News 10/30/24

Top News

Oracle Health will release a voice-powered, AI-enabled EHR in 2025.

The new system will be developed from scratch rather than being built on Cerner Millennium architecture, which will then require existing customers to migrate to the new one.

The company says that it discovered that Millennium has a “crumbling infrastructure” that was not suitable for enhancement.

Reader Comments

From TooCuteByHalf: “Re: Oracle Health’s application to become a QHIN. This is great news for interoperability … eventually. The application process takes months at the earliest, and even at that, it won’t be till at least mid 2025 before the first Oracle Health hospital goes live. TEFCA is nearly a year old, with millions of documents being shared, and the founding QHIN’s have been in the game for literally years. What took Oracle so long, and why take a victory lap in a race you’re not winning?” I’m even more interested in how Oracle Health plans to release a from-scratch EHR in the next few months that does not use Millennium’s underpinnings. It seems challenging to develop, test, document, and install a brand new EHR that will require existing customers to migrate, which is probably why no company has succeeded in rolling out a competitive inpatient EHR in decades. It’s a high-wire act to put out a huge software platform that directly affects patient care, especially given significant loss of former Cerner subject matter experts, and it wouldn’t take many clinically unfortunate missteps to send Oracle Health’s remaining customers fleeing to Epic. Meanwhile, having thrown the only available product under the bus after what seems to have been poorly executed due diligence, Oracle won’t likely make many new sales until the replacement system goes GA, not that it is selling much anyway. 

From Big Dog: “Re: Epic. Is the shared version (where multiple clients are on the same instance) of Epic a reduced functional version of Epic when it’s a standalone version? Was talking to a nurse at a local hospital the other day and they recently converted from Cerner Community Works and the nurse was stating they must have purchased the cheap version as it was no better than what they had been using.“

HIStalk Announcements and Requests

This week is a first, in that both Jenn and I are away on vacation at the same time. I’ll put in enough hours to not miss anything important, but will keep it simple otherwise.

Webinars

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

Acquisitions, Funding, Business, and Stock

London-based events operator Hyve acquires HLTH, whose HLTH USA conference will become its largest event by revenue. Hyve will take over HLTH USA (Las Vegas), ViVE (Nashville), and HLTH Europe (Amsterdam). Hyve says it has targeted HLTH for years as the top conference in healthcare, noting a post-pandemic trend in which the largest conferences are growing at the expense of smaller ones. Hyve will bring over 80 HLTH employees and founder Jon Weiner. Hyve was taken private by two private equity firms in June 2023.

Alpha II, which acquired RCxRules in October 2023, changes its name to Aptarro. 

A study by Peterson Health Technology Institute finds that digital hypertension management tools – which include blood pressure monitoring, medication management, and behavior change – don’t provide overall health spending value even though they can be effective. It concludes that solutions that send data to care teams for medication management are most effective, while those that focus on patient behavior change deliver substandard results compared to traditional care.

Sales

• Northeast Georgia Health System chooses Optimum Healthcare IT to support execution of its cloud strategy with Amazon Web Services.

People

Lissy Hu, MD, MBA (WellSky) joins healthcare learning solutions vendor Ascend Learning as CEO.

Announcements and Implementations

Oracle Health will apply to become a Qualified Health Information Network. The company says that it will continue to support CommonWell Health Alliance as a founding member. Epic welcomed Oracle Health to TEFCA, noting that Epic already has 700 hospitals live on TEFCA as a founding member and adding, “Epic hopes that today’s Oracle Health announcement indicates that they are finally ready to take interoperability seriously—and to deliver the technology that patients and providers deserve instead of making distracting, untrue statements.”

Altera Digital Health announces GA of Paragon Denali, a cloud-native EHR that runs on Microsoft Azure and is targeted to rural, critical access, and community hospitals.

Medscape announces a free, AI-powered scribe solution that transcribes and summarizes encounters.

Emory University and Emory Healthcare will consolidate their IT operations into a single organization under Alistair Erskine, MD, MBA,  who has been named to the newly created position of enterprise chief information and digital officer. He joined Emory Healthcare as chief information and digital officer in March 2023.

Inovalon announces new products for eligibility verification, network provider utilization, AI-powered record review, FHIR API connectivity for health plans, a research network, and expanded pharmacy functionality.

A new KLAS report on ambient speech solutions finds that Nuance is most often considered while Abridge is strong in affordability and physician acceptance,with both companies benefiting from their relationship and integration with Epic. Suki and Augmedix are often considered by Meditech users. 

Contacts

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

Morning Headlines 10/29/24

Oracle applies to join Epic and others in new federal medical record network

Oracle will apply to become a QHIN under TEFCA, well after Epic and others have gone live.

New unified IT structure will serve Emory University and Emory Healthcare

Emory will combine its healthcare and university IT organizations under Alistair Erskine, who joined Emory Healthcare in March 2023 as chief information and digital officer.

BREAKING NEWS: Hyve Group acquires US-based HLTH Inc portfolio

London-based, private equity-owned global event organizer Hyve acquires HLTH USA (Las Vegas), ViVE (Nashville), and HLTH Europe (Amsterdam), which will make HLTH USA its largest event by revenue.

Curbside Consult with Dr. Jayne 10/28/24

I recently had the opportunity to participate in a roundtable discussion with other CMIOs. As one would expect, “what is your organization doing with AI tools” was one of the questions given for discussion. It seemed like AI-assisted or ambient dictation was the most commonly used technology, with AI-driven patient engagement solutions in second place.

Although people initially talked with some enthusiasm about their projects, the conversation drifted to the topic of budgets and how much money is being dedicated to AI-based solutions. Although the CMIOs felt that they would be able to deliver a solid return on investment for those two solutions, there was quite a discussion of other tools that they are implementing that feel more like AI for AI’s sake rather than being focused on pressing problems.

Several individuals at the table discussed their ongoing needs for budgetary support to continue doing what they consider to be the basics, such as optimizing EHRs that they have spent hundreds of millions of dollars implementing, but that need funding to keep them current and to take advantage of new features. One spoke of her organization’s ongoing implementation fatigue, where not only is the informatics team running ragged, they feel that physicians are not tolerating the pace of change because IT projects are being deployed at the same time as operational projects around coding and compliance and clinical quality.

Another CMIO spoke in follow-up about the need to ensure that change management tasks are included in any proposal for new solutions. His hospital has a tendency to roll out new things without funding to cover the time that is needed to build consensus, ensure buy-in, and identify those on the medical staff who might openly sabotage an effort before it even gets out of the gate. His clinicians are tired of “too many solutions with too many promises and not enough improvements” to the point where they will vocally oppose changes to the system that introduce any new clicks or expanded work for the clinicians.

Another mentioned that his institution had been implementing a separate solution to help manage chronic conditions through a partnership with one of their payers. Although he originally voiced concerns about patient matching and data integrity, he was reassured that everything would be fine and that the payer’s solution had experience integrating with his particular EHR. Unfortunately, the system’s ability to integrate had been grossly overstated. After months of dealing with patient matching issues, the project was placed on hold while they worked to sort it out. It seems that at this point in the evolution of clinical informatics, we should have a solid handle on patient matching, but it’s often more difficult than it needs to be. Lack of a universal patient identifier in the US continues to be one of the difficulties.

