EPtalk by Dr. Jayne 6/6/24

ONC is seeking feedback on a recent white paper that highlights its vision for Health Equity by Design. The organization is formulating strategies to reduce healthcare disparities by including health equity throughout the creation and implementation of health IT policies, programs, and workflows. The approach aids in identifying gaps and disparities and creates an environment where “technology itself anticipates, avoids, and reduces, not exacerbates, health disparities.” Additional outcome goals include mitigating systemic inequities and improving person-centered decision-making, implementing population health interventions, and strengthening public health. Comments can be provided through June 10 at 11:59 p.m. ET.

Having worked in emergency and urgent care settings for the majority of my career, I’ve seen how the lack of easily accessible mental health services adds to overcrowded waiting rooms and delays patients from receiving appropriate care. A recent initiative in Oklahoma equips police officers and Certified Community Behavioral Health Clinics with IPads for telehealth visits, helping reduce the number of emergency visits and hospitalizations for mental health issues. More than 30,000 devices have been deployed to the field, allowing faster patient interventions in a less resource-intensive manner.

Police officers no longer have to wait with patients at the emergency department, and patients have a shorter wait time for lower-acuity care that better matches their needs. The statistics are impressive – a 93% reduction in inpatient hospitalizations for mental health crisis over a six-year period, and $62 million in savings. The program has expanded to provide IPads directly to behavioral health patients, further reducing the need for costly interventions. I hope other states, counties, and cities take note of this program and consider implementing it in their own areas.

A project for one of my clients led me to dig into the new final rule from the Office for Civil Rights (OCR) and CMS that is designed to prohibit discrimination in AI based on data points such as age, gender, race, and ethnicity. It’s great to have regulations, and this one in particular brings 558 pages of PDF joy, but it’s unclear how this will be enforced. AI bias can be difficult to detect, and when identified, there’s a chance that organizations will be subject to their own biases in determining how to address it. The presence of a formal rule opens the door for whistleblowers and reports of problems from end users, which should help keep the industry honest.

One of the important elements in the rule is the definition of the term “patient care decision support tool” as “any automated or non-automated tool, mechanism, method, technology, or combination thereof used by a covered entity to support clinical decision-making in its health programs or activities.” That definition encompasses everything from EHR-embedded AI clinical decision support to paper checklists found at the bedside, and everything in between. Hopefully this will serve as a catalyst for organizations to ask some questions about tools they have in place or are considering, including reviewing the data being used to trail the model or validate the tool, making the tool’s decision-making process transparent, identifying how people will be involved in the implementation and monitoring of tools, and describe the steps that will be taken if there is a suspicion that harm has occurred.

With that in mind, it’s timely that Epic Systems has released a new “AI Trust and Assurance Suite” that is designed to help clients test and monitor their AI models. According to announcements from Epic, the software is designed to automate data collection and mapping and to ensure consistency. Since one can’t really see Epic’s documentation unless one is an Epic customer (or someone violates all kinds of rules by slipping one a copy,) it’s unclear how this tool will work for the numerous Epic clients who have custom fields and their own unique ways of using data.

Epic says it will release the tool’s monitoring templates and data dictionaries as open-source software this summer, which should help clients who have custom AI models or who are using tools from third parties. Still, that’s a significant burden on clients who will have to analyze the tool and its functions carefully. I doubt many organizations have analysts budgeted to address it, so we’ll have to see what the speed of uptake looks like.

I’ve been mentoring a resident physician who is considering a fellowship in clinical informatics. One of our recent conversations was around the role of generative AI in academic pursuits. Most organizations I have encountered have come to the conclusion that they can’t prevent students from using the latest and greatest digital tools, but that guardrails need to be in place to preserve academic integrity. Oregon Health & Science University Professor William Hersh, MD has a clear policy for the “Introduction to Biomedical & Health Informatics” course that provides guidance to students. Key points include that generative AI systems can be useful tools but should not be used to substitute one’s own knowledge; and students can ask generative AI systems for content, but final responses — including those in discussions, quizzes, tests, and term papers — should reflect the student’s “own thinking, judgment, and language.” It is also noted that students shouldn’t shortchange their learning by relying on generative AI, and that the need for a fundamental core of knowledge and understanding is needed by practitioners in the field.

Pediatric dermatology researchers are celebrating their victory over ChatGPT as detailed in a recent study that looked at accuracy rates on board-type questions. They tested ChatGPT versions 3.5 and 4.0 using questions from the American Board of Dermatology as well as “Photoquiz” questions from the journal Pediatric Dermatology. Although ChatGPT 4.0 gave human pediatric dermatologists a run for their money in some areas, the humans outperformed both versions overall. Researchers call on clinicians to understand the tools and how they might be helpful in practice.

The Institute for Safe Medication Practices has released additional guidance on actions needed to prevent drug name selection errors when facilities are using automated medication dispensing cabinets. Although vendors have taken steps to improve their products, some features require a customer to opt in to the newer safety features through manual configuration or software updates. The Institute is calling on vendors to support dynamic search functions and standardized medication names, and for care delivery organizations to educate staff, analyze workflows, and require indications for certain overrides.

I spent some time this week helping teach CPR to a local youth group. Attendees were amazed at how much easier it looks in movies and television. Some of the participants were smaller physically and couldn’t generate the force needed to do effective compressions, but they were great at recognizing the signs that CPR is needed and demonstrating how to take charge of a scene. If you’re not certified in CPR and use of the AED (automated external defibrillator), consider taking a class. At minimum, consider learning about hands-only CPR from our friends at the American Heart Association and identifying where AEDs might be kept in your daily travels. Bystanders recently initiated CPR at my local Costco. Will you be ready if the time comes?

Email Dr. Jayne.

Morning Headlines 6/6/24

Direct Recruiters, Inc., a Starfish Partners Company and Health Innovations, LLC Join Forces to Revolutionize Healthcare Staffing and Analytics

Direct Recruiters announces that it will acquire Health Innovations, a staffing firm specializing in placing clinical executives and analytics leaders.

Eko Health scores $41M to detect heart and lung disease earlier and more accurately

Smart stethoscope developer Eko Health raises $41 million in Series D funding, bringing its total raised to $165 million.

Solarity Announces Strategic Growth Investment from TA

Automated clinical data processing vendor Solarity announces an undisclosed amount of funding from TA Associates.

Healthcare AI News 6/5/24

News

Researchers at George Mason University’s public health school create MeAgainMeds.com, a free AI-powered website that uses self-reported patient history and data that was extracted from 3.6 million patient records to help patients and clinicians choose the antidepressant that is most likely to be effective for them.

Kimberly Powell, healthcare VP/GM at Nvidia, says that she expects healthcare to be more affected by AI than any other industry, particularly in the area of drug discovery.

Business

Evolent acquires the software and development team of Machinify’s prior authorization and utilization management products. Machinify will continue its work with payer applications.

Innovaccer launches an AI-powered healthcare contact center that combines all available data to personalize the call center interaction of consumers.

Tampa General Hospital chooses Palantir Technologies to create an AI-powered care coordination system.

Spain-based AI medical triage chatbot vendor Mediktor acquires Sensely, which offers patients chat-based help with insurance.

Research

Researchers find that applying retrieval-augmented generation – where an AI system searches a specified database to craft its answers – improved the accuracy of ChatGPT-4 in answering cancer-related questions from 57% to 84%. However, it performed poorly when faced with conflicting advice statements from clinical trials, expert opinions, or committee recommendations.

Other

Children’s National Hospital hires Alda Mizaku, MS (Mercy) to the newly created role of VP/chief data and AI officer.

Montefiore Einstein Comprehensive Cancer Center doubles the colonoscopy completion rate among patients who cancelled or no-showed their colonoscopy appointments by using the AI tool MyEleanor from MyndYou to conduct voice call outreach. More than half of patients that the system called stayed on the line and half agreed to be transferred to a human navigator to reschedule.

