News 6/21/23

Top News

Healthcare shift-bidding platform vendor CareRev will reportedly lay off one-third of its corporate workforce, about 100 employees, following the departure of founder and CEO Will Patterson, RN. He resigned after admitting to colleagues that he delivered an investor Zoom pitch – which resulted in a $50 million Series A round — while taking LSD.

Patterson announced in January 2023 that the company would focus on expanding its technology platform, which would require laying off an unstated number of employees. 

Reader Comments

From Amicus Briefly: “Re: Oracle Cerner layoff. A physician says in a private member group that its whole clinical team was eliminated, including nurse and physician executives.” Unverified since the company hasn’t said a word on that topic, but I haven’t seen that claim elsewhere. Layoffs in big, far-flung companies are often hard to quantify otherwise since those involved don’t have easy ways to compare information. It’s easier in a one-office business because you see the empty cubes or watch out the window to see who’s being marched out. Those who should eventually notice are the company’s customers, whose interests are not necessarily aligned with those of shareholders.

Webinars

June 22 (Thursday) 2 ET. “The End of COVID Public Health Emergency is Here. Is Your Rev Cycle Ready?” Sponsor: Waystar. Presenter: Vanessa L. Moldovan, commercial enablement + insights program manager, Waystar. This webinar will describe the proactive steps that are needed to avoid increased rejections and denials. It will cover regulatory waivers and flexibilities, major shifts in telehealth, changes to reimbursement, and the impact of the end of the PHE on Medicaid coverage.

July 12 (Wednesday) 2 ET. “101: National Network Data Exchanges.” Sponsor: Particle Health. Presenter: Troy Bannister, founder and CEO, Particle Health. It’s highly likely that your most recent medical records were indexed by a national Health Information Network (HIN). Network participants can submit basic demographic information into an API and receive full, longitudinal medical records sourced from HINs. Records come in a parsed, standardized format, on demand, with a success rate above 90%. There’s so much more to learn and discover, which is why Troy Bannister is going to provide a 101 on all things HIN. You will learn what HINs are, see how the major HINS compare, and learn how networks will evolve due to TEFCA.

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

Acquisitions, Funding, Business, and Stock

Gradient Health, which offers AI developers a library of 350 million raw and labeled medical images from 1,000 partner hospitals for system training, raises $2.75 million.

The founders of India-based vanity drug telehealth vendor Mojocare admit — following an investor-commissioned forensic audit after the company laid off 80% of its employees — that they were falsifying sales. A report says that the “judgment-free wellness platform” vendor was selling products to companies that were owned by the relatives of the founders, then restocking the delivered products, inflating its gross merchandise value. The money-losing company raised $21 million in a Series A funding round in August 2022 after reporting that its revenue had increased 38-fold. The two founders have no healthcare experience.

Sales

• In England, Leeds Teach Hospitals NHS Trust will implement Flatiron Health’s real-world data for oncology research.

People

Evergreen Healthcare Partners promotes John Evans to SVP of operations.

Announcements and Implementations

Malaysia’s Health Ministry will implement an expanded, cloud-based EHR nationwide in 2026.

Silver Cross Hospital expands its use of Kyruus ProviderMatch to include scheduling of primary care, gastroenterology, and cardiology.

Microsoft opens a public preview of Azure OpenAI Service that allows running models on client-owned data, eliminating the need for training.

Government and Politics

A Tennessee news site reports that Vanderbilt University Medical Center has notified some of its patients that it has sent their medical records to the state’s attorney general, who it says is investigating VUMC’s billing for transgender care services for patients who are covered by state-sponsored insurance. Commenters question the legality of providing the records under HIPAA and how VUMC chose the patients whose records it sent. HHS advises under its HIPAA “Court Orders and Subpoenas” guidance that providers can share PHI under a court order, or in the case of a subpoena, if the patient has been notified in advance to give them the chance to object or seek a protective order. The cited VUMC communication refers to a “civil investigation” in which the patient records were “requested.” The AG’s chief of staff says that the office is “surprised that VUMC has deliberately chosen to frighten its patients like this,” adding that its billing investigation involves only VUMC and certain providers, not patients.

Contacts

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

Morning Headlines 6/20/23

How Palantir is helping hospitals with tasks that used to require spreadsheets and whiteboards

A CNBC report looks at Cleveland Clinic’s work with Palantir’s AI software to manage resource allocation.

CareRev Plans to Cut Roughly a Third of Staff

Healthcare shift-bidding platform vendor CareRev will reportedly lay off one-third of its corporate workforce, about 100 employees, following the departure of CEO Will Patterson over claimed conduct issues.

Biden picks North Carolina’s former health chief, Mandy Cohen, to run CDC

As previously speculated, the White House will name Aledade EVP Mandy Cohen, MD, MPH as new CDC director effective with the resignation of Rochelle Walensky, MD, MPH on June 30.

Curbside Consult with Dr. Jayne 6/19/23

I mentioned a few weeks ago that I have been having issues with my health system’s online billing functions. I was receiving paper statements before I received the online bills and couldn’t figure out how to adjust it so that I didn’t get paper statements.

At a recent visit, I asked the staff to see if they could adjust it on their side, and they said they would try. Interestingly, they also refused to accept my co-pay at the time of service, which is a big negative as far as revenue cycle management, so I wasn’t hopeful that they’d be able to get my account set up in a best practice fashion.

It looks like the “turn off paper statements” piece worked because I received an online invoice today. It included the co-pay (no surprise there) but also an unexpected co-insurance amount that doesn’t match how my insurance works. I haven’t even received the Explanation of Benefits document yet, so I’m not about to pay it. We will have to see how this cycle continues to unfold.

We had some family adventures in healthcare this weekend, with an unexpected injury that required attention beyond what I could manage with my first aid kit. Of the urgent care facilities in the area, some had spots available for online check-in, but others didn’t. Since we wanted a minimal wait, we opted for the one that was displaying available capacity, which is also an organization that I know fairly well.

As expected, walking in with a bleeding injury of the head puts one at the front of the line whether you have an appointment or not. Unfortunately, the provider wasn’t a great communicator and was mentioning how busy she was and how many other patients she was tending to rather than making the patient feel at ease.

She tried to downplay the injury a little, but fortunately the patient followed my advice and advocated for the treatment that is actually standard of care – they only knew that because I had prompted them after evaluating the injury and referring them to in-person care. The alternative treatment offered is typically less time-intensive for the provider, but results in poorer outcomes for this specific patient scenario. Most patients don’t know the difference, and it’s sad when our healthcare system is repeatedly putting time pressures ahead of patients.

After resolving the situation, we headed out for some Father’s Day celebrations, and then I came home to catch up on some work. It was timely that Mr. H called out this New York Times story on the level of moral crisis that physicians in the US are facing. Not a day goes by that I don’t hear a story from a colleague about this issue.

I’ve worked for organizations whose relentless focus on profits led to inappropriate prescribing behaviors as well as excessive ordering of tests. In one urgent care position, management justified these actions by saying, “we’re still only one-sixth the cost of a visit to the emergency department” and regularly presented me with reports that illustrated how much of an outlier I was to my peers when looking at the sheer number of prescriptions ordered. It should be noted that this organization had its own in-house pharmacy for which it didn’t submit insurance claims, so all prescriptions generated revenue.

