Recent Articles:

Readers Write: Medical Devices are Evolving, and How They are Managed Needs to Evolve, Too

November 22, 2021 Readers Write No Comments

Medical Devices are Evolving, and How They are Managed Needs to Evolve, Too
By David Klumpe

David Klumpe, PharmD is president of clinical asset management of TriMedx of Indianapolis, IN.

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Technological advancements in healthcare come at a rapid pace. While there are benefits to this, technological evolution can also bring challenges for healthcare systems that strive to run efficiently while maintaining quality care.

The management of medical devices is one such challenge. As devices become more complicated and increasingly get connected to the internet, how they are best managed becomes more complex. Optimum-use decisions are guided by lifecycle factors and cybersecurity risks, not the age of a device on a spreadsheet list or other simple factors.

To best meet the future of technology and retire inefficient practices, health systems can employ a clinical asset management solution to optimize their device fleets, increase staff productivity, and improve patient care.

Let’s talk about inventory accuracy and why detailed visibility into your fleet is the core element to driving efficiencies at scale.

The fundamental task of inventory visibility is knowing exactly what medical devices you have and where they are located. Healthcare staff lose valuable time and become frustrated searching for a device. Are the insulin pumps in this storage closet on this floor? Or on another floor? While caregivers search, patient care suffers.

But inventory visibility is at the heart of capital expenditure decisions, maintenance choices, and cybersecurity needs. A clinical asset management solution can provide real-time visibility and deep insights into the status of a healthcare system’s fleet. Software algorithms can help optimize asset life and disposal timing. By analyzing age, repair history, parts availability, amount of inventory, usage patterns, FDA recalls, cybersecurity risks, and other factors, clinical asset management solutions can establish the true useful life of a medical device and guide decisions on whether it should be replaced.

Perhaps instead of being replaced the device can be upgraded, typically a less-expensive choice than replacement. Clinical asset management teams can weigh factors such as device age, condition, and options for software and hardware upgrades to recommend options.

Visibility also gives insight into which devices should be disposed. Unused equipment still requires maintenance. A better option may lie in selling the equipment to other health providers.

Best use also entails making sure devices are available at the right place and at the right time, at the unit, hospital, and health system level. Meeting demand with existing assets maximizes revenue opportunities while avoiding additional capital expenditures such as medical equipment rental expenses.

Few recent technological advances present as much risk as the internet and the internet of things. The slew of rising cyberattacks with more profound effects is drawing the attention of consumers, businesses, and governments alike.

The threat to medical devices is intensifying as well. At first, the risk of connected medical devices was a vulnerable gateway into a health system where hackers could steal or hold ransom financial, patient, and other sensitive records. In recent years, the threat escalated to target medical devices themselves and render them inoperable. Worse now is the potential for far more maliciousness. Earlier this year, McAfee researchers discovered vulnerabilities in two types of infusion pumps that might allow hackers to deliver double doses of medicine to unsuspecting patients.

Cybersecurity provided by clinical asset management solutions can monitor, detect, prevent, and respond to cyberthreats in real-time. But what can be particularly valuable is a cybersecurity assessment for each device. Manufacturers at some point often no longer support a device, so a patch may be unavailable. What a clinical asset management team needs to know is the seriousness of the vulnerability. The cybersecurity assessment can evaluate the medical device profile, device behavior, and potential impact to patient safety and drive recommendations on whether to replace, upgrade, or dispose of the device to best prevent deadly cybersecurity downfalls.

A key component of the real-time status assessment of every medical device in a fleet is avoiding downtime. When equipment is down, hospital efficiencies suffer. When equipment is down, caregivers become frustrated because doing their job becomes more complicated and time-consuming. When equipment is down, patients grow more irritable with the delays, and quality of service suffers.

A modern clinical asset management solution uses powerful, real-time analytics to optimize device usage and prevent downtime. Spreadsheets or databases provide only a list, widening the risk that device upkeep falls through the cracks. A clinical asset management solution, on the other hand, provides a lifecycle and cybersecurity assessment of every device in the system to maximize device efficiencies in a fleet today and tomorrow.

Readers Write: How to Fill Staffing Gaps Without Hiring

November 22, 2021 Readers Write No Comments

How to Fill Staffing Gaps Without Hiring
By Hadi Chaudhry

Hadi Chaudhry is president and CEO of CareCloud of Somerset, NJ.

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According to the US Bureau of Labor Statistics, nearly 500,000 workers have left the field since the start of the pandemic. Furthermore, burnout continues to plague the workforce. Clinicians and support staff are suffering, but administrative teams are feeling the stress as well. Jobs that were lost when revenues fell off a cliff are now hard to refill. Many furloughed workers have decided to explore other industries or leave the workforce entirely, either to stay home with their families or to avoid vaccine mandates.

As a result, back-office workers have become stretched thin. Claims processing, especially due to new challenges like COVID lab tests, number in the millions of extra claims every week.

New alternatives are helping to ease the two-sided problem of unfilled positions and overworked staffers. Robotic process automation (RPA) is one tool for offloading mundane and repetitive tasks that plague support and administrative workers. Robotic processes can handle everything from claims denials and payment processing to document management. On the clinical side, RPA can automate wellness checks, medical uploads, and CPT code verifications.

RPA can be immensely productive for any healthcare organization. The microbots in RPA solutions are capable of increasing revenue by working through backlogs of thousands of transactions or claims in a single day. Underpayments, appeals, and filing limits are all candidates for RPA automation.

Another solution to staffing gaps is temporary or long-term workforce extension services. These outsourced services take routine, repetitive tasks off the backs of existing workers, saving practices up to 80% in resource costs.

Many payers and revenue cycle companies already depend on workforce extension services, and their use in provider organizations is accelerating. Many workforce extension providers offer talented, highly trained staff that are fully trained in scores of EHR, billing, and practice management systems. Solutions can be very specific and quickly mobilized, with specialists available for a hospital’s specific host applications.

Automation and on-demand workforces perform best when organizations work collaboratively with consultants and service providers. When considering RPA, medical groups should work alongside service providers to address the most repetitive tasks, such as  checking claims status, pre-authorizations, and insurance discoveries.

Organizations can use RPA for the most mundane tasks, leaving on-demand staff to handle more complex duties where a human touch is needed. Oftentimes the 80/20 rule applies — automation can resolve 80% of all routine back-office tasks, while the remaining 20% may require involvement of skilled revenue professionals.

It’s critical that solutions are implemented earlier rather than later. Hoping that situations will resolve themselves is misguided. Both automated platforms and workforce extensions typically take two to four weeks to implement, but the timeline for workforce extension will depend on the size of the incoming team. The longer an organization waits, the more difficult it is to work through backlogs and prioritize results.

On-demand and automated solutions can help with many challenges healthcare employers face, from adequately supporting remote workers to reducing stress and enabling employees to concentrate on patient engaging and revenue-increasing tasks. Small practices, large medical clinics, hospitals, and health systems alike are aware that we’re in a challenging hiring environment. Filling gaps with automation and supplemental staffing is the best way for weary workers, as well as their employers, to succeed.

Readers Write: How Hospitals and Healthcare Systems Can Curb Violence Against Staff

November 22, 2021 Readers Write No Comments

How Hospitals and Healthcare Systems Can Curb Violence Against Staff
By Terri Mock

Terri Mock, MS, MBA is chief strategy and marketing officer of Rave Mobile Safety of Framingham, MA.

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Hospitals and healthcare facilities are seeing an uptick in violence, no doubt attributable in part to frustration caused by the pandemic. Healthcare workers, lauded as frontline heroes 18 months ago, are now at higher risk of violent incidents. For instance, the National Nurses United found that 31% of hospital nurses have faced a small or significant increase in workplace violence, up from 22% in March 2021.

