Morning Headlines 4/9/24

Second Ransomware Group Demands UnitedHealth Pay for Stolen Data

RansomHub threatens to sell data stolen during the February ransomware attack on Change Healthcare if the company doesn’t pay a second ransom.

FocalPoint Holdings and CodexIT Join Forces to Acquire Conclusn, Building a Best-in-Class Healthcare Analytics Dashboard System

Healthcare software developer FocalPoint Holdings forms a joint venture with health IT and consulting firm CodexIT to acquire healthcare analytics company Conclusn.

Grow Therapy Raises $88M Sequoia Capital-Led Series C to Advance Effective Mental Healthcare

Mental health technology company Grow Therapy raises $88 million in a Series C funding round, bringing its total raised to $180 million.

Rater8 Accelerates Expansion With Strategic Investment

Provider reputation management and patient feedback company Rater8 raises an undisclosed amount of Series A funding.

Curbside Consult with Dr. Jayne 4/8/24

I found myself working this weekend in the path of totality for the solar eclipse. I’m glad I booked my travel almost a year in advance because standard rental cars aren’t available from the usual national brands. Rates for the remaining luxury vehicles are upwards of $400 per day, so I was glad to have locked in at $47 when I did.

My conference-rate hotel was also locked in at $104 per night and my hotel is sold out. I’m fairly certain they are not used to having so many guests, because they don’t have enough towels to restock the guest rooms in real time. They’re picking up towels in the morning, laundering them, and replacing them around dinner time. Management has been extremely apologetic, and I feel for them having to staff around a conference that always happens during this particular timeframe and then having an eclipse thrown on top of it.

It’s been interesting to hear people in the hotel restaurant talk about it. This morning, I sat next to someone who traveled 1,700 miles to experience a total solar eclipse. Based on the weather forecasts, there’s a good chance it will be cloudy on Monday, but even if you can’t see the sun, the eclipse will still happen. I was in the path of totality in 2017 as well, and it was pretty wild to feel the temperature drop and hear the bird song disappear, only to be replaced by the sound of crickets.

The pinhole viewer that I built worked well despite the fact that I made it from a cereal box and aluminum foil. Since I’m traveling this year I plan to just stick with a pair of certified eclipse viewing glasses. A recall has been issued for certain glasses that were sold at convenience stores in the area, which is sad as well as potentially devastating that someone would create counterfeit glasses that could lead to serious eye damage.

In anticipation of everyone wanting to go outside for the minutes of full totality, I made sure we have a gap in the agenda to accommodate it. I did something similar in 2018 when the first SpaceX Falcon Heavy rocket was launched, taking advantage of a high-end conference room projection system to see it live. For the people who were paying my salary back then, don’t worry, I worked it into the change management seminar I was presenting. I guarantee that people walked away with lessons in teamwork and diversity as well as having experienced history being made.

With respect to this year’s eclipse, several governors have made emergency or disaster declarations in advance of the arrival of throngs of people to their states. When people question why they might do that, I explain that it’s all about scarce resources and disruption of processes. I’m in an area that’s not exactly a tourist mecca and I guarantee that people will be pulling over on the interstate tomorrow, creating increased risk for first responders and ambulance traffic around the regional medical center. I’m sure there will be fender-benders as well if people are driving distracted.

It’s going to be in the 80s here tomorrow, which is unseasonably warm for this area, and that will increase the risk of heat-related illness. I met a traveler whose medications were in a piece of checked luggage that went missing, so they are going to need to get a replacement prescription and possibly need to visit an urgent care if their physician doesn’t manage the request on a weekend. I also chatted with some adults who were chaperoning a school trip to see the eclipse. They mentioned that so many teachers requested time off to experience it with their families that they didn’t have enough substitutes to fill the gaps, so the school decided to cancel for the day. They were planning on spending Sunday visiting some sites that were important to the Civil Rights Movement in the 1950s, so learning will going on that goes beyond just science.

A lively discussion is underway in one of the American Medical Informatics Association forums about the use of Microsoft Teams as a clinical communication platform. Many people have chimed in about their experiences with various types of messaging, including EHR-based secure chat, third party solutions, and use of old-school telephones and pagers. An article from the Journal of Medical Internet Research that was mentioned looked at use of an integrated EHR-based secure chat in a large Midwestern health system. Data was collected from July 2022 to January 2023 and analyzed with regard to message volumes, response times, message characteristics, user roles, work settings, and messages sent and received by users.

Researchers identified 9.6 million messages that were sent by 33,000 users. Nurses sent 40% of them, followed by physicians at 25% and medical assistants at 12%. Many users interacted with 20 more more messages per day, leading the authors to raise concerns that short message response times (average 2.4 minutes) and high volumes “highlight the interruptive nature of secure messaging, raising questions about its potentially harmful effects on clinician workflow, cognition, and errors.”

We hear a lot about workflow and the burdens that are associated with increasing message volumes, but I don’t see a lot of people talking about the impact on thought process and errors. Research has shown that true multitasking is a myth, and we’ve all seen the negative impacts of trying to do too many things at one time without enough focus.

The always-on nature of communication these days tends to make many clinicians I know feel edgy, like they can never turn off their workday. In my online forums, I routinely see questions from clinicians on how to disable messaging during non-work hours. One physician resorted to getting a separate work phone and having her spouse lock it in a drawer during her off times because she couldn’t help but check it all the time, fearful of missing something. Hopefully, that’s an outlier scenario, but it illustrates how caregivers are being impacted by technology.

The study also found that across 14 hospitals and 250 outpatient clinics, weekly message volume grew by 31% in a six-month period. It had some limitations, one of which was that they were unable to link the data with work schedules or to identify when messaging was being conducted during non-working hours.

The authors noted that additional work is needed to better understand whether secure messaging is replacing other methods of communicating, such as phone calls, or whether it is “simply increasing the overall burden of communication.” They also cited concerns on whether secure messaging is less efficient than other real-time modalities and whether the asynchronous nature of messaging increases the time to resolution of patient issues, since messaging conversations had a median duration of 25 minutes compared to what would likely have been a much shorter phone call.

Notwithstanding the need for additional research, it’s important to make sure that healthcare delivery organizations have their systems configured correctly so that the right people are receiving messages at the right time. Clinicians shouldn’t be expected to respond to secure messages 24×7 unless they are on call. Being able to have true downtime is essential to healthy functioning, whether people realize it or not. Clinicians should also be well-educated in how to set their accounts as “away” or similar so that other users don’t simply fire messages into the ether and hope for the best. From the virtual water cooler, it sounds like there are some opportunities in setup and education.

How does your health system handle secure messaging? Is it a helpful tool or an electronic tether that clinicians feel they can’t escape? Leave a comment or email me.

Email Dr. Jayne.

Readers Write: Navigating the Talent Terrain: Choosing Between Full-Time Employees and Fractional Resources in IT Hiring

Navigating the Talent Terrain: Choosing Between Full-Time Employees and Fractional Resources in IT Hiring
By Eric Utzinger

Eric Utzinger is co-founder of Revuud of Charlotte, NC.

Every day, healthcare leaders are faced with critical decisions regarding their IT staffing strategies. Among the most significant decisions is whether to hire full-time employees or use fractional resources. Both options offer unique advantages and challenges, and IT hiring managers must carefully consider various factors before making a choice that aligns with their organization’s goals and needs.

