit of the regulation, the 21st Century Cures rules are a big step in this direction.

One area of innovation that healthcare providers should give great consideration to is artificial intelligence. While the initial deployment of AI in the provider workflow didn’t take off, robotic process automation (RPA) is showing promise at an administrative level, as hospitals and physician practices are trying to do more with less.

AI is generating revenue and cost savings by taking on tasks like scheduling, benefit discovery, invoice processing, vendor management, and other duties, to free up staff to concentrate on more patient-facing needs. But AI also has the potential for helping value-based care and cost sharing efforts by identifying what each patient costs an organization, then identifying ways to keep them engaged in their healthcare.

Though many healthcare providers have been slow to adopt innovative solutions, the industry has reached a turning point for change. The motivation to implement cutting-edge solutions has never been higher, and there are more creative minds than ever before, standing at the ready to arm providers with the tools necessary to improve care and reduce costs. This preparation and approach will help healthcare further navigate the pandemic and position the industry to make unprecedented progress once things are back to normal — whatever normal may look like.

HIStalk Interviews Brian Schmitz, CEO, Clinect Healthcare

Brian Schmitz is founder and CEO of Clinect Healthcare of Charlotte, NC.

Tell me about yourself and the company.

I have 20 years in healthcare IT and the company is 10 years young. With Clinect Healthcare, practices and health systems can collect, monitor, measure, and act on their patients’ experience throughout the cycle of care, pre-, during, and post-encounter. We provide an integrated mobile-first and fully automated approach for intake, patient-reported outcomes or PROs, and patient experience, as well as provide the tools to gain insight and to act on patient responses in real time.

What kinds of technology solutions have become important during the pandemic?

People ask me, how has COVID impacted your business? I say that it doesn’t matter. How has it impacted our customers’ business and what technology are they asking for that allows us to help them?

As a case in point, one of our intake and PROs customers is expecting to have north of 20,000 new patients during Phase 1B alone. The same customer will see 832 patients today because of the Pfizer vaccine compared to 184 new patients one year ago today. There is a wave of new patients getting ready to descend on practices. We’re talking about the largest scale vaccination attempt in modern history. A positive patient experience for that new patient could translate into a long-term customer, so I recommend measuring their patient satisfaction and giving them a chance to feel important throughout their vaccine journey. Patient acquisition is in play.

But anecdotally, we’re seeing more and more technology interest to measure the efficacy, measure the side effects within the practice, but oversight of those patients is key. Using a PROs type platform where providing the automation, integration, and outreach to follow the journey pre- and post-injection. A learning based on response thresholds is also  important. But the best part is that we have patients’ clinical artifacts — age, chronic conditions, medications, allergies, et cetera — from the EHR. Marrying up those with PROs feedback for analysis is priceless.

Suffice it to say, healthcare systems and practices will need to prepare for high patient volume with COVID and the COVID vaccine. Intake solutions will be convenient with the influx — I get it, we offer it, too — but PROs are critical to drive value-based change and increase revenue. That is true beyond COVID. It is diagnosis- and specialty-agnostic, but that’s the type of technology that we’re beginning to see from a remote patient monitoring perspective within COVID.

How are providers, especially the smaller and less sophisticated practices, managing COVID-required activities such as selecting patients for the vaccine, notifying them, reporting the injection, and following up for their second dose?

There’s a behavior change and heavy lift that’s going on, both within the electronic health record vendors and working with the providers to ensure that we are able to collect new information within the medical record chart and PM system, as well as report those that fit the criteria for that next phase. Working within those confines, and working with the reportability of those systems, is key for the reach-out of bringing those patients back into the practice.

How will the tracking of vaccine side effects work in terms of patient-reported outcomes?

The PROs, the patient-reported outcomes side of it, is driving the need to measure what’s going on. We are finding that there are a lot of unknowns out there as it relates to the efficacy rate of these particular vaccines. Being able to leverage technology to have touch points post-vaccination throughout the first shot — how are you doing, how are you feeling — past the second shot. Identifying side effect information is very important. Healthcare systems and provider practices are just now understanding that this is an important thing to measure, and they’re looking at technology in order to automate that process and to bring information back to them in real time so that they can act on anything or any threshold that is out of bounds.

What is the state of the industry in using patient-reported outcomes to drive follow-up workflow on the back end instead of waiting for them to call with questions or to make another appointment?

Taking a proactive approach and engaging the patient is the key to getting more real-time understanding of what’s happening with the patient. As an industry, we’ve done a decent job of creating point solutions for interacting with your healthcare providers on an administrative level – portals and online scheduling, web payments, and so on. That’s a reactive approach. It’s time for the patient to have the opportunity to have a discussion with their care providers that is a proactive approach into their world. We’ve shaped our platform to do just that. They will engage at the conversation feedback level, where questions can be asked and responses can be acted on, in and out of the examination and the procedure room.

Is the coexistence between EHR vendors and third party solution providers better defined than in years past?

It is. We have great partnerships, from a data integration perspective, with the top PM and EHR companies that are out there, and the working relationship has been great. In fact, with COVID, we’ve formed a strong collaborative with a top EHR vendor and the health system that we worked with to ensure that the integration is in place and the data collection that we are taking is being consumed by the electronic health records in a meaningful way. I think they know where their space is, and they recognize that our solution complements the ability to reach patients both in and out of the office.

COVID has shown how archaic the process is of stacking up patients in waiting rooms or in the checkout line. How well have we used technology to streamline that?

We have advanced it so much over the years because the nature of what we want to learn and collect is changing. Even when looking at COVID, for example, the waiting room has extended into the parking lot and into the cars of the patients. So the timing in which we collect information has shifted. The nature of what needs to be collected has changed.