From a conscience standpoint, by the time I worked for this organization, my prescribing habits were well established. I didn’t fall into the trap of trying to keep up with my peers in a way that didn’t make sense for clinical quality. Due to my training and prior experience, I also tended to make more clinical diagnoses using decision support tools and algorithms rather than tests and imaging studies, so of course that was an issue as well.

Eventually the organization figured out that my clinical skills and procedural abilities allowed me to see patients at a pace and volume that still made them money, so they left me alone, and eventually, the reports stopped coming my way. At the same organization, I also had to deal with some occasional patient safety issues as they encouraged me to practice outside my comfort zone with certain procedures, forcing me to have difficult conversations about my refusal to treat patient care like the Wild West.

Once they transitioned from being physician-owned to being owned by non-clinical investors, I knew my time there was limited. Others saw the writing on the wall as well, and now the organization can’t even keep its locations staffed. Not because there’s a shortage of clinicians, but because there’s a shortage of those who want to work there.

The article details many of the issues I’ve run across while in practice or in talking with my colleagues. Physicians are reluctant to speak out when they find themselves in these situations, because it’s been reinforced that they need to be team players, or they have experienced that reporting their concerns can lead to retaliation.

Former physician peers have lied on exit interviews because they were afraid that what they said would make the rounds in the physician lounge and come to haunt them in their new positions. Even in large cities, the physician community can be small. Powerful physicians on a given hospital’s medical staff can make things difficult for physicians who are younger, newer, or who otherwise have less political clout.

When I initially entered practice, I was once called out by a senior physician who felt I wasn’t giving him enough referrals and demanded to know why. I’m not sure who I could have complained to about that since he was not only chair of his department, but president of the medical staff.

That situation is relatively mild compared to some of the pressures that physicians experience today, especially those who work in segments that are largely controlled by private equity organizations or who are under strict productivity models for their compensation. Many physician contracts have clauses that would be problematic for other classes of employees.

I was recently presented with a contract that specified compensation based on the concept of a 12-hour shift, with no extra pay for additional time spent. When I asked for the language to be changed, I was told no, that all the other physicians already working had agreed to it and they weren’t willing to alter it. Needless to say, I won’t be working for that organization. Whether they’re lying about what other physicians have agreed to or just being difficult, it’s a decent indicator that they don’t value their physicians’ time. I guarantee they wouldn’t offer that contract to a nurse.

When physicians don’t feel valued, it creates psychological challenges that make it difficult to deliver good patient care. Whether consciously or subconsciously, decisions are made in the heat of the moment that can impact patient care but are based on the provider’s current situation.

I suspect that’s what my family member experienced today, when they were offered two different but non-equivalent management plans with a comment that it was up to the patient to decide. The difference in the clinician’s time was about 10 minutes, but sometimes that 10 minutes is what keeps you from going to the bathroom, eating lunch, or taking care of two more patients waiting for care. It’s a sad commentary on what many of us are facing every single day with patients caught in the middle.

If you’re in a non-clinical role, do you consult clinical colleagues for advice prior to seeking care for yourself or a loved one? Have you had to advocate for yourself or someone else for medical care in the last year? Leave a comment or email me.

Email Dr. Jayne.

Readers Write: The Shift Toward an Employer-Driven Market in Healthcare Technology

The Shift Toward an Employer-Driven Market in Healthcare Technology
By Mike Silverstein

Mike Silverstein is managing partner of the healthcare IT and life sciences practice of Direct Recruiters, Inc. of Solon, OH.

Throughout the last few years, the healthcare technology market has been largely candidate driven. During the “grow at all costs” period that started in late 2020 and continued through fall of 2022, capital was cheap, and companies were doubling down on product that was to be delivered by expensive and newly hired engineering and data talent.

That has slowed tremendously in recent months and has been coupled with significant layoffs across most of big and medium tech. What felt like an inelastic demand for technical talent over the last number of years, which corresponded to growing compensation demands, has flipped.

Below are three market trends we are seeing that signify a shift toward an employer-driven market.

Technological Advancements

It’s no secret that technology continues to change the landscape of the global workforce. The continuous stream of new AI and automation tools being introduced has the potential to change processes, procedures, and potentially even replace human labor in some situations. According to a March 2023 report from Goldman Sachs, the automation of certain tasks could disrupt a staggering 300 million jobs worldwide.

As these changes evolve, employers’ expectations of current and prospective talent are to be able to adapt and leverage new technology to their advantage versus letting it replace them.

An Emphasis on Talent That Has a Near-Term ROI

Sales, business development, demand generation marketing, customer success, and FP & A roles are crucial right now. Investors are demanding greater discipline from their portfolio companies as the cost of capital has increased and the bottom has fallen out of company valuations, particularly in tech. Right now, each company is tasked with showing a path to break even and/or profitability. No investor wants their portfolio company to have to go out for a fundraise right now for fear of a down round.

While healthcare technology employers hire and retain talent, the pressure is high for candidates to showcase that they are results driven to land great roles. If you can help make a dollar, protect a dollar, or count a dollar – sales and marketing, customer success, and accounting and finance, respectively — there are still strong opportunities in the market. As companies strive toward profitability in a tumultuous time, there may be more uncertainty for roles further away from revenue.

The Abundance of Tech Talent

With recent layoffs, there is now an abundance of healthcare technology talent on the street with far less demand for its services. As a result, passive candidates have become more risk averse. Clients are realizing there is a bit of an opportunity to buy low(er) on some needle-moving talent.

A lot of mediocre candidates did really well for themselves over the last couple of years. Healthcare technology companies are seeing an opportunity to top grade on positions where they settled in the last 24 months, and there is added scrutiny on every candidate in the hiring pipeline.

As we face this potential shift in the market, talent that has a track record of being able to perform and execute in a capital-constrained environment will continue to thrive. Candidates who are more entrepreneurial in the traditional sense — in that they are comfortable doing more with less, versus relying on the ability to obtain unlimited growth capital whenever needed — are still in high demand, along with those with a strong accounting and operations acumen.

Morning Headlines 6/19/23

Optum health startup incubator on ice

Optum dissolves its Startup Studio incubator after three years and 100 health companies incubated.

Amazon called to account – on health data

Senators Peter Welch (D-VT) and Elizabeth Warren (D-MA) express concern to Amazon President and CEO Andy Jaffy that the company’s virtual Amazon Clinic may be collecting and sharing health data from customers.

Hackers claim responsibility for Norton Healthcare ‘cyber event’ as Louisville patients await answers

The BlackCat ransomware group claims responsibility for last month’s attack on Norton Healthcare (KY), the effects of which are still impacting the health system’s network and services.

Monday Morning Update 6/19/23

Top News

Oracle has declined to comment about its layoffs in the former Cerner business last week, but affected employees have cited numbers ranging from 500 to 1,200.

Reddit commenters said that recently hired managers were targeted, along with the HealthIntent and CommunityWorks teams, support service owners, and employees who were assigned to the VA’s stalled implementation.

Reader Comments

From Innit: “Re: [cancer screening technology vendor name omitted.] Fired the CEO and two of four salespeople after missing financial goals.” I left the name out pending a company response. Its leadership page and the LinkedIn profiles of the CEO and salespeople have not changed.

