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Morning Headlines 8/8/24

August 7, 2024 Headlines Comments Off on Morning Headlines 8/8/24

CVS’s stock drops as the healthcare-benefits business continues to hurt profits

CVS Health shares drop on the news of disappointing Q2 results, largely stemming from its lackluster Aetna health benefits business, and the ouster of Aetna EVP and President Brian Kane.

Roche considering divesting $1.9 bln cancer data startup, FT reports

Pharmaceutical company Roche is reportedly considering selling Flatiron Health, the oncology software and research company it acquired in 2018 for $1.9 billion.

McLaren hospitals disruption linked to INC ransomware attack

McLaren Health Care (MI) confirms that the recent disruption to its IT systems was caused by a ransomware attack led by the INC ransomware gang.

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Healthcare AI News 8/7/24

August 7, 2024 Healthcare AI News Comments Off on Healthcare AI News 8/7/24

News

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CHIME publishes a report of 10 principles, with detailed recommendations for each, that will ensure the ethical and effective implementation of AI in healthcare.

Amazon’s One Medical team is reportedly considering developing an AI agent called DoctorAI that would optimize clinician tasks, make product and service recommendations, and manage customer service requests.

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In England, NHS trusts are using patient engagement prediction software from Deep Medical to identify patients who are likely to no-show or cancel their appointments with short notice. Volunteers reach out to the patients who are identified by the system three weeks ahead of time to see if they need assistance – such as with transport, translation, or parking fees – and to reschedule their appointments in the event of conflicts. NHS England says that patients don’t show up for 6.4% of its 125 million outpatient appoints each year at a cost of nearly $2 billion.

FDA announces the members of its newly formed Digital Health Advisory Committee, which will hold its first meeting in November to discuss total product life cycle considerations for AI-enabled devices.

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Switzerland-based Sonova introduces the first hearing aid that uses real-time AI to improve speech clarify from background noise.


Business

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CMS approves separate Medicare payment for Annalise.ai’s obstructive hydrocephalus portion of its critical care platform. The company says the solution, which triages non-contrast brain CT scans, is the only radiology triage device that can be billed for additional hospital payment.


Research

Researchers find that ChatGPT isn’t good at diagnosing patient conditions. It incorrectly analyzed half of a set of the 150 case challenges it was given, where it struggled with interpreting lab values and imaging results and failed to use complete information that was relevant to the diagnosis. They found that it works well as an educational tool, did a good job with differential diagnosis, and accurately suggested next diagnostic steps.


Other

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In England, nine hospital trusts are using Ufonia’s Dora conversational clinical assistant to call patients three weeks after their cataract surgery and alert clinicians if they need further care. Two-thirds patients who undergo cataract surgery, which is performed 500,000 times per year, do not require an in-person appointment. The company is a spin-off of Oxford Unversity.

A pain patient’s op-ed piece expresses skepticism about AI in healthcare:

  • Hospitals could have already solved the same patient problems if they really wanted to.
  • The real motivation for health systems to use AI is to make more money rather than to lower patient bills.
  • AI-drafted responses and emails to patients are easy to spot, and many of the initial patient emails were generated because of inefficient policies, such as requiring patients who have incurable conditions to contact their doctor every month to have their pain medication refill approved.

Contacts

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Contact us.

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HIStalk Interviews Ajay Kapare, President, Ellkay

August 7, 2024 Interviews Comments Off on HIStalk Interviews Ajay Kapare, President, Ellkay

Ajay Kapare, MBA is president and chief strategy officer of Ellkay.

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Tell me about yourself and the company.

I’ve been with Ellkay for six and a half years. Ellkay is an interoperability solution provider company. We are in five segments of healthcare.

We are in ambulatory, where we do data migration, conversion, and clinical and financial archiving. We are also in hospitals, where we are an enterprise data management partner. We primarily decommission legacy applications. We provide an archive solution. We offer an interoperability solution called LKOpera to health systems. We are also in the lab segment, which is where we started our business, where we primarily do LIS to EMR integration and also order and result portals. LKOrbit is our lab platform. Close to 700 clinical labs use Ellkay.  Our fourth segment is providing interoperability for vendors. We do any integration that is needed with an EMR, getting the data out of the EMR or pushing the data into the EMR. We’ve been growing in this segment strongly. Finally, we offer an interoperability solution and clinical data exchange solution for the payer market.

We have been growing consistently the last six years and we have nearly 700 employees globally. In today’s market, few companies can say that they have been growing consistently year over year. Our customers and employees are our biggest assets. Customer-first and employee-first have always been our focus.

What business impact have you seen from TEFCA and QHINs?

We are proud to be participating in TEFCA through our work with CommonWell and achieving QHIN designation for the CommonWell 2.0 platform. TEFCA provides guidance for the secure exchange of health information regardless of the location of care. While organizations have been working to achieve this mission independently of each other for quite some time, this framework gives us all a goal to strive for. CommonWell, with Ellkay’s technology, is one of the seven QHINs.

What interoperability requests do you get most often?

More than 70% of hospitals are struggling financially. We are working with those that want to improve their efficiency and reduce costs, working with our interop solutions, LKOpera, or even decommissioning legacy applications that are sitting out there. We give them great ROI in having all that data for the informatics people and clinicians to use through LKArchive.

We see a lot of interest in FHIR. Hospitals, health plans, and vendors are all adopting FHIR within their interoperability arms. With this adoption, we also see the ease of data connectivity and exchange based on standards-based formats that allow the organization to communicate more efficiently and effectively. At Ellkay, we are continually evolving ahead of the industry to be able to accommodate all these standard methodologies and to integrate systems. We are assisting many organizations with transforming data to FHIR resources if that is not configured within their own system.

We feel strongly about our work with CommonWell and implementing the core functionality to their new platform, which is in production, including TEFCA, and all the work around that.

Has AI changed the demand for interoperability or given the company more capability?

The term AI is used everywhere. In the last few years, almost $5 billion in funding has been given to digital startups that are mostly focused on AI. There has been some confusion around exactly what AI is. Even someone who is doing screen scraping will call that AI.

As things have changed for us at Ellkay, we have been working as a true data management partner. Our experience of 20-plus years with healthcare data and data sources is unparalleled. We have almost 60,000 interfaces with different systems throughout the healthcare IT ecosystem.

As healthcare AI initiatives rely heavily on quality data, Ellkay has been laying this foundation for years. You can’t offer new AI technology without good access to quality data. We provide data integrity and data quality expertise to our client partners. We’re also helping them identify the best value-add use cases for the data and guiding them through the noise as they embark on their AI/ML journeys.

How does Ellkay address marketing differently given your strong background in it?

Marketing has always been my first love. Ellkay does strategic marketing. We truly believe that passion, action, and noble intention creates progress. We have never been a very aggressive marketer. We have always been a strategic marketer.

Our virtual user group meeting is August 13 to August 15. Last year we had more than 1,000 attendees — our strategic partners, people from the industry, and prospects. We opened it up to everyone. We had more than 50 speakers. The focus wasn’t Ellkay products, but rather what the trends are in the industry and what changes are happening. Post Meaningful Use and post COVID, what new challenges are health systems, the clinical lab, the ambulatory market, health plans, and payers going through? What challenges are vendors or vendor partners going through? We bring speakers who focus on those areas. When we’re at trade shows, you will see in our booth that our people are always happy. They smile and genuinely want to help.

We can do a great job if there is a market problem that we can solve as a true strategic partner, as we listen more and do focus groups. Our marketing is our voice. It tells the world who we are and what we believe in. It works well and resonates with people. We are true to the core, and whatever we say, we actually mean it.

How do you value collaboration and personal industry relationships?

Our core competencies as a company have always been innovation, execution, agility, and relationships. Relationships play an important role for us. You have to listen to your customers. You have to understand their needs and challenges. When I’m meeting a CIO, a lab director, or even a vendor CTO, I listen to understand their challenges. As a company, we take a customer-first approach and help solve their problems.