To prevent harm and abuse in the workplace, hospital and healthcare leaders must re-evaluate emergency response plans, adopt better mass communication tools, and support staff more effectively in dealing with abusive or potentially violent patients and aggressive visitors. These interventions are essential if we aim to keep healthcare professionals, especially nurses, from leaving the field.

On the emergency response front, leaders must ensure their teams are prepared and aware of the protocols that exist for dealing with violence in the building. If specific emergency response plans don’t exist for addressing violence, those should be created as soon as possible. If they exist within a bigger collection of emergency procedures and protocols, it’s worth considering when they were last updated and how easy it is for workers to access that information in the midst of a chaotic situation.

Emergency plans should be readily available and tailored to individual roles across the hospital or healthcare network. For larger organizations, it often makes sense to put emergency plans in a central digital repository that staff can access through mobile apps and online portals. That way, workers don’t have to chase down physical documents or navigate an unwieldy file system. They can pull up what they need, look up phone numbers, and take action according to their unique role.

Regarding communication tools, it’s time to go mobile and modern. Hospitals and healthcare systems today need to notify staff of critical incidents wherever they are located. Modern communication platforms enable staff, patients, and even visitors to collaborate in real time using two-way mass notification systems across multiple channels, including SMS, email and voice calls, anonymous reporting, push notifications, audience segmentation, and more.

These platforms also provide mobile apps for personal safety and secure communications. In an emergency, nurses or other healthcare professionals could easily alert security for assistance, give helpful details, and provide ongoing updates, if needed.

Finally, leaders must empower healthcare workers to improve their personal safety. We’re already suffering through a country-wide nursing shortage and burnout. By 2030, we may be short over one million RNs, according to a study conducted by Good Call.

Administrators have to educate staff on the importance of reporting violent incidents and follow through in taking those reports seriously. To carry out their responsibility for duty of care, healthcare organizations need the ability to locate and check on the wellbeing of their employees. Technology can be helpful here to solicit a healthcare worker’s real-time location and status when they may need help.

The ability to locate and contact a mobile, remote, and traveling healthcare workforce can be accomplished using a geo-polling feature available in a mass notification system. Healthcare organizations can require information from their workers with simple poll questions via SMS, email, and voice calls. The responses are collected to ensure every individual’s status and location is made known.

Should a nurse answer that they are in danger or need assistance, security personnel can identify who they are and where they are located, then trigger two-way communications to coordinate a response and facilitate their safety. A follow-up geo-poll can be sent to individuals who did not respond or to obtain further information to direct the appropriate response to their needs. With geo-polling, every healthcare worker’s status and location are known so you can protect and keep them safe.

Healthcare has always been a high-risk industry, and events over the past 18 months have exacerbated many of the challenges healthcare workers face. By updating emergency response plans, adopting better communication technology and giving staff more ways to report violence, leaders can protect the personal safety, decrease risk, and improve conditions for those on the front line.

Morning Headlines 11/22/21

November 21, 2021 Headlines No Comments

Bain, Hellman & Friedman Near Deal to Buy Athenahealth

The Wall Street Journal reports that two private equity firms are close to a deal to acquire Athenahealth for $17 billion, including debt.

Nuance Announces Fourth Quarter and Fiscal Year 2021 Results

Nuance announces Q4 results: revenue up 8%, adjusted EPS $0.09 versus $0.14.

Avodah Closes $7 Million Seed Round to Scale Digital Healthcare Platform with AI Capabilities

Avodah will use a $7 million seed round to further develop its AI-powered AvodahMed technology, which includes remote pre-visit administration, patient monitoring, and care management.

CenTrak Advances Managed Services with Infinite Leap Acquisition

RTLS vendor CenTrak acquires healthcare IT consulting and managed services company Infinite Leap for an undisclosed sum.

Monday Morning Update 11/22/21

November 21, 2021 News No Comments

Top News

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The Wall Street Journal reports that two private equity firms are close to a deal to acquire Athenahealth for $17 billion, including debt.

Bain Capital and Hellman & Friedman LLC are reported to be the high bidders in an auction of the company, which its owners planned to have completed in early 2022.

A private equity firm and hedge fund took Athenahealth private four years ago after they forced the ouster of CEO Jonathan Bush, combining the company with a GE Healthcare unit it had acquired and renamed to Virence Health. Their  total acquisition cost was $6.8 billion.


HIStalk Announcements and Requests

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The significant concern poll respondents have about remote patient monitoring is that they will need services that aren’t readily available, which explains why investor-backed companies are springing up to provide paramedics and other licensed people to visit patient homes for the hands-on component that would otherwise require a trip to a provider’s location. IANAL questions why a patient would choose care at home when it is perceived as inferior and may not save the patient money, while Paula says triaging will be important since not all recoveries or home situations support at-home care. I agree with both comments – it may be that at-home care isn’t appropriate for many or most patients and will never deliver on “hospital at home” expectations, but could provide a way to reduce the length of hospital stays and make some patients happier. Payment will likely drive adoption as it always does in healthcare, so the ball is in the hands of CMS and insurers.

New poll to your right or here: How are your employer’s 2022 business prospects looking compared to 2021?


Webinars

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


Acquisitions, Funding, Business, and Stock

I was curious about the stock performance of digital health companies that have gone public in the last couple of years, so I asked Chris McCord of Healthcare Growth Partners – which is my go-to source for brilliant market analysis – if he could save me some legwork with a list of companies. I excluded those that I consider marginally tech related, such as Medicare Advantage insurers and primary care operators, which left me with this list:

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  • About half of the companies are trading at below their initial offering price.
  • Companies that went public via a SPAC merger performed much worse than those that did an IPO. SPAC popularity as a mechanism to go public has plummeted in the last few months, with some of the shell companies failing to find acquisition targets within the required timeframe.
  • Buying an equal number of shares of each company at their IPO price would have increased the investment by about 37%, but obviously over various time periods.
  • While Phreesia is the big winner in price change, Doximity has earned the highest market cap at nearly $13 billion after just five months of public trading.
  • Livongo fell off the list since it was acquired by Teladoc Health, whose share price has increased 516% since its July 2015 IPO even though share price is down 56% from its January 2021 high.

Nuance announces Q4 results: revenue up 8%, adjusted EPS $0.09 versus $0.14. The company’s acquisition by Microsoft is expected to close in early 2022.


People

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Population health management platform vendor AssureCare hires Ankit Rohatgi, MD, MBA (Medpulse) as chief clinical officer.


Announcements and Implementations

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Vocera releases a skill for Amazon Alexa that allows patients to reach the right care team member and obtain stay information using voice requests made to an in-room Echo device.

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Spok launches GenA, a one-way alphanumeric pager that includes a high-resolution display, advanced encryption, and over-the-air remote programming to provide reliable, survivable, and affordable critical communications capability regardless of cell coverage.


Sponsor Updates

  • Clearwater publishes a new report, “Connecting the Dots Between Cyber Risk and Patient Safety.”
  • PMD celebrates its 23rd anniversary.
  • Sonifi Health publishes a new case study, “How technology can improve HCAHPS Scores: A 5-year impact case study.”
  • Sphere releases the results of a consumer survey focused on the use of online payment tools for medical bills.
  • HIStalk Sponsors exhibiting at RSNA November 28-December 1 in Chicago include Agfa HealthCare, Change Healthcare, Elsevier, Lyniate, Mach7 Technologies, Nuance, OneMedNet, Sectra, Visage Imaging, and Wolters Kluwer Health.

Blog Posts


Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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Contact us.

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Weekender 11/19/21

November 19, 2021 Weekender 2 Comments

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Weekly News Recap

  • Athenahealth’s private equity owners are reportedly in final discussions to sell the company for up to $20 billion.
  • Healthcare payment options platform vendor PayZen raises $15 million.
  • HIMSS estimates that modernizing public health IT systems will cost $30 billion.
  • The US Coast Guard completes its Cerner implementation.
  • Healthcare API company Ribbon Health raises $43.5 million.
  • QGenda acquires Schedule360.
  • Lightbeam Health Solutions acquires CareSignal.
  • Medidata Solutions co-founder Glen de Vries dies in a plane crash.