From Staffer: “Re: Children’s Mercy KC. Brought in expensive consultants to train the entire workforce on culture. Executive leadership talks the talk, but some are not changing or are almost weaponizing the culture concepts against staff. I’m curious about reader experience – how is the perception of your organization, has it run a culture initiative, did leaders change or did they get swapped out, and did the organization change following the initiative?” My only experience with this was in my short, long-ago stint with a for-profit company, but I suspect the same challenges remain:

• The organizations that undertake these projects are already in trouble and expect consultants to fix their most pressing problems.
• Executives who created the problems pretend to participate, but don’t actually plan to change their own behavior.
• Hiring a bunch of expensive consultants creates pressure to deliver ROI quickly, but culture change is slow and uncertain.
• Companies are paying consultants to ask their employees what they think instead of talking to them directly, which pretty much says it all with regard to the disconnect between management and employees.
• It’s a big de-motivator to ask for opinions that are then ignored.
• It’s easier to recognize a good or bad culture than to turn one around.

HIStalk Announcements and Requests

Nearly half of poll respondents have experienced a negative impact of a previously signed non-compete agreement. A couple of folks mentioned that non-competes should include compensation – either the old company pays you while your time-out ticks away or gives you vesting or other benefits to offset your potential lost earnings – but the Epic model of pushing the non-compete onto providers and consulting firms means that you might not get offers and won’t know why.

New poll to your right or here, as suggested by a reader: does the fear of losing your job force you to work in a suboptimal or unethical way?

Listening The Descendents (that’s how they spell it), inserted into my YouTube feed because I’ve been listening to the Hives. An HIStalk search finds that I mentioned them in 2017, where I noted that the lead singers of at least three punk rock bands have earned PhDs – Bad Religion, The Offspring, and The Descendents. They look like Walmart-fashioned grandpas waiting for the Applebee’s early bird special, but then they just rip into blazing fast and highly skilled punk rock that sends youthful moshers flinging themselves off the stage. The band formed in 1977, with Milo Aukerman stepping down temporarily to earn a UCSD PhD in molecular biology followed by postdoctoral research. Also on my playlist: the reader-suggested collaboration between Dolly Parton and Judas Priest’s Rob Halford, in which Parton’s warbling pairs surprising well with Halford’s growl as collaborators whose combined age is 148.

Lorre always offers Summer Doldrums incentives to new HIStalk sponsors this slow time of year, along with some first-year perks for small startups that need a boost. Contact her.

Webinars

June 22 (Thursday) 2 ET. “The End of COVID Public Health Emergency is Here. Is Your Rev Cycle Ready?” Sponsor: Waystar. Presenter: Vanessa L. Moldovan, commercial enablement + insights program manager, Waystar. This webinar will describe the proactive steps that are needed to avoid increased rejections and denials. It will cover regulatory waivers and flexibilities, major shifts in telehealth, changes to reimbursement, and the impact of the end of the PHE on Medicaid coverage.

July 12 (Wednesday) 2 ET. “101: National Network Data Exchanges.” Sponsor: Particle Health. Presenter: Troy Bannister, founder and CEO, Particle Health. It’s highly likely that your most recent medical records were indexed by a national Health Information Network (HIN). Network participants can submit basic demographic information into an API and receive full, longitudinal medical records sourced from HINs. Records come in a parsed, standardized format, on demand, with a success rate above 90%. There’s so much more to learn and discover, which is why Troy Bannister is going to provide a 101 on all things HIN. You will learn what HINs are, see how the major HINS compare, and learn how networks will evolve due to TEFCA.

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

Acquisitions, Funding, Business, and Stock

Optum dissolves its Startup Studio incubator after three years and 100 health companies incubated.

Sales

• The VA awards Sierra7 and partner AvaSure a contract to provide a TeleCare Companion solution to seven VA medical centers in VISN 9, powered by AvaSure’s TeleSitter solution.

People

John Noseworthy, MD (Mayo Clinic) joins Northwell-created virtual-first care ecosystem vendor Caire as executive chair.

Brent Averette (Komodo Health) joins Transcarent as SVP of enterprise sales.

Damo Consulting founder and CEO Paddy Padmanabhan, MBA died Thursday of cancer.

Privacy and Security

Politico reports that Senators Peter Welch (D-VT) and Elizabeth Warren (D-MA) have expressed concern to Amazon President and CEO Andy Jaffy that the company’s virtual Amazon Clinic may be collecting and sharing health data from customers. They ask in a letter that Amazon provide its patient authorization form, which they have heard requires prospective patients to consent to data disclosure that waives HIPAA protections. They also want to review sample provider contracts and how collected is shared.

A newly declassified report confirms that US spy agencies routinely purchase commercially available data on US citizens that includes their browsing history and cell phone location.

Other

Anthem Blue Cross Blue Shield — noting that 60% of the claims it receives for Ozempic suggest that it is being prescribed for weight loss rather than diabetes — sends letters to prescribers warning them that it will alert law enforcement and state licensure boards when it suspects inappropriate use or fraudulent activity. The letter provides few details, but since prescribers can legally order drugs for off-label uses, it seems likely that the insurer is going after doctors who improperly claim that patients have diabetes in getting insurance to pay.

A New York Times report says that the corporatization of healthcare has alienated physicians whose bosses order them to behave in profit-seeking ways that don’t align with their values. It notes that some doctors have been fired for raising issues related to patient safety or poor working conditions and are forced to hit productivity targets that preclude showing empathy or support. They also have to manage patients whose don’t have the insurance or cash to afford potentially beneficial treatments.

A TV station in Australia profiles the country’s first standalone, nationally accredited virtual hospital.

Sponsor Updates

• CereCore publishes a case study titled “Epic Advisory Services: An Acquisition and Install Story.”
• Experity celebrates a successful investment cycle with an employee trip to Orlando.
• Meditech publishes a new e-book, “A strong revenue cycle begins and ends with a satisfied patient.”
• Nordic releases a new Making Rounds Podcast, “Turning data into insights with managed services.”
• OmniSys parent company XiFin names Kyu Rhee, MD senior strategic advisor.
• Surescripts publishes a podcast titled “Bringing Healthcare to the People: How Dr. Brett Giroir Serves His Nation.”
• Le Bonheur Children’s Hospital, Children’s Hospital of Richmond at VCU, and Virginia Children’s Care Network join Premier’s Kiindo pediatric-focused collaborative and purchasing alliance.
• Verato publishes a new white paper, “What Is Referential Matching?”
• Waystar customer Alivi Health announces that it has achieved a 99.89% clean claim rate.

