News 12/8/21

Top News

The Spokane, WA newspaper talks to local patients and employees about the VA’s implementation of Cerner at the city’s Mann-Grandstaff Medical Center, reporting these issues:

• Two former senior VA officials who were involved in the project say it was misguided and is unlikely to improve on the existing VistA system.
• One hour after VA Deputy Secretary Donald Remy assured a House subcommittee that “The Cerner system works,” the system went down for 80 minutes and had at least some downtime 10 times in September and October. The system has gone fully down four times since it went live in October 2020.
• Former VA deputy CIO and CTO Ed Meagher said it is “absolute malpractice” that the VA did not anticipate performance problems by modeling workload against infrastructure, adding that otherwise, “you’re working off of Cerner marketing material.”
• Several veterans said they were unable to navigate the patient portal and it sometimes locks up and fails to deliver messages.
• Prescriptions were not transferred to Cerner, requiring mistake-prone manual re-entry that left some veterans without psychiatric and other chronic care medications.
• Employees sometimes have to fax medication lists when patients are sent to other facilities for emergency treatment that isn’t offered 24×7 at Mann-Grandstaff..
• The VA, which was the subject of a national wait-time scandal in 2014, has removed Mann-Grandstaff from the wait time web page because it hasn’t figured out how to measure wait times on Cerner.
• The VA’s training did not include the referral management module and one veteran whose urology referral was lost was found to have an untreated, aggressive form of prostate cancer when finally seen nine months later.
• A chief of anesthesiology said EHRs are billing systems with text editors tacked on while VistA was written by clinicians whose goal was to provide the best care possible. He says that Cerner told him that one online form requires 90 minutes to complete, and when doctors told the company that the nurse had under five minutes to examine the patient and document the visit, Cerner said they should hire more people.
• Meagher concluded, “What Cerner does best is capture billable events via exhaustive questions and back-and-forth as you input things. That’s what ties them up. They’re answering questions that are meaningless to them. They’re very meaningful to a commercial organization, because that’s how they get paid, but they’re meaningless to the VA.”

Webinars

December 8 (Wednesday) 1 ET. “What Lies Ahead for the EHR’s Problem List.” Sponsor: Intelligent Medical Objects. Presenters: James Thompson, MD, physician informaticist, IMO; Deepak Pillai, MD, MBA, physician informaticist, IMO; Jonathan Gold, MD, MHA, MSc, physician informaticist, IMO. The EHR problem list can be cluttered with redundant, missing, and outdated diagnoses, and displays don’t always help clinicians process the available data correctly. The presenters will discuss how improvements in creating, maintaining, and displaying problems could reduce errors and decrease the cognitive load of clinicians while continuing to optimize reimbursement.

December 9 (Thursday) 1:30 ET. “Cone Health: Creating Extreme Efficiencies in Surgical Services.” Sponsor: RelayOne. Presenters: Wayne McFatter, RN, MSN and Sharon McCarter, RN co-directors of perioperative services, Cone Health. The presenters will discuss how they have empowered the entire surgical care team, including vendor representatives, to get real-time access to surgery schedules and case requirements in the palms of their hand. RelayOne CEO Cam Sexton will also present the findings of a recent study of 100 hospital leaders regarding their operating room optimization plans for 2022.

December 14 (Tuesday) 1 ET.  “Using Cloud to Boost AI and Enterprise Imaging.” Sponsor: CloudWave. Presenters: Larry Sitka, MS, VP/CSIO of enterprise applications, Canon Medical Informatics; Jacob Wheeler, MBA, senior product manager, CloudWave. Enterprise imaging has remained a holdout of data center complexity despite the benefits the cloud offers. The presenters will discuss innovative ways to reduce complexity and lead with disruptive technology using AI, enterprise imaging, and the cloud.

December 15 (Wednesday) 1 ET. “Improve Efficiency, Reduce Burnout: Leveraging Smart Clinical Communications.” Sponsor: Spok. Presenters: Matt Mesnik, MD, chief medical officer, Spok; Kiley Black, MSN, APRN, director of clinical innovation, Spok. The presenters will identify the technologies that most often contribute to clinician burnout, then explain how improving common clinical workflows can help care teams collaborate better and focus on what they do best—taking care of patients. They will describe how a clinical communication and collaboration platform can automate clinical consults and code calls to alleviate burnout.

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

Acquisitions, Funding, Business, and Stock

Accounting and advisory firm BDO USA acquires 90-employee Culbert Healthcare Solutions.

Healthcare voice AI vendor Suki raises $55 million in a Series C funding round that values the business at $400 million.

Change Healthcare will permanently lay off 170 employees in Pittsburgh in February.

Sales

• The Christ Hospital Health Network in Ohio will offer IncludeHealth’s virtual physical therapy service to its pre- and post-operative patients.
• Kidney care company Strive Health selects Bamboo Health’s Pings real-time admission, discharge, and transfer (ADT) e-notifications; and interactive, real-time Spotlights performance metrics dashboards.

People

Valerie Simon (Rise Consulting) joins Lumeris as SVP and chief of marketing and communications.

Lee Taylor, MBA (Relatient) joins Health Catalyst as VP of sales. 

Geoff Gibson (Teladoc Health) joins Mend as VP of sales.

Wolters Kluwer Health promotes Greg Samios, MSE, MBA to president and CEO of the clinical effectiveness business unit.

Zach Wood, MBA (Surescripts) joins Well Health as head of corporate development.

Announcements and Implementations

Ochsner Health (LA) has implemented provider data management and API technologies from Kyruus to improve patient-provider matching on its website and apps.

Mach7 Technologies incorporates ImageMover’s EHR-integrated medical imaging capture technology into its vendor neutral archive and enterprise diagnostic viewer.

Surescripts leverages Diameter Health’s data optimization capabilities to ensure specialty pharmacies can easily access accurate patient data through the Surescripts Specialty Medications Gateway.

Holy Cross Health (FL) implements online patient appointment scheduling capabilities from DocASAP.

HCA Healthcare will go live on Meditech Expanse at three hospitals in New Hampshire by the end of 2022, with the assistance of CereCore.

A survey performed by the Center for Connected Medicine and KLAS finds that health system executives expect patient access to be the top area that will be improved by digital health. Respondents name telehealth as the greatest area of technology-driven improvement in the past two years, while 38% expect AI to be the most exciting emerging technology in the next two years but acknowledge that it hasn’t yet met expectations for improving patient outcomes. Nearly all of the respondents say their health systems are placing a high priority on improving access and most of those say they will invest in technology accordingly (most commonly used are telehealth, patient reminders, an online provider directory, and online bill pay). Just over half of responding health systems are using some form of a digital front door, but expect to continue improving and optimizing it while recognizing that not all patients want to connect digitally. Only 17% of respondents are using patient financial financial experience vendors such as Flywire, Patientco, and RevSpring. Health systems  like the idea of price transparency, but recognize that it’s hard to show a given patient their actual cost.

Other

A study using Epic Health Research Network finds that 91% of sore throat patients whose encounter was via telehealth are prescribed antibiotics without having a strep test performed (down from 98% pre-pandemic), while the test was done before prescribing (per AAFP recommendations) for in-office visits about half the time, raising concerns about future antimicrobial resistance.

An imaging magazine says that even though the just-concluded RSNA 2021 conference had two-thirds fewer professional attendees compared to pre-pandemic numbers, vendors were happier because the interactions they had were more serious in the absence of “tire-kickers.” It says that HIMSS21 similarly delighted exhibitors with one-third the usual attendance because only non-buyers stayed home (color me skeptical in a “make lemons into lemonade” sort of way now that brag-worthy record attendee numbers aren’t happening).

Sponsor Updates

• Availity rebrands its suite of provider products to Availity Essentials, and will soon give its customers the ability to gain access to additional payers throughout its network.
• The State of Delaware’s Treatment and Referral Network, built on Bamboo Health’s OpenBeds software, has in its first year seen a 45% increase in treatment referral requests and a 25% increase in the rapid acknowledgment of referrals.
• CHIME names University of Missouri Health Care CEO Jonathan Curtright and CIO Bryan Bliven winners of the 2021 CHIME-AHA Transformational Leadership Award.
• CloudWave congratulates 14 of its hospital partners for being recognized as part of CHIME’s Digital Health Most Wired program.
• Gartner includes Dimensional Insight in its 2021 “Hype Cycle for Healthcare Providers” report as a sample vendor in the Digital Analytics Architecture category.

Blog Posts

• Why Resilience is Not Enough for Today’s Healthcare Cybersecurity and Privacy Programs (Clearwater)
• Introducing: True remote diagnostic imaging workflow (Agfa HealthCare)
• Improve healthcare cybersecurity through Zero Trust (Alcatel-Lucent Enterprise)
• Azara Mourns Loss of Cherished Colleague (Azara Healthcare)
• How the CMS Interoperability and Patient Access Rule Creates a Vision for Interoperability and the Delivery of Whole Person Care (Bamboo Health)
• From EHR to Health IT Operations: 10 Ways to Lower Costs and Save Time (CereCore)
• HEDIS 2022 is Here: Everything Payers Must Know (Collective Medical)
• (Part 2) Reaching Patients Along the Specialty Medication Journey: Trusting Patients (ConnectiveRx)
• UMass Memorial Health: In-Home Hospital Care Focused on Equity (Current Health)
• Toward the Liberation of Medical Data (EClinicalWorks)
• Better estimates, faster payments: using automation for a better patient financial experience (Experian Health)
• Driving Value: Taking the Healthcare Revenue Cycle to the Next Level (EZDI)
• Sorting Through ServiceNow Opportunities (Optimum Healthcare IT)

Contacts

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

Morning Headlines 12/7/21

Well Health Provides Update on the Organic Growth of its Virtual Services Business, and announces Tuck-in Acquisition of CognisantMD’s Ocean Platform, Canada’s Leader in Patient Engagement Technology and eReferral Software

Well Health Technologies acquires CognisantMD, a Canadian developer of patient engagement and referral software, for nearly $14 million.

HealthStream Acquires Rievent Technologies

Healthcare learning management and performance software vendor HealthStream has acquired Rievent Technologies and its CME/CE management applications for $4 million in cash.

Lyn Health Emerges from Stealth to Pioneer New Care Model for Polychronic Patients

Lyn Health launches with funding from Summer VC to offer patients with chronic conditions access to virtual care and support services.