Best Reader Comments

[Amazon Care] sounds like how employees get care from their local doctor’s office through employer-provided insurance? Except with another megacorp inserted into the mix to soak up some healthcare dollars. I guess the home visits are unique but that will last only as long as the option doesn’t have any real utilization. (IANAL)

Just to be clear, Teladoc paid almost no cash for Livongo — about $11 cash a share which was then valued at $150. The rest was in stock. Still a great sale by Glen Tullman but there’s doubtless an alternative universe where the two companies are going after each other, with one paying up to build out a chronic care management operation and the other building a telehealth service. (Matthew Holt)

Medicine shouldn’t be a lousy job, but from what you write, it clearly is in many cases. I would think that telemedicine will become very common particularly in true health systems where providers across the whole system are using the same EHR – telemedicine, urgent care, ER, PCPs, specialists, and everyone else. I get my care from a such a system and it is comforting to know that however I need to get care for a particular thing, my up-to-date and comprehensive records will be available as long as I’m getting care in system. (West Coast Vendor Mgmt)


Watercooler Talk Tidbits

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Readers funded the Donors Choose teacher grant request of Ms. D in Arkansas, who asked for supplies, furniture, and math kits for her special education high school class. She reports, “I can’t tell you how much your donations have impacted my class. Being in special education, I deal with a low budget and many needs. So many of them have excess energy and now they are able to fidget around on their new stools without disturbing others. This has given them the opportunity to focus on the assignment rather than being constantly distracted by being redirected for making noise. The analog clock has been used by every class as we work in calculating the time and the time difference in word problems. The foam bag is a favorite of every student! They can relax, read and enjoy a break from the typical chairs and tables. Our students learn best with hands-on activities and the construction paper has given us the ability to build and create scenes from books, work geometry, and bring numerous projects to life in science. We are forever grateful for your kind generosity and will pay you back with our success in the future as productive members of society.”

Hospitals in Israel are dealing with incidents of mass violence such as parking lot gunfights, mobs attempting to force their way into EDs that are treating crime victims, and a funeral that turned into a shootout in which participants then stormed a hospital.

CDC predicts that when total ICU bed capacity reaches 75% in the US, 12,000 excess deaths can be expected in the following two weeks, while exceeding 100% of ICU capacity could be associated with 80,000 excess deaths.

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Apple profiles Northwell Health’s use of T6, an IPad trauma care app that was previously used only by the military. The app’s name refers to the six hours in which a traumatic injury requires medical intervention to achieve the best outcome. Northwell Health trauma surgeon Omar Bholat, MD, MS – who is also an Army reserves command surgeon who has deployed on six combat tours – says, “T6 is going to help streamline the flow of data from the point of injury to the ICU and everywhere in between. That’s going to be huge for trauma medicine, whether that’s civilian or military.”


In Case You Missed It


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Morning Headlines 11/19/21

November 18, 2021 Headlines No Comments

Athenahealth sales process is said in final stages

Sources report that several private equity firms are vying to acquire Athenahealth in a deal that could bring sellers Veritas and Evergreen Coast Capital as much as $20 billion.

SignalFire Backs ‘Care Now, Pay Later’ Pioneer PayZen to Fuel Healthcare Affordability

Healthcare payment options platform vendor PayZen raises $15 million in a Series A round.

Tech suppliers chosen for £5bn NHS digital records framework

The UK’s NHS selects 46 companies, including Nuance, Conduent, Hyland, and 3M Modal, to provide digital document services and related hardware and software.

Medicom Technologies Closes Oversubscribed $21.8M Series B Financing

Medicom, a health information network specializing in medical image sharing, raises $21.8 million in a Series B funding round.

News 11/19/21

November 18, 2021 News 5 Comments

Top News

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Healthcare payment options platform vendor PayZen raises $15 million in a Series A round.


Reader Comments

From Clicker: “Re: clicks. You have said you track certain clicks on the site. I’m wondering which had the highest numbers.” I usually count clicks for announcement of a new sponsor, a webinar, or anything for which I’m trying to gauge reader interest for future coverage. The most-clicked items (3,000 to 4,000 clicks each) were new sponsor announcements (which make up the top five spots), webinars (six), top-of-page banner clicks (two), and an interview (one). The question made me wonder about our webinar recordings, where I found that the one Frank Poggio and the late Vince Ciotti did in 2014 about Cerner acquiring Siemens Health Services has drawn 8,700 views, including one from me today as I enjoyed hearing Vince’s voice again.


HIStalk Announcements and Requests

HIMSS22 starts in 116 days. Early bird in-person pricing of $895 is good until January 10. I’m still waffling on whether it’s worth my time and money to attend, so I haven’t registered or booked a place to stay. You?


Webinars

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


Acquisitions, Funding, Business, and Stock

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Aptihealth, which matches health plan and health system customers with behavioral health providers, raises $50 million in a Series B funding round.

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MedArrive, which offers at-home care from licensed professionals such as paramedics as an adjunct to virtual visits, raises $25 million in Series A funding. Co-founder and CEO Dan Trigub spent short stints at Uber Health and Lyft before starting the company last year.

Precision medicine vendor Tempus announces that eight institutions are live on integration with Epic’s genomics module, which embeds Tempus test ordering and genomic data delivery into existing clinical workflows. The companies say that integration timelines will be reduced from months to weeks in 2022.

CVS will close 900 of its stores over the next three years, nearly 10% of its total, as online shopping has reduced customer demand for near-home convenience and the additional of in-store health services creates new demands for layout and location.

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Teladoc’s investor day presentation predicts that consumers will expect virtual-first encounters whose quality equals in-person ones and that offer them a variety of coordinated care services. The company says it has evolved from fee-for-service video visits and will become a partner with its customers in offering whole-person care at under value- and risk-based arrangements. It says it will be “the first place consumers turn to for all healthcare needs” for “whole-person care that is personalized, convenient, and connected.” TDOC shares dropped 8% on the day and have shed 25% in the past 12 months, with the company’s market value being $20 billion versus the $18.5 billion in cash it paid to acquire Livongo in late October 2020.


Sales

  • Northeastern Center (IN) chooses the SmartCare EHR of Streamline Healthcare Solutions.
  • Luminis Health (MD) will implement Cedar’s post-visit patient engagement and payment platform, integrated with Epic.

People

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Ochsner Health hires Denise Basow, MD (Wolters Kluwer)  as its first chief digital officer. She has been president and CEO of Wolters Kluwer’s clinical effectiveness business unit for six years and was previously with UpToDate, which was acquired by Wolters Kluwer Health in 2008, since 1996.


Announcements and Implementations

The UK’s NHS chooses 46 companies to provide digital document services and related hardware and software. Among those named for the nearly $7 billion program are Nuance, Conduent, Hyland, and 3M MModal.

A HIMSS report estimates that the federal government will need to spend $30 billion to modernize federal, state, local, and tribal public health reporting and data systems, recommending that Congress provide a minimum of $1.57 billion per year for technology and workforce development. The funding would support electronic case reporting and contact tracing, laboratory information management systems, syndromic surveillance, electronic vital records (births and deaths), a national notifiable disease surveillance system, analytics and visualization staffing, creating incentives for provider data exchange.

HIMSS creates a certification program in digital health transformation strategy, with CPDHTS joining its existing offerings CPHIMS and CAHIMS. Cost ranges from $1,099 to $1,399, while the two-year renewal requires 45 clock hours of continuing education and a payment of $299 or $399.

A review of the de-identified Cerner EHR records of 490,000 COVID-19 patients finds that the use of SSRI antidepressants was associated with a 28% lower relative risk of death.