We like to keep our head down, ignore the noise around us, stay focused, and keep on doing the same things again and again, repeating the same formula. It’s a process. It’s a journey. Focusing on the things that we can do well has always paid off for us.

What are the most important factors for the company over the next few years?

We want to be a trusted enterprise data partner. We want to be the true partner who can help organizations with their problems, whether it’s a new EMR journey, challenges within their interop needs, or challenges within their lab network. We want to be that true partner, and I’m going to keep repeating this, true enterprise data management partner.

Our future has always been meeting our clients where they are, but also going where they want us to go with them. We will continue to support our client partners by helping them manage their data needs and interop needs, but also by being a thought leader and consultative partner.

A lot of health systems want to do a rationalization exercise around applications that are sitting out there on vulnerable servers. We can do the entire process: true archiving data integrity and analytics based on the type of data and what operational, financial, or clinical needs make sense. Healthcare data is powerful and we should be doing more with it as an industry.

We have some good partners helping us. We are also working towards different growth. We’re looking at international growth. We are looking at what we can do on the data and life sciences side. It’s an exciting time to be at Ellkay.

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Morning Headlines 8/7/24

August 6, 2024 Headlines 1 Comment

OneBlood’s Critical Software Systems Back Online Following Ransomware Event

OneBlood, a blood center that serves 250 hospitals in the Southeast, restores its critical software systems after a July 29 ransomware attack forced them offline.

Guidehealth Closes $14 Million Seed Round With Strategic Investment from Memorial Hermann Health System

Guidehealth, which specializes in value-based care programs that incorporate AI-enhanced technology and clinical services, announces $14 million in seed funding.

Epic Wins Motion for Attorneys’ Fees Against Patent Troll

A federal court orders a patent troll to pay the attorney fees of Epic, whose customers it had sued claiming patent infringement.

News 8/7/24

August 6, 2024 News Comments Off on News 8/7/24

Top News

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OneBlood, a blood center that serves 250 hospitals in the Southeast, restores its critical software systems after a July 29 ransomware attack forced them offline.

The organization says that its processing and distribution of blood products has returned to nearly normal levels.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Guidehealth announces $14 million in seed funding. The company specializes in value-based care programs that incorporate AI-enhanced technology and clinical services. It acquired Arcadia’s managed services organization and value-based care business last year.

Orlando Health will acquire Tenet Healthcare’s Brookwood Baptist Health system (AL) for $910 million, and will enter into a 10-year contract with Tenet-owned Conifer Health Solutions for revenue cycle services for the newly acquired system.

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Startup investment in Wisconsin dropped significantly last year after the boom years of 2021 and 2022, but healthcare accounted for half the dollar total.

Definitive Healthcare reports Q2 results: revenue up 5%, EPS $0.09 versus $0.08, meeting analyst expectations. DEFN shares have lost 68% in the past 12 months, valuing the company at $433 million.


Sales

  • Samaritan Medical Center (NY) selects Loyal’s directory listings management software.

People

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Prashant Thumma (Teladoc Health) joins 3Aware as CTO.

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Josh Hoders, MBA (SteadyMD) joins WellSync as SVP of growth.

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Jocelyn Keegam (Health Level Seven International) joins Aetna, A CVS Health Company as VP of Aetna interoperability.


Announcements and Implementations

Baptist Anderson Regional Medical Center (MS) rolls out Epic as part of a system-wide implementation.


Government and Politics

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A US Government Accountability Office review of the Veterans Health Administration’s Accessing Telehealth at Local Area Stations (ATLAS) Pilot Program determines that the agency needs to develop performance goals and measures so that it can assess the effectiveness of the program on a regular basis. Established in 2019, the program offers veterans access to telemedicine services at 24 non-VA locations in rural areas. Over the last two years, however, veterans had only visited 10 of those ATLAS sites.

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A federal court orders a patent troll to pay the attorney fees of Epic, whose customers it had sued claiming patent infringement. “We will not back down to patent trolls looking to shake down Epic or our customers,” says Epic SVP Stirling Martin. Two dozen other entities, including EHR vendors, paid to settle the lawsuits that were brought by Decapolis Systems, whose claims the court assessed as “if not fully spurious, was dilatory at best.”


Privacy and Security

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McLaren Health Care (MI) announces that an unspecified IT issue has taken down computers and phone lines across all of its facilities. Its websites are also down, and several of its facilities have enacted ambulance diversions. It has not yet offered updates on restoring functionality.

HHS OCR fines emergency medical services provider American Medical Response $115,200 for failing to provide a patient with their requested medical records in a timely manner.


Other

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The New York Times documents New York City’s “zombie pharmacies,” vacated buildings that previously held now-closed chain pharmacies that are stuck with unbreakable, long-term leases at above-market rates. More than a million square feet of prime real estate serve empty eyesores as 222 chain pharmacies have closed since the pandemic started. The overall pharmacy count has remained the same, however, as independent drug stores have opened near the vacant buildings.

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The US Navy profiles Lieutenant J.G. David Tegtmeyer, a US Naval Academy graduate who decided to pursue Navy Medicine instead of flight school. He is deputy CIO and operations manager at the Navy’s training center in Bremerton, WA, which went live in the first wave of MHS Genesis deployments.


Sponsor Updates

  • CereCore releases a new podcast, “Behind the Scenes: Mayo Clinic’s Data Strategy for Transforming Patient Care.”
  • AvaSure publishes a case study, “How the North Texas VA Improved Patient Safety and Reduced Costs with Virtual Sitters.”
  • Capital Rx releases a new episode of The Astonishing Healthcare podcast, “Selling Pharmacy Benefits: Building Relationships & Meeting Clients’ Needs, with Nick Van Hook.”
  • The Driving the Deal Podcast features Clearwater CFO Baxter Lee, “Safeguarding Healthcare – Cybersecurity Insights with Baxter Lee from Clearwater Security.”
  • Revuud, which operates a healthcare IT talent marketplace, reports a 100% increase in engagement and 40% in client count in the first half of this year compared to last year.
  • EClinicalWorks releases a new podcast, “Know Your No-Shows and Optimize Your Schedule.”
  • Clinical Architecture publishes its “2024 Healthcare Data Quality Report.”
  • Consensus Cloud Solutions celebrates its 25th anniversary and the evolution of its e-fax solution.
  • CloudWave publishes a new whitepaper, “Patient-Centric Incident Response in Healthcare – A New Approach: What You Need to Know.”
  • Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust adds Altera Digital Health’s patient flow solution to its Altera Sunrise system.

Blog Posts


Contacts

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

Comments Off on News 8/7/24

Morning Headlines 8/6/24

August 5, 2024 Headlines Comments Off on Morning Headlines 8/6/24

Tenet Healthcare to Sell Five Birmingham Hospitals to Orlando Health

Orlando Health will acquire Tenet Healthcare’s Brookwood Baptist Health (AL) for $910 million and will enter into a 10-year contract with Tenet’s RCM vendor, Conifer Health Solutions, for revenue cycle services for the newly acquired system.

OneBlood software partially restored after ransomware attack

OneBlood’s software systems begin operating at a reduced capacity after a July 29 ransomware attack forced them offline.

Technical issue disrupts computers, phones for McLaren Health Care system

McLaren Health Care (MI) announces an unspecified IT issue has taken down its computers and phone lines.

Comments Off on Morning Headlines 8/6/24

Curbside Consult with Dr. Jayne 8/5/24

August 5, 2024 Dr. Jayne Comments Off on Curbside Consult with Dr. Jayne 8/5/24

Throughout my career in healthcare IT, I’ve seen the unintended consequences that can be found with the implementation of new technologies. As an example, we can look at EHRs and how they made it easier for physicians to capture the details of the care they were providing and to bill accordingly for it. As a result, previously bell-shaped distributions of billing codes started skewing towards more complex (and therefore higher revenue) codes, leading to increased audits and insurer crackdowns. The additional documentation that was generated by EHRs was treated with more scrutiny, and some physicians became reluctant to use the solutions that were supposed to make things better, manually lowering calculated billing codes to avoid the hassle of audits.