Curbside Consult with Dr. Jayne 12/6/21

One of the best parts of being a HIStalk sidekick is hearing from readers. I’ve got a handful of folks who correspond regularly, sometimes with comments on recent pieces, but other times giving me a heads-up on happenings that I otherwise would have missed. I’ve been way behind on my email due to the amount of work I’ve been doing for one of my new projects and was glad to see something from one of my regular correspondents as I reached deep into the abyss that is my inbox.

Most of us in clinical informatics tend to subspecialize, depending on where we work and how many other clinical informatics professionals are on a project. When I was starting out as a relatively new CMIO, I was a generalist as far as having to work with a lot of different clinical specialties, but was relatively specialized in that 90% of my work was in the ambulatory space. I only had to know about inpatient as much as was needed to address interoperability and the flow of data from health information exchanges and clinical repositories.

From there, I moved to the health system side and had to know a lot more about hospital-based medicine, but still worked with a broad swath of specialties. I became an expert in things like Meaningful Use and clinical quality reporting more out of necessity than anything else.

As a consultant, I run into all kinds of different informatics situations and have to think on my feet. Most of the time I’m fairly well-versed in the topics that get thrown at me, but occasionally I run into something I know very little about. This particular email illustrated one of those situations and was a good lesson on how essential change control really is, along with understanding the downstream impacts of systems changes. My reader was happy to provide some background to get me up to speed.

Over the last 15 years, the US Food and Drug Administration (FDA) has been implementing Risk Evaluation and Mitigation Strategies (REMS) for various medications with serious safety concerns. The goal is to reinforce appropriate use and to help reduce the risks of those medications. One of the most well-known REMS is the program for Accutane, which can cause serious fetal anomalies. As a precursor to REMS, one antipsychotic medication, clozapine, has had FDA-imposed monitoring requirements since its approval in the late 1980s. Clozapine is an antipsychotic drug that can sometimes cause low white blood cell counts, leading to a patient being unable to fight infections. In rare instances, those cell counts can get dangerously low. These effects were seen in the initial clinical trials and frequent laboratory testing was needed before patients could pick up their prescriptions from the pharmacy.

Initially, this was managed using a paper process to submit data to the registry, but for some time, the FDA has had a website where prescribers could enter laboratory results and pharmacists could query whether patients were current. My reader states it worked pretty well, including notifications to providers when a patient was late in having a lab result entered.

However, this changed during the initial months of the COVID-19 pandemic. They note, “FDA left the monitoring up to clinical judgment as patients who were stable on the drug for years really didn’t need monthly labs. But before the pandemic and currently, the rules have been quite clear – no lab test recorded, no dispensing of drug.” This made sense in the context of an emerging healthcare crisis when there may have been barriers to patients obtaining blood work, since having people miss medication doses aren’t good for patients, particularly when missed doses could cause relapse of a serious mental health condition. Additionally, when patients are off this particular medication more than 48 hours, they have to be brought slowly back up to their steady-state dose, which creates a window of suboptimal treatment.

Fast forward to the present, where FDA had an issue with the REMS website vendor that resulted in vendor and process changes. It wasn’t clear to the reader which process changes were supposed to be beneficial as opposed to which ones were caused by limitations of the new website contractor. Regardless, the transition has been described as “an unmitigated disaster.” They note that “the new process is hard to understand, even after taking the mandatory training to register for the new website.” There are PDF forms for submission as well as an electronic process, but the new process is more cumbersome with additional fields, poor layout, and suboptimal usability. Additionally, physicians had to re-enter the results for the most recent blood draw in the new system even though they were in the old system.

To cap it off, the website locked out users even though they had pre-enrolled for the new site, and the help line was overwhelmed, leaving many clinicians, pharmacists, and patients worried that patients wouldn’t be able to get their clozapine. Ultimately, following urgent meetings with stakeholders, the FDA temporarily suspended the documentation requirements. In FDA parlance, “Tthe FDA does not intend to object if pharmacists dispense clozapine without a REMS dispense authorization (RDA).” My reader closes out with this thought — even though the FDA has been focused on pandemic-related matters, they could have handled this transition better.

Putting on my “after-action” reporter hat, it sounds like some key steps were missed, things like stakeholder alignment on business requirements, clinical usability review and sign-off on development requirements, user acceptance testing, go-live support planning, and a contingency plan for reversion or emergent intervention if things were not going well. These are all things that many of us deal with on a daily basis and it’s always baffling how these big projects miss the mark. (Case in point: the VA and Cerner, but that’s a much longer topic and I don’t have enough wine in the house to start tackling that one.)

I hope FDA is able to work swiftly with its vendors to get this sorted out so that patient care can take precedence, and that the learnings from this one will allow them to do better in the future. It’s a good reminder for all of us that work with systems that directly impact patients – we need to be vigilant and make sure that corners aren’t cut so that patient’s aren’t harmed.

What’s the most egregious example of poor change management that you’ve seen in your healthcare IT career? Leave a comment or email me.

Email Dr. Jayne.

Readers Write: Improvements in Content Quality, Regulations Highlight 2021 Interoperability Trends

Improvements in Content Quality, Regulations Highlight 2021 Interoperability Trends
By Jay Nakashima

Jay Nakashima, MBA is executive director of EHealth Exchange of Vienna, VA.

Once again, the COVID-19 pandemic grabbed many health IT headlines in 2021. But interoperability was a major topic in 2021 as it truly turned a corner during the last 12 months. More providers are connecting into data sharing networks, and this is good for everyone. This momentum should continue in 2022, but definite challenges will arise.

As someone who heads the oldest and largest nationwide health information network in the United States, I continually monitor trends in healthcare technology. While the past 12 months have been packed with major developments, the following are what I deem are the most significant interoperability trends in 2021.

Public health emphasis. The COVID-19 pandemic spotlights the digital disconnect between healthcare systems and public health agencies. Much work remains in this area, but now it is recognized as a major issue and helped to drive the conversation around health IT this year. The EHealth Exchange partnered with the Association of Public Health Laboratories (APHL) to enable automated generation and transmission of case reports from electronic health records (EHR) to the necessary public health agencies, increasing accuracy while reducing reporting burdens of providers. This electronic case reporting (eCR) service is available to EHealth Exchange network participants, as well as those outside the network but connected via Carequality. The EHealth Exchange – APHL connections can be used for any reportable disease or condition, not just COVID-19.

Regulations. The information blocking rule clearly expanded access to patient data requested for treatment purposes. Anticipation of the final rule alone propelled EHealth Exchange’s transaction volume to 12 billion transactions annually. The industry continues to anticipate and plan for the Office of the National Coordinator for Health Information Technology’s (ONC’s) new Trusted Exchange Framework and Common Agreement (TEFCA) exchange paradigm.

Content quality. The industry as a whole saw great improvements in content quality in 2021. For example, 98% of EHealth Exchange participants were able to successfully pass rigorous content quality testing. Because of the vast number of participants and their influences in healthcare, there is now a new, universal floor of interoperability inside and outside the network. This means that the network isn’t just moving data; it is moving standards-based, computable data, which is human readable and machine consumable, the gold standard for interoperability.

Adoption of new technology such as FHIR. While exchanging Fast Healthcare Interoperability Resources (FHIR) at scale still requires final new standards, particularly related to security, the industry as a whole worked to implement FHIR in production after successful proof of concept initiatives. In partnership with public health, we expect to see finally see the promise of FHIR in broad, real-world connectivity in 2022.

Of course, these are not the only trends that drove the healthcare IT sector in 2021. We saw a major emphasis on privacy, cybersecurity, controlling healthcare costs, and efforts to address disparities. Look for these and other trends to continue into the new year as the sector continues to evolve and address new challenges that will surely appear.

Morning Headlines 12/6/21

Fortive to Acquire Provation, a Leading Healthcare Workflow Software Provider

Fortive will acquire specialty EHR vendor Provation from its private equity owner for $1.425 billion.

Netsmart Accelerates AI Healthcare Technology Innovations with Acquisition of Remarkable Health

Netsmart acquires Remarkable Health, which offers AI solutions – including an EHR and virtual clinical documentation – for behavioral health, substance use, and human services.

Adjuvare Launches Real-Time Remote Patient Monitoring Combining AI Mobile Technology and Virtual Acute-Care Services

NantWorks forms Adjuvare, which is built on AirStrip’s patient monitoring solution for remote patient monitoring.

U.K. Digital-Health Startup Vinehealth Raises Seed Financing

UK-based Vinehealth, whose app collects oncology patient-reported outcomes, raises $5.5 million in funding for a planned expansion to the US.

Monday Morning Update 12/6/21

Top News

Fortive will acquire specialty EHR vendor Provation from its private equity owner for $1.425 billion.

Seller Clearlake Capital acquired the company from Wolters Kluwer in early 2018 for $180 million. Provation then acquired Pentax Medical’s EndoPro endoscopy platform and documentation procedure vendor IProcedures, both in 2021, and EPreop in 2020.

Provation reports annual revenue of $110 million. It has 5,000 health system customers.

Reader Comments

From Sporacide: “Re: Adjuvare. I didn’t see you mention its formation.” I didn’t see it, but added it below. Patrick Soon-Shiong’s NantHealth is involved with the company, which uses technology from one-time high-flyer AirStrip, whose apex was sharing an Apple stage with Tim Cook way back in 2015 after raising $65 million (and another $22 million in 2019). NantHealth has seen its own struggles, with shares down 95% since its IPO and the company’s valuation down to around $100 million, while NantKwest died quietly in being merged with another Soon-Shiong company, immunotherapy developer ImmunityBio, whose shares have dropped 85% in the past 10 months.

From Roman Board: “Re: Boardsi. I was exploring potential board positions post-retirement. They are a pay-to-play setup like ExecRank and spam me with lots of opportunities that require paying to be considered. Do companies really pay them to recruit board members?” I hadn’t heard of the company, which charges candidates $200 upfront and $195 per month (auto-renewing) and in return guarantees nothing. Anonymous complainers claim the company posts fake LinkedIn board position postings and refuses to answer basic questions about percentage of people placed or its user satisfaction rate, while I would characterize quite a few of the glowing online reviews as questionable (no verifiable user or company names, bot-sounding reviews that refer more to job recruiting than board placement). BBB shows 18 complaints, mostly involving being ignored when requesting cancellation, not having emails and calls returned, and having zero companies make contact. Some observe that the few positions the were offered involve informal advisory boards, which pay nothing and aren’t much of a resume builder. Please share your experience with Boardsi.