Three entrepreneurs, including Ricky Caplin (The HCI Group), form The Aurora Forge, which will grow seed-state healthcare and government technology companies and donate the majority of its profits to charity. Several health system CIOs are among its advisors.


Government and Politics

The US Coast Guard finishes its deployment of Cerner as part of the DoD’s MHS Genesis project.


Other

A retiree from Vietnam who was stranded in the US for 18 months because of the pandemic is stuck with a $38,000 emergency glaucoma surgery bill even though the daughter he was visiting had bought him traveler’s medical insurance that had preauthorized the procedure. The insurer declined to pay, saying that his condition was pre-existing even though it hadn’t been previously diagnosed. His only income is a $260 per month pension. The man’s daughter, who had bought him plane tickets home on 14 flights that were eventually cancelled, may be on the hook to pay his bill even though he was finally able to return home because of California’s filial responsibility laws.

In Canada, Halifax family physician Ajantha Jayabarathan, MD wins a family medicine “Big Ideas” contest for her GIS-powered Health Geo-View, which allows virtual visit doctors to visualize the patient’s neighborhood for socioeconomic information, proximity to health services, and environmental risk factors.


Sponsor Updates

  • Olive offers its customers the ability to leverage DARVIS solutions including rapid hygiene check, bed logistics, medical inventory, and sterile equipment completeness.
  • LexisNexis Risk Solutions will work with secure data collaboration company Karlsgate to develop a secure identity resolution platform for the healthcare market.
  • Everbridge introduces the next generation of its Travel Risk Management Solution for business, healthcare, and government customers.
  • Lumeon’s Remote Home Monitoring solution earns Gold in the 2021 EHealthcare Leadership Awards in the Best Business Process Improvement Products category.
  • Magnolia Regional Health Center (MS) adds Prelude Software’s PayPilot to its Meditech Expanse EHR to save time and increase revenue.
  • CareSignal publishes a case study titled “Utilizing Deviceless Remote Monitoring Within a Medicaid Managed Care Plan to Identify Rising Risk for Early Intervention with Promising Results.”

Blog Posts


Contacts

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

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EPtalk by Dr. Jayne 11/18/21

November 18, 2021 Dr. Jayne 2 Comments

Road warriors, get ready. United Airlines has resumed sales of hard liquor on flights after resuming sales of beer and wine in June. Other airlines continue to hold off on serving alcoholic beverages as incidents involving disruptive passengers continue to rise. American Airlines plans to suspend alcohol service in the main cabin until at least January 18. There is still plenty of alcohol for sale in the nation’s airports, and several where I’ve recently traveled now allow passengers to drink the gate area instead of just within specified areas. I’m one of those people who keeps my mask on the entire flight and doesn’t snack or drink except for an occasional sip of water. Hopefully, the changes won’t bring an uptick in bad behavior, but only time will tell.

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HIMSS continues to try to push its Accelerate platform through email blasts. Honestly, I have absolutely no desire to join another social media platform, let alone one that is controlled by HIMSS. I was in the beta group for Accelerate and didn’t find the content to be useful. As for joining the groups they’re pushing now, I already participate in groups through my medical specialty society and through the American Medical Informatics Association, so I sort of feel like I have all the connections I need unless something really crazy happens. If readers have found value in Accelerate, drop me a line – I’d love to hear about your experiences.

From Jimmy the Greek: “Re: monitoring. I recently worked with an organization that was planning to roll out a software package that was embracing its Big Brother tendencies. It monitors how much time you spend in each application on your laptop, how much active typing/mouse time you have, etc. and provides a dashboard to your manager.” The system in question was advertised as allowing employees to “understand your personal work habits allowing you to maximize your workday and reach your potential.” For employees who are in roles that involve a certain amount of throughput, such as medical billing specialists, coders, claims processors, etc. this kind of solution might make sense if people are struggling with meeting their goals and need tools to understand their productivity.

In other roles, I question the need for it unless people aren’t getting their work done. Solutions like that that score people on how much they are “doing” don’t give any credit for the cognitive time preparing to do something or for analysis or strategic thinking. It doesn’t reflect any work done that doesn’t involve the laptop, such as diagramming on the white board, having non-electronic meetings with co-workers, or all the fabulous things that process improvement folks do with Post-It Notes and flipcharts. It’s one more way in which employers can devalue the actual thinking that people do for their jobs.

In medicine, we’re used to it since the cognitive specialties typically get paid far less than the procedural ones, but I don’t think such a focus on “doing” at the expense of “thinking” or “planning” is necessarily a good thing. Of course, it’s all about how the manager uses it, but as an employee, I’d be pretty annoyed by the concept.

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I attended a small gathering this evening with some former co-workers from my last clinical position. Except for me, everyone is still working full time, pulling 12- to 14-hour shifts as COVID-19 cases start to rise again in our community. It was a departure from our usual sessions since most of the attendees brought their children for some s’more making around the fire pit as well as photos with a 10-foot-tall inflatable turkey. It was quite a spectacle, but it was good to see people getting away from the office and doing some normal things with their children (at least until bedtime approached and the meltdowns started).

I daresay none of us at the bonfire think that COVID-19 is “no big deal” or “fake” or any of the things clinicians continue to hear from patients on a daily basis. Most of us are glad we haven’t been infected, and if we have, that our cases have been mild because that’s not always the case with our patients. After I returned home, I was scanning through email and came across an article in the Journal of the American Medical Association that put things in perspective and made me want to tell the moms and dads to hug their children tighter. The piece is titled “Thousands of US Youths Cope With the Trauma of Losing Parents to COVID-19.” It’s something people don’t like to talk about but that those of us in the trenches have seen. In our area, we’ve had several situations where children lost both parents to the pandemic, which is for most of us an unimaginable tragedy.

The article details some of the COVID-19 specific factors that make the situations even more tragic, such as children only being able to interact with dying parents via video calls and inability to hold memorial gatherings. Recent data indicate that more than 142,000 children have lost a parent, custodial grandparent, or grandparent caregiver due to the pandemic, looking at dates from April 2020 through June 2021. The worldwide estimate counts more than 1.1 million children losing a parent or custodial grandparent.

The piece goes on to contrast the losses due to COVID-19 with those from natural disasters or mass tragedies, where intense mental health services are available and where the causative incident is limited. The authors note that surviving children may be “extremely fearful that the virus will kill a surviving parent or siblings or claim their own lives.” They also describe feelings of “intense anger or shame” that may be felt by children mourning the loss of a parent who was unvaccinated or who refused to mask or distance.

As we move into the holiday season, it’s important to pause and think about those families whose holidays will be different this year due to the loss of loved ones. Unfortunately, the death toll continues to climb, mostly among unvaccinated individuals. For those on the fence about vaccination, I would offer the suggestion that becoming vaccinated might be the best gift you can give your family and yourself. I’m looking forward to spending time with my vaccinated and boosted family members who are in their 70s, 80s, and 90s as well as doing the traditional holiday things we usually do, some of which are a bit kooky, but that’s what family is all about.

What are your plans for the holiday season? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 11/18/21

November 17, 2021 Headlines No Comments

Aptihealth Raises $50 Million Series B to Scale Higher Acuity Behavioral Healthcare Services

Behavioral health telemedicine startup AptiHealth raises $50 million in a Series B round of funding, bringing its total raised to $65 million.

LifePoint Health launches health-tech incubator with $20 million seed

LifePoint Health (TN) will partner with private equity firm Apollo Global Management and venture studio 25madison to launch 25m Health, an incubator equipped with $20 million in funding.

Our Investment in MedArrive

On-demand and scheduled home healthcare company MedArrive raises $25 million in a funding round led by 7wireVentures.

Coast Guard completes MHS Genesis deployment

The US Coast Guard wraps up its nationwide rollout of MHS Genesis, the first US military service to fully implement the new Cerner software.