This has allowed patients to become more comfortable using their devices. We subscribe to mobile-first, and I personally subscribe to the idea that the lowest common denominator of technology is a button click. Being able to provide an easy approach to documenting your health history and your insurance information, your demographics, as well as PRO information that is meaningful, scored and pushed back to the medical record chart has been adopted very well by patients. We’ve seen that over the years and certainly with COVID, it is becoming more and more accepted by patients to fill things out outside of the brick and mortar of a practice.

Is there a software opportunity in the higher abandonment rate of patients who get tired of waiting for their telehealth visit to begin?

There is. When we talk about telehealth, we’re talking about a remote encounter. We need to focus on is making the patient feel as though there’s an extension of that remote encounter. We want to capture information ahead of the visit that will be meaningful for the provider to have. W want to monitor that patient to follow up with the their diagnosis. A solution that can complement a specific telehealth visit allows us to provide more of a holistic approach for the patient, both pre- and post-telehealth visit, for better care overall.

Who will be the driver of tools and processes for that interaction – primary care doctors, hospitals, or insurance companies?

It falls at the provider level. We are seeing a lot of interaction right now with payers that are interested in gaining insight and learning best practices, best techniques that could then be relayed down to their provider base. But there’s a lot of specificity to what PROs provide. With value-based care, it’s going to be very important at the specialty, practice, and health system level to measure their patients to identify the best techniques and best practices that work for us, that we can then also educate the patient on so that they can be more engaged into their care. A healthy patient is a more profitable patient. It gives us an opportunity to measure that at the local level so that they can act, because that is their patient and the relationship is within that patient.

Do you have any final thoughts?

Given the state of technology, as well as the sudden shift where remote and electronic interaction is acceptable and required in some cases, the cycle of care can be even more continuous and less episodic. Sitting in an exam room isn’t the only place where critical feedback can be received any more, but it needs to be simple for patients and easy to access for staff. The use cases with a platform like this are endless.

Morning Headlines 1/13/21

ONC Releases Draft USCDI Version 2 and SVAP Approved Standards for 2020

ONC releases United States Core Data for Interoperability Draft Version 2 for public comment.

Amwell Announces Launch of Proposed Public Offering

Telemedicine vendor Amwell, which raised nearly $750 million in its IPO last September, files paperwork with the SEC for a public offering of 11.3 million shares.

Central Logic Acquires Acuity Link for Intelligent Transport & Announces New Bed Visibility Capability, Advancing Mission to Enable Health Systems to ‘Operate as One’ through Improved Access and Orchestration

Central Logic acquires Acuity Link, a developer of communications and logistics management software for healthcare transportation.

HHS Invests $8 Million to Address Gaps in Rural Telehealth through the Telehealth Broadband Pilot Program

HHS allocates $8 million to the three-year Telehealth Broadband Pilot program, which helps rural providers assess broadband capacity and implement virtual care.

News 1/13/21

Top News

ONC releases United States Core Data for Interoperability Draft Version 2 for public comment.

Reader Comments

From What the HIMSS?”: “Re: HIMSS21. Any idea of how it will look? I hear a hybrid in-person and virtual approach. I’m not sure what that would even look like or if it would be worth my time to attend.” I haven’t heard anything, but I am interested in what readers have heard, especially exhibitors who are usually the first to know. Big conferences seem iffy to me for 2021 given that:

• Our country’s vaccine rollout in a raging pandemic is plodding along, pushing herd immunity  far down the road, and that’s assuming that new virus variants don’t make the situation worse.
• Attendance, presentation, and exhibitor decisions will need to be made fairly soon even as attention and stretched cash are being directed elsewhere because of the pandemic.
• An unknown number of folks won’t be comfortable herding into crammed spaces of unknown ventilation any time soon, regardless of mitigation measures.
• Hospital employees are busy dealing with COVID demands that may or may not end by August.
• It will have been 18 months since HIMSS19 when HIMSS21 rolls around, so the bandwagon effect that has always guaranteed big registration numbers will be diminished.

From Listicle: “Re: Becker’s. Found this on Twitter.” The various Becker’s publications are mostly written by recent college grads (this one from the class of 2020) whose entire job is looking up stuff someone else posted online and paraphrasing it while applying no expertise beyond wordsmithing. Most “news” sites think their readers are too unmotivated to read a story that doesn’t have pictures, so they resort to using irrelevant stock art and photos when everything else is copyrighted by the original source. Adding insult to injury in this case is that the Tweeter declared the swap of the photo of a black doctor with a white one to be racist, failing to notice that the original one isn’t Adekunle Odunsi, MD, PhD either (Google would have saved her some embarrassment). Not to mention that it’s pretty obvious that these are stock photos. Anyway, that’s just how these sites work since news has turned into a zip-bang-pow comic book for people who can’t read more than three consecutive sentences without breaking for a fun video.

HIStalk Announcements and Requests

I might be the only person who didn’t know that several companies sell USB 3.0 flash drives that are equipped with a Lightning plug that lets you move photos off your IPhone, perform automatic backups, stream video, and exchange files with other devices. It’s probably worth a shot at around $40 for 128 GB, even with some user reports of buggy required software, but still frustrating that you just plug MicroSD cards into Android phones while Apple’s lack support for external memory requires after-market gadgets, cords, and adapters.

Listening: The Fly-Bi-Nites, a long-defunct psychedelic band from Atlanta that made the “Found Love” 45 single in 1967, sold 300 copies, then disbanded when its members went to college. Singer and co-writer Greg Presmanes still records occasionally (country music, though, in an interesting pivot) and is a 72-year-old partner in an Atlanta law firm who must have some great stories to tell his grandkids. I Shazam’ed the song while watching Season 1 of the pretty good “Hap and Leonard” series on Netflix and appreciating its bizarre soundtrack that ranges from the aforementioned psychedelia to hippie-hating, throaty country warblers that were all the rage in the Vietnam-divided 1960s.

