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Weekender 7/9/21

July 9, 2021 Weekender 1 Comment

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Weekly News Recap

  • FDA clears AliveCor’s phone-attached EKG sensor and app to allow professionals to calculate QTc interval for diagnosis of irregular heartbeat.
  • Intelerad acquires Heart Imaging Technologies.
  • A second OIG review of the VA’s Cerner project warns again of unbudgeted infrastructure costs of several billion dollars.
  • Sophia Genetics announces IPO plans.
  • UC San Diego Health adopts the SMART Health Card.
  • Three institutions form Texas Health Informatics Alliance and announce its first conference.

Best Reader Comments

Regarding AmazonCare, calling it “value-based care” is generous. Telehealth companies used to charge per-member per-month. Insurance companies started to figure out that telehealth companies weren’t doing much. Even worse is that as the insurance companies added members, the cost to the insurance company rose linearly, but the cost to the telehealth company barely changed since so few of those members actually used the telehealth service. Insurance companies also did internal measurements on the value of “urgent care” style telehealth and realized it wasn’t really substituting for primary care visits and wasn’t driving down long term costs. In urgent care style telehealth, people use it for the sniffles, while before, they would just ride it out. Increased healthcare convenience means people use more healthcare, not less. That isn’t an interesting service for insurance companies. So about five years ago, insurance companies forced telehealth companies away from per-member per-month. Many initially tried straight charging per visit and some still do, but that style of telehealth is a race to the bottom, low-margin business. Your HR department that buys your benefits is less savvy to this stuff than insurance companies, so it is easier to make money off employers directly, but selling to them one by one requires a lot of sales people. (IANAL)

I was heavily involved in the original IBM/Epic bid for the DoD. When we lost and found out what Leidos / Cerner had bid, we were mystified. Either they had low-balled, had missed some major infrastructure pieces, or had some “secret sauce” that we just hadn’t figured out. Well, I think we’re finding there was no secret sauce involved. (Bob Smith)

[Epic Care Everywhere] internal structures and mechanisms have been built. There’s a whole support structure to enable information sharing. Therefore, when two compatible Epic HIS systems aren’t sharing data, it’s entirely a customer-side issue. Maybe they aren’t mature enough to share data (after all, I’d consider external data sharing to be an “advanced”’ HIS function, and less of a priority than internal needs and priorities). Or maybe, someone at the customer has specifically decided they don’t want to share data. After all, if setting up Care Everywhere is relatively easy and is fully vendor supported, one has to start to question what the hold-up is. (Brian Too)

I find it funny that slews of provider organizations are coming out saying sepsis AI doesn’t work because they’ve all upcoded sepsis diagnoses. Seems like some great candidates for a Medicare audit. Maybe they can use the sepsis predictor to predict overpayment! (Sepsis predictor)

The Supreme Court decision in the TransUnion case this week makes it pretty clear the lawsuit against Google isn’t going anywhere. If the court doesn’t consider you to be harmed when a credit reporting agency mistakenly informs you that you’re on the terrorist watch list, they’re definitely not going to consider you harmed by having some personal info undisclosed in a log file somewhere. (Dan)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Mr. G in Kentucky, who requested a camera for his school’s yearbook club. He reported back in December, “With school being in and out because of COVID, they have not gotten the opportunity to use it as much as they would like. However, earlier in the school year, we were lucky enough to take some action shots at a couple of our football games. This provided a great opportunity for some hands on learning with more than one student at a time. This is something that I am greatly appreciative of as a teacher! The students were able to take many great shots that will look great in our yearbook. We all thank you from the bottom of our hearts to allow us the opportunity to grow and have amazing opportunities for us to improve our school.”

I found through frustration that scanning your COVID-19 vaccination card into the HIMSS21 Clear Health Pass app works only by positioning your phone skinny side up (portrait mode) instead of the wide-side up (landscape mode) that I expected since that’s how my bank’s mobile deposits work. I finally got that to work, although the app shows my status as “pending verification” with no definition of what that means.

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A Tennessee doctor whose medical license was previously suspended for possession of controlled substances will face the state board again, this time for inappropriately administering COVID-19 antibody tests to determine whether patients are actively infected. The doctor, who had started an in-home COVID-19 testing program, was accused by patients of not wearing a mask or gloves, not performing a physical exam, and falsifying medical records in documenting work he didn’t actually perform.

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Riverside Regional Medical Center (VA) medical resident Eleanor Love, MD starts Richmond-based The Simple Sunflower, which asks newly married couples for their wedding flowers after the ceremony, repackages them into individual vases, and delivers them to hospitalized patients in Richmond, starting with those in palliative care. 


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Morning Headlines 7/9/21

July 8, 2021 Headlines No Comments

FDA Clears Personal ECG Device for Measurement of QTc Interval, a Critical Marker for Patient Safety

FDA issues 510(k) clearance for the use of AliveCor’s $149 KardiaMobile 6L by healthcare professionals to calculate QTc interval from its EKGs, a value used to diagnose certain disorders of electrical conductivity that can cause irregular heartbeat.

Intelerad Acquires Raleigh-Durham Based Heart Imaging Technologies, A Clinical Workflow Automation Leader

Intelerad acquires medical image management technology vendor Heart Imaging Technologies.

More Underestimated Infrastructure Costs Could Raise VA EHR Price Tag $2.5B

A second VA OIG review of the infrastructure cost of implementing Cerner adds another several billion dollars to the project’s likely final cost, which could reach $21 billion.

News 7/9/21

July 8, 2021 News 8 Comments

Top News

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FDA issues 510(k) clearance for the use of AliveCor’s $149 KardiaMobile 6L by healthcare professionals to calculate QTc interval from its EKGs. That value is used to diagnose certain disorders of electrical conductivity that can cause irregular heartbeat.

The company also offers a service to measure QT intervals.

I was an early user of KardiaMobile and am surprised every day that the company hasn’t been acquired by Apple or some other remote monitoring / wearables vendor given its strong history of working within FDA’s regulatory framework.

AliveCor has raised $154 million in funding, including a $65 million Series E round in November 2020 whose participants included the venture funds of Qualcomm and Omron.


HIStalk Announcements and Requests

I’m trying to understand the mental process that leads people to think that “app” should be spelled “APP.” Short words need more caps?

I received a robocall whose caller ID showed Clackamas, OR, so I’ve changed my fake LinkedIn location to the closest town to that it would allow, Happy Valley, OR. I looked it up and found that Tony Award nominee Hailey Kilgore was born there. I saw her in “Once on This Island” on Broadway few years back, so maybe that was her calling me to catch up.


Webinars

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


Acquisitions, Funding, Business, and Stock

Intelerad acquires medical image management technology vendor Heart Imaging Technologies.

Marketing company Finn Partners acquires health IT-focused communications and marketing firm Agency Ten22, whose founder and CEO Beth Friedman will join Finn as senior partner.


Sales

  • Knox Community Hospital (OH) chooses Hicuity Health to provide tele-ICU and cardiac telemetry services.
  • Specialty drug management vendor Magellan Rx Management will offer its members live behavioral health support and wellness coaching from Heuro Health.

People

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Edifecs promotes Venkat Kavarthapu, MBA to CEO. He replaces founder Sunny Singh, who will move to board chair.

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Industry long-timer Jamie Trigg, MSITM (Virginia Mason Medical Center) joins CommonSpirit Health as national system director of Cerner.

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Payer software vendor HealthEdge hires Ryan Mooney (Cotiviti) as EVP/GM of its payment integrity product division.

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Bon Secours Mercy Health names Jason Szczuke, JD (Cigna) as its first chief digital officer.

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Kansas City-based worker compensation technology vendor Bardavon Health Innovations hires Ed Enyeart (Cerner) as CFO. He was recruited by former Cerner President Zane Burke, who joined Bardavon’s board in January 2021.


Government and Politics

A second VA OIG review of the infrastructure cost of implementing Cerner adds another several billion dollars to the project’s likely final cost. OIG notes, however, that the two infrastructure cost reports its office performed were conducted separately, so overlap is likely. The cost of the project, which was initially estimated at $10 billion and then $16 billion, could be as high as $21 billion if the estimates for cabling, user devices, and interfaces do not overlap. The VA – which OIG says underreported costs in its poorly documented estimates — agreed to all of OIG’s recommendations, which include having an independent cost estimate performed and ensuring that any additional project funding that is required is made available.


Announcements and Implementations

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Philips and Cognizant will co-develop digital health solutions for Philips HealthSuite.