Readers Write: Protect Hospital Workers Now for a Safer and Brighter Future of Caring

November 17, 2021 Readers Write No Comments

Protect Hospital Workers Now for a Safer and Brighter Future of Caring
By Brent Lang

Brent Lang, MBA is chairman and CEO of Vocera of San Jose, CA.

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Nurses, doctors, and other healthcare team members deserve working environments that protect their physical, emotional, and psychological well-being. They also deserve equitable support and access to resources and tools to care for themselves and the patients they serve. At the heart of safety is a commitment from hospital leaders to build cultures that empower employees with essential equipment, technologies, and protocols that protect their well-being and enable them to work at the highest level of their skills.

After nearly two years, COVID-19 continues to wreak havoc on exhausted nurses, doctors, and others frontline workers. The pandemic, causing needless death and elevated stress levels, has burned out many of our caregivers. Some are retiring early, some are changing professions, and others are leaving the workforce entirely. The cognitive burden that healthcare workers are carrying, and have been carrying even before the pandemic, is extremely heavy. The emotional toll is unimaginable.

We must find ways to protect and support every care team member or we risk losing more of them too soon. The future of our healthcare system depends on what we do now.

To start, we must identify the root causes of staff shortages. Let’s call out what is harming the physical, emotional, and psychological well-being of healthcare workers. COVID-19, cognitive overload, and burnout are not the only things threatening their well-being.

Workplace violence, racial disparities, and bias are also contributing to the trauma healthcare workers must endure. While these threats existed well before the pandemic, the last 24 months have put a spotlight on the urgent need to protect the safety of our nation’s healthcare workforce who have risked so much to protect us.

Several health system CEOs from across the country have signed The Heart of Safety Declaration of Principles to redefine safety in healthcare and drive action for meaningful change. The three pillars of the Declaration highlighted below are helping galvanize support by other healthcare leaders, technology companies, policy makers, and more.

  1. Safeguard psychological and emotional safety. We must eliminate stigmas associated with seeking mental health support and advance a culture of open communication, so people feel safe to speak up and are empowered as equal and valued members of the care team. The Dr. Lorna Breen Health Care Provider Protection Act is an excellent start.
  2. Promote health justice by declaring equity and anti-racism core components of safety. Healthcare team members deserve to work in environments free from bias and discrimination. A recent UCLA study showed the proportion of Black physicians in the U.S. has increased by only four percentage points over the last 120 years. Focused policies and practices are needed to advance diversity, inclusion, and belonging in healthcare environments, which in turn enables more equitable care delivery.
  3. Ensure physical safety. Healthcare workers are five times more likely to suffer a workplace violence injury than staff in other industries. Zero-harm programs must be implemented to eliminate workplace violence, both physical and verbal.

Policies, protocols, and training staff how to handle a violent situation are important, but they are not enough. Hospitals and health systems need to give nurses, doctors, and other team members the ability to easily and quickly call for help when a situation escalates.

Many hospitals have equipped employees with wearable communication devices that enable emergency communication, such as a dedicated panic button, and understand simple voice commands while wearing the device under personal protective equipment (PPE).

Intelligent communication technology can also help safeguard team members from mental and emotional distress. All day long, clinicians are overloaded with complex processes, competing priorities, and interruptions by calls, texts, and alert and alarm notifications from nurse call systems, patient monitors, ventilators, and more. These communications are often not actionable, causing clinicians to feel lost and overwhelmed, spending valuable time looking for information or a colleague to help.

A unified communication and collaboration solution can reduce distractions, noise, and stress, which have increased during the pandemic. It can eliminate loud overhead paging and help organize and prioritize notifications so they only go with contextual information to the person or team who needs them and can act. Managing alerts and alarms creates a quieter healing environment, while helping reduce the cognitive burden on the healer.

There are many ways to help protect and connect team members. Together, with more collaboration and a renewed commitment to safety, we can accelerate the adoption of these solutions to safeguard our nation’s healthcare workers for a brighter future of caring.

Readers Write: Digital Healthcare Needs To Evolve, and the Cloud Is the Catalyst

November 17, 2021 Readers Write No Comments

Digital Healthcare Needs To Evolve, and the Cloud Is the Catalyst
By Kavita Khandhadia

Kavita Khandhadia is Amazon Web Services program manager for Infostretch of Santa Clara, CA.

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The continued impact of the connected society means there is an increased need for decision makers to understand not only why digitalization matters, but where it can most benefit their companies. Digital evolution and maturity are key differentiators in most industry sectors, many of which are adapting to the demands of their customers and integrating the technology required.

This ongoing focus on a required digital transformation is hardly breaking news, but the decision to become more cloud-centric has particular significance for the healthcare and life sciences (HCLS) industry.

For organizations that are looking to move the digital journey forward, it’s a case of when and not if. In many cases, business optimization strategies have become increasingly cloud-based, with a consensus among analysts and researchers that HCLS companies that integrate cloud platforms and services into their existing workflows will be best placed to scale, innovate, and launch.

The events of the last 18 months shone a spotlight on where digital healthcare is and where must improve. Over the last decade, the digitalization of legacy processes within the healthcare industry has moved at a steady pace, albeit that patient wellness is more likely to reflect physical as opposed to virtual insights.

The need for effective digital solutions becomes more apparent when you consider that the adoption of recent technologies within the sector as whole can often be labeled as a work-in-progress. HCLS companies, for example, have been both quick to accept the need for change and hampered by what needs to be done.

A research note by Gartner – Innovation Insight for Digital Health Platform (DHP) – applauded the “heroic efforts” that healthcare companies and providers had made to adopt innovative technologies, including virtual care and improvements to monolithic legacy systems such as electronic health records (EHR). The caveat was that the fundamental shift required was some way in the future.

However, the analyst noted that digital expectations of patients would lead to 75% of health providers reducing reliance on “EHR-native applications to deliver better experiences and outcomes, and improve efficiencies.”

That’s great news for digital healthcare, but it’s worth remembering that the technologies required to build a DHP are already part of existing wellness strategies. For example, companies that have integrated cloud solutions have access to data and predictive analytics while digital twins, artificial intelligence, and machine learning are having an impact on clinical and operational decisions.

The question that needs to be asked is whether the increased awareness of cloud-centric healthcare offerings will be the catalyst for the next stage of digital healthcare.

The simple answer is that access to platforms such as AWS Cloud is both changing the conversation over what modern wellness can be and how patient-centric cloud solutions are the future of healthcare itself.

A powerful argument for cloud migration is understanding that a culture of healthcare innovation already exists. Purpose-built HCLS offerings are part of the AWS for Health suite of solutions, for instance.

However, the concerns that have always been part of any cloud migration are often cited as reasons to maintain the status quo.

Healthcare remains not only a very traditional industry but also one that is subject to a plethora of regulatory requirements. And while the need for digital transformation may not seem as pronounced as it would be in, say, retail, the challenges of cloud migration can literally be the difference between life and death.

In many cases, the concerns are the usual suspects – security and governance, cost and time, workloads, solution availability, and cloud maturity.

When you invest in a cloud strategy, you are giving up a certain amount of control. Cloud computing is the on-demand delivery of compute power, database, storage, applications, and other IT services through a cloud services platform.

For instance, AWS is responsible for the security of the cloud (the protection of the infrastructure itself) while the customer provides security in the cloud (platform, applications, identity and access management). Known as the Shared Responsibility Model, this simple arrangement can be a daunting prospect for healthcare companies who have relied on their legacy infrastructure and working processes to maintain compliance and regional regulatory requirements.

Cost and time are also considered to be one of the main reasons for being hesitant about cloud migration. Companies may feel that the expense and potential downtime of cloud migration may not be worth it, despite all evidence pointing to the savings that can be achieved by moving to a cloud-based solution – migration can mean that a company focuses on products and innovations as opposed to maintaining an entire infrastructure and related applications.