Blog Posts

• Vyne Medical Introduces Fax Complete (Vyne Medical)
• Building a Data-Driven Culture: A Conversation with NeuroFlow Senior Director of Data Science Bill Lynch (NeuroFlow)
• How AI helps healthcare organizations achieve the Quintuple Aim (Nuance)
• Getting to grips with chronic disease management (Nordic)
• ChatGPT, Telehealth, and Financial Burdens: Is It Here to Stay? (Optimum Healthcare IT)
• The Journey of an Electronic Prescription (Surescripts)
• EHR-Based Targeting Strategies for Medical Device Marketing (OptimizeRx)
• Do Doctors Still Use Pagers? (PerfectServe)
• What is Revenue Integrity in Healthcare? (PMD)
• Lessons from a Top-Performing Health System on Lowering Mortality Rates (Premier)
• 2023 HL7 FHIR DevDays Top 3 Takeaways (Redox)
• The Joint Commission’s new emergency management guidelines: What they mean for your organization (Spok)
• CMS Introduces Prior Authorization Regulations for Medicare Advantage (WebPT)
• Three key strategies to harmonize digital health data and improve health equity (Wolters Kluwer Health)
• How Population-Based Clinical Decision Support Encourages Holistic Patient Care (Zynx Health)
• Healthcare CIO Advice on Leading through the Complexities of Change (CereCore)

Contacts

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

Morning Headlines 6/16/23

Oracle Cerner cuts more jobs, focusing on roles with VA, federal contracts

Oracle conducts another round of layoffs in the former Cerner business, according to employee reports on Reddit and LinkedIn.

Snooping in Medical Records by Hospital Security Guards Leads to $240,000 HIPAA Settlement

Yakima Valley Memorial Hospital (WA) pays $240,000 to settle allegations that several of its security guards accessed without permission the medical records of 419 patients.

Veradigm’s plan to regain compliance with Nasdaq receives approval

Nasdaq gives Veradigm another extension to submit its annual and quarterly reports, with the company expecting to file Form 10-K on September 18, 2023 rather than June 14.

News 6/16/23

Top News

Oracle conducts another round of layoffs in the former Cerner business, according to employee reports on Reddit and LinkedIn. Federal business groups, specifically teams involved in the VA’s now-paused implementation, were most often mentioned.

The company also reportedly rescinded some job offers.

Oracle CEO Safra Catz said of the Cerner business in this week’s earnings call, “You will be seeing some more significant changes, and we have legal entity combination imminently and that actually gives us a lot more flexibility regarding the way we operate the business. We are just at the very beginning of it. Their margins are nowhere close to the way we run our company.“

Oracle has reportedly laid off 3,000 of Cerner’s 28,000 employees in the year since the $28 billion acquisition.

Meanwhile, the stock market likes what it heard this week and has pushed ORCL shares to record highs, valuing the company at $342 billion and the wallet of CTO and Chairman Larry Ellison at nearly $150 billion. Shares rose another 3.5% on Thursday.

Webinars

June 22 (Thursday) 2 ET. “The End of COVID Public Health Emergency is Here. Is Your Rev Cycle Ready?” Sponsor: Waystar. Presenter: Vanessa L. Moldovan, commercial enablement + insights program manager, Waystar. This webinar will describe the proactive steps that are needed to avoid increased rejections and denials. It will cover regulatory waivers and flexibilities, major shifts in telehealth, changes to reimbursement, and the impact of the end of the PHE on Medicaid coverage.

July 12 (Wednesday) 2 ET. “101: National Network Data Exchanges.” Sponsor: Particle Health. Presenter: Troy Bannister, founder and CEO, Particle Health. It’s highly likely that your most recent medical records were indexed by a national Health Information Network (HIN). Network participants can submit basic demographic information into an API and receive full, longitudinal medical records sourced from HINs. Records come in a parsed, standardized format, on demand, with a success rate above 90%. There’s so much more to learn and discover, which is why Troy Bannister is going to provide a 101 on all things HIN. You will learn what HINs are, see how the major HINS compare, and learn how networks will evolve due to TEFCA.

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

Acquisitions, Funding, Business, and Stock

Nasdaq gives Veradigm another extension to submit its annual and quarterly reports, with the company expecting to file Form 10-K on September 18, 2023 rather than June 14. The former Allscripts announced at the end of February that audits internal had uncovered revenue recognition problems that would force a 15-day delay in filing its report that was due March 1. The company then announced on March 22 that it had fallen out of Nasdaq compliance by failing to file its 10-K by the revised date. It was given another 60 days to file the report. Nasdaq issued a delisting notice for MDRX shares on May 18 for failing to file its reports on time. MDRX shares have lost 35% since January 1 versus the Nasdaq’s 30% gain, valuing the company at $1.3 billion. 

Nasdaq retracts its delisting warning for shares of Healthcare Triangle, determining that it made a mistake in calculating the company’s per-share value following its May 26 reverse stock split.

Healthcare staffing company Aya Health acquires Flexwise Health, whose software forecasts hospital staffing needs.

BurstIQ acquires the business intelligence solution of Olive AI.

Sales

• Health risk management firm Captive Health will offer its covered members KeyCare’s virtual care services, accessed from MyChart and Captive Health’s mobile app.

Announcements and Implementations

A new KLAS report on population health management technology vendors finds that Epic and Innovaccer stand out, and along with Arcadia, are most often considered. Customers give high partnership marks to Azara Healthcare, Relevant Healthcare, and Salient Healthcare.

Government and Politics

Human Rights Watch calls for the US government to protect Americans from aggressive billing and debt collection by non-profit hospitals, which the organization says is interfering with their other human rights such as housing, food, and education. It concludes that the US model of giving tax breaks to privately operated hospitals and hoping they will reciprocate by delivering charity care isn’t working, making the US a big outlier in medical debt. The report says the government should require hospitals to provide as much charity care as they receive in tax subsidies, for the IRS to set national standards for hospital financial assistance, and for the Consumer Financial Protection Bureau to require debt collectors to make sure that patients have been screened for financial assistance eligibility before pressing them for payment. 

Sponsor Updates

• Team Ellkay raises over $35,000 for the Alpine Learning Group during its annual Go the Distance for Autism cycling event.
• Vyne Medical publishes a new case study, “How to Establish Proof of Patient Authorizations to Overturn Denials.”
• A new report from Forester recognizes InterSystems as a strong performer among top data management and analytics vendors.
• Redox publishes a new report, “Uncovering hidden data roadblocks of cloud and AI adoption in healthcare.”
• Black Book lists the top-ranked payer technologies category leaders exhibiting at AHIP this week. HIStalk sponsors include Wolters Kluwer Health (member and consumer education solutions) and Optum (end-to-end payer RCM outsourcing, payer analytics outsourcing).
• Wolters Kluwer Health and Laerdal Medical launch VRClinicals for Nursing to enhance nurse training with realistic, multi-patient scenarios using virtual reality.
• Konza National Network’s interoperability platform earns certified status by HITRUST for information security.
• Direct Recruiters parent company Starfish Partners acquires Global People and cybersecurity-focused NinjaJobs.
• Fortified Health Security names Katarzyna Parzonka conference and event coordinator.
• Healthwise wins six Digital Health Awards.
• Loyal names Matt Gove (Summit Health/CityMD) senior advisor.

