News 9/4/20

Top News

Boston-based Biofourmis raises $100 million to further develop its predictive analytics-based remote patient monitoring technology.

The company sells data and intervention opportunities to drug companies and offers hospitals a platform for monitoring their newly discharged patients remotely.

The company’s products have earned FDA 510(k) clearance for heart failure and arrhythmia detection.

Biofourmis uses Biovotion’s Everion armband sensor, which monitors 22 parameters, including heart rate, temperature, respiratory rate, blood oxygenation, motion intensity and steps, energy expenditure, sleep quality, and heart rate variability. Biofourmis acquired Biovotion in November 2019.

Reader Comments

From Significant Brother: “Re: remotely hosted EHRs. A practice asked their hosting vendor why the information of 50,000 of their patients was missing. The vendor told them that someone in the practice had deleted multiple directories. Should a vendor’s security practices allow records to be deleted by the thousands, especially in light of MU and HIPAA requirements for protecting patient records?” Readers, please weigh in. We’re missing an important piece of the story here — did the vendor identify the employee, were that user’s credentials maintained properly by the customer, and were backups or logical (rather than physical) deletes not available for restoring the missing records? Healthcare has seen a few instances where a fired employee trashed company data, and cloud configuration might allow limiting the extent of their destruction. But if the practice fired someone without turning off their access, or if they are sloppy in giving users more privileges than their jobs require, then that’s the age-old issue of running a business like something other than a business.

From Transmaniacon: “Re: COVID testing technology. I’m interested in a cloud-based patient registration system – basically a lightweight EHR – that can be installed quickly and easily to send results back to the person. Maybe you know of something.” I’ll enlist reader help here.

HIStalk Announcements and Requests

Jenn is continuing to update the Cerner-specific news page for: (a) those who care mostly about only Cerner news, and (b) those who want to see a longitudinal view of previous, significant news from the company. These items have already been vetted and summarized by appearing in HIStalk, so it’s not just regurgitated fluff. I also added a menu item called “Company News History” that lets you jump to that page, and maybe later to similar news summary pages for Epic, Meditech, and Allscripts. Somebody who asked for this years ago expressed interest in sponsoring this particular page and of course I didn’t retain that information because I lack discipline, so let me know if that was you.

Webinars

September 9 (Wednesday) 1 ET: “APIs for Data Liquidity in Pandemic Times.” Sponsor: Chilmark Research. Presenters: Brian Murphy, research director, Chilmark Research; Gautam “G” Shah, VP of platform and marketplace, Change Healthcare; Drew Ivan, chief product and strategy officer, Lyniate; and Dave Levine, MD, co-founder and chief medical officer, Datica. This webinar will present the findings from a recently published research report on the state of the healthcare API market. The presenters will describe their work in deploying APIs to enable new functionality to address COVID-19. They will cover the use cases that have been most reliable for enabling effective data liquidity, how developers are using APIs to respond to the pandemic, and how different parts of the healthcare system are making APIs more widely available.

September 17 (Thursday) 1 ET. “ICD-10-CM 2021 Updates and Regulatory Readiness.“ Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, VP of global clinical services, IMO; Theresa Rihanek, MHA, RHIA, mapping manager, IMO; Julie Glasgow, MD, clinical terminologist, IMO. IMO’s top coding professionals and thought leaders will review additions, deletions, and other revisions to the 2020 ICD-10-CM code set that will be critical in coding accurately for proper reimbursement.

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

Acquisitions, Funding, Business, and Stock

Nordic lays off 72 of its 1,000 US-based employees due to the pandemic-induced financial disruptions its customers have faced.

Publicly traded Medicare primary care center operator Oak Street Health will open clinics in three former Walmart Care Clinic locations in Texas. Shares of the Chicago-based company, which operates 55 locations, jumped 90% on their first day of trading in early August, with the company now valued at $12 billion.

Sales

• Bayless Integrated Healthcare (AZ) will implement Saykara’s app-based, automated clinical documentation software across its eight locations in Phoenix.
• Prime Therapeutics selects RxRevu’s Real Time Benefit Check, giving prescribers on-demand information about drug options and pricing, and pre-authorization requirements.

People

William Mintz (Leidos) joins Cerner as chief strategy officer.

Announcements and Implementations

DeWitt Hospital (AR) implements Azalea Health’s EHR.

Arkansas Surgical Hospital adopts Medhost’s cloud-based EHR.

KLAS finds that the risk adjustment and analytics space is dominated by Change Healthcare, Cotiviti, Inovalon, and Optum, although of that group, only Optum was willing to share its customer list. Apixio and SCIO Health Analytics stand out in customer satisfaction, while Advantasure has the least-satisfied users.

AHRQ names Premier as the winner of its predictive analytics challenge, in which its PremierConnect most closely predicted admissions and length of stay.

Government and Politics

The US Coast Guard goes live on the DoD’s Cerner-powered MHS Genesis EHR at four facilities in California, with facility-wide deployment expected by 2024. The Coast Guard join the DoD’s EHR program two years ago after spending $60 million over seven years to unsuccessfully develop its own software.

The DoD’s Defense Innovation Unit will work with Google Cloud to develop a digital pathology solution that will include augmented reality microscopes and AI models for more accurate and timely cancer detection.

COVID-19

CDC Director Robert Redfield, MD sends an urgent letter to state governors asking them to clear the way for getting McKesson-operated COVID-19 vaccine distribution sites up and running by November 1. That presents challenges — the leading vaccine candidates require storage and delivery at below-freezing temperatures and people who get the shot must return for a second injection 3-4 weeks later. States will need to create immunization registries to track those who have received the initial dose, remind them to come back for the second dose, and ensure that the doses are distributed to the right locations in adequate supply. Hospitals will need to arrange delivery logistics and freezer capacity for a large amount of product, while rural clinics and health centers will be especially challenged.

The US, EU, Japan, and UK have contracted with drug companies for 3.7 billion doses of a successful COVID-19 vaccine and China and India will use the doses they manufacture for their own citizens, leaving much of the world, especially poor countries, without access to any successful vaccine.

Atul Gawande says in The New Yorker that the key to beating coronavirus in the US is what other countries have done — running widespread, inexpensive testing and recommitting to public health. He notes that the only-in-America health system’s maze of referrals, prior authorizations, co-pays, insurer policies, large number of uninsured people, and inconsistent screening criteria have made it hard for people to get tested, and delayed results reporting by the four companies that run most US tests is limiting their value. He concludes, “The lunacy of our testing system is the lunacy of our health system in a microcosm.” He advocates addressing logistics issues, such as creating a testing grid similar to that of electric companies, where samples would be routed to labs with excess capacity while others are overwhelmed, describing the testing industry as, “The big four commercial labs are really logistics and distribution companies wrapped around a network of regional laboratories.” He calls out the success of San Francisco, which applied its experience in addressing HIV/AIDS to mobilize a rapid, effective COVID-19 public health response.

Penn State’s athletic medicine director says that one-third of Big Ten athletes who tested positive for COVID-19 showed mycoarditis on cardiac MRIs, regardless of whether or not they showed COVID-19 symptoms. 

Israel’s largest hospital uses facial recognition software, in conjunction with its existing security cameras, to identify visitors who aren’t wearing masks and give them encouraging messages like, “No mask kills my vibe.”

Other

TechCrunch profiles Peer Medical, a startup that offers lung cancer patients the ability to share treatments with each other using de-identified EHR data. Patients can search Peer Medical’s database by biomarker, stage, age, or gender to review verified treatments and care journeys.

A Surescripts report on health IT adoption finds that e-prescribing and real-time prescription benefit utilization have increased over the last six months.

Two-thirds of Americans who file bankruptcy do so because of healthcare expenses. Experts say a lot of those people have insurance that provides poor financial protection given that only 40% of Americans have enough savings to cover a $1,000 emergency expense.

Points from Epic CEO Judy Faulkner’s online interview with Cleveland Clinic CEO Tom Mihaljevic, MD:

• She was supposed to college summer work at University of Rochester in particle physics, and since she had never seen a computer, they gave her a Fortran book and one week to learn.
• She applied to graduate school in math, but University of Wisconsin moved her without asking to computer science, which she did not know was an option. She worked with informatics pioneer Warner Slack, MD and was later asked to develop a clinical system in the days before commercial EHRs and widespread use of commercial database management software.
• She started Epic as a half-time employee with two half-time assistants, working from a basement.
• She says the Midwest is a great company location because people are friendly and work hard and having a rural footprint means the company has room to put up new buildings as needed.
• Technology is moving from rules-based systems to artificial intelligence, with statistical methods providing ways to issue early alerts for potential sepsis and to manage drug-drug interactions.
• Clinician notes are four times longer in the US than in other countries due to the administrative requirements for getting paid.
• Clinicians should review their software options to make the system work their way, and where that isn’t possible, examine how they do things to see if there’s a better way that the system can support. It’s helpful to have specialist physician builders who know how to configure systems for their specialty.
• Epic has created the role of BFFs, who take the “best friends forever” approach in recognizing and publicizing client innovation and bringing back developments from other clients.
• MyChart is available to 165 million patients. Only 0.5% of MyChart users want to manage their own information, and the even that tiny number falls off with time. Patients want their health system to maintain and exchange their records.
• Epic Cosmos has 60 million customer patient records that are being used for research. Epic is building a “best care for your patient” module that will use this data along with that of the specific patient to provide clinicians with evidence-based recommendations.

Sponsor Updates

• Cerner associates deliver care kits, school supplies, and gift cards to those affected by Iowa’s devastating windstorm.
• Wolters Kluwer publishes “5 Forces for the Future: Virtual care reaching the vulnerable.”
• Frost & Sullivan recognizes Jvion with its 2020 North American Technology Innovation Leadership Award for its Care Optimization and Recommendation Enhancement (CORE) technology.
• Premier takes first place in AHRQ’s Bringing Predictive Analytics to Healthcare Challenge.
• Bumrungrad International Hospital in Thailand uses InterSystems TrakCare Lab Enterprise to create one of the first fully digital microbiology laboratories in the world.
• MDLive works with the Soldiers’ Angels’ Women of Valor Program to offer caregivers of veterans virtual care for physical and mental health.
• NextGate updates the usability, reporting, and performance of its Enterprise Master Patient Index with version 11.
• Goliath Technologies partners with IntraSystems to help IT professionals anticipate, troubleshoot, and document Citrix end-user performance issues.