And we must not overlook the importance of defined workloads. HCLS relies on data management and regulatory compliance, while the nature of the services companies provide requires low latency and processing requirements on a local level. That provides an additional challenge, even more so when these digital workloads must respond as quickly as possible to a patient or provider requirement.

However, the HCLS sectors are well placed to take advantage of cloud migration. Companies and providers are increasingly data-driven and already looking to digitally transform – the global healthcare market will be worth $11.9 trillion by the end of 2022, a recent industry report said – so it follows that patient wellness will be subject to the digital experiences that are part of the connected society.

Digital healthcare’s evolution has been years in the making. Providers and patients have become more digitally aware in recent years, because the tools required to make health-related decisions are now available.

What matters is how HCLS both integrates the solutions that exist and invests in ones that can make a difference to the physical and virtual services provided.

COVID-19 was not the catalyst for digital transformation that people wanted, but the industry became focused on how digital healthcare could move forward. Cloud migration is one part of the puzzle, the companies that understand this will be able to deliver the right patient and wellness outcomes.

HIStalk Interviews Bret Larsen, CEO, EVisit

November 17, 2021 Interviews No Comments

Bret Larsen is co-founder and CEO of EVisit of Mesa, AZ.

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Tell me about yourself and the company.

EVisit is the market-leading virtual care platform. We help the largest health systems in the country craft excellent consumer experiences for care delivery. I’ve been in telemedicine for the last decade, give or take. I started originally on the national provider network side with a company that was acquired by Teladoc. I saw an opportunity to help simplify healthcare delivery for local healthcare infrastructure.

Telehealth boomed not because consumers were demanding it, but because regulations and payment rules were adjusted to support virtual care as the only safe way to conduct encounters. To what degree do those temporary changes need to become permanent to keep telehealth as a mainstream service?

Telehealth needs to be an option in care delivery. Gartner estimates that telehealth utilization will normalize at about 30% over the next three to five years. As CEO of a virtual care platform company, I wanted to believe that the pandemic had accelerated and changed telemedicine and the utilization of telemedicine forever, but what I think it actually accelerated was the consumerization of care. It has caused local healthcare infrastructure, health systems, and hospitals to take a close look at their care delivery strategy and when and where to apply specific delivery mechanisms — whether it’s in-person, virtual visits, or asynchronous — to make sure that they are helping to support the delivery of the right outcomes.

Insurers are offering virtual-first health insurance, which should expose even more people to telehealth. Will those consumers remain in the telehealth fold?

We started the company to help local healthcare infrastructure maintain the relationships they have. Those virtual-first plan approaches can only work if they connect patients with local providers. A health plan or payer’s job is to manage and mitigate risk. I think that down the road, as we look back at the data, the outcomes diverged with the utilization of national provider networks, like call center-based national provider networks. They are working to do good. They are trying to change accessibility for the better.

But we will see a massive disconnect when you pull a patient out of the ecosystem and the PCMH that knows them best. Those will struggle to find efficacy, because when a patient needs specialty care, where does that patient get referred to? Does the provider on the other end of that virtual-first encounter have context of the market to know where to refer them to ensure the continuation of the right care for that patient?

How will the market shake out between companies like yours that sell the platform versus those companies that sell clinical services, which may augment but also compete with those offered by the local health system?

If you look at the strategic roadmap for these national provider networks – and don’t hear me saying “shame on them” – they are working to do what’s best for the end-user patient. But if you look at the strategy that they’re driving at, look at what they’re acquiring. They are acquiring specialty groups. When these large national provider networks showed up on the scene, there wasn’t a ton of concern from the health system side, because they were going after an ambulatory side of the business where we lose money anyway as a loss leader to feed our specialty groups. 

But the reality is that the acquisition strategies show that where they are headed long term is specialty groups. They are acquiring respiratory and chronic care groups, so they are moving into the specialty side. For health systems, that means that when a patient is in need of specialty care, and their first interaction is with one of these national provider networks, they will refer to their own specialists, not to the local group. Health system executives need to keep a close eye on this.

Health systems need to answer the question of, how do I craft an excellent consumer experience? Because that’s what they are competing with. The pandemic accelerated the transition, not necessarily the adoption, of telemedicine long term, because admins are still going to refer back to where they did from muscle memory. But rather it accelerated the consumerization of care. As consumers, many of us would never bring our business back to a service provider that didn’t show up on time to an appointment or was 45 minutes late. It’s really about, how do we craft excellent consumer experiences to serve the consumer, not the patient?

Some providers created ill will among their patients who felt abandoned during the pandemic, as offices were closed and calls weren’t returned. How much education or marketing do health systems need to provide to get consumers to value an ongoing relationship and to trust them to deliver it?

It’s a business strategy question. Where do your strengths lie? The strengths that I would expect health systems to have is in the care they deliver. There’s a lot of responsibility on the health system to educate the consumer and to help repair some of that disconnect. Having the right tools to accomplish that will make it easier. I would rather pull out my phone and order dinner from an app than call the restaurant and order it over the phone. Consumers want to be able to navigate to their own outcome.

I have allergies, so I could self-diagnose, but having the support of a provider to make sure that’s actually what’s going on and helping navigate efficiently to that reality and the corresponding care that I might need — if it isn’t allergies and is a sinus infection, a cold or the flu – that’s important. It can go a long way for health systems to help to start to find the right technologies to help consumers navigate to the most appropriate point of care for the issues they are experiencing and the value that comes with the downstream impact of that when they need more hands-on care.

From the food delivery analogy, we don’t yet know if telehealth shifts demand from in-person care or creates new demand. How will telehealth volume impact the availability of providers?

I saw a stat recently that for every hour a provider spends in delivering care, they spend as much as two hours charting care. That’s staggering. If you look at the top 10 compensated roles in commerce, in industry, those top 10 are all physicians. The number 11 is CEO. In a health system setting, it makes more financial sense for the CEO of the health system to be charting care than it does for the providers who are delivering it.

At EVisit, we are big believers that the best interface for a provider is no interface at all. The tools need to come around the provider to help support the delivery of that. The provider’s willingness to adopt that technology will be directly correlated to how easy that technology makes their job.

I hesitate to say this because I’m not looking to be confrontational, but the only reason that electronic health records have a business today is because the people who buy it don’t have to use it. If they did, they wouldn’t buy it, because it’s not easy to use. It is solving a super complex problem. There’s a bunch of various issues that it needs to address. But it’s not built for users.

If I were on the strategic side of a health system executive team, it would be about choosing and crafting the tools that are around a provider to help them more efficiently deliver care in a remote setting versus forcing them into a two-way video visit where it requires seven more people than it would need to, hundreds more clicks, and three or four more interfaces that makes care delivery more complicated. The way health systems should be thinking about it, especially from the provider adoption side, is how do you make it as simple for the care deliverer as possible?

Unless the business model is different, providers still need to document for billing and legal purposes, recording the same information that is required for an in-person visit. How can virtual visits reduce that documentation burden?

My point in bringing that up isn’t the fact that they will have to document less, it’s that technology can make it more efficient. We are working on using natural language processing for auto-charting. The microphone that is listening to a provider can differentiate between what the provider is saying and what the patient is saying, pull out the relevant information around self-diagnosis and the provider diagnosis, and pull together a fairly accurate depiction of what’s happened in that visit, how it should be coded, and where it should be submitted. All with cursory review by the provider, not with the provider having to sit down, or use a scribe to sit down, and run through that interaction and spend the two-to-one ratio of time against it.

How many early adopters of offering video visits are revisiting their technology choices and what are they looking for?