One of the CMIOs mentioned ongoing problems trying to reconcile gaps in care across his organization. They’re a large health system and have acquired multiple independent physician groups over the last couple of years, slowly working to integrate all the platforms. His predecessor didn’t ensure due diligence with data mapping and adjustment of clinical quality reports, which means that physicians aren’t getting credit for their patients having appropriate screening tests or treatments because the system isn’t recognizing them properly.

After doing some digging, he discovered that certain reports were looking for particular character strings in the names of lab tests rather than looking for test codes or even something more standardized like a LOINC code. Since there were variations on the test names sent by outside systems that are now inside, they had to embark on a large project to fix the issue. Of course this wasn’t part of the 2024 budget, so now he’s scrambling to get it fixed as quickly as possible before end of year reports are generated while simultaneously cutting other projects they had planned to finish before 2025.

Others at the roundtable mentioned that they would like to be able to implement new features of existing systems, but simply don’t have the money to do so. One mentioned going through the budget cycle for 2025 and being concerned that he will likely receive about 60% of the funding that he requested since the hospital is running with negative margins.

That led to a discussion of which health systems have been in the news for laying off IT and other non-clinical teams. That got heated since several at the table are in positions of having to trim headcount and are trying to do it through retirements or other more natural sources of attrition rather than having to conduct a layoff.

One of the topics that had nearly everyone participating was that of workforce planning for clinical informatics. Although the majority of those in the conversation believe that we need more experienced clinicians helping with informatics projects, they agreed that their organizations don’t necessarily want to provide financial support in exchange for the expertise of those clinicians. One mentioned that his organization’s non-clinical leadership has an attitude that physicians should be grateful for the opportunity to have input on clinical technology and should not expect to be compensated because the solutions don’t benefit anyone else.

I thought this was an interesting comment, but didn’t have time to dig into it. Does it mean that physicians aren’t involved in multidisciplinary projects, or is the organization not doing any multidisciplinary projects? Either answer would indicate some less than ideal priorities.

Another mentioned the influx of physicians who are burned out in their original specialties and are looking at informatics as a way to potentially get out of the clinic. The majority of those individuals don’t have formal informatics training and don’t understand why they are not selected when roles open. Some are not willing to put in the time to complete informatics courses and build a more formal skillset. Others think that they can command the same salaries as they would earn in their clinical specialties even though they don’t have any experience.

It sounds like it makes for many difficult conversations between experienced informatics physicians and those who are trying to use it as an escape. I’ve certainly run into those folks myself, and they always seem shocked that I’m not willing to bring them on as highly paid consultants simply because they’ve used an EHR.

The group is scheduled to meet again in six months, and it will be interesting to see whether the overall priorities are the same or whether there have been small changes or even dramatic ones. I enjoy building these kinds of relationships over time and was thrilled to be part of the roundtable, so I’m looking forward to catching up in the spring.

If you’re a CMIO, what do you think of these topics? Are you dealing with the same issues or do you have completely different ones drawing your attention? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 10/28/24

WellSky Acquires Leading Durable/Home Medical Equipment Software Provider Bonafide, Enhancing Home Care Solutions

WellSky acquires Bonafide, which offers software for durable medical equipment and home medical equipment.

Researchers say an AI-powered transcription tool used in hospitals invents things no one ever said

Experts find that OpenAI’s Whisper technology, which is used by ambient documentation vendors, hallucinates to the extent that its transcriptions should be reviewed carefully.

Healthify Closes $45 Million Financing Round Led by Khosla Ventures and LeapFrog Investments

The nutrition and health coaching app vendor will use the funds to enter the US market.

Monday Morning Update 10/28/24

Top News

UnitedHealth Group’s HHS OCR breach notice filing indicates that the information of 100 million Americans was exposed in Change Healthcare’s February 2024 ransomware attach.

The company had previously said only that the cyberattack had affected “a substantial proportion of people in America.”

Reader Comments

From Granular Argument: “Re: long-time Cerner customer Children’s National. Doing demos of Oracle Health and Epic.” Verified, assuming that the graphic the reader sent is legit.

HIStalk Announcements and Requests

Poll respondents reported limited negative HR experience in the past couple of years, although with some dealt with RTO conflicts and layoffs.

New poll to your right or here: Is employer-paid attendance of the HLTH conference beneficial to patients and healthcare in general? I will disclose my bias, having never attended, that it seems to focus on socializing, being entertained, and sharing air with celebrities that include high-profile CEOs who are mostly selling themselves and their companies, all with the goal of coming back home “energized” having run up the expense account for questionable quantifiable benefit. Ironically, all of this took place smoky casinos, which surround attendees with just about every known health risk. I suppose the real question is the value of the strong networking component of any conference, other than companies seeking customers or health system attendees seeking jobs. I doubt that the life of a dying cancer patient would be enriched by the knowledge that their medical costs funded an IT person’s attendance at a concert by frequent incarceree Busta Rhymes.

Webinars

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

Acquisitions, Funding, Business, and Stock

WellSky acquires Bonafide, which offers solutions for durable medical equipment and home medical equipment.

Hospital quality reporting platform vendor Pharos closes a $5 million seed funding round.

An Nvidia blog post says that the company is working with Deloitte to create digital health AI agents, which it refers to as “customizable digital humans.” The Ottawa Hospital is using an agent that it calls Digital Teammate to answer surgery patient questions about procedure preparation and post-op recovery.

Sales

• Barking, Havering and Redbridge University Hospitals NHS Trust will implement Sectra One Cloud.

Announcements and Implementations

Researchers find that AI-powered transcription, including ambient clinical documentation, contains a surprising number of errors and hallucinations even when the source conversation is short and clear. Research is also limited because the medical transcription products erase the audio recording immediately, leaving the AI-generated text version as the only artifact. Everybody involved urges doctors to review the AI draft carefully, which of course some won’t because it is “usually” OK.

A YouTube blog post says that Cleveland Clinic is testing new AI tools for easily publishing authoritative videos. The clinic’s digital marketing director says they are using the tools to recommend topic ideas by searching YouTube and the web and to suggest interview questions.

Sponsor Updates

• Alpha II’s RCxRules will exhibit at NextGen Healthcare UGM October 27-30 in Nashville.
• Vyne Medical publishes a new case study, “How Hurley Medical Center Expanded Services to Increase Access to Care.”
• Alpha II, Artera, Crossings Healthcare Solutions, Ellkay, FinThrive, Fortified Health Security, Healthcare IT Leaders, Impact Advisors, Nordic, and Surescripts will exhibit at the Oracle Health Summit October 28-30 in Nashville.
• Notable announces the 2024 Notable Impact award winners in six categories.
• Net Health adds Tali’s AI assistant and ambient clinical documentation capabilities to its Optima, ReDoc, TherapySource, and WoundExpert EHRs.
• UiPath honors customer AGS Health with a UiPath A125 Award for its innovative use of fax automation and AI.
• FinThrive achieves claims management certification for oracle health patient accounting.
• Guam Regional Medical City implements PerfectServe’s care team communications software.
• TruBridge  Senior Director of Revenue Cycle Solutions Laura Osborne joins the HFMA Voices in Healthcare Podcast episode “Lessons from Tribal Health.”
• Waystar publishes a new case study, “AnMed Health’s Way Forward.”
• A Black Book Research survey of 4,000 healthcare organizations and 2,500 coding professionals highlights leading HIM and coding vendors, including the following HIStalk sponsors: Redox (clinical data integration and interoperability solutions, Alpha II ( computer-assisted coding applications), Verato (enterprise patient master index and clean-up),  Wolters Kluwer Health (clinical surveillance and compliance applications), and Nuance (medical speech-recognition solutions.)

