Recent Articles:

News 12/3/21

December 2, 2021 News 2 Comments

Top News

image

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

image

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

image

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

A VA update on lessons learned includes:

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

Reader Comments

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

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


Webinars

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

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

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

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

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


Acquisitions, Funding, Business, and Stock

image

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

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

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

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

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

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

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


Sales

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

People

image

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

image

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

image

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

image

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

image

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

image

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

image

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

image

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


Announcements and Implementations

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

The International Medical Informatics Association publishes a history of informatics.

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

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

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

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

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


Sponsor Updates

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

Blog Posts


Contacts

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

125x125_2nd_Circle

EPtalk by Dr. Jayne 12/2/21

December 2, 2021 Dr. Jayne No Comments

image 

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

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

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

clip_image003

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

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

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

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

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

clip_image008

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

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

Email Dr. Jayne.

Morning Headlines 12/2/21

December 1, 2021 Headlines No Comments

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

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

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

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

VA advances Electronic Health Record Modernization program

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

HIStalk Interviews Steven Scott, CEO, VitalTech

December 1, 2021 Interviews No Comments

Steven Scott is CEO of VitalTech of Plano, TX.

image

Tell me about yourself and the company.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

What are Best Buy’s ambitions in healthcare?

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

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

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

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

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

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

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

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

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

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

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

Morning Headlines 12/1/21

November 30, 2021 Headlines No Comments

Babyscripts Raises $7.5M in Additional Series B Funding

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

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

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

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

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

News 12/1/21

November 30, 2021 News 1 Comment

Top News

image

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

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


Reader Comments

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

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


HIStalk Announcements and Requests

image

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

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

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


Webinars

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

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

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

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

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


Acquisitions, Funding, Business, and Stock

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

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

image

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

image

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


Sales

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

Announcements and Implementations

image

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

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

image

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

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

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

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


Government and Politics

image

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

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

image

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

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


Other

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

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

Sponsor Updates

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

Blog Posts


Contacts

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

125x125_2nd_Circle

Morning Headlines 11/30/21

November 29, 2021 Headlines No Comments

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

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

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

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

Greenway Health names Pratap Sarker as Chief Executive Officer

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

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

November 29, 2021 Readers Write 1 Comment

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

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

image

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

November 29, 2021 Readers Write No Comments

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

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

image

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

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

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

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

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

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

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

Curbside Consult with Dr. Jayne 11/29/21

November 29, 2021 Dr. Jayne 2 Comments

The holidays are often a time for families to catch up and share recent happenings. Especially in the ongoing COVID-19 era, there is often a lot of catching up to do if people haven’t been seeing each other as recently as they did in the past, and if they haven’t been keeping up by other means. Although most of my older relatives are on social media (including one who has a Facebook account for each device she owns, because our attempts to explain how accounts work have not been well received), others spent the time catching up on their grandkids’ exploits. I always find it interesting to see how people in the same age bracket embrace technology differently.

In the early days of Facebook, I had avoided joining because I was super busy with a multi-hospital EHR conversion project and didn’t need one more thing to suck up excess time. I remember the night I finally signed up, sitting in a hotel room in the middle of nowhere during a hospital site visit. When it searched my contacts to try to find “friends,” the first person that came up was my then 88-year-old grandmother. It turns out that was the best way for her to see pictures of my cousin’s children, since they lived across the country. Even though she used a computer for little else, she saw the value in trying something new. She was also the kind of lady who spent part of her retirement auditing classes at the community college so she could learn new things, so I think that had a lot to do with it.

Fast forward to this year, and one of our relatives is struggling with a new iPhone that her son bought for her, seemingly without talking to her about it. She had been an Android user for years but her base model phone was low on memory and speed. Since she was on her son’s plan, he volunteered to help her pick out a new device, but it turned into him buying her what she thought she needed versus what she actually needed. Now she’s stuck with an expensive phone she doesn’t like, and the family dynamics make her not want to speak up about getting something else. The grandkids worked with her to do basic things such as connecting her phone to her house’s wi-fi network and doing some minor adjustments to voice-to-text settings, but I suspect she’s still going to struggle with it.