The vast majority of them are looking. The sound bite that we consistently hear from CIOs of large health systems is, we recognize that two-way video is not virtual care. It’s not the same thing. Video visits are not the same as virtual care. We have some great data around the margin impact of using a two-way video solution like a Skype, FaceTime or Zoom versus using an all-in-one comprehensive virtual care solution like EVisit. The margin impact is almost triple on the gross margin side, because patients are able to self-serve through much of the experience.

Early video visits involved just the two-way video conversation. Will we see them evolve to look more like in-person visits, with waiting rooms where information is collected upfront and satisfaction surveys and patient education afterward?

Two-way video is a commodity. You can go to a number of places and find great solutions. It’s the workflows and the efficiencies that can be gained around that. The advancement of that is moving outside of just a single interaction of, I have a sinus infection, I need a Z-Pak, so let me go through this workflow to get it. How does it fit into the care delivery strategy that you’re crafting? What does it look like? When should a patient present to a synchronous video visit versus an asynchronous chat visit versus in person?

There’s an outcomes question there. There’s a financial implication question there. It’s important to answer that question appropriately, bring the right tools and the right integrations with the core electronic health record to make sure that the data is all sitting in one place and that there’s a comprehensive view of who the patient is and what they’ve experienced, and determine how that informs care going forward. The ecosystem grows by moving ahead.

Other forms of virtual visits got lost in the excitement over virtual visits. Doctors might provide expertise via email messages, telephone conversations, or asynchronous messaging that is appropriate given the patient’s need and preference, with the only difference in outcomes versus a virtual visit is that they might not bill for their time or get paid for it. To what degree will the choice of communications options be driven purely by payment?

It’s absolutely an important mechanism to consider. At the end of the day, we need to make sure that as an industry that we can support the services being delivered financially. I think what you’ll find is that many patients would opt to pay out of pocket in certain scenarios where convenience or accessibility comes into question. If an asynchronous visit isn’t reimbursed, I still would be willing to pay a fee for service.

Our data shows that one provider can handle up to 200 interactions in a shift asynchronously for minor things like sinus infections, UTIs, colds, and flu. But the efficiency gained there, if you look at the productivity of that provider and a nominal out-of-pocket fee in that scenario, is interesting. It’s also interesting from a patient retention perspective. As a business, I would rather provide a service that ensures my customers continue to come back to me. I may eat the cost on that rather than have them go elsewhere and potentially lose the opportunity to bring them back to my services when the time comes again.

We’ve seen a lot of investment, separately, in telehealth and remote patient monitoring. Do you see the services or the business of those two entities converging?

Yes, yes. In a lot of the RFPs that we’re seeing, remote patient monitoring is a key question. 

One of the key trends, and this existed before the pandemic, is that health systems and hospitals are trying to figure out how to transition care to home and the RPM ecosystem. How that plays into it is going to be a very important component of that. That transition’s happening, not because of the pandemic, but  because you can deliver care more profitably when the patient can be out of the physical setting and can be monitored and that feedback can be quick. When and where the patient needs physical attention, that can happen where appropriate. It absolutely will continue to converge. The market and the landscape are in early days in how that’s being addressed, but it is on every health system’s five-year strategic roadmap.

How do you see the company and the industry moving along in those areas that you monitor?

The key question that all healthcare IT companies need to answer is the consumer question. How do you craft an excellent consumer experience? The pandemic forced us as patients to become consumers. It helped us recognize we have choice. To your point, there were certain avenues that were closed to us and we had to find other ways to receive care that we needed. As you look at the various players in the market, what that turns into, and how it is shaped, the key question is, how do we create excellent consumer experiences that support the right outcomes? That is the question that we’re hearing most health systems ask themselves, either explicitly to the market or via the RFP questions that end up coming together. That entire ecosystem of how a solution handles acute ambulatory and RPM. Health systems want to deal with one vendor that can address a lot of the value chain versus cobbling together nine or 10 different point solutions that drive a semblance of that same outcome.

Morning Headlines 11/17/21

November 16, 2021 Headlines No Comments

Ribbon Health Raises $43.5M Series B to Become the Leading API Data Platform in Healthcare

Ribbon Health, which has developed an API that enables health IT developers to access data on doctors, insurance plans, and costs and quality of care, raises $43.5 million.

QGenda Acquires Schedule360, Adding the Best in KLAS Nurse and Staff Scheduling Solution to its Market-Leading Healthcare Workforce Management Platform

Workforce management software vendor QGenda acquires Schedule360, which offers Best in KLAS nurse and staff scheduling software.

H1 Raises Series C

H1, which offers drug companies a platform to identify opinion leaders and to monitor the drug trials of competitors, raises $100 million in a Series C funding round.

News 11/17/21

November 16, 2021 News 5 Comments

Top News

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Population health management company Lightbeam Health Solutions will acquire CareSignal, which offers more than 30 condition-specific remote patient monitoring programs, for an undisclosed sum.

I interviewed CareSignal CEO Blake Marggraff last year. He launched the company coming out of pre-med in 2015 at the age of 22.


Webinars

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

Here’s the recording of our recent webinar titled “Increasing OR Profitability: It May Be Easier than you Think,” sponsored by Copient Health.


Acquisitions, Funding, Business, and Stock

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Ribbon Health raises $43.5 million in a Series B funding round. The company has developed an API that enables health IT developers to access data on doctors, insurance plans, and costs and quality of care.

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Workforce management software vendor QGenda acquires Schedule360, which offers Best in KLAS nurse and staff scheduling software.

H1, which offers drug companies a platform to identify opinion leaders and to monitor the drug trials of competitors, raises $100 million in a Series C funding round.


Sales

  • The Maryland Department of Health will use NTT Data’s consulting services to enhance its Medicaid Enterprise Systems Modular Transformation program with tech-enabled solutions.
  • MetroHealth in Cleveland enters into a managed services agreement with Pivot Point Consulting for its Epic EHR.
  • Ergotron will integrate Imprivata’s Confirm ID technology with its CareFit Pro Medical Cart, giving hospital staff password-free access to cart drawer contents.
  • Premier’s PINC AI will conduct a hospital-acquired infections clinical trial with medical solutions company Mölnlycke using Premier’s anonymized clinical data and provider network to test interventions, including its TheraDoc clinical surveillance technology.

People

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Nasim Afsar, MD, MBA (UCI Health) will join Cerner as its first chief health officer in January.

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Oscar Callejas, MSE (Hillrom) joins Olive as SVP of customer programs.

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Carrum Health hires Randy Hawkins, MD (ConsumerMedical) as chief medical officer.

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Tony Burke (Pivot Health Advisors) joins Teladoc Health as SVP of partnerships and innovation.

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Care transitions software vendor ReferWell hires Chad Baugh, MBA (Teladoc Health) as chief revenue officer.


Announcements and Implementations

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PerfectServe brings together its clinical collaboration, physician scheduling, patient engagement, and practice communication technologies under the Unite platform.

Elevate Holistics launches a medical marijuana card platform that includes patient scheduling, an EHR that supports telehealth, an online store for selling nutraceuticals and CBD, and a partner marketing integration system with custom landing pages.

Big news from HIMSS22: Michael Phelps, who used to swim fast, will keynote. Maybe healthcare experts Dana Carvey, A-Rod, and that mountain climber who sawed his own arm off weren’t available to reprise.


Other

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Researchers at the University of Texas Health Science Center at Houston develop the Epilepsy Tracking and Optimized Management Engine, an informatics tool designed to help physicians better manage the care of epileptic patients. Neurologist Katherine Harris, MD says the software has helped cut her billing documentation time down from 20 clicks in her EHR to just three clicks using EpiToMe, which also includes modules for reports, statistics, and scheduling.

A Stat investigative report says that Ascension, the country’s largest Catholic health system at 140 hospitals, is running a $1 billion private equity operation like a Wall Street firm rather than as a passive investor.  The article notes that the tax-exempt health system isn’t required to disclose how its investment profits are used to benefit vulnerable patients.