Blog Posts

• The Right Medical Device Integration Strategy Can Increase the Efficiency of Medical Device Security (Capsule)
• Your Insulin Management Process is Wasting Nurses’ Time (Glytec)
• How to Troubleshoot “Citrix is Slow” for Remote Workers (Goliath Technologies)
• Beginners guide to painless machine learning (Google Cloud)
• Plan Now for New Electronic ADT Notification Requirements (Healthcare Triangle)
• The Post-Pandemic Leadership Conundrum: Balancing Expenses While Investing in Digital Transformation (The HCI Group)
• Telehealth is here to stay. Now what? (HCTec)
• Virtually Kicking Off the 2020 Healthcare Analytics Summit (Health Catalyst)
• Health Literacy Lessons from COVID-19 (Healthwise)
• Healthy People 2030 Elevates Social Determinants of Health (Imat Solutions)
• QPP Proposed Rule for 2021: Update & Analysis (Impact Advisors)
• Growing Our Company Culture While Working from Home (Imprivata)
• Data is Key to COVID-19 Contact Tracing and Syndromic Surveillance (InterSystems)
• Surgical schedules slow to recover even as operating rooms reopen (Intelligent Medical Objects)
• COVID-19: Healthcare Consumerism’s Tipping Point (Loyale Healthcare)
• A Guide to Patient Retention for Physical Therapists (MWTherapy)
• Apart But Not Alone: How Grief Support Prevails Amid a Pandemic (Netsmart)

Contacts

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

EPtalk by Dr. Jayne 9/3/20

It’s been a busy week in the consulting trenches. Several of my clients had projects that they wanted to take live on September 1. I commend them for choosing that as a go-live date because it’s a Tuesday. Far too many people want to do go-lives on Mondays.

I’m usually opposed to Monday go-lives because it’s typically a busy day, whether you’re in the inpatient world or the outpatient world. Patients who have been ill over the weekend are trying to get appointments and complex surgeries are often scheduled earlier in the week to better optimize discharge planning prior to the weekend. I’m also a fan of doing go-lives on Thursdays, because if it’s rocky, you only have two days in the week and then people can rest over the weekend. Even in hospitals, things are slower over the weekend and many services are only offered on an emergency basis.

CMS has released the Fiscal Year 2021 Inpatient Prospective Payment Systems (IPPS) for Acute Care Hospitals and the Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) Final Rule. That’s certainly a mouthful, and I’m not sure the abbreviations help. There are several highlights within the Medicare Promoting Interoperability program. Some of these make perfect sense, such as being to use any continuous 90-day period as the EHR reporting period, and keeping the measure that looks at queries of Prescription Drug Monitoring Programs as optional. Others leave me scratching my head, such as “Modifying the name of the Support Electronic Referral Loops by Receiving and Incorporating Health Information measure to the Support Electronic Referral Loops by Receiving and Reconciling Health Information measure.” I get that they’re trying to better describe what hospitals have to do, but it just adds to the confusion.

The American Medical Association released the 2021 Current Procedural Terminology (CPT) code set this week. There are some major changes involved, with one outlet describing it as the first major overhaul in more than 25 years. The changes coincide with those proposed by the Centers for Medicare & Medicaid Services and are intended, according to AMA, to free physicians from “irrelevant administrative burdens that led to time-wasting note bloat and box checking.” Office-based clinicians will certainly welcome the elimination of specific history and physical exam elements for code determination.

Since AMA owns the rights to the codes, they’re happy to sell you resources to support the transition, including books and videos. If you use an EHR, chances are that the AMA license fee is already baked into what you are paying for maintenance. Personally, I think if Medicare requires use of something it, should be in the public domain, but there’s too much money and lobbying involved to make a change.

ONC has opened a funding opportunity to “measure the use and impacts of health IT among a nationally representative sample of US office-based physicians” as well as to “produce national-level data on interoperability among office-based physicians.” Prospects have until September 11 to apply. The awardee will run a three-year program to gather “insights on the implementation and effects of federal health IT policies as well as identify disparities or unintended consequences resulting from their implementation.” Funding is $290,000 for the first year with additional funds “subject to availability and progress made against the program.” The program starts September 30, 2020, so it looks like ONC is ready to make a quick decision.

New data from the Centers for Disease Control shows that nearly 30% of healthcare workers with COVID-19 were asymptomatic and nearly 70% reported never having been formally diagnosed with COVID. Researchers looked at 13 hospitals across the US, where up to 6% of staff caring for COVID-patients had tested positive themselves. The concern is that those symptom-free staffers may have spread the infection to patients and co-workers. The report concludes that universal masking of healthcare workers is important, as is a coordinated testing program for frontline workers.

I see patients with COVID every time I work. The highest number of positives I’ve seen in a single work day is 20, which is a lot. Fortunately, my time in the room with patients is limited. I’ve been fortunate to have enough N95 masks so that I don’t have to reuse them too many times, and a family friend made me a fantastically lightweight face shield. Still, being constantly exposed is a stressor and I try not to interact with people in person if I don’t have to, although it’s rough. I’ve made a couple of exceptions, but with distancing and masking, and always with transparency about my exposure history.

I’ve also had the benefit of being able to stack my clinical shifts recently, so I work a ton at once but then have longer stretches without face-to-face patient care. Even with my healthcare friends, we debate who has been the most exposed and whether getting together in person would be riskier than anything else we do. I’d like nothing more than to sit and sip a cocktail and decompress with one friend in particular, but I’m not sure how long it will be before we both feel the timing is right.

I had a chance to play the Zoom Happy Hour game with one of my friends this week, which was tons of fun with lots of laughing involved. She’s a total extrovert and it was great to swap stories about the “new normal” in our respective parts of the country. I’ve been making it a point to connect with people who’d I usually see while traveling since my next business trip is probably months off. As a foodie who loves to try new things across the US, sticking close to home has been a challenge. I’ve checked out a bunch of cookbooks from the library, but unsurprisingly, this cocktail edition is my new favorite.

While we’re in the boozy frame of mind, big props to my friends at Medicomp Systems for sending another care package my way. I’m resupplied with N95 masks along with some Medicomp ones, which I really like because they’re adjustable and don’t sag. They also included some high-octane hand sanitizer supplies, including handy bottles for pocket or purse. I was also advised that the large bottle could be used either as a refill or for slamming down during a zoom meeting. Based on some of the calls I’ve had lately, I’m not opposed to it.

Have you made your own homebrew hand sanitizer or are you sticking with Purell? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 9/3/20

Coast Guard Begins Deploying Pentagon’s New Electronic Health Records System

The US Coast Guard goes live on the DoD’s Cerner-powered MHS Genesis EHR at four facilities in California, with facility-wide deployment expected over the next two years.

WELL Health to Expand into US Market with Proposed Majority Stake in US Telehealth Leader Circle Medical and Announces $23M CAD Offering with Group of Investors Led by Mr. Li Ka-shing

Canadian Well Health Technologies will acquire San Francisco-based primary care company Circle Medical for $14 million.

Insurer Centene invests in start-up Hazel Health in $33.5 million venture funding round

Student-focused telemedicine startup Hazel Health raises $33.5 million in a Series C round led by Bain Capital and Owl Ventures.

Boston startup Biofourmis raises $100m for remote medical tech

Biofourmis raises $100 million to further develop its predictive analytics-based remote patient monitoring technology.

HIStalk Interviews Guillaume Castel, CEO, PerfectServe

Guillaume Castel, MBA is CEO of PerfectServe of Knoxville, TN.

Tell me about yourself and the company.

I worked 14 years in technology, first with IBM and then Cisco Systems. I was fortunate to rise through the ranks. I come from a family of healthcare providers and executives and I am married to a physician-epidemiologist, so I felt I had no choice but to go into healthcare. I joined The Advisory Board Company in Washington, DC in 2014. It was probably the most consequential experience I have had in my career, an amazing 4-5 years before we sold the company to Optum.

Then I went to work for a health system in the DC area. I put what I thought I knew into practice and learned what it means to deliver care every day. I joined the advisory board of PerfectServe about two years ago at the request of our private equity sponsors, and then about a year and a couple of months ago, I became the CEO of the company.

PerfectServe offers unified healthcare communications solutions to help physicians, nurses, and care team members provide patient care. We serve 145,000 physicians, 240,000 nurses, and 600,000 users. I mention those metrics because we track them each month to remind of us the importance of the work that we do and the number of lives that we are privileged to touch each day.

How has the company absorbed its recent acquisitions of Lightning Bolt, CareWire and Telmediq?

PerfectServe acquired three companies in essentially 12 months. Telmediq was complementary to PerfectServe. CareWire was in the slightly different space of patient engagement, which was visionary at the time. Lightning Bolt has become a critical part of our company in delivering scheduling capabilities for physicians, and increasingly, beyond physicians.

We spent a great deal of time thoughtfully integrating the various capabilities and thinking about how we could make the sum of the parts bigger than what they were. What we have now is a cross continuum way of enabling communications at scale for the largest health systems in the United States. We embed optimized and sophisticated dynamic schedules to make sure that we get the right communication to the right person at the right time, which is critical. Then, in this era of ongoing crisis for health systems in the United States and beyond related to COVID, it has become critical to help patients who are inside the four walls of the hospital communicate with their families and for hospitals to communicate with patients who have gone back home.

How has technology changed the ways that hospitals and practices are serving patients compared to a year ago?

We have gone through an acceleration of a three-year roadmap into a three-month timeframe. Care providers suddenly had to manage patient flows safely at volumes that they could not have anticipated. They also had to provide as much care as possible without requiring the patients to come into physical spaces such as a physician office, an ambulatory setting, or an inpatient setting.

The news was most prominent around the advent of telehealth, but telehealth is not new. It has been important in care delivery for years. But we have learned that we can and should provide good care remotely.

PerfectServe has committed to helping our clients through the crisis with bi-directional texting capabilities with their patients and families from home or anywhere they wish to be. We built a video capability, which took off in March, April, and since then because it does not require scheduling – it is completely ad hoc. It is secure and does not require infrastructure for hospitals to deploy it. These are the required ingredients for any solution to become relevant.

Some of our most innovative and forward-leaning clients expected to do 1,000 telehealth visits in 2020, but have already done 300 times that number. Our essentially app-less offering was the most convenient way, in a moment of urgency, for physicians to get in touch with their patients at home or elsewhere.

Do you see a second wave where organizations that quickly implemented consumer tools such as Zoom or Skype will look for video solutions that are more specific to healthcare?

People did what they could during the urgency. Health systems and physician groups are essentially doing pervasive preparedness for what another wave of COVID or another virus outbreak could mean to them. They are thinking about not just what’s required, but what the perfect design would be to stay connected to their patients in a moment of crisis. That goes far beyond having access to video capability.

