Best Buy will acquire home monitoring platform vendor Current Health, which raised a $43 million Series B round earlier this year.
Co-founder and CEO Christopher McCann will remain with the company. He completed a master’s in computer engineering and left medical school in Scotland to start the company in 2015 with his co-founder and CTO, who had just completed a PhD in computing science.
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.
Acquisitions, Funding, Business, and Stock
Cerner President and CEO David Feinberg, MD. MBA kicks off the virtual Cerner Health Conference with a call to “eliminate the noise in healthcare” by getting the right information to the right people at the right time. He mentioned the essential clinical dataset, defined by 12 Cerner clients in 2016 as the EHR data elements that are essential for providing quality care.
CDC will use HealthVerity’s privacy-protected data exchange to develop a real-world dataset for projects related to COVID-19, viral hepatitis, and HIV.
Andrea Marks (UnitedHealth) joins Walmart as VP of clinical performance, overseeing the clinical data and analytics team.
Announcements and Implementations
MSU Health Care (MI) leverages remote Care Everyday patient monitoring technology from Higi as part of its RPM program for patients with chronic conditions.
Government and Politics
Rumors of an enterprise Epic implementation across the NHS in England begin swirling after NHS England Director of Transformation Ian O’Neil attended “high-level meetings” with Epic CEO Judy Faulkner. Adding flame to the fire of speculation is the fact that Tim Ferriss, NHS England’s new head of digital transformation, comes from Massachusetts General Hospital, which rolled Epic out in 2016.
In Canada, Newfoundland and Labrador’s COVID-19 vaccine passport system crashes just a few hours after launching due to overwhelming traffic. At one point, 600 QR codes were being downloaded every minute to the province’s NLVaxPass app.
Netsmart VP and GM AJ Peterson and customers present at the American Health Care Association/National Center for Assisted Living 2021 Convention and Expo through October 13 in Washington, DC.
Istishari Hospital in Jordan selects Wolters Kluwer Health’s UpToDate and Medi-Span Clinical clinical-decision support tools.
CareSignal publishes a new case study featuring The Andrews Center, “High-Touch Care: Remote Patient Monitoring for Mental Health Identifies Potential Crises Ahead of Time.”
CHIME awards 10 healthcare organizations the highest level of its Digital Health Most Wired Survey.
Early in my informatics career, I worked on a health information exchange project. It was during the early days of HIEs, and many of the challenges were legal and operational as opposed to technical. We had to wade through the minefield of consent, debating opt-in versus opt-out models within the confines of the laws of multiple states. We also had to address access issues, decide when break-the-glass functionality could be used, and create policies and procedures around auditing access to the data and ensuring appropriate use. Only once those thorny issues were settled could we begin to define the clinical data sharing model and determine what information would be shared from what sources.
We then had to work through the technical issues. We had to decide whether we wanted ambulatory office visits to automatically query the HIE versus whether providers would have a manual trigger to prompt data sharing. We had to address hosting issues as well, along with the pure limitations of the product we had, since we had purchased our solution from a company whose strategy was still evolving. There were dozens of interfaces to evaluate and integrate, and we had to create a solution that would provide immediate value while not breaking the bank, buying ourselves time to bring up the rest of the data feeds. The big draw for our solution was its ability to allow providers to incorporate discrete data from the HIE into their charts so that they could use it instantly within the context of the patient encounter.
We didn’t necessarily see them coming, but many issues we faced though turned out to be political in nature. Unknown to us, the CIO of the health system with which our physician group was affiliated had his own HIE plans, and they didn’t involve us. He had secured funding for his own HIE and had crafted a strategy without any input from the thousands of ambulatory physicians who were clamoring to be connected. His solution was more of a viewable repository that was document based rather than enabling the exchange of discrete data. The last thing our physicians wanted was to have to sift through textual information and then perform data entry tasks in order to incorporate that information in their own records, so you can guess whose solution was more popular.
Needless to say, he spent a lot of his time trying to kill off our project. Not only would our HIE concept provide more value, but we were planning to deploy it for a fraction of the cost of what he had planned. He also wasn’t terribly fond of having to work with physician informaticists, let alone one who was relatively young and decidedly sassy.
Since we were technically independent despite the affiliation, we pressed ahead and implemented quickly, helping physicians from day one. Our most valued feature was assisting in reconciling medication lists from different sources and identifying patients who might be seeking controlled substances from multiple physicians. Other solid features involved supplying data for problem and diagnosis lists as well as laboratory and biometric data.
Although I moved on before our little HIE reached maturity, I still regard it as one of the best projects I ever worked on, and also the most educational for me as a clinical informaticist. I learned more about discrete data, interfaces, and interoperability in those months than I probably did in the first five years of my career. In the early days of data normalization, I also learned that laboratory directors don’t like it when outsiders find problems with their data, and if you’re going to question senior physicians who are twice your age, you had better come ready with plenty of facts and examples because it’s going to be difficult to convince them that their system isn’t perfect.
Since then, I’ve kept my eye out for interesting HIE stories and have enjoyed seeing how exchanges have evolved over time. Although many of the technology issues have stabilized, there are a host of challenges that are both operational and financial. A Brookings Institution blog post caught my attention last week. It reviewed some of the digital transformation that has occurred as a result of the COVID-19 pandemic, including increased adoption of telehealth and the rise of healthcare technology startups and retail healthcare.
The authors note that the transformation is also impacting the health information exchange world, raising questions about how HIEs fit into the larger healthcare ecosystem. Where traditional HIEs typically involve data exchange among physicians and hospitals, there is a growing need to incorporate data from a multitude of other sources. Since many of the newer players, including retail clinics, involve large national organizations, there is motivation for them to maintain their own medical records without necessarily having to integrate with traditional provider or hospital organizations.
Additionally, given functionality required by federal incentive programs, patients now have a greater ability to view, download, and transmit their own health information. The authors note that new features such as Apple’s iOS Health Records functionality allow patients to communicate more directly with their physicians. However Epic, was not included in the Apple implementation. They summarize, “Not only can these companies choose which HIEs to work with, but they disrupt the original purpose of HIEs, which was to centralize medical care for improved efficacy of patient care.” This means that HIEs may need to play a new role in the marketplace, and the authors list strategies for HIEs to try to remain relevant:
Diversify network members and data types to stay relevant.