As clinicians begin to incorporate technologies such as generative AI into daily practice, it’s important for researchers to diligently assess the solutions to ensure that they are enabling safe care and to monitor for unintended consequences. Every time I see a real-world study addressing this issue, it reminds me how rewarding it can be to practice clinical informatics. A study was published last week in JAMA Network Open that looked at the issue of using large language models to generate responses to the communications that patients send to their care teams through EHR patient portals.

The first thing that I noticed about the article were the listed author affiliations. Although they were all from New York University, they represented not only the NYU Grossman School of Medicine, but also the NYU Stern School of Business and the NYU Tandon School of Engineering. The specific question the authors were investigating was this: can generative artificial intelligence (GenAI) chatbots aid patient-health care professional (HCP) communication by creating high-quality draft responses to patient requests?

The study was conducted at NYU Langone Health, specifically using responses that were created in three internal medicine practices that were piloting a generative AI solution. Sixteen primary care physicians were then asked to evaluate messages but were blinded to whether the messages were drafted by GenAI or by human healthcare professionals.

The primary care physicians who were evaluating the messages were recruited from the organization’s internal medicine listserv, with only 16 of 1,189 physicians volunteering. That’s barely more than 1%, which although surprising at face value, really isn’t that surprising, given the stresses that many primary care physicians face on a daily basis. The sample was 50% female, with practice locations split between NYU Langone Health, Bellevue Hospital, and the Manhattan Veteran’s Affairs hospitals. They rated the messages on content quality, communication quality, and whether the reviewer felt a draft was usable or whether they’d prefer to start over with their own response.

During an initial survey, reviewers received five to eight pairs of responses without any follow-up questions. A subsequent survey contained 15 to 20 pairs of responses with additional follow up questions to assess characteristics such as empathy, personalization, and professionalism. The response pairs for the first survey were drawn from 200 random in-basket messages that were extracted from the organization’s EHR in September 2023. Messages that required outside context, such as laboratory results or medications, were excluded. Those from the second survey were pulled a couple of weeks later, with an initial sample size of 500 messages. The same exclusions were applied.

The study corroborated one finding that we’ve seen before, that GenAI responses may demonstrate greater empathy than human-crafted messages. However, I was surprised by some of the other findings. AI-generated responses tended to be “longer, more linguistically complex, and less readable” than those that were created by human respondents. The authors concluded that these could be problematic for patients with lower health literacy, or those for whom English is not their primary language.

The authors also found that certain types of messages, including those involving laboratory results, may need enhanced prompt engineering to be useful. They noted some limitations to the study, including the fact that it was conducted at a single facility and that the sample size was small. It would be interesting to see how physicians at community hospitals or community health clinics would rate the responses in comparison to colleagues who are practicing at larger medical centers or hospital-affiliated clinics. They also noted that they didn’t assess whether templates were used for those extracted messages that were drafted by healthcare providers and recommended that templated responses should be treated as a separate comparison group in future studies.

It will be interesting to see how similar responses might be graded over time, as people become more used to seeing AI-generated responses. Similarly, technologies may evolve to include more human or colloquial speech patterns in AI-generated drafts. For those of us who have moved from region of the country to another, or who have transitioned from academic medical center environments to community health centers, we could also see our own speech and writing patterns change accordingly. This may also vary generationally depending on when physicians completed their residency training and by specialty.

For example, some specialty training programs, including primary care, give more attention to health literacy and communication topics than do others, such as the procedural subspecialties. As a primary care physician, when I’m graded on how well I can use words to convince my patients to receive a vaccine or to go for a colonoscopy, I think much more carefully about what I’m saying and how I say it than others who are not scored in such a manner. As large language models evolve and appropriate feedback is applied, we should see responses that grow closer to what we need to provide the best care for our patients.

I’ll be on the lookout for additional studies that look at these topics, but I know my limits as far as being able to see everything that turns up in the literature. Here’s to hoping that my colleagues clue me in when they see one of these topics, and I always appreciate it when our readers give us a heads up that something interesting is available for our perusal.

What do you think about using AI-generated drafts to help clinicians respond to patient messages? Are you using it in your organization and how is it going? Leave a comment or email me.

Email Dr. Jayne.

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Readers Write: Six Foundations of Highly Productive Technology Teams: How to Handle System and Talent Transitions

August 5, 2024 Readers Write Comments Off on Readers Write: Six Foundations of Highly Productive Technology Teams: How to Handle System and Talent Transitions

Six Foundations of Highly Productive Technology Teams: How to Handle System and Talent Transitions
By  Mark Thomas

Mark Thomas, MS, MBA is CTO of MRO.

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There is one certainty in healthcare IT. Teams, tasks, and technology will always change. Maintaining a productive and efficient team culture during these transitions is essential to keep up with today’s fast-paced and connected health IT ecosystem.

A well-developed technology culture ensures optimal outcomes through months of high-volume activity, such as EHR conversions, and during regular day-to-day operations. And by focusing on high productivity, health system CIOs build a solid foundation to weather our industry’s inevitable shifts in strategic initiatives and organizational leadership.

This article explores six principles of developing a technology team culture for high production and resilience in healthcare. The leadership journey begins with flexibility and the willingness to accept change.

Embrace change and inspire flexibility

One of the most important qualities of a high-production culture is the ability to evolve. Effective technology leaders exhibit flexibility and welcome changes that drive positive outcomes for the team. This involves personal accountability at all levels to challenge barriers and work toward common goals.

A recent example is our company’s deliberate decision to rebrand the “IT” team to the “Technology” team. Rebranding the name of the department was a simple, yet effective way to help the team transition away from IT ticket-takers to strategic business outcome thinkers.

By fostering an environment where change is accepted and encouraged, CIOs ensure their systems and processes remain adaptable and responsive to advancing business needs.

Use data-driven decision-making

Predictability is important for sustaining high productivity. But predictability is often elusive during times of dramatic change and system transition. Savvy healthcare CIOs use data to build a bridge between opposing forces — doubt and certainty.

Whether with clients, partners, or internal stakeholders, data is a proven guide to effective technology leadership decisions. Teams make more informed decisions and remain focused on outcomes when performance can be tracked against data-driven commitments.

A variety of metrics can be used to measure the impact of team culture. This includes use of the Westrum culture survey, delivery predictability, and alignment of talent with skills and interests. By continuously monitoring these metrics, organizations can ensure teams are performing well and remain engaged and motivated. This data-driven approach enables the organization to make informed adjustments and sustain high productivity over time.

Finally, rewarding transparency when teams go off track further reinforces a culture of honest and continuous improvement.

Build composable and collaborative teams

Organizing teams around domains that require cohesive changes fosters a composable culture. This means aligning teams with a common backlog and driving toward shared outcomes.

This approach, coupled with a systems-thinking mindset, ensures that each team understands its role within the broader system and takes personal accountability for its contributions. By empowering teams to self-regulate, technology leaders also quickly identify necessary shifts and improvements to maintain high productivity.

Encourage extreme ownership for optimal availability

In today’s 24/7 plugged-in healthcare environment, system availability is non-negotiable. The concept of extreme ownership holds teams accountable for their systems end to end, from implementation to bringing disabled systems back online.

Eliminating handoffs and ensuring continuous monitoring helps teams proactively address issues before clients are affected. This cultural shift drives significant technological progress and ensures systems experience upmost reliability.

This type of accountability model eliminates reliance on project managers. Teams and individuals are directly responsible for their outcomes, fostering a sense of pride and ownership while delivering remarkable improvements in release frequency and quality.

Use telemetry and feature flags to support scalability

All systems must be scalable to enable future growth. Build telemetry into every step of the development life cycle, providing visibility into system performance and identifying bottlenecks.