It needs to be integrated in the way that you would want your physicians, nurses, and care team providers to communicate with the patient. It needs to be safe. It needs to be the right person at the right time. It needs to be secure. It needs to be connected with your EMR. It needs to be connected with the way you would want to manage clinical communications within your hospital.

Horizontal technology providers just aren’t going to get there. They don’t understand the workflows. We are seeing a lot of work and money being spent on how to deal with the next wave or the next crisis. That pushes us and assures that health systems and their patients will be better prepared for the next time.

I saw on your website that 85% of patient records contain their cell phone number, which allows providers to text them with health management questions and appointment reminders with minimal work and infinite scale. I also saw an interesting statistic about how patient portal use can be increased dramatically by texting patients a link to the log-in or to materials that exist within the portal.

It’s fascinating to me what we’ve had to do over the last six months. What you are touching on is critical. We build products at PerfectServe by spending a lot of time with our clients, making sure that we are educated, vetting the solution, and testing it. What we heard about engaging with patients remotely in their use of portals is that it can’t require a three-month deployment. It needs to be lightweight, secure, and app-less. This concept of asking a patient or a patient family member to download yet another application was a non-starter and will continue to be.

We put our best brains on it. We established the most practical things that folks can use in a moment of urgency, and that was essentially a link. We send a link to the phone number that was gathered at the point of registration the week before, the month before, or the year before. That has changed the way practitioners are embracing new technologies.

What are some practical uses of escalating messages that haven’t been responded to within facility-defined parameters?

Our approach to that issue is that we need to enable person-to-person communication, nurse-to-nurse communication, nurse-to-doctor communication, and care team member-to-care team member communication. We also need to track and document that whatever communication was sent has been received and read. The traceability, the ability to audit backward, is critically important to our clients, and we believe that that level of sophistication is now baseline. You don’t get that level of transparency with emails.

We believe that we are differentiated by our standard of delivering the right message to right person at the right time. We do that using algorithms that leverage what we think of as situational variables. The person’s role is the one that is most often mentioned, but it’s much more complicated than that. It also includes their department, the facility, the day, the time, and the call schedule. We establish deep, optimal communication that is based on those variables.

It’s essentially an optimized communication pathway that folks can standardize around. Our most sophisticated clients have established standards across their 10, 20, and sometimes 30 facilities to establish a standard around communications. We track and we give the sender the ability to see who has received the communication, who has opened the communication. It doesn’t need to be sent back that it has been read, but you can track it. We believe, and have always believed, that this is critically important. People are now accepting this is a benchmark and a standard.

Texting, as the preferred messaging mode of many or most people, is a channel by which messages can be scaled infinitely, covering health follow-ups, pre-visit questions, appointment reminders, and anything else that the provider organization feels is important. How do organizations decide how to use that capability optimally without seeming annoying or impersonal to their patients?

Our job is to give our clients options to communicate with their patients in the way they believe is most effective. I don’t believe that voice has completely gone away, so we need to continue to enable that. Texting is core, unquestionably, and video has become important. Six months ago, people communicated maybe 20% by videoconference and the rest of the time with just regular conference calls, but now 90% of my days are spent in front of a camera.

Our goal is to give our clients options for their patients, a multi-channel array of capabilities. The ability to do appointment reminders, surveys, and education pre- and post-visits or procedures is critical. We see it now. I’ve been spending a ton of time with potential partners around this concept of education for patients who are coming in for surgery or an oncology appointment. The more you know, the better prepared you will be and the less stressed you will be, which has proven to have an impact on the efficacy of the care you’re receiving.

We are using all those ways of communicating to funnel real quality to patients, pre and post, having an interaction with a care provider. That’s not going to go away. How people decide to digest it, how proactive health systems are in actually promoting it, is a  matter of sophistication level. We are committed to helping any and all systems, regardless of where they are on that spectrum of sophistication. But I believe that the engagement with patients and consumers will grow through text.

People don’t talk as much about the importance, the crucial importance, of the call center. We see call centers as a core to that multi-channel communication strategy. They are a huge part of how clinical communications are relayed to and from the front lines and patients and family members. There are massive opportunities for health systems to engage more effectively.

People like texting because it can be real time if both parties are available and interested, but it can also be asynchronous if you don’t catch someone at the right moment. Does that same concept apply to video, where two people converse via video messages that aren’t necessarily answered in real time?

I think it’s all based on the use case, the degree of acuity, the stress expressed by the patient, and the urgency expressed by the health system. These are all variables that come into play. We think that having three or more ways of applying communication strategies to the situation is the right answer.

Texting seems most convenient for less-urgent situations, but when you’re back home after a round of chemotherapy, you want immediate video or voice feedback from a care professional who can tell you that how you feel is normal and you don’t need to drive an hour to come back to the facility to be checked out. We will continue to invest in having as many communication strategies as possible to allow every use case to be facilitated by our platform.

Do you have any final thoughts?

The journey is what we think of as unified communications. It crosses boundaries and it cannot be an afterthought. It needs to be core to the mission of the company that commits to delivering it. Similarly, workflow enhancements can be achieved by combining technology and innovation with experience and know-how, not just releasing tools and demanding that a clinician use them.

All 350 of us at PerfectServe wake up in the morning with a desire to solve bigger problems for our clients and their patients.We start with the end in mind. We are excited about the progress that we have made with our clients and the progress that they are making with their patients.

Morning Headlines 9/2/20

PicnicHealth Announces $35M in Funding to Accelerate Medical Research Based on Real World Data

PicnicHealth, which assembles a user’s health history from their medical records, packages them into a PHR, and then allows the user to send their anonymized data to drug companies as real-world evidence for research, raises $35 million.

TigerConnect Acquires Call Scheduler, Launches Fully Integrated TigerSchedule to Simplify Physician On-Call Scheduling

TigerConnect acquires Adjuvant’s physician scheduling tool, which it will release as TigerSchedule in combining physician scheduling with clinical collaboration.

Apple and Google will build their coronavirus contact tracing software right into your phone

Apple and Google will include COVID-19 exposure notification in the next updates of IOS and Android, eliminating the need for users to install them as a separate app.

News 9/2/20

Top News

PicnicHealth — which assembles a user’s health history from the medical records of their providers using phone and fax, packages them into a personal health record, and then allows the user to send their anonymized data to drug companies as real-world evidence for research — raises $35 million in Series A and B funding rounds.

It’s not a free or even inexpensive service. Users pay $299 upfront to have their information gathered from their providers and then $39 per month to keep it current. They can choose the research studies to which they want their information released, but receive no compensation.

It seems unlikely that large numbers of people will pay that much. CareSync had a similar service with more user benefits and charged a fraction of this cost before the company shut down in June 2018.

HIStalk Announcements and Requests

Welcome to new HIStalk Platinum Sponsor Cerner. Cerner Corporation’s health technologies connect people and information systems in thousands of contracted provider facilities worldwide, dedicated to creating smarter and better care for individuals and communities. Recognized globally for innovation, Cerner assists clinicians in making care decisions and assists organizations in managing the health of their populations. The company also offers an integrated clinical and financial system to help manage day-to-day revenue functions, as well as a wide range of services to support clinical, financial, and operational needs, all focused on people. Healthcare is too important to stay the same. Thanks to Cerner for supporting HIStalk.

I found this YouTube video that describes how Great Lakes Health System is creating a single patient record using Cerner.

Webinars

September 3 (Thursday) 2 ET. “How Does A Global Pandemic Reshape Health IT? A Panel Discussion.” Sponsor: Intelligent Medical Objects. Presenters: Rob Wallace, chief product officer, IMO; Andrew S. Kanter, MD, MPH, chief medical officer, IMO; Lori Kevin, VP of enterprise IT and security, IMO; Sahas Subramanian, MCA, enterprise architect, IMO. As COVID-19 continues to spread, regulation changes, code system updates, and an increased reliance on technology are making it hard to stay on top of the many ways the pandemic is altering health IT. What’s more, we’re confronting challenges that rely heavily on technological solutions – like accurate reporting tools or telehealth adaptations – and we need those solutions now. The panel of subject matter experts across the enterprise will share insights on how the global pandemic is reshaping the health IT world.

September 17 (Thursday) 1 ET. “ICD-10-CM 2021 Updates and Regulatory Readiness.“ Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, VP of global clinical services, IMO; Theresa Rihanek, MHA, RHIA, mapping manager, IMO; Julie Glasgow, MD, clinical terminologist, IMO. IMO’s top coding professionals and thought leaders will review additions, deletions, and other revisions to the 2020 ICD-10-CM code set that will be critical in coding accurately for proper reimbursement.

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

Acquisitions, Funding, Business, and Stock

TigerConnect acquires Adjuvant’s physician scheduling tool, which it will release as TigerSchedule in combining physician scheduling with clinical collaboration.

Germany-based Semalytix — which analyzes patient-generated treatment experience information from their posts on blogs, forums, and social media and sells the insights to drug companies – raises $5 million in a Series A funding round.

Sales

• Oregon Health & Science University will implement Bright.md’s automated telehealth platform as part of its Virtual Care Hub, which will guide patients through an online interview whose results are combined from their EHR information to display a chart-ready SOAP note to the provider.

People

Chris Bayham, MBA (Brookdale Senior Living) joins payer-provider precision medicine technology vendor Xsolis as COO.

SignalPath hires Andy Corts  (Sarah Cannon Research Institute) as as SVP of sponsor and CRO solutions.

Announcements and Implementations

Collective Medical releases an infection control reporting solution for skilled nursing facilities that allows them to meet federal requirements for reporting COVID-19 cases to the federal government.

The American Medical Association releases the 2021 CPT code set, which includes the proposed CMS changes that take effect January 1, 2021.

Boston startup Statum Systems announces a mobile communication and collaboration system that communicates with traditional paging systems as a backup to WiFi and cell connections. Users add a smart card to their ID badge or smartphone case to allow their phone to connect via Bluetooth to a pager receiver, after which the system will choose from the best available communications network even during outages or when in areas with low signal penetration.

Government and Politics

The VA awards Cerner a $161 million contract to implement an enterprise health services network at four of its Ohio facilities. I assume, but haven’t confirmed, that this is a milestone payment for the VA’s general implementation of Cerner.

COVID-19

HHS bids out a $250 million contract for a public relations firm to “defeat despair and inspire hope” related to COVID-19 and to encourage businesses to reopen to restart the economy, with most of the money to be spent by the end of the year.

New White House medical adviser neuroradiologist Scott Atlas, MD is urging the White House to embrace a herd immunity strategy for COVID-19, calling for lifting restrictions so that the virus will spread through healthy populations while the government focuses on protecting high-risk people. Sweden’s use of that strategy yielded infection and death rates that are among the highest in the world and failed to prevent economic problems. Epidemiologists, of which Atlas is not one, project that reaching 65% herd immunity in the US would require over 2 million deaths.