Johns Hopkins palliative care doctor and cartoonist Nathan Gray, MD creates a fascinating “op-comic” for the LA Times that describes his experience with his hospital’s ambient documentation pilot project. He says that he had to learn to suppress the urge to type and had to remember to speak his findings out loud, but enjoyed “not having a screen stand as a dividing wall between doctor and patient.” He found that the program generated an accurate, coherent summary of the conversation even when it didn’t follow an obvious structure. His biggest complaint is that as a palliative care doctor, the AI ignored the hopes, dreams, and fears of the patient in seemingly mistaking that part of the conversation as chitchat.

Contacts

Mr. H, Lorre, Jenn, Dr. Jayne.
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HIStalk Interviews Jeff Richards, Co-Founder and COO, SnapCare

Jeff Richards, MS, MBA is co-founder and chief development and operation officer of SnapCare.

Tell me about yourself and the company.

I spent the first 19 years of my career as a clinician and administrator in anesthesia at a large public health teaching hospital here in Atlanta, Georgia. Grady Hospital was connected to Emory University, which where I went to school. I educated clinicians that came in. I eventually moved into a leadership role, where I dealt with the complex balancing act that every administrator does — providing some clinical care, overseeing a staff of almost 100, and doing the schedule, which was the seed for launching this company with my partner in Atlanta.

When I went back and got an MBA in 2016, I wrote a paper about a mobile healthcare staffing app. Out of the blue, a classmate of mine from 19 years before reached out and said, hey, can you help me with my startup? It’s called SnapNnurse. I had not intended to start a company when I went to MBA school, but I teamed up with her and we went out to raise capital. We talked to lots of VCs who said, this is a brilliant idea, healthcare often lags behind, and creating a mobile-friendly platform for clinicians to sign up and for facilities to book staff is right on time, in 2017 anyway. We ended up raising $1 million in seed capital in the summer of 2017, launched the company, had good success here in Atlanta, and created a marketplace with about 60 facilities and 10 ,000 clinicians. 

Two and a half years into our entrepreneurial journey, COVID hit. We couldn’t have known that the platform would scale the way it did or predict the benefit of how we interact with social media to sign up clinicians. We pointed it at that situation, turned into a rapid response company, and essentially grew to a billion-dollar company in 2021 and 2022, deploying thousands of clinicians in all 50 states and scaling into a different entity.

In the last 10 months, we’ve rebranded from SnapNurse to SnapCare because we’ve become a broader workforce solution, not just a contingent staffing mobile application. It’s also well past nurses and goes into the entire healthcare clinician continuum other than physicians, which we don’t staff, but do subcontract.

How has the clinician labor market and the use of contract resources changed in the past year or two as healthcare organizations tried to resolve the pandemic-caused, unsustainable labor cost trajectory?

That unprecedented demand was what was needed at the time. You needed to move clinicians around the country as fast as you could from the different hotspots, sometimes happening simultaneously. As the pandemic waned, that demand went away and went below many of the pre -pandemic levels. 

As that was happening, we had evolved from a technology platform. Our orientation and what we had built changed. We said, why don’t we put the technology that we use to mobilize clinicians, engage them, match them, attract them, onboard them, credential them, and deploy them, in the hands of clients themselves? Why not empower them by plugging them into the software?

As that demand was waning, we were in the midst of rebranding into the company that we are today. Facilities are struggling from contingent staffing. There’s a lot that we can offer them as a company to help them manage their internal staff and attract, credential, and onboard candidates more efficiently than they do today.

The moving around of clinicians was like a shell game, where the supply was limited and the demand for their services was at least temporarily unlimited, which predictably sent pay rates up. Will we ever have enough clinicians to avoid ever-increasing compensation as organizations poach them from each other?

When we started this company, my research in MBA school was in the state of Georgia. In 2007, the Georgia state legislature commissioned a study to better understand and predict the healthcare workforce shortage. What they predicted was that without a massive change in the number of school schools and the number of educators – which is a huge piece of this puzzle – and the investment to support all of that, there would be a healthcare healthcare workforce shortage would begin to peak in 2017, which was when I was writing the paper. The legislature did the right thing and was correct in their assessment, but they did not fund the initiatives that would would have alleviated the problem. 

To your question, the answer is a decade-long investment across the country to enable the number of clinicians who are going into school and the number of educators that are needed. A lot of resources got pulled away as facilities attracted clinicians out of educational roles to work at the bedside. It is a complex problem in the sense that that’s a decade-long fix, with lots of steps in between.

AI will probably play a role in the solution. It’s in telehealth. It’s in the way that you manage the internal staff. We recently did an acquisition, a company called Medecipher, that has a machine learning and AI algorithm for predictive analytics. It helps deploy internal staff across a six- or eight-week schedule to better match the acuity of the clinician, their specific certifications and qualifications, to the census and to the acuity of the patients. They are in different departments throughout a facility. There are absolutely tools and technologies that are on the table to help manage it, but the big picture solution is to increase the supply of clinicians.

I think AI is the future of this industry. It’s often an overused buzzword, but there’s a there’s a fast-paced change going on. Artificial intelligence has changed the speed with which technology keeps doubling the capacity. Moore’s Law, which was established by Gordon Moore in the 1960s, says that the number of transistors in a microchip doubles approximately every two years. Somehow through technology innovations and the number of chips and the way we make those chips internationally, we’ve maintained that.

Everyone thinks that AI has only come along in the last couple of years, but it has been decades in the making. But in the last 12 years, the speed with which the capacity for AI — which is software, it’s not hardware — has been doubling at a rate of every 3.4 months. It gets a little geeky to get that specific, but the highlight is that at the end of the year, it’s 400% more capable. Every quarter, things are getting faster and faster and faster. 

I think we are in the beginning of a two-ish year run where the way facilities and clinicians engage will be heavily driven by AI. The companies that figure that out and leverage it will be the leaders ,and clinicians will be attracted to them because of how they can interact, get access to jobs and onboard, and maintain their credentials. All of it will be significantly easier than it is today.

How are organizations using an internal resource pool and related technologies to reduce their reliance on higher-cost outside resources?

The internal resource pool for us is a natural, the other side of the coin of the Medecipher acquisition. Number one would be to deploy Medecipher and use no contingent staff whatsoever, just better utilizing the staff that you have. Then combining it with our platform, which has a shift booking engine and matching algorithm to ensure that every facility has a pool of PRN type candidates, often without benefits at a slightly higher rate, who do that for flexibility. Maybe they work at two or three locations around town.

Most organizations don’t have the technology to send out the shift requests, send reminders, and ensure that once they do work, they get notifications to submit time cards and things like that. This is basic technology that we have used for years, and that is the offering to take that and use it to develop internal resource pool. We think that the smartest combination is to combine that with a predictive analytics scheduling solution.

Moving people around to unfamiliar facilities with different practices must create some degree of patient safety risk, plus it seems logical that a clinician would prefer to pick up extra shifts at their home organization rather than moving around. Are employers trying to create an environment to support that?

Absolutely. The facilities as employers want to ensure that. The larger part of their workforce is made up of full -time employees with full-time benefits and the facility is working well for them. But there is always a sizeable percentage, five to 10% – which is hundreds of people when you’re talking about 4,000 or 5,000 clinicians — who want  to work in a more flexible way and may opt out of benefits. It may not be that they’re moving to different facilities across town. It could be that it’s a system that has two or three hospitals that are in relatively close proximity. For the option of the flexibility, to have a little more control over their schedule, they are willing to opt out of benefits.

To move them around and to mobilize them in the smartest way, you need a technology platform that can help distribute the shift requests, send reminders, and support an on-call backup auto notification that can go two or three levels deep into those who didn’t get the shift but have opted in to be in an on-call capacity.  Those are basic bread and butter techniques to ensure that you have the staff when you need them and where you need them. That technology, whether its sounds staggeringly innovative or not, is missing in most facilities. We offer it as a platform.

What are the benefits of your transparent pricing promise?