Blog Posts

• IT Networks and their Undeniable Impact on Patient Experience and the Bottom Line (CereCore)
• Under the Hood: Key Insights from Notable’s Technology Leaders (Notable)
• Implementing a Healthcare Workforce Management System: 5 Common Challenges and Practical Solutions | Part 4 (QGenda)
• LPN vs LVN: What’s the Difference? (SnapCare)
• Solving Some of Physicians’ Major Pain Points with Patient Engagement Technology (TrustCommerce, a Sphere Company)
• 3 Ways Medication History for Reconciliation is Making Prescribing Safer (Surescripts)

Health Data Movers at the CHIME Fall Forum

HDM will facilitate a focus group titled “Unlocking M&A Success: Merging Systems for Seamless Integration and Maximum Impact” with Curtis Cole, MD, chief global information officer at Cornell University; Doug Turner, MBA, VP of enterprise applications at UCI Health; and Mehul Malhotra, delivery director at Health Data Movers on Monday, November 4 at 2:30 p.m. We will also be hosting a Taco Tuesday event following the sessions on November 5- RSVP here.

Contacts

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

Morning Headlines 10/25/24

Hack at UnitedHealth’s tech unit impacted 100 mln people, US health dept says

The February ransomware attack on UnitedHealth-owned Change Healthcare has compromised the personal information of 100 million people, making the attack the largest healthcare data breach in US history.

CorroHealth Announces Strategic Partnership with Patient Square Capital

Patient Square Capital invests in RCM company CorroHealth and becomes a joint owner of the business with investment firm Carlyle.

Dyania Health raises $10M for clinical trial recruitment LLM

Automated chart review and clinical trial pre-screening software startup Dyania Health raises $10 million.

UMC operations largely restored after hospital faced month-long ransomware attack

University Medical Center (TX) has restored the majority of its patient-facing computer systems after a September 26 ransomware attack took them offline and forced the hospital to divert patients.

News 10/25/24

Top News

The Department of Defense will award Leidos a three-year, $1.13 billion sole-source contract for MHS Genesis / Oracle Health integration services.

Leidos will be paid an additional $263 million for a nine-month maintenance period if DoD decides to issue bids for a new integrator after the three-year term.

Deliverables of the new contract include cloud migration and process documentation.

Webinars

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

Acquisitions, Funding, Business, and Stock

Healthcare telephone call automation vendor Infinitus Systems raises $51.5 million in Series C financing.

Healthcare workflow and task automation startup Penguin Ai emerges from stealth mode. The four co-founders have data and AI technical leadership experience with UnitedHealth Group. Industry long-timer Peter Longo is heading up sales.

Sales

• HCA Healthcare will implement ambient documentation from  Athelas/Commure, which acquired Augmedix in July 2024.
• Billings Clinic- Logan Health will expand its use of its Oracle Health EHR to all 30 of its hospitals, replacing Meditech at the former Logan Health sites. The systems merged in September 2023.

People

Healthmonix names Paul Grant (EMDs) as VP of sales.

BayCare Health hires Lynette Clinton, MBA (UT Medical Center) as CIO. She was VP of applications at BayCare until December 2023, when she took the SVP/CIO job at University of Tennessee Medical Center.

Tiffani Misencik (Greenway Health) joins MultiPlan as chief growth officer.

Lisa Dykstra (Lurie Children’s Hospital) joins CHIME as CIO strategic advisor.

Announcements and Implementations

WellSpan Health uses an AI agent from Hippocratic AI to boost colorectal cancer screening in underserved, at-risk people who are not actively engaged with the health system. Engagement rates and home test kit opt-ins were significantly higher for Spanish-speaking patients versus English speakers, which the health system attributes to language barrier elimination, convenience, and the ability to conduct higher-quality calls than human agents who are held accountable to call productivity targets.

ProPublica exposes a “denials for dollars” practice in which health insurers outsource prior authorization review work to companies that are incentivized to deny claims. Cigna-owned EviCore by Evernorth uses an AI algorithm, called “the dial” by insiders, to adjust denial rates based on the financial guarantees that it has promised an insurer. The algorithm rejects more requests if savings aren’t sufficient or increases approvals if complaints arise. The article also describes a lawsuit that was brought against Carelon, which is owned by Elevance Health, that alleges that the company intentionally limited its fax machines to accept no more than 10 pages so it could then reject those claims for not having complete documentation.

Optum Rx implements Rx PreCheckPrior Authorization, which uses Surescripts technology to reduce PA approval time for 25 specific drugs from 8.5 hours to under 30 seconds.

Government and Politics

KFF Health News reports that Kooth, a digital mental health app vendor whose California state funding has been threatened, covered $15,000 in travel expenses for state officials to visit its London headquarters. Mental Health Commission Director Toby Ewing, who has been placed on administrative leave following whistleblower complaints, supported preserving Kooth’s $271 million contract despite low usage of its app, which has facilitated just 2,800 coaching sessions.

The government of Saudi Arabia institutes a licensing initiative that will facilitate the use of medical software by eliminating the requirement that companies operate physical factories.

The FDA names Michelle Tarver, MD, PhD director of its medical device division. She replaces Jeffrey Shuren, MD, JD, who is retiring.

Other

A local group raises concerns about the planned acquisition of Jenny Stuart Health (KY) by Deaconess Health System. A member of Save Jennie Stuart says that the 194-bed hospital seeks new ownership because of “a recently purchased artificial intelligence boondoggle” from an unnamed vendor that cost $8 million. The hospital wants to implement Epic, which Deaconess uses.

Florida nurse Katelyn Watts, RN, DNP develops a human trafficking screening tool for Epic, which in her three-month doctoral project resulted in the identification of five trafficking victims and the arrest of three suspected traffickers.

Sponsor Updates

• Netsmart adds VNS Health’s predictive analytics for Hospice Visits in the Last Days of Life into its MyUnity EHR.
• St. Luke’s Medical Center in the Philippines implements Altera Digital Health’s Sunrise EHR.
• Ellkay, Consensus Cloud Solutions, Waystar, and Surescripts will exhibit at NextGen Healthcare UGM October 27-30 in Nashville.
• Avia Marketplace recognizes EVisit in its “Top Virtual Nursing Companies” report for 2024.
• Five9 opens a new office in San Francisco.
• Impact Advisors releases a new episode of “The Impactful Advisor” podcast, “Impactful AI.”
• Konza National Network will present at the NCQA Health Innovation Summit October 31-November 2 in Nashville.
• FinThrive earns claims management certification for Oracle Health Patient Accounting.
• The Digital Health Hub Foundation’s Digital Health Awards recognizes Linus Health as the best in class winner in the longevity category for its digital screening solution for mild cognitive impairment, and NeuroFlow as the winner in the mental and behavioral health category.
• Meditech releases a new “This Week Health” podcast, “Clarion Hospital shares care coordination success.”
• MRO joins the CHIME Foundation as a Premier partner.