Include knowledge discovery in their focus.
Work horizontally and vertically to meet patients and providers where they are.
These are certainly important points. HIEs are going to need to widen their user base and make sure they stay current in understanding the needs of their constituents. HIE use cases have gone far beyond catching patients who are seeking duplicate prescriptions (most states have prescription drug monitoring programs for that now) to providing opportunities for analysis of broad aggregations of patient data that could provide valuable information for public health as opposed to being merely push/pull platforms. In the third point, the authors propose that HIEs consider mergers and acquisitions to expand in similar service lines, such as collaborating with HIEs in neighboring states, where vertical integration would allow them to better integrate with their current data suppliers and consumers or add stakeholders such retail healthcare providers.
The authors also note that further HIE growth may be limited by other factors. These include concerns over patient privacy and worries about increased regulation.
For the latter, there are concerns that charging a fee for data exchange might be construed as information blocking, so there are plenty of issues to resolve there. I’d also mention that they need to worry about cyberattacks and maintaining adequate financial resources to ensure solvency.
In our current environment, they also need to be wary of becoming embroiled in political controversies. For clinicians, sharing vaccine information through HIEs has been a tremendous benefit and allows us to have complete records on pediatric patients and avoid giving duplicate immunizations. In our polarized political climate, I wouldn’t be surprised to see certain states try to make it illegal for healthcare organizations to share COVID-19 vaccination data.
HIEs have always had tremendous potential, but the road to success has been a rocky one and there have been quite a few failures along the way. I’m hopeful that the current generation of HIE leaders understands the challenges and that those leaders are getting creative about ways to ensure longevity and a bright future.
What role do you see for HIEs in the coming years? Leave a comment or email me.
In recent years, the importance of incorporating social determinants of health (SDOH) — the conditions, circumstances, and environmental factors that influence health outcomes — into care delivery has risen to priority status.
Most providers understand that patients with limited access to healthy food, safe living quarters, and income security are higher risk for realizing poor outcomes. They’ve read studies that suggest that SDOH accounts for as much as 90% of an individual’s health.
But although awareness of SDOH’s role in overall health has increased, far too many providers lack actionable knowledge of how to help.
A recent American Academy of Family Physicians (AAFP) survey indicates that 80% of family physicians feel they don’t have adequate time to discuss social determinants during routine consults, and 64% say they lack the staff or resources to do anything even when they identify risk factors.
Therein begs the question facing providers in 2021 and beyond: What can physicians do to improve identification of poor SDOH and do a better job of engaging high-risk patients?
In a recent memo unveiling its Healthy People 2030 initiative, HHS included a list of SDOH that need to be addressed in order to significantly improve quality of life for all Americans. These include everything from racism and domestic violence to polluted air and lack of job opportunities.
Yet many of these underlying social determinants remain unseen during a routine visit and difficult to gauge. The reality is that SDOH often go underreported because physicians are trained to treat acute physical issues, such as an earache, urinary tract infection, or broken arm.
Consequently, opportunities are missed. For example, consider a pediatric asthma patient who is treated only for their condition without insight into their living conditions. If parents are smokers or high levels of air pollution exist, they may be more likely to develop serious respiratory disorders later in life.
Lack of time is another challenge. The US medical system is still largely volume-driven, with the demands for doctors exceeding supply in some areas. With only 15 minutes to interact with a patient for a sick visit on average, providers are less likely to prioritize asking about socio-economic issues or risk factors, epecially since there are likely patients in the waiting room with acute needs.
Referrals to social workers help, but what providers truly long for is a better way of identifying SDOH and the ability to contribute toward improving patient health in a more impactful, meaningful way.
On the positive side, more recent efforts on the regulatory and technology front are beginning to address barriers. In late 2020, the National Committee for Quality Assurance (NCQA) proposed introducing race and ethnicity stratification into select HEDIS measures, with the goal “to advance health equity by leveraging HEDIS to hold health plans accountable for disparities in care among their patient populations.”
Time, staff engagement, and cost can be deterrents for meeting health equity goals for organizations of all sizes. To that end, the Department of Health and Human Services is offering free training with some excellent benefits for staff with professional licenses, such as free continuing education credits required for ongoing licensure.
In December, The Gravity Project, a community-led HL7 Fast Healthcare Interoperability Resources (FHIR) Accelerator, unveiled an EHR implementation and recommendation guide for SDOH data and terminology, which emphasizes food insecurity, housing challenges, and access to transportation.
However, most EHRs used by healthcare providers aren’t loaded with pathways that can direct a physician to next steps when SDOH challenges are identified.
To do a better job of addressing SDOH, physicians can strengthen the following areas:
Awareness. Knowing which patients are more likely to struggle with SDOH is key to establishing trust. The AAFP’s Social Needs Screening Tool offers sample questions that can be included in an intake questionnaire to gauge the challenges patients encounter on a regular basis. But awareness extends beyond questionnaires. Providers need to consider the impact of outside events such as COVID or the escalation of racism on the communities they serve and how trauma might impact the ability for a patient to access care.
Communication. No small complaint, or comment pertaining to SDOH should go unacknowledged. Physicians and other healthcare stakeholders should engage in more pointed follow-up to determine actual needs. Active listening can encourage a broader dialogue around SDOH and help care partners, such as social workers, connect patients to the most appropriate resources. The ‘Ask me 3” method is an excellent way to engage patients.
Technology. EHRs need to support with care collaboration between multiple care partners in a patient’s ecosystem to ensure everyone is on the same page. They should also be customized to meet the practice’s informational needs, with care pathways that guide physicians in a new direction when needed. For example, if a patient answers the question, “do you have adequate transportation?” with “no,” the EHR should pre-populate other follow-up questions pertaining to transportation access.
With greater commitment to addressing SDOH, providers have an opportunity to engage their patients in new ways and improve their experience. And by leveraging more targeted communications tactics, coupled with smarter technology applications tailored to SDOH, providers are better equipped to improve outcomes and save lives.
The Next Generation of Intelligent Decision Support By Carm Huntress
Carm Huntress is founder and chief innovation officer of RxRevu of Denver, CO.
Research has repeatedly shown that Americans trust doctors more than any other professionals they interact with. But what happens when healthcare providers don’t have reliable data at their fingertips? They may prescribe medications that are not covered under the patient’s insurance. They may send the patient to a lab that is out of network. Or they may order care that is costly and requires authorization from the patient’s health plan. In the blink of an eye, trust in providers can be broken.