Full-time employees are individuals who work for an organization on a permanent basis, typically receiving benefits such as healthcare, retirement plans, and paid time off. They are fully dedicated to the company and work a set number of hours per week.

Fractional resources — also known as contract workers, consultants, or freelancers — provide services to an organization on a part-time or temporary basis. They are hired for specific projects or tasks and may work remotely or onsite as needed. Fractional resources offer flexibility and scalability, allowing businesses to access specialized expertise without the long-term commitment of hiring full-time staff.

These are the factors to consider.

Expertise and Specialization

Full-time employees often offer deep institutional knowledge and continuity, which can be invaluable for long-term projects and organizational stability. They can be trained and groomed to align with the company’s culture and values. However, fractional resources bring diverse skill sets and specialized expertise that may not be available internally. They can provide fresh perspectives and innovative solutions to complex challenges.

Cost Considerations

While full-time employees may entail higher initial costs due to salaries, benefits, and overhead expenses, fractional resources offer cost savings in terms of flexibility and scalability. Organizations can hire fractional resources on a project-by-project basis, avoiding long-term financial commitments and reducing overhead costs associated with maintaining a full-time workforce.

Flexibility and Scalability

Fractional resources provide organizations with the flexibility to scale their workforce up or down based on project demands and business needs. This agility is particularly beneficial in industries with fluctuating workloads or seasonal demands. Full-time employees, while offering stability, may lack the flexibility to adapt to changing circumstances without incurring additional costs or disruptions.

Time-to-Hire and Onboarding

Hiring full-time employees typically involves a longer recruitment process, including sourcing, interviewing, and onboarding, which can delay project timelines and impact productivity. In contrast, fractional resources can be onboarded quickly, allowing organizations to address immediate needs and accelerate project delivery.

Risk Management and Compliance

Full-time employees are subject to labor laws, regulations, and employment contracts, requiring organizations to adhere to various compliance requirements. Fractional resources, while offering flexibility, may introduce legal and regulatory risks if not properly managed. IT hiring managers must ensure that contractual agreements are clearly defined, and compliance standards are met when engaging fractional resources.

When determining whether to use full-time employees or fractional resources, IT hiring managers should carefully evaluate the unique needs and priorities of their organization. It’s essential to assess factors such as expertise, cost considerations, flexibility, scalability, risk management, and organizational culture.

In some cases, a hybrid approach combining full-time employees with fractional resources may offer the best of both worlds, providing the flexibility to leverage external expertise while maintaining core internal capabilities. By leveraging the strengths of each staffing model, organizations can optimize resource allocation, enhance agility, and drive innovation in an increasingly competitive market.

Ultimately, the decision between full-time employees and fractional resources requires a nuanced understanding of the trade-offs involved and a strategic assessment of the organization’s priorities. By weighing the considerations outlined above and aligning staffing decisions with overarching business goals, organizations can position themselves for success in the ever-evolving landscape of IT.

Morning Headlines 4/8/24

Teladoc Health Board of Directors Announces Leadership Transition

Teladoc shares rise slightly on the news that the company’s board fired CEO Jason Gorevic after 15 years in that role.

Amwell Receives Continued Listing Standard Notice From NYSE

Telehealth company Amwell risks having its shares delisted by NYSE due to low share price.

Change Healthcare wants data-breach lawsuits heard in Nashville federal court

Change Healthcare asks the court to consolidate lawsuits related to its February data breach in the federal court in Nashville, its hometown.

Monday Morning Update 4/8/24

Top News

The board of Teladoc Health fires CEO Jason Gorevic after 15 years in that role. CFO Mala Murthy will take over as interim until a permanent successor is recruited.

TDOC shares rose slightly on the news, valuing the company at $2.4 billion, but have lost nearly 50% of their value in the past 12 months. They are down 95% from their all-time high in February 2021, shortly after the company acquired Livongo for $18.5 billion and before Teladoc took a $13.7 billion write-down of that business in February 2023.

In related news, telehealth competitor Amwell risks having its shares delisted by NYSE due to low share price. They are at $0.72 after losing another 10% following the announcement, valuing the company at $208 million. AMWL shares have lost 67% in the past 12 months and are 98% off their all-time high from early 2021.

Reader Comments

From Bluebella: “Re: grammar. You need this shirt.” Actually not, since I am judgment-free on spoken grammar, and in fact I relish hearing (and using) regional accents, word usage, and unusual expressions. Those are real-time artifacts of our upbringing, over which we had no control. I am only annoyed by sloppiness in the written word, where people expect strangers to read their thoughts, but are too lazy or indifferent to edit or to even bother reading what Siri spat out. The first-impression distinction between looking unintelligent versus merely lazy and disrespectful to the reader doesn’t much matter. Hopefully the bar will be raised by AI tools, where even poorly expressed and error-ridden writing can be easily turned into polished prose as smoothly as Google Translate converts Spanish to English.

From Ormond: “Re: physicians. A doctor posted this email sent to PCPs by the local hospital.” I assume that the EORH identifies the source as 140-bed East Ohio Regional Hospital, which ironically is owned by a psychiatrist who bought the hospital after it was closed by a for-profit company that has since gone out of business. This memo, assuming it is authentic, could be interpreted as an order – unwisely documented in writing — to commit billing fraud by overriding medical needs and patient preference to book business for EORH’s specialists and to crank out follow-up visits. Patients must be no-showing those medically questionable follow-ups frequently if PCPs are expected to schedule 32 patients per day while seeing only 20-24.

HIStalk Announcements and Requests

Cash beats the touchy-feel stuff for employers who want to retain poll respondents as employees, although the ability to work remotely remains a hot button.

New poll to your right or here: What healthcare-related organization frustrated you the most in the past 12 months?

Forget ChatGPT – the most impressive AI product is Suno, which can generate amazing songs given the user’s specifications. I requested a dark, operatic metal song about a menacing stranger ringing the doorbell, which generated a really cool, Nightwish kind of Flying V head-banger that you can stream here. Musicians now get to join writers and artists in questioning their future given AI’s ability to create similar works at any user’s command, and given the huge financial stakes, musicians will be lawyering up to figure out whether Suno’s training used their work or creates music that sounds like theirs.

Thanks to these companies that recently supported HIStalk.