Blog Posts

• A Sneak Peek into the eClinicalWorks 2024 National Conference (EClinicalWorks)
• Elevating Health Literacy: Empowering Patients to Act on Their Understanding of Trusted Health Information (First Databank)
• Top Technology Investments for Healthcare Organizations (FinThrive)
• Third-Party Risk Management in Healthcare: The “Must-Haves” (Fortified Health Security)
• The Buck Starts Here: Front-End RCM’s Contribution to Claims Denials (Inovalon)
• 3 Ways an EHR Enhances Hospital Disaster Preparedness (Medhost)
• Modern Efficiencies for a Modern Audit Team: MRO Experts Share How to Reduce Risk (MRO)
• AI in Physical Therapy: The Future of Operations and Patient Care (Net Health)

I received just one sponsor’s information about their participation in the CHIME Fall Forum in San Diego November 4-8, so I’ll just insert it here:

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

Contacts

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

EPtalk by Dr. Jayne 10/24/24

Dr. Jayne Goes to HLTH

I managed to swing by the HLTH conference earlier this week, en route to other client work. Even though HLTH positions itself as the hipper and cooler of the healthcare technology conferences, it is still plagued by attendees behaving badly.

I was shocked at the number of people who stopped in the middle of high-traffic areas to read their phones, or who wandered oblivious of their surroundings because they were heads down. It’s not hard to step off to the side, and a little courtesy might just keep you from being slammed into by the crowd rushing from stage to stage trying to catch hot topic presentations.

Normally I am annoyed by people who are whistling — in the same way I’m annoyed by people who are having loud video chats on their phones or watching movies without headphones — but I had to smile a little when I realized that the guy walking in front of me was whistling one of Bach’s Brandenburg Concertos.

From my tour through the exhibit area, kudos to Steel Patriot Partners and its booth team for being on the alert and greeting passers-by with strong eye contact and using attendee names and titles, which was doable at this conference because the font on the badges was large enough to read as people were passing. The company is always solid in the hall, and I wish more teams would follow their example in being outward facing and engaging. My day continued on the upswing with a brief Jonathan Bush sighting and a trip to the Puppy Park, which always puts a smile on my face.

The Zappos team also had a strong booth work ethic, greeting people promptly and fielding questions about their employee engagement program. If you’re looking for something that’s more fun than the usual logo-bearing tchotchkes, they’re worth checking out. Especially with organizations encouraging team members to move more and improve their own personal health, making sure that everyone has appropriate footwear makes sense.

Speaking of footwear, IMO again brought a strong sock game as well as the usual highly polished dress shoes. This picture highlights the weirdness of the exhibit hall aisles, where there was bare concrete between the borders of exhibitor booths and a spongy purple runner that was placed down the centers of the aisles. The problem with the purple runner is that the sides curled up midday in some areas, creating a trip hazard. It was also weird to stand talking to people and having that uncarpeted no man’s land at the edge of the booth. I know that everyone is trying to save money, but it just felt a little too industrial, not to mention that one good slip-and-fall lawsuit will surely wipe out any savings that was had from the strategy.

Several booths, including behavioral health vendor Headspace, had arcade-style claw machines. Other eye-catching features seen on the show floor included the tried and true “spin the wheel and win a prize” gimmicks as well as notebooks, stress balls, and plenty of logo-bearing socks. I spotted a “Top Gun” Val Kilmer Iceman impersonator several times, complete with flight suit. He was amazingly close to the character in looks and bearing, including full swagger. I was never successful at figuring out what booth he was with, or in catching a good photo, so if you know the story or have a good picture, please share.

Nurses are superheroes, and these were even wearing the capes to prove it.

I made a couple of logistics notes during the meeting, the first of which was this sign that was placed near where attendees entered the exhibit hall through a tunnel of stage lighting. As a physician, I don’t feel very good about knowingly excluding a subset of attendees on the basis of a medical condition. It seems that as a healthcare conference we should be able to chill on the stage effects in order to include everyone.

There were also issues with lunch timing, as buffets were fully set, but with expo center staff blocking their opening. One line had a staffer who was doing 30-second countdowns as the lines grew, telling attendees “5 minutes” then “4 minutes 30 seconds” and so on. Finally, a HLTH team member came by and told them to go ahead and open the lines at the one-minute mark. I know they don’t want to open lines early if everything isn’t in place, but that wasn’t the case here. Swinging by again towards the end of lunch service, I noticed that they had one lunch area entirely closed with 45 minutes left in the lunch time, and in another area, three of four buffet lines were shut down with 35 minutes to go.

Part of the way that HLTH justifies its high prices is the food service, and it seemed a little lackluster compared to when I attended a couple of years ago. I also heard several complaints about the lack of adequate table seating during lunch, especially when food was served that required use of a fork and knife. Most people are less happy about trying to eat a piece of steak with a plastic knife and fork while sitting on a white sofa compared to using a table.

Although there was a good amount of lounge-style seating around the hall, I saw plenty of individuals who had just plopped in the middle of a sofa rather than choosing a seat at the end so that someone else could perhaps use the other end. That’s not HLTH’s fault as much as attendee manners, but future logistics plans might want to take that into consideration and add more individual seating for those who like to avoid being next to anyone. An architect friend of mine has a tremendous amount to say about the psychology of seating design, so I’m sure brilliant event planners can figure it out. Maybe someone can chip in an AI solution to generate suggestions.

Alas, it was a long day in the exhibit hall trenches and I had a plane to catch, so I left through an alternate exit door where I found this sign. I thought it was funny since it was facing the doors I had just come through. The other side was blank, so if they really wanted people to not use those doors, they probably should have turned it around, especially since it was (at least in my opinion) pretty funny.

I visited a couple of vendor parties during the evening. Despite us being in a post #MeToo era, I experienced some sexual harassment for the first time in a number of years. Too much alcohol definitely brings out the worst in some and doesn’t make boorish behavior better in others. One reader shared a picture of someone sleeping in a hotel hallway wearing their conference badge the next morning at 6 a.m. I’ll hold off on sharing that picture because it’s bad enough to wake up that way, let alone potentially lose your job over it, since we don’t know if they were just tired, lost their room key, or were under the influence of something else.

If you attended HLTH, what were your highlights? Anything you would change for next year? How was the Busta Rhymes show? Leave a comment or email me.

Email Dr. Jayne.

Readers Write: HLTH 2024 Did It Again

HLTH 2024 Did It Again
By Mike Silverstein

Mike Silverstein is managing partner of healthcare IT and life sciences at Direct Recruiters, Inc.

Once again, HLTH 2024 delivered. In my opinion, HLTH has become the most important healthcare conference on the calendar, and this week’s event in Las Vegas did not disappoint. While sales teams manning booths may have found it less fruitful for direct lead generation, that’s not the true purpose of this conference. HLTH and its sister conference ViVE are where healthcare’s biggest strategic moves are set into motion.

No other event except perhaps the JP Morgan Healthcare Conference brings together such a diverse mix of healthcare investors and vendors from around the world under one roof. HLTH plays a crucial role in shaping the industry’s three- to five-year outlook, and I would argue that it’s even more impactful than JPM since it fosters face-to-face connections in one concentrated venue.

Despite ongoing political uncertainties, the market flywheel is starting to spin again. After a year and a half of valuation struggles, investors and companies are finding common ground. Investment bankers who I spoke with mentioned that deals are once again flowing, and I expect a wave of health tech and healthcare services companies to announce successful funding rounds in the coming months.