We hear from facilities the same thing that I felt myself as an administrator at Grady. I’m paying this high bill rate, but what are you paying the clinician? Inevitably, somebody will get it out of the clinician. Administrators are already frustrated because they don’t want to be using contingent staffing, so they do it in a somewhat begrudging way. But it should be transparent. You should know where the dollars are going. When you’re hiring someone at a premium, dollars also go to the stipend, because you’ve relocated them. If it’s a local contractor, then you’re going to see what that margin is. 

It’s a promise of trust to our clients that when when they use contingent staff, they know what it costs. We have such trust and confidence in our technology that we have driven the cost down. Those margins are much lower than a traditional legacy staffing agency, which often has brick and mortar buildings, a larger group of staff, and lower utilization of technology that require it to maintain a higher margin to pay for all of that.

Why do health systems use your services to recruit for making direct hires?

Some facilities need to make 300 hires and their HR department is not up to do that, so they seek us out. The way we differentiate ourselves is twofold. Because of our cost structure as a technology company, we can do it for less and have some of the lowest one-time costs for permanent placement when you’re doing direct hire. Then, the way we combine the our platform with social media to reach out to candidates is a broader way to access them and whatever pools they are in. The message leverages what the facility wants to do, whether they want to have an incentive like a sign-on bonus or speak to the benefits that they offer at their facility. Our reach and the interactivity of the platform with social media is another differentiator. Overall, it’s cost and the technology platform itself.

Where does the company go from here?

It’s really the shift from external contingent human capital management — the contingent staffing world whether technology enabled or not — into an increasingly pure SaaS product, where significant elements of the business are dedicated to predictive analytics. That’s the reason for the acquisition that’s only two months old. Leveraging the internal resource pool, and only when they have exhausted those techniques as well as permanent placement and have decided to use contingent staffing, to use a best in class marketplace that can aggregate PRN contract staffing, leveraging the technology across multiple different agencies to leverage the cost, get it down. We differentiate ourselves from contingent staffing competitors by seeing ourselves as constantly transforming further down the pathway towards a technology-only company.

Morning Headlines 6/5/24

Sword Health Introduces Phoenix, the First AI Care Specialist and Raises $130 Million in a Mix of Primary and Secondary Sale, Increasing Valuation to $3 Billion

Sword Health, which offers AI-powered digital support solutions for issues related to musculoskeletal problems, physical therapy, and pelvic therapy, raises $130 million.

Cybersecurity Event Update

Ascension restores EHR access in its Florida, Alabama, and Austin markets, and hopes to make the system available to the entire organization by June 14.

WM to Acquire Stericycle, a Leader in Medical Waste Services, for $7.2 Billion

Waste Management will acquire Stericycle, which specializes in medical waste disposal, compliance training, and secure information destruction, for $7.2 billion.

AssureCare Acquires Cureatr and SinfoniaRx Technology

AssureCare acquires the medication management technologies of Cureatr, which abruptly shut down last October, and of Cureatr affiliate SinfoniaRx Technology.

News 6/5/24

Top News

Ascension says in a June 4 cyberattack update that it has restored EHR access in its Florida, Alabama, and Austin markets. It hopes to use that experience to make the EHR available to the entire organization by next Friday, June 14.

The health system adds that its retail pharmacy, home delivery, and specialty pharmacy sites have reopened and can once again receive prescriptions electronically.

Ascension’s systems have been offline for four weeks.

Ascension warns that remediation of its other systems is ongoing and will require time to complete.

Reader Comments

From Janky: “Re: conferences. How do companies justify the ROI of exhibiting? It’s not like every exhibitor goes home with a fistful of hot leads or commitments for on-site follow-up.” I don’t run conferences, but I’ll describe how I position the value of sponsoring my site that goes beyond lead generation or immediate pipeline building.

• Everything a company does, including making sales, happens because someone has heard of them, probably repeatedly. One-shot exposure, regardless of the medium, will rarely be enough to seal a deal.
• Exposure isn’t just to prospects, but also potential partners, acquirers, acquisition targets, investors, executive hires, and consultants who may influence prospects. Most of the sponsors I lose is because a company — very often another of my sponsors –buys them.
• Our industry has quite a few competitive niches with specific audiences, and conferences and sponsorships will probably reach some who are outside traditional marketing channels.
• Prospects often make buying decisions based on an early recommendation by a non-C level employee who tips their boss off to a possible solution to their specific problems. You can’t just cold call C-level employees hoping for magic. Don’t ignore the influence that is wielded by attendees and readers who are at the mid-executive level or who are clinicians.
• It’s impossible to tell which kind of exposure, and to which people, will provide a pathway to success until after the fact.
• My conclusion is that companies that expect dramatic, short-term, easily-measurable ROI from conference participation or being a sponsor will do a one-and-done because they don’t see that result. Those who see it as patiently building a foundation and making industry connections in often intangible ways will end up reaping the benefit over the longer term.

Webinars

June 6 (Thursday) noon ET. “From Data to Decisions: The Vital Combination of AI and Human Expertise in Patient Care.” Sponsor: DrFirst. Presenters: David Wetherhold, MD, CMIO of ambulatory systems, Scripps Health; Dana Darger, RPh, director of pharmacy, Monument Health Rapid City Hospital; Colin Banas, MD, MHA, chief medical officer, DrFirst. In this Epic Med Management Fireside Chat, two health system leaders will share real-world examples of how AI is working in concert with their clinicians to streamline medication management by populating medication histories into Epic. generating initial drafts of patient conversations, and summarizing complex information. The presenters will also cover the latest developments on the critical and expanding role of pharmacists in patient care.

June 27 (Thursday) noon ET. “Snackable Summer Series, Session 1: The Intelligent Health Record.” Sponsor: Health Data Analytics Institute. This webinar will describe how HealthVision, HDAI’s Intelligent Health Management System, is transforming care across health systems and value-based care organizations. This 30-minute session will answer the question: what if you could see critical information from hundreds of EHR pages in a one-page patient chart and risk summary that serves the entire care team? We will tour the Spotlight, an easy-to-digest health profile and risk prediction tool. Session 2 will describe HDAI’s Intelligent Analytics solution, while Session 3 will tour HDAI’s Intelligent Workflow solution.

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

Acquisitions, Funding, Business & Stock

Waste Management will acquire Stericycle for $7.2 billion. Stericycle specializes in medical waste disposal, compliance training, and secure information destruction. It sold off its patient engagement solutions business to Carenet Health in 2022. I remember the Stericycle team always having fun, candy-filled booths during the heyday of HIMSS.

UPMC acquires Washington Health System (PA), which includes two hospitals and 18 practices. Washington Health will presumably move its Veradigm inpatient and EClinicalWorks outpatient EHRs to UPMC’s new Epic system.

Healthcare workflow automation software startup Keragon launches with $3 million in funding. The company specializes in using AI to synchronize patient data across different apps in real time.

Sword Health, which offers AI-powered digital support solutions for issues related to musculoskeletal problems, physical therapy, and pelvic therapy, raises $130 million in financing that increases its valuation to $3 billion. The company also announces a conversational AI tool called Phoenix that conducts natural conversations with patients, provides them with verbal feedback, and summarizes their performance for their clinician.

Sales

• Visage Imaging signs new customers Consulting Radiology, Nationwide Children’s Hospital, Nicklaus Children’s Hospital, Moffitt Cancer Center, and US Radiology Specialists.
• WellSpan Health (PA) will enhance primary care delivery with wraparound behavioral healthcare services and technology from Concert Health.
• Johns Hopkins Health Plans launches a multi-payer portal powered by Availity Essentials to help providers manage benefits, claims, and authorizations.

People

Adam Hameed, MBA (GrandPad) joins Glooko as president of connected care.

Baptist Health South Florida promotes Sha Edathumparampil to chief digital and information officer.

Eagle Telemedicine names Kat Thousand, RN, MHA (Envision Healthcare) VP of clinical services.