I asked what the #1 realistic first step should be for improving US healthcare outcomes, cost, and accessibility. Lots of folks missed the “realistic” part and went right for the healthcare Hail Mary, but I like that they were thinking big. Anyway, here’s what people said, with responses combined and the total count listed where appropriate:

• Single payer / universal coverage / Medicare for all / public option (33)
• Eliminate employer-sponsored health insurance (8)
• Full transparency / simplification of prices charged by doctors, hospitals, and clinics (4)
• Standardize claim format / implement uniform pricing / pay the same price for procedures and prescriptions (3)
• Set a higher tax on processed foods or improve food quality / offer incentives for maintaining a healthy weight (3)
• Increase payments to primary care providers  / add family medicine providers (3)
• Create national HIE that is run by CMS / increase interoperability (2)
• Get rid of insurance as the backbone of healthcare / require paying cash (2)
• Set Medicare pricing for all patients, adjusted regionally
• Expand VA eligibility
• Take the government out of the healthcare business
• Reform the tort system
• Add medical schools to increase the supply of physicians to lower salaries, which is the biggest cost
• Increase spending on primary care for children
• Remove payers from physician decision-making and workload
• Develop a plan and incentives to move from a sickness model to a wellness model
• Add more clinical hospitals in outer suburbs or rural areas
• More emphasis, access, and education on preventative care / pay physicians based on preventative care services instead of increasing payer profits as providers struggle (2)
• Increase accessibility to digital health products without a prescription
• Reduce documentation requirements
• Eliminate smoking
• Eliminate conglomerates and mergers / don’t allow for-profit entities and private equity to buy health systems
• Require private equity and publicly traded firms to divest all hospital / clinic assets
• Pilot virtual-first health plans
• Clean up and consolidate data for analytics and decision-making
• Remove CMS from HHS control and turn it into a public benefits corporation
• Mandate use of a consumer usage transparency tool with binding real-time estimates, insurance coverage details, and quality metrics for procedures
• Keep providers independent
• Make the entire healthcare industrial complex non-profit
• Create a national license for telehealth providers
• Implement and enforce mandatory staffing ratios
• Pay physicians based on panel size and management instead of RVUs
• Eliminate lobbyists and campaign contributions
• Eliminate direct-to-consumer drug advertising
• Better detection and prevention of fraud

Webinars

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

Acquisitions, Funding, Business, and Stock

The Global X Telemedicine and Digital Health exchange-traded fund lost 2.4% of its value in the past 30 days, 22% in the past year, and 42% since it was launched in mid-2020. A $10,000 investment at launch would be worth $5,680 now versus the $15,360 you would have earned by just buying the S&P 500 index.

People

Christine Swisher, PhD (Project Ronin) joins Oracle as VP of health data intelligence.

Announcements and Implementations

UnitedHealth Group hasn’t updated its Change Healthcare cyberattack update page since March 27. The Optum solution dashboard shows 23 of 137 applications restored. UHG got screwed if it actually paid the $22 million in speculated ransom that showed up on the hacker’s Bitcoin blockchain over a month ago. Meanwhile, the company sides with the plaintiffs in asking the court to centralize the cases in the US court in Nashville, which is Change’s home city, for efficiency.

A Kaiser Permanente study finds that AI triage of patient-sent messages allowed one-third of them to be diverted to other employees, saving time for the physician who otherwise would have had to read and route them.

A NEJM-published study finds that semaglutide — and presumably the other GLP-1 drugs that are best known for weight loss and Type 2 diabetes control – is effective for treating certain types of heart failure. A study published last week tentatively showed that the drugs may slow the advance of Parkinson’s disease symptoms, while previous research suggested their value in reducing inflammation. Interesting work remains to be done to determine whether the unexpected benefits are due to the intrinsic properties of the drugs or the improved general health of patients after they lose weight. I predict that barring any discovery of catastrophic side effects, GLP-1 drugs will be the most significant of all time in terms of life extension, or at least right up there with vaccines, penicillin, and insulin.

Government and Politics

The owner of two telemedicine companies pleads guilty to his involvement in defrauding Medicare of $110 million. Telemarketing companies generated lists of Medicare beneficiaries, then paid the telemedicine companies to find providers who would generate prescriptions for durable medical equipment without contacting the patient (seems like those providers should be charged as well, but DoJ didn’t say). The telemarketing companies then sold the orders to DME suppliers so they could submit false claims. The LinkedIn of Steven Richardson, aged 40, includes years running a South Florida “healthcare marketing group” whose work looks like a Medicare fraud keyword list in “assisting patients with their diabetic testing supplies, pain, and compound management.” I Google-stalked his Florida house, which looks pretty nice for spending time wearing an ankle monitor.

CMS drops the requirement that providers submit appropriate use criteria (AUC) as a condition of being paid for performing advanced diagnostic imaging. The long-delayed AUC program was implemented as part of the Protecting Access to Medicare Act in 2014.

Other

A major New York Times article looks at data analytics firm MultiPlan, which tells payers how much less than the billed price they should pay providers for out-of-network cases. MultiPlan pockets up to 35% of the savings, sometimes earning more than the billing provider, with the patient potentially on the hook to pay the difference. MultiPlan’s president and CEO as of March 1 is former Cerner executive and Oracle Health GM Travis Dalton. MPLN shares are at $0.84, down 27% in the past 12 months, valuing the company at $550 million as it faces NYSE delisting. Dalton’s shares at signing were worth $13 million plus $2 million per year in salary and bonuses. MultiPlan went public via a SPAC merger in October 2020 at an implied valuation of $11 billion, with share price having dropped 91% since. Financials aside, I might have to side with the company on this one and instead blame self-insured employers and payers who create a network that has no available providers, sending desperate people to specialists who may well have sold their practices to private equity firms who love out-of-network billing.

Sponsor Updates

• Lotus Weight Loss & Wellness (KY) reports a 30% increase in new patient visits after implement EClinicalWorks EHR and Healow Open Access software.
• Experity will exhibit at the Urgent Care Association Conference April 13-17 in Las Vegas.
• Findhelp will present at the National WIC Association Annual Education and Training Conference April 7-10 in Chicago.
• FinThrive releases a new Healthcare Rethink Podcast, “Population Health is Becoming Precision Community Health.”
• Health Data Movers publishes a new “Cancer Data Abstraction.”
• Inovalon releases a new INovators Podcast, “AI in Healthcare: The Value of Innovative Technology, Paired with Clinical Expertise.”
• Mobile Heartbeat will exhibit at AONL 2024 April 8-10 in New Orleans.

Blog Posts

• 10 Essential Contact Center Metrics and KPIs to Measure in Healthcare (Five9)
• Cowboys and Clinicians: Enhancing Rural Healthcare with Freestone Medical Center (Medhost)
• Advanced analytics providers a real-time window into clinician behavior and insights to help reduce care variation (Wolters Kluwer Health)
• Strengthen your workforce: How Logan Health retains home health and hospice staff (Meditech)
• MDS Changes: Why Section GG Does Not Equal Section G (Net Health)

Contacts

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

Morning Headlines 4/5/24

Massachusetts Justices Mull Applying Wiretap Law to Web Tracking

A court reviews a class action lawsuit that argues that hospital use of web tracking technologies violates the state’s Wiretap Act.

Cerberus says its investment in Steward hospitals yielded an $800 million profit

The investment firm tells a Senate subcommittee that its only cost in creating the now-struggling, for-profit Steward Health Care that it sold at an $800 million profit was buying Caritas Christi for $246 million.

Former University of Iowa Hospital employee used fake identity for 35 years

A hospital network architect pleads guilty for living under another man’s identity since 1988, which caused that man to be wrongly confined to jail and then a mental hospital for 20 months.

News 4/5/24

Top News

The Massachusetts Supreme Judicial Court is reviewing a class action lawsuit that claims that New England Baptist Hospital and Beth Israel Deaconess Medical Center violated the state’s Wiretap Act by using undisclosed web visitor tracking technologies such as Meta Pixel to secretly intercept website user communications.

Key issues:

• Are web visitors who just look at web pages conducting a “conversation” that is protected by the Wiretap Act?
• Is the information collected secretly when visitors are notified that the website uses website traffic analysis tools?
• Are website warnings sufficient when they do not explicitly tell visitors that their medically-related search or form entry information is shared with third parties?
• Were hospitals misleading people by promising to protect their privacy when the technology was specifically designed to help identify them?