What’s needed to maintain trust in our healthcare providers is better data at the point of care. New intelligent systems are necessary that can deliver comprehensive, curated, actionable data to provider workflows so that they can select the most clinically relevant, affordable care options for their patients.
Real-time prescription benefit (RTPB) – one type of decision support tool that brings pharmacy coverage data to EHR workflows – has been adopted by thousands of health systems, hospitals, and clinics across the country. However, some RTPB solutions leverage outdated or static files that are not exact. This has caused providers to lose trust in these tools and has slowed progress toward transparency.
We can no longer accept inferior data and inaccurate processes that prevent us from delivering cost-effective care. Patients and providers deserve better.
By working in lock step, EHRs, payers, providers, and RTPB vendors can deliver prescription data that is normalized, actionable, and valuable. Some examples of how intelligence can be used to enhance this type of point-of-care decision support include:
Real-time delivery. Data displayed must be updated in real time, showing patient-specific cost and coverage information that matches what the claims system would display. This way, patients are not surprised when the find out the actual cost of their care.
Quantity translations. Providers often enter medication quantities in simple terms (inhalers, pills, bottles), but vendors must be able to translate these quantities into those that the payer/PBM can bill for (mL, grams). Otherwise, no prices will be returned.
Better data mapping. While providers are often unaware of the drug codes required to identify each medication prescribed, in order to receive an accurate price, solutions must automatically swap inapplicable codes and convert codes to display relevant information.
Smart filtering. In many cases, solutions display any covered care option. Instead of creating more EHR noise, it is essential that vendors suppress irrelevant alternatives and ensure only meaningful options are shown.
It is the combination of these intelligent features that can create a truly exceptional prescribing experience and drive trust in decision support tools. By augmenting raw patient data with a next-gen intelligence layer, effective decision-making can become the norm.
Delivering prescription data is just the beginning. The industry is quickly moving toward, and providers are often requesting, the transmission of medical benefit data to allow for a more complete picture of patient coverage. With both pharmacy and medical benefit data available, providers can view real-time insights on patient health needs and deliver care in new, meaningful ways.
Technology vendors can no longer meet the minimum delivery requirements for patient coverage and cost data. If they do, providers will ignore data presented to them, and patients will lose trust in their caregivers. However, vendors are leveraging advanced logic to deliver real-time data that is individualized to the patient and intuitive technologies to enable better decisions at the point-of-care. Connecting intelligent systems into payer, PBM, and EHR ordering process allows for visibility into valuable information when it matters most, reducing costs, improving workflows, and getting patients the right care the first time.
Why Patient Control of their Own Data is the Key to Health Equity By Oleg Bess, MD
Oleg Bess, MD is co- founder and CEO of 4medica of Marina Del Rey, CA.
To enable coordinated care, improve patient outcomes, and better manage costs, it is imperative that providers, payers and other healthcare stakeholders share data. This requires interoperability between authorized members of a healthcare network.
But an often-overlooked stakeholder in discussions about healthcare networks and data sharing is the patient, which is ironic given that the patient really is the ultimate healthcare stakeholder. Yet patients often struggle to access even the most basic digital information about their health.
Patients may have multiple providers, each with their own patient portals and login requirements. They may have a provider that “data hoards” to prevent patients from switching to a competitor. Patients may not be able to access all their medical records. Patients particularly struggle to access diagnostic tests from labs, which is a serious problem since diagnostic test results are the most critical information clinicians use when devising treatment plans.
Ensuring patients can easily and securely access their digital health records increases both data transparency and patient control of their personal health information. Beyond the obvious benefits to individuals who are able to view and manage their health information, the increasing ability of patients to control their own health data is the key to health equity on a larger scale. That’s because segments of the population negatively impacted by social determinants of health (SDOH) such as unemployment, no access to primary care, or lack of health insurance most need access to their health information even as they are less likely to have that transparency.
Consider the patient who uses emergency rooms (ERs) as their provider of primary care. As this patient bounces from one ER to another, invariably getting tests, they often are unable to inform clinicians about where they previously were tested or the results. This typically leaves an ER clinician with little choice but to order a new round of tests, some of which already may have been conducted.
More importantly from a clinical view, lack of data transparency and control for patients can be dangerous or even fatal. As an obstetrician-gynecologist, I have seen many pregnant women come into the ER bleeding internally and requiring immediate surgery. If clinicians had access to the patient’s records from recent previous visits to other ERs – where she likely had been tested for human chorionic gonadopotropin (HCG), the pregnancy hormone, or given an ultrasound – they would know whether the patient was having a miscarriage or a ruptured ectopic pregnancy, conditions that require entirely different clinical approaches. This right clinical information in the right hands at the right time literally can save lives.
Data transparency for patients can be a powerful catalyst for improving health equity by empowering people lacking primary care or health insurance to access and manage their data. It will require user-friendly health data apps that enable access to aggregated data. I am confident these apps are coming soon because data transparency for providers and patients are essential to achieving the value-based care goals of improving outcomes while reducing costs.
ONC expands its United States Core Data for Interoperability standards program to enable federal partners like CMS and CDC to establish and use interoperable, agency-specific datasets beyond those available through the initial USCDI program.
The VA hires an independent body to review its Cerner implementation and to provide an estimate of the project’s full cost. It expects to see the results in 12 months.
The VA hopes that the review will finally capture all of its project-related expenses, including infrastructure upgrades that were omitted from previous estimates due to inconsistent cost tracking methods across its organizations.
Conducting the review is Institute for Defense Analyses, a non-profit that administers three federally funded research and development centers.
The most recent cost estimate was $16 billion versus its initial $10 billion price tag.
From Critical Mass: “Re: Optum-Change Healthcare merger. Survey your readers whether it should be allowed and why or why not.” I don’t know that many or most readers have an opinion either way and I question whether a yes-no poll would be enlightening, but feel free to click the Comments link and add your thoughts.