From Lindy: “Re: VCU Health. The CIO is leaving abruptly in the middle of an Epic rollout, 10 days post go-live, four years into her first CIO job.” Verified. Susan Steagall, MBA will leave VCU on December 16 after its December 4 go-live on Epic.

HIStalk Announcements and Requests

Most poll respondents expect their employers to struggle with staffing over the next few years. Commenters brought up good points: (a) senior people are leaving, both because they have more opportunity with competitors but also because they have lost trust in their employers due to layoffs and poor corporate culture; and (b) work-from-home has created endless opportunities that devalue geographic loyalty and break through local compensation practices,

New poll to your right or here, following up on last week’s question: Did you change employers in 2021 or do you expect to do so in 2022?

We offer tiny startups a first-year, one-time sponsorship discount. Lorre says she will make that same deal available for companies of any size that have never sponsored HIStalk through December 31. Contact her.

Thanks to the following companies for recently supporting HIStalk. Click a logo for more information.

Webinars

December 8 (Wednesday) 1 ET. “What Lies Ahead for the EHR’s Problem List.” Sponsor: Intelligent Medical Objects. Presenters: James Thompson, MD, physician informaticist, IMO; Deepak Pillai, MD, MBA, physician informaticist, IMO; Jonathan Gold, MD, MHA, MSc, physician informaticist, IMO. The EHR problem list can be cluttered with redundant, missing, and outdated diagnoses, and displays don’t always help clinicians process the available data correctly. The presenters will discuss how improvements in creating, maintaining, and displaying problems could reduce errors and decrease the cognitive load of clinicians while continuing to optimize reimbursement.

December 9 (Thursday) 1:30 ET. “Cone Health: Creating Extreme Efficiencies in Surgical Services.” Sponsor: RelayOne. Presenters: Wayne McFatter, RN, MSN and Sharon McCarter, RN co-directors of perioperative services, Cone Health. The presenters will discuss how they have empowered the entire surgical care team, including vendor representatives, to get real-time access to surgery schedules and case requirements in the palms of their hand. RelayOne CEO Cam Sexton will also present the findings of a recent study of 100 hospital leaders regarding their operating room optimization plans for 2022.

December 14 (Tuesday) 1 ET.  “Using Cloud to Boost AI and Enterprise Imaging.” Sponsor: CloudWave. Presenters: Larry Sitka, MS, VP/CSIO of enterprise applications, Canon Medical Informatics; Jacob Wheeler, MBA, senior product manager, CloudWave. Enterprise imaging has remained a holdout of data center complexity despite the benefits the cloud offers. The presenters will discuss innovative ways to reduce complexity and lead with disruptive technology using AI, enterprise imaging, and the cloud.

December 15 (Wednesday) 1 ET. “Improve Efficiency, Reduce Burnout: Leveraging Smart Clinical Communications.” Sponsor: Spok. Presenters: Matt Mesnik, MD, chief medical officer, Spok; Kiley Black, MSN, APRN, director of clinical innovation, Spok. The presenters will identify the technologies that most often contribute to clinician burnout, then explain how improving common clinical workflows can help care teams collaborate better and focus on what they do best—taking care of patients. They will describe how a clinical communication and collaboration platform can automate clinical consults and code calls to alleviate burnout.

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

Acquisitions, Funding, Business, and Stock

Netsmart acquires Remarkable Health, which offers AI solutions – including an EHR and virtual clinical documentation — for behavioral health, substance use, and human services.

NantWorks forms Adjuvare, which is built on AirStrip’s patient monitoring solution for remote patient monitoring.

UK-based Vinehealth, whose app collects oncology patient-reported outcomes, raises $5.5 million in funding for a planned expansion to the US. Co-founder and CEO Rayna Patel, MBBS, MPhil is an NHS England National Innovation Fellow.

Shares in the Global X Telemedicine and Digital Health ETF dropped 16% in the past month versus the Nasdaq’s 4% loss. They’re down 15% in the past 12 months versus the Nasdaq’s 23% gain.

People

The Wall Street Journal profiles recently named Mass General Brigham CIO/Chief Digital Officer Jane Moran, MBA (Unilever). She says the health system is working to extend its EHR with CRM capabilities and is working on remote patient monitoring.

Announcements and Implementations

United Arab Emirates launches Riayati, a national medical record that will be linked to the Wareed and Nabidh EHRs and Dubai Health Authority’s HIE. UAE intends to create an integrated medical record for every UAE resident.

Google adds languages spoken to its medical office search results, although of course it’s up to the office staff to update the information by claiming their Google Business Profile (and making sure that the person who speaks the claimed language is working on any given day). Google previously added the insurances accepted by practices, which is almost certainly wildly inaccurate since even insurers can’t keep track of that.

Michigan Health Information Network Shared Services, Velatura Public Benefit Corporation, and Findhelp will establish a national HIE portal that will offer interoperable social services referrals.

VCU Health (VA) was scheduled to go live with Epic over the weekend, replacing Cerner.

Other

US COVID-19 deaths are at 777,000.

Google will reportedly launch the Pixel Watch smart watch in 2022, which will offer a heart rate monitor and activity tracking. It will not bear the Fitbit name even though Google acquired that company for $2.1 billion in January. Google killed off its first Google-labeled watch before it was scheduled to be announced in 2016, choosing to license its software to other companies instead. Business Insider quotes company sourcea as saying that Google’s offering will be “a pretty direct mirror” of Apple Health.

Sponsor Updates

• OptimizeRx names Brandon Feldmeier BI engineer.
• Olive extends its Hack for Health 2021 virtual hackathon submission deadline to December 17.
• VitalTech integrates Bright.md’s asynchronous telehealth solution with its remote patient monitoring technology.

Blog Posts

• Reducing Hospital Readmission Rates Through Discharge Interventions (PatientBond)
• How to Choose the Right Healthcare Predictive Analytics Software (Pivot Point Consulting)
• How to Improve Nursing Communication and Collaboration (PerfectServe)
• Provider Data, Remote Care Management and Telehealth (Symplr)
• Breast Cancer Diagnosis in 36 Hours or Less? (Premier)
• Evaluating AI-driven analytics for radiology: What “good” looks like (Nuance)
• Digital Patient Engagement: What It Does for Patients and Providers (Sphere)
• 3 ways to leverage your hospital contact center to improve clinical communication (Spok)
• Why you should be archiving your legacy EHR data (Summit Healthcare)
• Helping Care Managers Bring Members and Providers Closer Together (Surescripts)
• Be grateful. Count your blessings (Talkdesk)
• Tegria Unites in Second Annual Giving Together Campaign (Tegria)
• Founder Letter: A Year in Retrospect: What Rehab Therapists Learned in 2021 (WebPT)

Contacts

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

Weekender 12/3/21

Weekly News Recap

• Nordic acquires S&P Consultants.
• A private equity firm will acquire CNSI.
• The VA revises its Cerner implementation timeline to restart the project in early 2022 and complete the rollout in 2024.
• A new investment values Iodine Software at $1 billion.
• HHS OCR settles with five providers who failed to give patients timely access to their medical records.
• Greenway Health promotes President Pratap Sarker to CEO.
• FDA forces Owlet to stop selling unapproved baby socks that monitor vital signs and sleep patterns.
• Best Buy discloses that its October acquisition of remote patient monitoring technology vendor Current Health cost $400 million in cash.

Best Reader Comments

Thank you for honoring our dear Dr. Virginia K. Saba. She was a colleague, educator, mentor, and friend to many. Her influence is international. Her work will carry on through the multitude of nurses and others she has mentored. Dr. Saba promoted her Clinical Care Classification to the very end. Her legacy also will continue with two named awards that she endowed administered by Sigma and AMIA. (Susan K. Newbold)

Re: The WSJ Article: I think one of the takeaways from that article is that operations, both clinical and business, needs to take ownership of their role in decision-making, priorities, strategy, etc. In a lot of organizations (including my own), I don’t see this happening well. Many departments are fine with throwing things over the wall as an “IS problem” instead of an organizational problem. That puts IS (or IT) in a bad spot and enforces the image of IS being a barrier. (Ralphie)

Fast Forward 10 years: new WSJ.com Headline – “Decentralized IT Departments are Dead – Centralized IT Could Solve Fragmentation and Interoperability Issues.” (HITPM)

I think getting into healthcare regulatory reporting software would make a ton of sense for InterSsystems. InterSystems has an existing relationship with almost every health system running Epic. InterSystems has an integration product, and the majority of the work in integration projects are related to understanding the organizations data and understanding the organizations process. If you do regulatory software, you also have to do the work to understand data and processes in order to compare that to what the government expects. (IANAL)

If you implemented distributed IT at my employers, the result would be an unsatisfactory mess. Some few departments would be organized and effective. The majority would be rather distracted and neglectful  (IT is neither their interest nor their core competency). A few would do the absolute minimum, which might mean they do nothing at all. Most companies wind up with a central IT department. I don’t think that’s an accident. Truly distributed businesses are a rarity; trying to shoe-horn in IT as distributed, when everything else is centralized? It’s a culture clash and a recipe for big problems. It’s one thing to identify a problem, WSJ. It’s quite another to recommend a solution which will be helpful. (Brian Too)

About that WSJ article. I take EXTREME exception to the author’s assertion about the type of people that work in healthcare IT. I can tell you most, if not all that I have worked with do so because of the greater good and being part of something that matters. (Justa CIO)

Having acknowledged those failures, the wheels didn’t come off [on Athenahealth] until Elliott got rid of Bush, through questionable means, and forced an acquisition. It’s extremely charitable to call Elliot’s involvement merely “applying discipline.” Hundreds of employees were laid off, which Bush and his management team initially refused to do. Benefits were scaled back. Products were cancelled. Market segments were eliminated. Investment in R&D was significantly reduced. Efficiencies and discipline that leads to greater shareholder value could have been achieved without going to those extremes. I’m of the opinion that shareholder interests are important, but they should be balanced by customer and employee interests. Elliot only realized those gains by prioritizing shareholder interests (and primarily their own, at that) over those of customers and employees  (who don’t have a voice in the boardroom, of course). So who won in the end? Certainly not customers. (Ex-Athena)