Reader Comments

From AI Ball: “Re: AI in healthcare. Are patients demanding more of its use, or are we again speaking on their behalf without actually asking them?” The latter. Surveys suggest that people are wary of sticking AI into a process that is already cumbersome and impersonal. Consumers will flock to Dr. AI as they did Dr. Google for looking up symptoms or conditions, generating plain English interpretations of medical gobbledygook, or perhaps even searching for providers. Otherwise, they have zero interest in AI-powered clinical documentation and literature searches unless it frees up doctor time so they can actually get an appointment or experience a less-rushed visit. I believe it’s also true that technologists who think doctors are desperate for AI-supported diagnosis, image analysis, or precision medicine help should probably actually ask those doctors. In the case of health systems, think of the most impersonal, maddeningly inefficient bureaucracies that you dread dealing with over billing or service issues – the DMV, a utility, an online merchant, or your local sprawling health system – and ask yourself if your experience is likely to improve if they add AI without changing anything else. Or, as a form of real-world evidence with earlier technologies, did you love it when those same bureaucracies hid their humans behind automated attendants or simply let the phones ring unanswered? TL;DR – companies do whatever benefits them most and customers win only if companies fear losing their business.

Webinars

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

Acquisitions, Funding, Business, and Stock

Venture studio Aegis Ventures will collaborate with nine health systems to co-develop and invest in health tech solutions, with a common theme of using AI and automation. The studio’s collaboration with Northwell Health resulted in the creation of four companies, including Optain (AI-powered retinal imaging) and Upliv (menopause virtual support).

Epic is developing an AI validation suite to help health systems evaluate and monitor the performance of AI models, both third party and self developed.

Manifold, which offers an AI-powered clinical research platform, raises $15 million in a Series A funding round.

AI-enabled workforce marketplace SnapCare acquires Medecipher, which offers a predictive analytics staffing decision support tool.

Investment firm Cerberus Capital Management tells a Senate subcommittee that it paid $246 million for Caritas Christi Health Care in 2010, didn’t invest a penny more as it turned it into for-profit Steward Health Care, and then sold it for an $800 million profit in 2020. A consulting firm says that level of return isn’t exactly a home run in private equity world of quick flips, although the partners usually get management fees on top of profits from the sale. Cerberus declined to tell the senators how much the firm and its executives made from its investment.

Sales

• Springfield Clinic (IL) expands its use of Health Note’s patient engagement and intake platform.
• Jordan Valley Community Health Center (MO) will implement Epic.

People

UK HealthCare hires Katie Dickens, MSA (Bronson Healthcare) as chief digital and information officer.

Imaging real-world data vendor OneMedNet promotes Aaron Green to president and CEO following the retirement of CEO Paul Casey.

Symplr promotes Allison Morin, RN, MSN to chief nursing informatics officer.

Andy Dé, MS, MBA (MedeAnalytics) joins Verato as chief marketing officer.

DrFirst promotes Irene Froehlich to chief brand officer.

Gary Hall, who retired as CIO of Estes Park Health (CO) in September 2023, is elected mayor of Estes Park.

Announcements and Implementations

A report by the American Organization for Nursing Leadership and Laudio looks at the impact of hospital nurse managers:

• The median span of control is 46 employees, with 25% of inpatient nurse managers having responsibility for 78 or more employees. Spans are largest in ED and ICU.
• A larger span of manager control is associated with higher rates of RN turnover, use of overtime, and burnout.
• While 56% of nurse managers have at least one assistant nurse manager, nurses almost always report directly to the nurse manager.
• RN retention is higher when managers have purposeful interaction with them at least monthly, most influenced by recognition and celebration.

HCA Healthcare integrates referrals to Talkiatry’s virtual psychiatry service with its EHR.

A new KLAS report on managed help desk and application management services names Pivot Point Consulting as #1 in performance, followed by CereCore. Nordic and Tegria were noted as being able to scale but with customer-reported problems with staff consistency. Most respondents plan to maintain or increase their use of managed IT services to mitigate cost and staffing challenges.

Government and Politics

Matthew Keirans, who worked 10 years for University of Iowa Hospitals & Clinics as a network architect, pleads guilty to stealing the identity of an acquaintance named William Woods and using it for 30 years to take out loans and to obtain his remote hospital IT job. Woods visited his bank in 2019 to alert them that someone was running up debt using his account, but they became suspicious even though he showed ID. The police were called and they contacted Keirans, who faxed them phony documents – including one that included the wrong middle name of Woods — that resulted in the arrest of Woods, who spent the next 20 months in jails and mental hospitals. Once released, Woods notified the hospital that their $140,000-per-year employee was not him, which detectives proved using DNA evidence. Keirans faces up to 32 years in prison and a $1.25 million fine.

Privacy and Security

A University of North Carolina at Chapel Hill’s medical school employee falls victim to a social engineering attack in which they clicked on a malicious link that was sent by a trusted contact, then were tricked into sharing their multi-factor authentication code, which gave the hacker access to their email account.

Other

Payers and providers have been slow to adapt biosimilar versions of the antinflammatory injectable drug Humira – which has generated $200 billion in lifetime sales for drug maker AbbVie – because pharmacy benefit management companies and specialty pharmacies would lose most of their profit by dispensing the less-expensive option. The report by the Biosimilars Council and IQVia found that only 1% of Humira patients have been switched to the cheaper alternative, with many of those associated with small payers that don’t have loyalty to the big three PBMs (CVS Caremark, Express Scripts, and OptumRx). The authors conclude that patients, employers, and health plans are paying an extra $700 million per month for sticking with the brand name.

An employee of Mayo Clinic Hospital in Phoenix files a proposed class action lawsuit against the health system, claiming that the hospital provided such low-quality health insurance under its self-insured plan that some employees incur $10,000 per year in costs while others avoid seeking care entirely. Also included in the lawsuit is third party administrator Medica, which the plaintiff claims misstated the network status of providers in its member portal. Workers who were contacted by a news site said that Mayo’s remote employees struggle to find affordable care, also noting an insurer’s “phantom network” that lists dozens or hundreds of in-network providers who have retired, no longer accept the insurance, or aren’t taking new patients. The site also found that Mayo’s doctors and executives are reimbursed at up to $10,000 per year to cover the difference between in-network and out-of-network costs, but most employees don’t qualify.

Sponsor Updates

• Five9 celebrates 10 years on the Nasdaq stock exchange by ringing the opening bell.
• Nordic releases a new Designing for Health Podcast, “Interview with Susan Snedaker.”
• Optimum Healthcare IT celebrates surpassing 400 go-live projects.
• SnapCare will exhibit at the Oregon Health Care Association Spring Expo April 11-12 in Salem.
• Symplr will exhibit at the Health Care Compliance Association’s Annual Compliance Institute April 14-17 in Nashville.
• Upfront Healthcare will present at the Urgent Care Association’s annual conference April 13 in Las Vegas.
• PSQH: The Podcast features Wolters Kluwer Health VP and GM of Clinical Surveillance, Compliance & Data Solutions Karen Kobelski, “Preventing Drug Diversion with Technology.”
• Zen Healthcare IT names Ryan Kopiske technical project manager.