Webinars

January 13 (Wednesday) 2 ET. “The One Communication Strategy Clinicians Need Now.” Sponsor: PerfectServe. Presenters: Clay Callison, MD, CMIO, University of Tennessee Medical Center; Nicholas E. Perkins, DO, MS, hospitalist and physician informaticist, Prisma Health. Healthcare organizations are leveraging their current investments and reducing their vendor footprint, so there’s no room for clutter in healthcare communication. The presenters will describe the one communication strategy that clinicians and organizations need today, how to improve patient experience and protect revenue, and how to drive the communication efficiency of clinical teams.

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

Acquisitions, Funding, Business, and Stock

Home care coordination software vendor Dina raises $7 million in a Series A funding round. The Chicago-based company has also developed an AI-powered virtual assistant for patients and software to help employers with staff availability tracking and automated COVID-19 screening.

Health data and analytics company Komodo Health secures $44 million in Series D funding and acquires Mavens, a cloud-based technology company that is focused on biotech, rare disease, and specialty pharma markets.

Central Logic acquires Acuity Link, a developer of communications and logistics management software for healthcare transportation.

Sales

• Community Health Network (IN) selects automated appointment scheduling and chatbot software from Loyal.
• Scripps Mercy Partners (CA) will implement Doctible’s patient relationship management technology across its practice network.
• La Rabida Children’s Hospital selects Emerge for clinical data access.

People

Jim Corrigan (ERT) joins ConnectiveRx as president.

SOC Telemed names Ron Egan (GE Healthcare) chief customer officer.

Heidi Kemp, MEd (The SSI Group) joins Medstreaming as VP of marketing and channel partners.

Announcements and Implementations

Dominion Radiology Associates (VA) implements Spok Go care team messaging software.

Nuance announces GA of its Patient Engagement Virtual Assistant Platform.

Prescription patient engagement service vendors Pleio and Medisafe launch GoodStart, in which patients who are starting new prescriptions are supported with live calls and digital nudges from Pleio’s concierge program, then transition to Medisafe’s medication management services.

Athenahealth will include health plan data in its display of patient medical records in a collaboration with insurer Humana.

Healthcare Growth Partners publishes its twice-yearly market review, which is so brilliantly written and admirably concise that any attempt I would make to summarize it would do more harm than good. It’s not a dispassionately nerdy investor view of obscure data points, but rather a big-picture view of our entire industry. I don’t strew editorial superlatives indiscriminately, but I can’t help but fawn over an investor-focused report that grabs me with this brilliant opening paragraph that is as close to poetry as you’ll get in a financially focused report:

The paradox of a raging bull market amidst a raging pandemic is a reality nearly impossible to reconcile. While health IT fundamentals are as  strong as ever, it feels cavalier to begin our market discussion without recognizing the toll of this pandemic. After all, we at HGP and readers of our research choose to be in healthcare because we collectively believe in the industry’s responsibility to serve the greater good. We know our industry is fraught with moral hazard, and while a few seek to exploit, most aim to solve. Fueled by low interest rates and stimulus, the pandemic has bolstered the investment thesis in health informatics, yet we know the gains will never atone for the losses.

Government and Politics

HHS allocates $8 million to the three-year Telehealth Broadband Pilot program, which helps rural providers assess broadband capacity and implement virtual care.

Banner Health pays $200,000 to settle HIPAA Right of Access violations involving five-month delays in giving two patients access to their records.

The owner of an Orlando telemarketing center is convicted of federal charges of healthcare fraud for cold-calling Medicare beneficiaries to offer them “free” cancer genetic tests, bribing telemedicine doctors to order the $6,000 tests without ever talking to the patient, and then selling the resulting orders to laboratories in return for kickbacks. Labs submitted $2.8 million of the claims, Medicare paid $880,000, and the call center owner made $180,000.

COVID-19

The latest COVID-19 statistics for the US as of Monday:

• 129,748 people are hospital inpatients.
• 1,739 people died.
• Deaths are at 376,000.
• States with the highest number of deaths per 100K population in the past week are Arizona, Pennsylvania, Tennessee, and West Virginia.
• 9 million vaccine first doses have been administered of the 25.5 million doses distributed, leaving two-thirds of available doses sitting in freezers.

US Representatives Bonnie Coleman (D-NJ), Pramila Jayapal (D-WA), and Brad Schneider (D-IL) test positive for COVID-19 after sheltering in place in the Capitol last week along with several Republican colleagues who refused to wear the masks that they were offered. Congresswoman Coleman is a 75-year-old cancer survivor.

New York City’s comptroller says that online COVID-19 vaccine signup is so complicated that appointment slots aren’t being filled. He says that setting up an account involves a multi-step verification process, six more steps are needed to set up an appointment, and the user is required to complete up to 51 data fields and upload an image of their insurance card. A college professor says it took her 4.5 hours to find a location and make an appointment. The city has three sign-up websites, seven community clinics each have their own, four require calling them on the phone, and one involves email.

HHS will ask hospitals to submit weekly numbers on how many of their employees and patients have been vaccinated.

The family of a healthy, 50-year-old Beverly Hills plastic surgeon who died of COVID-19 says he was infected when a patient on whom he was performing a lip injection coughed on him, then called the office days later to let them know she had since tested positive for COVID-19.

Former White House coronavirus adviser Scott Atlas, MD deletes his Twitter after complaining that he lost 12,000 followers in a purge of accounts that were spreading misinformation.