Sherman Sanchez, MHA (BN Consulting) joins Dina as president.

SSM Health (IL) hires Saad Chaudhry, MPP, MS (Luminis Health) as chief digital officer.

Health Recovery Solutions promotes Jason Comer, JD to CEO.

Announcements and Implementations

A new KLAS report finds that the move to the cloud for image viewing and/or storage is happening quickly, with Visage Imaging and Sectra generating both high customer confidence and market interest. Customer perception of Intelerad’s cloud strategy is mixed, while users of GE HealthCare question its ability to execute. Visage Imaging, Agfa HealthCare, and Sectra top the list in “confidence in vendor’s strategy for imaging in the cloud.” The biggest concerns about moving to the cloud are cost, privacy and security, the bandwidth and infrastructure that are required, and system performance.

Privacy and Security

Several London hospitals declare a critical incident and cancel procedures due to a ransomware attack on pathology services vendor Synnovis. The company is a partnership between Synlab UK and Ireland, Guy’s and St Thomas’ NHS Foundation Trust, and King’s College Hospital NHS Foundation Trust.

A judge rules that CMS inappropriately lowered the 2024 Medicare Advantage star ratings of SCAN Health Plan, which cost the plan hundreds of millions of dollars in reduced federal bonuses. As a result, the government will pay SCAN $250 million, which is likely to encourage other MA plans to seek a recalculation of their bonuses. Experts say that the star system doesn’t accurately reflect quality of care.

Sponsor Updates

• Groups of Availity HR staff work with Challenges Inc. to build and personalize wagons for Nemours Children’s Hospital and Ronald McDonald House Charities.
• Wolters Kluwer Health will offer ConsortiEX’s Assure-Trak IV Workflow Management in its Simplify+ compounding compliance suite.
• Healthcare Growth Partners launches HGP Health IT Momentum Index, which offers a real-time view into health IT M&A, investment value, and valuations.
• Visage Imaging’s Director of Customer Experience Steve Deaton participates in a new video titled “The Imaging Wire Show: Throwing Out the Imaging Playbook with Apple Vision Pro.”
• Optimum Healthcare IT publishes a new case study titled “EMR Test Management at Methodist Le Bonheur Healthcare.”
• Get-to-Market Health founder Steve Shihadeh joins Penn Presbyterian Medical Center’s board of trustees.
• Loyal announces that its consumer health platform is now available on the Oracle Healthcare Marketplace.
• Business Awards UK recognizes Altera Digital Health UK with its IT Product of the Year Award for its Sunrise solution.
• Arcadia publishes a new guide, “3 solutions to master data management.”
• Arrive Health publishes a new whitepaper, “The Crushing Weight of Prior Authorization and What You Can Do About It.”
• AvaSure will integrate CLEW’s advanced clinical surveillance solutions with its virtual care platform.
• Biofourmis will present at the Hospital @ Home Leadership Summit June 5 in Boston.
• Cardamom Health CEO Vivek Swaminathan celebrates the launch of the Wisconsin Investment Fund, a VC initiative that will initially invest $100 million in startups throughout the state.
• Clinical Architecture partners with Ready Computing to offer healthcare organizations an industry-leading solution to consolidate, manage, and improve the quality of clinical data at scale.
• DrFirst announces that its AI-powered SmartRenewal solution earned high ratings from customers in KLAS Research’s latest First Look report.

Black Book announces the 2024 awards for the highest user experience and customer satisfaction in health plan technology and outsourcing, recognizing the following HIStalk sponsors:

• Symplr – end-to-end provider data management and credentialing solutions.
• Inovalon – payer cloud platform.
• Surescripts – payer member safety, PBM, and pharmacy solutions.
• Availity – clearinghouse alternative solutions.

Blog Posts

• MIPS Improvement Activities: What qualifies as a high-weight activity? (AdvancedMD)
• Agfa HealthCare: Leading the Way in Healthcare Innovation at SIIM 2024 (Agfa HealthCare)
• Building Your Digital Workforce: Launching and Sustaining Your Intelligent Automation Journey (AGS Health)
• Budget-friendly ways to improve your cybersecurity (Altera Digital Health)
• What you should know about SDoH and SOGI, the data sources shaping health equity (Arcadia)
• The Impact of Prior Authorizations on Patient Care (Availity)
• Managed Services: A Scalable Solution for Community Connect Support (Cardamom Health)
• Burnout Buster: Prioritizing the “People Piece” During an EHR Replacement (CereCore)
• Capture More Revenue and Save Resources with Artera’s New Intake and Payments Solution (Artera)
• Compliance Matters: User Access Monitoring – 5 Things You May Not Be Thinking About (Clearwater)
• Cybersecurity in Healthcare: Why Response and Recovery Matter (Divurgent)

Sponsor Spotlight

Revuud has launched a new AI matching functionality designed to revolutionize talent acquisition. This advanced matching algorithm swiftly sifts through talent profiles, pinpointing candidates whose skills, experiences, and preferences perfectly align with job requirements. By leveraging continuous learning from user interactions, feedback, and successful matches, the system refines its capabilities over time, delivering increasingly accurate and relevant results. This innovation promises significant time savings, expediting the hiring process by rapidly identifying the most suitable candidates.

Contacts

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

Morning Headlines 6/4/24

TouchSource Acquires Healthcare Business and Patient Room Network From True Sync Media

Digital signage and wayfinding technology vendor TouchSource acquires True Sync Media’s healthcare business, which sells waiting room display solutions and content.

General Catalyst-backed Jasper Health lays off staff

Jasper, which offers tech-powered support to cancer patients, reportedly lays off half its staff.

BD to Acquire Edwards Lifesciences’ Critical Care Product Group for $4.2 Billion to Expand Smart Connected Care Solutions and Become an Advanced Monitoring Technology Leader

BD will acquire the critical care monitoring solution group of Edwards Lifesciences, which includes AI-enabled clinical decision support tools, for $4.2 billion in cash.

Curbside Consult with Dr. Jayne 6/3/24

I use HIStalk as a primary source for healthcare IT news as much as the next person, so I was interested to see the recent Morning Headlines call-out about Google’s AI Overviews. I had seen them pop up in searches, but didn’t think too much about them since the last couple of weeks have been a whirlwind of meetings and deadlines with travel to a conference sandwiched in the middle.

I had a little bit of downtime this weekend and was planning to use it to complete my mandatory Maintenance of Certification questions that I have to do every quarter to maintain status with my specialty board. The online quarterly questions are open book and you’re allowed to use online resources. Normally I use well-trusted sites such as the United States Preventive Services Task Force, various professional journals, and UpToDate to research the answers if I don’t know them outright. This time, I decided to use Google to see what it would come up with.

Due to the honor code involved with the quarterly questions, I can’t share the exact queries that I did during the project, but I’ll share the results of some questions that recently came up related to continuing medical education quizzes and conversations with colleagues.

Asking Google how much calcium I should be taking in each day resulted in the AI overview that displayed the same data that appears on the website of the National Institutes of Health’s Office of Dietary Supplements. It showed values by age range and sex, since Google wouldn’t necessarily know how to define “I” in the query. However, asking it for tips on selecting the best blood pressure intervention for a female patient with a blood pressure of 200/90 didn’t provide an AI Overview. (UpToDate won that one, hands down, with multiple articles addressing the topic.)

The recommendations for breast cancer screening in the US recently changed. I asked Google for the current mammogram guidelines and was greeted with four sponsored results and then a result with a link to the US Preventive Services Task Force site, so that was a plus since it was a direct link to the primary source material. Of the sponsored links, the one from Mercy wasn’t even about mammograms, but rather a promotion for its multi-cancer-screening blood test. Another one of the sponsored links, from a local fitness organization, was last updated in 2020 and provided incorrect information. As a clinician, I was pleased to find that the search for “are COVID vaccines bad” returned two websites from the Centers for Disease Control and Prevention followed by one from Johns Hopkins Medicine.