Elliott did quite a bit better than 3x on its investment [in Athenahealth]. The original deal was funded with about $4.8B of debt and $1B of equity from the hedge fund sponsors. Add in the acquisition cost of Centricity (call it $500M of equity, $500M of debt) and the equity investors are all-in with $1.5B of equity and $5.3B of debt. They sold off some assets for a total of ~$600M in cash, so net equity in play is $900M. They turned that equity into $11.7B (assuming no interim debt pay down), which is a 13x return. 13x feels ridiculous, but if you’d invested that same levered-up $6.8B in the Nasdaq (QQQ) on the same timeline (Elliott began buying ATHN in spring 2017), you could sell today for $18.1B. Absurd as this whole deal sounds, it has actually underperformed the market. This story is more about tech multiple expansion/bubble broadly than it is about improving management or running the business. (Debtor)

Watercooler Talk Tidbits

Generous “Giving Tuesday” donations from Vicki and Mark (Mark’s was made in honor of the IT professionals of Atlantic Health System), with matching money from several sources along with my Anonymous Vendor Executive, allowed me to fully fund these teacher projects, nearly all of which involve historically underfunded schools:

• A drawing tablet for Mr. M’s middle school science class in Hemet, CA.
• A programmable robot for Ms. K’s STEM computer science class in S. Ozone Park, NY.
• Science books and resources for Ms. H’s middle school class in Hattiesburg, MS.
• Computer science and robotics materials for Ms. H’s middle school class in Kissimmee, FL.
• STEM kits for Ms. H’s first grade class in Escondido, CA.
• A makerspace for Ms. G’s elementary school library in Paterson, NJ.
• An all-in-one printer, fax, and scanner for school nurse Ms. U in Trenton, NJ.
• AV presentation technology for Ms. M’s middle school class in New Castle, DE.
• Learning station supplies for Ms. W’s middle school science class in San Marcos, TX.
• Programmable robotics kits for Mr. N’s middle school class in San Antonio, TX.
• Privacy boards and math flash cards for Ms. S’s elementary school class in Kittanning, PA.
• Hands-on STEM materials for Ms. Z’s elementary school class in New Windsor, NY.
• Headphones for Ms. H’s middle school class in Manassas, VA.
• Inclusive STEM books for Ms. K’s middle school class in Las Vegas, NV.
• Weighted hula hoops for the structured autism class of Ms. D in Laguna Niguel, CA.
• Magnetic letters for Ms. G’s first grade  class in Philadelphia, PA.
• Kites and balls for outdoor science learning for Ms. C’s elementary school class in Ryan, OK.
• Online resources for the International Baccalaureate high school class of Ms. K in McAllen, TX.
• Instructional resources for Ms. S’s high school class on Los Angeles, CA

Ms. P checked in with an update on the projector and remote control presenter readers provided to her Baltimore elementary school via Donors Choose donations: “Thank you! The technology has really helped transform family events, classroom experiences, staff professional developments, and more. The projector has allowed me to project presentations that converted our learning. Students were able to see across the classroom the texts we were discussing, videos to supplement the work, and dance it out to ‘brain breaks.’ The projector was also utilized for family and student events. For example, students who had perfect attendance got to watch a movie with snacks and another time, we utilized the projector to share a presentation that discussed health to families. It was great! Instead of being hovered around a tiny computer screen or only having paper copies of the materials, we were able to create a view large enough for all to see! The most exciting part about receiving the items was seeing the students react! They were so grateful that people they never met and some they knew chose to donate to support them. They were appreciative that people cared about their education and making it fun. So thank you again for thinking of my kiddos!”

Physicians are complaining that physician assistants – who say that their jobs haven’t required hands-on physician oversight for decades – are pushing to change their titles to “physician associates.” The AMA says the new name would confuse patients and is intended to position PA’s for independent practice. Another group pushing for a name change is the former American Association of Nurse Anesthetists (they changed the last word to “anesthesiology” last year), who said “anesthetist” was confusing to the public and hard to pronounce, but they note that the new title still labels them as nurses rather than physicians even though “we’re doing the lion’s share of anesthetics in this country.” Both name changes were chosen carefully to preserve the all-important existing abbreviations.

A South Carolina rehab center’s director of nursing is indicted on federal charges of creating phony COVID-19 vaccination cards, then lying to FBI and HHS. Her lawyer says she only made a couple of fake vaccination cards to “help” an anti-vaxxer family member.

In Australia, a cosmetic surgeon who has 13 million TikTok followers is ordered to temporarily stop practicing medicine pending an investigation into issues with hygiene, safety, and surgical mistakes. Daniel Aronov, MBBS was also ordered to take down his social media accounts, which included photos of near-nude female patients and explicit lyrics. Australia allows anyone with a basic medical degree and no specific training – such as Dr. Aronov, who is a GP – to call themselves cosmetic surgeons.

In Italy, a dentist is charged with fraud after a healthcare worker notices that the veinless arm that he bared for his COVID-19 shot was in fact artificial. The man, who was trying to obtain the country’s Green Pass that requires vaccination for most public activities, asked the worker to ignore his failed attempt and said, “Would you have imagined that I’d have such a physique?” The local newspaper speculates that he bought a male chest suit from Amazon since someone commented on that listing in Italian, “If I go with this, will they notice? Maybe beneath the silicone I’ll even put on some extra clothes to avoid the needle reaching my real arm.”

In Case You Missed It

• News 12/3/21
• EPtalk by Dr. Jayne 12/2/21
• HIStalk Interviews Steven Scott, CEO, VitalTech
• News 12/1/21
• Readers Write: Filling the Healthcare Data Glass: The Glass Doesn’t Need to Stay Half Empty
• Readers Write: Contactless Tech Surge Supports Healthcare’s Quadruple Aim
• Curbside Consult with Dr. Jayne 11/29/21
• Monday Morning Update 11/29/21

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Morning Headlines 12/3/21

Nordic Consulting acquires S&P Consultants, expands Cerner division to meet industry demand

Nordic acquires S&P Consultants, which focuses on providing Cerner-related services.

Carlyle agrees to acquire healthcare tech company CNSI from Alvarez & Marsal Capital

Private equity firm Carlyle Group will acquire government health IT vendor CNSI from its private equity owner.

Omnicell to Acquire ReCept

Omnicell will acquire specialty pharmacy management services vendor ReCept Holdings for $100 million in cash.

News 12/3/21

Top News

The VA revises its Cerner implementation timeline to restart the project in early 2022 and complete the rollout in 2024 (click graphic to enlarge).

The VA will also create two new positions to oversee the project, a program executive director for EHR integration and a deputy CIO for EHR.

It named VA executive Terry Adirim, MD, MPH, MBA to the PED position.

A VA update on lessons learned includes:

• Creating an EHR sandbox for clinician training.
• Optimizing the rollout schedule within VISNs.
• Assessing the capability of Cerner’s patient portal.
• Convening a safety summit this month to review how the VA will collaborate with local clinical stakeholders on informatics issues.
• Addressing issues raised at Mann-Grandstaff.
• Implementing a new management and governance structure.
• Finalizing a data strategy between VA and DoD.

Reader Comments

From Long-Timer: “Re: Fruit Street. You blasted them back in 2014 for their tactics. I have health IT people asking me almost weekly if this guy is legit. Google his or the company’s name to see some history.” LT is referring to a reader who said they received an unsolicited LinkedIn invitation to become an advisor to a telehealth company that I didn’t name (Fruit Street Health) in return for being allowed to buy shares and to earn a percentage of sales they facilitate. Fruit Street CEO Laurence Girard, 29, previously ran telehealth company Prevently until they fired him and then went out of business, after which he offered its investors free shares in Fruit Street, which offers digital diabetes prevention, weight loss, and general telehealth. All of Girard’s ventures focus on getting doctors to invest. He quickly put up COVIDMD.com early in the pandemic, offering Salesforce-powered telemedicine visits only for Medicare and cash-paying patients, but that web address now forwards to Fruit Street Clinic. He wrote an article in late 2019 declaring “shame on these investors” who accuse startup founders of being fraudulent or running a Ponzi scheme (he had a few of those), suggesting that the company add a non-disparagement and non-disclosure clause to its stock purchase agreement that call for immediate payment of $10,000 in liquidated damages. His attorney wrote in 2014 that the primary business strategy of three companies he founded (Nutritas, Prevently, and Welliko) was to sign on physician investors, make them his key advisors, and then make money from patient software use and physician software licensing. His now-deleted website provides fascinating reading  — he was involved romantically with the CTO who then tried to take over the company, he accused one physician investor of destroying Prevently by calling Girard’s mother a terrible parent and sending investors his baby pictures, he didn’t have enough money to pay student loans and buy groceries after being fired, and he called one investor a “loan shark” whose Mexican billionaire investors were only interested in tax benefits. The “physicians as investors” strategy isn’t illegal or necessarily unethical, so my takeaway here is that his gripes against just about everybody he worked with is a rare insight into what it’s like trying desperately to save a struggling startup. I imagine that quite a few physician software company investors have discovered that it’s not quite as glamorous or as satisfying as they expected to try to demonstrate knowledge and insight outside of their own field. 

From Promotional Consideration: “Re: job changes and promotions. Some of those you mention don’t include links to the announcement.” I see many of them in my LinkedIn feed, where 3,000 nice industry folks have connected with me and thus I’m able see their otherwise unannounced job changes and news. You can do the same – I accept all connection requests from health IT people. LinkedIn’s news feed is increasingly junked up as it attempts to turn into a business-focused Facebook Junior, but I still find it useful, although I really wish it would allow me to suppress seeing items that my connections have liked or commented on since that’s where the irrelevant noise originates (but of course that’s how Facebook Senior does it in getting users addicted via their baser emotions). 

Webinars

December 8 (Wednesday) 1 ET. “What Lies Ahead for the EHR’s Problem List.” Sponsor: Intelligent Medical Objects. Presenters: James Thompson, MD, physician informaticist, IMO; Deepak Pillai, MD, MBA, physician informaticist, IMO; Jonathan Gold, MD, MHA, MSc, physician informaticist, IMO. The EHR problem list can be cluttered with redundant, missing, and outdated diagnoses, and displays don’t always help clinicians process the available data correctly. The presenters will discuss how improvements in creating, maintaining, and displaying problems could reduce errors and decrease the cognitive load of clinicians while continuing to optimize reimbursement.