Interest rates are beginning to tick down, and HLTH serves as a prime meeting point for key players across the ecosystem — vendors, payers, providers, life sciences, and employers. As healthcare costs continue to rise, software designed to reduce expenses and drive system-wide efficiency is becoming indispensable. Unlike HIMSS, which is more narrowly focused on health systems, HLTH brings together the entire healthcare economy, providing early-stage investors with access to companies on the cutting edge of innovation.

AI was the dominant theme at HLTH, and its influence is only expanding. The companies that are making the most traction attracted significant attention from investors who are eager to deploy capital from the funds raised in 2022, which remained largely untapped in 2023 and early 2024. These companies are focusing not only on cost reduction, but also on addressing the looming clinician shortage that will hit the healthcare system over the next decade.

Solutions that reduce time spent by doctors and nurses on administrative tasks, allowing them to focus more on patient care, are in high demand. Technologies like ambient scribing and workflow tools that augment Epic are gaining traction, helping clinicians operate at the top of their licenses. Additionally, AI is finally showing real potential to address healthcare’s persistent interoperability challenges, a problem that has long frustrated the industry.

While the upcoming election could reshape parts of the healthcare landscape, HLTH 2024 reaffirmed a more immediate truth: the healthcare industry is primed for growth and innovation, with investors ready to fuel the next wave of transformation.

Morning Headlines 10/24/24

PEO-DHMS to Award Leidos Follow-On MHS GENESIS System Support Contract

The Program Executive Office for Defense Healthcare Management Systems will likely award Leidos another potentially multi-billion dollar contract to continue providing system integration support for the DoD’s MHS Genesis EHR.

Infinitus Systems raises $51.5 million Series C funding on the strength of AI guardrails

Infinitus Systems announces $51.5 million in Series C funding and the launch of its FastTrack healthcare phone call automation software.

Commure To Partner with HCA Healthcare on Ambient AI Platform

HCA Healthcare selects Commure, which acquired ambient documentation technology vendor Augmedix in July, to develop and deploy ambient AI.

Healthcare AI News 10/23/24

News

Amazon One Medical launches AI tools for its 1Life proprietary EHR – ambient documentation, a summarized medical history, draft responses to patient messages, and workflow routing.

Anthropic releases a beta developer version of Claude’s API that adds “computer use” capability, in which developers can program interaction with a user’s computer such as looking at a screen, moving the cursor, clicking buttons, and typing text.

Google Cloud announces GA of Vertex AI Search for Healthcare along with new features of its Healthcare Data Engine.

GE HealthCare announces CareIntellect for Oncology, which summarizes clinical reports, flags deviations from a patient’s treatment plan, and identifies relevant clinical trials.

The Coalition for Health AI (CHAI) publishes draft frameworks of how it will certify independent quality assurance labs and standardize their test results into what it compares to a nutrition label for AI product performance and safety.

Aidoc and Nvidia will co-develop a framework for integrating AI into clinical workflows.

Business

Ozarks Healthcare will integrate Avo’s AI clinical decision support with its Meditech EHR. The tools include scribing, chart summary and care guide, and the ability for clinicians to ask clinical questions about the patient’s information and relevant medical evidence.

Zoom will integrate Suki’s ambient documentation into Zoom Workplace for Clinicians, a recently announced paid offering.

Atropos Health announces GA of ChatRWD, an AI co-pilot that generates real-world evidence to answer clinical questions.

Tennr, which offers AI-powered healthcare document processing, raises $37 million in Series B funding.

AI-driven patient preference and informed consent system vendor HealthEx raises $14 million in seed and Series A funding.

Artera announces new AI co-pilots to its Harmony patient communications platform: Staff (translation, predictive text for patient inquiries, message shortening, and conversation summaries that can be saved to the EHR) and Insights (no-show reports).

HCA Healthcare selects Commure to develop and deploy ambient AI. Commure closed its $139 million acquisition of ambient documentation technology vendor Augmedix in July 2024.

Research

Researchers develop a system of AI-powered GoPro cameras that detects when the wrong drug syringe or vial is being used to prepare a patient’s doses, which the authors note could prevent serious medication errors in ORs, ICUs, and EDs.

Other

Harvard Medical School adds a required month-long AI course for students in its MD/PhD translational medicine program and engineering program that it offers with MIT.

Contacts

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

Readers Write: Primary Care Mental Health Support Requires a Whole-Person Care Approach

Primary Care Mental Health Support Requires a Whole-Person Care Approach
By Cynthia Horner, MD

Cynthia Horner, MD is chief medical officer of Amwell. 

Primary care physicians started seeing a dramatic uptick in the number of patients with mental health concerns even before COVID took a toll on the country’s mental health. Now, as the nation struggles with record-high rates of distress and a lack of access to mental health support, there’s a critical need for the healthcare industry to embrace an integrated, whole-person approach to care.

Nearly one out of four adults experienced a mental, behavioral or emotional illness of some type in the past year, according to the latest report from the Substance Abuse and Mental Health Services Administration. For primary care physicians, the swell in the need for mental health support reflects a pattern they have seen during the past two decades:

• From 2006 to 2018, primary care visits that addressed mental health concerns grew 50%, from 10.7% to 15.9%, according to a study in Health Affairs.
• Between 2016 and 2018, about 40% of patients who were diagnosed with anxiety, depression, or any mental illness saw their primary care physician for treatment.
• The percentage of people suffering from anxiety and depression has doubled since before the pandemic. Medicaid data illustrates the enduring impact of COVID, with prescriptions for mental health-related conditions outpacing prescriptions for other conditions in 2022.

To help as many people as possible, we must initially reach patients where they are most likely to be seen: by their primary care providers.

The shortage in the behavioral health workforce may be why more people are turning to primary care physicians for support. The National Center for Health Workforce Analysis reports that as of December 2023, more than half the U.S. population—169 million Americans—lives in a mental health professional shortage area. Compounding the issue is a lack of primary care physicians to meet patients’ health needs.

Given the shortfall of mental health and primary care professionals, virtual care is vital to ensuring that patients have access to the right resources for a whole-person, integrated approach to care. Adopting hybrid care models that include telehealth is crucial to closing care gaps and enabling continuity and access for all.

Primary care physicians have a foundational understanding of mental health conditions. However, a whole-person approach to care — including comprehensive and ongoing mental healthcare from digital programs and behavioral health specialists — is vital to positive outcomes.

That’s one reason why it’s important to continue managing patients even after referring them to a specialist for support. This integrated approach can effectively bridge the gap between physical and mental health.

When it comes to which mental health conditions primary care providers should treat, the acuity matters more than the diagnosis. For example, earlier in my career as a family medicine physician, I managed a patient who was living with schizophrenia. His condition was well controlled and he complied with his regimen and his follow-up. For these reasons, I could continue to treat him. But had his disorder been more acute, or if he had been a new patient and the severity of his schizophrenia was unclear, I would have referred him to a behavioral health specialist.

Ideally, even after that referral, I would have remained part of his care team, received progress updates, and helped manage his other care needs. That’s the best scenario for patients and their primary care providers when they begin working with a mental health professional and receiving care through digital programs.

Whole-person care—delivered in-person, virtually, and through automated care—facilitates collaborative care. It removes the challenges of geography at a time when nearly 80% of U.S. counties are considered healthcare deserts. Whole-person care also offsets the challenges that patients face when they need support from a behavioral health specialist but can’t find one.