A London-based mathematician-epidemiologist and public health professor illustrates the potential number of deaths from a more transmissible strain such as the B117 variant (yellow line) versus a strain that is 50% more lethal (red) or the original virus strain (gray). Ireland’s case count has jumped six-fold in just a couple of weeks as B117 became the dominant strain (9% of cases on December 27 versus 46% on January 10).

Beaumont Health (MI) CIO Hans Keil says the system tripled its server capacity over the weekend to better handle patient requests for COVID-19 vaccine appointments through its Epic MyChart patient portal. The system crashed Friday morning after nearly 9,000 patients — 10 times the usual number — attempted to access it at the same time.

WHO says that global COVID-19 herd immunity is not likely to be reached this year, making it critical that countries maintain mitigation measures, especially as poorer countries struggle to obtain vaccine whose supply is being bought up by wealthier ones.

Well Health develops a COVID-19 vaccine rapid deployment and implementation program that includes pre-appointment resources.

Other

An analysis in JAMA of medical fundraisers conducted on GoFundMe shows that users sought more than $10 billion and raised $3 billion in charitable contributions over an eight-year period. Treatment for cancer and trauma/injury were the top fundraising categories.

Sponsor Updates

• Santa Rosa Consulting staff donate toys and books to Toys for Tots.
• A local news podcast features Arcadia Chief Medical Officer Rich Parker, MD discussing Community Health Plan of Washington’s rollout of the company’s COVID-19 vaccination education and engagement platform.
• Artifact Health publishes a new case study, “OU Health standardizes physician query workflow and achieves positive results.”
• Vaco and Pivot Point Consulting launch a LinkedIn Live series that showcases female leaders across all industries.
• The Chartis Group unveils Next Intelligence branding.
• Ellkay features Meditech EVP Helen Waters in the latest installment of its Women in Health IT series.
• The National Quality Forum re-appoints Health Catalyst SVP of Professional Services Stephen Grossbart to its Primary Care and Chronic Illness Standing Committee.
• Change Healthcare helps providers comply with the CMS Price Transparency Rule with its Shop Book and Pay and Clearance Estimator Patient Direct solutions.
• Saykara wins a 2021 BIG Innovation Award for its AI-powered voice assistant that automates clinical charting, and the 2021 Sharp Index Award for “Best Health Tech Company to Reduce Burnout.”
• Central Logic adds Intelligent Transport and Bed Visibility capabilities to its healthcare access and orchestration technology.

Blog Posts

• Why It’s So Important to Perform Clinical Validation During EHR Data Conversion (314e)
• Top 10 Tips to Start Your Healthcare ESignature Project Now (Access)
• Prestera Health exposes 3,700+ patients’ info in email breach (AdvancedMD)
• Agfa HealthCare supports leading hospitals in Latin America (Agfa HealthCare)
• Differentiate Yourself: Upgrade Your Virtual Care Platform Strategy (Bluetree)
• The Hidden Benefits of a Legacy Data Management Strategy (CereCore)
• The Compelling Case for ‘Healthcare Access and Orchestration’ and Why It Matters (Central Logic)
• The 4 cybersecurity resolutions every care provider should make in 2021 (Cerner)
• Combating Ransomware: Preparation and Teamwork (Dimensional Insight)
• How HEDIS Analytics is Helping Healthcare Practices (EClinicalWorks)

Contacts

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

Morning Headlines 1/12/21

Dina raises $7 million for its AI-powered at-home care platform

Dina will use $7 million in Series A funding to further enhance its AI-powered virtual assistant and home care coordination software, as well as its staff screening and check-in technologies.

Moxe Announces Funding to Accelerate Growth

Madison, WI-based payer-to-provider health data exchange vendor Moxe raises an undisclosed amount of funding.

Komodo Health Acquires Mavens, Creating the First Data-Driven Enterprise Platform for Life Sciences

Health data and analytics company Komodo Health acquires Mavens, a cloud-based technology company focused on biotech, rare disease, and specialty pharma markets.

Curbside Consult with Dr. Jayne 1/11/21

My weekend took a decidedly positive turn after I was able to get my second dose of COVID vaccine. The side effects were a little more noticeable compared to the first dose, with a brief temperature elevation and headache. Tylenol and a nap vanquished them both, although I felt a little more tired than usual, but it’s unclear if that was from finally being able to let go of the anxiety of whether I’d be able to get a second dose or not.

It is unreal that frontline physicians who are actively caring for COVID patients would have to worry about getting a vaccine, but that’s the reality in many states across the US. I’m active in several nationwide physician forums and the majority of states are having difficulty vaccinating all frontline healthcare workers, while others are already vaccinating the general population based on age and comorbid conditions. We certainly live in interesting times. Artwork credit: physician Cindy Hsu.

I received the Pfizer vaccine and should reach target immunity two weeks after the second dose. I still don’t get to change any of my habits since the vaccine is only proven to reduce the risk of severe disease and/or death – we don’t have strong data on reduction of transmission at this point, although those studies are ongoing. There’s still the risk of being infected with COVID. I’m just less likely to die, which is a good feeling to have when you’re exposed to 20 or more COVID-positive patients a day.

My area continues to be in a surge that is being fueled by mass defiance of the county’s “safer at home” order, which means I still get to deal with heartbreaking situations at the office as people infect their grandparents and other loved ones when we are so close to getting vaccines for them.

A non-medical friend wasn’t aware of the lack of transmissibility data and asked me how long I planned to continue strict masking. After explaining the limits of the vaccine, I mentioned that I’ll most likely be masking forever. It’s not due to a concern about disease or contagion, but the fact that I’ve lost all ability to control my facial expressions simply due to the volume of ridiculous statements I have to hear on a daily basis. Plenty of patients still believe that the vaccine contains microchips or has the capability to modify human DNA, science be damned. As a physician, the most effective treatment I have right now is education, and although I’m happy to deliver it, I miss the days when I could solve problems with a flip of my electronic prescription pad.