Wesleyan University is testing every student and on-campus employee twice per week for COVID-19,  arranging for a 10-day isolation period for those who test positive, and performing contact tracing. Students, faculty, and staff members bring their ID to a tent, where they are given a nasal swab kit, perform their own swab, and return their sample to testing staff. The school has reported four positive results in nearly 5,000 tests.

An article in The Atlantic explains why contact tracing works everywhere in the world except the US:

• The US didn’t start early before case numbers became unmanageable.
• People often don’t answer their phone when called by someone they don’t know.
• Test results often take several days to arrive and people don’t always self-isolate while waiting for them.
• A significant number of Americans don’t trust the government or believe in conspiracy theories.
• The US doesn’t provide much social support, so those who test positive are expected to isolate away from work and family at their own expense and in what could be space-limited living quarters.

NIH announces that a Phase 3 trial of an investigational COVID-19 vaccine that was developed by Oxford University has begun and will ultimately include 30,000 adult volunteers in 30 states. AstraZeneca has purchased the rights to the vaccine.

ProPublica notes that the US has no overall strategy for testing symptom-free people for COVID-19 because of the different needs involved with clinical versus public health use. Symptom-free testing offers no clinical value since treatment would be the same whether positive or negative, but public health departments want to be able to identify those silent carriers to assess the overall severity and source of the infection’s spread and to perform contact tracing to ask people to isolate themselves.

The National Institutes of Health concludes says the data used by the FDA to support its Emergency Use Authorization for convalescent plasma treatment is not adequate to recommend the treatment or to make it a standard of care. NIH says no conclusions can be drawn in the absence of randomized clinical trials even though FDA, HHS, and the White House publicly announced the EUA as a historic breakthrough that will save 35 of 100 hospitalized patients in misinterpreting the study’s results.

The US will not participate in the World Health Organization’s 170-country Covax effort to develop, manufacture, and equitably distribute a coronavirus vaccine. A White House spokesperson announced that “we will not be constrained by multilateral organizations influenced by the corrupt World Health Organization and China.” Experts say the downside of the “America first” policy is that if none of the vaccines being tested here work, then Americans won’t have access to successful ones that other countries are testing. The global concern is that the US will hoard doses and vaccinate even low-risk people while other countries are left without.

Florida’s health department cuts ties with Quest Diagnostics after it discovers that the company failed to submit 75,000 COVID-19 positive results going back to April. Quest apologized, saying that a technical issue prevented it from reporting 75,000 test results of the 1.4 million tests it performed, and notes that individual patients and providers received their results in a timely manner even though the state did not.

Studies find that proper ventilation can help reduce coronavirus spread indoors, as researchers recommend that schools and business upgrade their air circulation systems and open windows when possible.

Apple and Google will include COVID-19 exposure notification in the next updates of IOS and Android that begin rollout immediately, eliminating the need for users to install them as a separate app. Users will receive a push notification of the public health options that are available in their area should they choose to opt in.

Sponsor Updates

• Arcadia makes its Outreach module available for free to payer and provider partners so that they can communicate with patients about pediatric vaccination needs and other gaps in care.
• Impact Advisors publishes a white paper titled “EHR Hostring Strategies and Options.”
• The Chartis Group hires James Green as a director of its revenue cycle practice.
• CereCore wins ClearlyRated’s 2020 Best of Staffing client and talent awards for service excellence.
• Public sector technology vendor Tyler Technologies and Cerner will help state health departments comply with Medicaid reporting requirements using Tyler’s Entellitrak and Cerner’s HealthIntent.
• Clinical Architecture releases a new episode of The Informonster Podcast, “The COVID-19 Interoperability Alliance.”
• Dresner Advisory Services names Dimensional Insight an overall leader in business intelligence in its annual Industry Excellence awards.
• Everbridge and the National Center for Missing & Exploited Children celebrate six years of successful collaboration.

Blog Posts

• Top 6 Problems with Paper Consent Forms (Access)
• 3 Steps to Ensure Smooth Medical Billing with Every Patient (AdvancedMD)
• The Immunization Gateway Portfolio: Preparing for COVID-19 Mass Vaccination (Audacious Inquiry)
• Maximizing Staff Scope of Practice (Bluetree)
• Interoperability e-Notification CoPs: Why a National Network is Critical (CarePort Health)
• Millions are Uninsured Due to COVID-19: What This Means for Payers (Collective Medical)
• CoverMyQuest: Updates from Our 2019 Winners (CoverMyMeds)
• Virtual Healthcare IT Projects Webinar Recording (Optimum Healthcare IT)
• What is FHIR and Why it Matters (Diameter Health)
• Going Big for Their Go-Live (EClinicalWorks)
• Tearing Down SDoH Barriers to Discharge During a Pandemic (Ensocare)
• Optimizing Data for Revenue Recovery in Your Health System (ESolutions)

Contacts

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

Morning Headlines 9/1/20

CMS agrees to cover ‘breakthrough’ medical devices

A proposed CMS rule would give Medicare beneficiaries access to medical devices the FDA designates as breakthrough technology.

Cerner Unit Books Potential $161M VA Health Network Deployment Order

Cerner’s government services business receives a $161 million order to implement an enterprise healthcare services network at four VA medical centers in Ohio.

Madison nurses start company to provide online COVID-19 screening

Former Epic nursing innovation and product lead Bre Loughlin, RN co-founds Nurse Disrupted to offer virtual COVID-19 screening to men’s and women’s shelters in Madison, WI.

Curbside Consult with Dr. Jayne 8/31/20

Over the last few years, I’ve done quite a bit of work with healthcare IT startups. There are hundreds of people out there who think they have the next big thing and jump headlong into the journey of trying to make it a reality. It’s a difficult road from having an idea to going live in production, and an even more challenging one taking a product from go-live to profitability. We’ve all seen the startup failures and even those that make it to the big time seem to struggle becoming profitable.

The biggest issue I’ve seen with some of the startups I’ve worked with is that they fail to determine how they’re going to govern themselves and their application. I’m a huge fan of governance, not only because good fences make good neighbors, but because being able to make decisions effectively also helps prevent wasted effort and rework when it turns out something was built that doesn’t make sense.

There are numerous governance questions that need to be addressed. First, there are issues about how the organization will be formed. Is it a partnership, a limited liability company, or something else? Does everyone have an equal share in the profits and liabilities? Is the company based somewhere with favorable laws? I was recently approached by a startup that had no corporate structure. While I’m comfortable contracting with individuals, I wasn’t comfortable having one partner hire me to fix what sounded like a problem with one of the other partners.

Next, there are issues around contracting and spending money. Who has signatory authority for contracts? Who has the ability to spend money? Can everyone spend money up to a certain threshold, but do expenditures above a certain point require a greater decision-making authority? What kinds of expenses qualify as business expenses? Do various functions have budgets and are expenditures regularly reviewed to ensure things are not getting out of hand? Are the appropriate checks and balances in place?

There are certainly more “business-y” things that have to be done when you’re contemplating a startup, but operational and product governance also needs to be in place if an effort is going to be successful. On the operational side, is there a mission and a vision for the company? Do the involved parties have a common understanding of what they are trying to build and sell? Or are there simmering disagreements about whether the effort is more technology-based or service-focused, or a bit of both? Who is the target audience, and does the group understand their needs? I’ve seen plenty of great ideas fall flat because no one involved in the visioning process understands the target audience, or even the target industry. Cue the music for all the big tech companies that thought they could “do healthcare” and exited after spending a lot of money and not accomplishing much.

There also needs to be some level of product governance figured out before the first line of code is even written. Who makes decisions on what the product is going to do? In a startup, people may wear multiple hats, but who owns the functions of product management, clinical oversight, development/dev ops, testing, marketing, and sales? If there are competing priorities, how will decisions be made? Who determines minimum viable product? Who will represent the voice of the customer? Who will keep up with regulations, if applicable? I once worked in a startup that had a brilliant development mind who didn’t play well with others. He’d stay up all night writing code, without running anything past the clinical advisors (and often without running it past others who were writing conflicting features). When his ideas were shot down, not only did we have to untangle the content from the application, but it took days and sometimes weeks to get him back to his happy place where he could be productive again.

Another sticking point I see people get in trouble with is the management of contractual requirements for customers or prospects. This goes back to the mission and vision part. If a client or prospect asks for a feature to be built as part of a contractual requirement, who makes the decision? Is it more important to land the customer, even if it means delaying other planned features or moving away from the product’s comfort zone? If a contractual requirement is agreed upon, does the agreement contain enough detail to make the feature a reality, or will there be room for the client to claim that it wasn’t properly delivered because the contract was vague? I see a lot of startups that try to be everything to everyone and move well outside their comfort zone and often into the danger zone because they lack governance.

One of the most important things that startups need to develop is the ability to say no. Sometimes a prospect just isn’t a good fit or has needs that are beyond where the company is in its development. It can be more important to walk away from a deal rather than saddle the team with an unwinnable situation, or unreasonable product demands. I recently worked with a group that had a truly cool offering that was just coming into its own when COVID hit. A large health system approached them about modifying it a little and trying to scale it up to fill a COVID-related need. Fortunately, the managing partners said no, because trying to get the health system live would have been a huge distraction from all their other priorities for the year. Although some argued that it was a missed opportunity, the reality is that saying no gave the company additional opportunities to be true to their core mission and their existing clients.

Seeing a cool idea become reality is incredibly exhilarating. It’s also exhausting, and I’ve seen it weigh heavily on individuals, their families, and their careers. Playing in that part of the industry isn’t for the faint of heart, although it’s a relatively great place if you’re an adrenaline junkie or if you enjoy staying awake at night sweating all kinds of things which might go wrong. It’s fun to wake up wondering what adventures each new day might bring, but it’s even more fun when you get to do it within the confines of a leadership team that’s done the legwork needed to increase the odds for success.

What’s your best (or worst) startup story? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 8/31/20

GoodRx files to go public with a rare characteristic: Profits

Prescription shopping vendor GoodRx files for an IPO, showing first-half results of $55 million in profit on $257 million in revenue with high growth in both.

Ascension Michigan health system to lay off and outsource 223 IT jobs in Troy

Ascension Michigan will lay off 223 employees of its IT network operations and service desk in October as the health system outsources their jobs.

HHS Deputy Secretary Hargan Statement on Appointment of Acting CIO

HHS Principal Deputy CIO Perryn Ashmore will begin serving as acting CIO following the resignation of Jose Arrieta.