Most of my relatives don’t really understand what I do since I “gave up being a doctor,” so of course there were some conversations about that. I’ve given up on explaining how you can still be a doctor and not necessarily see patients. In the interests of simplifying the explanation, I’ve tried to explain that what I do is kind of like being a medical school professor who helps a resident learn a new surgical technique or a better way to treat a patient, and that sometimes I also work to help create the tools that doctors use to do their jobs. They still don’t get it, but that’s OK. I’m still the one they come to with all their medical questions, even in disciplines I know absolutely nothing about, so I guess I’m still a doctor after all.

There were of course the usual conversations about everyone’s chronic health conditions and the woes of choosing the wrong Medicare secondary policy. Since I’m working on a project that involves heavy use of a health system’s patient portal, I tried to get some information about whether and how my relatives might be using the ones they have access to. Use was all over the map, partly due to limitations in what their providers allow patients to access and partly due to lack of knowledge. It seemed like using it to send messages to the doctor was the most common, followed by prescription requests. No one was using it to read their visit notes, and none of them were aware of the ability to grant proxy access to a family member or caregiver.

The latter would be great for the other members of the family that are doing a lot of caretaking, so I hope they’re able to set this up in the near future. I’m not sure I would push them to read their visit notes since they would probably become aggravated by any inaccuracies or jargon. I recently had a visit at a large academic health system and there were at least five small errors in my note. I’m not going to get excited about it because it doesn’t change the treatment plan but I’m sure they would be less sympathetic if they saw something like that in their notes.

As with any technology, it takes time for adoption to occur, and I see wide variation in how different health systems are encouraging people to use their patient portals as well as in the support that they provide to users. Those that understand how much a well-configured patient portal can help office efficiency promote it more and are willing to spend more resources on development and configuration. Those that instead view it as something they have to provide and don’t want to cultivate likely have a lower return on investment as well as a less-fulfilling patient experience. This phenomenon shouldn’t be a surprise to anyone who has worked in healthcare IT, but I think sometimes people forget it as they’re planning projects.

Since I’m working on a project that assumes heavy use on the part of both patient and provider, I’m trying to learn everything I can about what works and what doesn’t work so I can help create the best solution for my client. In addition to talking to other CMIOs who have maximally leveraged their solutions, I’m taking some classes to really learn the details about what the system I’m working with can and can’t do. I’m working with some great analysts, but there’s always a chance they missed something or didn’t think about it in a way that a physician would, and my client is supportive of the approach.

In talking with a friend who does some clinical informatics work for his university, his institution restricts him from attending vendor classes. I think that’s absurd, especially if he planned to use his own continuing education funds to cover the cost of training. I get that they don’t want random people going to classes and demanding that they make changes that are problematic, but there’s a thing called “discussion” when people have ideas, and preventing staff from learning isn’t a good look for those in higher education. It’s also not a great recipe for stakeholder engagement, but I’ve known that his employer hasn’t cared about that for a very long time, so I’m not surprised.

I hope readers were able to at least get some down time this weekend, and that all the games of “refrigerator Tetris” were successful. What was the best thing you did over the holiday? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 11/29/21

November 28, 2021 Headlines No Comments

The NFL Is Giving Players Sensor-Laden Mouthpieces Instead of Just Lip Service to Study Concussions; Four College Programs Join In

Several NFL and college football teams are collecting impact data from sensor-embedded player mouthpieces to test helmet effectiveness and to influence future rule-making to reduce concussions.

MIT Catalyst Program welcomes new VHA Innovation Ecosystem Fellows

The MIT Catalyst program announces a new group of VHA Innovation Ecosystem Fellows, who will work to improve veteran care through need-driven biomedical research and innovation.

New Exa Platform Functionality Automates Decision Support, Insurance-Related Tasks for Enhanced Productivity and Profitability

Konica Minolta adds Appropriate Use Criteria for advanced diagnostic imaging to its Exa Platform, in which orders placed through its physician portal will be validated electronically against CMS criteria using logic from LogicNets.