The best side effect of the vaccine was the fact that I received it at a facility where I hadn’t previously been a patient, which exposed me to their version of Epic’s MyChart platform. Compared to the version being used by Big Medical Center where I usually receive care, it was amazing. Clean lines, no clutter, no distracting colors, and a much cleaner view of upcoming and past appointments. The medication list was easier to read without distracting color as well. Knowing that Big Medical Center is typically reluctant to take upgrades or to stay current with general release versions of software, I can only assume my new access is to a later and greater version.

I also haven’t been overwhelmed with announcements and updates from the new platform, so perhaps their communication plan or governance is a little tighter as well. It will be interesting how these contrasts play out now that I have access to both systems. I’m also curious to see how long it will take my previous employer to upgrade to the latest and greatest.

I spent a good chunk of time preparing my plan for the Consumer Electronics Show. I’ve never been in person, but have seen a lot of media reports and the in-person version sounds pretty overwhelming. The online schedule is a full one, but I suspect that like HIMSS, most of the interesting finds are found by checking out the exhibitors, which is a bit of an interesting process for most of the virtual conferences I’ve attended. I’ve been poking around the website and haven’t found anything that looks like a virtual exhibit hall yet, although there are lists of exhibitors and I’ve been getting plenty of emails from them. We’ll have to see if new features go live once the show officially starts tomorrow.

I’ve already identified quite a few digital health, wellness, smart home, and lifestyle vendors that I want to check out. I’m involved in some efforts to promote aging in place for older patients, so I hope there are innovative solutions that won’t cost an arm and a leg but will give patients and families greater peace of mind. Based on the lockdowns of the past year, so many people are afraid of moving to retirement communities or assisted living facilities even when they could benefit from expanded services. Hopefully, organizations have moved to fill that need. Kohler is scheduled to debut some smart home kitchen and bath accessories, but I’ll also be looking for design inspiration to finally complete what is possibly the world’s longest bathroom remodeling project.

Of course, there are also cool things that are not directly related to healthcare, but may provide interesting innovations in a secondary capacity, such as the unveiling of the world’s first autonomous racecar at the Indianapolis Motor Speedway. There are over 500 university students competing to win a $1.5 million prize in what’s billed as “the world’s first high-speed, head-to-head autonomous race.” The engineering types in my household are particularly excited to hear what that’s all about.

Some of my show sessions start as early as 6:30 a.m. local time, so I’d better get my rest this week if I’m going to keep up. Unlike the typical Las Vegas show, though, I’ll be able to readily access snacks from my own refrigerator and won’t have to wait in an eternally long line for a bad cup of convention hall coffee. I’ve stocked in extra martini supplies so I can pretend like I’m actually at a trade show.

If you’re attending CES, let’s have a virtual cocktail together. You can find me on Twitter: @JayneHIStalkMD

Email Dr. Jayne.

HIStalk Interviews Drex DeFord, Healthcare Strategist, CI Security

Drex DeFord, MSHI, MPA is healthcare strategist for CI Security of Bremerton, WA.

Tell me about yourself and the company.

I’m a recovering CIO. I have been a healthcare executive for most of the last 30 years and an independent consultant for the past four or five years. I serve as the healthcare strategist for CI Security. CI Security is a group of world-class security professionals who provide managed detection and response and cyber consulting services, with a mission to secure critical systems. We specialize in healthcare, but also cover other critical infrastructure.

What are the takeaways from University of Vermont Health Network’s month-long downtime from a cybersecurity incident?

This is one of those situations where the breach occurred long ago. The bad actor was in the system for a long time before they ultimately wound up revealing themselves. That’s part of the challenge today.

Historically, we have worked hard to build high castle walls to keep the bad guys out. But what we’ve realized, at least in the last few years since ransomware became prevalent, is that all of your frontline employees are now frontline cybersecurity people, too. One wrong click going to the wrong website and you’ve been breached.

You feel like you have to meet this challenge of building a tall castle wall, but the real opportunity is to find those bad guys as soon as they’re behind the castle walls, catch them, and throw them out. That’s a lot of what managed detection and response is about. Whether you’re in a big place or a small place, rethinking the strategy around security is critically important.

Is it true that human hackers aren’t involved until sometime after the technology back door has been discovered or opened via mass Internet probing?

This is another way that cybersecurity and attacks have evolved over time. You can certainly have nation state attacks, but now there’s ransomware as a service. We often find that health systems or other organizations are hit by ransomware as an accident. They are just collateral damage. Somebody was trying to make a quick buck, punched out a bunch of ransomware, and somebody in the health system clicked on it. It wasn’t directed, it wasn’t intentional, and it wasn’t focused on that health system. It’s just one of those things that the organization found themselves wrapped up in. 

As the types of ransom market and attacks evolve, we will see more and more and more of that, where it’s not really aimed at a health system or hospital, but the cybersecurity posture of many health systems leave them vulnerable to these collateral damage attacks.

How can CIOs convey that threat to board members who might see it as theoretically possible but so unlikely that it doesn’t warrant funding and focus?

A lot of this is keeping your board informed and helping them see the negative results on competitors or other organizations. Boards and other executives are very involved in this now, from what I see as I talk to CIOs across the country. Every time there’s a SolarWinds attack or something like that, board members start sending questions about, are we covered? How are we doing? Is everything OK?

You are right that it’s hard to prove a negative. If you’ve been doing a good job in your cybersecurity posture and you haven’t been breached, there’s still plenty of story to tell about the number of taps you’ve forwarded and the number of ransomware emails that don’t get through. A lot of those things are still happening to you, but you’ve been doing a good job of catching them. Those are the stories you should be telling.