HIStalk Announcements and Requests
About one-fourth of poll respondents have faxed something in the past six months, most commonly to a physician’s office and rarely to a hospital. My own experience matches that of poll comments – don’t even bother trying to enlighten the front desk person why it doesn’t make sense that the practice will accept only faxes while refusing emailed scans that they could print. I think it’s probably as much laziness as anything else since it’s easier to make the sender jump through hoops in trying to set up a free online faxing service while the recipient just occasionally wanders by the fax machine to see what’s new. Office Depot still sells exactly one model of fax machine (a pretty slick Brother for $200) but you would need a plain old telephone line that is increasingly uncommon.
New poll to your right or here: Who is most responsible for physician dissatisfaction? Remind me to run the same poll for nurses next week.
It’s nearly that time of year when I should be registering for HIMSS22 and booking somewhere to stay, but I have to say that the lackluster HIMSS21 makes me at least consider bailing for the first time in many years.
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.
In Portugal, Unilabs chooses Sectra’s enterprise imaging solution.
Colombia’s Clínica Imbanaco joins the TriNetX global health research network.
SSM Health will outsource technology-focused inpatient care management, digital transformation, and revenue cycle management to Optum, rebadging a reported 2,000 SSM Health employees.
Heather Nelson, MHA (University of Chicago Medicine) joins Boston Children’s Hospital as SVP / CIO.
Memorial Healthcare System (FL) promotes Jeffrey Sturman, MHA from CIO to SVP /chief digital officer.
GE Healthcare promotes Catherine Estrampes, MBA to president and CEO of US and Canada.
Announcements and Implementations
China’s largest retailer, JD.com, extends its telehealth services from humans to pets. JD Pet Hospital has signed up 3,000 veterinarians who provide 24×7 online consultations and connect users to in-person providers. The company says it will attempt to solve problems such lack of industry standards, price transparency, and availability of timely services.
I took a look at productivity software Notion after reading that the company’s valuation has reached $10 billion, bolstered by viral TikTok videos by users – many of them of Generation Z – who are happy to have a minimalistic team workspace tool for remote work. I don’t know how it stacks up against its many competitors, but it looks interesting. The personal version is free and a team edition is $8 per user per month.
Diameter Health names former Anthem BCBS executive Jill Hummel to its board as an independent director.
CHIME announces incoming board members and 2022/2023 board officers.
Virgin Pulse announces that it will acquire Welltok.
Healthcare Triangle revises its $40 million IPO plans down to $21 million.
Carbon Health acquires remote patient monitoring tools vendor Alertive Healthcare.
Evolent Health acquires Vital Decisions.
Cerner launches RevElate, which will be its single go-forward patient accounting system.
Three large health systems launch Graphite Health, a non-profit that will help member organizations with digital health solutions.
Quality measurement and clinical intelligence platform vendor Apervita shuts down.
David Feinberg, MD, MBA takes the helm as president and CEO of Cerner.
Cerner, reversing its previous position, will require US employees to be vaccinated by December 8.
Best Reader Comments
If all that Jobs + Woz had done had been the Apple I & II, they would have been important. Add in the Mac and they became industry leaders. Now add to that the iPhone, iPod, Apple Music, iPad, and more. Jobs also had those interesting side projects of NeXT and Pixar. Thank goodness that Jobs didn’t fade away during Apple’s low point in the 1990s. (Brian Too)
Many people, especially those with serious mental illnesses, have very brittle illness, just like a brittle diabetic. No one would think of terminating a brittle diabetic from care just because their glucose levels are under control by one or more glucose measurements. So why are we even discussing the “benefits” of “measurement based care” in making quicker transitions and terminations of care for those with psychiatric disorders for whom we know that a stable consistent therapeutic alliance is just as important (if not more so) than in other clinical contexts. Perhaps, in addition to the other barriers to using patient reported outcomes in mental health treatment, clinicians are being understandably cautious in trying to protect their patients from even greater harm and outright discrimination and victimization by insurers and others. (Concerned clinician)
I don’t know anything about Apervita, but it seems like an extremely consulting heavy business, one that wants to be product-like. In my idea of consulting’s business model, lots of senior rock star consultants are the exact opposite of what you need for product-based consulting. Implementing quality measures seems very similar to the most common type of consulting business: implementing new accounting practices and performing accounting audits. The big accounting firms know that this work does not require rock stars. It requires a few senior people to sell to the C suite and verify juniors’ work, and it needs an army of juniors to do piles of grunt work for a manageable cost, which in turn necessitates a hiring pipeline so you always have a fresh crop of juniors to replace the attrition of juniors aging into seniors, being poached, or otherwise leaving. The most successful companies in the accounting consulting market are the ones who are the best at hiring and managing lots of juniors. (IANAL)
I tend to refer to HR, legal, and marketing as the “pink ghetto.” It’s unfortunate, really. It’s difficult to be CEO when you haven’t been responsible for P&L. (Pamela)
Will having someone with informatics experience directing the Joint Commission make it more or less likely that they will continue to (1) Demand more EHR documentation that doesn’t help patients but burns out clinical staff; (2) Require use of “evidence based” scales for which the evidence of actual benefit is weak (e.g. C-SSRS); (3) Terrorize organizations with the threat of impending visits while they are just trying to stay ahead of a raging pandemic. Yes, I understand that the Joint Commission is just doing what CMS tells them to audit, but it’s also clear that they have a neat little racket going, frightening organizations into paying for their consulting services in the hope of not getting dinged in the next visit. Has anyone actually examined the evidence that the CMS conditions of participation and the other Joint Commission requirements are actually worthwhile? Perhaps health care organizations should band together and just say no to JCAHO. (Joint question)
Watercooler Talk Tidbits
Readers funded the Donors Choose teacher grant request of Ms. C in North Carolina, who asked for headphones and teacher motivational stamp for her combined kindergarten and first grade class. She reports, “Thank you so much for your generosity to our classroom. Our school has IPads that our students use for independent reading and lessons. With kindergarten and first grade students, they are able to have the iPad read aloud to them. Unfortunately it becomes very disruptive for the students to focus on their lesson when the student next to them is listening to a lesson. The headphones allow the students to focus on their own lesson. Focusing on their own lessons and reading will allow them to be more successful in the classroom.”
A Virginia woman’s tweet earns puzzlement and scorn for the US health system from Twitter users in other countries who understandably misinterpret the hospital’s charge description for CPT 96127, a short mental screening questionnaire whose full description is “brief emotional / behavioral assessment.” Those Twitter users are directionally correct in their brief emotion at how our health system differs so wildly from theirs and the rest of the civilized world – a company has turned CPT 96127 into a business by selling quiz software that doctors can use to generate up to four of the charge items per patient visit.