I then turned to more routine primary care questions, such as “do I need penicillin for sore throat” and was pleased with the information the AI overview provided, including that “antibiotics only help with bacterial infections, not viral infections” and “most sore throats are caused by viruses , such as the common cold, and will go away on their own within a week without treatment.” It went on to suggest reputable home remedies including rest and gargling with salt water as well as links to appropriate articles from UpToDate, GoodRx, and the National Library of Medicine.

I also asked, “what is a sinus infection” and although the information that returned was appropriate, I was thrown by the weird punctuation and capitalization that came with it: “Sinus infections can be caused by a number of things, including: An inflammatory reaction, Allergies, A code that doesn’t get better or gets worse after 7 to 10 days, and Smoking.” Even my Microsoft Word editor function caught that one and didn’t want me to send it along to Mr. H. I was pleased that it got the Oxford comma right, however. The AI Overview blurb also included some solid home remedies, such as reducing stuffiness by drinking lots of fluids, using nasal saline spray, and putting warm wet washcloths on the face.

By this point, I was fairly enthusiastic about some of the responses, since they included basic self-care items that a lot of the patients who come to see me in emergency and urgent care settings don’t seem to know. I see too many patients who present for care without having tried any kind of remedies at home, so I asked a tricky one: “Should I treat my child’s fever?” I see a fair number of parents who don’t give their children any fever-reducing medications when they are sick, under the pretense that they didn’t want to treat it because they “wanted the doctor to see how high it was.” Speaking generally for the physicians in my generation, unless your child is an infant or has one of a few chronic health conditions, we trust your use of a thermometer and want you to give your child some acetaminophen when they have a fever because it will help them feel less miserable.

The AI overview was spot on, advising caregivers to treat a fever “if it’s making them uncomfortable or preventing them from drinking fluids.” It also advised that treatment might not be needed for toddlers and children who are eating, drinking, playing, and sleeping normally. Sometimes I see children who are running fevers, but zooming around the exam room eating Cheerios and drinking apple juice, so this kind of information might have saved parents a $50 or $100 co-pay as well as prevented a couple hundred dollars in overall costs to the healthcare ecosystem. The overview was followed by links to content from UC Davis Health, Stanford Medicine, and Cleveland Clinic, so I felt good about the overall results of the search.

From there, I asked Google for symptoms of abdominal aortic aneurysms, and received an AI Overview. The second item on the list of symptoms, a pulsing sensation in the abdomen, can also be completely normal. The overview then recommended that anyone with the symptoms listed “should see your doctor as soon as possible.” In reality, if someone is having symptoms from this condition, they need to be in the nearest emergency department because it can be a life-threatening emergency requiring immediate medical management and the potential for emergency surgery. I’d give that particular response a D-minus if not an F since the potential for catastrophic consequences is high.

I asked the question again in a different way: “Do I have an aortic aneurysm?” and was told that “many people with aortic aneurysms don’t have symptoms until the aneurysm ruptures” and had to scroll off the screen to see any kind of recommendations for evaluation or care, so on the overall topic of aneurysms I would give Google an F.

In summary, I thought the technology did decently well for basic questions that I deal with every day, although it bobbled a little on the aneurysm question. Given the lack of basic health education in many communities, including how to treat minor illnesses and injuries, Google’s AI Overviews might be a nice step towards improved health literacy. It certainly makes the “finding” health information component easier, especially for patients and caregivers who might not know how to access the website of a local health system or other respected health information organization. It also did pretty well on the board certification questions, although some of them were more specific and therefore didn’t generate an AI overview. I’ll give the tool a solid B-plus as today’s grade but will keep an eye on it to see how it does in the future.

Happy Birthday, HIStalk! Congratulations on officially being old enough to buy a round of drinks. As is fitting for a publication created by anonymous people across the country, I celebrated with pastry for one. Healthcare IT has evolved in ways that I never dreamed it would, and I’m happy to have been along for the ride with HIStalk.

Email Dr. Jayne.

Morning Headlines 6/3/24

OCR Updates Change Healthcare Cybersecurity Incident FAQs

HHS OCR provides specific information related to breach notification responsibility from the Change Healthcare cyberattack.

Wrongful death lawsuit alleges baby dies as a result of Springhill Medical Center’s negligence during cyberattack

A woman whose baby died in childbirth during a cyberattack says that the hospital is refusing to pay its previously agreed-on settlement.

Google Is Using A.I. to Answer Your Health Questions. Should You Trust It?

Google’s AI Overviews, which displays AI-generated search result summaries before showing the individual links, can provide health information that is incorrect or that uses unreliable sources.

Demands were sent to 4 hospitals/systems re: AI products for use in healthcare facilities

An investigative reporter finds that Texas Attorney General Ken Paxton has used the state’s consumer protection laws to demand that Houston Methodist, Parkland Health, Children’s Health, and Texas Health Resources provide his office with their AI-related contracts, policies, and disclosures.

Monday Morning Update 6/3/24

Top News

HHS OCR updates its cybersecurity FAQ to include the Change Healthcare cyberattack:

• Nobody has issued the breach notification that was due April 21, 60 days from when the incident occurred.
• Covered entities should contact Change Healthcare if they expect the company to issue the mandatory breach notification to affected patients on their behalf.
• Providers don’t have to issue a breach notification as long Change agrees to do so.
• All parties are responsible for ensuring that affected patients are notified.
• OCR’s interest in the business associates of the companies, including providers, is secondary.
• Determining if a ransomware attack is a HIPAA breach involves whether the attack caused PHI to be encrypted and the likelihood that the PHI is identifiable or capable of being re-identified and whether the data was actually acquired or used.

Reader Comments

From Orator: “Re: Oracle. Does the company believe that sarcastic, confrontational pieces like Ken Glueck’s blog post panning the BI article will draw healthcare admiration or improve sales?” Larry Ellison is widely recognized as Silicon Valley’s biggest bully, and one might expect his underlings to share that trait. I don’t think that this type of argumentative swagger has ever worked in healthcare, although ironically Cerner’s Neal Patterson was probably the best example before Larry bought his former company, and even Neal learned that macho personal attacks on Epic and Judy Faulkner just made Cerner look worse. Our industry respects corporate drive, but only when it is backed by some level of humility and empathy for the patients and employees of mostly non-profit health systems. Ken didn’t help the cause of the obviously butthurt Oracle by launching a public peeing match against a minimally influential website, although he’s done it before. Far better would have been a professional, factual, accomplish-centered response from David Feinberg, who at least carries healthcare credibility and holds the title of “chairman of Oracle Health,” even though it seems to be a ceremonial role of glad-handing and selfie-snapping while while the real puppet masters are Oracle’s EVPs.

Just in case any other health IT executives are considering providing their angry hot take on negative reporting about the company, I’ll offer this:

• Don’t give a negative story legs by mentioning it, unless most of the industry is buzzing about it and demands a response.
• Focus on the unemotional correction of misinformation.
• Acknowledge any claimed issues that are factual and commit to resolving them.
• Consult the employees who are the most knowledgeable to identify the article’s errors and the validity of the company’s planned response.
• Keep the tone professional and constructive since the company will be judged on it. Have a communications expert review and offer suggestions.
• Don’t take shots at competitors, or even better, don’t even acknowledge that they exist unless they are the focus of the article.
• Attribute the article to the executive who has the best credentials or highest recognition among the article’s audience.
• Consider the article’s sources and examine whether a company disconnect exists caused them to convey erroneous or negative information.
• Invite dialog and offer to continue the discussion.

HIStalk Announcements and Requests

It’s close to an even split among poll respondents about the federal government paying for the development of health system cybersecurity tools. Commenters expressed these supporting thoughts: the federal government needs to protect patient information because healthcare organizations aren’t doing it well and someone needs to do something drastic before a bad actor takes the entire health system down. Counterpoints: the feds should encourage / require health systems to effectively using existing security technologies and the government should not spend taxpayer money just because health systems haven’t.