Is healthcare more at risk because the many hospitals that are outside of big cities won’t have a lot of local cybersecurity expertise available and might not have the money to develop it?

That’s a real challenge in most places, especially with small and medium-sized health systems. The talent problem is real. It’s tough enough to try to hire the hire the people and get them to move to these areas. But once you get them there and you start teaching them some of these cybersecurity tools, you’re apt to lose them quickly, too. Retaining good talent is tough.

The other challenge I see over and over is that lots of vendors have silver bullet products that they would like to sell to organizations. The organizations get them, install them, and run them, but then quickly start to realize that it’s going to take more than a fractional FTE to actually get value out of that product. After they have accumulated a whole plate full of these products, they realize they have created a situation where they are more exposed. They know about these things, but they can’t do anything about them, or they don’t have the talent to actually run those products.

Being able to bring somebody in and let them do management section of response for you, 24/7/365, is the other big gap that we see. But being able to do it 24/7/365 — and having wraparound professional services that can help you get started through things like security, risk assessments, and penetration tests and all the other things that can be combined into a single package — makes a big difference to small and medium-sized health systems. They just don’t have the people to handle the challenges that face them. It’s not a core business skill that they would normally have.

Have recent incidents raised an awareness that cybersecurity breaches aren’t just an IT annoyance but in fact could put a hospital out of business?

There’s a cybersecurity and risk continuum that ranges from not very mature health systems to mature ones. There’s an understanding, or lack of understanding, that it’s not just about being hacked, It’s about the impact to the business. Short term, you have to get the systems back up and running and help get patients get back in. But long term, there’s the reputational impact. Especially for not-for-profits that have fundraising arms, being able to instill confidence in your donors that you’re a good place to donate money to because you take good care of patients and families and you never let them down. That’s how cybersecurity is tied to everything else, because it really isn’t standalone.

A simpler, relatively modern infrastructure is way easier to secure than one that has been built haphazardly over a number of years. That includes even infrastructure projects, upgrading switches, and upgrading end-user user devices. It doesn’t have to be bleeding edge, but that maturity and understanding makes the difference between mature organizations and relatively immature organizations.

Attacks in the past were usually focused on widely present misconfiguration vulnerabilities in JBoss servers or Windows Remote Desktop, where if an organization was paying even modest attention it could protect itself. Have attack methods broadened, and how do healthcare organizations share information about their experience and actions?

Trying to protect yourself against yesterday’s attack is a good thing to do, but lots of new types of attacks happen every day. It also comes back to doing simple, straightforward things. If you’re a CIO, you need to make sure that your network, server, and application teams have the time to apply patches to reduce your vulnerability. Cybersecurity is connected to everything else, including operations. Healthcare has gotten a lot better at sharing information through organizations such as CHIME.

H-ISAC – the global, non-profit Health Information Sharing and Analysis Center that crowdsources cybersecurity — has become a critical component in the sharing of cybersecurity information. You do preparatory work, such as doing tabletop and full-blown exercises where you connect to the organizations that you may need help from. You want to have your connections – such as state police, the FBI, or other healthcare organizations in your area – in place and on speed dial so that you are ready to connect. That’s not something you want to figure out after you’ve been breached. More connections and more collaboration puts you in a better position from a cybersecurity perspective.

ISACs exist for different industries and healthcare has a great team there who are always looking and working closely with the FBI, HHS, ONC, and others. They log, catalog, make recommendations, and share information about the kinds of breaches that are occurring.

It’s another reason too think about managed detection and response, because if you’re a standalone medium-sized hospital, you’re working off only the connections that you’ve been able to make as a small shop without a lot of time. A professional service organization like ours has lots of connections, not only in healthcare, but in other industries. This is what we do every day, so we are more likely to be looking for problems or openings for the bad guys that you may not have even heard about yet

What are the security risks involved with vendors and providers making initial moves to the cloud?

A cybersecurity professional company can help you navigate these waters. We have seen health systems, time after time, assume that software as a service means that if I don’t run this on my premises, and instead have it run by a company who does it for a lot of other people, I should be more secure. Generally speaking, that’s probably true, as long as you’re doing all your due diligence with that third party to make sure that they’re doing all the things that they should do to be secure.

When it comes to the cloud, the true cloud, this is another one of those situations where there are opportunities to make mistakes. You’re probably going to be more secure than you are. If you try to do it yourself — especially if you’re a small or medium-sized health system — engage a professional to look at the vulnerabilities and make sure you’re covered for what you’re trying to do.

Do you have any final thoughts?

CI Security is happy that 2021 has arrived and 2020 is in the rearview mirror. Cybersecurity is in front of boards and healthcare leaders.We look forward to supporting the need for critical healthcare infrastructure with easy to understand, easy to consume cybersecurity services and managed detection and response that is packaged up to be delivered in a better, faster, cheaper way.

Morning Headlines 1/11/21

After SPAC merger, Clover Health president eyes membership growth this year

Shares in Medicare Advantage insurer Clover Health began trading Friday on the Nasdaq after it went public in a reverse merger with an SPAC.

CareDx Agrees to Acquire TransChart and Expands EMR Connectivity to Over 90 Centers

Transplant testing, lab, and software vendor CareDx acquires TransChart, which sells a transplant center EHR.

Carrum Health Raises $40 Million to Transform Healthcare Delivery and Lower Costs through First-of-Its-Kind Digital Marketplace

Carrum Health, whose marketplace connects employees of self-insured companies with company-screened, bundled-price surgery providers, raises $40 million in a Series A funding round.