Blog Posts

• Should you be worried about OpenAI’s new Voice Engine? (Nuance)
• AI Before AI (Netsmart)
• Five Proven Strategies to Improve Operating Margins: Part Two – Eliminate Costly Payroll Errors (QGenda)
• Redox hydrates new GenAI solutions from Google Cloud (Redox)
• No more on prem? How quickly is the NHS imaging moving to public cloud? (Sectra)
• TEFCA, QHINs & Surescripts: Our Commitment to Advancing Interoperability (Surescripts)

Contacts

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

EPtalk by Dr. Jayne 4/4/24

As usual, Epic put smiles on peoples’ faces with its annual April Fools’ Day webpage, stating that “the newest building on Epic’s campus will have the coolest theme, like, ever: Barbie Dream House.” It went on to say that the fictional building would include a pool slide and conference rooms named Beach, Girls’ Night, and Mojo Dojo Casa House.

The page also joked that Epic had been selected by television network ABC as the official EHR of “Grey’s Anatomy” to add more medical realism to the series. It wrapped up with a discussion of MyHeart: Epic’s New Dating Portal that “runs advanced searches to find patients near you who might be a good match based on hundreds of criteria, including your problem list, allergies, medications, and more.” Well played folks, well played.

I’m in the middle of an onboarding process for a new position, and although I was dreading the experience, it’s one of the better ones I’ve been through. As a consulting CMIO, I’ve worked with dozens of health systems and care delivery organizations and have gone through either full onboarding processes (when I’m an employee) or through modified onboarding (when I’m a contractor.) The experiences have varied dramatically. One of the worst processes I’ve ever seen involved demands to sign documents attesting to the fact that I had received and read policies that didn’t exist, which I only found out after asking to see them. I wonder how many of their regular employees just signed blindly? Some of the better processes have a clear onboarding checklist to ensure that you’re doing everything in the right order, and the best have that plus the ability to ask questions real time.

I’ve been through dozens of HIPAA training courses, as well as education on fraud, waste, and abuse, to the point where I could probably teach the curriculum. For this position, even though the role is technically non-clinical, I had to go through training on proper lifting, ergonomics, and the importance of non-skid footwear, none of which I’ve gone through for patient care despite the fact that they would have been useful. If you’re looking for an example of training that will engage people rather than make them snooze, I highly recommend Skip, the workplace safety superhero. It will be interesting working in an actual office again. Even though I’ve done patient care in person, this will be a different type of environment, and I’m excited that it doesn’t require navigating a TSA checkpoint or wondering whether my rental car will be there when I arrive. It’s time to dust off my trusty lunchbox and pack my Thermos for what I’m sure will yield many good stories.

From Jimmy the Greek: “Re: telecommuting. I’m a fan, but also recognize that with privileges come responsibilities. Now that I’m fully entrenched in a hybrid model where employees within a one-hour commute of an office are required to be in the office three days per week, it’s been interesting to see how our remote employees still enjoy a certain relaxed atmosphere in their home offices. The company I work for has a strict tobacco-free policy on all company campuses, but it also covers remote work, where employees are prohibited from ‘smoking or using tobacco products’ while visible on a web conference. It was a bit jarring, therefore, when one of my fully remote co-workers stepped onto her front porch to enjoy a smoke while fully visible on a Zoom meeting. I don’t smoke, but if I did, seeing someone light up a Marlboro while I was stuck in a conference room almost a kilometer away from an area where I could smoke without fear of disciplinary action would definitely reduce my overall job satisfaction.” I’ve read a number of employee handbooks in my career and this is one place where the devil might be in the details and sentence structure is everything. The use of the phrase “prohibited from smoking or using tobacco products” implies that they are only blocked from smoking tobacco cigarettes and not others. Vaping, which is certainly as distracting as smoking cigarettes, isn’t mentioned, nor are marijuana cigarettes. Perhaps the human resources department might want to consider more specific language that includes all the different things one can smoke as well as vaping and/or use of other tobacco-containing products. For the employee in question, a refresher on learning how to operate camera controls might be in order.

I was excited to see that the Department of Veterans Affairs is implementing some solid use cases for artificial intelligence. One model called REACH-VET is designed to help identify veterans who are at highest risk for suicide. Another uses natural language processing to flag patient feedback for comments that suggest homelessness or other issues where human intervention might be appropriate. A third model looks as veterans with prostate cancer to differentiate those who will do well after initial treatment from those who need more frequent follow-up. Congressional subcommittee members responsible for VA oversight want to ensure that safeguards are in place when AI is used, with Technology Modernization Subcommittee Chair Matt Rosendale pushing the VA to make veterans aware of instances where their data is being used in AI models.

I was also pleased to see the US Senate looking into whether emergency department care delivery has been harmed by the involvement of private equity firms. The inquiry follows interviews with emergency physicians who are concerned about patient safety issues related to aggressive cost control activities. The most recent investigation falls under the Homeland Security and Governmental Affairs Committee and follows one that is already in progress by the Budget Committee that is looking at hospital systems that are associated with private equity.

I’ve worked for some of the companies that are part of the investigation, and based on my experiences, I don’t think the Senate is going to like some of the things they uncover. It’s no secret that what are considered the most cost-effective ways of delivering emergency care often involve the least-trained and least-experienced clinicians. When things get wild, there is no substitute for a seasoned emergency department physician with decades of experience under their belt, but organizations are certainly eager to replace them strictly on cost alone.

How do you feel about the rise of private equity in healthcare? Have you seen examples of where it’s helping or hurting? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 4/4/24

Aegis Ventures Announces Partnership with Nine Health Systems to Build and Deploy Healthtech Solutions

Nine health systems will co-develop and invest in solutions with venture studio Aegis Ventures.

FDA authorizes Prenosis software as first AI tool that can diagnose sepsis

FDA grants marketing clearance to the sepsis detection tool of Prenosis, which applies AI to biomarker and EHR clinical data to assess sepsis risk.

Epic plans to launch AI validation software for healthcare organizations to test, monitor models

The product will help health systems evaluate and monitor the performance of AI models, both third party and self developed.

Healthcare AI News 4/3/24

News

Plastic surgeon Robert Pearl, MD, who was executive director and CEO of The Permanente Medical Group through 2017, predicts that ChatGPT’s eventual ability to remember and use information across multiple chat sessions — its “context window” — will be significant in healthcare. He says that while its current capacity won’t hold an average medical record, generative AI systems are expected to become 30 times more powerful in the next few years, which along with GPTs, will allow records from multiple providers to be consolidated to provide patients with diagnosis and treatment suggestions. He also expects the extended memory to improve patient monitoring with its capability to look back into historical clinical status and to issue real-time alerts when established best practices are not followed.

The World Health Organization launches Sarah, an AI-powered health information avatar for consumers. Sarah replaces a previous WHO non-AI tool called Florence that provided public health information. Sarah is available online.

Epic is developing an AI validation suite to help health systems evaluate and monitor the performance of AI models, both third party and self developed.

OpenAI offers access to ChatGPT 3.5 without requiring registration, although functionality is limited and content safeguards are expanded over the paid version.