Blog Posts

• How to Maintain a Thriving Healthcare System Despite Inflating Costs (Vyne Medical)
• How Analytics Can Transform Interoperability (Dimensional Insight)
• The Hidden Benefits of Staff Augmentation in Healthcare (Divurgent)
• EClinicalWorks Day is Back – and Coming to Your Area (EClinicalWorks)
• Doctor’s Urgent Care Sees Immediate Improvement to Revenue Potential by Switching EMR (Experity)
• EHR Implementation: How to Achieve Successful Change Management (HealthTech Resources)
• Proceed with caution: Why code crosswalks are built to fail (Intelligent Medical Objects)
• Unique Challenges of Healthcare Application Testing: Why It Is So Different (Keysight)

Contacts

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

EPtalk by Dr. Jayne 6/15/23

I recently took a smaller version of The Great American Road Trip and made it a point to visit some historical roadside attractions. In the 1950s, it was all about seeing the USA in your Chevrolet (or equivalent) and families might have stopped at various quirky museums or points of interest.

One of the places I visited had a collection of antique cars. I was struck by the idea of this 1960s era Amphicar. In some ways it’s a solution in search of a problem, which is something we see often in the world of healthcare IT. I have so many vendor emails hit my box each week promising to solve problems that I didn’t even know I had that I can’t keep track of them all.

The Amphicar was innovative, but didn’t make it big, ceasing production only four years after it began. Sounds like a lot of the products I see out there.

A group of organizations including AstraZeneca, Elevance Health, Geisinger, and UCSF have come together to publish a framework for evaluating digital health products. The goal is for care delivery organizations, health insurers, and trade groups to use it to determine whether digital health products are evidence based. The authors examined 70 frameworks that were created to assess the evidence around digital health intervention, determining that the existing frameworks lacked the specificity needed by healthcare organizations.

Sometimes people forget that digital health interventions can be as important and useful to patients as medications and surgeries. For example, an appropriate intervention to help patients stop smoking can prevent lung cancer. Digital coaching to manage body weight can lead to reductions in heart disease and stroke. The authors identified certain requirements as being potentially non-negotiable for organizations depending on their needs: HIPAA compliance, FDA clearance, and ability to be understood by patients with a fifth-grade reading level were examples.

Organizations are instructed next to use existing evidence assessment frameworks that have been defined for non-digital interventions. Following that, they should apply the new framework’s 21-item supplementary checklist for considerations specific to digital health. These may include elements such as assessing an intervention for selection biases, looking at data gaps, or ensuring that underserved patients were included in the product’s clinical trials.

According to the article, there are 300,000 health apps and 300 wearables in the marketplace, so being able to determine quality of an intervention is key. I wonder how much traction this approach will get, especially when we’re already struggling to make use of evidence quality in non-digital interventions. One of the hottest topics among physicians in my area is the surge in providers offering non-evidence-based hydration and vitamin infusion services. Comments such as “the patients want it, and I don’t see the harm” win the day, along with the potential for revenue. I’ll be watching closely to see how the world of evidence for digital interventions plays out.

Mayo Clinic is planning a $1 billion expansion and its new clinical spaces will incorporate data from patient wearables. Clinicians will have the opportunity interact with patient data elements such as pulse, steps, and sleep. I got a chuckle out of the fact that the article specifically called out Mayo’s “marble-filled lobby” since so many hospitals are overly proud of their non-patient-care spaces while patients may struggle to have basic needs met.

I also found it interesting that it mentioned the tension between Mayo’s lobbyist and Governor Tim Walz over the potential for penalties against hospitals that have excessive cost growth. The project is part of Mayo’s plans to transform the city into an international medical hub. The system has pitched the state, county, and city for $500 million in public funding for campus-serving infrastructure improvements. The new expansion will impact several blocks in downtown Rochester and is intended to make the campus more streamlined and modern, eliminating wayfinding confusion and harmonizing the patient experience. Construction is slated to begin in 2024.

Northwell Direct has inked a deal with the US State Department to offer telehealth consultations to patients seeing Department of State medical professionals around the world. The offering will apply to US government employees and their families posted outside the US. Consultations will be available 24 hours a day, seven days a week and requests will be triaged for assignment to the appropriate Northwell provider staff in more than 100 specialties and subspecialties. Those providers will also provide medical clearance services before employees are sent outside the US, as well as clinical case reviews. Northwell Health also partners within the US with Teladoc for additional virtual care delivery services, so it’s not entirely clear how this will all fit together.

Speaking of government, the Surgeon General of the United States has issued an advisory about the impacts of social media on adolescent and child mental health. The report notes that social media use is nearly universal in those ages 13 to 17 with nearly two-thirds reporting daily social media use and one-third reporting use of platforms “almost constantly.” It goes on to conclude that “social media presents a meaningful risk of harm to youth” with those spending more than three hours daily facing double the risk of mental health problems as others who spend less time on social media.

The long and short of it is that “we cannot conclude social media is sufficiently safe for children and adolescents” and lists steps that can be taken to reduce the risk of harm in those groups. These include: reaching out for help for those negatively impacted by social media; creating boundaries to balance media use; being selective about what is posted and shared online; and addressing cyberbullying. A short summary is available or you can view the full advisory.

Many of my family physician colleagues are still trying to figure out how to balance their use of telehealth within the context of traditional primary care practice. A recent report from the University of Washington Center for Health and Workforce Studies showed that while there was limited data about how medical assistants participate in the telehealth setting, those staffers can transition to virtual roles following additional education and training. Unfortunately, I think a lot of organizations just try to throw people in a role without fully thinking it through. We saw this a decade ago, when practices decided they would just turn their medical assistants into scribes but didn’t think through how to create an appropriate training program or how that role transition might otherwise impact office dynamics.

More on the topic of transitioning historically in-person tasks to virtual caregivers. I was talking with some CMIOs earlier this week about whether they think virtual nursing is going to solve some of their staffing issues. Systems such as Washington-based Providence and Arkansas-based Mercy have already rolled out programs and labeled them as successful, preparing for expansion. Among the group, several were enthusiastic about the idea, and one said their system was in the process of rolling it out using internal resources. However, another said her system was about to sunset the concept because it hadn’t yielded the savings it anticipated. Although that organization’s efforts did dramatically reduce its dependence on travel nurses, those savings were countered by expenditures for hardware and third-party staff management.

Has your organization dipped its toes into the waters of virtual nursing? How is it going? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 6/15/23

BurstIQ Acquires Business Intelligence Platform from Olive AI

Healthcare analytics vendor BurstIQ acquires Olive AI’s business intelligence solution, now known as LifeGraph Intelligence.

Hackensack Meridian Health Invests in Canary Speech, Company with AI Software to Assess Anxiety, Wellness in Spoken Words

Hackensack Meridian Health (NJ) invests in speech analysis technology startup Canary Speech through its Bear’s Den accelerator program.

Apixio and ClaimLogiq Merge to Create a Leading Connected Care Platform

Healthcare analytics vendor Apixio acquires ClaimLogiq, which offers health plan claims technology.

Healthcare Triangle Maintains Compliance with Nasdaq Listing Requirements as Nasdaq Resolves Delisting Determination Error

Healthcare Triangle regains its Nasdaq compliance after the financial services organization determined the health IT vendor had been de-listed in error.

Healthcare AI News 6/14/23

News

The American Medical Association’s House of Delegates considers a resolution that would urge doctors to educate patients about the risk of large language models. It also directs AMA to work with the federal government to protect patients from inaccurate, AI-generated medical advice.

Dartmouth launches the Center for Precision Health and Artificial Intelligence.

In England, the British Labour Party recommends that the UK create a mandatory licensing model for companies that do AI work.