Feature flags are another proven tool for health IT leaders. With these flags, technology teams release features at a controlled pace that enables organizations to scale effectively. This continuous improvement mindset should be ingrained in the team culture to ensure the organization is able to grow alongside new technological capabilities and industry demands.

Gather direct feedback from end users

A user-focused culture is essential for delivering valuable products. Routine inspections and direct feedback from end users are integral to the development process.

Teach your technology teams to speak the language of the business for each department or service line they support. Knowing the proper vernacular (e.g., nursing, laboratory, revenue cycle) helps teams effectively communicate with stakeholders and translate technical requirements into business value.

Frequent feedback loops with end users are also encouraged to ensure constant refinement and alignment with departmental needs.

With these six principles in mind, CIOs turn their leadership focus to individuals within and across their teams, ensuring the right people are in the right roles to drive technical excellence.

Translate Culture into Sustained Productivity

A new talent management strategy is the final cornerstone of its high-production culture. Instead of traditional promotion paths that elevate individuals based on technical skills, consider identifying specific strengths, interests, and weaknesses that suggest positions as individual contributors or talent managers.

By embedding these principles into your team’s culture, organizations create an environment where high productivity is both achievable and sustainable. Hospitals and health systems looking to embark on a similar journey should apply these strategies to transform their technology culture and achieve exceptional results.

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Readers Write: The Future of Healthcare Data: Unveiling the Potential of Vector Databases

August 5, 2024 Readers Write 1 Comment

The Future of Healthcare Data: Unveiling the Potential of Vector Databases
By Faiyaz Shikari

Faiyaz Shikari is CTO of HHS Tech Group.

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Healthcare information technology (HIT) leaders are the last people who need to be convinced of the transformative power of data in healthcare. However, many leaders may have given little thought to a pervasive industry problem that limits the potential of HIT to fully deliver the value that it is capable of — the traditional relational databases that have served the industry well for decades are reaching their limits when it comes to managing the ever-growing complexity and volume of healthcare data.

This is where vector databases emerge as a game-changer, offering a paradigm shift in how we store, analyze, and leverage healthcare information.

Traditional databases excel at storing structured data, neatly organized in rows and columns. But healthcare data is a different beast. It encompasses a rich tapestry of patient demographics, medical history, lab results, imaging data – often in diverse formats and constantly evolving. Vector databases tackle this challenge head-on by representing these diverse data as “vectors,” mathematical entities with magnitude and direction. This allows for efficient storage and retrieval of complex information, particularly for tasks like patient similarity analysis and drug discovery.

Imagine a scenario where a physician is treating a patient with a rare disease. With traditional databases, pinpointing similar cases might involve laborious manual searches. Vector databases, however, can analyze a patient’s unique medical profile and identify others with similar vector representations, potentially leading to faster diagnoses and treatment options. This personalized approach empowers physicians to move beyond a one-size-fits-all model and tailor care to everyone’s needs.

The potential of vector databases in healthcare extends far beyond patient similarity analysis. Consider the realm of drug discovery, a notoriously time-consuming and expensive process. Vector databases can store and analyze vast datasets of molecular structures, accelerating the identification of potential drug candidates. By comparing the vector representation of a disease target with potential drug molecules, researchers can prioritize promising avenues for further investigation.

Furthermore, vector databases play a crucial role in unlocking the potential of artificial intelligence (AI) in healthcare. AI algorithms thrive on large amounts of diverse data, and vector databases can provide the efficient foundation for their operation. Imagine AI-powered systems that can analyze medical images with unprecedented accuracy or predict potential health risks based on a patient’s unique profile. Vector databases can empower these powerful tools, paving the way for a future of data-driven precision medicine.

The new AI algorithms use two main components. Sparse vectors handle exact word matching, like traditional keyword search, such as identifying specific symptoms in a patient. Dense vectors capture overall meaning and context, like how our brains understand language, such as grasping the overall health profile of a patient. These algorithms employ a method called Reciprocal Rank Fusion to blend results from both approaches, ensuring precise matching and contextual understanding.

The impact is evident in several practical scenarios. For customer support, AI-powered chatbots can find relevant information from knowledge bases, providing faster, more accurate responses. In legal research, lawyers can quickly locate relevant case law and legal documents, understanding both terminology and legal concepts. In medical diagnosis, healthcare systems can search medical literature for studies and case reports matching symptoms and patient context. For content recommendation, streaming services and online retailers can offer more accurate recommendations, understanding user preferences and broader trends.

Integrating any new technology requires careful consideration. Security and privacy remain paramount in healthcare. Vector databases must be designed with robust security measures to ensure patient data remains confidential. Additionally, establishing clear guidelines for data governance and ownership will be crucial for fostering trust and promoting responsible use of this powerful technology.

In conclusion, vector databases hold immense potential to revolutionize healthcare. From enabling personalized medicine to accelerating drug discovery, these innovative databases offer a future where data truly empowers better patient care. As we navigate this exciting landscape, collaboration between healthcare professionals, data scientists, and cloud computing companies will be essential to unlocking the full potential of vector databases and ushering in a new era of data-driven healthcare.

Readers Write: A New Industry Standard: How the VBPR IG Is Advancing Value-Based Care

August 5, 2024 Readers Write Comments Off on Readers Write: A New Industry Standard: How the VBPR IG Is Advancing Value-Based Care

A New Industry Standard: How the VBPR IG Is Advancing Value-Based Care
By Michael Pattwell

Michael Pattwell is principal business advisor for value-based contracting at Edifecs.

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The introduction and adoption of the HIPAA transaction standard X12 837 for electronic claim submission revolutionized the way providers were reimbursed in the early 2000s. This standard eliminated administrative overhead for both payers and providers by shifting from paper-based claim submission to electronic submission, reducing claims processing time, errors, and reimbursement turnaround. The standardized structure allowed healthcare providers and payers to communicate efficiently and accurately in a universal format while maintaining security and privacy standards.

Fast forward two decades and the transition from fee-for-service to value-based care has necessitated a new shift. To address this challenge, a new open industry standard has been published to facilitate this transition to value-based care. This standard was designed and developed by the HL7 Da Vinci Project.

The Da Vinci Project is a private sector initiative that addresses the needs of the value-based care community by leveraging the HL7 Fast Healthcare Interoperability Resource (FHIR) platform. The HL7 FHIR platform enables payers, health systems, and other industry participants to identify and enumerate healthcare business use cases that involve managing and sharing clinical and administrative data between industry partners.

On June 17, 2024, The Da Vinci Project published its newest business use case called the “Value-Based Performance Reporting (VBPR) Implementation Guide (IG).” The VBPR IG is designed to support a standards-based exchange of financial and quality performance data based on contractual performance measurements agreed to by payers and providers. The VBPR IG is designed to leverage the existing FHIR resources created for other business use cases. The VBPR IG profiles the “measure report” resource. This existing FHIR resource is profiled by the VBPR IG as is and consumed using the FHIR framework that facilitates this interoperability standard.

This new VBPR IG interoperability standard is designed to solve many of the challenges payers and providers have faced implementing value-based care contracts over the past decade. Some of the challenges that can be solved by implementing the VBPR IG include:

  • The timely tracking of performance across contractual measures. It is difficult, if not impossible, for providers to understand how well they are performing prior to various settlement dates.
  • Lack of a standard format for value-based care contract performance reporting. There is variation in metrics and methodologies used across payers including financial terms, quality measures, attribution, and reconciliation periods. Reconciling the numerous reports providers receive from multiple payers in unstructured formats. This process is time intensive because reports come from various portals.

The immediate goal of the VBPR IG standard is to enable payers to summarize provider performance across different categories, including lines of business, contracts, populations, quality measures, financial metrics, and reporting periods on a scheduled and ad-hoc basis. Based on the calculated performance scores, incentives are calculated and distributed to providers as rewards or penalties, encouraging continuous improvement in care quality and efficiency.