New poll to your right or here: How has your opinion about Oracle Health changed in the past 12 months?

HIStalk turns 21 this week, started by me in 2003 as a hobby that would keep me current on the industry for my health system IT executive job. The time has flown by and filling the blank screen energizes me every single day. I’m thrilled to have readers and sponsors, but my selfish motivation has always been my own satisfaction, although it’s gratifying that influential readers make decisions based on what they read here.

Webinars

June 6 (Thursday) noon ET. “From Data to Decisions: The Vital Combination of AI and Human Expertise in Patient Care.” Sponsor: DrFirst. Presenters: David Wetherhold, MD, CMIO of ambulatory systems, Scripps Health; Dana Darger, RPh, director of pharmacy, Monument Health Rapid City Hospital; Colin Banas, MD, MHA, chief medical officer, DrFirst. In this Epic Med Management Fireside Chat, two health system leaders will share real-world examples of how AI is working in concert with their clinicians to streamline medication management by populating medication histories into Epic. generating initial drafts of patient conversations, and summarizing complex information. The presenters will also cover the latest developments on the critical and expanding role of pharmacists in patient care.

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

Other

Attorneys for a woman whose baby died during childbirth at Springhill Medical Center (AL) during a 2019 cyberattack ask the judge in her negligence lawsuit to force the hospital pay the settlement that they previously agreed to. The lawsuit claims that the ransomware attack took down the fetal monitoring system that should have alerted nurses to call the OB-GYN, who has said that she would have performed a C-section had she known that the baby’s umbilical cord was wrapped around her neck. The hospital said that the doctor had the responsibility to notify the patient. The lawsuit is believed to be the first in which a patient’s death was attributed to ransomware.

Contacts

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

Morning Headlines 5/31/24

Cybersecurity Event Update

Ascension says it has restored EHR access in one of its markets.

NHS computer issues linked to patient harm

Half of NHS trusts say that they have documented EPR-caused patient harm, including three deaths and 126 instances of serious IT-caused harm.

Thankfully Business Insider Is Not Responsible for Healthcare Modernization

Oracle EVP Ken Glueck calls a recent negative BI article “clickbait,” declares Epic’s Judy Faulkner to be “the single biggest obstacle to EHR interoperability,” and says that Epic will fail and Oracle Health will succeed.

News 5/31/24

Top News

Waystar targets a valuation of nearly $4 billion in its upcoming IPO.

The company, which was formed in early 2018 by the merger of Navicure and ZirMed, was valued at $2.7 billion in a 2019 investment.

Reader Comments

From Mandible: “Re: Oracle Health. The Business Insider article struck a nerve. The company’s blog post exposes a lot of anger. It also takes a shot at Epic for their lack of commitment to interoperability.” The Oracle response is a textbook example of why companies should take a breath and get PR help before lashing out in righteous indignation, not to mention that they should follow Mark Twain’s advice to “never pick a fight with people who buy ink by the barrel.” Oracle’s blog post was penned by EVP Ken Glueck, whose background is politics and lobbying (EVP Mike Sicilia, who has gone radio silent for months, was also a company lobbyist, and neither have any healthcare experience). I’ll summarize the post further down the page. Business Insider is likely delighted that the company is giving it free publicity and probably a ton of inbound clicks for a marginally informative piece. This isn’t Ken’s first journalism rodeo – he used Oracle’s blog to go nuclear on The Intercept when it reported that Oracle was marketing its analytics software to police in dissent-suppressing countries and then doxxed the reporter (and had his Twitter account suspended for doing so) and urged followers to send him dirt about her. Click the graphic above to enlarge the archived copy before the reference was expunged. Unrelated: despite being in such a high-ranking position, Ken’s photo appears basically nowhere on the Internet and he doesn’t include it in his X and LinkedIn profiles, so I can’t include his headshot.

From Jeepers: “Re: Oracle Health. Oracle stockholders should be livid that objective due diligence was not performed before buying Cerner. Larry Ellison wanted it and all his yes men said yes. The board and maybe even the SEC has a case for dereliction of duties or similar charge.” The comment quoted in the Business Insider article came from the Senate testimony of Oracle EVP Mike Sicilia: “I would say there’s always things that you discover after the fact. You know, we certainly had read the press, and we certainly had read things that were publicly disclosed. But there’s nothing like owning something to fully understand what’s going on.” It should be noted that Sicilia was referring to the VA project specifically, not the entirety of the Cerner acquisition.

Webinars

June 6 (Thursday) noon ET. “From Data to Decisions: The Vital Combination of AI and Human Expertise in Patient Care.” Sponsor: DrFirst. Presenters: David Wetherhold, MD, CMIO of ambulatory systems, Scripps Health; Dana Darger, RPh, director of pharmacy, Monument Health Rapid City Hospital; Colin Banas, MD, MHA, chief medical officer, DrFirst. In this Epic Med Management Fireside Chat, two health system leaders will share real-world examples of how AI is working in concert with their clinicians to streamline medication management by populating medication histories into Epic. generating initial drafts of patient conversations, and summarizing complex information. The presenters will also cover the latest developments on the critical and expanding role of pharmacists in patient care.

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

Acquisitions, Funding, Business, and Stock

Dollar General ends its parking lot clinic program that it launched with DocGo less than 18 months ago as part of its DG | Wellbeing brand.

Virtual Therapeutics, which offers game-based mental health apps, will acquire game-based cognitive treatment vendor Akili for $34 million in cash. Akili went public via a SPAC merger in August 2022 at a $1 billion valuation and saw its shares lose 70% of their value in the first week of trading. They are now down 97%.

Pharmacy workflow automation vendor Plenful raises $17 million in a Series A funding round.

IMO, aka Intelligent Medical Objects, renames itself to IMO Health.

Cardamom Health will receive funding from the newly launched Wisconsin Investment Fund.

Oracle EVP Ken Glueck lashes out at Business Insider and its “Oracle deadly gamble” article (he dismisses it as “clickbait”) that questions its VA performance and the state of the former Cerner business in general. Summary:

• The article recycles old news, anonymous quotes, and its own piece from two years ago while omitting Oracle’s response, which he says is “your typical Business Insider preconceived ‘expose’’.”
• The Cerner system has improved since BI’s July 2022 piece. Oracle fixed the “unknown queue” problem in 2022 just 10 days after it was reported.
• DoD implemented the Cerner system successfully and it has gone live at the jointly operated Lovell Federal Health Care Center, the first go-live since Oracle acquired Cerner.
• Glueck cites a 2020 BI article about Epic that he calls a “puff piece” that contains “Epic misinformation.”
• He calls Epic CEO Judy Faulkner “the single biggest obstacle to EHR interoperability” and says that Epic’s contracts give the company ownership of patient data in “stretching HIPAA beyond recognition.”
• He says the same issues that caused other industry outsiders to fail in healthcare will cause Epic to fail and Oracle to succeed.

People

Augmedix hires Alex Stinard, MD (HCA) as chief clinical AI officer.

Phillip LaJoie (Qbase) joins the Defense Health Agency as COO of the market technology integration office.

DirectTrust’s Interoperable Secure Cloud Fax Consensus Body elects Jeffrey Sullivan, MS (Consensus Cloud Solutions) as chairperson.

Announcements and Implementations

Medicare Advantage insurer Clover Health will offer its Clover Assistant clinical decision support tool for sale to payers and providers. The company went public in a SPAC merger in January 2021 at a $7 billion valuation, now at $553 million.

Ascension says in a May 29 cybersecurity event update that it has restored EHR access in one of its markets.

UCSF and UCSF Health receive a $5 million charitable donation to develop a system that will monitor the performance of AI tools in real time for efficacy, safety, and equity.

Black Book ranks Veradigm’s Payerpath as the #1 overall provider of claims and clearinghouse platform solutions for small medical practices.

Government and Politics

HHS taps national coordinator for health IT Micky Tripathi, PhD, MPP as acting chief artificial intelligence officer while it searches for a permanent replacement. He will also continue in his national coordinator role.