Monday Morning Update 11/29/21

November 28, 2021 News 5 Comments

Top News

image

Best Buy discloses in its quarterly earnings call that its cost to acquire remote patient monitoring technology vendor Current Health in October was $400 million in cash.


HIStalk Announcements and Requests

image

Most poll respondents feel pretty good about how their employers will fare in 2022.To what degree will resignations and hiring challenges affect your employer’s prospects in the next few years?

New poll to your right or here: To what degree will resignations and hiring challenges affect your employer’s prospects over the next few years? This in response to a comment on last week’s poll in which a reader predicted significant long-term impact of organizations losing experienced health IT employees.


Webinars

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

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

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

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


People

image

Alexander Scarlat, MD (Codixim) joins Mitre as principal data scientist of its health IT group. He wrote the “Machine Learning Primer for Clinicians” series for HIStalk a while back.

image

Matt Lungren, MD, MPH (Stanford Center for Artificial Intelligence in Healthcare) joins Amazon Web Services as principal for clinical AI and machine learning for worldwide public health.


Announcements and Implementations

Konica Minolta adds Appropriate Use Criteria for advanced diagnostic imaging to its Exa Platform, in which orders placed through its physician portal will be validated electronically against CMS criteria using logic from LogicNets. 


Government and Politics

image

The MIT Catalyst program announces a new group of VHA Innovation Ecosystem Fellows, who will work to improve veteran care through need-driven biomedical research and innovation.

Medical University of South Carolina sues six of its oncologists and HCA Healthcare, alleging that the doctors – who will leave MUSC on December 1 to take jobs at HCA-owned Trident Medical Center — stole confidential information such as case logs and patient lists to help their new employer create a competing head and neck oncology program. MUSC said the doctors used its email servers to send confidential preference card information to Trident officials.


Other

Several NFL and college football teams are collecting impact data from sensor-embedded player mouthpieces, pairing the force, speed, direction, and location information with video to test helmet effectiveness and to influence future rule-making to reduce concussions.

In Canada, Peterborough Regional Health Centre lays off 84 employees as part of its Epic implementation. The hospital says it is eliminating a “limited number of clerical roles.” The hospital is one of seven Central East Ontario health systems, representing 14 hospitals, that will go live on Epic on December 3.

A Wall Street Journal article titled “It’s Time to Get Rid of the IT Department” says that the typical IT department is a bureaucratic island that hinders innovation, digital transformation, and customer focus, making these points:

  • Separating the IT department – both organizationally and physically – from the core business doesn’t make sense, even if the group is given a sexy new name like “global digital solutions.” Technology is no longer optional.
  • Treating IT as a partner to the business encourages it to be judged using metrics that are often irrelevant to long-term business outcomes, such as budget, uptime, and project completion. “Meeting specs” doesn’t correlate with success, and businesses isn’t driven by owning, building, and managing IT systems.
  • Business units can’t predict their technology needs months or years in advance as required by IT budgeting, making it impossible for siloed IT departments to meet expectations for being faster and more flexible.
  • Most IT employees work there because they love technology rather than the company’s core business, creating a culture gap that ignores the fact that the business is the technology and vice versa.
  • Some companies are moving toward focusing on realizing value from IT within business units instead of rewarding the IT department for centrally managing it. This makes more sense as cloud computing relieves IT from managing physical assets such as data centers and servers and low-code software development reduces the need for programming talent.
  • Companies are organizing their missions around groups that include embedded technical experts, which encourages innovative thinking, deeper subject matter expertise, and fewer handoffs.
  • IT decentralization comes with “freedom within a framework,” such as requiring use of standardized development tools, architecture, and security protocols.

image

RSNA expects 19,000 attendees to attend this week’s in-person conference at Chicago’s McCormick Place, with another 4,000 participating virtually. The exhibit hall will showcase 500 vendors. The last in-person meeting, RSNA 2019, drew 52,000 registrants, with exhibitor personnel making up nearly half of the total.