Solving these critical business problems with value-based care contract transparency and standardization will accelerate the transition away from a fee-for-service reimbursement model to the value-based care model. This will lead to the ultimate goals and objectives to encourage superior care, enhance patient outcomes, and lower costs by compensating providers according to their quality performance, as opposed to the quantity of services provided.

So, what is next for the multi-stakeholder VBPR IG Team at The Da Vinci Project? The next release is is in development. Future releases will continue to extend the VBPR IG and include consuming and leveraging additional FHIR resources. These additional resources include, but are not limited to, CRD IG – Coverage Requirement Discovery and DTR IG – Document Templates and Rules.

Members of HL7’s Da Vinci Project will continue to advance the HL7 FHIR standards and collaborate with all industry stakeholders to accelerate the adoption of a digital future across healthcare. The Da Vinci Project founders and private sector partners are supporting the implementation of the VBPR IG and looking forward to seeing it in action across the industry.

Comments Off on Readers Write: A New Industry Standard: How the VBPR IG Is Advancing Value-Based Care

HIStalk Interviews Vivek Swaminathan, CEO, Cardamom Health

August 5, 2024 Interviews Comments Off on HIStalk Interviews Vivek Swaminathan, CEO, Cardamom Health

Vivek Swaminathan is CEO of Cardamom Health.

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Tell me about yourself and the company.

I like to think of myself as a technical generalist. My education is in electrical and computer engineering and business, but I’ve been in healthcare IT for 15 years and IT overall for over 20, some of that in manufacturing. I’ve been in leadership roles for 15 years and managed nearly every business functions that businesses typically have. Across all of that, I just love working with people and technology. I continue to be fascinated by both, and everything I’ve done has been with that in mind and the idea of trying to do something good and helpful for the world.

I started Cardamon knowing that we would be a little bit different than most businesses, but we had learnings and experiences that we wanted to apply. For example, we often see data analytics, applications, and operations in silos. I’m not saying that they don’t come together necessarily in certain situations, but they’re often not as collaborative as we would like them to be.

For the last 20-something years, we’ve had a huge focus on getting data in, whether it’s implementing a new system, looking at workflow, and doing optimization. But there’s been a lot of struggle to get that information out at the right time, make sure it’s actionable, and all those things that can make an impact. Meanwhile, I’ve watched consulting firms continue to focus on billable hours. Even if they do different things or try to come up with new models, it’s been about that margin spread per hour of billable work. 

We wanted to do something a little differently. We are focused very much on team. We have a team that has data analytics and application experts who want those groups to work together so that we can focus on outcomes. That aligns incentives with our clients. You don’t have this situation where our consultants and our company want the most available hours possible, but the health system or the payer wants the fewest. Instead we focus on the results. What can we do together? What can we make contractual commitments around to get those results for our customers? That means there’s a variety of things that we do, from advisory or specific AI solutions to keeping the lights on and application management services. Our goal is to partner with our customers and find ways to make their lives easier and impact their results.

We focus on two areas. We want to enable the best outcomes for healthcare by maximizing the value of data and technology. The other is for our community. We want to foster an inclusive economy by growing a great, diverse team, but making sure that it also includes people who are overlooked or aren’t often given a chance. That’s how we’ve built this company.

How do you differentiate the company from other consulting firms?

It can be challenging to differentiate at times, often because the health systems that we work with have this tendency to think about staffing. They are used to picking a single person and employing them, or picking them and managing them, and they do progress reports for me. It can be challenging to work with them and find good ways to show value.

The way that we try to differentiate is to say, let’s focus on what it is that we’re trying to do and we can commit to those results. Often it’s at a fixed price instead of continually having hours grow. Often it’s the more complex areas, where you have to work across groups so that we can bring those different experts together. It might be an operational goal or a strategy. It might also just be that you have to work on something, but you don’t already know what your solution is or exactly how you want to approach it. Sometimes that’s how a traditional consultancy might come into play. Here’s this exact thing that I want you to work on. But we’re often trying to work on some of those more complex things, or those strategic initiatives, or the opposite, which is, “Just let me keep the lights on for you while you go do that.”  

How is starting and running a business different from your previous roles with Epic and Nordic?

I will say that it is not for the faint of heart. It has been fun for sure. There have been a ton of learnings. I thought that having been through a lot of different roles that I understood the wide array of things that could happen in any given day in any given hour as you jump from one meeting to another or one subject to another. But it’s exponentially more dramatic when you’re in pure startup mode and you’re jumping from dealing with some insurance issue to then helping a customer and then working on something financial in your cash flow.

It’s kind of all over the place, which has been invigorating because I love variety and change, and I find it exciting. But it’s challenging and can be nerve-wracking at times as you have to think about cash flow every day. I’m not the type of person who focuses a lot on money a lot, and every day you have to think about that next deal in a more substantive way than when you’re already a $50 million company.  It has been a wild ride, but I have fully enjoyed it.

When investors are involved, the focus is often scaling the business up. Is that harder to do with a services business?

I’m not sure that it’s necessarily harder. It’s definitely different. Having worked for both software companies and service companies and having businesses where you have a little bit of both, you have to approach it differently. With software businesses, you’ve done a lot of the R &D work upfront, and a lot of that money or investment is about getting something created or a proof of concept, things like that. On the services side, there’s this balance where you are focusing on these pre-revenue people, but also sometimes they are partially pre–revenue and they’re partially post–revenue.

The challenges and the conversations when you’re bringing in money about what to do next and how to use it can be challenging. There’s a lot more discussion around how much to raise. I try hard to make sure that we are bringing in good investment, not bad investment, where you make sure that you have the right partners that are aligned to where you’re trying to go. Otherwise, you get forced into situations where they wanted to put more money in and now you have to spend it. Maybe you’re not spending it on the right things, and you’re in this perpetual loop of raising more and raising more and raising more. 

Our goal is to find ways to keep that in check. You can always hire people. It’s not that hard to look out there and say, that person’s great, why not hire them? This perpetual balance or back and forth of saying, this is the time to do it. This is exactly what we’re going to use the funds for so that you can grow in a controlled way, but always be ready to grow quickly. That’s what I look for on the the services side.

What’s it like to run a company like yours in Madison?

It’s especially interesting having grown up here. What the environment is like now is nothing compared to what it used to be. Epic and the other successful organizations around here get credit for it. I feel very supported here in terms of having an ecosystem and an environment in which you can find other people to work with, who can give advice,and who are willing to help each other out.

Historically, there have been fewer opportunities to raise funds here, but HealthX Ventures is a great. They are our partner, so obviously I’m biased, but they’re a great example of a group that is tapped into our community and wants to change that and put more money into organizations here. There are others doing that as well. 

There’s more visibility now in Madison, and there are more people looking here than there ever have been. I certainly have felt that support. But out of all the groups I talk to, by far the most people who are interested in investing or being a part of this are not in Madison.

What are some interesting ways that people are using EHR data?

I see it in your AI updates. There are plenty of cool, interesting things that are happening out there, especially from various software companies or product organizations.  I actually get more excited about the functions that are almost administrative. We have some. We created an LLM that’s focused on the bloat that has been happening around reporting and analytics, and how can you analyze that quickly and look at what’s redundant. What isn’t? Where can you do cleanup?

I’m a little bit of the dork on the support side, where it’s like, “How can we bring down the number of things that we’re managing and supporting? How can we clean it up and then make sure we don’t have so many duplicates and things like that?” I don’t hear as many people talking about it, but I think it’s low-hanging fruit that’s out there that needs to be addressed, and there are multiple versions of that kind of use case.

Searching, of course, is another one. We think about our Google searches or Gemini or whatever it is out there. But there’s a lot of benefit from using some of these things for searching or self-service. I almost think of the analogy to the service desk and a lot of the initiatives in the service desk world around self-service and moving work left and all of those kinds of things. A lot of that be can be done in the AI and data world.

Do you feel an urgency to do something with AI because it’s popular?