Other

In England, BBC News investigates claims of a cover-up involving problems with NHS’s electronic patient record systems, which it says have been linked to three deaths, have left 200,000 medical letters unsent, and have caused payment problems in half of the trusts. The coroner who reviewed one of the deaths specifically called out its Cerner / Oracle Health system for not clearly indicating the level of acuity of ED patients as did the system it replaced.

Ukraine-connected digital health vendor BeKey runs a crowd-funding campaign for its rollout of YODD (Your Online Doctor Diagnostics), a telehealth device for homes. The company will donate devices to people in Ukraine and volunteers with Doctors4UA. Supporters will receive one of the devices later this year.

Contacts

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

EPtalk by Dr. Jayne 5/30/24

I was talking to a colleague this week. We had a stroll down memory lane about the changes that have happened in the healthcare technology sphere during our tenures in the industry. I had made a comment about “doing electronic healthcare records since before Meaningful Use was a thing” and the conversation just spiraled from there.

We’ve seen practices opt out and take the penalties for non-participation, and we’ve seen practices overhaul themselves trying to get the most out of the bonuses. We’ve also seen a lot of organizations in the middle of that spectrum that just seem perpetually lost because they struggle to keep up with everything that’s going on in the regulatory world.

For those organizations in the swirl, the Merit-based Incentive Payment System (MIPS) Value Pathways (MVPs) registration is open for the 2024 practice year. Organizations that plan to report an MVP can register through December 2, 2024 at 8 p.m. ET. That seems a bit of an arbitrary choice on the time and date to close out registrations, but I’m far from being the clock or calendar police. Organizations that plan to register should identify the MVP they plan to report, whether they’re going to use the Consumer Assessment of Healthcare providers and Systems (CAHPS) for MIPS Survey, and the population health measure they would like to be evaluated on. There are several other decision points, such as participating as an individual versus group versus subgroup, so if you’re not familiar with all of that, it might be time to do some reading.

I haven’t heard much about data being used in this way, but Vanderbilt University Medical Center is using data to identify outlier clinicians who are receiving a high number of patient complaints. Once the physicians are identified, trained physician peers review the data and provide feedback that is targeted towards behavioral modification. The program has lowered malpractice claim costs for the identified physicians by 83%. Although the work at Vanderbilt was only done in orthopedic surgery, it would be interesting to see how similar initiatives might pan out in other specialties. I’m curious how other organizations might be using patient complaint data – it’s not something I hear much about in the informatics community.

Speaking of data, I can’t wait to see some actual research on this new solution. Crescent Regional Hospital in Lancaster, TX has deployed a solution that creates life-size holograms of physicians in patient care areas, “creating an immersive, engaging, interactive experience.” It sounds exciting and all, especially when the hospital CEO uses the word “teleport” to describe what is going on, but other than being in 3D and requiring specialized equipment, it’s a very fancy video visit. It is being described as a “non-touch” visit rather than a virtual visit or video visit. I’d love to see a head to head study comparing this type of solution with in-person care and non-hologram virtual visits. I suspect it will score similarly to the latter, although there’s a potential for it to score worse if there are technical issues. I wholeheartedly support the use of video / virtual care, especially in areas where it’s challenging to recruit clinicians, but I can’t help but remember something else that creates an “immersive, engaging, interactive” environment – live physicians.

Depending on the specialty, some departments have been slow to integrate virtual care into everyday practice. A recent submission in JAMA Pediatrics looks at the incorporation of clinician-to-clinician e-consults within pediatric care organizations. Ideally, it would allow primary care physicians to collaborate with subspecialists about the care of a particular patient. However, researchers found rates for the under-18 population that were significantly lower than other patient groups. The authors note key areas that need to be addressed in order to expand the use of the modality: specific payment mechanisms, EHR interoperability, operational processes, consent, privacy, and patient engagement. It will be interesting to look back at this topic in a few years and see if advances have been made.

As I was wrapping up my recent trip, the idea of innovation labs was a hot topic. Apparently Atrium Health is building a 20-acre “innovation district” in Charlotte, NC that includes research buildings, a residential tower, retail shops, and a hotel. It will surround the medical school that is planned for the area.

Plenty of large health systems have innovation centers or programs. I’ve heard of them ranging from high-performing units that can create and commercialize solutions to buzzword-friendly boondoggles. One of my drinking buddies shared a feature from The Hustle that suggests that the innovation lab concept has lost its sparkle. Examples of non-healthcare innovation labs that were cited in the piece include Estee Lauder and Microsoft “to infuse AI into your beauty routine (whatever that means)” along with Major League Soccer, Mars (home of M&Ms and Snickers), Sephora, and Visa.

That particular edition of The Hustle also included a blurb about a startup (BrainBridge) that wants to transplant a human head onto a donor body within eight years. They plan to use high-speed robotic surgeons and AI algorithms to make it all work (of course there is AI!) The blurb links out to an article in the New York Post, so that’s something right there. I’d love to hear what actual neuroscientists think about the potential for this.

My buddy also shared that the edition mentioned that Firefox recently resolved a software defect that was opened in March 2000 for the Netscape Navigator product. I had a 15-year relationship with a software company once, but generally gave up on defect fixes once the requests hit the five-year mark. Kudos to the team for closing the loop on this one.

I’m back in the cicada zone this week, and I’d be lying if said I wasn’t eager for them to finish their life cycle and have the next generation burrow back into the ground. They are projected to decrease in my area in mid-June, but work travel will take me to places where they might continue well into July. I try to dodge them when I’m out for a walk or a run, but it’s amazing how loud it can be when one of them hits your windshield at high speed. Good luck, little critters, we’ll see you again in 13 years.

What is your cicada-palooza experience? Are you fascinated by it or ready to be done with it? Or tired of hearing the Eastern half of the US talk about it? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 5/30/24

Virtual Therapeutics, Akili Interactive Enter Into Definitive Merger Agreement to Establish Leading Digital Health Company

Virtual Therapeutics, which offers game-based mental health apps,will acquire game-based cognitive treatment vendor Akili for $34 million in cash.

HHS names acting chief AI officer as it searches for permanent official

HHS taps national coordinator for health IT Micky Tripathi, PhD, MPP as acting chief artificial intelligence officer – in addition to his existing role — while it searches for a permanent replacement for Greg Singleton.

Dollar General pulls mobile clinic mentions from website, partner no longer offering appointments

Endpoints reports that Dollar General has removed from its website mentions of its mobile clinics, which it operates in a partnership with DocGo, less than 18 months after launching the service.

Healthcare payments firm Waystar aims up to $3.83 bln valuation in US IPO

Waystar targets a valuation of nearly $4 billion for its US IPO, 50% more than its previous valuation in 2019.

Healthcare AI News 5/29/24

News

Microsoft announces new features for Copilot that include expanded Teams capabilities, the ability to create custom copilots that act as agents, and extensions and connectors for developers.

OpenAI says in an unrelated blog post that it bas begun training the success to ChatGPT 4o, which it says will “bring us to the next level of capabilities on our path to AGI.”

XAI, which was founded in July 2023 by Elon Musk, will raise $6 billion in funding to bring its first products to market. The company’s first release was its Grok AI system.

Mayo Clinic will hold an AI summit on July 8-9 at its Rochester, MN campus and virtually, with a registration fee of $350 for either option.

Business

Google profiles 24 healthcare-related startups from Europe, the Middle East, and Africa that are part of the 2024 cohort of its health startup support program.

Videra Health, which offers an AI-driven mental health assessment platform, raises $5.6 million in seed funding. Its product uses patient self-assessments and AI analysis of video patient responses.

Atropos Health raises $33 million in a Series B funding round, which the company will use to expand the stake of its evidence-generating applications in value-based care.

Other

China’s Wuhan Union Hospital launches an AI pilot project in collaboration with Baidu Health that includes AI-powered patient triaging, appointment scheduling, and wait time management.