Monday Morning Update 8/31/20

Top News

Konica Minolta will pay $500,000 to settle false claims act charges involving its former subsidiary Viztek, which the federal government says fraudulently obtained certification for its Exa EHR that allowed users to falsely collect Meaningful Use payments.

Also named was EHR certification company InfoGard, which “facilitated and participated” in Viztek’s false attestations by certifying the product even as its tester noted obvious manipulation.

Details of the whistleblower’s complaint, in which the government intervened without filing its own complaint, are more interesting than the $500,000 settlement might suggest:

• PACS vendor Viztek announced rollout of its EHR-PACS integrated Exa EHR in mid-2014. It developed that product in reworking its previously acquired Opal EHR, which was ONC certified.
• Viztek’s India-based developers underestimated the work that was required to bring Exa EHR up to 2014 edition standards.
• The whistleblower – Exa EHR’s product manager – said Viztek founder and president Joe Cermin told her that “I don’t care if you have to lie, beg, cheat, steal, or kill” to earn certification since failure to do so would jeopardize the millions of dollars that would result from the company’s acquisition by Konica Minolta, which was underway during the certification testing.
• Konica Minolta acquired the 120-employee, North Carolina-based Viztek in October 2015.
• Viztek chose the remote testing option so it could manipulate the testing scenarios using a hard-coded product version that was never released. The whistleblower was told to keep multiple tabs open on her screen, one to run the test script and the other to show an already-configured result. The software failed testing at several points, at which time the company’s executives would ask for a break to allow two on-call teams in India to dummy up test results on two versions of the software, then demonstrate the result of whichever team finished first. At several points, the developers accidently displayed live patient data.
• The developers hard-coded the EHR to pass the XML output requirements for Common MU Data Set by using programming they found on an ONC testing website. They didn’t even bother to remove the other EHR vendor’s name that was still embedded in the programming.
• InfoGard “facilitated and participated” in the false attestations by giving Viztek multiple attempts to pass and approving frequent breaks and delays that gave developers time to falsify the programing. The InfoGard tester passed the product even though she noticed that on-screen version numbers, colors, and field layouts changed after the developers had taken breaks.
• The UL subsidiary of Underwriters Laboratories acquired InfoGard in December 2015.

Reader Comments

From Debbie Downer: “Re: [health IT executive name omitted.] Does it seem they had to be at least somewhat evil to have made their way to the top?” We all have a good-bad behavior ratio that changes situationally, earning us a perceived “jerk score” that may be based on only superficial aspects of our character as observed at our most inopportune moments. Steve Jobs, Bill Gates, Elon Musk, and Neal Patterson kicked their dents in the universe with a psychologically obsessive focus, notoriously flaring temper, an intolerance of naysayers, psychological issues that in some cases were tied to a traumatic childhood, and a general indifference to the wellbeing of the folks who were rowing their corporate boat. But they built lasting and daringly innovative companies in their image that likely would not have happened if they were easygoing everymen. It’s probably not true that nice people finish last, but it is true that people who are successful in any field have to push themselves and others in ways that cheap-seaters would likely find despicable. Whether that leaves them happier on their deathbeds or whether society is better off as a result is an issue that is above my pay grade. Maybe my conclusion is that you can be happy only if you act as your natural self, regardless of how acceptable that may or may not be to others, and the vast majority of jerks don’t accomplish all that much.

From Woodstock Generation: “Re: US withdrawal from WHO. All of my HIM colleagues say no impact will result. We will continue to use ICD-10 diagnoses from WHO and modify them as usual to crate our ICD-10 CM. We will also will continue to create procedure codes (ICD-10 PCS) for use only in the US.”

HIStalk Announcements and Requests

Many poll respondents say that their family connection and money situations have improved in the past year, although quite a few others don’t have much positive to report (with “optimism” taking a big hit, likely due to COVID-19).

New poll to your right or here: how much consumer and healthcare impact will the Amazon Halo wearable have?

Webinars

September 3 (Thursday) 2 ET. “How Does A Global Pandemic Reshape Health IT? A Panel Discussion.” Sponsor: Intelligent Medical Objects. Presenters: Rob Wallace, chief product officer, IMO; Andrew S. Kanter, MD, MPH, chief medical officer, IMO; Lori Kevin, VP of enterprise IT and security, IMO; Sahas Subramanian, MCA, enterprise architect, IMO. As COVID-19 continues to spread, regulation changes, code system updates, and an increased reliance on technology are making it hard to stay on top of the many ways the pandemic is altering health IT. What’s more, we’re confronting challenges that rely heavily on technological solutions – like accurate reporting tools or telehealth adaptations – and we need those solutions now. The panel of subject matter experts across the enterprise will share insights on how the global pandemic is reshaping the health IT world.

September 17 (Thursday) 1 ET. “ICD-10-CM 2021 Updates and Regulatory Readiness.“ Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, VP of global clinical services, IMO; Theresa Rihanek, MHA, RHIA, mapping manager, IMO; Julie Glasgow, MD, clinical terminologist, IMO. IMO’s top coding professionals and thought leaders will review additions, deletions, and other revisions to the 2020 ICD-10-CM code set that will be critical in coding accurately for proper reimbursement.

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

Acquisitions, Funding, Business, and Stock

Prescription shopping vendor GoodRx files for an IPO, showing first-half results of $55 million in profit on $257 million in revenue with high growth in both. The company was valued at $3 billion in a 2018 funding round.

COVID-19

US COVID-19 deaths are at 183,000, with 220,000 projected by November 1.

Public health experts question whether COVID-19 PCR tests are overly sensitive, causing people who are carrying insignificant amounts of virus to be labeled as positive and treated as contagious. The answer isn’t to stop testing, as CDC’s controversial new guidance suggests, but instead to use the newly introduced rapid tests that are less sensitive. Other options would be to confirm PCR tests a few hours later with a rapid test, or to interpret the same PCR test result using lower cycle threshold ranges. A run of samples at New York’s state lab identified 794 positive results using the common setting of 40 cycles, but detuning the sensitivity to 35 cycles reduced that number in half, which would make the results more meaningful and make contact tracing easier. The experts also question why labs report their test results as simply positive or negative instead of listing the actual measured viral load.

HHS dismisses two of its high-level PR experts following the backlash that followed erroneous statements made by FDA Commissioner Stephen Hahn, MD about the effectiveness of convalescent plasma treatment that he later declined to correct in a public forum. Hahn, President Trump, and HHS Secretary Alex Azar touted FDA’s Emergency Use Authorization of the treatment as a “very historic breakthrough” that offers a 35% reduction in deaths, a wildly incorrect misinterpretation of results from an observational study that showed that a tiny subset of patients had 35% fewer deaths when given the treatment early versus those who were given it later. Hahn tweeted that he misspoke in characterizing the findings as an “absolute reduction” instead of a “relative reduction,” but he has not elaborated further or provided more accurate information to the public. No randomized clinical trial has been done to prove that convalescent plasma treatment reduces deaths, and even taking the data at face value suggests a 5% mortality reduction at best from using the 100-year-old treatment.

FDA assigns Emergency Use Authorization to allow all hospitalized COVID-19 patients to receive remdesivir, although no research has been published to prove its benefit. FDA issued an EUA in May for using the drug in non-ventilated hospitalized patients who need oxygen. FDA Commissioner Stephen Hahn, MD said that “data show that this treatment has the potential to help even more hospitalized patients,” citing one study from May and another that found only that five days of treatment work as well as 10. Hospitals worry that broader authorization is unproven, it came in the absence of new research, and the EUA will make it harder to obtain the drug for patients whose need is better documented by evidence.

FDA Commissioner Hahn says the agency will authorize widespread use of a COVID-19 vaccine via Emergency Use Authorization before Phase III clinical trials are complete if they think the benefits outweigh the risks. He says it won’t be a political decision – companies apply for such authorization and FDA makes a determination based on the evidence they submit. The only countries that have approved vaccines before their clinical trials were completed are China and Russia.

People who are misinterpreting CDC’s data are spreading the rumor that only 6% of reported coronavirus deaths were caused by COVID-19, confusing the fact that 6% have COVID-19 as the only ICD-10 code listed while the other 94% include COVID-19 as well as comorbidities such as obesity or diabetes, as is common in many Americans and nearly ubiquitous in older people. It was already widely published that older, sicker people are more likely to die of COVID-19, as are minorities and those who are poorer. The pandemic won’t just go away by pretending that people who die of pneumonia in conjunction with coronavirus infection didn’t really die of COVID-19 and therefore everybody else’s odds are better. But you want to blame people for letting COVID-19 kill them by daring to be older, sicker, poorer, or less white, then these are some good numbers to share with others who don’t really care about their deaths either.

Other

Ascension Michigan will lay off 223 employees of its IT network operations and service desk in October as the health system outsources their jobs. SVP/CIO Gerry Lewis said in a blog post two weeks ago that “we have begun shifting some of our technology functions to third-party partners who specialize in these services” as part of its “digital transformation.”

Cleveland Clinic President and CEO Tom Mihaljevic, MD will interview Epic CEO Judy Faulkner on Wednesday, September 2 at 6 p.m. ET as part of the speaker series “Ideas For Tomorrow.” It will be live-streamed on Facebook and YouTube Live.

Elon Musk’s Neuralink demonstrates its skull-inserted brain-computer link in a pig, as the company continues its progress toward creating “neural shunts” that could allow paraplegics to regain use of their limbs. Musk also envisions people communicating using “conceptual telepathy” without writing or speaking. He admits that people will be wary of the technology that he calls “a Fitbit for your skull,” acknowledging that “this is increasingly sounding like a ‘Black Mirror’ episode.”

Sponsor Updates

• OptimizeRx CEO William Febbo will present at the LD 500 virtual investor conference on September 3.
• The National Council for Prescription Drug Programs honors Surescripts Clinical Informatics Manager Larry King with its Rising Star Award.
• TriNetX announces that Duke-NUS, a medical school in Singapore, has joined its global research network.
• Vocera will present virtually at the Baird 2020 Global Healthcare Conference September 9, Wells Fargo Virtual Healthcare Conference September 10, and Morgan Stanley Virtual Global Healthcare Conference September 14.
• Wolters Kluwer launches “5 Forces for the Future” series to reimagine healthcare post-COVID-19.