As the industry looks for ways to integrate mental healthcare into the primary care setting, here are ways providers can foster whole-person care for overall patient well-being.

• Lean into virtual technologies for support. With virtual primary care, network providers can manage referrals and care across digital behavioral health, urgent care, specialty care programs, and digital companions. This facilitates personalized care and optimal health outcomes by giving providers medical and mental health updates, helping to inform clinical decisions. Embracing virtual technology also minimizes instances where underserved communities can’t access the support they need. Today, 60% of psychologists report that they do not have openings for new patients.
• Establish stronger relationships between primary care providers and behavioral health specialists. Care teams that share assessments, treatment plans, and test results support an integrated model for healthcare. The adoption of health tech solutions nurtures this collective approach to care. It also improves the patient experience and helps align specialty referrals and digital care program enrollments, which empower patients to take an active role in improving their health.
• Partner with health plans to provide the right support for digital populations. This may include investment in a platform that blends in-person care with digital health tools. Evidence shows that patients who are receiving primary care services regularly see 33% lower healthcare costs. In 14 studies that examined the relationship between engagement and efficacy, 64% found that increased engagement with digital interventions was significantly associated with improved patient outcomes.

The movement of patients who are seeking care for mental health conditions from trusted primary care physicians isn’t going to slow or reverse. The industry can strengthen health outcomes by embracing a whole-person care approach, in-person and virtually. We can also keep primary care providers close to a patient’s physical and mental health care, offering the complete, integrated, and personalized support that patients want and need.

Morning Headlines 10/23/24

Counsel Health Launches with $11M in Seed Funding to Deliver Physician-Led, AI-Powered Medical Advice

Counsel Health, which offers asynchronous messaging with physicians, raises $11 million in a seed funding round.

Tennr lands $37m while tearing through the paper mountain in healthcare with leading document reading model

Tennr, which has developed automation software for the reading and processing of medical documents, announces $37 million in new funding.

MPath Secures $3 Million in Funding to Expand Cancer Screening and Preventive Health Initiatives

Automated cancer screening technology startup MPath secures a $1 million investment from Oncology Ventures, bringing its total raised within the last four months to $3 million.

Senators demand answers on telehealth platforms from Pfizer and Eli Lilly

Senators want drugmakers Pfizer and Eli Lilly to explain why their direct-to-consumer programs don’t violate anti-kickback statutes by offering telehealth prescribing for the drugs they manufacture.

News 10/23/24

Top News

Remote patient monitoring company CopilotIQ acquires competitor Biofourmis to offer tech-enabled, home-based care to seniors with chronic conditions.

Reader Comments

From Suspicious Minds: “Re: HIPAA. Why is the excuse used everywhere? You can’t record our time together because of HIPAA?” The policy makes sense if the sign is hanging in the lobby, where a patient shooting video doesn’t violate HIPAA (they aren’t a covered entity) but would raise valid privacy concerns. HIPAA also doesn’t address patients recording their own encounter, although it prohibits the provider from doing the same without the patient’s permission. I’m not sure what the sign means by “recorded media,” although I’m guessing that it is awkwardly referring to audio recording.

From HLTH Bellth: “Re: HLTH. Where the substance at?” HLTH attendees do three things, according to the visual evidence that they provide: go to parties, mug for selfies with pals, and stand around vendor booths. Not to mention interviewing each other for podcasts and videos that nobody will consume and seeking celebrity elbows to rub. HLTH seems to be where high-level executives throw around vaguely futuristic ideas without fear of anyone remembering later when they turn out to be wrong (everybody’s a futurist in the short term). Substantive accomplishments are still mostly announced at HIMSS, or even better, immediately instead of holding them for PR reasons that ceased to be valid 10 years ago.

Webinars

October 24 (Thursday) noon ET. “Preparing for HTI-2 Compliance: What EHR and Health IT Vendors Need to Know.” Sponsor: DrFirst. Presenters: Nick Barger, PharmD, VP of product, DrFirst; Tyler Higgins, senior director of product management, DrFirst. Failure to meet ASTP’s mandatory HTI-2 certification  and compliance standards could impose financial consequences on clients. The presenters will discuss the content and timelines of this key policy update, which includes NCPDP Script upgrades, mandatory support for electronic prior authorization, and real-time prescription benefit. They will offer insight into the impact on “Base EHR” qualifications and provide practical advice on aligning development roadmaps with these changes.

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

Acquisitions, Funding, Business, and Stock

Medbridge, which offers patient education and care software, acquires AI-enhanced rehab app development company Rehab Boost. Paul Jaure, Rehab Boost’s founder, will join Medbridge as head of AI.

HealthEx launches its patient-centric health data preferences and consent solution with $14 million in funding.

Counsel Health, which offers asynchronous messaging with physicians, raises $11 million in a seed funding round. Founder and CEO Muthu Alagappan, MD was previously chief medical officer of healthcare intelligent agent workflow vendor Notable.

Cleveland Clinic will open a Northeast Ohio primary care office in affiliation with Amazon One Medical, which offers members same-day or next-day appointments, 24/7 on-demand care, care team messaging, and insurance billing.

HealthSstream announces Q3 results: revenue up 3.9%, EPS $0.19 versus $0.13, beating earnings expectations but falling short on revenue. HSTM shares are up 36% in the past 12 months, valuing the workforce solutions company at $914 million.

Pelvic pain virtual care platform Zencape Health shuts down. Founder and CEO Abi Sundaram says that the company earned positive user feedback and signed a health system partnership, but ran out of money and found that its model was too reliant on expensive physician time.

Sales

• Palomar Health (CA) selects IKS Health’s Care Enablement Platform.
• Rush University System for Health (IL) will incorporate Clear’s identity verification software into its MyChart password reset within its My Rush app.

People

Enlitic hires Brenda Rankin (Nuvoke) as COO.

Jonathan Malek (Veradigm) joins Avodah as CTO. Malek co-founded Practice Fusion in 2004 and transitioned to Allscripts (now Veradigm) when it acquired the company in 2018 for $100 million.

Vitalchat Telehealth names Michael Raymer (Health Advisory Partners) CEO.

Orbita hires Jeff Taylor, MS (Innovative Consulting Group) as CEO.

Fullscripts names Chief Financial and Strategy Officer Ashley Koch to the additional role of president.

Moffit Cancer Center rehires its former CIO Beth Lindsay-Wood, MBA (City of Hope) as SVP and chief informatics and technology officer.

Derek Anderson (The HCI Group) joins HCTec as VP of sales.

William Hudson, MBA (Aidoc) joins Hippocratic AI as chief transformation officer.

Kaia Health hires Adam Pellegrini (Jasper Health) as CEO.

Announcements and Implementations

Prairie Lakes Healthcare System (SD) will implement Epic through its affiliation with Sanford Health.

Cleveland Clinic adds Ayble Health’s digital care pathways and behavioral health content to its virtual care program for patients with chronic digestive diseases.

The Ohio Department of Mental Health and Addiction Services rolls out Epic across the state’s six psychiatric hospitals.

Laudio and the American Organization for Nursing Leadership publish a nurse manager trends report that uses the company’s 200,000-employee dataset and nurse manager interviews.

Confluence Health (WA) adds virtual visit capabilities from KeyCare to its virtual care services.