A new KLAS report looks at early use of healthcare AI, concluding that:

• ClosedLoop’s predictive modeling leads the market in performance, especially with ACO and health plan users.
• Customers of second-place Epic are expanding beyond clinical use cases into operational and financial areas, with good employee adoption because of integration with EHR workflows. Some customers complained about Epic’s pricing and its subpar ability to incorporate outside data.
• Oracle Health customers were split. Satisfaction was good with the company’s cloud plans and its use of clinical data, but some customers complain that support quality and nickel-and-diming has gotten worse since Oracle acquired Cerner.
• Health Catalyst customers say the product is robust, but half of them believe that the product fails to deliver on its potential because of insufficient training and support.

Business

Amazon ends its Just Walk Out checkout-free experience at its Amazon Fresh grocery stores, which will be replaced by in-cart scanners that customers use themselves. A report by The Information says that while the Just Walk Out system seemed automated and AI powered, 1,000 offshore workers served as low-paid remote cashiers in monitoring shoppers via video camera and manually ringing up items. Social media wags labeled the failed experiment as API – A Person in India. Amazon rolled the system out to hospitals in January 2024 for cashier-less employee purchases, with St. Joseph’s / Candler as its first customer.

Healthcare AI company John Snow Labs releases a no-code solution that allows healthcare domain experts to train, tune, test, and share models without help from data scientists. The company says that creating small, task-specific models can be used to train other models, are cheaper to run, and can operate behind an organization’s firewall. They can also include human-in-the-loop oversight.

FDA grants marketing clearance to the sepsis detection tool of Prenosis, which applies AI to biomarker and EHR clinical data to assess sepsis risk.

Research

Penn researchers find that AI analysis of Facebook postings is three times less likely to accurately predict depression among black American users as compared to white. The model uses prior findings that white people who have higher levels of depression use more first-person singular pronouns — along with words that suggest isolation, self-criticism, worthlessness, anxious-outsider, and despair — but the model performed poorly when analyzing posts from people who are black. The authors note that their study illustrates the need for caution when applying AI in mental health settings.

Other

HFMA notes the “battle of the bots” as hospitals that have been outgunned by payers that used technology to deny or delay payment are implementing AI to beef up revenue cycle management. Examples of provider use of AI:

• Using robotic process automation to ensure that claims are clean and to manage work queues (Luminis Health).
• Reducing RCM headcount by 30 FTEs by using AI bots (Mayo Clinic).
• Reducing authorization-related denials by using bots to notify payers when patients are admitted (Care New England).
• Increasing administrative efficiency by using Copilot for Microsoft 365 and using RPA to save labor in authorization, registration, credentialing, and billing workflows (Corewell Health).

Contacts

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

Morning Headlines 4/3/24

Risant Health completes acquisition of Geisinger

Kaiser-backed hospital operator Risant Health completes its acquisition of Geisinger, which will become its inaugural health system.

HealthArc Secures $5 Million in Growth Funding to Revolutionize Healthcare

Virtual care management company HealthArc announces $5 million in funding.

Electronic prescribing giant Surescripts is exploring a sale

Surescripts is reportedly exploring a sale of its business, the ownership of which is evenly split between pharmacy benefit managers CVS Health and Express Scripts and pharmacy trade groups.

Providence Spins Out Praia Health with $20M in Oversubscribed Series A Funding led by Frist Cressey Ventures to Scale New Consumer Platform for Health Care

Praia Health, which offers automated personalization of a patient’s care journey, secures $20 million in Series A funding.

News 4/3/24

Top News

Risant Health completes its acquisition of Geisinger, which will become its inaugural health system.

The non-profit Risant Health, which will focus on value-based care, expects to acquire up to five community health systems in the next five years.

Reader Comments

From Anonymous IT: “Re: Intermountain Health. Layoffs of 500+ last week in the Nevada Region, plus demotion offers to others.” Unverified.

Webinars

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

Acquisitions, Funding, Business, and Stock

Business Insider reports that Surescripts is exploring a sale of the business, which is 50% owned by pharmacy benefit managers CVS Health and Express Scripts and 50% owned by pharmacy trade groups. Insiders say the ownership structure could complicate the sale, adding that a private equity firm is the most logical buyer because of transaction’s expected high price and the need to balance the needs between the PBM and pharmacy owners.

Praia Health secures $20 million in Series A funding. The company, which was spun out of the Providence health system in October 2023, offers automated personalization of a patient’s care journey for improved engagement.

3M spinoff Solventum, which includes health information systems among its four business segments, begins trading on the NYSE.

Axios reports on the “economic and operational nosedive” of Amwell, whose valuation has dropped from $10 billion in late 2020 to $235 million now. The article says that Amwell overpromised, botched product rollouts at big clients like CVS Health and Memorial Hermann, and failed to develop a post-pandemic strategy. AMWL shares took another drop when the article ran, down 66% in the past 12 months.

Sales

• Intermountain Health (UT) will use Sensorum Health’s remote patient monitoring technology as part of a house calls pilot program for homebound seniors who have chronic conditions.
• Hartford HealthCare will implement Axuall’s clinician onboarding system.

People

Alan Tam (Actium Health) joins Reveleer as chief marketing officer.

Harmony Healthcare IT names Kelly Hahaj (Indiana Health Information Exchange) VP of corporate development.

Announcements and Implementations

Commure launches Scribe, a free ambient documentation tool for its users that integrates with EHRs such as Epic, Athenahealth, and Meditech.

Availity announces Predictive Editing, an AI claims denial prediction tool for its Availity Essentials Pro RCM platform.

Ascom launches RemoteWatch, a remote monitoring service for its Ascom Healthcare Platform that allows hospitals to identify technical issues.

Eko Health earns FDA clearance for its AI-powered heart failure detection for its stethoscopes. The technology — which will be added to the company’s Sensora Cardiac Early Detection Platform that diagnoses atrial fibrillation and heart murmurs — identifies low ejection fraction. Mayo Clinic developed the algorithm and is an investor in Eko.

Greenway Health integrates DrFirst’s RxInform prescription notification and patient engagement software with its Intergy EHR.

Connect Oregon, the state’s coordinated social care network, adopts payment software from Unite Us to improve Medicaid billing amongst its nine Coordinated Care Organizations.

Verato develops its Identity Data Management Maturity Model to help healthcare organizations assess, benchmark, and improve their identity data management processes.

Carium and CareDirections announce a commercialized version of StrokeCP, a post-discharge management system for stroke survivors that was developed by Atrium Health Wake Forest Baptist.

Microsoft unbundles Teams from Office globally to address anticompetitive regulatory pressure. The company added Teams to its business software suite in 2017 and saw its usage soar in the pandemic’s early days, triggering a Slack complaint to the EU three months before Slack sold itself to Salesforce for $28 billion.

Change Healthcare has not updated its cyberresponse page since March 27. Its dashboard shows 117 of Optum’s 137 applications remain down from the February 21 cyberattack.

Government and Politics

The US Coast Guard hopes to finish scanning paper medical records into its MHS Genesis / Oracle Health system by the end of the year, but in the mean time, it is advising service members that obtaining medical records copies will take longer.

Other

Epic will probably never top the sheer cleverness or sassiness of its years-ago April Fool’s post in which it claimed to have changed its name to EPIC since people mistakenly all-caps it regularly, but this year’s spoof was pretty good:

• Epic gets construction approval for the Barbie Dream House campus.
• The company is chosen as the official EHR of “Grey’s Anatomy.”
• A recipe for a carrots and wings dish called Roots & Wings, which is a subtle reference to Judy’s charitable foundation Roots & Wings that will get the proceeds of her Epic shares.
• My personal favorite – MyHeart, a dating app that uses MyChart messages and patient history to suggest romantic matches based on clinical factors.