A AHRQ-funded Regenstrief study finds that EHR alerts that are intend to reduce prescribing of dementia-linked anticholinergics in older adults are nearly never read by providers or medical assistants, so their effectiveness could not be measured. The authors conclude that human-based interventions might work better than computer-issued nudges for reducing anticholinergic prescribing.

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The Commons Project releases a free SMART Health Card Verifier App for IOS and Android that will allow businesses and other organizations to scan a COVID-19 vaccination card that uses the SMART standard to determine its validity and display vaccination details.


Other

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I ran across information for Microsoft 365 Business Basic, which seems like a great deal for $5 per user per month, with no mention of a minimum number of users. It includes web versions of Office apps, 50 GB of mailbox storage with Exchange, 1 TB of OneDrive storage and sync, a full implementation of Teams that includes webinars and 300-user meetings, and some elements of SharePoint that I don’t quite understand. No desktop app versions are included, but I’m pondering getting a lot of storage plus a Webinar platform for just $60 per year, which also includes 24-hour support.

Business Insider says that prospective business customers of its Amazon Care virtual service want it included as a benefit in their health insurance plans, but those insurers are balking, possibly because Amazon is recommending value-based contracts and the insurers would rather pay under fee-for-service deals.

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Eric Bricker, MD of First Stop Health notes a trend in physicians selling their medical practices to private equity firms, as follows:

  • The PE firm offers the physician owners of the practice a lump sump of cash and offers to take over its billing and collections.
  • The practice agrees to pay the PE firm up to 40% of future annual revenue.
  • The PE firm takes advantage of its now-larger group practices to squeeze insurers for higher payments.
  • Healthcare costs increase, but the doctors in the practice who weren’t owners – most of them younger — make less, allowing the PE firm to pocket the difference.

Sponsor Updates

  • Impact Advisors receives a high overall score in the KLAS “Security & Privacy Services 2021 Report.”
  • Redox enables its customers to create digital health apps using Unqork’s no-code platform that are interoperable with any organization in the Redox Network.
  • Healthcare Triangle achieves Google Cloud affiliate Partner status.
  • CereCore welcomes Michael Gagnon as its first Enterprise Fellow, where he will provide technical direction in IT solutions, cloud, and disaster recovery management.
  • VirtualHealth adds Healthwise’s educational healthcare content to its Helios care management platform for payers.
  • Vocera will relocate and expand its San Jose headquarters early next year.

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Contacts

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

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EPtalk by Dr. Jayne 7/8/21

July 8, 2021 Dr. Jayne 6 Comments

It’s always good to hear about true interoperability in action. The Surescripts Clinical Direct Messaging platform has sent over 7 million COVID-19 immunization notifications from retail pharmacies to primary care providers. Now if only we could get health systems to share amongst themselves so that patients could have one cohesive record, that would be great.

I have multiple Epic charts in practices that are literally across the road from each other, but because they belong to competing health systems, they don’t recognize each other’s data. I know that Epic is capable of sharing, but the systems aren’t ready for that. Information blocking, anyone?

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The World Health Organization issues its first global report on the use of AI in healthcare. Titled “Ethics and governance of artificial intelligence for health,” it includes six guiding principles for the regulation and governance of AI that are fairly straightforward and frankly are in line with what we should be doing in all facets of healthcare IT:

  • Protect human autonomy.
  • Promote human well-being and safety and the public interest.
  • Ensure transparency, explainability, and intelligibility.
  • Foster responsibility and accountability.
  • Ensure inclusiveness and equity.
  • Promote responsive, sustainable AI.

The report does note that we need to be cautious about overestimating the benefits that AI can provide, particularly if resources are diverted from core investments needed to achieve universal health coverage. I thought it was a nice way of saying, “watch out for shiny object syndrome.” When you’ve got people in the world who lack basic hygiene and sanitation, clean water, and immunizations, it’s sometimes difficult to think about spending millions of dollars on advances like AI.

During the last few weeks, I’ve seen multiple articles looking at the impact of the COVID-19 pandemic on various preventive screenings. One article looked specifically at screening test volumes through the National Breast and Cervical Cancer early detection program. In analyzing data from January to June 2020, the authors found that the pandemic reduced screening rates among low-income women covered by the program. This is not at all surprising to those of us who have been in primary care. When push comes to shove and women are under stresses, they tend to put themselves last because they’re busy caring for their family members. The pandemic added extra layers of stress, including economic burdens, distance learning, and greater care responsibilities for elderly relatives or those at high risk for complications due to COVID-19.

Several of my clients have asked me to assist them with campaigns to reach out to patients for preventive screenings. The more sophisticated clients can trigger scheduling of the services through text messages, but some still require patients to call in or access a patient portal to schedule.

Although they’re excited about the capabilities of their patient engagement platforms, I have to keep reminding them that getting the patients engaged and scheduled is only part of the battle. They need to be making operational changes to make it easy to actually have the tests performed. This means leveraging technology investments to streamline in-person registration processes and history updates. The facility where I had been getting my mammograms is one of my clients and my last experience was so unfortunate that I transferred care elsewhere.

What could they do to better serve their patients? First, leverage the EHR. Use the system’s capability to generate pre-populated patient information forms so patients merely have to update their history rather than filling out a bunch of redundant information, including name and date of birth on every page. Use the data already in the system regarding primary care physician, ordering physician, and date of last exam to make it clear that you already know a good chunk of what’s going on with the patient.

Second, streamline the “COVID hygiene theater” processes that are still going on in many medical facilities, including excessive distancing and unwarranted surface cleaning that slow patient flow or create unneeded levels of concern regarding infection control.

Third, figure out how to schedule so that you can run on time. Use the data from your systems to fully understand your throughput so people can have timely testing and get back to their other responsibilities. Getting a mammogram or a pap test shouldn’t be an all-day affair, but in many places, it is, which adds additional barriers for patients in hourly jobs or patients who might not have protected time off.

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Props to Steve Edwards, president and CEO of CoxHealth in Springfield, MO. He tells those who are spreading vaccine misinformation to “shut up.” Even better is the thread where his mother, a 90-year old retired operating nurse, says “I have always told you not to tell people to shut up, but this it is okay.” Ready to rumble, indeed.

I recently heard the phrase “innovation through imitation” used and kind of chuckled at it, but the more I think about it, the more it applies to entirely too many initiatives. The most recent example I’ve seen is the recent announcement that Dollar General plans to jump into the healthcare fray with a push to expand health offerings across rural communities in the US. The press release summarizes the company’s plan to “establish itself as a health destination” by stocking “an increased assortment of cough and cold, dental, nutritional, medical, health aids and feminine hygiene products” in stores. To further this effort, they’ve hired a chief medical officer, Albert Wu, MD, formerly of McKinsey & Company.

I hope one of the first thing Dr. Wu does is to consider bringing the company’s press release writers into the world of inclusive language by using modern terminology such as “menstrual care products” to describe some of the offerings they plan to stock. News flash: transgender men and nonbinary people may menstruate, and the continued use of “hygiene” around menstrual products perpetuates myths that menstruation is somehow unclean. According to the press release, Dr. Wu went straight from his anesthesiology residency to being a consultant at McKinsey, so I’m betting his missed out on the subtleties that many of us learn to appreciate through decades in practice. I’m a little embarrassed on his behalf about the way it was worded, as well as about some of the things in his LinkedIn profile, but I wish him the best in his efforts.

What do you think would be the most helpful strategy for building greater healthcare infrastructure in rural communities? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 7/8/21

July 7, 2021 Headlines No Comments

Xifin Enters Radiology RCM Services Segment with Computerized Management Services Acquisition

Health IT and RCM vendor Xifin acquires Computerized Management Services, which offers RCM services for radiology groups and imaging centers.

Novo Holdings A/S Invests in US Healthcare IT Company Availity

Availity, which offers RCM, clearinghouse, and digital provider engagement services, secures a strategic minority investment from Novo Holdings.

Opioid addiction treatment apps found sharing sensitive data with third parties

Researchers find that 10 opioid addiction treatment apps available for Android collect and share a user’s information with third parties, prompting privacy and security concerns.

HIStalk Interviews B.J. Schaknowski, CEO, Symplr

July 7, 2021 Interviews 1 Comment

B.J. Schaknowski, MBA is president and CEO of Symplr of Houston, TX.

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Tell me about yourself and the company.