Contacts

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

Readers Write: Healthcare’s Digital Leap: The Game-Changing Benefits of Online Marketplaces

Healthcare’s Digital Leap: The Game-Changing Benefits of Online Marketplaces
By Eric Utzinger

Eric Utzinger is co-founder and chief commercial officer of Revuud.

Digital marketplaces have become a transformative force across various industries, redefining how people transact and interact. From Uber to Airbnb, these platforms have revolutionized sectors and sparked trends like the gig economy and micro-entrepreneurship. 

The healthcare industry is experiencing its own revolution. Just as Uber changed transportation and Airbnb altered accommodation, digital marketplaces are shaking up healthcare. With over 150 online marketplaces today, while the concept isn’t entirely new, its application in healthcare is innovative. 

These platforms simplify the process of buying, selling, and hiring healthcare resources, transforming how doctors, nurses, medical equipment, medical coding, and IT services are managed. Let’s delve into how these marketplaces are enhancing healthcare’s efficiency, cost-effectiveness, and accessibility.

Boosting Access to Talent: Doctors and Nurses

• A bigger talent pool. Finding the right healthcare professionals used to be a local affair, often limited by geography and specific recruitment agencies. Enter marketplaces like LocumTenens.com and Vivian. These platforms expand the reach, allowing hospitals and clinics to connect with specialists and nurses from all over the country, or even the world. This broader talent pool ensures they can find the perfect fit for their needs.
• Faster hiring. In healthcare, time is of the essence. Traditional hiring processes can be slow, involving multiple steps and heaps of paperwork. Digital marketplaces streamline everything, providing robust platforms where job openings can be posted, and qualified professionals can apply directly. With features like instant messaging and credential verification, hiring becomes much quicker and more efficient.
• Flexibility and scalability. Marketplaces offer unmatched flexibility. Healthcare facilities can easily find part-time, temporary, or per-diem staff, allowing them to scale their workforce according to patient volume and seasonal demand. This adaptability helps manage operational costs and maintain high standards of patient care without the burden of overstaffing.

Revolutionizing Medical Coding

• Access to specialized coders. Accurate medical coding is crucial for billing and regulatory compliance, but finding specialized coders can be challenging. Marketplaces like The Coding Network connect healthcare providers with experienced coders who specialize in various medical fields, ensuring accuracy and compliance.
• Cost savings. Marketplaces offer competitive pricing for coding services, often cheaper than traditional staffing agencies. This cost efficiency is achieved through dynamic matching of supply and demand, reducing the overhead costs associated with conventional hiring processes.
• Scalability and flexibility. Medical coding needs can vary, especially with changing healthcare regulations or peak periods. Marketplaces provide the flexibility to scale coding services up or down as needed, allowing healthcare providers to manage their workload efficiently without long-term commitments.

Advancements in Healthcare IT Services

• Access to specialized IT talent. The digital transformation of healthcare requires specialized IT skills, from electronic health record (EHR) management to cybersecurity. Traditional hiring methods can limit the search for such talent. Marketplaces offer access to a pool of IT professionals with the expertise required for healthcare projects, ensuring providers find the right match for their highly technical needs.
• Cost efficiency. Hiring IT professionals through marketplaces often leads to significant cost savings. These platforms eliminate many overhead costs associated with full-time hires, such as benefits and long-term contracts. Healthcare providers can hire IT experts on a project basis, paying only for the services they need.
• Agility and speed. The rapidly evolving landscape of healthcare technology demands quick, agile responses. Marketplaces provide an efficient way to bring in IT professionals for short-term projects or to address immediate issues like system upgrades or security breaches. This agility is crucial for maintaining the integrity and functionality of healthcare IT systems, allowing organizations to scale their IT departments up or down when needed.

Conclusion

Digital marketplaces are revolutionizing healthcare by offering a more efficient, cost-effective, and flexible approach to managing resources. From doctors and nurses to medical equipment, coding, and IT services, these platforms provide numerous benefits over traditional methods. They democratize access to talent and resources, enhance transparency, and streamline processes, ultimately leading to improved patient care and operational efficiency.

As healthcare continues to evolve, embracing the advantages of marketplaces will be key for providers aiming to stay competitive and deliver high-quality care.

Readers Write: Strengthening the Net: The FTC’s Expanded Reach on Health Data Protection

Strengthening the Net: The FTC’s Expanded Reach on Health Data Protection
By Chris Bowen

Chris Bowen, MBA is founder and CISO of ClearData.

The Federal Trade Commission (FTC) recently finalized changes to the Health Breach Notification Rule (HBNR), signaling a move from fragmented, independent privacy and security measures towards a unified, collaborative defense. This new rule puts patients and consumers in the driver’s seat of their privacy and serves as a call to action for companies that create, collect, manage, and use health information, providing a potent deterrent against vulnerabilities that could expose their data.

Understand this: The FTC’s stance is unwavering and authoritative. It demands not mere compliance, but the utmost adherence to rigorous standards of care and caution in handling confidential health information.

The Health Breach Notification Rule mandates that vendors of personal health records and associated entities that are not covered by HIPAA must inform individuals in case of a breach with unsecured data. If a third-party service provider to these entities experiences a breach, it must inform the entity, which then notifies the individuals. The Rule also outlines the specifics of when, how, and what to notify in the event of specific breaches.

HBNR specifically applies to personal health record vendors and other entities that offer products or services through them, and third-party service providers to them. It covers a variety of platforms from health apps to wearable technologies. Unfortunately, 81% of Americans assume that all protected health data that is collected by digital health apps is protected under HIPAA.

In May 2023, the FTC proposed amendments to the Health Breach Notification Rule (HBNR) to clarify its scope regarding the collection of consumer health data by health apps and related technologies. The finalization of these changes is an unambiguous signal to the digital health ecosystem that the integrity of healthcare data is non-negotiable. No longer can firms hide behind the complexities or nascent nature of digital health technologies; the time to comply and protect is now, and the FTC has implemented rules that leave no uncertainty about the seriousness of the endeavor.

The updated HBNR ushers in several key shifts that set a higher standard for security and transparency. First among these is the expanded content required in a breach notification to patients. This move is not merely bureaucratic; it aligns with the growing demand for clarity and accountability that patients and providers alike require to maintain trust in the face of technological unknowns.

The Commission has made significant revisions and clarifications to the rules governing health apps and technologies that are not covered by HIPAA, enhancing the protection of personal health information (PHI). Among these changes are revised definitions to emphasize the rule’s application to health apps, clarification on what constitutes a “breach of security,” and a more precise scope for “PHR related entities” that includes those offering services via online and mobile platforms.

Additionally, the final rule expands the methods and content of breach notifications to consumers, including the use of electronic communication and detailed information on the breach’s impact.

It also adjusts the timing for notifying the FTC in the event of a breach, setting strict deadlines to ensure prompt action. These updates mark a significant step forward in securing PHI and underscore the importance of compliance and clear communication in the digital health space.

The FTC’s action demands not just compliance, but leadership — leadership in technological integrity, transparency, and fortitude in the face of cyber threats. Change will require investment, invention, and unwavering commitment, but the benefits extend far beyond mere regulatory peace of mind. In championing cybersecurity, we champion the future of healthcare, a future that is secure, trusted, and resilient. Digital health entities that fall short will find themselves lacking not just in regulatory compliance, but also in the trust and investment of a discerning public.

Consumer Protected Health Information is not just a term. It embodies the very essence of what is ours, our narratives of health, history, and future.

The time has come for a unified front in healthcare cybersecurity. We, the technologists, innovators, lawmakers, and guardians of the healthcare digital landscape, must rise to this challenge with unity and tenacity.

It is time for every digital health company, every healthcare professional, and every policymaker to reassess, reinvent, and redouble their efforts in cybersecurity. The FTC’s changes provide the roadmap. It is now up to us to ensure a future where patient data is as secure as the healthcare we strive to provide.

The stakes are too high, the threats too real, and the need for action too pressing.