Monday Morning Update 1/11/21

Top News

Shares in Medicare Advantage insurer Clover Health began trading Friday on the Nasdaq. The company, which went public in a reverse merger with a SPAC, is valued at $7 billion despite a low Medicare star rating, availability in just some counties of eight states, and 50,000 members.

Clover Health offers doctors the free, web-based Clover Assistant, which provides access to patient data, personalized care plans, and faster payment.

Clover Health’s leadership team with health IT connections includes CEO Vivek Garipalli (co-founder of Ensemble Health and founding investor of Flatiron Health); Chief Clinical Informatics Officer Sophia Chang, MD, MPH (CareMore Health Plan and VP/medical director at Accretive Health); and Calvin Chock (McKesson).

Reader Comments

From Plymouth Meeting:: “Re: hospital IT meetings. What would you do to improve them?” Ideas:

• Identify the one person who is in charge. They don’t have to actually run the meeting, but they need to state why the meeting is being held, explain why each attendee was invited, and make assignments. It’s common for a hospital meeting to start with, “Whose meeting is this?” and nobody can answer.
• Start and end on time. Do not wait for stragglers, which is almost everyone in hospitals, because that will encourage them and make the meeting seem less urgently important.
• Send out an agenda days in advance with assignments. If nobody can find the time to do that, then cancel the meeting.
• Implement a “no looking at electronic devices” policy.
• Assign someone to keep the meeting moving and to take notes. I used to scoff at needing to record minutes until I attended my first meetings where they were scrupulously maintained and distributed by someone, and it was eye-opening. And someone needs to muzzle the attendees who can’t shut up (which is often a reflection of job title) and engage those who have tuned out because nobody’s listening to them or they are intimidated by higher-ranking or more verbally aggressive co-workers. A junior person who has little knowledge of the meeting’s topic is ideal for recording minutes – they have no skin in the game, they will follow up, and their lack of the understanding of the specific issue forces them to ask basic questions that nobody else noticed weren’t answered.
• Don’t invite more than 5-10 people to a meeting where a decision will be made. Otherwise, the only decision that results will be to have more meetings.
• When making a decision, do a voice vote and record each person’s choice to make sure they aren’t just coasting on in-room dynamics and that they understand that their consideration of the issues has consequences.
• Don’t allow guests or uninvited add-ons. Hospitals are supportive democracies where most folks would never ask, “Why are you here, again?” and some people just love conference room gamesmanship.
• Groups larger than a handful of people will never be able to reach consensus among all the position-jockeying. Get the ideas on the table in one or more larger meetings, but don’t give those big groups voting power beyond making recommendations to the smaller group. Big groups should be for brainstorming only.
• Don’t make IT decisions without getting input from the users who will be most affected. Many IT attendees have quirky personality types, the inability see any nuance that isn’t black and white, and overreliance on either “I’ve been here a long time and that didn’t work when we tried it before” or “I’ve not been here long and I wish you would all stop living in the past and think boldly.” Make those users part of the brainstorming meeting, not the decision-making meeting, because they are seeing just a small part of the elephant at hand but will feel passionately that they are right.
• Make sure standing meetings are really necessary. Those often waste the most time in hospitals because the only expectation of attendees is to show up and share their feelings, which hospital people do readily.

HIStalk Announcements and Requests

My once-yearly and newly shortened reader survey takes seconds to complete and will earn you my gratitude and possibly a randomly drawn $50 Amazon gift card. I don’t know who’s reading otherwise since I don’t require registration or hide articles behind a paywall. Thanks.

Less than one-fourth of poll respondents say their health is worse now than a year ago.

New poll to your right or here: Is more than 10% of your net worth invested in health IT-related company shares or equity? I make it a point to not hold any such ownership since I don’t think it would be right as someone who reports news and rumors, but I suspect it’s common and entirely reasonable for employees of publicly traded companies to hold shares in their retirement or incentive plans.

Welcome to new HIStalk Platinum Sponsor Sphere. The Nashville-based financial technology and software company’s cloud-based platform is used by the country’s largest health systems to reduce friction and facilitate better, more secure patient payments in a single platform. Its integrated payments offering supports the native workflows of leading EHRs such as Epic, while its Health IPass solution enhances provider revenue collection and a streamlined consumer experience from appointment to final payment. It includes security and fraud tools, API integration, robust reporting and reconciliation, support for billing plans and tokenization, and support for all payment types and flexible spending accounts. Thanks to Sphere for supporting HIStalk.

Webinars

January 13 (Wednesday) 2 ET. “The One Communication Strategy Clinicians Need Now.” Sponsor: PerfectServe. Presenters: Clay Callison, MD, CMIO, University of Tennessee Medical Center; Nicholas E. Perkins, DO, MS, hospitalist and physician informaticist, Prisma Health. Healthcare organizations are leveraging their current investments and reducing their vendor footprint, so there’s no room for clutter in healthcare communication. The presenters will describe the one communication strategy that clinicians and organizations need today, how to improve patient experience and protect revenue, and how to drive the communication efficiency of clinical teams.

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

Acquisitions, Funding, Business, and Stock

Transplant testing, lab, and software vendor CareDx acquires TransChart, which sells a transplant center EHR.

Carrum Health, whose marketplace connects employees of self-insured companies with company-screened, bundled-price surgery providers, raises $40 million in a Series A funding round. The company supports orthopedic, spine, cardiac, and bariatric procedures.

Hinge Health, which offers employers and insurers sensors, apps, and coaching to prevent and treat chronic back and muscle pain, raises $300 million in a Series D funding round, valuing the company at $3 billion. The company plans to launch an IPO in 2022.