I’m a 25-year software veteran. I was with big publicly traded companies like Intuit, Sage Software, LexisNexis, CA Technologies, and Vertafore prior. I had done primarily go-to-market roles. I’ve done operations, M&A, strategy services, almost any job you can have inside of a software company. I spent about 10 years in the last two companies prior to this in vertical software. Legal for about four and a half years with LexisNexis, trying to help large and small law firms run better, and then the last almost four years at Vertafore, trying to help independent insurance agencies modernize their technology.

Symplr felt like an obvious opportunity, because at least from my diligence, there’s no more inefficient operational entity than some of these big healthcare systems. I thought it would be a great opportunity to bring my technology background and help modernize what is effectively the healthcare operational landscape at Symplr. 

That’s really what we do. We cobble together, consolidate, and standardize everything between ERP and EMR, where today there are hundreds of point product solutions, small companies all over the board on data migration, data security and privacy, and look and feel. We believe we can consolidate that into a single operational platform that allows CIOs, CMOs, and COOs to better run their healthcare systems to the benefit of not only the top and bottom line, but also operational efficiency as well as patient safety.

Can a company that has grown by acquisition keep all of its three constituencies of customers, employees, and investors happy?

It’s the imperative. The investment thesis for Symplr from our sponsors is exactly that. At the end of the day, world-class run companies with successful, happy customers are the ones that get world-class valuations. Our backers literally have a vested interest in making sure that we are solving for our healthcare systems. 

There are only 1,900 acute care systems in the United States. We have 85% of them as Symplr customers. If we’re not providing extraordinary value, if we don’t have good customer Net Promoter Scores, if they’re not really happy with Symplr all day long, this thing isn’t going to work regardless. Believe it or not, I 100% stand behind the fact that we as Symplr and our sponsors have to make this work for customers. If not, our sponsors won’t get the financial results that they want.

The company is looking for a financial transaction at a multi-billion dollar valuation. How would you characterize the health IT investor market?

You have three or four driving forces relative to the healthcare IT market today. The first one is that the pandemic shone an absolute spotlight on the fact that healthcare operations are wholly deficient. You’ve got physicians who can provide COVID care that can’t get tagged in from the sidelines because they can’t get credentialed for three or four months. You’ve got nurses on the evening news who are working 12- to 15-hour shifts without lunches because their staffing and scheduling systems don’t talk to their HRIS system, and that’s criminal. So now you have this imperative because of the spotlight on healthcare operations, and as a result, you’re seeing those companies inherently become more valuable.

The second thing is the cost of capital is still relatively cheap, and healthcare has always been a great place for investment. You are now seeing this modernization initiative take hold and consolidation within many of the largest systems, which will be good for technology providers.

Third, you’ve got some market conditions relative to what likely will be perceived as enhanced regulation, which typically is addressed with software businesses, particularly the governance and compliance area.

Those three areas are driving what is an incredibly hot healthcare IT market right now. Frankly, we don’t see that slowing down. It’s interesting because it’s making multiples meaty, to say the least. But Symplr’s strategy is to look for the right companies that add additional value to the portfolio that we’ve already built and strengthen our position in healthcare operations. We’re taking the more long-term views, and sometimes we might be willing to look into investment differently because we can look at it over time, not just in the next 12 to 18 months in terms of our returns.

Do those meaty market multiples give you an urgency to act quickly to find a buyer or investor?

The short answer from my seat is no. I have the benefit as the CEO of Symplr of making it the best healthcare IT software vendor provider in the world. If our sponsors look at high multiples and say, now’s the time to look for a new partner to change hands, I leave that in their hands, frankly. But I will tell you that I think it’s more indicative of the value that software modernization, technology modernization, can provide to healthcare systems. 

I don’t see healthcare technology multiples fading, because there’s so much value to be brought here. We are just cracking the surface on the potential of improving operational effectiveness of healthcare systems. I think that will only continue to rise as these systems truly embrace what technology modernization can mean for them. They start to stitch it together. They don’t have the data security and privacy risks any more. They have the data and insights to make intelligent decisions. They understand where they fit relative to other systems and peer community. I only see them going up.

People keep expecting technology to reduce costs, reduce inefficiency, and improve outcomes in healthcare, but somehow that never seems to happen at a macro level. Are prospective customers becoming more demanding?

Yes. People were still looking at this whole middle infrastructure realm in a point product way. The reality is you can keep investing in point products all day long, but if you don’t have better interoperability, if you don’t have a common look and feel, if you don’t have a common data layer that gives you better insights in how to run your healthcare system, you’re not going to see the benefits.

We’re seeing these top-down initiatives that are starting with some of the biggest healthcare systems in the world moving down into what I’ll call the more mid-market or mid-tier size healthcare systems. I’ve talked to some CEOs and CMOs who would reinforce this. As recently as seven or eight months ago when I joined, the theme was, we just let our facilities and our teams pick whatever solutions they want and we just make sure that we get the right price on them. Maybe there’s some data security and privacy standards, maybe there aren’t, which is frightening on so many dimensions. 

But now what you see is these large systems that keep getting bigger, they know they can’t run with 100, 200, 300 different point product solutions, many of which are trying to achieve the same outcome. They are now driving this consolidation standardization, not just as a technology, but of workflow and processes, such that you can  have a facility in Oregon and a facility in California and you can transfer an employee. A lot of those systems and tools are made the same way, so you can onboard them immediately and they’ll understand the look and the feel and the healthcare system’s way of doing things.

That’s going to be better for business. Number one, you get the obvious financial impact of system consolidation. But beyond that, it’s going to be so much better for the frontline workers who live in those in those tools for a couple hours a day who need to be as efficient and productive as humanly possible. When you’ve got a nursing leader who spends three to four hours a day of his or her time in systems instead of providing care or mentoring younger nurses, that’s horrible for your system. The ability to reduce that to an hour or hour and a half a day provides meaningful time back. That’s why you’re seeing a lot of these top-down down initiatives that previously had just been left to a fragmented, decentralized decision-making process. That’s the way of the past.

Has Symplr’s acquisition and operation of Phynd given you an appreciation for the challenges involved with the seemingly simple task of provider data management?

It’s so strange coming in from the outside. It’s a plumbing problem. If your pipes are set up the right way, your data flows. This shouldn’t be that hard. But because of the way credentialing takes place, because of the way a lot of these systems do provider data management, it’s been wholly inefficient. We look at Phynd as another part of provider management, which is one of the core categories that Symplr operates in as part of healthcare operations and GRC. If that front door doesn’t work, it  impacts the entire downstream operational landscape.

Phynd was so obvious for us. What had been Cactus and all the other provider applications we have that – Symplr Provider – and we saw the opportunity to bolt Phynd — now called Symplr Directory — into that and extend the operational wherewithal and competency in through the digital front door. Systems are now able to identify and convert more of those patient opportunities. It just made a ton of sense to stitch the whole thing together. It’s one plus one equals seven with those products together. It was a great opportunity for us to add a lot of value by simplifying something that shouldn’t be that hard.

You’ve said that companies need leaders who can stop debating and instead take action based on the 80% of information that is known. You’ve also said they must get along with each other. Did that mindset come from your military experience?

It’s this whole concept of task and purpose, and it really comes down to alignment and goal setting. If you have an organization that is trying to do too many things and doesn’t understand collectively what winning looks like or what success looks like, that’s when you get these rogue individuals who are well-intentioned, but are off doing their own thing. 

At Symplr, we have three strategic priorities — grow organically, become one Symplr internally and externally, and then win with mergers and acquisitions. The individual goals of everyone in the company, including me, ladder up to those three objectives. If you have continuity and consistency of purpose, the organization is able to better win together and remain aligned. We also have to know what right looks like, such that if someone is off doing something, the rest of the organization has a mandate to say, wait a minute, I think we’re out of balance here. How does this align back to our common objectives? 

Whether it’s in the military — where you basically have tasks and purpose, you have very specific missions with a specific purpose and clarity around mission intent – or in business — where you have three strategic goals, here are measures for each, here’s how your job ladders into each of those, here’s how we collectively in a system achieve those — it’s much easier to create organizational alignment.

I say I joined Symplr for four reasons, and one of the primary ones was the culture of Symplr when I walked in the door. This was a company that had grown up through acquisition. I was shocked to learn that the employee engagement was as high as it was. We had world-class Employee Net Promoter Scores the day I walked in the door, which told me you’ve got a workforce that wants to actually understand and solve for customers. That it’s looking for singularity of purpose, if you will. We’ve done a pretty heavy internal transformation to become one Symplr — our own infrastructure, our own processes, a common way of doing things. We do EMPS every quarter and we’re still world class. The organization was hungry for that kind of goal-oriented management and I think we have thrived as a result.