A UK pathologist who pioneered the use of AI to diagnose prostate cancer is advocating the use of similar AI pathology tools to diagnose breast cancer within three days and help finalize treatment recommendations within a week. He says that diagnosing cancer isn’t hard, but it takes more time to review biomarkers to determine optimal treatment, creating patient uncertainty and straining staff resources.

Business

Healthcare analytics vendor BurstIQ acquires Olive’s AI business intelligence solution.

Healthcare analytics vendor Apixio acquires ClaimLogiq, which offers health plan claims technology.

The CEO of drug manufacturer Sanofi says it will be the first pharma company that is powered by AI at scale, using AI and data science to discover drugs, design clinical trials, and improve manufacturing and supply chain processes.

Accenture will spend $3 billion to double its AI-focused employee headcount to 80,000, incorporate generative AI in its client work, and help customers use the technology.

Opinion

A Health Affairs opinion piece predicts that AI will set interoperability back, as providers will use technical and legal tools to prevent large competitors from using their data to train large language models to create competing consumer medical services.

Research

Researchers test ChatGPT’s ability to provide venomous snakebite advice to consumers, finding that it gives accurate and useful responses, including recommendations to seek medical care when appropriate, but with limitations involving outdated knowledge and lack of personalization.

Other

Peter Lee, VP of OpenAI investor Microsoft, says he was “alarmed” to learn that within the first three days of the release of ChatGPT, doctors were not only using it, but were asking it to help them communicate with patients more compassionately. A former physician executive at Microsoft says that he was “blown away” by ChatGPT’s ability to help him communicate empathetically with a friend with cancer, but observes that doctors don’t evangelize its use because that would require admitting that they aren’t good at talking to patients.

A health technology firm creates Lifesaving Radio, an AI-based radio station whose playlist of hard rock music is optimized to get surgeons “in the zone” of relaxed high efficiency during surgery. The playlist was developed using Spotify’s AI DJ analytics technology to find songs with the ideal tempo, key, and loudness for surgeons. It features an AI-powered DJ that calls out the surgeons and team members by name. The channel’s first music set is an AC/DC-inspired collection called “Highway to Heal,” which includes parodies such as “You Sewed Me All Night Long.”

Contacts

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

Morning Headlines 6/14/23

American College of Gastroenterology and American Gastroenterological Association Invest in Oshi Health to Accelerate Adoption of Hybrid Digestive Health Care

Shortly after the close of a $30 million funding round, virtual digestive care provider Oshi Health announces investments from the American College of Gastroenterology and the American Gastroenterological Association’s GI Opportunity Fund.

Oracle beats on top and bottom lines as cloud revenue jumps

Oracle reports Q4 results: revenue up 17%, adjusted EPS $1.67 versus $1.54, beating Wall Street expectations for both and sending shares to an all-time high.

Penn State Health enhancing access to primary care through subscription-based virtual service

Penn State Health launches a subscription-based virtual primary care service, initially available to employees and Penn State College of Medicine students and their dependents.

News 6/14/23

Top News

Oracle reports Q4 results: revenue up 17%, adjusted EPS $1.67 versus $1.54, beating Wall Street expectations for both and sending shares to an all-time high. From the earnings call:

• Total cloud revenue was up 55%.
• The Cerner business contributed $1.5 billion to the company’s $13.8 billion of total revenue that was up 18%.
• The company is partnering with Nvidia to build the world’s largest high-performance computer, which will run AI at 16,000 GPUs.
• CTO and Chairman Larry Ellison says that cloud usage is charged by the minute, making Oracle half the price of competitors because it runs twice as fast. He adds that a new Oracle version of MySQL is 1,000 times faster than Amazon Aurora.
• Ellison says Oracle loves Java for building applications, but the company uses Apex for a tenfold developer productivity gain, which he says is why the company believes that it can rewrite Cerner’s entire suite in a “very, very short period of time.”
• Ellison says that the company will earn many healthcare wins because of Oracle’s application breadth, also noting that competitors say they are “cloud” when they are actually “hosted.”
• Ellison adds, “We not only have all the Cerner healthcare apps for hospitals, we’ve specialized our ERP system for hospitals, we’ve specialized our HCM for managing the hospital workforce. We’ve done a bunch of things around the healthcare industry. One of the things we want to do is, you know, we’re the largest provider of clinical trial software. But the clinical — the results of the clinical trial goes to a government regulator. And we’re now working with the government regulators to develop the software that allows them to take the clinical trial output in digital form and get it through the regulatory process much faster at a much lower cost. So, we’re looking at the entire healthcare ecosystem and trying to automate both sides of the transaction.”
• CEO Safra Catz says “we’re still at the beginning” with the Cerner business, as Oracle has been focused on stabilizing the operation, but work remains to increase Cerner’s profit margins and to move its products to Oracle Cloud.

Reader Comments

From Apex: “Re: Elation Health. We were notified that our implementation manager is no longer with the company, apparently part of a structured RIF. Not sure how big, but it was a sign of companies hunkering down for the recession and the lack of non-AI investor capital.” Unverified, because I couldn’t find a press contact on their site to confirm the non-anonymous report.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Ronin. The San Mateo, CA-based company’s advanced data science and human-centered interfaces embedded in the EHR help clinicians make more precise, confident, and personalized patient care decisions while enhancing the patient and care team experience. Intuitive display of the patient journey: More efficiently and more confidently guide patient care using a reimagined dashboard within the EHR that presents all available patient data in a single click. Efficiently rendered data reduces clinicians burden and supports data-driven decisions. Actionable data insights for personalized care: Preempt adverse events and improve treatment effectiveness using predictive insights delivered at the point of care in the patient chart to accelerate informed, individualized decisions about patient care. Real-time symptom monitoring for effective intervention with PROs: Identify and proactively course-correct at-risk patients for fewer adverse events and emergency department visits through EHR-integrated capture of patient reported outcomes, remote monitoring, effective patient management, and intelligent alerting. Thanks to Ronin for supporting HIStalk.

Webinars

June 22 (Thursday) 2 ET. “The End of COVID Public Health Emergency is Here. Is Your Rev Cycle Ready?” Sponsor: Waystar. Presenter: Vanessa L. Moldovan, commercial enablement + insights program manager, Waystar. This webinar will describe the proactive steps that are needed to avoid increased rejections and denials. It will cover regulatory waivers and flexibilities, major shifts in telehealth, changes to reimbursement, and the impact of the end of the PHE on Medicaid coverage.

July 12 (Wednesday) 2 ET. “101: National Network Data Exchanges.” Sponsor: Particle Health. Presenter: Troy Bannister, founder and CEO, Particle Health. It’s highly likely that your most recent medical records were indexed by a national Health Information Network (HIN). Network participants can submit basic demographic information into an API and receive full, longitudinal medical records sourced from HINs. Records come in a parsed, standardized format, on demand, with a success rate above 90%. There’s so much more to learn and discover, which is why Troy Bannister is going to provide a 101 on all things HIN. You will learn what HINs are, see how the major HINS compare, and learn how networks will evolve due to TEFCA.