December 9 (Thursday) 1:30 ET. “Cone Health: Creating Extreme Efficiencies in Surgical Services.” Sponsor: RelayOne. Presenters: Wayne McFatter, RN, MSN and Sharon McCarter, RN co-directors of perioperative services, Cone Health. The presenters will discuss how they have empowered the entire surgical care team, including vendor representatives, to get real-time access to surgery schedules and case requirements in the palms of their hand. RelayOne CEO Cam Sexton will also present the findings of a recent study of 100 hospital leaders regarding their operating room optimization plans for 2022.

December 14 (Tuesday) 1 ET.  “Using Cloud to Boost AI and Enterprise Imaging.” Sponsor: CloudWave. Presenters: Larry Sitka, MS, VP/CSIO of enterprise applications, Canon Medical Informatics; Jacob Wheeler, MBA, senior product manager, CloudWave. Enterprise imaging has remained a holdout of data center complexity despite the benefits the cloud offers. The presenters will discuss innovative ways to reduce complexity and lead with disruptive technology using AI, enterprise imaging, and the cloud.

December 15 (Wednesday) 1 ET. “Improve Efficiency, Reduce Burnout: Leveraging Smart Clinical Communications.” Sponsor: Spok. Presenters: Matt Mesnik, MD, chief medical officer, Spok; Kiley Black, MSN, APRN, director of clinical innovation, Spok. The presenters will identify the technologies that most often contribute to clinician burnout, then explain how improving common clinical workflows can help care teams collaborate better and focus on what they do best—taking care of patients. They will describe how a clinical communication and collaboration platform can automate clinical consults and code calls to alleviate burnout.

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

Acquisitions, Funding, Business, and Stock

Nordic acquires S&P Consultants, whose 90-person team focuses on providing Cerner-related services. The business will continue to operate under its existing name. S&P co-founder and COO Steve Pratt died in 2020.

HealthStream acquires Rievent Technologies, which offers a continuing medical education management  platform.

Omnicell will acquire specialty pharmacy management services vendor ReCept Holdings for $100 million in cash.

A private equity firm takes an unspecified “significant stake” in clinical documentation technology vendor Iodine Software that the company says values it at over $1 billion. Iodine acquired ChartWise Medical Systems and Artifact Health this year.

Private equity firm Carlyle Group will acquire government health IT vendor CNSI from its private equity owner.

Digital consulting firm West Monroe acquires Carbon Five, which offers product management, digital design, and software engineering. West Monroe’s health system offerings include building data-driven operations, developing patient access centers, creating digital products, assisting in M&A, and developing cybersecurity plans.

Wall Street executives urge JPMorgan to cancel its annual healthcare conference that is scheduled for January 10-13, expressing concerns that San Francisco is unsafe for attendees and questioning whether in-person attendance is necessary. The 2021 version of the conference, which usually draws 20,000 attendees plus thousands more who conduct business in neighboring restaurants where captains of industry rent tables rent for hundreds of dollars per hour and sleep in hotels that charge up to 10 times their usual rates, was moved online because of COVID-19.

Sales

• Northwell Health will implement Playback Health’s patient engagement system, which allows patients to receive, replay, and share information from their visits. A co-founder is Lenox Hill Hospital neurosurgery chair David Langer, MD, who was featured in the Netflix documentary “Lenox Hill.”
• Remote care automation vendor Datos Health will integrate its system with provider EHRs using technology from Redox.

People

Jeremy Warner, MD, MS (Vanderbilt University) will join Brown University’s Center for Cancer Bioinformatics and Data Science.

Massachusetts-based health plan Health New England hires Casey Hossa, MBA (Cardinal Innovations Healthcare) as CIO.

Graphite Health hires Ryan Smith, MBA (Intermountain Healthcare) as COO. Intermountain was one of three health system founding members of the company.

Shaun Priest (Clearwave) joins ReportingMD as chief revenue officer.

Rob Lazerow (Advisory Board) joins Health Evolution as SVP.

Clinical data repository vendor Smile CDR hires Shane McNamee, MD (Peraton) as CMIO.

Jessie Minton, MS (University of Oregon) joins Washington University in St. Louis as vice chancellor for technology and CIO. She succeeds interim Stephanie Reel.

Nursing informatics pioneer Virginia Saba, EdD, MS, MA, RN died November 20. She developed the Clinical Care Classification System of standardized nursing terminology for electronic documentation.  

Announcements and Implementations

An ISMP Medication Safety Alert further explains the previously described problem in which three pharmacy data sources sent Surescripts incorrectly formatted medication history instructions, which caused problems such as “take 1 1/2 tablets daily” being sent to the network as “take 112 tablets daily.” Surescripts helped the three data sources fix their problem, removed their medication history response messages until they implement a permanent fix, and offers health systems and technology vendors a report of their impacted patients.

The International Medical Informatics Association publishes a history of informatics.

IT critical event management platform vendor Everbridge launches a Digital Operations Platform that offers analytics-driven decision-making, alert suppression, cross-functional communication, and out-of-the-box integration.

Intelligent Medical Objects collaborates with Amazon Web Services to offer AWS customers migration of their clinical data using IMO’s terminology technology, regulatory code mapping, and semantic normalization.

Zoom is accepting beta customers for its integration with Cerner, which includes notification of patient arrival in PowerChart, clinician sharing of test results and documentation, sending links to additional attendees, and placing patients in the Waiting Room for continuity between multiple caregivers in a visit.

UK-based digital triage and remote consultation solutions provider EConsultHealth will expand its capabilities by using InterSystems IRIS for Health.

CVS Health will work with Microsoft on consumer tools, use of Teams and Office, task automation using Azure cognitive services, expanded use of cloud solutions, and working with technologies such as HoloLens.

Sponsor Updates

• Meditech launches a podcast series in which AVO Christine Parent interviews experts and leaders on the subjects of digital transformation, cloud technology, quality, and care delivery.
• InterSystems announces the availability of HealthShare 2021.2, the latest version of its HealthShare suite of connected health solutions.
• Lumeon publishes a new report, “The New Productivity Era for Perioperative Care.”
• Divurgent publishes a new white paper, “Choosing an Activation Partner: Key factors in selecting a high-performing at-the-elbow support partner for your EHR implementation.”
• Fortified Health Security names Eamon Mulholland incident response specialist.
• Citrix’s Tech Fusion Podcast features Goliath Technologies Director of Product Marketing John Grant.
• Lyniate publishes a new case study featuring MedUSA, “Driving 600% annual growth with Lyniate Rhapsody.”
• Butler Health System (PA) improves access and relationships using Meditech’s Expanse Virtual On Demand Care.

Blog Posts

• Workflow Assessments Offer Insights for Productivity Improvement (Vyne Medical)
• Butler Health System improves access, relationships with Expanse Virtual On Demand Care (Meditech)
• If you try sometimes, you get what you need (Nordic)
• Department Managers Key to Implementation Success (Optimum Healthcare IT)
• Taking on Healthcare Consumerism with Digital Health (Get Well)
• Nurse Leader Strategies to Address Alarm and Alert Fatigue (Halo Health)
• 12 leadership tips for a post-modern healthcare CIO (HCI Group)
• Predicting the Future of Healthcare IT: A surge in demand for IT support services (HCTec)
• The Four Pillars of Successful Self-Service Analytics in Healthcare (Health Catalyst)
• 3 Tips for Writing Mental and Behavioral Health Content (Healthwise)
• 5 Top Reasons Employees Stop Sharing Ideas (Ideawake)
• TEFCA: Update for 2022 (Impact Advisors)
• Losing sleep over cyber security insurance? How to get the coverage your HDO needs. (Imprivata)
• Infor shines in hackathon showcasing interoperability (Infor)
• Measuring healthcare quality in a post-pandemic world (Intelligent Medical Objects)
• Top 3 Strategy Priorities in Digital Identity Management (LexisNexis)
• Is Staffing in Perioperative Care at a Crisis Point? (Lumeon)
• Medhost Hackathon 2021 Recap (Medhost)
• Evaluating AI-driven analytics for radiology: Understanding the lingo and the landscape (Nuance)

Contacts

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

EPtalk by Dr. Jayne 12/2/21

Last May, the Office of the National Coordinator for Health Information Technology (ONC) launched its Health Interoperability Outcomes 2030 initiative with a goal of engaging the public around the future of interoperability. It received over 700 submissions of “Interoperability Outcome Statements” during the comment period and has created summary statements to reflect what the future should look like. Several of the summary statements resonated with me based on current projects and recent patient experiences:

• Individuals will be able to seek and receive care (e.g., telehealth, specialty) without needing to gather and provide their health information themselves.
• Individuals will no longer fill out paper forms for any healthcare encounter or process.
• Health professionals will be able to search for and access electronic health information within their workflow and have it presented in ways that intelligently synthesize relevant data.
• Reporting for public health, quality measurement, and safety will all be completed automatically and electronically.
• Duplicate diagnostic tests and procedures will be reduced.
• Health professionals will spend less time on administrative tasks and more time caring for their patients.

If you’re interested in some bedtime reading, individual submissions are also available. Some of the more high-profile submitters have their names listed and a few have videos. Repeat themes from the bulk of the comments include the desire to stop using fax machines, the desire to have end of life or advance directives universally available without being provided by the patient, and the need for a unique patient identifier to support interoperability.

In other government health news, the Centers for Medicare & Medicaid Services (CMS) announced this week that it is ending part of the Primary Care First innovation model, specifically the Seriously Ill Population component. The initiative targeted Medicare clinicians who provided care for high-need, seriously ill Medicare beneficiaries. The patients would be attributed to a specific clinician who would receive additional payments for coordinating and delivering care. CMS determined that the outreach methods planned to identify patients would most likely not result in a sufficient number of participants, making evaluation of the model impossible. The CMS Innovation Center plans to look for other ways to best serve these patients either through new models or enhancement of existing programs.

Zoom announced this week that it is accepting beta customers for its new integration with Cerner’s EHR. The integration will allow for EHR-based provider notifications when patients are in the virtual waiting room as well as sharing of test results during the Zoom meeting. There’s been a Zoom integration with Epic since the pre-COVID days. I wonder how many development hours it took for Cerner to play catch up?