You are early in your first CEO job, but have already been involved in acquisitions and presumably some discussions about the possible change in company ownership form. What are you learning as the person who has to make those big decisions?

The two observations that I probably reflect upon the most are, number one, you can’t undervalue the importance of having an incredibly strong executive team. Do the leaders of the functions of our organization all understand what the goals are? Do we ladder up against them? Do we have the right culture on the executive team such that the organization sees us working together, challenging each other, but always being professional and having a ton of fun doing it?

I probably believed this before I took the Symplr job, but now I very much understand it because I own it as part of my job, but having the right executive leadership team, senior leadership team creates wonderful opportunities for engagement, for alignment, and for internal employee mobility. That’s what it looks like done right.

The other piece is that you never know, until you sit in the chair, how amazingly complex and varied the different parts of the business are. In the same day, I’ll go from evaluating our return to travel and the office COVID policies — relative to vaccinations and who is, and who isn’t, what do we do — to incredibly important diversity and equity and inclusion initiatives that we’re overseeing, to product strategy, to facility rationalization, to sales bookings growth. You get everything in the same day. If you’re not intellectually curious enough to be able to pivot five or six times in a given day and focus on different things, this could be exhausting. If you enjoy that, and thankfully I do, it’s exhilarating. But until you sit in the seat, you have no idea the amount of variety that goes into the day-to-day.

Some technologies found their way to success being led by top executives whose temper, insults, executive turnover, and micro-managing control were legendary. Does that approach still work, where one person’s force of will pushes the company forward even while alienating many of the people who work in it or with it?

A majority of those examples involve founders and majority shareholders, so they could get away with it. I would argue that nobody wants to work for a jerk. There are too many options, particularly in technology. If you are good, you can go work in a million different places and be treated really, really, really well. Our philosophy as an executive team is that we are ruthless in our decision-making, but we’re nice to everyone all the time. Because why would you not be? No one wants to do this if it’s not fun and enjoyable and if you don’t trust the people that you work with and for.

That other way may have worked. It may still work for some folks. It’s never been my style. You learn early on in your career that you can rattle your saber, shake your fist, and pound the desk and nobody cares. You’ll end up seeing higher degree of turnover and maybe the enterprise will be successful, but at what cost? As opposed to a place that is welcoming, nurturing, and accepting of all. That has high standards for performance, but just as an expectation of the role, never an indictment of the individual. 

We don’t yell. We don’t scream. Sometimes people work really hard, but hopefully it’s never all the time. This is not sustainable. I believe that the better financial outcomes come from happy and engaged employees, because then they’ll take incredibly good care of our customers, write great code, sell really hard, and market really well, and that will lead to the financial outcomes that you want. I hope those days are gone and you see more of a accountable, but accepting kind of leadership in technology.

Where do you see the company in the next 3-5-years?

I get this question a lot because of our size, growth trajectory, and profits. The financial profile at Symplr is just wonderful, so we have a lot of options. We might go public in a few years. We might remain privately held via a private equity sponsor. We may find a home with a very large strategic partner that thinks we can be accretive to their healthcare IT strategy.

More than anything, we’re focused on creating incredible healthcare outcomes for our customers, driving great growth as a result of that, and maintaining our financial discipline relative to the profit that we put off. If we do those three things, the options for Symplr will be unlimited. But the reality is that we’ll continue and maintain and extend our market leadership position within healthcare operations.

My dream is the day where healthcare systems, CMOs, COOs, CIOs, wake up and say, you know, we’re a Symplr shop. We use Symplr for provider management, workforce management, contract and spend access, compliance, quality, and safety. We’re a Symplr shop, which means we’re a best-in-class healthcare operation or healthcare system with our operations. If that happens, Symplr’s corporate outcomes involve a ton of different options, but that’s how we think about driving business.

Do you have any final thoughts?

It’s funny that probably 90% of the folks today are using a Symplr product and may not know it because we’ve grown through acquisition of brands like Cactus, API, TractManager, HealthcareSource, and ComplyTrack. We have all these wonderful point products that for years were best-of-breed in each of the categories they served. What we’ve now done at Symplr is to begin to stitch them together and create common workflows across systems, a common look and feel, and interoperability, We are making game-changing operational improvements. 

I would encourage folks to come talk to the business and come talk to Symplr to learn a little bit more how we can benefit them, because it’s probably not the same collection of point products that they once knew. There’s meaningful value to be had.

Morning Headlines 7/7/21

July 6, 2021 Headlines No Comments

Healthcare Technology Firm Sophia Genetics Files for $100M IPO, Inks Cancer Data Deal With GE Healthcare

Sophia Genetics announces its IPO plans and that it will work with GE Healthcare to develop AI-powered analytics and workflow software for cancer care.

Puerto Rico Health Dept. launches online platform to manage patient data

Puerto Rico’s health department launches an HIE with an initial seven provider organizations, with another 15 scheduled to connect next week.

Exclusive: After rebrand, Tampa Bay Wave telehealth company raises $1.5M

ERemede raises $1.5 million in seed funding to further scale its patient engagement solutions and educational resources for pre- and post-op patients.

News 7/7/21

July 6, 2021 News No Comments

Top News

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UC San Diego Health adopts the SMART Health Card, giving patients and employees digital access to their vaccine records through the health system’s patient portal.


Reader Comments

From Informatics Nurse: “Re: COVID-19 vaccination. Since the ruling was upheld to allow hospitals to make COVID-19 vaccination a condition of employment, five consulting companies have reached out, saying they have a need for vaccinated go-live staff. The contracts are for 2-4 weeks, starting immediately, with all expenses paid and at hourly rates not seen since 2009. The reason is the termination of unvaccinated hospital IT staff who must have felt themselves indispensable and immune (pun intended) from termination after years of working on the project with go-live impending.” Unverified. Consulting folks – are hospitals calling to get quick, short-term replacements for IT-related staff who were let go because they declined vaccination?

From Inappropriate Umbrage: “Re: interviews. Some you’ve done contain fun or insightful tidbits, while others seem to recite the obvious. How do subjects prepare?” They don’t, because I don’t give them a topic list in advance, I don’t allow anyone else to get on the call, and I don’t give them the interview transcript draft afterward for their approval or editing. I decided early on to  buck the trend of dull health IT “interviews” that are really just committee-formulated company responses to a emailed list of non-insightful questions. I interview CEOs only, talk about whatever interests me, and then run a full transcript of that conversation, so give those interviewees credit for being willing to have an actual unscripted dialog — much of it related to the industry as a whole rather than the company — and have it just appear on the site without any other personal or company involvement. That requires a certain amount of courage and trust by the subject and some tolerance by readers who might not recognize the pressure the subject is under in being interrogated by an anonymous nobody of uncertain agenda in an unfamiliar setting.


HIStalk Announcements and Requests

I watched Questlove’s powerful, exuberant “Summer of Soul” Monday on Hulu and it was a stunning documentary, a historical look back at the tumultuous 1960s that is backdropped by concert footage of the forgotten “black Woodstock” of 1969’s 300,000-attendee Harlem Cultural Festival over six weekends. Musical highlights for me were shockingly charismatic The 5th Dimension and Sly and the Family Stone (I’m not really a gospel-funk fan even though I acknowledge the obvious talents of Mahalia Jackson and Mavis Staples) and seeing Stevie Wonder drumming better than most drummers. The film sat unprocessed and forgotten in a basement for 50 years — thank goodness it wasn’t on videotape — yet it offers perfect audio quality and depicts a bold palette of 1960s colors that, like the festival, have been largely forgotten (seen any bands wearing matching Creamsicle orange suits lately?) Questlove is a multi-talented and curious genius, of course, and he stayed out of the film’s way, allowing the tears and wistful reminiscing glow of festival performers and attendees who were shown footage 50 years after the event to provide the narrative. This festival was 100 miles geographically and light years away culturally from Woodstock. Segments about the Vietnam war, assassinations, and the moon landing are jaw-dropping, and you’re left with the message that while the music and fashion have changed, the struggle has not. 

I’m peeving once again on people who say they have “over 12 years of experience.” We know it isn’t 13 years or their carefully enumerative precision would have said so, maybe even rounded up if it was more than 12 years and six months, so why not just say “12 years of experience” and assume that the absence of those few extra months is immaterial? Otherwise, every since person’s resume would, except for one day per year, pointlessly describe their years of experience as “more than.”