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

Acquisitions, Funding, Business, and Stock

A new survey of C-level health system executives by marketing intelligence firm Panda Health looks at the “Churn Index,” as digital health contracts that health systems signed during the pandemic will start expiring, forcing customers to evaluate whether their renewal is cost effective. Telehealth and remote patient monitoring solutions have a potentially high Churn Score due to moderate levels of dissatisfaction.

Forbes questions why Andreessen Horowitz led a recent $50 million seed funding round in healthcare startup Hippocratic AI even though its founder came from a Medicare Advantage broker with a history of debt, laid-off employees, and unpaid invoices.  Several Health IQ co-founders and executives, including CEO Munjal Shah, MS, moved to Hippocratic AI, angering the small companies – mostly lead generators and call center operators — that are stilled owed millions by Health IQ.

People

Will Weider, MS (PeaceHealth) joins Aspirus Health as SVP/CIO.

UCSF promotes Julia Adler-Milstein, PhD as chief of its clinical informatics and digital transformation division.

Spencer Korn (Salesforce) joins League as SVP of sales and business development.

PatientNow hires Bethany Little, MA (Community Brands) as CEO.

Curt Thornton, MHS, MBA (Anatomy IT) joins Linus Health as chief growth officer.

AvoMD hires Mark Citrone (Doximity) as chief commercial officer.

Announcements and Implementations

Artera launches Artera Harmony to unify and streamline patient messaging from across the enterprise.

KLAS reports that as health system acquire independent oncology practices and care centers, more are being moved to Epic and Oracle Health, with Epic users reporting satisfaction with the company’s development roadmap but noting that the system’s complexity creates a user learning curve. Oracle Health users say that PowerChart Oncology is customizable and well integrated, but development is slow and the system is hard to learn.

Government and Politics

Former Theranos CEO Elizabeth Holmes says she can’t afford to pay $250 per month toward the $452 million that she and former COO Sunny Balwani have been ordered to pay as restitution to defrauded investors. Holmes says she will spend the rest of her working life trying to pay her legal bills, although her attorneys did not object to starting a payment plan from prison at $100 per year. 

Privacy and Security

St. Margaret’s Health (IL) will cease operations this week after failing to overcome staff shortages, the lingering effects of the pandemic, and a 2021 ransomware attack on parent organization SMP Health that prevented it from submitting claims to payers for nearly three months.

Other

Bon Secours Mercy Health (OH) develops a Community Health Data Hub for public health research.

Allina Health will re-examine its recently exposed policy of withholding services from patients who have accrued $4,500 in medical debt. The Minnesota-based nonprofit will not, however, restore care for those who are already flagged as debtors.

Sponsor Updates

• Five9 publishes a demonstration video titled “Five9 Helps with Medicaid Redetermination.”
• AssociatesMD (FL) increases patient engagement after implementing Healow technology from EClinicalWorks.
• Waystar enhances its healthcare payments platform for improved transparency, efficiency, and accuracy.
• Baker Tilly releases a new Healthy Outcomes Podcast, “Navigating challenges in 2023 and beyond for healthcare provider organizations.”
• Nordic releases an episode of its In Network podcast titled ““Making Rounds: Turning data into insights with managed services”
• Bamboo Health names Amelia Burnett and Laura Reese software engineers, David Antosh cloud engineer, and Bill Alderson senior payroll specialist.
• The local business paper honors Care.ai with a 2023 Fire Award in the Fresh Faces category.
• CHIME releases a new Trailblazers Podcast, “Digital Future Optimization, Efficiency, Process – Where Do We Start?”
• AGS Health, Amenities, Arcadia, Availity, CereCore, Current Health, Medhost, Nordic, Nym Health, Optum, Sphere, VisiQuate, and Waystar will exhibit at HFMA June 25-28 in Nashville.

Blog Posts

• How to Transition from Meditech Legacy EHR to Expanse (CereCore)
• Rising costs of prescription drugs could drive alternate options (Wolters Kluwer Health)
• We Surveyed Our Customers on Mental Health Issues. Here’s What We Learned. (AdvancedMD)
• Preventing Revenue Leakage with Integrated Financial Clearance and Patient Access (AGS Health)
• Value-based care and ROI: Connecting an Allen wrench to healthcare analytics (Arcadia)
• The Top 5 Takeaways from Artera’s First-Ever Customer Conference, Heartbeat. (Artera)
• Getting to grips with chronic disease management (Nordic)
• Improving the Patient Experience Through Technology (Ascom)
• From Challenge to Opportunity: Exploring Clinical Data Acquisition and Integration in the Healthcare Ecosystem (Availity)
• Utilizing DRVS Tools to Address Social Drivers of Health in Your Community (AGS Health)
• 5 ways patient engagement can improve outcomes (CarePort)
• FHIR-side Chats with Clearsense (Clearsense)
• Recent OCR and State Attorney Generals’ HIPAA Enforcement Actions Stress the Critical Importance for Asset-Based Risk Analysis of All Systems with EPHI (Clearwater)
• The Danger Within: How Unpatched Vulnerabilities Leave Your Hospital Open to Cyberattacks (CloudWave)
• A Roadmap to Successful Application Modernization (CTG)

Contacts

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

Morning Headlines 6/13/23

An Illinois hospital is the first health care facility to link its closing to a ransomware attack

St. Margaret’s Health will close its doors this week after failing to overcome staff shortages, the lingering effects of the pandemic, and a 2021 ransomware attack that prevented it from submitting claims to payers for nearly three months.

Oracle beats quarterly revenue estimates on cloud services demand

Oracle attributes its 17% increase in Q4 revenue to demand for cloud products by companies deploying AI, coupled with the boost its Cerner acquisition has given it against competitors like Microsoft and Amazon.

Iowa invests $1.5 million in innovative Centers of Excellence to boost rural health care access

The State of Iowa’s Centers of Excellence program offers providers the opportunity to qualify for grant funding that will enable them to invest in new technology.

Curbside Consult with Dr. Jayne 6/12/23

I was intrigued by a recent study published in in JNCI Cancer Spectrum that looked at how capable ChatGPT is when asked questions about common cancer myths and misconceptions. The study, performed with the Huntsman Cancer Institute, compared ChatGPT output against social media.

I understand the premise. Many patients are getting their information from social media, friends, family, and people they know on a personal basis rather than being able to learn key information from their care teams. Sometimes this happens because people may be receiving cancer diagnoses via their patient portal accounts due to immediate-release results policies stemming from governmental regulations. Other times it happens because patients are unable to reach their care teams when they have questions or they don’t feel that their team is listening to them.

Cancer is also a condition that leads people to leave no stone unturned as far as investigating treatment options and potential outcomes. It’s one of the scariest diagnoses you can receive, and even as healthcare professionals, we are rarely prepared for it. There can be a lot of uncertainty about treatment plans and sometimes even about diagnoses, and patients often seek additional information or alternative treatments as a way of trying to maintain control of their own health and lives.

Generally, physicians appreciate working with engaged and involved patients who want to understand the pros and cons of various treatment options. But a number of industry forces create pressure on that scenario, including time pressures, insurance limitations of treatment options, and availability of options in a particular geographical area.

In fairness, the study was performed shortly after ChatGPT became widely available, so it may not be entirely applicable today. Researchers used a list of frequently asked questions that they sourced from the National Cancer Institute’s “Common Cancer Myths and Misconceptions” website. They found that 97% of the time, the answers from ChatGPT were in agreement with the responses provided by the National Cancer Institute.