Blog Posts

• The difference between ambient clinical intelligence and ambition (Nuance)
• How Far We’ve Come: Immunizations (OmniSys)
• My Unexpected First 100+ Days (PatientKeeper)
• Clarifying 5 Misconceptions about CMS’s E-Notifications Condition of Participation (PatientPing)
• Investing in Partnerships Pays Dividends (PMD)
• Executive Analysis Elevates a Transfer Center’s ROI and Strategic Value (Central Logic)
• Take Advantage of the PAMA Deadline Extension (Premier)
• Sell to hospitals. Get your product live. (Redox)
• Back to the Future with SailPoint Predictive Identity (SailPoint)
• 3 key questions to determine if your data protection software is Privacy-Grade (Spirion)
• How to strengthen your emergency call system to comply with Kari’s Law and the Ray Baum’s Act (Spok)
• Vocera and EASE: Humanizing the Patient and Family Experience, Together (Vocera)
• What Healthcare Can Learn From Fintech’s Digital Evolution (Waystar)
• Is Professional Liability Insurance Worth It? (WebPT)

Contacts

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

Weekender 8/28/20

Weekly News Recap

• Amazon announces its Halo health and wellness wearable, app, and membership program, with Cerner posting its own news that it has integrated the device with Millennium.
• Konica Minolta Healthcare Americas Inc. will pay $500,000 to settle federal false claims allegations that its former Viztek subsidiary fraudulently earned certification for its EXA EHR that allowed users to claim Meaningful Use funds.
• The private equity owners of behavioral software vendors Qualifacts and Credible Behavioral Health announce that they will merge their respective companies.
• CMS issues emergency regulations that require hospitals to report their COVID-19 capacity data daily to HHS to continue being paid by Medicare and Medicaid.
• Google Cloud will invest $100 million in Amwell when the company begins public trading.
• The VA implements patient scheduling in an Ohio facility in its first Cerner go-live.

Best Reader Comments

There are some really affordable solutions that allow patients to either pre-register online or fill out information on a tablet or other mobile device when they’re checking in. It’s more convenient for the patient and eliminates a lot of expensive data entry in the back office. You can also do things like connect to a clearinghouse to check a patient’s insurance coverage. I’m no longer surprised at how much hospitals and clinics invest in technology, but still waste time and money with manual paper processes, but it’s hard to fathom. (Greg Mennegar)

I am an Epic builder and it annoys me to no end when I pre-register and fill out all the MyChart questionnaires for an appointment at one of the “big hospitals” here in Boston only to be handed a clipboard with the same questionnaire in paper form that I am asked to fill out. I have even offered to show the front desk staff how to print out the filled out questionnaire from my chart to no avail (this has happened to me more than once and in different departments). Sometimes it is less about the lack of technology and more the lack of user training that can be the issue. (Craig Molway)

Any organization that deems it necessary to purchase higher ratings to game the system should be called out. It clearly points to an act of desperation to sell services or products that can’t stand on their own merit or reputation. This is certainly a warning sign to potential clients that an organization is willing to do all the wrong things to get a contact besides providing a high-value / quality service. (PT Franks)

I would argue that the mental / behavioral health crisis that has gained national attention to the pandemic has its roots in young people being taught that certain emotions are bad and to be avoided. If you look at metaphors, happiness is bright and full of sunshine and sadness is blue and full of clouds and rain. Who want want to admit being sad?!? To your point about the person who told you to wear a smile, it’s akin to a person asking you, “How you are?” and only wanting to hear something superficial like “good” or “not bad.” Perhaps many folks don’t have the language or skills to talk about the “bad” emotions in a meaningful way, so they choose avoidance.(Elmer Phd)

Your “compared to a year ago” poll made me smile. Exactly one year ago I was at peak misery of hot, swollen and uncomfortable, because I was nine months pregnant. I was instantly happier, healthier, and more optimistic two days later when our son was born. (What a year)

Watercooler Talk Tidbits

Readers funded the Donors Choose teacher grant request of first-year teacher Ms. N in Miami, who asked for engineering learning centers for her elementary school class. She reported in early March, “I work in a title one school with mostly students from low-income families and a low-income community. Getting gifts for the classroom makes them so excited to learn and come to school everyday regardless of what they face at home. When my students first saw the items that were donated they could not control themselves, they were so excited. They wanted to dive in right away! Some of their favorites are the turn and learn gears and the car building kit. Engineering time in my classroom is my favorite part of the day because it fosters their creativity and this time was made more special because of your donations!”

Ralph Lauren will outfit those working as “ballpersons” during the US Open with a muted uniform, with each shirt listing the name of a Mount Sinai Health System essential employee on the back. The company says bright, colorful designs didn’t seem appropriate and thinks having the names of those who have saved lives on display will celebrate the many ways in which people can make a difference. The company will also feature profiles and stories of nine of the workers on its website.

A team of 14 nurses, two neonatal nurse practitioners, three respiratory therapists, and a neonatologist worked through the night to care for 19 NICU babies at Lake Charles Memorial Hospital (LA) as Hurricane Laura hit with winds of up to 135 miles per hour early Thursday morning, taking out the hospital’s air conditioning and water. The team moved the babies, some of them on ventilators, to the hallway away from windows. The babies had been transferred there a few hours before when the women’s hospital was evacuated.

The CEO of Bristol Regional Medical Center (TN) resigns after accepting a cardiothoracic surgeon’s invitation to make the first incision in a patient despite having no medical training. The hospital also parted ways with the surgeon.

A Georgia nurse who contracted COVID-19 during a two-month assignment in New York City and then couldn’t return to hospital work because she was haunted by the experience of seeing families watching their loved ones die via FaceTime starts a company that helps businesses keep their employees safe from COVID.

The Washington Post profiles former Baton Rouge General Medical Center security guard Russell Ledet, who is now doing his third-year medical school rotation at the same hospital while completing his MD and MBA degrees. He joined the Navy out of high school and was convinced by his wife to go to college, where he doubled-majored in biology and chemistry while supporting his family with the security guard job. After finishing undergrad, he earned a PhD from NYU in molecular oncology, then started medical school at Tulane. He plans to earn triple board certification in pediatrics, general psychiatry, and child and adolescent psychiatry and then open a New Orleans mental health services clinic for marginalized communities. 

In Case You Missed It

• News 8/28/20
• EPtalk by Dr. Jayne 8/27/20
• News 8/26/20
• Curbside Consult with Dr. Jayne 8/24/20
• HIStalk Interviews Jose Barreau, MD, CEO, Halo Health
• Monday Morning Update 8/24/20

Get Involved

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

Morning Headlines 8/28/20

Cerner ties in with new Amazon Halo to add depth to data in health records

Cerner integrates its systems with Amazon’s new Halo, a health and wellness wearable, app, and membership program.

New Jersey Electronic Health Records Company to Pay $500,000 to Resolve False Claims Act Allegations

Konica Minolta Healthcare Americas will pay $500,000 to settle allegations that its Viztek subsidiary obtained Meaningful Use certification for its EXA EHR under false pretenses, causing end users to falsely attest for MU incentives.

HHS Awards $117 Million to Support Health Center Quality Improvement

HHS will award over $117 million to 1,318 health centers across the country to help with quality improvement efforts including advancing the use of health IT.

News 8/28/20

Top News

Amazon introduces Halo, a health and wellness wearable, app, and membership program.

Cerner simultaneously announced that it has integrated its systems with Halo, which will allow consumers to share their connected health values with their care team. Sharp HealthCare is the first to implement Halo in a healthcare setting.

The screen-free Amazon Halo measures body composition from selfies, activity duration and intensity, sleep quality and quantity, and mood as evidenced by voice tone. It will also offer health improvement ideas, such as specific exercises.

The device is swim-proof and will run seven days on a 90-minute charge if its tones are disabled.

Scientists will be interested to study the types of sensors that Amazon is using and to learn if Amazon will publish results from their use.

Amazon Halo is available via an early access program for $65 and a $4 per month subscription after the first six months. The regular price will be $100.

Reader Comments

From Down Underwear: “Re: HIMSS. Good thing they didn’t go ahead with HIMSS20.” Researchers say the 175-attendee conference of drug company Biogen at Boston Marriott Long Wharf in February has led to at least 20,000 COVID-19 cases, based on tracking the virus’s genetic makeup over four Boston-area counties. HIMSS20 would have involved 50,000 attendees from all over the world, many of them working in patient care, so that would have been a disaster. Unrestricted travel as we have in the US makes it hard to contain and track the virus, as public health agencies are discovering in wondering how many of the hundreds of thousands of people who attended the recent Sturgis Motorcycle Rally brought coronavirus home with them.

From Hermit: “Re: Allscripts. Layoffs continue, with almost all of the Paragon development and product management team gone as jobs continue to move to India.” Unverified.

From GrBuckeye: “Re: Virginia Commonwealth University Health System. Outsourcing its revenue cycle operations to Ensemble Health Partners as of 11/1. Only patient-facing employees, such as in patient access and registration, will remain VCUHS employees, while the other 300 to 600 will become Ensemble employees. I assume that a press release will come out soon with more details.” Unverified.

Webinars

September 3 (Thursday) 2 ET. “How Does A Global Pandemic Reshape Health IT? A Panel Discussion.” Sponsor: Intelligent Medical Objects. Presenters: Rob Wallace, chief product officer, IMO; Andrew S. Kanter, MD, MPH, chief medical officer, IMO; Lori Kevin, VP of enterprise IT and security, IMO; Sahas Subramanian, MCA, enterprise architect, IMO. As COVID-19 continues to spread, regulation changes, code system updates, and an increased reliance on technology are making it hard to stay on top of the many ways the pandemic is altering health IT. What’s more, we’re confronting challenges that rely heavily on technological solutions – like accurate reporting tools or telehealth adaptations – and we need those solutions now. The panel of subject matter experts across the enterprise will share insights on how the global pandemic is reshaping the health IT world.

September 17 (Thursday) 1 ET. “ICD-10-CM 2021 Updates and Regulatory Readiness.“ Sponsor: Intelligent Medical Objects. Presenters: June Bronnert, MSHI, RHIA, VP of global clinical services, IMO; Theresa Rihanek, MHA, RHIA, mapping manager, IMO; Julie Glasgow, MD, clinical terminologist, IMO. IMO’s top coding professionals and thought leaders will review additions, deletions, and other revisions to the 2020 ICD-10-CM code set that will be critical in coding accurately for proper reimbursement.

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

Acquisitions, Funding, Business, and Stock

SeamlessMD raises $3 million in a Series A funding round. The Toronto-based company’s app helps patients before, during, and after hospital stays. The company plans to expand its use of machine learning and expand into home and oncology care.

Research and advisory nonprofit Altarum sells its Prometheus Analytics software to Change Healthcare.

Employer-focused, prescription-savings startup Prescryptive Health raises $26 million in a Series A funding round. Co-founders Chris Blackley and Kevin Young started the company in 2017 after long stints at Microsoft.