Webinars

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


People

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CMS appoints Meena Seshamani, MD, PhD (MedStar Health) as deputy administrator and director of the center for Medicare.

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Dina hires Maryann Lauletta, MD (Inspira Health) as its first chief medical officer.

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John Sheehan (All Tier Health Care Consulting) will join Rochester RHIO as CEO on August 1.


Announcements and Implementations

The incubator of Innovation Institute — whose members include Bon Secours Mercy Health System and MultiCare — will co-develop solutions with process automation vendor Olive and share commercialization revenue.

Children’s Hospital & Medical Center implements cloud-based enterprise imaging informatics and data insight solutions from Philips across its facilities in five states.

An InterSystems TrakCare Unified Health Information System update includes integration with its HealthShare Personal Community patient portal to support appointment scheduling and synchronization of third-party app data with patient records; support for virtual visits using Google Meet, Microsoft Teams, and WeChat; and support for SMART on FHIR apps. TrakCare is used in 27 countries, although not the US.


Privacy and Security

In England, an Information Commissioner’s Office analysis finds that more data breaches occurred in healthcare between 2019 and 2020 than in any other sector examined, prompting NHS Digital to delay its plans to share the health records of NHS patients with third-party organizations.


Other

A randomized controlled trial of a large company’s multi-site workplace wellness program after three years finds that while employees said they more actively managed their weight using the program, it otherwise had no impact on self-reported health, clinical health markers, healthcare spending or utilization, absenteeism, or job performance.

A Kaiser Health News report finds that rural, volunteer-based ambulance services are struggling to respond to calls due to a shortage of volunteers who are wiling to take the extensive emergency medical technician training and tests. it also notes that Medicare and Medicaid payments cover only about one-third of actual costs, leaving the services running in the red. Suggested solutions include funding EMS services via taxes, merging the services with fire departments, or turning them over to hospitals. 

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Saint Vincent Hospital (MA) CEO Carolyn Jackson cites an ongoing nurses strike as the reason for the Tenet-owned hospital’s decision to delay its Cerner implementation until early next year. The strike, which mostly involves concerns about nurse-to-patient staffing ratios, has been going on for nearly five months.


Sponsor Updates

  • EClinicalWorks releases a new customer success story, “PrimeCare Medical Clinic: Rocking Patient Engagement in Little Rock.”
  • Agfa HealthCare adds a chest X-ray visualization package to its Rubee for AI workflow software for radiology.
  • Clinical Architecture releases a new The Informonster Podcast, “Working Towards Price Transparency in Healthcare.”
  • Divurgent releases a new The Verged Podcast, “The Promise of the FDA Real-World Evidence Program.”
  • Ellkay recognizes VP of Customer Success Sunita Pradhan as part of its Women in Health IT Program.
  • Experian Health’s Enterprise Health Patient Identifier Solution and Hospital Claims Management Systems have been recognized as top-rated solutions in Black Book’s “Top Client-Rated Financial Solutions Achieving Accelerated Digital Transformation in the Nation’s Healthcare Systems” rankings.

Blog Posts


Contacts

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

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Morning Headlines 7/6/21

July 5, 2021 Headlines No Comments

Vitalhub Corp. Announces Acquisition of UK Based Alamac Limited

Canadian health and human services software vendor VitalHub acquires Alamac, a consulting firm that caters to NHS organizations.

R1 Completes Acquisition of VisitPay

First announced in May, R1 RCM finalizes its $300 million acquisition of digital payment company VisitPay.

Saint Vincent nurses strike delays modernization of hospital’s record system to 2022

Saint Vincent Hospital (MA) CEO Carolyn Jackson cites an ongoing nurses strike as a contributing factor to the hospital’s decision to delay its Cerner implementation until early next year.

Morning Headlines 7/5/21

July 4, 2021 Headlines No Comments

Texas Health Informatics Alliance launches, opens registration for its first conference

University of Texas Health Science Center at Houston, The University of Texas at Arlington, and The University of Texas Southwestern Medical Center form the Texas Health Informatics Alliance.

Thousands of patients hit by NHS data breaches

In England, an Information Commissioner’s Office analysis finds that more data breaches occurred in healthcare between 2019 and 2020 than in any other sector examined, prompting NHS Digital to delay its plans to share the health records of NHS patients with third-party organizations.

An email sent by One Medical exposed hundreds of customers’ email addresses

Primary care company One Medical inadvertently exposes 981 email addresses when an employee forgets to use the BCC option on a mass patient mailing.

Monday Morning Update 7/5/21

July 4, 2021 News 6 Comments

Top News

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Three University of Texas organizations – University of Texas Health Science Center at Houston, The University of Texas at Arlington, and The University of Texas Southwestern Medical Center – form the Texas Health Informatics Alliance.

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THIA will hold its first conference virtually on September 9.


Reader Comments

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From Censored: “Re: HIMSS21 podcasts and video. The conference guidelines say that audio and video recording are mostly banned. Attendee interviews must be scheduled in advance and recorded in an enclosed location outside the aisles. Perhaps that applies to press only.” I’m one of few people who have been threatened (years ago) with expulsion by the HIMSS police for daring to snap a photo of a booth I was walking by. Despite that, I expect it’s mostly a complaint-based system designed to protect exhibitors from competitive espionage. According to the HIMSS21 guidelines:

  • Video recording, audio recording, and photography is prohibited during keynote sessions. HIMSS warns attendees that its staff will immediately escort anyone out who takes photos (good luck with that).
  • In the exhibit hall, photos and videos can be taken only in the exhibitor’s booth, with cameras or other equipment facing into that booth. Recording another exhibitor’s booth may result in termination of future exhibiting privileges. Media members must have HIMSS media credentials to take video or photos in a booth.
  • Attendees may not record interviews by walking up to people – interviews must be scheduled ahead of time and done in a booth or enclosed location away from the exhibit hall aisles and hallways outside keynote presentations.

Bottom line, as the reader is suggesting, anyone who is recording or taking pictures other than in an individual exhibitor’s booth is breaking conference rules. I swear last conference you could barely walk around without constantly running into someone who was recording an interview that the world cared nothing about.


HIStalk Announcements and Requests

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Most poll respondents don’t believe that the compensation of remote workers should be adjusted based on their local cost of living, with comments reflecting a “just pay people what the are worth” belief.

New poll to your right or here: How much impact has the information technology used by your providers and insurers had on your overall health and happiness?

Thanks to these companies that recently supported HIStalk. Click a logo for more information.

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I’m fascinated by the sad situation at the collapsed Champlain Towers South in Florida, mostly because it is unfolding nearly exactly as laid out by John D. McDonald’s 1977 novel “Condominium.” The book weaves a tale of Florida condo builder greed, the misery of living under HOA oversight, volunteer condo board members who are personally attacked by their neighbors over the necessary but potentially unaffordable cost of maintaining their shared homes, construction shortcuts that builders get away with, and Florida’s draw of newcomers who treat every day as a responsibility-free vacation. I got my copy in a “fill a bag with books for $5” library sale years ago and I’ve read it at least 10 times since, although I’ve misplaced that copy and am balking at paying $12 for its Kindle replacement. It’s a great read at nearly 600 pages, so I’ll probably pull the trigger even though I would be happier if Amazon allowed me to lend or gift the Kindle copy after I’ve read it for the 11th time as I did its $0.25 predecessor.


Webinars

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


Sales

  • Virtual care vendor Orb Health chooses Redox to enable access to provider EHRs.

People

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TransformativeMed hires industry long-timer Shawn DeWane (Hayes MDaudit) as president and CEO.

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Mon Health (WV) promotes Mon Health Medical Center Chief Administrative Officer Mark Gilliam to SVP of the health system (he was the health system’s first CIO through June 2021) and promotes Associate CIO Mark Combs, MBA to CIO.

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The city celebrates retiring Huntsville Hospital CEO David Spillers, MBA, who started his healthcare in the 1980s as an IT analyst and then became CIO of Mission Hospitals (NC). 


Announcements and Implementations

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Belma Andric, MD, MPH, chief medical officer at Health Care District of Palm Beach County, celebrates its Epic go-live with a team photo. 