Analysis finds that private equity-owned air ambulance services bill higher rates and generate surprise patient bills more frequently, charging 60% more than other carriers.

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Former Sanford Health (SD) CEO Kelby Krabbenhoft, who left the system in late 2020 after making controversial remarks about his refusal to wear a mask, received a payout of nearly $50 million. The health system says he would have been contractually owed the money regardless of his departure circumstances, which involved $15 million in severance, $29 million in retirement payout, and $5 million in salary. Sanford Health ended its planned merger with Intermountain Healthcare because of the leadership change.


Sponsor Updates

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  • ConnectiveRx team members support Operation Gratitude with a financial donation and cards of support for veterans.
  • Netsmart will integrate the American Society of Addiction Medicine’s Continuum and Co-Triage assessment tools with its EHR.
  • Al Kindi Hospital in Jordan selects Wolters Kluwer Health’s UpToDate and Medi-Span Clinical solutions.
  • EClinicalWorks releases a new podcast, “PDMP Software for Safe Prescribing of Controlled Substances.”
  • The Behavioral Healthcare Executive Podcast features AdvancedMD President Amanda Hansen.
  • Actium Health releases a new Hello Healthcare Podcast, “Physician Relations: A Love Letter.”
  • Change Healthcare helps measure and reduce carbon emissions from the healthcare industry.
  • Optimum Healthcare IT wins the CHIME Foundation Partner of the Year Award.
  • Ellkay will exhibit at Modernizing Medicine’s Momentum Conference November 19-21 in Orlando.
  • Waystar achieves top rankings in Black Book’s latest customer experience RCM technology and outsourcing report in the categories of end-to-end RCM software & technology, hospital chains, systems, corporations, IDNs & corporation; and end-to-end RCM software & technology, community hospitals & medical centers.
  • OptimizeRx will host the second annual Innovate4Outcomes event virtually December 9.
  • Health Catalyst partners with Datavant, enabling healthcare and life sciences organizations to exchange tokenized, de-identified data within Health Catalyst’s Research Network and Touchstone Match.

Blog Posts


Contacts

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

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Morning Headlines 11/16/21

November 15, 2021 Headlines 1 Comment

Lightbeam Health Solutions Announces Acquisition of CareSignal

Population health management company Lightbeam Health Solutions will acquire remote patient monitoring vendor CareSignal for an undisclosed sum.

Videra Health Announces $3 Million in Seed Funding to Scale Patient Interactions for Behavioral Health

Mental health-focused remote patient monitoring startup Videra Health raises $3 million in a funding round led by Artis Ventures.

Amazon’s healthcare business has landed Hilton as a key customer

Hilton Worldwide Holdings will offer its employees virtual and in-person care from Amazon Care.

Curbside Consult with Dr. Jayne 11/15/21

November 15, 2021 Dr. Jayne No Comments

Big news this week, as CMS announced that it would automatically apply the “extreme and uncontrollable circumstances” exception to the 2021 Merit-based Incentive Payment System (MIPS) performance year. Previously, clinicians would have been required to specifically apply for the exception. The automatic exception will be applied for the 2021 performance year and only to those clinicians who are participating as individuals. Those participating as groups, virtual groups, or alternative payment model entities will instead have to apply for performance category reweighting. This can be done on the Quality Payment Program website prior to December 31.

Those who are carefully following how MIPS works will note that the exception reweights the MIPS performance categories to zero, which means that there will be a “neutral payment adjustment” (aka no penalty) for the 2023 payment year. Given inflation, even a neutral adjustment is still a reduction in payments, which adds to physician unhappiness. CMS also reopened the exception application for the 2020 performance year; participants can apply prior to November 29 by submitting a targeted review form.

As physicians consider the ongoing calculus of how they are paid, how they deliver services, and what their patients want them to offer, I’m starting to see more of my primary colleagues considering direct primary care practices. In that model, patients pay a monthly membership fee to see their physician. There is no third-party billing, and the model is designed to delivery quality care at a reasonable cost. The Direct Primary Care Coalition notes that “most DPC memberships / subscriptions cost less than the average cell phone bill” and that patients typically have greater access, shorter waits, and longer appointments with their physician. In addition to reducing administrative burden and costs, the model has the goal of building back the old-school physician-patient relationship and a mutually trusting therapeutic environment.

Many patients are demanding telehealth, especially during hours that aren’t considered traditional office hours. Those practices that remain part of traditional fee-for-service arrangements are continuing to advocate for payment parity for telehealth services so they can be reimbursed at the same rate for virtual visits as they would for in-person ones. On the physician side, the thought is that the visits require the same level of cognitive expertise and also the same amount of time as in-person visits. Opponents of payment parity argue that those visits should be less expensive due to reduced resources, but the reality for most physicians is that they’re still paying rent, they’re still paying staff to assist them and manage patient data, and they’re also paying additional fees for either freestanding video conferencing software or telehealth modules / content from their EHR vendors.

In New Jersey, Governor Phil Murphy recently rejected parts of a bill that would have required payment parity for telehealth services. He noted that the cost to state taxpayers may be “substantial” and that in-person care should be prioritized except when telehealth would increase access and improve patient outcomes. Murphy reinforces the idea that providers should have long-term cost savings with telehealth due to decreased clinical space and support staff. It didn’t sound like he spends a lot of time talking to physicians who are running low-margin practices and working hard to keep the lights on while they are struggling to retain staff in a market where solid clinical personnel are commanding premium salaries. I’ve performed telehealth visits with no support staff as well as those in a model where staff did all the same pre-visit prep as they would in a brick-and-mortar office, and I have to say the latter is much preferred.

Murphy also notes a concern that over the long haul, “pay parity could over-incentivize telehealth, further limiting in-person options” and that it might be “especially detrimental for those in underserved communities.” On the other hand, pay parity might allow those in underserved communities to have consultations with distant primary care physicians without an untenable wait, which is already the case in many rural and underserved communities. It could also provide opportunities to consult with previously inaccessible subspecialists when patients are unable to travel the distance to tertiary care centers. I agree that Murphy has a valid concern that CMS hasn’t fully made up its mind on payment parity, which could create confusion for Medicare and Medicaid beneficiaries.

Murphy goes on to make it clear that he believes that telehealth “was intended as a stopgap to preserve public health during an unprecedented emergency” rather than something that patients and physicians have decided serves both of them well. It’s unfortunate that he sees it as a way to deliver care of last resort as opposed to a rapid evolution in healthcare delivery. The bill received a conditional veto, which allows the senate to potentially incorporate his recommended changes and amendments. Those include a requirement that the state health department would revisit payment parity over the next 18 months and make a subsequent recommendation. In the mean time, payment parity would be in place through the end of 2023 if the recommendations are followed.

As a patient, I enjoy having options. I have two physicians who I see who really need to be seen in person due to the nature of the examinations involved. I see each of those physicians annually, which between the two of them, results in a comprehensive physical examination with a fair amount of overlap every six months. They’re part of the same medical group as my internal medicine physician, who has full access to both their records. When I see my internist in person, 90% of the visit is a discussion – what’s working for me health-wise, what’s not, and a review of laboratory results, my goals, and how I feel. Very little of it is dedicated to the physical exam and that’s OK given my current state of health. In reality, I’m seeing him for his brain much more than I’m seeing him for his exam skills, especially since I monitor the most important indicators of my health at home. As a patient, it would be much better for my schedule to be able to see him virtually and have him compensated fully for his expertise, which is why I value his care.

Time will tell how much cost reduction can really happen with virtual care. I think a lot of it has to do with how integrated various platforms are and how well physicians can learn to work with patients virtually. Will we have it all figured out by 2023? I’m not sure, but I’m committed to trying.

What’s your preference in the virtual versus in-person care debate? Leave a comment or email me.

Email Dr. Jayne.

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