Physicians who rapidly embraced telehealth visits last year have been struggling with lack of integration over the past year often resulting in clunky workarounds as well as patient and clinician frustration. When you look at smaller EHR vendors as well as some of the larger ones, the pace of integration has been slow. I know of quite a few physicians still using completely freestanding telehealth systems or just using conferencing software because their organization claims it doesn’t have the time or resources to work on existing integrations, not to mention the number of folks using systems where they haven’t been released yet. Even when organizations have homegrown solutions to provide integration, they’re still often clunky.

It’s not every day that we see an article about a good old HIPAA violation. HHS settled with five providers who violated the law’s Right of Access Rule, which states that providers have to give patients copies of their medical records in a timely fashion at a reasonable cost. As someone who used to enjoy reading her state’s Provider Discipline Newsletter, I wonder what these organizations did to receive such disparate penalties. Where one pain management clinic received a $32,000 fine and two years of monitoring, one internal medicine physician will pay a $100,000 penalty. A medical group settled for a $10,000 fine and performance of corrective actions. There has been a total of 25 actions since this particular enforcement started in September 2019. Based on the number of health systems I see behaving badly in this regard, I’m surprised there aren’t more actions.

I’m no stranger to wandering through the woods, so I was interested in this “News & Perspectives” piece in the Journal of the American Medical Association. In response to seeing patient take toxic but ineffective drugs during the pandemic, they applied to the US Food and Drug Administration (FDA) for approval to perform clinical trials using medicinal mushrooms and traditional Chinese herbs. The double-blind, placebo-controlled study (known as MACH-19) looks at treatment of mild to moderate COVID-19 with the agents and is ongoing at UCLA and UCSD. Recruitment has been challenging due to declining pandemic cases, however. Another trial is looking at whether medicinal mushrooms can be used alongside COVID-19 vaccines for better protection. The theory is that mushrooms can alter the behavior of immune cells. Unfortunately, robust science takes time, and results might not be available until well into 2022. Hopefully, the pandemic will be greatly reduced by then, but the findings could be helpful for other viral infections. If nothing else, the effort demonstrates the need to actually test proposed therapeutics, rather than encouraging patients to take unstudied drugs or those not meant for humans.

One of my clients offered to add me to their Grammarly subscription, so I thought I’d give it a try. With the various hats I’m wearing and roles I’m juggling, I can use all the help I can get a times. I like how it works with social media and various apps, not only highlighting any potential issues as they occur, but allowing one-click corrections. Apparently, it is impressed that I have a 12-week writing streak and today announced, “You’ve surely earned some ambrosia for your efforts.” I don’t know about ambrosia, but I’d settle for some dark chocolate.

What’s your favorite celebratory treat? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 12/2/21

Iodine Software Surpasses $1 Billion Valuation With Strategic Growth Investment from Advent International

PE firm Advent International invests in AI-powered clinical documentation vendor Iodine Software.

Gal Gadot and Jaron Varsano Join Forces With K Health to Get Better Health Care Into the Hands of Millions

App-based virtual care company K Health secures an unspecified amount of funding from actress Gal Gadot and her husband, producer Jaron Varsano.

VA advances Electronic Health Record Modernization program

The VA creates a revised schedule for the continued roll out of its Cerner system, as well as new deputy CIO and EHR integration management roles to oversee EHR modernization efforts.

HIStalk Interviews Steven Scott, CEO, VitalTech

Steven Scott is CEO of VitalTech of Plano, TX.

Tell me about yourself and the company.

I’ve been doing healthcare for much longer than I like to think, probably about 30 or 35 years. That includes the areas of senior housing, long-term care facilities, large hospital groups, software analytics, and healthcare IT. I joined VitalTech three months ago. What brought me here was that services are getting more and more pushed out into the home setting and we have the ability to provide services there that are driven by information and data. Remote patient monitoring is just one aspect of that. Using the biometric information helping people make decisions and helping them age in place — those are the concepts that attracted me to VitalTech, which does that on the remote patient monitoring side.

Will we see new advancements in wearables, sensors, and in-room technologies that will support advancing that concept?

If you look back just two years ago at the things that were available versus what’s out there today, there have been pretty good leaps in technologies in both size and connectivity now that 5G is out there. The ability to leverage and move data around from the home, which is helping the hospital-at-home concept, and the types of monitoring that we know will be done in the hospital that are being pushed out in the home and the companies that are looking at leveraging the technology.

In a lot of aspects of our lives outside of healthcare, technologies are advancing rapidly. We’ll see more devices that have an even higher clinical capability, if that’s a way to describe it, as complexity in the types of patients that need to have that at home come online. Technology is rapidly advancing. What we saw two years ago versus what we see today to what we’ll see two years from now will grow prior in a capability perspective. Connectivity has had a big impact in that, too. We’re just now beginning to realize what 5G is to recognize and utilize it.

The remote care market includes platform vendors, telehealth services, behavioral health providers, remote patient monitoring, senior living support, and patient engagement. How do you see that market of providers and vendors either consolidating or changing over the next few years?

There will be some consolidation. Some of that will be driven by not just the people who are out there providing the services, but also in the payer world. UnitedHealthcare just announced a couple of weeks ago that they basically have a digital-first health plan as the first level of engagement with their patients. The premiums are paying for those digital cares services. Virtual care is here. Virtual care is being adopted, both on the payer and the provider side. When your benefits start to align, you receive those services at home, and you get your equipment through your payer, you’re going to see he adoption grow significantly.

Then for those people that provide services in and around that — as technology advances, as the investment community takes a look at that as owners, and vendors and physician groups and those things engage, you’ll see some consolidation. That’s a normal progression that we’ll see over the next three to five years.

How will the payment policies of insurers and employers as well as patient spending lag or lead adoption?

It’s a little bit of both as it shifts. A lot of that is driven by government programs. CMMI has had a lot of initiatives around that. The physician fee schedule, remote patient monitoring, care coordination, and chronic care management leverage those virtual care aspects. Those are now reimbursable and they are changing the codes along those lines, which influences the fee-for-service world or an ambulatory setting world. You see in the risk arrangement side of the world where people — whether they are managing a population, a disease state, or interacting with their high-utilization chronic care members — leveraging technology, remote patient monitoring, and care coordination services for the home setting and the managed care environment, and it’s HCBS type services are getting deployed and moving along that line.

The incentives are all being aligned from a reimbursement perspective, an outcomes perspective, and a care delivery and services perspective. This has been in motion for several years. It’s just starting to snowball. A lot of that was influenced by COVID, where we needed to manage chronic care patients or were dealing with a high-risk disease state where we couldn’t have them come to the office. When you couldn’t have them in the hospital and no one was showing up in the ER, you needed to be a more proactive. When you look at how telemedicine intervened, people realized that we also need to get the biometric data. We need to see what going on with the weight gain or the weight losses or the glucose monitoring.

Those types of things were highlighted during COVID. People were looking to provide those services. Commercial and government programs and large employer groups recognize the need to provide those services outside the hospital walls.

How will health systems participate in the hospital-at-home concept, which otherwise threatens their revenue?

Some of our largest clients are hospitals. It’s usually because hospitals are involved not just as the provider of services, but also on the payer side, whether that member or patient is most likely part of an ACO arrangement. They’re responsible not only for the inpatient stay, but what happens on the outpatient world also. Hospitals have grown in their physician practices and in their marketplace, staying engaged with the patient post-hospital, whether it’s a readmission prevention type of a thing or trying to improve an outcome. Staying engaged with the patient, not just a phone call, but staying engaged in the actual care and the care delivery, whether that’s remote patient monitoring or care navigation. Keeping them within the network, utilizing their provider groups or the groups that they’re aligned with. Hospitals are probably more active in that today than they have ever been.

Hospitals have some number of lives where they are in a risk-sharing arrangement. Even if it’s still a fee-for-service patient, there’s some kind of a shared savings program. It’s relatively low incremental cost to run a virtual care program that keeps that patient engaged, that keeps them utilizing within their network, that keeps the readmission rates lower. It’s the net sum impact of that, not the small incremental cost, that they are shifting their focus on. As those arrangements become larger and more lives are doing it, hospitals are reacting.

How much does the local mix of patient payers, such as Medicare Advantage, lead hospitals to decide how actively they want to be involved in remote care?

A lot of those Medicare lives are in some kind of an ACO arrangement on the fee-for-service side. Large employer groups in a regional market that has a large employer footprint or a heavily managed government program — whether it’s managed Medicaid or managed Medicare — are influential on that. The commercial is looking at that also and seeing the impacts and the outcome improvements to do that. They are all aligning together and the hospitals are right in the middle of all that.

What are Best Buy’s ambitions in healthcare?

They’ve been doing a lot of acquisition in and around the homecare-bound services side, whether that’s in the senior area or just the general population. People are more interested in monitoring their own health at home with the evolution of the Apple Watch, the Apple Health app, a multitude of apps and  peripherals around the Fitbit and those types of things. They see an opportunity there, from being a vendor of the hardware, but also on the services side. They have bought services companies to be a player in that space. Just like Amazon, to some extent. Healthcare is such a huge segment of the general business world right now that they are looking to how they can participate and do that. Then just by size and leverage, they can bring some economies of scale that other vendors don’t have.

Does the ability to scale remote patient monitoring depend on AI that can monitor the data and then alert humans when interventions are needed?

The biggest part of remote monitoring is people who monitor themselves. I have an iPhone, I’m counting my steps, I’m capturing my heart rate, I can do my own EKG, and I’m looking to see if anything is wrong. That’s the largest portion of who’s doing it.

As you go up the complexity of the medical condition, when the payer gets involved and the provider gets involved, they are actively monitoring a condition. They are doing it with their own staff or using a third-party vendor, but as  you move up the acuity chain, that’s where you start seeing the other service vendors actively involved in that case. Case management, care navigation, care coordination, or your doctor wants to know weekly what your average blood pressure has been for the last three days as he is working through your medication regime. That’s where service providers start to get involved. But the largest market and the largest number of people are just monitoring themselves.

I have an IPhone and I have to walk 10,000 steps. What does that mean? I get on my scale that I just bought at Best Buy and hooked it up on Bluetooth, so now I weigh myself every day. I’m entering my nutritional data. I’m putting the barcode in, or talking about how much I had and what I ate. I’m monitoring my sodium level. I just got diagnosed with cardiomyopathy, so I’m managing my own care. Then when that condition worsens to a point where the service providers, the doctor, is more involved, I need that help, and assistance evolves into that.