Sponsor Updates

• Ascom launches RemoteWatch, a remote monitoring service for the Ascom Healthcare Platform designed to help hospitals proactively identify technical issues before they impact patient care.
• Findhelp and Uber Health support patients beyond the four walls of a medical office.
• Censinet offers NIST Cybersecurity Framework 2.0 enterprise assessments, which include support for compliance with HHS Healthcare and Public Health Sector Cybersecurity Performance Goals.
• Artera adds dashboards for patient engagement benchmarking and no-show revenue recovery estimates to its Harmony Analytics solution.
• Spok’s mobile clinical communications software earns the top ranking for customer satisfaction for the seventh consecutive year in Black Book Market Research’s recent survey of 7,000 end users.
• Waystar extends its Accelerated Implementation Program through April to help healthcare organizations process claims in the wake of the Change Healthcare cyberattack.
• CereCore publishes a new e-book, “In Sync with Care: The Future of Clinical IT Service Desks.”
• Arrive Health sponsors the Health Evolution Summit April 3-5 in Dana Point, CA.
• QGenda, Wolters Kluwer, Elsevier, SnapCare, Symplr, and Care.ai will exhibit at AONL 2024 April 8-11 in New Orleans.
• AvaSure publishes a new Use Case Spotlight, “Expand the Reach of Care Teams with Virtual Nursing.”
• Clearwater names Jackie Mattingly (Coker Group) senior director of consulting, small and medium hospitals.
• The Pinnacle Take Podcast features Direct Recruiters Managing Partner of Health IT and Life Sciences Mike Silverstein, “A Network of Friendlies.”

Blog Posts

• Six Cybersecurity Points Healthcare CIOs Should Explain to Their Boards (CereCore)
• Capturing Medical Necessity in Ambulance Coding (AGS Health)
• National Doctors’ Day: Three Altera clinicians share their perspectives on designing for clinicians today (Altera Digital Health)
• SATRE: Standardised Architecture for Trusted Research Environments – Information Governance (Arhidia Informatics)
• The Referral Process: Closing the Loop on Patient Care (Artera)
• Introducing Availity’s Mission Moments Series (Availity)
• 10 Work Comp Did-You-Knows (Bardavon)
• The Making Care Primary Model: How it is revolutionizing primary care (CarePort Health)
• Takeaways from HIMSS24 (Dimensional Insight)
• Separating the Hype from the Hope in Healthcare AI Trends for 2024 (DrFirst)
• Boosting Billing Efficiency with the Clinical Rule Engine (EClinicalWorks)

Contacts

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

Morning Headlines 4/2/24

Solventum Begins Trading on the New York Stock Exchange

Solventum, a 3M spinoff that includes health information systems among its four business segments, begins trading on the NYSE.

Walmart Health Clinic Expansion On Track For 70 By Year’s End

Walmart will open 22 new health clinics within Walmart Supercenters this year, bringing its total to 70 across the country.

New Valley Hospital ready to welcome patients with state-of-the-art tech

New Jersey-based Valley Health System will open a new hospital in Paramus equipped with smart beds, bedside infotainment systems, and AI-powered fall-prevention technology.

Curbside Consult with Dr. Jayne 4/1/24

I’ve spent the last couple of weeks catching up on some reading, after my library “hold” list went rogue. I typically keep several dozen books on hold but in a frozen status so that I sit at the top of the wait list and can release them when I’m ready.

For some reason, a cluster of them released unexpectedly, dropping on top of my already planned reading. Unfortunately, at my library there isn’t a way to send a book back to the hold list once it’s in transit, unless you want to start over at the end of the line. I dutifully picked up my books and dug in for some intense reading, since you can’t renew them if others have them on hold and I wanted to make sure I was able to read them all. One of the books was “The Chaos Machine: The Inside Story of How Social Media Rewired Our Minds and Our World” by Max Fisher.

Being in healthcare and taking care of adolescents, teenagers, and young adults, I’m acutely aware of the impacts social media has had on these groups in recent years. Even before the societal disruptions of the COVID pandemic, research tied use of social media to sleep issues, which are in turn associated with depression, memory issues, and poor school performance. As we became physically isolated during the pandemic, many young people turned to social media to fill the void, with varying results. In many communities, cyberbullying has been on the rise, and concerns about social media have increased to the point where the US Congress is stepping in.

“The Chaos Machine” is full of meticulous details, many of which are pulled from interviews with Silicon Valley executives, social media experts, gaming experts, academics, and those who have been negatively impacted by social media. It references scholarly works, court records, and other primary sources that tell a story that most of us can’t even fathom. Given the subtitle, I expected it to dig heavily into the physical and psychological impacts on individuals with the concept of world impact as an abstract. I’ve read about the impacts on social media on US politics but wasn’t aware of many of the details the book provides about how the technology has directly impacted other countries, such as Myanmar and Brazil.

Parts of the book are difficult to read, including descriptions of online mobs threatening whistleblowers with violence ranging from swatting to rape or murder. Even more difficult to read are the descriptions of indifference by social media executives when confronted with evidence that their products are causing harm. Surprise, surprise, internal Facebook documents from 2018 reveal that systems were intentionally designed to deliver “more and more divisive content in an effort to gain user attention & increase time on the platform.” The book covers the rise of medical misinformation on social media and some of its harms, but having been a frontline physician, it doesn’t really explain the magnitudes of harm that we see when people use social media for medical advice.

Especially interesting was the description of the growth of Silicon Valley, comparing it to the Galapagos Islands as far as providing a unique evolutionary environment for technology development. However, instead of the isolation leading to the development of unique animal species, it led to “peculiar conditions” that “produced ways of doing business and of seeing the world that could not have flourished anywhere else – and led ultimately to Facebook, YouTube, and Twitter.” I see some of the same conditions in healthcare IT, where people still believe that you can just throw money at problems and somehow they’ll get solved, and where the people calling the shots often have only a rudimentary understanding of how healthcare is delivered in the US.

The book takes a walk down memory lane, talking about strife that took place in 2006 as Facebook introduced its News Feed. It was one of the first documented episodes of internet outrage becoming action, complete with protesters and the side outcome of dramatically expanding user engagement. “The Chaos Machine” covers the so-called casino effect, where social media platforms use the human dopamine system to hook users with intermittent variable reinforcement. It chronicles the rise of social media “like” buttons, which provide additional reinforcement through validation from other users.

I don’t’ want to give away the rest of the book, but I think it’s worth the read. I would recommend it for anyone who is trying to raise children in this crazy world and who thinks it’s OK to just let them play on a parent’s phone or that it’s a good idea to help a child falsify their age to obtain a social media account.

I met a new neighbor whose children attend a Waldorf school, which holds the philosophy that “exposing children to computer technology before they are ready (around 7th grade) can hamper their ability to fully develop strong bodies, healthy habits of discipline and self-control, fluency with creative and artistic expression, and flexible and agile minds.” In thinking about adolescent patients, I’m supportive of this stance, although I know that for parents it’s a nearly impossible battle unless the rest of the “village” around your child is similarly aligned. In thinking about some of the adults I know, it might have been a good idea to keep them away from social media even longer because they’re apt to behave badly even though they’re of age and should know better.