Blue Shield of California and Salesforce will offer a prior authorization platform as part of Salesforce Health Cloud. The system will assemble relevant EHR information into an electronic form that physicians can submit immediately to Blue Shield, which will approve or deny the PA request before the end of the visit.

Samsung enhances its Health app to allow users to collect their health records from providers electronically, after which the app will offer insights, alerts, and next best steps. The app will also add barcode scanning to its food tracker. Data access is provided by B.well Connected Health.

Government and Politics

England’s health secretary unveils a plan to issue “patient passports” for data-sharing across providers that will save an estimated 40,000 hours of NHS staff time each year and reduce wait lists. The government will also explore the use of patient wearables for self monitoring.

Other

Senators want drugmakers Pfizer and Eli Lilly to explain why their direct-to-consumer programs don’t violate anti-kickback statutes by offering telehealth prescribing for the drugs they manufacture.

A Black Book Research survey of 300 HLTH attendees finds that the majority are window-shopping for generative AI, machine learning, cybersecurity, and post-acute care technologies. Their organizations likely won’t invest in these areas for at least another 18 months.

Sponsor Updates

• Ascom Americas employees in Morrisville, NC pack 200 disaster relief kits for the American Red Cross.
• AGS Health, HealthMark Group, MRO, TruBridge, Vyne Medical, and Wolters Kluwer Health will exhibit at AHIMA October 27-29 in Salt Lake City.
• WellSky partners with Connect 211 to improve online data sharing and make community resources easier to find.
• Black Book Research shares the results of its latest survey of health information management professionals, revealing critical challenges confronting the medical coding industry in Q3 2024.
• St Jansdal hospital in the Netherlands extends its enterprise imaging software contract with Agfa HealthCare.
• Altera Digital Health publishes a new client story, “Inland Empire Health Plan brings benefits of data interoperability to 1.5M members.”
• Arcadia CTO Aneesh Chopra will present at the NCQA Health Innovation Summit October 31 in Nashville.
• Avia Marketplace recognizes AvaSure in its “Top Virtual Nursing Companies” report for 2024.
• Consensus Cloud Solutions, Netsmart, SnapCare, Waystar, and WellSky will exhibit at the LeadingAge Annual Meeting October 27-30 in Nashville.

Blog Posts

• Cybersecurity Risk Mitigation Suggestion: Share the Burden (CereCore)
• CMS Announces Resources for Hurricane Milton (AdvancedMD)
• How AI is Reshaping the Future of Medical Coding (AGS Health)
• Creating a Thriving Ecosystem for a Seamless Patient Experience (Artera)
• Q&A with Availity CISO Mike Green: Part 1 (Availity)
• Clearwater Cyber Briefing: Key Trends and Takeaways for October 2024 (Clearwater)
• Building an Interconnected Digital Corridor Beyond the Digital Front Door (Cordea Consulting)
• Building a Strong Employer Brand: Key Strategies for Recruitment Success (Direct Recruiters)
• AI, Outages, and Interoperability: Top Takeaways From a CMIO Summit (DrFirst)

Contacts

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

Morning Headlines 10/22/24

Medbridge Acquires Rehab Boost, Launches Medbridge Motion Capture as Part of Medbridge AI

Medbridge acquires AI-enhanced rehab app development company Rehab Boost.

HealthEx Raises $14M led by General Catalyst to Empower Patients and Health Systems to do more with Health Data

Patient health data access and consent startup HealthEx launches with $14 million in funding.

CopilotIQ and Biofourmis Merge to Create the First End-to-End Platform for AI-Driven In-Home Care

Remote patient monitoring company CopilotIQ acquires competitor Biofourmis to offer tech-enabled, home-based care to seniors with chronic conditions.

Curbside Consult with Dr. Jayne 10/21/24

When I decided to pursue a career in family medicine, I saw the specialty as promoting three primary goals: health promotion, disease prevention, and helping patients live longer and healthier lives. As a third-year medical student, I had little understanding of all the factors that would be working against me in that pursuit.

I knew that there would be insurance companies that would put prior authorizations and other blockers in the way of recommended treatments. I knew that I would have challenges finding resources for patients who are without insurance and with low health literacy. I didn’t know that I would also be fighting an uphill battle against corporate America in the form of tobacco companies, giant food conglomerates, and many others that are reaping profits from reinforcing unhealthy behaviors and addictions.

As I moved into clinical informatics, we saw ways in which technology could help us do more with less and to better identify patients who were in need of health interventions. When we started looking for the needle in the haystack trying to find patients who had fallen through the cracks on preventive screenings, more often we found a giant pile of needles needing attention because so many patients had fallen through the cracks. Even after we had identified the patients, we still had to convince them to adopt healthy behaviors and undertake recommended screenings and treatments, which was an entirely different undertaking. It became discouraging to watch data pile up and not have the resources to act on it.

Fast forward to the world of wearables and the quantified self. We became excited about the ability to put data in patients’ hands on a daily basis, motivating them to make changes in their health status. The rise of wearables highlighted economic disparities when some patients had multiple different kinds of devices – from step counters to sleep trackers – and others were struggling with basic subsistence needs. As a primary care physician, that evolution created a bit of whiplash in the office as I moved from room to room. Some contained patients who brought printouts and jump drives so I could see their data. Other room had patients who were lucky to take a blood pressure reading at Walgreens once or twice a month. Although some employers and insurance companies developed programs to get devices to their patients, those were few and far between in my practice.

We are now 15 years past the release of the Fitbit, which made tracking more accessible for many, but I’m not sure that we are any healthier. Recent articles that looked at life expectancy show that the improvement curve of the last century has hit a slowdown, even in economically advantaged nations. Public health interventions and new medical treatments have been a primary driver of those improvements, but we still haven’t cracked the code on how to help our patients overcome many of the challenges that they face, from lack of health resources to the ability to cope with the decreases in function that come with normal aging.

Ten years ago, when getting together with physician colleagues over drinks, we could expect to talk about interesting cases that we had seen at the hospital, or we might be kvetching over student loan repayment. Now, we’re more likely to discuss how we are juggling our own health issues or the challenges of managing health needs for aging parents and loved ones. As part of a family whose members routinely approach 100, it’s a topic with which I have experience.

The article contains a discussion of research around life expectancy that has been done over the last three decades. The authors conclude that we’ve reached a point where it’s increasingly difficult to drive life expectancy upward. I found their discussion of the percentage of patients that could be expected to live to be 100 years of age most interesting. To make this happen, they note that we would need ways decelerate death rates among older people, and due to the costs involved in such a project, I’m not sure the world is ready to spend that kind of money.

Additionally, having been around plenty of people who are in their mid to late 90s, the ones I know aren’t terribly interested in radically longer lives. Although they have had tremendous life experiences, they have also had to grow used to living without their friends and loved ones and sometimes seeing their children and grandchildren predecease them. One of my relatives continually asks why she’s still here when so many others have gone, and it’s terribly sad. It’s certainly something that should be considered when we’re talking about changing how we look at medical interventions.

In thinking through this topic with the understanding of where we are with healthcare spending in the United States, it makes me wonder whether we have the right information to try to solve the problem of truly helping people live longer healthier lives, or whether we will continue spinning in circles.