Maybe I wasn’t doing any of that. All of a sudden I had a sentinel event, and now I need to be involved in that and I need a service provider to step in and do it. There’s several different scenarios of how that plays out. But as we adopt more and more technology in the home, we monitor our home security. We know who when FedEx drops off the package. We have the Ring doorbell so we know when people are at the door. This monitoring your health and that evolution that adoption of technology getting out into our daily lives is growing.

What are the most valuable lessons you’ve learned from helping companies find a successful path?

There is so much opportunity in healthcare to make a positive impact, as a business, but also in making sure that a patient is taken care of correctly. Are they getting where or what they need on time? The information that they need? Then as a business, are you providing that service and is there value-add? The businesses that I’ve been involved with have been in the early development of the market, where people are trying to figure out what’s going on. 

I was involved with one of the original hospitalist programs. The hospitalist has a huge amount of value, but people didn’t understand what they did. We got involved in a high-risk member management in another company when people weren’t really sure how to start providing services and finding these people in the home. Then here the same thing with remote monitoring – we are starting to leverage technology and gain information that can make a huge impact on the delivery of care. There is so much opportunity in that.

From a business perspective, where do you focus and how you make that impact? The performance of a business will come along at that point. One thing that attracted me here is that coming through COVID, people were realizing we have this technology and we can leverage it. We can improve a grandmother’s or a young child’s life by knowing this information upfront and getting it to the right service provider.

The business will follow in doing that. People see that. They see the value of it. They see not only from an outcomes perspective, but also from a business perspective and the ability to do that. That’s what’s exciting. That’s what I personally like doing. I think that’s one way you give back.

Morning Headlines 12/1/21

Babyscripts Raises $7.5M in Additional Series B Funding

Babyscripts increases its previously announced Series B funding round with an additional $7.5 million investment, bringing the total round thus far to $19 million.

Penn spinout CareAlign raises $2.3M from investors with ties to Harvard, Princeton

Clinical task management software vendor CareAlign raises $2.3 million in seed funding.

Five enforcement actions hold healthcare providers accountable for HIPAA Right of Access

HHS OCR settles with five providers that failed to give patients timely access to their records at a reasonable cost under the HIPAA Privacy Rule, with settlement costs ranging from $10,000 to $160,000.

News 12/1/21

Top News

Greenway Health promotes President Pratap Sarker, MBA to CEO, effective January 1.

Sarker replaces Richard Atkin, who will take on the role of executive chairman.

Reader Comments

From Orion’s Roar: “Re: LinkedIn. A telehealth company sent me an invitation to become a strategic advisor, based purely on my profile. They offered the chance to buy shares, get stock options, and earn a percentage of revenue from B2B sales that I would help them earn. I’m sure they could find better advisors and this is just clever bait for investing in their company.” I see nothing impressive about the company (I’m omitting its name), which seems to be selling shares rather than product and recruiting sales affiliates rather than advisors. 

From DeeDee Centralized: “Re: closing the IT department. Is WSJ right?” The IT pendulum is always swinging from “let departments do their own IT work with their own people and budgets” to “we have to regain control of rogue departments whose mini-IT fiefdoms are spending even more money with less accountability and measurable corporate benefit.” Everybody is an IT expert until their cool tech stuff breaks or screws up a downstream department that they failed to consider in their on-the-fly design. The answer is always a less-dramatic compromise that won’t make management professors famous – centralize the technology rule-making to avoid an unreliable hodgepodge of faddish technologies, oversee the IT spend both centralized and decentralized so it can be understood and optimally deployed (in hospitals, failure to do this means the well-connected finance and patient accounting departments get about 70% of the total budget), and embed IT people on the front lines and vice versa to make sure everybody understands the current and desired future state. People who write “first kill all the IT people” articles are no different than those who can’t decide if outsourcing is brilliant or stupid — they just take the opposite position every few years to get press as contrarians despite having no experience running the organizations they advise.

HIStalk Announcements and Requests

Thanks to ConnectiveRx for upgrading their HIStalk sponsorship to Platinum. They have supported HIStalk since 2012.

My Bitdefender Total Security 5-Device subscription was set to auto-renew at $90 for one year. As always, I cancelled the auto-renewal and found a better deal, in this case $30 for two years from Best Buy, saving me 83%. All I had to do was enter the new code into Bitdefender Central to pop the expiration date out 24 months.

I’ve decided that I’ll attend HIMSS22 after months of waffling about whether to go or not, motivated more by habit than desire or high ROI expectations. I compromised by choosing a short stay in which I’ll just go Tuesday and Wednesday.

Webinars

December 8 (Wednesday) 1 ET. “What Lies Ahead for the EHR’s Problem List.” Sponsor: Intelligent Medical Objects. Presenters: James Thompson, MD, physician informaticist, IMO; Deepak Pillai, MD, MBA, physician informaticist, IMO; Jonathan Gold, MD, MHA, MSc, physician informaticist, IMO. The EHR problem list can be cluttered with redundant, missing, and outdated diagnoses, and displays don’t always help clinicians process the available data correctly. The presenters will discuss how improvements in creating, maintaining, and displaying problems could reduce errors and decrease the cognitive load of clinicians while continuing to optimize reimbursement.

December 9 (Thursday) 1:30 ET. “Cone Health: Creating Extreme Efficiencies in Surgical Services.” Sponsor: RelayOne. Presenters: Wayne McFatter, RN, MSN and Sharon McCarter, RN co-directors of perioperative services, Cone Health. The presenters will discuss how they have empowered the entire surgical care team, including vendor representatives, to get real-time access to surgery schedules and case requirements in the palms of their hand. RelayOne CEO Cam Sexton will also present the findings of a recent study of 100 hospital leaders regarding their operating room optimization plans for 2022.

December 14 (Tuesday) 1 ET.  “Using Cloud to Boost AI and Enterprise Imaging.” Sponsor: CloudWave. Presenters: Larry Sitka, MS, VP/CSIO of enterprise applications, Canon Medical Informatics; Jacob Wheeler, MBA, senior product manager, CloudWave. Enterprise imaging has remained a holdout of data center complexity despite the benefits the cloud offers. The presenters will discuss innovative ways to reduce complexity and lead with disruptive technology using AI, enterprise imaging, and the cloud.

December 15 (Wednesday) 1 ET. “Improve Efficiency, Reduce Burnout: Leveraging Smart Clinical Communications.” Sponsor: Spok. Presenters: Matt Mesnik, MD, chief medical officer, Spok; Kiley Black, MSN, APRN, director of clinical innovation, Spok. The presenters will identify the most common clinical technology contributors to alarm fatigue and clinician burnout. They will describe how improving three clinical workflows can increase care team collaboration and reduce non-patient care workload and explain how a clinical communication platform simplifies finding care team members and pulling actionable information from the EHR.

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

Acquisitions, Funding, Business, and Stock

Elsevier acquires digital healthcare educational content company Osmosis, which it will add to its Global Medical Education portfolio.

Analytics and data integration vendor Innovar Healthcare is among several companies that are purchasing the liquidated assets of Bridge Connector, a Nashville-based data migration startup that closed last year. The company, which had raised over $25 million several months before going out of business, and owes its creditors $5.4 million.

Babyscripts increases its previously announced Series B funding round with an additional $7.5 million investment. The virtual maternity care company has raised $37 million since launching in 2013.

Clinical task management software vendor CareAlign raises $2.3 million in seed funding. Former Penn Medicine associate CMIO Subha Airan-Javia, MD created the company in 2014, spinning it out of Penn five years later.

Sales

• UAB Medicine selects specialty pharmacy-focused analytics and data integration services from Loopback Analytics.
• Elsevier integrates Nuance’s PowerScribe radiology reporting software with its STATDx diagnostic decision support tool for radiologists.
• Phoebe Putney Health System (GA) will implement Wolters Kluwer Health’s POC Advisor for sepsis detection and patient management at three hospitals.

Announcements and Implementations

Nuance announces GA of its new Precision Imaging Network, cloud-based technology that transmits AI-generated data and analytics from diagnostic imaging systems to existing clinical and administrative workflows.

UC Davis Health (CA) and Amazon Web Services launch a Cloud Innovation Center that will focus on developing digital health solutions that are accessible and equitable.

Teleradiology service StatRad implements Change Healthcare’s cloud-based Stratus Imaging PACS.

Edifecs announces implementation of a work model that allows most of its employees to work from wherever they think they are the most productive – home, office, or a combination – while allowing them to reduce commuting stress and run personal errands.

Per-diem nurse staffing platform vendor IntelyCare launches a credentialing passport for uploading and providing licenses, screening test results, certifications, and employment eligibility verification.

NextGen Healthcare launches a benchmarking and analytics service for Community Health Centers.

Government and Politics

FDA forces Owlet to stop selling its smart baby monitoring socks that track vital signs and sleep patterns until it earns FDA approval. FDA did not require the company to recall the 1 million sock it has sold over the past six years. Owlet says it will soon launch a new sleep monitoring solution. 

The VA awards a five-year, $65 million contract to Caregility, ThunderCat Technology, Sterling Heritage, and Iron Bow Healthcare for remote patient monitoring software and services that it will roll out through its TeleCare Companion Patient Observation Support and Services Program.

The Pharmacy HIT Collaborative meets with ONC and pharmacy system vendors about pharmacy interoperability, including integrating the information in the Pharmacists ECare Plan with provider EHRs and payer systems, as required by the Cures Act.

HHS OCR settles with five providers that failed to give patients timely access to their records at a reasonable cost under the HIPAA Privacy Rule, with settlement costs ranging from $10,000 to $160,000. A cardiovascular disease doctor who ignored a patient’s request for a copy of their medical record and then ignored OCR investigators waived his right to a hearing in paying $100,000.

Other

Business Insider asks eight big health systems to describe the most interesting tech project they are testing (and in some cases, also investing in):

• Northwell Health: AI analysis of EHR data to identify pregnant women who are at risk for pre-eclampsia.
• New York – Presbyterian: EHR triggers to make sure orders are completed that would otherwise prevent a patient from being discharged as planned.
• Cleveland Clinic: optimize use of unnecessary lab tests and supplies based on historical patient data.
• Providence: allow behavioral health referrals to be ordered during primary care visits.
• LifePoint Health: remote patient monitoring.
• CommonSpirit: open a bricks-and-mortar women’s and reproductive clinic with telehealth startup Tia.
• Universal Health Services: notify providers of patient health or admission status using EHR data sent to a homegrown app.
• UPMC: remote patient monitoring.