Federal agents arrest 18 former professional basketball players who are charged with defrauding the NBA out of $4 million by submitting fake medical claims for reimbursement. They were caught because of mistakes they made in creating the claims, such as one player claiming that he had dental work in Beverly Hills during a week he was playing in Taiwan. Others may have recalled their college days when they copied each other’s claims, with multiple players declaring that they had the same dental procedures performed on the same six teeth on the same days.
A St. Louis children’s hospital doctor follows through on her promise to a nine-year-old with aplastic anemia that if a bone marrow transplant caused the girl’s hair to fall out, she would shave her own head. She even let the patient do the honors.
Member engagement and wellness app vendor Virgin Pulse will acquire Welltok, which offers analytics-powered multi-channel healthcare communications.
Virgin Pulse, which has made several acquisitions, is owned by Morgan Equity Partners, which was reportedly shopping for a buyer for the company in early 2020 at $2 billion. It acquired the company from Sir Richard Branson’s Virgin Group in mid-2018 and merged it with digital coaching company RedBrick Health.
Welltok has raised $262 million in funding, most recently a Series E round in July 2020.
From TAA-Da!: “Re: Ascension IT. Another WARN notice, now approaching 1,000 employees since August. Why does it seem like all this outsourcing is invisible to most people?” Most people pay only casual attention to layoffs and/or outsourcing unless they have direct connections to those affected or the companies involved, especially since cheap-seats opinions are unlikely to reverse the course anyway. There’s also limited benefit to recognizing a possible trend unless you, as an employee who might be affected down the road, have options for mitigating your risk. Lastly, the outsourcing pendulum often eventually swings back for at least some jobs because cost savings and quality were overpromised.
From Nordic Viking: “Re: Cerner. Seems like they are losing ground in the Nordics since the City of Jyväskylä just announced that they withdrew from the Central Finland Cerner program. It will for sure have a negative impact on the already troubled and delayed projects in the South of Sweden.”
HIStalk Announcements and Requests
Welcome to new HIStalk Platinum Sponsor OneMedNet. The Eden Prairie, MN-based company provides innovative solutions that unlock the significant value that is contained within the clinical image archives of healthcare providers. Its OneMedNet iRWD offering securely de-identifies, searches, and curates a data archive locally, bringing a wealth of internal and third-party research opportunities to providers. By leveraging this extensive federated provider network, together with industry leading technology and in-house clinical expertise, OneMedNet successfully meets the most rigorous RWD Life Science requirements. Thanks to OneMedNet for supporting HIStalk.
None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.
Acquisitions, Funding, Business, and Stock
Carbon Health, which offers telehealth and in-office primary and urgent care from five locations in New York City and Columbus, acquires remote patient monitoring tools vendor Alertive Healthcare.
The private equity owner of advance care planning technology vendor Vital Decisions sells the company to Evolent Health.
Revenue cycle management vendor Aspirion Health Resources acquires Advicare, which resolves clinical denials.
Virtual medical documentation contractor Augmedix launches a $40 million IPO offering.
Global imaging platform vendor Arterys chooses OneMedNet to provide de-identified real-world provider data for the development, validation, and regulatory approval of its solutions.
Hackensack Meridian Healt hires Kash Patel, MSEE (Penn Medicine) as EVP / chief information and digital engagement officer.
Helia Care, which offers a platform that connects hospitals and medical device companies for ordering, hires Gregg Smith (Sharecare Provider Solutions) as chief commercial officer.
Isabelle Stapf, MS (AppFolio) joins Well Health as SVP of product.
Announcements and Implementations
Cerner launches RevElate as its single go-forward patient accounting system following years of high-profile struggles with Cerner Patient Accounting. The company says it will begin phasing in the product to replace existing Millennium and Soarian systems in 2023. A hospital CIO sent along these notes they took during the announcement:
RevElate is based on the Soarian Financials platform.
Former Soarian customers were electing to keep Soarian Financials while migrating to Millennium clinicals.
Cerner Patient Accounting support will be phased out over the next 5-6 years. New sales will stop immediately.
Patient access, charge capture, and the charge master will remain in Millennium, while patient accounting, including contract management, will be in RevElate.
HealtheEDW is the go-forward strategy for reporting and analytics.
Key development partners BayCare and Charleston Area Medical Center will initially deploy the system .
Cerner clients that are upgrading to RevElate will undergo a six-month project.
The product will be available to the full customer base in Q1 2023.
Demos will be offered during the CHC virtual conference next week.
Data from Premier’s PINC AI predictive modeling shows that hospital clinical labor costs have increased 8% per patient day since the pandemic began, with overtime and agency use adding $17 million in annual costs for the average 500-bed facility.
Health IoT cybesecurity vendor Cynerio launches a small-hospital subscription program to protect against malware, ransomware, and other device security threats.
Abbott’s president and CEO will keynote the CES 2022 technology show in early January, the first time that a healthcare company will take its main stage.
HLTH announces COVID-19 safety precautions for its upcoming in-person meeting in Boston – mandatory proof of vaccination via Clear, PCR testing either within 72 hours before the conference or taken free onsite, and mandatory wearing of masks.
CHIME publishes its list of Digital Health Most Wired for 2021.
In Spain, the local health service apologizes for a gynecologist who documented “homosexual” as the current illness of a 19-year-old woman. The health service says it was an honest mistake caused by documenting her sexual orientation in the wrong part of the EHR, but the woman says that a hospital employee told her that several of the doctor’s patients had lodged similar complaints.
Wolters Kluwer Health launches Best Care Everywhere, a mission-driven movement to build and strengthen global health equity.
Spok will highlight the importance of healthcare communication at its Connect 21 Virtual Conference October 11-12.
The Nurse Keith Show Podcast features Glytec Clinical Project Lead Lori Weiss, RN “The Promising Future of Cutting-Edge Diabetes Care.”
KLAS recognizes Halo Health in its latest report, “Clinical Communication Platforms – Improved Efficiency Leading to Concrete Outcomes.”
PatientBond achieves 15 million touchpoints in August, sending automated email, text messages, and phone calls to 2.5 million unique patients.
OncoSpark adds interoperability to it oncology prior authorization platform in partnering with Ellkay.