Sales

• Medical University of South Carolina Children’s Health selects Proficient Health’s PH Connect referral and health data exchange software.
• Wellstar Health System (GA) will implement telestroke and teleneurology technology from VeeMed at nine of its hospitals.
• The Missouri Hospital Association’s Hospital Industry Data Institute will upgrade its statewide care coordination platform with predictive alerts and analytics from Collective Medical.

People

Sean Slovenski, former head of Walmart Health, joins diagnostic testing company BioIQ as CEO.

Best Buy names former IBM Watson Health executive Deborah DiSanzo (Harvard T.H. Chan School of Public Health) as president of Best Buy Health.

Ambulatory surgery network operator ValueHealth hires John Gresham (Cerner) as COO.

Announcements and Implementations

Carrus Health (TX) implements Medhost’s Enterprise EHR and RCM software at its new Behavioral Hospital.

Nova Southeastern University (FL) goes live on InteliChart’s Healthy Outcomes patient engagement software across its 20 multi-specialty health centers.

CentraState Medical Center (NJ) implements tele-ICU services from Advanced ICU Care.

The University of Kansas Health System goes live on Epic at its locations in Great Bend.

COVID-19

The FDA issues Emergency Use Authorization for Abbott’s rapid test for COVID-19. The company will sell the credit card-sized test, which provides results in 15 minutes using technology much like a pregnancy test, for $5. The test uses a nasal swab and must be administered by a healthcare professional who is operating under a CLIA certificate. Abbott has developed a companion app called Navica, which will display a boarding pass-style, time-limited QR code that employers, schools, and group activity organizers can scan to limit entry to those who have tested negative. Abbott anticipates manufacturing 5 million tests a month starting in October, although the White House is rumored to have brokered a deal to buy 150 million of the tests for $750 million that the federal government will distribute to high-risk schools and nursing homes, which may exhaust the supply for many months.

CMS issues emergency regulations that include requiring hospitals to report COVID-19 patient and testing data daily to HHS or face possible termination of Medicare and Medicaid payments. In addition, nursing homes will be required to test staff and offer testing to residents.

Sources say that HHS and the White House pressured CDC to quietly issue new guidance this week for people who have been exposed to COVID-19 but who are not experiencing systems. CDC now says that those people should not seek COVID-19 testing. Experts are expressing public concern that the goal should be testing more people without symptoms instead of fewer, symptom-free people can be prolific spreaders, more widespread testing is important and especially so as students return to campus, and CDC is again changing its position under apparent White House pressure. CDC Director Robert Redfield, MD, responding to criticism, has since walked back the recommendation to say that testing “may be considered” for all close contacts of people who are known or suspected to be infected. However, the changed guidance remains on CDC’s website without such clarification.

The New York Times notes that since the White House no longer allows Anthony Fauci, MD to participate in high-profile interviews and the Sunday news programs, he is instead appearing on celebrity podcasts, academic webinars, and Instagram feeds where such approval is not required. Big-audience reporters are bypassing their lack of access by listening to his niche appearances and reporting his newsworthy comments. He is scheduled to offer a session at AMIA’s virtual symposium in November.

Other

A scenario-based survey of 523 graduating college students finds that nearly half would violate HIPAA for between $1,000 and $10 million. Between 65% and 78% of respondents would illegally share the medical records of a politician or reality show celebrity with media outlets to pay for a friend’s medical expenses.

Non-profit technology access service Human-I-T provides 30 tablets to allow COVID-19 patients of Olive View – UCLA Medical Center who can’t have visitors to connect virtually with their loved ones.

Sponsor Updates

• Healthwise employees and their families volunteer in the Boise, Idaho area by sewing and donating masks, and packing lunches.
• Goliath Technologies partners with Automai for app-performance monitoring.
• Intelligent Medical Objects publishes a new white paper, “The 21^st Century Cures Act in the age of COVID-19.”
• Kyruus Chief Customer Officer will co-present with Jefferson Health SVP Lisa Griffin during the virtual Greystone.Net Contact Experience Conference August 28.
• MDLive CEO and Chairman Charles Jones joins CNBC to discuss telemedicine amid the pandemic and the company’s plans to go public next year.
• 3M Health Information Systems makes its MModal virtual assistant technology compatible with the Hey Epic! Voice Assistant in Epic Hyperspace.
• Spok earns SOC 2 Type II compliance for Spok Go solutions, paging solutions.
• Cedar will integrate Waystar’s pricing estimates, payment options, and eligibility verification capabilities into its patient engagement software.
• Hayes adds revenue optimization insights to its MDaudit Enterprise revenue integrity software.
• SailPoint updates its Predictive Identity software to include integrations with Epic and Microsoft Teams.

Blog Posts

• Advancing telehealth with Amwell (Google Cloud)
• Analytics in the New Normal: The FDA and the Power of Real-Time Data, Collaboration, and Improved Interoperability in the COVID Fight (Health Catalyst)
• HDMLive Presents: The 5 B’s of interviewing (Health Data Movers)
• Lessons Learned While Implementing a Vendor Neutral Archive (VNA) (Impact Advisors)
• How To Overcome Common Community Connect Hurdles (Optimum Healthcare IT)
• Tracking Health Checks with Infor Workforce Management (Infor)
• How little things can make a big difference (Nordic)
• Risk Only Goes So Far: We need a new health outcomes equation (Jvion)
• Healthcare Affordability is More Than a Problem. It’s a Crisis (Loyale Healthcare)
• Plan Now for New Electronic ADT Notification Requirements (Healthcare Triangle)
• Investing In Partnerships Pays Dividends (PMD)
• A Guide to Patient Retention for Physical Therapists (MWTherapy)
• EHR Shortcomings Hinder Patient Matching and Contact Tracing Efforts for COVID-19 (NextGate)

Contacts

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

EPtalk by Dr. Jayne 8/27/20

Telemedicine provider Avera ECARE creates the American Board of Telehealth, positioning it as a national body to develop best practices and standards for telehealth education. The new board plans to focus on telehealth quality and education across the scope of individuals involved in telehealth, from administrators to physicians and everywhere in between. The ABT’s advisory board includes leadership from industry players such as Amwell and the American Telemedicine Association (ATA), along with a couple of academic faculty.

Avera received a $4.3 million grant from the Leona M. and Harry B. Helmsley Charitable Trust last year, which funded a telehealth education center along with a certificate program. The new ABT program will launch online September 7 with a CORE (Clinical, Operational, Regulatory, and Ethics) Concepts in Telehealth Certificate Program. Validated guidelines will be supplied through the Harvard medical Physician Faculty Group and the curriculum will be delivered using seven online modules. I’ve been underwhelmed by previous educational opportunities from the ATA and telehealth vendors, so my curiosity sent me to check out the website. There’s a $400 fee for the program and it sounds like they will mail you a handsome certificate, since they note that there is a $150 fee for a replacement.

My wacky clinical story of the week comes courtesy of our broken healthcare system, because if it was functional, the visit would never have happened. A patient presented to a direct-to-consumer telehealth service after seeing her primary care physician, who referred her to a subspecialist, who recommended a course of treatment that the patient didn’t feel was working. She was unable to reach the subspecialist due to limited office hours, so she called telehealth for a “second opinion.” It never occurred to her to reach back out to her primary physician to further discuss it. She ended up on the phone with an emergency medicine physician who wasn’t able to assist due to both limitations of knowledge and the constraints of his scope of service. Operations people take note: technology is not the answer here (but it can help).

Doing what I do for HIStalk is a great excuse to spend time every week checking out new companies. Sometimes a friend clues me in on an interesting thing they’ve seen, or mentions a need that gets me questioning whether a solution exists. Such was the case this week with SS&C’s Vidado platform, which was formerly under the Captricity moniker. Apparently they are a player in the insurance and financial services sector, with clients such as MetLife and Guardian. They have a track record with OCR and data extraction of insurance history and medical forms, which gives support to their entry into the world of healthcare. They processed over 300 million pages last year and obviously can play at scale.

It looks like their healthcare focus includes drug prior authorizations and specialty pharmacy orders, along with common documents such as claims forms. It sounds like they have a short-term proof of accuracy offer that allows clients to see how the solution would handle their forms before signing on the dotted line. If I was looking for a vendor in the space, that would certainly be compelling. I’ll certainly be keeping my eye on them to see how they fare in the wacky world of healthcare.

There are still plenty of paper forms out there, as I learned at the imaging center last week. They are now two years into their Epic implementation and are still handing patients a paper form to complete that looks like a downtime document – it doesn’t even have the patient’s name or demographics on it. Forms that make you fill out your address when it’s already in the registration system, EHR, and RCM system are just annoying.

One of my favorite techies has been out of work for a while and reached out today to share his acceptance of a new position. He’s been to hell and back in his job search and we caught up about some of the strange behaviors he’s seen among recruiters and hiring managers. One disheartening tale involved a recruiter who reached out twice for the same position, missing the fact that she had previously told him he wasn’t selected to move to the next step. Another involved a manager who noted that he was the first to interview for the position, but they planned to conduct interviews for the better part of a month, so he shouldn’t expect a decision any time soon. Nothing says “we don’t know what we’re looking for” like an admission that you haven’t narrowed your candidate pool.

My friend noted that multiple people asked questions like “why have you been out of work for so long” as if they were unaware of major layoffs in the healthcare IT industry or a global pandemic that has eliminated hiring in many sectors for the last six months. Not to mention that people may have been impacted by COVID personally or with the illness or loss of a family member, so it’s just not that great of a question. I’ve always found it better to focus on what the candidate is bringing to the table rather than the circumstances that led them there.

Regardless, I’m glad he found a position that seems like a good fit and that happens to be in his favorite industry. The fact that it’s work-from-home well into 2021 is a bonus, too. I know there are millions of good people looking for work right now and I wish them productive interviews with companies that have their acts together.

Everyone falls victim to clickbait headlines. I have to admit I was pulled into this viewpoint article in Nature Reviews Urology. “Making love in the time of corona – considering relationships in lockdown” looks at impact of societal lockdowns on intimacy. Topics range from the practical to the philosophical, so if you’re looking for an interesting read, it certainly fits the bill.

What’s the worst clickbait headline you’ve ever fallen for? Leave a message or email me.

Email Dr. Jayne.

Morning Headlines 8/27/20

SeamlessMD Raises $4 Million CAD Series A to Meet Increased Demand for Digital Patient Engagement Due to COVID-19

Toronto-based SeamlessMD will use a new round of funding to further scale its patient engagement app, designed to help patients before, during, and after hospital stays.

Prescryptive Health Closes $26 Million Series A Financing

Employer-focused, prescription-savings app startup Prescryptive Health raises $26 million in a Series A round led by Morningside Ventures.