Sponsor Updates

• The Rotherham NHS Foundation Trust and Agfa HealthCare celebrate Enterprise Imaging’s 34^th UK go-live.
• PRWeek highlights Actium Health’s role in helping Virtua’s marketing team launch a campaign that successfully encouraged patients to come in for missed screenings.
• Intelerad launches a cloud-native disaster recovery solution.
• Cerner staff assemble 200 meal baskets for veterans and families supported by Veterans Community Project and Jackson County Family Court Services.
• Netsmart partners with the National Council for Mental Wellbeing to improve care coordination and use data to drive outcomes for certified community behavioral health clinics.
• A public regional hospital group in Italy will implement Ascom’s Digistat software in several of its facilities.

Blog Posts

• Vendor HIPAA Breach Affects 319K Patients & Their Providers (AdvancedMD)
• The Glidepath to Downside Risk: Future-Proof You Healthcare Business Through Value-Based Care (Arcadia)
• Embracing Interoperability with FHIR (Availity)
• Interoperability is Key to Care Coordination (Bamboo Health)
• The Path to Meditech Expanse: Where Should You Begin? (CereCore)
• Optimize Star Ratings in the Medicare Advantage Market: 3 Strategies for Payers (Collective Medical)
• Five powerful COVID-related shifts in patient care (ConnectiveRx)
• Driving Health Care 4.0 (Diameter Health)
• The Shift to Care-at-Home: Are You Ready? Why You Need to Be (Dina)
• The Future is Online Appointment Scheduling (EClinicalWorks)
• What does the connected generation (Gen C) expect from providers? (Experian Health)

Contacts

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

Morning Headlines 11/30/21

Elsevier acquires Osmosis.org, an innovative digital health education platform and enhances its global medical education portfolio

Elsevier will add newly acquired healthcare educational content development company Osmosis to its Global Medical Education portfolio.

New initiative to make UC Davis Health a leader in digital medicine

UC Davis Health and Amazon Web Services launch a Cloud Innovation Center to develop digital health solutions that are accessible and equitable.

Greenway Health names Pratap Sarker as Chief Executive Officer

Greenway Health promotes Pratap Sarker to CEO, effective January 1.

Readers Write: Filling the Healthcare Data Glass: The Glass Doesn’t Need to Stay Half Empty

Filling the Healthcare Data Glass: The Glass Doesn’t Need to Stay Half Empty
By Alex MacLeod

Alex MacLeod is director of healthcare commercial initiatives for InterSystems of Cambridge, MA.

In recent years, there has been a lot of talk about the unfulfilled promises of artificial intelligence (AI) in healthcare and concerns about how to effectively incorporate it into practice and realize immediate value. There is a real “glass half empty” mentality at play due to false starts and over-ambitious expectations for AI adoption and commercialization. But that doesn’t need to, and shouldn’t, be the case.

Google’s hospital partnership to collaborate on algorithm development using patient records for AI development is a strong sign of healthcare AI’s imminent proliferation. Gone is the barrier of highly fragmented patient data. This is a significant market shift, and other giants in tech and healthcare will follow Google’s lead. The question now is, what can and should the healthcare IT industry do to prepare? We will answer that by looking at three core areas – data, patterns, and areas of caution.

AI in healthcare has had positive growth in recent years, but the meaningful application of AI products (FDA-approved AI products) and the widespread application of data to the decision-making process has lagged, according to a recent study published in the Medical Futurist Institute. There have been major recent advances in sensor technology, allowing for a broad range of devices that help inform patients about their health or fitness and warn about risks. The sensors generate raw data, but the interpretation of it is based on AI analysis, which hasn’t developed at the same rapid pace.

IT departments, payers, providers, and patients are overwhelmed with the high volume of data generated on a daily basis and need to better articulate their end goal for its use. To do so, they need to pay close attention to their current processes and determine what can be done differently and what needs to change in order to be able to analyze data and apply it to future decisions.

The biggest questions those in healthcare face in regard to health information are:

• What do we do with all this data?
• What is most important to analyze?
• How can it be made actionable? (i.e. can it be used to become compliant with regulations?)

To answer those questions, we need to start by understanding what the data represents and asking a few more questions. Is the data set composed of lab results, physician-collected, or patient-submitted data? Why was it generated and collected in the first place?

The answers are typically more straightforward in other industries than healthcare. That’s why it is important to take a close look at the data and identify patterns and similarities. Analysis in healthcare AI is different from other consumer-facing algorithms.

Healthcare AI has less algorithm-friendly base data compared to social media or online shopping, for example. Healthcare algorithms work with complicated inputs of clinical notes, medical imaging, and sensor readings. Outcomes are relatively well defined in non-healthcare AI settings, most commonly in terms of attention or purchase. In healthcare, outcomes have time and severity dimensions on top of opportunity for interference with other effects, not all of which can be stratified through raw statistics.

Current effective applications of AI in healthcare include the use of ML tools in triage practices and administration. For example, what makes it effective in triage is how AI nuances the health system’s basic risk scoring systems as a way to identify patients who need immediate attention or who require higher acuity resources and pathways.

That said, patients must consent to their data to be applied to healthcare AI algorithms, and to provide value, the data must be made actionable. It must be clean, comprehensive, and normalized data where there are no duplicate records, formatting errors, incorrect information, or mismatched terminology. This gives those analyzing the data complete confidence in how and why it was curated.

Collecting data always introduces the risk of the information being “repurposed,” a possibility spotlighted when fitness tracking app Strava released a dataset of 3 trillion distinct GPS readings that inadvertently exposed US military bases in Afghanistan. Modern bots, and to some extent even legitimate social media marketing tools, are making efficient use of analytics and AI to game the platform’s algorithms in order to attract more views, clicks, and likes. But, when such technology ends up in the wrong hands, the focus may be on spreading misinformation rather than the intended use.

As with most technology, discretion is key. Collect and analyze only the minimum necessary. Don’t invite scrutiny over private data or enable access to it. Remain diligent in your data practices.

It’s understandable why people see the glass as half empty, but we have reached an inflection point in healthcare AI, a point at which we can add water to the glass.

To add to the glass and fully benefit from the anticipated results, we should embrace incoming regulation and think hard about self-regulation measures. Healthcare IT practitioners should closely monitor how laws and oversight will adapt in real-time, similar to as we have seen with the FDA Digital Health Innovation Action Plan. As Google’s big step forward in healthcare AI development signals a new level of digitization of health, we can expect changing attitudes towards healthcare AI, including an uptick in trustworthiness and increasing differentiation from other categories of consumer AI.

AI in healthcare has strong potential if we harness it correctly. In the right scenarios, AI augments the work of healthcare providers and doesn’t replace them as long as we maintain a little bit of human intelligence to complement the artificial.

Readers Write: Contactless Tech Surge Supports Healthcare’s Quadruple Aim

Contactless Tech Surge Supports Healthcare’s Quadruple Aim
By John Sola

John Sola is senior product manager for Ascom Americas of Morrisville, NC.

In a matter of months, the COVID-19 pandemic precipitated digital transformation across a wide swath of industries, driven by contactless operations that improve productivity and mitigate the need for physical interaction. Whether it’s curbside pickup, a digital guitar lesson, or delivery of lunch to your front porch with automatic digital payment on receipt, contactless service has become commonplace across so many areas of our lives. It has led to new business models that are yielding innovative and efficient products and services.

We have witnessed its significant impact on healthcare as well. Telehealth usage, for instance, has surged since the pandemic began, allowing providers to deliver safe and timely access to healthcare services.  According to a recent McKinsey & Company Telehealth report, “new analysis indicates telehealth use has increased 38X from the pre-COVID-19 baseline.”

Technology has been a key driver for health systems in attaining performance goals since the Triple Aim concept – patient experience, lower costs, better outcomes – was first developed by IHE in 2007. It was later expanded by many organizations to include a fourth (“Quadruple”) aim incorporating the importance of improving the work life of clinicians and staff.

To support the Quadruple Aim, healthcare’s utilization of technology is evolving rapidly.  Recent advances such as IoT, big data, AI, and wearables enable providers to transition treatment from passive and reactive to predictive and proactive.  The rapid pace of digitalization was aptly highlighted by Mayo Clinic’s Bart Demaershalk, MD: “The COVID-19 pandemic has essentially accelerated US digital health by about 10 years.” Contactless healthcare is positioned to support this shift in care delivery from the emergency room and hospital bed to the patient’s home, linking data-rich health observations to clinical knowledge and decision marketing.

One such example is ASL Napoli 1 Centro, a group of hospitals in Napoli, Italy. A remote monitoring solution for at-home COVID patients offers a level of service halfway between hospital care and the home. A package of wearable medical devices provides monitoring for oxygen saturation, heart rate, and body temperature, along with non-invasive spot-check blood pressure measurements. The service was managed by hospital general practitioners using medical device surveillance and clinical decision support system (CDSS) software. Of the 500+ patients monitored during a certain period, less than 10% required hospitalization. Based on the program’s effectiveness, the hospital intends to continue offering the contactless solution after the COVID emergency for managing patients with chronic conditions.   

As ASL Napoli 1 Centro shows us, the movement to prediction and prevention can be accomplished quickly and efficiently when it’s coupled with contactless technologies, such as wearable medical devices. Acquired vital signs can be analyzed in real time with CDSS-based early-warning scoring and other clinical measures to detect or predict patient deterioration. The data must be presented in a meaningful, understandable way if it is to be useful for decision-making and timely clinical intervention. Such solutions fit squarely in the objectives of the Quadruple Aim. It provides patients peace of mind that their condition is being watched closely.  It helps manage more patients with fewer staff. It improves outcomes by acting sooner.  It supports overburdened nurses by streamlining the process of data collection and validation.

As the way we approach healthcare continues to change, contactless technologies can help address existing and future care challenges, such as pandemics, the wave of aging Baby Boomers, and a looming shortage of nurses. Hastened by COVID, contactless care is here to stay, offering new and transformative opportunities for providers worldwide.