Announcements and Implementations

KLAS takes a look at the hospital EHR market in Canada, which in many cases involves group- or province-led collective decisions that are intended to keep costs down. Meditech leads Epic in hospital count, but has lost some market share as 88 big-system hospitals have replaced Meditech with mostly Epic from 2015 to 2019, while 31 legacy Meditech hospitals have upgraded to Expanse. Customers report satisfaction with Expanse, but say they could have used more guidance and best practices before going live and a better idea of the maintenance requirements afterward. Satisfaction with Cerner is stable, but customers say the Citrix-heavy client-server footprint requires a lot of maintenance, although experience with Cerner’s recently introduced remote-hosted option is good. Allscripts hasn’t had a new Sunrise sale in Canada in the past 10 years, Harris Healthcare is rarely considered in new deals, and Telus Health’s Oacis is rarely considered and hasn’t sold since 2015.

Government and Politics

The American Hospital Association lost its lawsuit challenging the federal government’s hospital price transparency rule last week, so it now asks HHS to not enforce it, saying that hospital IT employees are too busy with COVID-19 work.

COVID-19

Saturday’s COVID-19 stats: 3,500 deaths and 130,777 patients in hospitals. Last week was the highest number of cases, hospitalizations, and deaths of any week in the pandemic.

CDC vaccination updates: 6.7 million first doses administered of 22 million doses distributed. At a goal of vaccinating 70% of Americans to reach herd immunity, we are less than 10% finished with first doses alone. Nursing homes have administered only 17% of the 4 million doses they have received.

Denmark’s CDC warns that the B117 variant is so contagious that it will become the dominant virus in the country and likely the world by mid-February. Even Tier 4 restrictions – stay-at-home requirements, closed shops, no public gatherings, no overnight travel – will not stop its spread, they say, as UK districts under Tier 4 stay-at-home orders are seeing a 10-fold increase in B117 cases every three weeks. US FDA says existing TaqPath and Linea tests can specifically identify the B117 variant and retesting previous positive samples to see whether B117 was involved does not require its approval.

The UK approves use of two rheumatoid arthritis drugs – tocilizubam and sarilumab – for treating COVID-19 patients in the ICU, where they appear to reduce the risk of death by 24% if given within 24 hours of admission.

California’s slow COVID-19 vaccine rollout is being partially blamed on problems with PrepMod, the state’s vaccine management system that coordinates waitlists, tracks inventory, and sends proof of vaccination to patients. The system, which is used by several states, appears to have been developed by the non-profit Maryland Partnership for Prevention. California’s COVID-19 testing program was hampered last year by problems with the CalREDIE results data collection system. The state says it knew that both systems weren’t ideal for their current use and is designing replacements.

A large study of discharged COVID-19 hospital patients in Wuhan, China finds that three-fourths still have symptoms six months later, including fatigue, insomnia, depression, anxiety, and lung problems. Excluded from the study were the sickest people, such as those who could not be interviewed or who were readmitted in the six-month period.

Experts question whether health systems and states that use online systems and other technology for COVID-19 vaccine administration are limiting access to elderly, low-income, and rural populations.

The city of Nangong, China will pay $75 to anyone who reports a resident who has not received a mandatory COVID-19 test. Areas with outbreaks of a few dozen cases are being locked down, every resident is being tested, highways have been blocked, and some cities allow only one member of a household to leave their homes every days to buy supplies.

Sponsor Updates

• OpenText donates $15,000 to the Manna Food Center in Gaithersburg, MD.
• Wolters Kluwer Health announces integration of its Health Language clinical interface terminology solutions with Henry Schein MicroMD’s EHR platform.
• Rush University Medical Center expands its deployment of Nuance Dragon Ambient Experience to 14 clinical specialties.
• OptimizeRx will present at the HC Wainwright Virtual BioConnect Conference on January 11.
• Nordic releases a new podcast, “Creating and leveraging a successful Super User program.”
• Pure Storage will participate in fireside chats during the Needham Virtual Growth Conference on January 11, and the Goldman Sachs Virtual Tech and Internet Conference on January 12.
• The local news features a story on how one family stayed connected to their hospitalized infant through Vocera’s Ease app.
• Saykara President and Chief Medical Officer Graham Hughes, MBBS publishes a guest article titled “Physician Groups Turning to AI for Relief from EHR Documentation Burden” in AI TechPark.

Blog Posts

• Worried Sick: 5 Major Risks with Telehealth Data Security and How to Mitigate Them (Spirion)
• Physician groups turning to AI for relief from EHR documentation burden (Saykara)
• Digital Front Door, Ambient Technology, AI, and the Revenue Cycle (Nuance)
• Cybersecurity in Conversation: Experts Answer Must-Know Questions (Netsmart)
• If You Choose Not to Decide, You Still Have Made a Choice (Nordic)
• Support COVID-19 Vaccination Efforts with Provider Data Platform (Phynd Technologies)
• Miscommunication in Patient Hand-Offs and Its Impact on Patient Care (PMD)
• How Two Health Systems are Carrying COVID-19 Innovations into the New Year (Premier)
• How to Design Products for EHR Integration Using Clinical Workflows (Redox)
• Improve Medication Ordering Workflows with Better Patient Data (RxRevu)
• Acute Telemedicine in 2020: A Wrap Up (SOC Telemed)
• Data Privacy and Security Trends in 2020 (Spirion)
• 8 lessons from the pandemic to guide us in 2021 (Spok)
• FHIR Power: Picture-Perfect for Patient Engagement (Krames)
• Scrambling to Complete High-Volume, Repetitive Data Entry Tasks Before Year End? (Summit Healthcare)
• Lessons Learned About Information Sharing During a Pandemic (Surescripts)
• The Complete Guide to Implementing a Physical Therapy Software (WebPT)

Contacts

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