Other

Providence St. Joseph Health Senior Clinical Data Engineer Angelique Russell, MPH lists reasons that sepsis predictive models – like the one offered by Epic – fail:

  • Hospitals don’t equip many of their beds with continuous monitoring technology, so manual vital sign measurement and entry is delayed.
  • Hospitals upcode to maximize revenue, as coders are prodded to find enough sepsis criteria in “rule out sepsis” orders to justify higher bills that may not meet a strict clinical definition of sepsis. Systems that use bill codes for clinical purposes are likely to be unsuccessful.
  • Models developed elsewhere may not be generalizable depending on the other facility’s clinical definition of sepsis and the at-risk populations it treats.
  • No evidence exists to guide sepsis treatment that is predicted hours in advance.

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I don’t usually get involved with open positions, but Community Health Center of Southeast Kansas in Pittsburg, KS is recruiting a CIO. I figured they could use some pro bono help and I’ve got little to write about this holiday weekend, so there you go. Pittsburg is a two-hour drive from Kansas City or Tulsa and you can get a lot of house for the money – a richly detailed 4,000 square foot two-story from the early 1900s is less than $300K. I’ve heard of the town because it has two fried chicken restaurants next door to each other, Chicken Mary’s and Chicken Annie’s (their curious existence spawned a well-received fictional novel called “The Chicken Sisters.”) Anyway, I’ve worked in rural health systems and the opportunity and quality of life can be excellent, so consider your career objectives and whether a CIO job might help you attain them.


Sponsor Updates

  • Intrado’s HouseCalls Pro digital patient engagement platform earns a score of 88.3 out of 100 in a new First Look report from KLAS.
  • Protenus Chief of Staff Sherrod Davis wins a Baltimore Business 2021 Best in Tech Award.
  • Talkdesk launches Talkdesk for Service Cloud Voice on Salesforce AppExchange.
  • Business First Louisville names Waystar CFO Steve Oreskovich to its Best in Finance list.

Blog Posts


Contacts

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

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Weekender 7/2/21

July 2, 2021 Weekender No Comments

weekender 


Weekly News Recap

  • The valuation of process automation vendor Olive reportedly reaches $4 billion following a new $400 million investment.
  • HIMSS announces COVID-19 vaccine verification and masking policies for HIMSS21.
  • The VA reaffirms its commitment to implementing Cerner while awaiting the results of an internal project review.
  • Harris acquires Ingenious Med.
  • Ireland’s health service estimates that the ransomware attack that has kept its systems down for six weeks and counting will cost at least $600 million for recovery.
  • A private equity firm acquires and combines Verisys and Aperture Health.
  • Health Catalyst announces its intention to acquire Twistle.
  • Britain’s Health Secretary Matt Hancock resigns after a tabloid runs photos of him kissing a female executive who he appointed.

Best Reader Comments

Not sure I’d put so much faith in the public market, given Doximity’s IPO valuation of $9B+ for a business not that much different in its fundamentals than the founders’ previous effort (Epocrates) which lost 75% of its IPO value and ultimately sold for ~$250M. But America loves second chances! (Debtor)

Olive’s valuation at $4B is a signal that we’re in the midst of a bubble. They were valued at $1.5B as recently as December 2020. One could argue that the $1.5B valuation was frothy. Now they claim to be worth nearly 3 times that, a mere 6 months later. I’ve seen these companies before: Raise, dilute, raise, dilute, acquire, raise, dilute, acquire, raise. The real test will be if they IPO, what valuation does the market support. The market will be more careful, and do more diligence .., Olive seems like they are somewhere in between an enterprise software company (valuation would be 5-6 times revenue) and a consulting firm (valuation would be 1-2 times revenue). I’ve looked at lost of pure SaaS companies in my day, and Olive does not deserve a pure play SaaS valuation. Unless their revenue is way above what we estimate (even with the recent tuck-in acquisitions), this $4B valuation is an outlier – and in a bubbly way. Too bad they can’t just cash in now (but not from me). (Healthcare VC Guy)

I agree that mortality probably isn’t the best measure of EMR benefit. I also agree that having EMRs, e-prescribing, electronic transmission of lab results and vaccine receipt, and an ability to do a quick pívot to telehealth have all been very important in dealing with the pandemic. I’m less convinced that quality of care has improved in general [with EHRs] and don’t believe that documentation is improved (except for being legible). However, it’s hard to figure out because there are so many confounding factors that were introduced at about the same time … Despite the hype associated with the “learning health system”, much of the data in the EMR is incomplete or inaccurate. This will become even worse with greater propagation of errors through more and more health records with the push for interoperability … Overall EMRs have probably had more benefits than negatives but it could have been and could be so much better if the focus was actually on delivering care and less of the regulatory and payment related impediments. (Clinical N Cynical)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. B in Nebraska, who is in her second year of teaching and, as she says, “still waiting to experience a ‘normal’ year.” She asked for a library of books, organizers, clipboards, earbuds, and supplies for her fourth grade class. She reports, “Our school district is using a unique model this year where we only have half of the students in-person at one time. The other students are learning at home through pre-recorded videos made by the district. The headphones allowed my students to listen to their instructional videos in peace, without any loud interruptions. The books that were provided to my students absolutely LIT UP my kiddo’s faces! They loved being able to have books of their own, since we can’t share books through my classroom library.”

NBC News covers the medical care obstacles faced by people who are too large to fit in a CT scanner or hospital gowns. One woman can’t have a cardiac ablation procedure for fibrillation because she exceeds the surgical table’s weight limit and she can’t get an MRI for the same reason, leading her to unsuccessfully to seek testing from veterinarians whose machines are sized for horses and cows.

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This is for the programmers out there. A woman’s last name of True locks her out of Apple ICloud, which mistook it for a Boolean value when she mistakenly failed to capitalize it. For disco and 1970s porn fans, her first name isn’t Andrea.

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A North Carolina nursing home suspends a nurse whose TikTok videos featured her joking about mistreating patients. She says she’s a victim of “cancel culture” since “all my videos are comedy skits.” Her GoFundMe to raise $20,000 for legal fees has yielded $170.

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A closed hospital that has been called “Kentucky’s second most haunted place” is listed for sale, with the former Hayswood Hospital (built in the early 1800s as a school, expanded to its current form in 1925, and opened as a hospital in 1931 that closed in 1983) featuring 80,000 square feet on nearly 3 acres. Locals say the building is not only full of ghosts and trespassers from outside the state hoping to spot them – especially in its former morgue on Halloween — but also asbestos that will cost $3 million to clean up to the point the $800,000 building can be torn down.


In Case You Missed It


Get Involved


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Morning Headlines 7/2/21

July 1, 2021 Headlines No Comments

Olive hits a $4 billion valuation with $400 million of capital led by Vista Equity Partners

Process automation vendor Olive raises $400 million in a funding round that values the company at $4 billion.

Tendo Systems Secures $50 Million to Accelerate Digital Engagement Between Patients, Clinicians, and Caregivers

Tendo Systems raises $50 million in a Series B funding round, valuing the healthcare digital engagement platform vendor at $550 million less than a year after its founding.

Osmind Closes $15 Million Series A Round to Help Clinicians and Researchers Bring Innovative Mental Health Treatments to More Patients

Neuropsychiatry-focused EHR and research company Osmind raises $15 million in a Series A round led by Future Ventures.

News 7/2/21

July 1, 2021 News 5 Comments

Top News

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HIMSS will offer HIMSS21 attendees three options for proving that they have received COVID-19 vaccine, which is required for picking up their conference badge and entering the conference venue:

  1. Install the Clear Health Pass app and either link to their vaccine provider’s records or upload a copy of a CDC-issued vaccination card. This option is not available for attendees from outside the US.
  2. Book an appointment to show paper or digital vaccination record in a virtual call with a Vaccine Concierge, who will then email a verification card for printing or displaying on a mobile device. Appointments for the video calls will be available weekdays starting July 12.
  3. Bring paper or digital vaccination records to the conference and have them reviewed on site at one of four Vaccine Verification Centers.

Other safety procedures:

  • Attendees will not need to show vaccine-related records once they have picked up their badge.
  • Mask-wearing won’t be required.
  • HIMSS has eliminated its previous requirement that presenters wear face shields.
  • Exhibitor staff will need to pick up their badges individually since they will be required to provide proof of COVID-19 vaccination.
  • COVID-19 testing will be offered on site.