Altarum’s Innovative Value-based Payment Solution—PROMETHEUS Analytics®—is Acquired by Change Healthcare

Research and advisory nonprofit Altarum sells its Prometheus Analytics software to Change Healthcare.

Morning Headlines 8/26/20

Warburg Pincus and Martis Capital Announce the Merger of Qualifacts and Credible Behavioral Health

The private equity owners of behavioral software vendors Qualifacts and Credible Behavioral Health will merge their respective companies, giving the merged organization a client base of 800 behavioral health agencies.

Lyra Health Closes $110M in Series D Funding

Lyra Health, which offers technology-powered mental health benefits for employers, raises $110 million in a Series D funding round, increasing its total to $290 million and valuing the company at $1.1 billion.

PatientPop Announces $50M in Series C Funding

Practice management software vendor PatientPop raises $50 million in a Series C funding round, increasing its total to $125 million.

Trump Administration Strengthens COVID-19 Surveillance with New Reporting and Testing Requirements for Nursing Homes, Other Providers

CMS issues new emergency regulations that include requiring hospitals to report COVID-19 data daily to HHS or face possible termination of Medicare and Medicaid payments.

News 8/26/20

Top News

Google Cloud invests $100 million in Amwell, with timing and per-share price to be set by the company’s announced IPO.

Amwell will move parts of its business from Amazon Web Services to Google Cloud.

Reader Comments

From Chuck: “Re: Qualifacts and Credible. I heard they are announcing their merger tomorrow [Chuck was correct – he sent this on Monday and the announcement was Tuesday]. This is kind of like T-Mobile and Sprint. With Netsmart, that will make two 800-pound gorillas in the behavioral health EHR space, leaving a handful of mid-level EHRs (TenEleven, NextGen, Streamline, Echo, Foothold, Core Solutions) competing for larger opportunities.”

From Dancing Iguana: “Re: links. We aren’t seeing web traffic coming from HIStalk like we used to. Have you changed something?” I didn’t change anything, but this inquiry led me to learn that WordPress did in an effort to eliminate a particular kind of security issue. Links that open a new browser tab intentionally hide the source website from the receiving one. That can be changed in two ways: (a) by making programming changes; or (b) setting all links to open in the same browser tab instead of a new one. Example: here’s how it works now (a new tab opens), and here’s how it would look otherwise (the existing tab displays the linked page). Let’s go to the poll: would it bug you if clicking an HIStalk link opened the new page in the same browser tab instead of a new one as in the second option above? It probably would me since I don’t like using the “back” button for navigation and then re-loading the page, but that’s the default browser behavior. Now I know why companies have asked me if my readership is down (it isn’t) – the traffic I send them doesn’t show as coming from HIStalk.

Webinars

September 3 (Thursday) 2:00 ET. “How Does A Global Pandemic Reshape Health IT? A Panel Discussion.” Sponsor: Intelligent Medical Objects. Presenters: Rob Wallace, chief product officer, IMO; Andrew S. Kanter, MD, MPH, chief medical officer, IMO; Lori Kevin, VP of enterprise IT and security, IMO; Sahas Subramanian, MCA, enterprise architect, IMO. As COVID-19 continues to spread, regulation changes, code system updates, and an increased reliance on technology are making it hard to stay on top of the many ways the pandemic is altering health IT. What’s more, we’re confronting challenges that rely heavily on technological solutions – like accurate reporting tools or telehealth adaptations – and we need those solutions now. The panel of subject matter experts across the enterprise will share insights on how the global pandemic is reshaping the health IT world.

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

Acquisitions, Funding, Business, and Stock

The private equity owners of behavioral software vendors Qualifacts and Credible Behavioral Health will merge their respective companies, giving the combined organization a client base of 800 behavioral health agencies. Warburg Pincus invested in Qualifacts a year ago at a reported valuation of $350 million.

Lyra Health, which offers technology-powered mental health benefits for employers, raises $110 million in a Series D funding round, increasing its total to $290 million and valuing the company at $1.1 billion. Co-founder and CEO David Ebersman spent 15 years as an executive with drug maker Genentech and then joined Facebook as CFO for five years before co-founding Lyra Health.

PatientPop raises $50 million in a Series C funding round, increasing its total to $125 million. The company offers practice management tools such as website development, online scheduling, appointment reminders, and reputation management. The co-CEOs came from ShopNation, which offers a fashion shopping engine.

Sales

• Dignity Health Management Services will use Innovaccer’s Data Activation Platform for interoperability as well as its population health management solution. 

People

B.well Connected Health hires Dunnie Norman (InsightRX) as chief revenue officer.

Dan Thelen, MBA (Evergreen Healthcare Partners) joins First Health Advisory as VP of cybersecurity.

Jay Sultan, MA (Cognizant) joins LexisNexis Risk Solutions as VP of strategy in its healthcare business.

Announcements and Implementations

The VA launches its Cerner appointment scheduling system at the VA Central Ohio Healthcare System, with a VA-wide rollout to follow.

Health IT startup Emme launches its first product, a $99 Bluetooth-connected smart pill case that sends women reminders to take their birth control pill via its IOS-only app. The company says that 80% of women miss at least one pill each month, causing 1 million unintended pregnancies.

Government research contractor Mitre and Nuance will work together to advance use of the MCODE cancer research and treatment data standard by using Nuance’s Dragon Medical One to capture clinician dictation that is sent to the EHR.

COVID-19

FDA Commissioner Stephen Hahn, MD, President Trump, and HHS Secretary Alex Azar incorrectly state that the use of convalescent plasma for treating hospitalized COVID-19 patients reduces deaths by 35% in announcing FDA’s Emergency Use Authorization for the treatment. They mischaracterized the original Mayo Clinic study, which concluded that giving the plasma within three days of diagnosis was associated with a seven-day mortality rate of 8.7% versus 11.9% if transfused later, which represents a 35% relative (not absolute) improvement between the timings in a small fraction of patients but does not support any evidence of an improved survival rate overall. Hahn acknowledged his mistake in a Monday night tweet, but scientists question how he could have made such an obvious error and then allowed others to repeat it uncorrected. President Trump had accused the FDA on Twitter the day before the announcement as being run by the “deep state” and intentionally obstructing vaccine and treatment studies in hopes of harming his re-election bid, although Hahn says that that White House pressure did not impact FDA’s action. Scientists say the FDA’s EUA will have a negative effect since use of convalescent plasma has not undergone randomized controlled trials and now patients aren’t likely to sign up for those studies knowing that they have a 50% chance of receiving placebo when they can just have the plasma ordered directly under the EUA. They also worry that White House publicity will cause shortages of the plasma, which is collected from volunteer COVID-19 survivors, and that FDA might allow a vaccine to be released prematurely with similarly unconvincing science behind it.

HHS Secretary Alex Azar told hospitals in an April 21 email that they would be required to submit their COVID-19 capacity data to HHS’s newly launched TeleTracking database to be eligible for the federal government’s $100 billion provider relief fund, a stipulation that Congress had not included in the legislation. 

A Georgia health district explains that a sudden COVID-19 case jump was caused by activation of a new lab reporting connection to Navicent Health that sent a backlog of one hospital’s reports going back to mid-June. They organizations are working together to remove the duplicate entries.

A testing lab tells the NFL says that 77 new positive COVID-19 results that affected 11 football teams were false positives caused by contamination that occurred during test preparation.

Other

A shareholder of SCWorx Corp. sues the company, claiming it misled investors by announcing a contract to sell $35 million worth of COVID-19 test kits each week for 23 weeks to Rethink My Healthcare. The shareholder says that customer was too small to afford the kits that it had supposedly committed to buy. SCWorx offers hospital supply chain, analytics, and interoperability solutions. According to its SEC filings, it has eight employees and is losing money to the point that its auditors question its survival. It acquired several mixed martial arts fighting championships that it still operates as subsidiaries. WORX shares are a rollercoaster, trading in the past year from $1.50 to $15, currently at $1.56, valuing the company at $15 million.

Former Sutter Health CIO John Hummel, PhD passed along the back story of former Sutter IT project manager and convicted murderer Mario Garcia, who a jury found guilty of killing a 27-year-old woman in 2005 even though her body had not been found. John says police searched the IT facilities extensively and his CISO was able to recover deleted pictures from a Sutter-owned camera in which Garcia documented scratches to his face. The photos, along with DNA evidence that proved that the victim had been in his car, convinced the jury of his guilt. John spent years searching for the woman’s body as a promise to her mother and now investigators have finally found the remains of Christie Wilson buried at Garcia’s former residence.

Cory Chase, a network analyst at Johns Hopkins All Children’s Hospital, records “Quarantine Radio,” a half-hour music and humor show that he creates after his work-from-home day ends.

Sponsor Updates

• CloudWave Director of Sales Engineering Mike Donahue receives the Patriot Award through the DoD’s Employer Support of the Guard and Reserve after being nominated by CloudWave Technical Consultant and US Air Force Guard member Osmandy Polanco.
• Dimensional Insight sponsors registration for the St. Jude Walk/Run in Boston September 26.
• Dina will exhibit at Health Catalyst’s virtual Healthcare Analytics Summit September 1-3.
• Elsevier launches a Medical Student Hub for first-year students that offers masterclass videos, podcasts, survival tips, anatomy flashcards, and toolkits.
• Everbridge’s contact tracing software experiences rapid global adoption across education, corporate, and government sectors.

Blog Posts

• Looking beyond COVID-19: the top 3 telehealth challenges to start combatting now (Ability Network)
• Healthcare IT in the Age of Coronavirus: HIPAA & Cybersecurity Protections (AdvancedMD)
• Bluetree’s Managed Services: Close the Support Loop and Do More with Less (Bluetree)
• Using SDOH Data to Create More Healthy Days at Home (Dina)
• Your Superpower Is Your Virtual Front Door: Multiply your revenue starting now (Bright.md)
• From Reactive to Proactive Care (Capsule)
• Culture Still Driven by Leadership During Crisis Times (Impact Advisors)
• Addressing Physician Burnout via EHR Inboxes and Patient Message Management (ChartLogic)
• 3 Best Practices for Successfully Leveraging CMS Conditions of Participation (Collective Medical)
• Using Technology to Improve Medication Access and Impact More Patients (CoverMyMeds)
• Our National Conference in 2020 (EClinicalWorks)
• Five Strategies to Ensure Cybersecurity During COVID-19 and Beyond (Ensocare)
• Helping Hospitals Get Back on Their Feet with Advanced Analytics (EPSi)
• Hospitals and Health Systems: Using Revenue Integrity Principles to Stabilize Your Revenue Cycle Amid COVID-19 (ESolutions)

Contacts

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