The HCI Group’s DGTL Voices with Ed Marx Podcast releases a new episode, “CIO and CMO – the Importance of this Relationship,” featuring Cleveland Clinic CMO Paul Matsen and CIO Matt Kull.
In telehealth news, California’s governor recently signed a bill (SB 306, the STD Coverage and Care Act) which requires health plans to cover at-home test kits for HIV and sexually transmitted infections (STIs). The state has had recent increases in STIs, and the bill is aimed to help reduce those numbers. Patients can self-collect samples for many STIs. Studies have shown that self-collection (even in the physician office) increases rates of adherence for recommended testing. Coverage is required for health care contracts that are issued, amended, renewed, or delivered after January 1, 2022.
If I was working at a telehealth vendor that didn’t already offer a business line that addressed this kind of testing, I’d be spinning it up right away. There are some nuances to managing these types of tests (including being able to report results to local public health authorities) but the COVID pandemic accelerated automation of these functions so that they’re much less onerous. Developers have about three months to get their functionality in gear, so it’s ready-set-go for anyone with clients in California.
The National Institutes of Health announced that its All of Us Research Program will make more COVID-19 data available for researchers. This could allow better exploration of the long COVID symptoms that some patients experience as well as help identify factors that might identify which otherwise healthy patients will do poorly if they become infected. The expanded dataset now includes data on over 300,000 patients, with nearly 80% of them representing groups that are typically underrepresented in medical research.
Having access to such a robust dataset is going to be key to ensure artificial intelligence technologies don’t have bias from the data used to train the models. A testimonial from researcher Sally Baxter, MD, MSc explains the limitations of using a single-site dataset from her own institution versus the improved performance after using the All of Us data for training the model.
In the “healthcare folks behaving badly” category, a pharmacist in Puerto Rico enters a guilty plea after administering COVID vaccine to children who did not meet the age minimum approved by the FDA. In addition to improperly vaccinating children aged 7 to 11, the pharmacist billed Medicaid for the services. Additionally, since the vaccines were part of stock provided by the US government, not only were the administrations clinically inappropriate but also “unauthorized and unlawful.” The vaccinations were identified by the Puerto Rico Department of Health, which suspended the pharmacy’s participation in COVID-19 vaccination efforts. Only a couple of dozen patients were involved, but since the dosing for that age group hasn’t yet been approved, it’s not clear what they were given and if they received the full adult dose or something else. I hope all the children involved are doing well and didn’t experience any complications from the situation.
The COVID-19 pandemic has placed a tremendous burden on provider organizations, many of whom tapped the US government’s $178 billion 2020 Congressional Provider Relief Fund. STAT news has created a database showing how much funding physicians and healthcare organizations received. Not surprisingly, large health systems and those in major metropolitan areas received large pieces of the pie. Altogether, there were 412, 591 payments, with 90% of them being below $192K. The median payment was $12,530.
Looking at the data from my state, it’s difficult to see how much some of the large health systems received since some of them are listed separately and have a number of hospitals, clinics, and affiliated entities. I found it interesting that my former urgent care employer received more funding than many of the smaller hospitals in the state, but I wasn’t surprised given the volume of care they deliver and the acuity of patients, as well as the number of employees. What I did find surprising was the number of optometry practices that received several million dollars each. Also, at the bottom of the list, there were over 200 practices that received less than $100, which I’m sure didn’t even cover the money spent filling out the application. A couple of dozen practices were between $1 and $20. I found the fact that they issued checks for $1 to be bizarre since it probably cost many times that amount to create the check and will cost the practice more than that to cash it when you figure in staff salary and the potential for bank transaction fees.
It’s always interesting to use the various available databases to see what kinds of payments physicians and other healthcare providers are receiving. One of the more well-known data sources is the Open Payments database, which gathers numbers on payments made by drug, medical device, and other companies to physicians and other covered recipients. If a pharmaceutical rep buys a physician lunch and it’s over a certain amount, it’s reportable. CMS recently released adjustments to the reporting threshold for the 2022 Program Year, based on the Consumer Price Index. In case you’re curious, anything less than $11.64 doesn’t need to be reported unless the total annual value of payments to a covered recipient exceeds $116.35. I searched for myself in the Open Payments database, which goes back to 2014. I had exactly one payment for some consulting work that I did as a clinical informaticist, looking at specs for a new diagnostic testing apparatus. I’m not sure it should have been subject to Open Payments, but I’m not about to argue it.
I’m nearly back to normal after the side effects of my recent COVID-19 booster, with only some aggravating itchy sensations remaining at the injection site. Several readers weighed in on my request for good shows to watch while recuperating. There seems to be a general theme to some of the options, with many of them being on location in the UK. Fortunately, I was able to reserve a couple of the recommendations at my local library, so I’ll be able to stay well entertained as soon as they’re ready for pickup. In the mean time, I’m venturing into the great outdoors this weekend. I’m about to start a very big project that will take up most of my time for the foreseeable future, so I’m looking forward to kicking back around the campfire and enjoying some delicacies cooked in cast iron. There’s more to fall than pumpkin spice, y’all.
Quality measurement and clinical intelligence platform vendor Apervita shuts down.
Chief Informatics and Innovation Officer Blackford Middleton, MD, MPH, MSc said in a LinkedIn post that the company was unable to complete a second funding round. It had raised $60 million since December 2012 through a Series A.
Apervita sold its value optimization business to Clarify Health in August 2021.
From Executive Channel: “Re: females as VPs of HR, legal, and marketing. We would likely see the same phenomenon in IT if technology jobs weren’t dominated by men.” Health system support departments such as IT don’t contribute directly to profit and loss except as a cost center, which is why executives of those areas aren’t usually seen as prime candidates for broader roles in areas that have dozens or hundreds of insiders who are ready to move up the ladder. Most of the big bumps in CIO compensation and job responsibility over the years came from consolidation into ever-larger health systems and horizontal expansion of CIO responsibility in taking over other support departments such as biomedical engineering, telecommunications, informatics, analytics, and quality reporting (headcount and budget responsibility drive pay in health systems). The few former CIOs who are now COOs or CEOs of large health systems gained experience in other positions, which I would anecdotally observe usually involved only a short stay in IT as part of being moved around for executive grooming — a long stint as a CIO in a single health system likely means you’ve topped out there. It’s not quite the same in vendorland, where CTOs of tech-heavy startups are often co-founders in companies where technology is a core competency rather than a supporting function.