It is a strategy. We definitely get a lot of questions about it. Certainly investors are asking questions about it and want to pressure you that way. But customers are very interested in it, and we have had it as a strategy. When we’re focusing on data analytics and applications, there’s no question that’s they are a part of that world. 

However, we’re not trying to be AI product company. We’re not trying to go out there and say, “We’ve done this one thing, and now let’s resell it all over.” Because I think that you have to meet the customer where they are, and customers are at all different levels and they have different early pain points. I think it’s more valuable to have wraparound services and using AI when it makes sense. There are times to use it when it can bring down the people hours so that you can bring down the cost and the time to value. For me, those are no -brainer situations to start using AI and to lump that in with whatever services that you’re using. Similarly, there’s automation and other things that we can do in that respect. 

I don’t feel a strong push or desire to be an AI company, per se. It’s just not who we are or what we’re trying to be. But I definitely think we would be doing ourselves a disservice if AI wasn’t a part of our strategy and how we do business.

How has consulting changed after services moved to remote rather than on site during the pandemic?

There has been a lot of change over the last few years, certainly since COVID. I remember 10 or 15 years ago having conversations with customers about asking for people to be able to have one week remote a month. It was a real challenge to get people to accept that. People didn’t necessarily trust that work could be done remotely. I think we’re past that now. For the most part, people understand that you can do work remotely.

It doesn’t mean all the organizations have changed their decision-making on whether they are allowing for remote work. I also recognize there’s some of that as challenges with having to be registered in multiple states and all those kinds of things, but not everybody has accepted that. However, the vast majority I think have, and what we’ve found is that now you have this national marketplace for people, and there’s even more competition for talent. Certain organizations in certain parts of the country have more money and are able to command or pay for the best talent, and it can become challenging for people. It has put a magnifying glass in some of these things that have been around for a while, and now you’ve got more competition for talent, more organizations that are just struggling.

We have customers we work with that have six or seven open positions on one team, let alone across a larger group of IT, and they’re just not able to hire or keep people. That continues to create opportunity for us because we can be helpful to our help systems by having this team for them. It also allows them to maybe hire or get work not to their maximum amount of capacity they need during their peak times, but maybe bring somebody else like us in just to make sure the minimums are covered, and then work with others to scale up and scale down as needed. More and more organizations are opening up to that idea, and nearly everybody I talk to has bought into the concept, but I haven’t necessarily seen everybody be able to actually get it through their processes and make good on it. We’re in an in-between phase right now, but I think that’s where the industry’s going.

What Epic-related work is popular?

New applications continue to be an area of interest. Things like Payer Platform, which has become a bigger thing, especially with small payers or health plans. Part of why we’re working in this data and analytics space is that Epic did a lot to improve their toolset and add functionality in the past five or 10 years, and nearly every health system we talk to says they know that they are not fully utilizing them. Most aren’t there even things like self-service, where they know they can use Slicer Dicer to offer more real-time reports for end users. So a lot of what we’re seeing, and I don’t know that I’d call it optimization, is that if you already own Epic, let’s utilize it to its full extent. That’s the biggest part. There are other things like Cheers when you’re looking at patient experience and campaigns that people are excited about as well.

What do you see as important for the company’s strategy in the next handful of years?

Certainly being an early stage company, we have to think about financials and making sure that we are self–sustaining. We aren’t trying to be the type of organization that has financial backing that then is always raising capital again and again and again. We need to make sure that we are always in a good spot there. As time progresses, we will continue to improve there and be able to make the right investments for our customers so that we are ahead of the game and ready as they need us, which gets to the customer side. We want to make sure that we are making positive lasting impact for them, applying learnings. Hopefully we’re the top partner for many of our health systems that we’re working with. I certainly hope that people are thinking about this approach and are trying this data and analytics and applications together concept, as we are kind of the glue between it, we’re doing managed services for them, and they are seeing the value so that they can focus on their strategic initiatives.

The last thing, and it’s super important to us, is making sure that our team and our culture continue to grow and thrive. We have to bring the right people on board. That’s always a focus for us. It takes work always to have a great culture, and we’re going to do that. We are never going to skimp on that. Three, four years from now, we’re going to be utilizing those economies of scale, the larger team, to be able to do more for our customers in a way that just makes life easier for them.

I challenge myself all the time with this. Let’s all keep learning. Let’s embrace change. I’m a big believer in incremental improvement. Let’s all find ways to make that incremental improvement to slowly move in the direction that we need to go. Obviously, we need to keep people at the center of all this. Let’s not forget that. Let’s not forget our patients that are out there. Let’s not forget our own staffs. Let’s not forget those people that we interact with, whether they’re partners or vendors or whomever else. Above everything else, if we keep people at the center and we keep challenging ourselves to improve, we are going to make tremendous progress in healthcare. So thank you to everyone who is already doing that.

Comments Off on HIStalk Interviews Vivek Swaminathan, CEO, Cardamom Health

Morning Headlines 8/5/24

August 4, 2024 Headlines 1 Comment

Criminal Division Corporate Whistleblower Awards Pilot Program

The Department of Justice launches a program that pays corporate whistleblowers up to 30% of the first $100 million of assets forfeited.

EnableComp Acquires ANI Healthcare Solutions, Expanding Its Denial Management Solutions Within Its Award-Winning Specialty RCM Platform

RCM vendor EnableComp acquires San Francisco-based ANI Healthcare Solutions, a competitor that specializes in denials management.

Many online pharmacies selling weight loss products illegally: Study

Researchers determine that consumers are increasingly turning to illegal online pharmacies for semaglutide products, obtaining weight-loss medications without prescriptions and/or receiving products that pose risks to patient safety.

Monday Morning Update 8/5/24

August 4, 2024 News 1 Comment

Top News

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The local paper describes how the CrowdStrike update problem affected Duke Health:

  • 40,000 of the health system’s 60,000 devices got the bad patch, 22,000 of those went to the Blue Screen of Death, and 18,000 stayed up only because they hadn’t been rebooted.
  • SVP/Chief Digital Officer Jeff Ferranti, MD, MS says that it was the first time that an IT problem required the health system to activate the hospital incident command system.
  • Every affected machine had to be touched by a one of 100 IT volunteers to decrypt the drive, delete the errant file, and reboot, which he says took five to eight minutes.
  • The high-priority devices were flagged with a yellow sticky note to be fixed first.
  • All machines were restored within 72 hours, including those that gave the BSOD on Monday morning when some closed offices reopened.
  • Clinicians were advised to use IPads or IPhones to access Epic until machines were restored.

Reader Comments

From Ye Hack: “Re: ransomware. My mother’s cardiology care was delayed when Ascension’s computers went down for weeks, and now my father is unable to donate blood thanks to the OneBlood breach. The pool of patient safety incidents is likely large.” Ransomware attack frequency is starting to take down multiple and sometimes overlapping services in the same area, such as hospitals, 911, and government. It’s probably only a matter of time before someone takes down one of the big drug chains or a drug distribution company like McKesson.


HIStalk Announcements and Requests

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Laid off recently? It might not just be you.

New poll to your right or here: Which technologies have you used in the past year?

Listening: Tombstone Three, which I Shazamed after hearing it on a telenovela-type series Mrs. H and I were watching. I can find nothing online about this band, which then adds obscurity points for me. The music is surf rock meets Nick Cave and falls into a genre I hadn’t heard of called “dark country,” which blends traditional country music with dark, Southern Gothic-themed storytelling. I’m not a fan of country, but I’m liking this more authentic and less commercial subgenre. I’m also deep-tracking REM in a wave of guitar band nostalgia that doesn’t seem to have a place in today’s music, faves being this earworm song and this concert.

I was thinking about ambient documentation leading the AI charge in healthcare and recalled that we should be thanking Carl Dvorak of Epic for coming up with the idea in 2014, based on my 2020 interview with Nuance executive Joe Petro:

Ambient clinical intelligence is super exciting. Five or six years ago, Carl Dvorak at Epic was having a conversation with us and floated the notion of a room being able to listen. At the time, we didn’t have any necessarily tangible connection with how we were actually going to accomplish that. As conversational AI and other technologies developed, we started to get a firmer notion around what the exam room of the future could look like.