Reader Comments

From Servile Pleaser: “Re: HIMSS21. Any updates?” We’re just about five weeks out, it’s 110 degrees every day in Lost Wages, and the enthusiasm I’ve seen mostly comes from excessively exuberant amateur podcasters and video-makers who can’t wait to clog up the exhibit hall aisles with self-important “broadcasting” that nobody will actually consume. Exhibitor count has improved to 626, about half the usual number. I usually get many dozen HIStalk sponsors providing their information for my HMSS guide, but so far I’ve received submissions from just five companies (the last chance to be included is at hand – submit your information here). I’m dreading going, but happy it will likely be far from the usual grueling marathon – I’ve rearranged my travel to leave on a Thursday night redeye to minimize my time in Las Vegas.

From Grammar-Minded Lad: “Re: Bill Cosby getting off on a ‘technicality.’ Wondered what you think about the use of that term?” Labeling a controversial but legally supported decision as being due to a “technicality” or a “loophole” is an insidious way for news organizations to pander to armchair experts who think they know more than actual experts (i.e., just about anyone who uses Facebook or Twitter and will obligingly click an inflammatory link). Our democracy is built on technicalities and loopholes, such as reading a suspect their rights even though they’ve heard them on TV a thousand times. Both are, by definition, legal and thus ethical. I’m skeptical that high-horsers who claim they would not personally take full legal advantage of tax or criminal laws that would give them huge personal benefit. As has been said way too many times, don’t hate the player, hate the game.


HIStalk Announcements and Requests

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Welcome to new HIStalk Platinum Sponsor EZDI. The Louisville, KY-based company offers a cloud-based, AI-powered integrated clinical documentation and medical coding platform (computer-assisted clinical documentation, computer-assisted coding, computer-assisted coding compliance, comprehensive data analytics, and clinical NLP APIs). Its computer-assisted coding platform earned the top overall KLAS score of 92.5 among competitors. Its clinical NLP APIs extract meaningful clinical entities (problems, procedures, modifiers, lab data, etc.) from structured and unstructured data such as physician notes, clinical reports, and lab reports for use cases such as risk adjustment, prior authorization, fraud detection, semantic search, clinical trials management, population health, and predictive analytics. Thanks to EZDI for supporting HIStalk.


Webinars

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


Acquisitions, Funding, Business, and Stock

Process automation vendor Olive raises $400 million in a funding round that values the company at $4 billion. The company says its products are being used in 900 US hospitals.

Netsmart acquires post-acute care reimbursement and quality measures analytics vendor SimpleLTC.

Virtual musculoskeletal pain physical therapy vendor Sword Health raises $85 million in a Series C funding round.

Tendo Systems raises $50 million in a Series funding round, valuing the healthcare digital engagement platform vendor at $550 million less than a year after its founding. The company’s website is maddeningly vague on exactly what it is selling.


People

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Lawrence General Hospital (MA) promotes Gerald Greeley, MHA to CIO.

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NThrive names Hemant Goel, MBA (Capsule Technologies) as CEO and James Evans, MBA (ESolutions) as CFO.

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Bryan Wolf, MD, PhD retires from a long career at Children’s Hospital of Philadelphia and Penn’s medical school that included years as CIO and chair of the department of biomedical and health informatics.


Government and Politics

VA Secretary Denis McDonough reaffirms its commitment to its Cerner implementation as a review of the project concludes, indicating that any changes to the VA’s program will be announced within two weeks.


Privacy and Security

Google asks a California federal judge to dismiss a proposed class action lawsuit that claims the company’s COVID-19 free contact tracing app – which it developed with Apple — exposes the confidential information of Android users. Google says the plaintiffs are making theoretical arguments related to storing contact tracing data in Android system logs, which it says has never resulted in an actual exposure of information. Google cites previous rulings that information must be viewed to violate someone’s privacy and that California privacy claims must allege that information was wrongfully disclosed.


Other

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Screenshots have been leaked by supposed early testers of the Google Health medical records management app, Android’s equivalent of IOS-only Apple Health Records.

The New York Times reviews the roughly 80 medical schools – most of them for-profit — that operate from the Caribbean, noting that 60% of their graduates are chosen for US residencies versus 94% of graduates of US schools. The Educational Commission for Foreign Medical Graduates will stiffen school accreditation requirements by 2024 and has already banned certification of graduates of two Caribbean schools.

Interesting: IBM employees report a multi-day loss of access to emails and calendars after the company’s attempt to convert from an old version the Notes platform it formerly owned. IBM sold the former Lotus Notes and Domino to India-based HCL Technologies awhile back, then decided to migrate off that platform because its employee email data would have been stored in that country.


Sponsor Updates

  • Summit Healthcare publishes a new client use case, “Cottage Hospital Improves Physician Relationships, ROI, and Secure Data Exchange with Summit All Access.”
  • Glytec publishes the largest descriptive analysis of adult T1D patients with and without diabetic ketoacidosis treated with insulin management software.
  • Goliath Technologies publishes a new case study, “Universal Health Services Uses Goliath to Prevent EHR and VDI Logon Issues.”
  • The How AI Happens Podcast features Gyant co-founder and CEO Stefan Behrens.
  • Halo Health publishes a new case study, “Improving Clinical Communication and Collaboration at Great River Health System.”
  • Jvion’s clinical AI wins a Globee in the 2021 IT World Awards.
  • Optimum Healthcare IT adds Robert Morris University as a partner in its CareerPath program.
  • Medicomp Systems releases a new Tell Me Where It Hurts Podcast featuring Amy Gleason, project lead at the US Digital Service.
  • Pivot Point Consulting publishes its Q3 healthcare insights and trends report.
  • Meditech customers receive top hospital safety grades from the Leapfrog Group.
  • HealtheConnect Alaska renews its contract with NextGate for patient identification and statewide data exchange.

Blog Posts


Contacts

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

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EPtalk by Dr. Jayne 7/1/21

July 1, 2021 Dr. Jayne No Comments

Patient engagement is a hot topic. I’m glad to see organizations really starting to think through how patients of different ages, educational statuses, and technical abilities can interact in the digital health world. Organizations that think that everyone can just “use a smart phone” are likely missing out on a good percentage of the population that either doesn’t want to interact that way or who lack the skills (or confidence) to try. I was pleased to see a Kaiser Health News article covering the topic. It starts with a vignette of a person who bought a computer to email and Zoom with her great-grandchildren, but she ended up never taking it out of the box because of concerns around setup and lack of help.

The article cites some good data from AARP about the number of seniors needing help with technology. I’m far from senior status, but I admit that some new technologies leave me baffled, even as a clinical informaticist. Sometimes what 20-something UX designers feel is intuitive isn’t so easy to use for those who don’t share a common digital experience. Also, depending on people’s learning styles there are many of us who prefer to read a manual or follow a tutorial as opposed to just experimenting around with something and hoping for the best. I am being forced by my wireless carrier to upgrade my phone (despite the fact that it works well for me and does everything I need it to do) and am honestly dreading the process. It’s supposed to be seamless but never is, at least in my experience. I have until February to get it done though, so wish me luck.

For those patients who are tech savvy and want to interact through text messaging or video calls, a recent study looked at those modalities for case-managed patients living with HIV. The sample size was small, but both patients and providers were in agreement that text and video interaction was desirable. Convenience was a positive, but cost and access were potential barriers to adoption. As one might expect, “some providers were concerned that offering text messaging could lead to unreasonable expectations of instant access and increased workload.” The authors concluded that overall, both patients and providers found value in expanded lines of communication, however, “taking both perspectives into account when using implementation frameworks is critical for expanding mobile health-based communication, especially as implementation requires active participation from providers and patients.”

Speaking of telehealth, the state of Florida’s executive order declaring a public health emergency expired on June 26, decreasing telehealth flexibility for Florida residents. Phone-only visits are no longer acceptable for delivering services to non-Medicare patients, physicians can’t use telehealth to prescribe controlled substances to existing patients for chronic non-cancer pain, and telehealth can’t be used to recertify patients for medical marijuana. Additionally, out-of-state physician and nurses can no longer treat Florida residents without a specific Florida license, which they’ve been able to do for the majority of the COVID-19 pandemic. As of July 1, Medicaid behavioral health services will be limited in frequency and duration, and by July 15, prior authorization requirements for those services will go back into effect.

Parts of my state are being hammered by continued COVID-19 outbreaks and hospitals are again stressed, but I guess things are just fine in Florida. They might be an outlier, though, because The Commonwealth Fund notes that 22 states have changed their laws or policies during the pandemic to increase coverage of telehealth services. There are a variety of changes that states have made, including coverage of audio-only services (18 states added this for the first time, for a total of 21) and 10 states created payment parity policies. The report concludes that not all patients have benefitted from telehealth, with usage being lower in economically disadvantaged areas and by patients with limited English proficiency.