HIStalk Announcements and Requests
Welcome to new HIStalk Platinum Sponsor Interbit Data. The Natick, MA-based company’s software automation solutions ensure that clinicians and hospital staff have easy, secure, and reliable access to patient and financial information so they can get back to quality patient care and stay in touch. Its products integrate with any HCIS platform to distribute reports that help care teams stay informed. It is the pioneer and best-practice leader in downtime business continuity, providing reliable access to patient information at the point-of-care during downtimes, as well as during more challenging cyber crises. Using its software automation solutions, hospitals can be more efficient, streamline workflows, and improve overall patient care and safety. It provides secure, reliable, and cost-effective solutions that help 800 healthcare facility customers worldwide remain connected. Thanks to Interbit Data for supporting HIStalk.
October 6 (Wednesday) 2 ET. “Solving Patient Experience Challenges Through a Strong Digital Front Door.” Sponsor: Avtex. Presenters: Mike Pietig, VP of healthcare experience, Avtex; Jamey Shiels, MBA, VP of consumer experience, Advocate Aurora Health; Chad Thorpe, care ambassador, DispatchHealth. Patients expect healthcare providers to offer them the same digital experience they get when banking, shopping, and traveling. This webinar will describe how two leading healthcare providers created digital front doors that exceed patient expectations, improve patient outcomes, drive loyalty and acquisition, and future-proof their growth strategies in competitive markets.
October 6 (Wednesday) 1 ET. “A New, Streamlined Approach to Documentation and Problem List Management in Cerner Millennium.” Sponsor: Intelligent Medical Objects. Presenters: Deepak Pillai, MD, physician informaticist, IMO; David Arco, product manager, IMO; Nicole Douglas, senior product marketing manager, IMO. The IMO Core CSmart app, which is available for Cerner Millennium in the Cerner code App Gallery, helps providers document with specificity, make problem lists more meaningful, and improve HCC coding. This webinar will review the challenges and bottlenecks of clinical documentation and problem list management and discuss how streamlined workflows within Cerner Millennium can help reduce clinician HIT burden.
ManpowerGroup finalizes its acquisition of IT staffing and services provider Ettain Group, which acquired Leidos Health in 2019. Ettain will merge with ManpowerGroup’s Experis IT talent and solutions business and will operate under the Experis name.
Cancer Treatment Centers of America will implement Lyniate’s Corepoint interoperability platform.
Rochester RHIO selects Direct Secure Messaging capabilities from Secure Exchange Solutions.
Commure promotes Ashwini Zenooz, MD to CEO. She replaces industry long-timer Brent Dover, who will remain as an advisor.
Michael Wagner, MSA (MPRO) joins Honor Community Health as CIO.
QS Systems hires Kendall Stanley (Inovalon) as VP of sales and marketing.
Radiology Partners promotes Jennifer Beaumont to SVP of regional support services and clinical practice integration (she was SVP of IT) and hires Mark Logan (IBM Watson Health) as SVP of IT clinical technologies.
Patient and employee experience platform vendor Qualtrics hires Adrienne Boissy, MD (Cleveland Clinic) as its first chief medical officer.
Announcements and Implementations
Central Logic renames itself to About as it integrates recent acquisitions Ensocare (inpatient referral to post-acute care) and Acuity Link (transportation communications and logistics management).
Privia Health implements Kyruus ProviderMatch to enable patients to find and book appointments with physicians.
Sparrow Health (MI) adds a proof of COVID-19 vaccination feature developed by Epic to its MySparrow patient app. It enables users to display a QR code, download a PDF, or export verification to a health wallet.
Intermountain Healthcare, Presbyterian Healthcare Services, and SSM Health form Graphite Health, a nonprofit that will help member organizations vet, access, and implement digital health solutions.
Microsoft releases Windows 11 as a free upgrade for eligible Windows 10 PCs and on new PCs that have it pre-installed. My two-year-old laptop passed Microsoft’s Windows 11 readiness test, so I’ll give it a few weeks and then upgrade.
New Cerner President and CEO David Feinberg, MD, MBA will kick off the two-day virtual Cerner Health Conference 2021 next week.
Mackinac Straits Health System will affiliate with MidMichigan Health to address its IT needs and to implement Epic.
A new KLAS report on point-of-care references for clinical decision support finds that market share leader Wolters Kluwer is loved by physicians who learned to rely on UpToDate in medical school, but health systems say it’s the most expensive of available solutions and they sometimes switch to a cheaper alternative. Users of IBM Watson Health, especially pharmacists, like its NLP search feature even though the company scores poorly in customer support. Elsevier and IBM Watson Health both suffer from content delivery that can run months behind, users report. Ebsco earns the highest overall score with deep content at a fraction of the price of competitors.
Privacy and Security
In Indiana, Johnson Memorial Health and Schneck Medical Center recover from apparently unrelated cyberattacks that forced the organizations to take their IT systems offline.
Business Insider looks at problems in Apple’s healthcare organization, most of which have been described previously:
Employees say people were disciplined for disagreeing with their bosses over the way health data is being used to develop products and the questionable quality of that data.
The company expected the Apple Watch to spawn a subscription-based health program in which consumer data would be shared with their physicians, but the engineers who developed Watch designed its features for consumers rather than patients who are seeking medical care. The Watch can identify conditions, but isn’t as strong at measuring them.
Apple uses its AC Wellness employee clinic as a healthcare workshop, but the company is questioning its cost compared to similar programs such as that of Crossover Health.
Apple has talked to health plans about selling its HealthHabit app that allows its employees to track fitness goals and blood pressure, but poor user engagement has caused Apple cut back on the project roadmap and to reassign its employees.
Steve Jobs died 10 years ago at 56, having kicked a dent in the universe that outlives him.
Availity integrates TruthMD’s MedFax healthcare data solutions with its initiatives for provider data management.
Olive will hire an additional 300 employees by the end of this year, increasing its employee base by 30%.
Wolters Kluwer Health CEO Stacey Caywood earns a Bronze Stevie Award in the category of Female Executive of the Year – Business Products.
EClinicalWorks publishes a new customer success story, “Using Prisma to Help Staff and Close Care Gaps at Centerpoint Health.”