Thanks to these companies that recently supported HIStalk. Click a logo to check them out and to thank them for keeping my keyboard clacking.

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Webinars

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


Acquisitions, Funding, Business, and Stock

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KFF News reports that University of Florida Health and a private equity-backed firm have opened three combined urgent care center and emergency room facilities in suburban areas, with doctors triaging and recommending which side of the building to go to. Consumer advocates worry that hospitals have an incentive to steer patients to the much more expensive ER service instead of the urgent care service, which charges a flat $250. UF Health’s partner is Intuitive Health, which has similar arrangements with a dozen other health systems in 10 states. A sign on the door wants patients that the doctors inside may be out of their network and that they will be charged an average facility fee of $1,491. 


People

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Podimetrics hires Matthew Oefinger, PhD (Ahara Corporation)  as chief data and technology officer.


Announcements and Implementations

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Telehealth hardware provider VSee Health and Ava Robotics will develop telepresence solutions for ICUs, including a robot.


Government and Politics

The Department of Justice launches a program that pays corporate whistleblowers up to 30% of the first $100 million of assets forfeited. One of four eligible areas is fraud committed by private insurers or against patients and investors.


Sponsor Updates

  • Arcadia earns Certified Data Partner designation in NCQA’s Data Aggregator Validation program.
  • PerfectServe releases a new Lightning Bolt case study, “How to Rapidly Deploy a Scheduling Solution Across a Large Health System.”
  • The Digital Healthcare Roundtable Podcast features SnapCare co-founder, COO, and chief development officer Jeff Richards.
  • Waystar will exhibit at the HFMA 2024 Mid-America Summer Institute August 5-7 in Omaha.

Blog Posts


Contacts

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

Morning Headlines 8/2/24

August 1, 2024 Headlines Comments Off on Morning Headlines 8/2/24

R1 RCM to be Acquired by TowerBrook and CD&R for $8.9 Billion

Private equity firms CD&R and TowerBrook will take R1 RCM private at a valuation of $8.9 billion.

WeightWatchers Cuts Jobs, Weighs Selling Copycat Obesity Drugs

In the wake of disappointing Q2 results, WeightWatchers announces plans to lay off staff and potentially sell knockoff prescription weight-loss drugs via the weight management telehealth company it acquired last year for $132 million.

Federal suits stemming from Geisinger data breach likely to be consolidated

Ten federal lawsuits related to a November 2023 Geisinger data breach allegedly perpetrated by a former Nuance employee will be consolidated into one class-action lawsuit.

Comments Off on Morning Headlines 8/2/24

News 8/2/24

August 1, 2024 News 1 Comment

Top News

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Teladoc Health reports Q2 results: revenue down 2%, EPS –$4.92 versus –$0.40, beating Wall Street expectations for earnings but falling short on revenue.

News of the company’s nearly billion-dollar quarterly loss sent shares down hard in after-hours trading. They closed Thursday down 9%.

TDOC shares have lost 71% of their value in the past 12 months, valuing the company at $1.5 billion versus the $42 billion it hit in February 2021, not long after it paid  $18.5 billion to acquire Livongo. From the earnings call:

  • Newly hired CEO Chuck Divita says the company’s technology is essential to growth, citing member-to-provider matching engine, its patient interaction database, and its investments in data science and AI.
  • The loss includes a $4.64 per share write-down, $790 million, due to sliding share price and challenges in its BetterHelp virtual mental health unit, some of that due to high customer acquisition costs and prohibitive out-of-pocket costs for patients.
  • The company will no longer provide long-term financial guidance due to uncertainty about BetterHelp.

Reader Comments

From Roy G. Biv: “Re: ambient documentation and billing.  I’m not surprised about the discrepancy between the MD’s perception of billing and what is found in the notes. That is why AI can be so valuable in proper billing if it is trained to read the full EHR documentation and map to CPT codes from the language and procedures.” I’m usually not a fan of finding new ways to increase charges, but it seems fair to follow the rules in tying doctor-patient conversations to billing codes to reflect reality. It’s a rare win for both the white coats and the suits – the doctor saves time and enjoys reduced cognitive load while the bean-counters justify paying for it via more accurate (i.e., higher) charges. 

From Giddy Lee: “Re: UT Medical Center. Looking for an SVP/CIO five months after hiring one.” Lynnette Clinton’s LinkedIn doesn’t say she has left, but it sounds like they are posting that job. I don’t recall ever seeing an SVP/CIO position that reports to the SVP/CFO since that’s usually a small-hospital thing where IT is viewed as an expense in need of being managed.


Webinars

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


Acquisitions, Funding, Business, and Stock

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Two private equity firms will take R1 RCM private at a valuation of $8.9 billion.

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Eye practice software vendor Eye Care Leaders sells itself to new owners and renames the company Sightview Software. A bankruptcy court approved the sale of the company for $14.5 million to an insurance company in May 2024. Both the software vendor and the insurer have connections to investor and claimed former billionaire Greg Lindberg, who is awaiting an appeal for his federal conviction for bribery and wire fraud.

Identity solutions company HID acquires RTLS asset management system vendor Vizzia Technologies.

CompuGroup Medical promotes the son of its founder, Daniel Gotthardt, Dr. Med, to CEO. He was previously SVP and chief medical officer. Current CEO Michael Rauch, who was promoted from CFO just over a year ago, will leave the company.

MultiPlan replaces its EVP/CFO with Doug Garis (Oracle Health & Life Sciences), who shares his previous employer with MultiPlan President and CEO Travis Dalton.


Sales

  • Ochsner Health will implement DeepScribe’s ambient documentation across its 46 hospitals and 370 health and urgent care centers.
  • Carti Cancer Center (AR) implements Zen Healthcare IT’s Zen Insight Integration Monitor for Mirth Connect alerting and monitoring.

People

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Iris Telehealth hires Glenn Wada (Blue Ocean Go To Market Partners) as chief growth officer.

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Upstate Medical University names John Kairys, MD (Jefferson Health) as CMIO.


Announcements and Implementations

The Sequoia Project launches a Surescripts-funded pharmacy workgroup that will address the integration of pharmacy data and clinical services.

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KONZA National Network announces Birth Connect, which will provide alerts to OB/GYNs when a birth parent who is under their care has delivered a baby. The technology will link the medical records of birth parents and newborns to solve problems such as delayed notification, loss of the infant’s medical record when they are given a full name, and providing a more complete view of birth outcomes for quality initiatives. Hartford HealthCare was the development and pilot site.

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The American College of Cardiology publishes a guide for remote patient management.

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Highlights from a new KLAS recap of its recent enterprise imaging summit:

  • Two-thirds of participants say they will expand their EI strategy into new service lines within two years, with likely areas including point-of-care ultrasound (POCS), scopes, pathology, and ophthalmology.
  • Expanding to POCS will be challenging since workflows differ across departments and the reports and images need to be sent to the EHR.
  • Attendees were split on whether study distribution via a unified worklist should be managed by the EHR or by imaging vendors.
  • DICOM routing is a needed component.
  • Digital pathology offers many benefits, but requires more than just buying a scanner and an image management system.
  • The AI value proposition includes efficiency, enhanced detection, and increased hospital revenue with lower costs, but strong governance is needed, algorithms should be validated, and the system should be tested for bias.
  • A move to cloud-based imaging is inevitable even though costs will be neutral or higher than for on-premises solutions.

Privacy and Security

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OneBlood, a blood center that supplies 250 hospitals in Florida, Georgia, and the Carolinas, warns that it is operating at reduced capacity due to a ransomware attack.