Sponsor Updates

  • In England, North Tees and Hartlepool NHS Foundation Trust implements TrakCare electronic prescribing and medication administration technology from InterSystems.
  • CHIME honors HCA Healthcare and Meditech with its Collaboration Award.
  • OptimizeRx wins two Digital Health Awards.

Blog Posts


Contacts

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

125x125_2nd_Circle

Morning Headlines 11/25/21

November 24, 2021 Headlines No Comments

HHS Announces $35 Million for Telehealth in the Title X Family Planning Program

HHS allocates $35 million to help Title X family planning providers enhance and expand their telehealth infrastructure and capacity.

Peterborough Regional Health Centre lays off 84 as new digital records system rolls out

Peterborough Regional Health Centre, one of seven hospitals in Ontario preparing to go live on Epic in early December, lays off 84 employees in a move management says is necessitated by changes brought on by the new software.

Disclosures reveal Current Health was sold for $400m

Records reveal that Current Health, which offers remote patient monitoring, telehealth, and patient engagement technologies, was acquired in September by Best Buy for $400 million.

Morning Headlines 11/24/21

November 23, 2021 Headlines No Comments

San Diego-based startup LifeVoxel raises $5 million seed funding for its AI diagnostic visualization platform

Remote diagnostic software startup LifeVoxel raises $5 million in seed funding.

Luma Health Raises $130 Million In Series C Funding To Unify, Automate, And Transform Patients’ Healthcare Journeys

Patient engagement software vendor Luma Health raises $130 million in a Series C round that brings its total funding to $160 million.

ImagineSoftware Announces Strategic Growth Investment from Marlin Equity Partners

Medical billing automation vendor ImagineSoftware secures an undisclosed amount of funding from Marlin Equity Partners.

News 11/24/21

November 23, 2021 Headlines No Comments

Top News

image

Private equity firms Bain Capital and Hellman & Friedman will acquire Athenahealth from Veritas Capital and Evergreen Coast Capital for $17 billion.

Veritas and Evergreen will retain a minority investment in the company. The management team will remain in place.

Hellman & Friedman’s health IT portfolio includes Change Healthcare and PointClickCare, while Bain Capital’s includes HST Pathways.


Webinars

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

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

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


Acquisitions, Funding, Business, and Stock

image

Health technology and services company Edifecs will acquire Health Fidelity, which offers natural language processing-enabled risk-adjustment technologies and consulting services. Edifecs will add Health Fidelity’s assets, along with similar offerings from recently acquired Talix, to its Encounter Management software for payers.

image

Digital musculoskeletal care company Sword Health raises $163 million in a Series D funding round, bringing its total raised to over $300 million at a valuation of $2 billion.

image

Remote diagnostic software startup LifeVoxel raises $5 million in seed funding.

image

Patient engagement software vendor Luma Health raises $130 million in a Series C round that brings its total funding to $160 million.


People

image

Cerner names Johnny Luu (Google Health) as chief communications officer.

image

Healthcare Triangle hires Jason Polli, MBA (Leidos) as VP of client success.

image

Albany Med (NY) promotes Kristopher Kuschem MEng to VP/CIO.


Announcements and Implementations

Ascom announces GA of its Digistat clinical workflow software in North America.

image

Monument Health (SD) implements Healthcare Triangle’s Readable.AI technology for automated document processing.

image

The Ohio Department of Mental Health and Addiction Services launches TreatmentConnection.com, an online mental health and addiction treatment screening and provider locator available through technology developed by Bamboo Health.