The book was a fairly quick read, as well as something different from my recent binge reading of murder mysteries and detective novels. Next on the list are two novels from Stacy Abrams, followed by chef Iliana Regan’s memoir “Burn the Place.” I enjoy reading about strong and determined women who have made their mark in industries that aren’t supportive. If it’s a good read, her second book “Fieldwork: A Forager’s Memoir” also threw itself out of my rogue hold queue. After that will be “Symphony of Secrets” by Brendan Slocumb, which I’m auditioning for a potential book club selection. If you’re in a book club with a sassy CMIO, you might want to hold on reading that one for now just in case.

What kind of books do you read when you have free time? Or do you accumulate a list or stack that you might never make it through? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 4/1/24

U.S. Attorney Announces $3.1 Million False Claims Act Settlement With Radiology Company And Its CEO For Fraudulent Billing Practices

Teleradiology vendor The Radiology Group pays $3.1 million to settle False Claims Act charges that its US-based radiologists rubber stamped draft image interpretations that were performed by India-based contractors who are not licensed in the US.

QuickMD Expands Healthcare System with Acquisition of Project Recovery

Telemedicine provider QuickMD acquires South Dakota-based addiction treatment clinic Project Recovery.

Hume AI Announces $50 Million Fundraise and Empathic Voice Interface

Hume AI, which has developed an emotionally intelligent voice interface for AI chatbots and other digital applications, raises $50 million from a spate of investors that includes Northwell Health’s venture capital arm.

Monday Morning Update 4/1/24

Top News

Atlanta-based teleradiology vendor The Radiology Group pays $3.1 million to settle False Claims Act charges that its US-based radiologists rubber stamped draft image interpretations that were performed by India-based contractors who are not licensed in the US.

Highlighted in the complaint is Radiologist A, who signed more than 10,000 reports in a single month, approved drafts in as little as 16 seconds, and did not check the “critical” tag when it was indicated.

The company notes on its technology page that all of its software is powered by AI.

Reader Comments

From Bollinger’s Band: “Re: Oracle Health. You mentioned Larry’s age and his cheerleading for the former Cerner. They may be re-architecting the former Cerner offering and that will let them come roaring back.” I don’t see that happening, for these reasons:

• A key reason that Cerner was getting kicked out of hospitals was fallout over its deficient RCM product and its “solution” of rolling out a spiffed-up Soarian offering.
• I don’t think that most hospitals that moved to Epic did so because of Cerner’s architecture, so Oracle’s whiz-bang technology may not prove to be competitive differentiator.
• Epic is so far ahead of Cerner in customer KLAS rankings that Oracle Health will never catch up. I don’t see Oracle making the huge investment that would be needed to make their product more competitive.
• Layoffs and attrition has likely caused a big loss of industry knowledge at Oracle Health, and putting a bunch of hotshot technologists in charge of a complicated, industry-specific critical application has never worked that I can remember.
• They’re not getting all those former customers back from Epic, so there’s nobody left to sell to. The only potential greenfield is outside the US, and product localization is always a challenge even for more focused vendors.
• The DoD business isn’t as lucrative as it sounds since Cerner wasn’t the prime contractor, and the VA may or may not ever get widely enough implemented to unleash the gravy train.
• Oracle paid way too much for Cerner and expresses near-embarrassment about its latest jewel in every earnings call. Customers were already sprinting for the Epic door, and raising prices or lowering costs to increase margins to “Oracle standards” will only hasten the exodus.
• Oracle Health is lucky that the company is printing money overall from its cloud business and that Larry Ellison is still enamored with it. At some point, Safra is going to get tired of making excuses for Larry’s plaything, at which time Oracle could strangle it financially or sell it for parts, such as the government business. The Larry-funded Project Ronin had noble aspirations, but was shut down without notice in early March.

HIStalk Announcements and Requests

Most of us who have posed health inquiries to an AI tool were just Dr. GPTing, but two poll respondents took its answer to their doctor who changed their advice or orders as a result.

New poll to your right or here: What single factor would be most attractive in considering a change of employers? I recognize the urge to check more than one option, but pretend you are reading a job posting – what would get your attention first?

Here’s a bonus survey, as suggested by a reader. What single, realistic first step would you take to improve US healthcare outcomes, cost, and accessibility? You get one sentence.

Webinars

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

Announcements and Implementations

A study finds that patients who were forced by their employer to switch to a high-deductible health insurance plan were more likely to experience diabetes complications.

Other

DrFirst gets the April Fool’s jump on Epic in rolling out the Magic Med Mash-Up, which squashes all your individual pills into one big capsule. Paging Martin Shkreli for the Daraprim play.

Sponsor Updates

• Vyne is recognized as a Becker’s Top RCM Company in 2024.
• Optimum Healthcare IT adds Mike Jackman (Leidos) to its boards.
• PerfectServe announces several 2023 milestones, including awards and recognition from industry analysts, 10% revenue growth, and a 107% enterprise net customer retention rate.
• QGenda will exhibit at AONL 2024 April 8-11 in New Orleans.
• WellSky launches a Medicare Certified Home Health certification for clinical teams.
• SnapCare and Incite Strategic Partners partner to provide clinical workforce solutions for the senior living and senior care segments.
• Waystar publishes a new e-book, “4 opportunities for healthcare revenue cycle improvement.”
• Wolters Kluwer Health launches Lippincott Ready for NCLEX to help prepare nursing students for the National Council Licensure Examination.

Blog Posts

• Aligning for change: Driving quality performance and risk management with AI (Notable)
• Population Health and the Power of Data (Netsmart)
• Five Proven Strategies to Improve Operating Margins: Part One: Optimize the Healthcare Workforce for Retention and Cost Savings (QGenda)
• The Rise of AI in Healthcare IT & Implications for Hiring Strategies (Revuud)
• Congratulations to all award winners recognized at HIMSS24 (Rhapsody)
• Reducing Pharmacy Costs with Innovative Enrollment Technology (RxLightning)
• Patient experience: the hospitality effect in healthcare (Sonifi Health)
• Helping Healthcare Heal Itself Starts with Collaboration (Surescripts)
• 5 Ways That Outdated On-Call Scheduling is Hurting Your Hospital (Symplr)
• The Outdated Practice of Security Questionnaires in Healthcare – Moving Towards a Real-Time Approach (VisiQuate)
• Revolutionizing Clinical Data Exchange: Healthcare Innovation 2024 Innovator Award Winner (MRO)

Contacts

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

Morning Headlines 3/29/24

US offers $10 million bounty for info on ‘Blackcat’ hackers who hit UnitedHealth

The US State Department offers a $10 million reward for information leading to the Blackcat ransomware group that hijacked Change Healthcare’s systems last month.

YC-backed Pelago, a virtual clinic for addiction treatment, raises $58M Series C

Virtual addiction clinic Pelago raises $58 million in Series C funding, bringing its total raised to $151 million.

Walgreens Boots Alliance Reports Fiscal 2024 Second Quarter Results

Walgreens beats Q2 revenue and earnings expectations, but reports a $5.8 billion impairment charge related to its VillageMD primary care business, which will close another 160 locations versus the previously planned 60.