Other

The CIO of a drug manufacturer cancels a 500-employee trial of Microsoft’s Office 365 Copilot, concluding that its ability to create presentations is at middle school level and therefore not worth the cost. Copilot AI nearly doubles the cost of Microsoft 365 at an extra $30 per user per month. The CIO said the tool was good at summarizing Teams meetings, but the drug company’s legal team advised against retaining transcripts.


Sponsor Updates

  • Health Data Movers posts a new episode of its “QuickHITs” podcast titled “Breaking Down Barriers in Healthcare IT: Insights from Stephanie Davis.”
  • EClinicalWorks announces the results of a recent survey on the perceptions of how AI helps the healthcare industry.
  • Five9 announces that its GenAI Studio has been named the Most Innovative Product at the 2024 UC Awards.
  • Consensus Cloud Solutions celebrates its 25th year of providing online fax solutions.
  • Arcadia earns Certified Data Partner designation in the NCQA Data Aggregator Validation program.
  • Abhinandan Kamble (Persistent Systems) joins Fortified Health Security as threat analyst.
  • Healthcare Growth Partners publishes the July 2024 edition of its “HGP Observations.”
  • Inovalon publishes a new customer success story, “Cincinnati Children’s Uses VigiLanz Clinical Surveillance to Identify Patients with Penicillin Allergies.”
  • The NEOM region in Saudi Arabia will implement InterSystems TrakCare health information system across its hospital and 41 clinics.
  • The “DGTL Voices Podcast” features KeyCare CEO Lyle Berkowitz, MD “Embracing Opportunities and Being Prepared: Lessons from Dr. Lyle Berkowitz.”

Blog Posts

Sponsor Spotlight

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Discover how Bermuda Hospitals Board transformed their IT contractor management with Revuud in our exclusive Q&A with CIO Keltie Jamieson. During the conversation, Keltie reveals how Revuud streamlined their access to specialized resources, improved team efficiency, and reduced costs. Learn from their experience and insights on optimizing IT contractor management and achieving strategic goals in healthcare. (Sponsor Spotlight is free for HIStalk Platinum sponsors).


Contacts

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

EPtalk by Dr. Jayne 8/1/24

August 1, 2024 Dr. Jayne Comments Off on EPtalk by Dr. Jayne 8/1/24

I’m catching up on a lot of healthcare IT news after coming out of a whirlwind of travel. I’m just reading the HHS press releases about the changes at ONC. I always struggle with typing the wrong thing when organizations rebrand or merge, so I’m thinking I’m going to have to just set my autocorrect to ensure I stay current with ASTP/ONC moving forward.

My inbox is bursting at the seams and my work calendar is full, so I’m sure I’m missing interesting newsy tidbits along the way. I have a couple of large projects wrapping up soon and will be happy to have some catch-up time once they do.

The US Senate passed two pieces of legislation this week that would create additional safeguards to protect young people online. Both the Kids Online Safety Act (KOSA) and the Children and Teens’ Online Privacy Protection Act (COPPA 2.0) passed with overwhelming majorities. KOSA, which has been working its way through the halls of Congress since 2022, requires social media platforms to incorporate “reasonable” technologies to reduce the risk of cyberbullying. Features like autoplay that are designed to keep children and teens glued to their phones would be restricted. COPPA includes provisions to ban advertising that targets minors. It also allows young people or their parents / guardians to delete their information from online sites. It’s unclear what will happen with the companion bills in the House of Representatives, where committee hearings won’t even be an option until September.

From Get A Room: “Re: return-to-office policies. I have to go into the office despite the fact that no one on my team lives in this city. I just got to hear an entire Zoom call in stereo, because the participants were sitting on either side of me.” I asked my correspondent if the attendees knew they were in the same office and he wasn’t sure. With the ubiquitous presence of noise-cancelling headsets in the office, it’s a distinct possibility. I think I would have been tempted to send instant messages to both of them, adding my own commentary to their call just to be sassy. Another option is to use in-house scheduling functionality to have a conference room send an appointment to both of them.

One of the hot topics in the virtual physician lounge this week was what one described as the “escalating arms race” of AI-enabled insurance preauthorization requests, denials, and appeals. Tired of struggling to get insurers to cover expensive treatments that they believe would benefit their patients, physicians have begun to leverage tools like ChatGPT to summarize patient information and increase the changes of approval. Payers have responded by using AI-powered systems to deny requests even faster, leading to AI-generated appeals. There was a new physician in the conversation who recently graduated from his residency training program and he was incredulous at the discussion. As a reminder, folks: for-profit insurance companies have to deny care in order to drive value for shareholders. They’re willing to pay for an enormous infrastructure to do so. Those who don’t think we ration care in the United States need to consider the definition of rationing.

Another hot topic was that of private equity groups purchasing hospitals and physician practices. A research letter that was published in the Journal of the American Medical Association this week certainly spiced up the conversation. Key points from the article: PE firms spent half a billion dollars on health care between 2018 and 2023, with a strong track record of loading them with debt and selling assets to increase shareholder profit. The authors compared acquired facilities with non-acquired controls, matching for year, region, and bed count. They found that acquired hospitals had nearly 25% less assets after two years. They note that further study of the impact of private equity ownership on patient care is needed, and I would bet that the vast majority of physicians trying to provide care in PE-owned facilities would heartily agree.

I ran across an article this week about virtual MRI programs. Rather than transfer inpatients from one facility to another for advanced MRI services, AdventHealth is allowing community hospitals to perform the procedures under standardized imaging protocols. The program allows seasoned staff to collaborate with those building their skills, through a combination of audio / video and chat features. It reminded me of a conversation I had with the team that was conducting my own MRI a few months ago. One technologist mentioned that they had completed a research protocol, copying a longstanding program in Germany where radiologists managed MRI scanning at multiple locations from a centralized command center.

Although the clinical outcomes were similar, the program encountered resistance here due to concerns about liability and regulatory compliance. Clearly other parts of the country are more accepting of this kind of change, so it will be interesting to see how many years it takes my region to think outside the box. In the mean time, I just have to hope there’s not a snowstorm or ice storm when it’s time for me to go for my next exam, since trying to reschedule will introduce at least a 90-day delay due to lack of available slots at the academic medical center.

I was excited to see the launch of the All of Us project several years ago, charged with better understanding how genetics, lifestyle, and environment play a role in health outcomes. More than 770,000 patients have enrolled in the program as of March 2024. As a way of sharing the value of research with study participants, leaders of the project provided summaries of the research done to date. A recently published article looked at the impact of those summaries, specifically with how participants engaged with digital communication. The summaries reached more than two-thirds of participants, exceeding the rates of other program communications. Those most likely to engage with the summaries included those with higher income, age greater than 45 years, and higher levels of educational attainment. The authors conclude that more personalized summaries may yield even greater engagement in the future.

Have you ever participated in a research study, and at what point did you learn about its results? Leave a comment or email me.

Email Dr. Jayne.

Comments Off on EPtalk by Dr. Jayne 8/1/24

Morning Headlines 8/1/24

July 31, 2024 Headlines Comments Off on Morning Headlines 8/1/24

Spring Health Announces $100 Million Series E Funding to Accelerate Growth and Expand Global Access to Mental Healthcare

Spring Health, which offers digital mental healthcare programs to employers and payers, achieves a $3.3 billion valuation with a $100 million Series E funding round led by Generation Investment Management.

OneBlood Target of Ransomware Event

Blood donation and distribution non-profit OneBlood advises the hundreds of hospitals it serves to implement critical blood shortage protocols as it deals with a ransomware attack.

Following Sale to New Owners, Eye Care Leaders Becomes Sightview Software and Commits Additional Investment to All Products

Eye practice software vendor Eye Care Leaders sells itself to new owners and renames the company Sightview Software.

Teladoc (NYSE:TDOC) Misses Q2 Revenue Estimates, Stock Drops 15.6%

Teladoc Health shares drop on news of the company’s Q2 revenue and earnings, the former of which fell short of analyst expectations.

Comments Off on Morning Headlines 8/1/24

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