Sponsor Updates

  • Medcare Orthopaedics & Spine Hospital in Dubai goes live on InterSystems TrakCare.
  • Jvion shares predictions for how AI will continue to shape healthcare in 2022.
  • The First Coast Connect Podcast features Availity CTO Jack Hunt.
  • Cerner releases a new podcast, “What does it take to be a real-time health system?”
  • CHIME’s 2021 Digital Health Most Wired Trends Report reflects the rapid digital transformation of and growth in patient engagement.
  • AHLA’s latest Speak of Health Law Podcast, “Legal Liabilities of Enterprise Cyber Risk Management,” features Clearwater founder and executive chairman Bob Chaput.
  • KLAS Research and Arch Collaborative release a case study featuring Baptist Health and Divurgent.
  • Everbridge will exhibit at the National Healthcare Coalition Preparedness Conference November 30-December 2 in Orlando.
  • Fortified Health Security names Audra Barnes security compliance analyst.
  • FeaturedCustomer’s “Fall 2021 Hospital Communications Software Customer Success Report” includes Halo Health as a top performer.
  • Healthwise wins several Digital Health Awards.
  • Visage Imaging will introduce Visage 7 Video Reports at RSNA21.

Blog Posts


Contacts

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

125x125_2nd_Circle

Morning Headlines 11/23/21

November 22, 2021 Headlines 8 Comments

Athenahealth, Healthcare Technology Leader, to be Acquired by Hellman & Friedman and Bain Capital for $17 Billion

Private equity firms Bain Capital and Hellman & Friedman will acquire Athenahealth from Veritas Capital and Evergreen Coast Capital for $17 billion.

Edifecs Enters Into Definitive Agreement to Acquire Health Fidelity

Health technology and services company Edifecs will acquire Health Fidelity, which offers natural language processing-enabled risk-adjustment technologies and consulting services.

Sword Health Raises $163M and Reaches $2B Valuation as the Fastest Growing Digital MSK Company

Digital musculoskeletal care company Sword Health raises $163 million in a Series D funding round, bringing its total raised to over $300 million.

Curbside Consult with Dr. Jayne 11/22/21

November 22, 2021 Dr. Jayne 1 Comment

As health systems continue to refine strategic planning for a potential upcoming influenza season or yet another wave of COVID-19 infections, telehealth is undoubtedly part of nearly everyone’s strategy. As a consultant, it’s interesting to see how different organizations have decided to use it.

For some, it’s strictly for acute visits and urgent-care type services that they can’t accommodate due to packed office schedules. For others, it’s an adjunct to their offerings for chronic care visits, which depending on the condition may be less likely to require a physical exam. Others are using it to grow their business by reaching out to previously untapped patient populations. A small number are using it as an option for physicians and other providers who may not be able to work in-person due to a personal health issue that precludes face-to-face contact with patients, or potentially having a family member at home who is at risk for infection.

I know a number of physicians who are going through cancer treatments or who are otherwise immune compromised and being able to practice virtually has kept them from going on disability or leaving medicine altogether. It’s an option that few physicians had previously and might be one of only a handful of good things that have come out of enduring a global pandemic. Not only is the option good for those individuals, but it’s good for care delivery organizations who would have otherwise lost capacity. When those physicians can keep their own panels it’s ideal since there can still be continuity, but I know that’s not always the situation, such as in the case of physicians who are in procedure-based subspecialties.

Still, there are growing concerns about how telehealth fits into the care landscape. Concerns with the cost of telehealth compared to in-person visits have been fairly straightforward, but questions about the clinical care provided have been less well defined. A recent report from Quest Diagnostics reviewed one of the concerns in more detail. The report, titled “Drug Misuse in America 2021: Physician Perspectives and Diagnostic Insights on the Drug Crisis and COVID-19,” found that almost 70% of physicians worried that signs of drug misuse were missed during pandemic-related care disruptions. The drugs in question include both prescribed substances as well as those obtained illegally.

Researchers looked at some 5 million test results performed by Quest Diagnostics, including 475,000 from the year 2020. They combined that data with survey results from the Harris Poll, which queried more than 500 primary care physicians. The report concluded that physicians are concerned about their ability to manage patients given the risks of drug misuse. In addition to worrying that they missed warning signs of drug misuse during the pandemic, 94% of primary care physicians state they are seeing an increased number of patients with mental health issues during the pandemic and “fear a correlation between rising mental health issues and prescription drug misuse.” Additionally, 98% of physicians are concerned about issues with controlled substances as a whole, compared to 75% who are concerned about opioid medications.