The fragmentation of care from state to state will continue as long as we don’t have a national health policy or robust public health infrastructure, and I’m not sure that Congress will have the wherewithal to address the inconsistencies. Time will tell whether telehealth really bends the cost curve or whether it can lead to improved clinical outcomes, but we won’t be able to measure those potential changes unless we commit the funding to study them. Based on some of the behaviors I’ve seen over the last couple of weeks, people think we are completely out of the woods with the pandemic, and I’m not convinced that public health efforts will continue to have the visibility or the funding that they deserve.

A recent study by my friends at Regenstrief Institute, Indiana University, and the US Department of Veterans Affairs shows that EHRs are failing to deliver on their promise for improved primary care. Ambulatory physicians are struggling to make sense of fragmented data that fails to show a comprehensive view of the patient. The authors reviewed numerous studies that describe misaligned EHR workflows, usability issues, and fragmented communication that make it difficult for physicians to achieve situational awareness. They conclude that more user-centric design processes could improve the situational awareness, satisfaction, and decision-making capabilities of primary care physicians.

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HIMSS has announced more details related to its COVID-19 vaccination requirements. Participants will have to complete a two-step validation process prior to picking up their badges. Step One involves obtaining Clear Health Pass Validation, Safe Expo Vaccine Concierge Validation, or Safe Expo On-Site Validation. Step Two involves bring proof of one of those validation options, along with a photo ID, to the registration area for badge pickup. HIMSS notes that links to the Clear and Safe Expo validation options will be provided in early July. Given that many of us in healthcare have hastily scrawled and often handwritten vaccination cards, I’m not sure how this is going to go. If you’ve been through either of the validation processes, I’d be interested to hear about your experiences.

Regarding masking, the HIMSS21 guidance states: “Masks will be supported but not required on the HIMSS21 campus.” Every year I come home from HIMSS with a nasty cold, which COVID-19 vaccination will not prevent. Based on the fact that there are plenty of non-COVID viruses circulating freely in the population due to reduced masking and increased mingling, I’ll definitely be wearing a medical grade mask, possibly with something decorative over the top.

Should fancy masks be the new fancy shoes at HIMSS? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 7/1/21

June 30, 2021 Headlines No Comments

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MDI Health announces $6 million seed round, launches personalized AI medication platform

Medication management startup MDI Health secures $6 million in seed funding and announces GA of its AI-powered prescription decision support software.

VA’s McDonough reaffirms commitment to Cerner records management platform

VA Secretary Denis McDonough says the department’s review of Cerner implementations has concluded and that a timeline for remaining implementations will likely be available in mid-July.

Sword Health closes on $85 million Series C for virtual MSK care

Digital physical therapy company Sword Health raises $85 million in a Series C round of funding led by General Catalyst.

HIStalk Interviews Sonny Hyare, MD, CEO, ReMedi Health Solutions

June 30, 2021 Interviews 2 Comments

Sonny Hyare, MD is CEO of ReMedi Health Solutions of Houston, TX.

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Tell me about yourself and the company.

I was born and raised in Houston, Texas. I did my undergrad degree in Europe and then started medical school. I finished up my medical training in Chicago. I’ve been in the EHR space for about 11 years now. I worked for some pretty big consulting companies through 2017 and then started ReMedi Health Solutions, so we are five years in now.

What post-pandemic changes are you seeing with the company and its customers?

When the pandemic hit, we saw everything change, either going virtual or shutting down certain aspects of what was happening in the hospitals. Rightfully so, because of everything that was happening, especially with some of our clients in the Northeast that were being hit with COVID a lot harder than we were down south at that time. What I saw was quick adoption of tools that already existed. I didn’t see anything new come up. I just saw a bunch of people take platforms or technology stacks, put them together, and create what they needed. 

Post-pandemic, we assumed that we would have a hybrid model, or even not going back at all to what the norm had been. But I feel like we are getting more back to normal than we had originally anticipated. Some of the workforce wants to be back in the office. They’re trying to get out of the space that they’ve been in for the last 18 months. People are also seeing a different type of productivity versus at home or in the office.

Many health systems are operating under a budget that was created during the pandemic’s bleakest times. Are they reconsidering their priorities or just making it up as they go?

A little bit of both. They were making it up as they went, but now I l feel like the budgets are coming back into the plans they originally had. It is all coming back as if it hadn’t taken that 12- to 16-month pause.

How do you combine the value of a remote go-live with the benefit of having people wandering the halls looking for puzzled or frustrated clinicians who probably won’t open a help desk ticket?

That’s one reason that our virtual model includes a live video feed. It gives the feeling that somebody is there. But your example is why we need some folks to be on ground. We need this hybrid model to engage the physician who we won’t find sitting on a computer or being in a newsfeed, where you could see frustration in any end user. The live feed makes sure that we maintain that emotional connection, but you could have five tablets with one resource supporting all five of those clinics at the same time. The support model will definitely change post-pandemic, and instead of bringing 1,000 resources, you figure out how to bring in a hybrid model of on-site versus remote.

Are you seeing health systems that are worried less about physician EHR satisfaction and instead see the EHR as a way to implement corporate decisions that may take away individual physician choice?

I do see it, but I’m also seeing  more physicians getting involved in the administrative side of things, making sure that the right decisions are made for the physicians. That was one of the reasons we came about — we essentially understood both sides of the playing field. It was our job to be that liaison, to help the physicians understand why these decisions were being made from an administrative level. Then on the flip side, help explain to the administrative side of things of why physicians needed certain things.

It is getting harder for physicians to what they need, but it’s also getting more complicated on the IT side as well, where you see both sides of the story.

Are you seeing physician EHR dissatisfaction that is driven by local implementation decisions rather than core product design?

That definitely is one of the reasons. Sometimes what I see, and have seen in the past, is having the knowledge of what the tool can do and how it can drive the efficiency that we are all trying to achieve. Sometimes it starts as simply as that. We’ve seen this across the board. You don’t know what you don’t know. Physicians who I’ve known and worked with have dug into these systems over the last decade and could probably answer any question that a physician might have on what and how they need to do something. They have the inefficiencies in both ways.

When we talk about certain changes, we know there’s a lot that goes behind getting something changed like that. Nine out of 10 times, the physicians will be satisfied, but they just don’t know how to do it. That comes back to, are we talking about training, or upgrades, or new additions? These systems have the capability of doing a lot more than the way the physicians are using them now.

Health systems have said in various recent KLAS reports that they wish their software vendors would take a more active role in telling them how to implement and optimize their systems. Are you seeing more demand for a prescriptive approach that takes advantage of broad vendor experience?

Absolutely, and it makes sense. Why would we not explain these certain milestones or scenarios in the implementation in a better way? We were working with a client 18 months prior to them hitting the switch on the EHR that they had selected. The EHR vendor had a list of items that they were going to run through, but at the end of the day, there was no explanation or details in what needed to be done. Some of these bullet points were engagements that would have taken one or even two months. That is misleading the client.

The consulting company and the EHR vendor have to help them guide and understand the decisions that they are making to maximize satisfaction as a whole for everyone. Not only the end users, but the people who made the decision to bring that EHR vendor in.

Are metrics used to identify users who are struggling or functions that aren’t being used optimally?

We live in a data-driven world. Every metric and every data point that we can grab helps us make a better decision. It helps us explain to our clients, as well as to the vendors, why and how this is happening and how we can mitigate the issue. I don’t look at it as a ticket, but something more detailed than that, that has helped us get success. We have to collect information from one-on-one sessions and at-the-elbow support to get a bird’s eye view and understanding of what’s actually happening.

What changes do you expect to see in the company and in the industry over the next 3-5 years?

Three to five years ago, I thought all of this implementation and conversion activity was going to end. But it seems to be constant due to mergers and acquisitions and systems deciding to replace or upgrade software. We may see the same types of engagements in 3-5 years that we are seeing now. I only hope that we are getting better and better as a whole, the EHR vendors, the hospital organizations, and the consulting companies. How can we make this process better for the actual end users who are going to be using these systems on a daily basis? Can we get rid of the term physician burnout?

Do you have any final thoughts?

We are thankful where we’ve gotten to over the last five years. We’re thankful for all our clients that have trusted us. We are still working with our first client, all the way until our last client. Our firm appreciates that, knowing that we’re giving the value that we said we would. For that, we are thankful for the hospitals that took a chance on us.

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Reader Comments

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