CareSignal has partnered with Innovaccer to offer deviceless remote-patient monitoring to organizations and payers participating in value-based care on the Innovaccer Health Cloud.
Change Healthcare will host its 2021 Virtual Innovation Summit October 12-13.
CHIME releases a new Digital Health Leaders Podcast, “A Conversation with Sarah Richardson, FCHIME, CHCIO, SVP and CIO, Tivity Health.”
Clearwater expands its customer training content and security awareness capabilities through a new partnership with cybersecurity education company Infosec.
CloudWave publishes a new whitepaper, “Enterprise Imaging in the Cloud.”
CoverMyMeds will present at Epic’s App Orchard Conference October 6.
A new KLAS report, “Clinical Communication Platforms 2021,” recognizes Vocera as a top-rated vendor in health systems with enterprise-wide deployments.
Diameter Health Chief Architect Sam Schifman will present at the John Snow Labs NLP Summit October 6.
Engage publishes a new case study, “From Chaos to Control: How Exeter Hospital Addressed Their Disaster Recovery Challenges.”
EClinicalWorks will host its national conference virtually October 7-8.
EZDI wins at the HIC2 in India for the use case “Digital Clinical Assistant for Integrating with Legacy EHR.”
HIStalk sponsors named top-ranking outsourcing vendors in 2021, according to Black Book Research’s latest survey, include:
Primary and urgent care company Carbon Health launches a clinical trial research program that will focus on medical devices, diagnostics, therapeutics, and vaccines, including Merck’s new COVID-19 antiviral treatment pill.
It’s been a rough weekend at Casa Jayne, with some bothersome side effects from my end-of-week Pfizer booster.
Don’t get me wrong — even with side effects I still like the vaccine odds better than the odds for naturally occurring COVID-19, and I’d do it again in a heartbeat. This time around it was a family affair, as my parents were able to get appointments within a few minutes of mine, so we got to spend some quality time in the observation room together. I was grateful that they were able to get their boosters on a beautiful sunny fall day rather than having to drive through snow and ice and stay in a hotel across the state, as they did for previous vaccines. It was good to catch up in person rather than by phone or text. My dad mentioned that the local farm and home store has a sign that warns people not to use ivermectin on humans. I’ll stick with my FDA-approved drugs (whether they’re under an Emergency User Authorization or not) any day. Except for one person who had a recent “breakthrough” case, we’ve all avoided infection. Now just crossing my fingers for a speedy approval for the Moderna booster for my grandparents, followed by quick scheduling at their retirement community.
Because most of my symptoms involved my dominant arm, I didn’t get much done over the weekend that didn’t involve reclining on the sofa with a pillow under my arm. Big thanks to the hospital auxiliary who made “cough” pillows post-op patients the last time I ended up in an operating room – it was the perfect size for a post-vaccine prop. I did however get a lot of reading done. I finished one novel, downloaded three more freebies, and started going through mountains of email.
One email reminded me to read the HealthIT Buzz blog from ONC, which had some good information on how ONC plans to better communicate with stakeholders. Moving forward, ONC plans to have additional options for communication and education, including more frequent FAQ postings; plainer language on blog posts aimed at non-legal, non-technical audiences; regular leadership blogs reviewing progress on implementation of the regulation; active outreach for public events and stakeholder meetings; and my favorite – “focused posting of Myths vs. Facts on social media to dispel inaccurate information and direct stakeholders to authoritative resources in a timely manner.” Maybe we need a cross between MythBusters and TikTok for ONC to reach both seasoned healthcare informatics folks as well as the newest generation in the workforce.
Another email took me deep into the rabbit hole that is the Theranos trial. There are so many summaries and recaps out there, I certainly had my choice of news sources. I do think that the delay in holding the trial, partially due to the pandemic and partially due to legal maneuvers, might be helping Elizabeth Holmes as she tries to defend herself. There have been many specific questions about individual recollections of conversations and events which occurred years ago, and when those recollections don’t match emails which are later entered into evidence, it certainly reflects on the credibility of the witness testimony.
The overall picture is one of desperation at Theranos, where they so wanted their solution to succeed that they were willing to go to great lengths to make it look like it was performing better than it was. In reading about some of the patient impact, my heart breaks for the women who had erroneous tests of the pregnancy hormone human chorionic gonadotropin. In one case, the patient’s values were off by a factor of 10, leading her to believe she was experiencing a miscarriage. Although she later received a corrected value, it’s hard to undo the level of anguish that someone experiences when receiving the news that she did. Some medical practices figured out quickly that there was trouble at Theranos, but others continued to use the lab, magnifying their exposure for inaccurate results.
The Theranos trial is also a good reminder that work email is not a safe place, and phone records might not be either. There were plenty of emails between Holmes and her boyfriend, former Theranos Chief Operating Officer Ramesh “Sunny” Balwani, that some might find fairly cringeworthy when viewed in the light of day and with consideration of the current situation. Holmes apparently found him to be her breeze, in the desert, her water, and her ocean. They also texted about being able to “love” and “transcend” even in the middle of a major whistleblower investigation. None of the documents I came across included any sexting, so at least we can be grateful for that. But it’s a reminder of how people might want to be careful and avail themselves of other modes of communication than non-secure texting.
The last email that caught my attention was from local government, letting me know that county council meetings would no longer be available on YouTube due to its recent push to remove videos that spread certain types of medical misinformation. The “public comment” portions of the meetings have been so chock-full of conspiracy theories, bad science, and false claims that they ran afoul of the terms of service. YouTube will still allow what it calls “personal testimonies,” but will not permit content that promotes vaccine hesitancy or promotes misinformation. Commentary that vaccines cause cancer, infertility, or contain microchips will also be banned.
Although my vaccine yet again failed to improve my wireless connectivity or make me magnetic, I’m glad I was able to get one quickly and close to home. It was good to have some downtime, albeit forced, because I had loads of end-of-quarter work earlier in the week and probably needed a mental break more than I would admit. I caught up on some TV watching as well – “Blue Bloods,” “Endeavour,” and “Inspector Lewis” to name a few. I’m on a bit of a crime drama kick, I suppose. Of the three, “Endeavour” is my favorite, although it’s so full of details you have to be careful if you’re nodding off while watching, because it will lead to a lot of rewinding.
What’s your favorite TV show for sofa-based recovery time? Leave a comment or email me.