Specific to telehealth, 75% of physicians are concerned that telehealth visits limit their ability to identify whether patients are at risk for or already having issues with prescription drug misuse. Where 91% of physicians feel they can recognize warning signs during in-person visits, only 50% feel they can recognize issues during a telehealth visit. In my experience as a physician, most of the warning signs I’ve identified come from the patient’s history and discussion of their current situation rather than from the physical exam, so I find this phenomenon interesting. Beyond the information gathered from the patient’s story, I’ve used data such as refill patterns or information from prescription drug monitoring program records to identify potential misuse. Although I don’t question how some physicians feel, I’d be interested to understand more deeply why they feel this way and what they find lacking in a telehealth visit.

Another angle that was brought up was the idea that physicians are less willing to prescribe opioids during the pandemic, as well as the lack of alternatives for treatment for chronic pain. Nearly 80% of them are concerned that patients will turn to illicit fentanyl if they can’t get prescription medications, with 86% of them being concerned that illicit fentanyl will lead to higher death rates than prescription opioids. I totally understand not wanting to prescribe controlled substances during a non-face-to-face visit, especially since I was fairly strict in traditional practice as far as random drug testing during visits, and agree that we need better options for treating chronic non-cancer pain. The illegal drug crisis is real and it’s important for physicians to have strategies to identify such drug use, but I don’t think that a telehealth visit rules out that ability.

The report went on to look at drug testing as a component of treatment, with 81% of physicians seeing it as critical to prevent overdose deaths. However, more than half of physicians aren’t following up when presumptive drug tests are positive, and it’s not clear why. Given the capabilities of EHRs to include flowsheets for medication management as well as trackers and prompts for drug surveillance testing, I wish more of my peers would take advantage of those features so that they could more confidently care for patients. Additionally, only a third of physicians felt confident in prescribing naloxone to treat potential opioid overdose. It’s pretty easy to configure order sets that include both opioid pain medications and naloxone, so failing to do so is another missed opportunity to leverage technology. Existing clinical guidelines can be built into the EHR to help with clinical decision making and screening for changes in prescribing patterns.

I think it’s important to not overlook telehealth as a potential adjunct to pharmaceutical pain management. There are many providers out there who offer psychotherapy via telehealth, which could help as part of team-based care to identify patients who might not have their needs met with current pain management regimens. With the potential of using lower-cost resources such telehealth therapy versus in-person physician visits, patients could have more frequent check-ins about their needs as well as the ability to learn additional techniques to better manage their pain. Other options like telehealth-enabled physical therapy could be added for patients who might not be able to participate in traditional physical therapy appointments due to time or logistical limitations.

I polled a few primary care colleagues about the report, and their consensus opinion was that identifying drug misuse was more about having a relationship with the patient and ongoing contacts than it was about being in-person versus virtual. They were significantly more concerned about fragmented care as a risk factor for drug misuse as opposed to telehealth. I’d be interested to hear if any reader institutions are looking further at this issue, and whether they’re reaching different conclusions.

Have any thoughts on the connection between telehealth and prescription pain medication abuse? Leave a comment or email me.

Email Dr. Jayne.

Text Ads


Recent Comments

  1. 100% agree about the remote employees - particularly in health care. If you think you can 100% work from home…

  2. Re: NEJM Article "The Solution Shop and the Production Line..." I totally agree that there can be a bias towards…

  3. In the NEJM piece that you pointed out, I wonder how you see the impacts of hospital-employed physicians, use of…

  4. You asked, "Readers, what is your experience with Oracle as a vendor?" Oracle is notorious for charging a LOT of…

  5. This quote from your article is just hilariously and provably wrong. "At the cost of millions to billions of dollars…

Tweets

Founding Sponsors


 

Platinum Sponsors


 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Gold Sponsors


 

 

 

 

 

 

 

 

 

 

Sponsor Quick Links