In contrast, approximately one-third of social media articles contain misinformation. Distrust of medical institutions and medical professionals has grown exponentially since the beginning of the COVID pandemic, and patients may decide not to pursue standard treatments based on information they’ve heard from friends or family or might have found online. This can lead to negative outcomes for patients, who may expose themselves to increased mortality rates when selecting unproven treatments.

Even when considering medical professionals as a source of information, I’ve seen instances where misinformation can be spread. Sometimes patients consult neighbors or friends who might be physicians, but who are in specialties nowhere near the patient’s area of need. I’m not even an old timer, but I know that the treatments for various cancers have progressed exponentially since I last cared for patients with those diagnoses. I’m always careful to refer patients back to their oncologists, hematologists, or surgeons, but not everyone does that. I’m part of several Facebook groups that have exclusive physician membership, but we still see bad answers circulating when physicians who are patients themselves pose certain questions.

For physicians who are actively caring for cancer patients, knowing that patients might receive medical misinformation can increase their feeling of burden in delivering care. One of my colleagues feels she can never disconnect from managing patient portal messages because she feels that if she doesn’t answer the patient’s questions promptly, they will be more likely to go down the proverbial internet rabbit hole, leading to greater stress for the patients and their families. When we discussed having boundaries around these kinds of interactions so my colleague can have a break, she said she’s thought about it, but feels that correcting the misinformation later actually requires more work and emotional effort than just being continuously available to field questions. It’s a difficult spot for clinicians to be in when they feel called to serve their patients so broadly.

The study involved a blinded review of the answers to the questions, grading them not only for accuracy , but looking at word count and Flesch-Kincaid readability grade level factors. Answers from both sources were less readable than recommended by most health literacy advocates, but the responses from ChatGPT tended to use more words that led to a perception of hedging or uncertainty. The questions evaluated were striking, and included items such as:

• Is cancer a death sentence?
• Will eating sugar make my cancer worse?
• Do artificial sweeteners cause cancer?
• Is cancer contagious?
• Do cell phones cause cancer?
• Do power lines cause cancer?
• Are there herbal products that can cure cancer?
• Do antiperspirants or deodorants cause breast cancer?

I have to say that I have heard at least four of these questions from friends and family members in the last month or so,  and I am not surprised that they made the question set. The issue of antiperspirants and breast cancer risk comes up often in some of my social media channels, as to the questions about eating sugar and using herbal remedies.

Full documentation of both the National Cancer Institute answers and the ChatGPT answers are included in the article, in case you’re curious.

In addition to the question of accuracy, there’s also the question of specificity. Researchers noted that while the ChatGPT answers were accurate, they were also more vague than the comparison answers from the National Cancer Institute. This could lead to patients not thinking the answers were valid, or to them asking additional questions in clarification.

There was also concern about patients who might ask ChatGPT questions about cancer that are less commonly asked, and which might not have a large body of knowledge to form a training database. The study was also limited to the use of English, which has an impact on its applicability to broad swaths of the US and the world. As a patient and knowing what I know about the propensity for ChatGPT to hallucinate, I don’t think I’d want to go there for my medical information.

Given the newness of the technology when the study was performed, it would be interesting to see how newer versions would perform in the same circumstances. There are a couple of possibilities. It could become more accurate, or it could go completely off the rails as we’ve seen it do with some queries. Additionally, the content used for the models typically only runs through 2021, so current data might influence the results. I hope researchers continue to look at how ChatGPT might be useful as a healthcare adjunct, and where it might serve patients best.

What do you think about ChatGPT as a debunker of medical misinformation? Will it tell patients to inject bleach to kill viruses, or declare it to be an insane strategy? Leave a comment or email me.

Email Dr. Jayne.

Readers Write: Automation’s Role in Patient Engagement Strategies

Automation’s Role in Patient Engagement Strategies
By Lew Parker

Lew Parker, MSIS, MBA is CTO of Arrive Health of Denver, CO.

Thanks to ChatGPT, there’s no shortage of content on the topic of AI and automation’s impact on the future of the workplace. You don’t have to be a technology professional to understand that we’re approaching — if not already in — a pivotal moment that will change how we all do work, much like how the IPhone changed our everyday lives.

While AI may feel like a daunting new topic, the reality is that automated solutions have been widely adopted within all industries for quite some time. Healthcare is no exception, with AI-driven tools commonly being used to make the revenue cycle more efficient.

A prime opportunity within healthcare is bringing AI-driven solutions from the back office and using them to create better patient experiences and outcomes. If we can leverage AI-driven automation tools to drive engagement throughout the patient journey while also alleviating administrative burden for overworked providers, why wouldn’t we invest in tools that do that? The key is determining when and where within patient engagement strategies to implement automated approaches, and how to do so in a thoughtful way that preserves data security and protects patient PHI.

Medication adherence presents an ideal opportunity to enter the waters. According to the World Health Organization, medication adherence can directly impact patient outcomes more than a specific treatment itself. But traditional methods to drive adherence — including relying on staff to conduct massive amounts of personalized outreach once a script has been selected – leave room for improvement, as evidenced by one in five prescriptions never being filled and burned out pharmacists, providers, and care teams.

One factor contributing to non-adherence is the engagement gap that exists from the time a provider writes a prescription to when the patient arrives at the pharmacy counter. A lot can occur during that period to prevent a patient from picking up the prescription. AI-driven solutions, specifically patient outreach tools to connect with patients during this time in a more natural and ultimately human way. Anyone who has worked with traditional chatbots or robocalls can attest to the frustration of both patients and implementers when the conversation strays outside the boundaries of what computers could handle. That has fundamentally changed, and now we can bridge the gap to support patient engagement and medication adherence by:

• Reducing significant volumes of manual and repetitive tasks by automatically sending information over text messaging about topics such as onboarding, medication information, and refill reminders.
• Creating additional patient touch points along the medication adherence journey while reducing the overall cost of outreach.U
• sing AI to identify which patients have barriers to adherence and then prioritizing them for personalized pharmacist outreach. This will allow pharmacy staff to focus on high-value, high-touch care.

It’s impossible to expect pharmacists and providers to conduct the level of personalized outreach needed across all populations served without the help of technology. There are simply not enough hours in the day. However, using AI-driven tools as described above will drive better patient experiences, engagement, and outcomes while also helping an already overburdened healthcare workforce. As IT leaders, it’s our job to encourage innovation while also supporting responsible and impactful use of AI in new ways, including bringing these tools to patient engagement strategies.

Morning Headlines 6/12/23

A Message From Our CEO: Cityblock’s Next Chapter

Cityblock Health, a tech-enabled primary and behavioral healthcare provider serving Medicaid and Medicare patients, will lay off 155 employees.

Pomelo Care collects $33M for maternal and newborn VBC

Pomelo Care, a virtual clinic specializing in pregnancy and newborn care, raises $33 million.

23andMe to cut roughly 9% of workforce, or about 75 employees

Consumer genetics and research company 23andMe will eliminate 75 jobs in early 2024 as part of a restructuring plan it estimates will save $13 million.