We certainly know that some relatively inexpensive interventions, like vaccinations, help. However, we’re fighting an often losing battle in convincing patients to partake of these interventions due to conspiracy theories, fears related to debunked not-so-scientific research, and for some, a genuine belief that doctors only recommend vaccines because of personal profits. As a primary care physician, I can attest that the latter is most certainly false, but it’s difficult to convince patients. Improving nutrition is one of the areas that has the most potential to boost health, but it’s not sexy or exciting, so it languishes as a not-so-hot topic. 

We know that it costs money to improve patient health, whether through improved nutrition, health coaching, medications, or procedural treatments. However, because of our fragmented healthcare finance system, insurance companies pay for those interventions on younger patients but don’t realize the long-term savings, which sometimes don’t happen until patients are covered by Medicare. This phenomenon, along with our profit-driven insurance companies, drives the willingness of payers to try to deny treatment, which starts a cascade of activity by patients and physicians that unfortunately in some cases leads to everyone giving up before the patient actually receives the care that they need.

I’m still looking for the technology silver bullet that cuts through all this mess and matches the right patient with the right treatment at the right price at the right time. Maybe AI will help create that solution, but it’s also going to require a lot of individual commitment and political will that seems to be lacking.

Before we had so much data, we didn’t know if  we were doing a good job for our patients. Now we have lots of information, and although it shows that we do a lot of good things, it also shows ongoing deficiencies that still need attention. Maybe I can convince some of the smart folks who I work with to create an app to give me a weekly reminder of “great things we’ve found in the data and have been able to act on” so that the other findings we encounter don’t seem so discouraging. Although it might have been easier back when we knew less than we do now, knowledge is power, and it just reminds us of what is yet to be done.

How well does your organization drive outcomes using data? Are you helping move patients to improved health or are people running in circles? Leave a comment or email me.

Email Dr. Jayne.

Readers Write: Harnessing the Full Potential of AI in Healthcare Requires Carefully Prepared and Clean Data

Harnessing the Full Potential of AI in Healthcare Requires Carefully Prepared and Clean Data
By Brian Laberge

Brian Laberge is solutions engineer at Wolters Kluwer Health.

Artificial intelligence (AI) implementation in healthcare is gaining more and more traction. However, messy data can lead to challenges in training these platforms and helping uncover bias to ensure they offer the most impact. With 80% of healthcare data existing in unstructured formats, there’s often an extra step required to map these insights to more structured standards, enabling AI algorithms or large language models to parse through the information and distill takeaways in a clear and comprehensive way.

As the saying goes, garbage in means garbage out with these platforms. To fully embrace large language models in healthcare and capitalize on the opportunities for AI, it’s important to acknowledge the data quality challenges to overcome and tips for maintaining clean data for optimal use of advanced technologies.

When considering the use of AI in healthcare, there are two phases to consider — the training of the technology and the implementation and insights that will ultimately be delivered. When thinking about training the technology, one of the biggest challenges with healthcare data in particular is consistent data quality and accuracy. With multiple standards across healthcare, and valuable information stored in unstructured fields, it can be difficult to map insights from one care setting to another and ensure that data doesn’t lose meaning amid these bridges.

Additionally, lab or medical data often comes back with portions incomplete, inaccurate, or lacking validity, which skews the data from showing AI models the full picture. Adding further complexity, physicians often use different clinical verbiage to mean the same medical term. All of these data quality issues can result in a hallucination, where the model perceives a pattern that doesn’t exist, which results in made-up, incorrect, or misleading results. Knowing what those synonymous phrases are and being able to address them when training new models or tuning an existing large language model can help increase accuracy.

Another challenge comes from deciphering clinical notes. When you get a mix of data, these notes need to be extracted and properly codified to an industry standard. If this process cannot be completed, it’s often recommended to exclude them, as the data will lead to noise and bias within the AI models. This gap could represent a huge loss of insights that could be incredibly impactful for patient care and outcomes reporting.

In general, human error, or simply the large amount of disparate verbiage used in healthcare, doesn’t always translate easily for a uniform standard to train AI. In order to avoid this, healthcare organizations should make sure they have tools or processes in place to assess the quality of their data, clean their data, and standardize it before implementing LLMs.

Though it can be challenging to fully prepare data before training an AI model, it’s imperative to ensure that future AI use and insights are purposeful and accurate. It can be dangerous to train an AI with messy data for a number of reasons. Missing, incomplete, or incorrect information can reduce the accuracy and insert bias, which could lead it to infer incorrect assumptions that are then built into the core of the model.

Additionally, low quality or overly simplified data for minority populations could cause a bias to be built into the model. In data, race and ethnicity often are jumbled together. Sometimes, because of biases within the healthcare system itself, there is not as much data for certain groups compared to another. While addressing those care gaps is a much larger discussion, staying ignorant about the fact that the data gaps exist is also dangerous.

For example, if you are building a model to predict the most effective drug for a patient based on historical administration of various drugs, and the data used to train the model has data quality issues with race, then it is more likely not to detect a situation where a drug is more effective for a particular race and would result in a bad recommendation.

Maintaining the data, including knowing where the gaps are, and evaluating training data to address these gaps is a challenge. However, it’s essential to address from the get-go as bias or inaccuracy in the model will make the system harder to use, and ultimately, these biases will then be intrinsic to the AI platform and future insights.

Integrating data, particularly high-quality data, is proven to save hospitals money and reduce risks to compliance and industry standards. There are six core elements to maintaining data quality that organizations should consider when preparing to implement AI tools:

• Accuracy is important in reflecting the true outcomes of healthcare.
• Validity assesses the appropriateness of the data to support conclusions.
• Data integrity ensures the reliability of the data.
• Having complete data helps to identify any possible gaps within the data set.
• Consistency is important to maintain uniformity across the set.
• Timely data helps to harness the full potential of the data for meaningful actions.

All of these qualities will strengthen the data and create an easier AI implementation with less room for error.

While maintaining clean data for use by advanced analytic platforms can be challenging, there are steps that organizations should take to keep data ready for use in AI models. First, it’s important to have a strong data governance process to ensure accurate data, and to decipher good versus bad data before feeding it to an AI model. It’s also important to verify lab results against the appropriate codes to eliminate errors and incorrect codes being built into the model. We have found in one data set that the data quality was as low as 30% accurate as it contained invalid codes and incorrect codes for the labs.

Ensuring alignment of data, and validating codes to an industry standard, will help to streamline the process. The richer the data used to train the AI, the better the outcome will be. Normalizing and mapping the data can help to streamline data from multiple sources and authors. Mapping the information ensures accuracy in the data and helps break down any discrepancies between sources.

Lastly, constantly assessing and ensuring an understanding of data from the team that is responsible for training the model will help to identify gaps or potentials for biases within the data itself. It’s important for the team that is training the model to work with their data governance colleagues to ensure that they are aware of any missing data, such as gaps in lab results and member data, to remedy these gaps for more complete quality measure reporting.

By implementing these best practices, data can be properly utilized to its full potential to inform decision-making, increase quality, and enhance patient care.

Healthcare data can be messy, but creating a process where the data is properly assessed and cleaned can be beneficial in so many ways beyond AI. It’s encouraging to see an industry that has historically moved slowly be so eager to adopt new technologies. While the opportunity for AI use in healthcare is great, we can’t forget the basics of data quality that are essential in determining the future success of these platforms. With this process, organizations can make better use of AI and ensure the most accuracy in their models to help better serve patients.