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Morning Headlines 7/6/23

July 5, 2023 Headlines No Comments

Mount Sinai Launches Center for Ophthalmic Artificial Intelligence and Human Health

In New York, Mount Sinai’s Icahn School of Medicine launches the Center for Ophthalmic Artificial Intelligence and Human Health to help ophthalmologists diagnose eye disease and assess underlying health conditions.

CloudMD Divests Non-Core U.S. Electronic Medical Records and Practice Management Business

Constellation Software’s Harris Computer business acquires the US-based EHR, practice management, and RCM assets of Canadian company CloudMD for $6.3 million.

ResMed Acquires Somnoware, a Leader in Digital Sleep and Respiratory Care Diagnostics Software

Sleep management technology company ResMed acquires Somnoware, a sleep and respiratory care diagnostics software vendor based in California.

BlueKey Equity Partners Invests in Telemetrix

Remote patient monitoring vendor Telemetrix secures an undisclosed amount of funding from BlueKey Equity Partners.

Anatomy IT Enhances Value-Based Care Services Through Acquisition of MIPS Business Unit from MarsdenAdvisors

Health IT and cybersecurity business Anatomy IT acquires the MIPS/value-based care business of MarsdenAdvisors.

Healthcare AI News 7/5/23

News

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In New York, Mount Sinai’s Icahn School of Medicine launches the Center for Ophthalmic Artificial Intelligence and Human Health to help ophthalmologists more quickly diagnose eye disease and assess underlying health conditions. The center will initially work with AI models in Mount Sinai’s ophthalmology tele-consult program, tele-retina program, and eye stroke service.


Business

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A local Dallas media outlet profiles Sniffle, an AI-powered virtual care app that offers telemedicine to patients, and white-label virtual consult capabilities to physicians. The State of Arkansas has invested in the company, and its technology is now used by 85 physicians in 10 Arkansas clinics.


Research

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Crisis call support line operator Protocall Services and Lyssn will use a $2 million grant from the National Institute of Mental Health to customize Lyssn’s AI technology for use in the analysis and review of crisis calls. Lyssn’s call evaluations and summary dashboards are intended to help call center counselors improve their assessment of a caller’s suicide risk. The companies will soon begin an 18-month study to determine whether or not Lyssn’s software improves the performance of counselors over time.

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UPMC researchers develop a machine learning algorithm for the ECG diagnosis of occlusion myocardial infarction in patients with chest pain that outperforms providers and other ECG interpretation software.


Other

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The Responsible AI in Healthcare consortium launches to help health systems and other providers safely use AI. Backed by the Responsible AI Institute, Harvard Business School, and NHS in the UK, the group is working to develop a Responsible Generative AI Safety Index scoring system for healthcare.

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Mayo Clinic scientists develop an AI-augmented kidney stone test to help providers pinpoint any underlying health conditions that may have contributed to the patient’s condition.


Contacts

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

Morning Headlines 7/4/23

July 3, 2023 Headlines No Comments

Alfie nets $2.1M for obesity management

Virtual obesity management clinic Alfie raises $2.1 million in a pre-seed funding round.

WHO and HL7 collaborate to support adoption of open interoperability standards

The World Health Organization and Health Level Seven International will work together to support the global adoption of open interoperability standards.

Apple closes at $3 trillion market cap

Apple becomes the first company to close a day of trading with a $3 trillion market cap.

Curbside Consult with Dr. Jayne 7/3/23

July 3, 2023 Dr. Jayne 1 Comment

In advance of the holiday, the HHS Office of Inspector General dropped this sweet hundred-plus page final rule on information blocking. It includes the details of the civil monetary penalties that health IT developers will be subject to if they’re caught and OIG determines that information blocking did indeed occur. The document won’t be fully official until it is published in the Federal Register, and the majority of it will go into effect 30 days after that publication date.

I like the OIG’s clear description of the problem that it is trying to address: “Information blocking poses a threat to patient safety and undermines efforts by providers, payers, and others to make the health system more efficient and effective. Information blocking may also constitute an element of a fraud scheme, such as by forcing unnecessary tests or conditioning information exchange on referrals.” The fact that the mention of patient safety is the first thing on the list is important. Often, in the technology space, I see organizations that forget that none of the things that we’re trying to do mean anything if there’s not a patient at the center. Personally, I know I can give better care when I have full access to all of the patient’s information, but I often don’t have it.

This final rule specifically addresses civil monetary penalties for practices that are “likely to interfere with, prevent, or materially discourage access, exchange, or use of electronic health information (EHI) if the practice is conducted by an entity that is: a developer of certified health information technology (IT); offering certified health IT; a health information exchange (HIE); or a health information network (HIN) and the entity knows or should know that the practice is likely to interfere with, prevent, or materially discourage the access, exchange, or use of EHI. Most of the information blocking that I see as a physician isn’t being done by healthcare IT developers. I’ve been behind the scenes with the development teams of multiple EHRs over the last two decades and I’ve seen a tremendous amount of effort around data sharing. One of those vendors helped me stand up the first HIE in my state “way back when” and was as shocked as I was when we couldn’t get healthcare delivery organizations to play nicely with us.

On the flip side, the HIE in a neighboring state was charging what I thought was an exorbitant fee for providers to connect. In digging deeper, their entire pricing model was built around the idea of connecting large health systems to the HIE, with little consideration for independent providers. I was working as a locum tenens physician at the time, providing coverage across a number of organizations in the state and was trying to get my own credentials to access the system so that I could have the most data at my fingertips regardless of where I was seeing patients. They had no way of accommodating anything like that at the time and said they could only do a direct EHR connection. Even if a smaller practice (most of the ones I was working with had five physicians or less) wanted to connect, the price tag was daunting. They definitely wouldn’t be going to the expense and time commitment of a project like that just because I asked for it, so I was never able to get connectivity to better serve my patients.

In reality though, the majority of information-blocking activities that I see in real life are directly related to behaviors by health systems and care delivery organizations. The hoops that patients go through to try to make sure that consulting physicians receive the records needed to render service are unreal. And sometimes, the physicians themselves don’t even understand what needs to happen or how to help make the system effective even when organizations are freely sharing data. I’m a member of a number of online physician forums, and questions about this come up frequently. Just this past week, there was a complaint from a primary care physician that a consulting physician sent back a “snarky” letter about a patient’s condition, suggesting that the primary care physician hadn’t taken appropriate steps to address the patient’s condition before sending a referral.

In digging deeper, the relatively inexperienced primary care physician assumed that since they and the consultant were on the same enterprise EHR, that the consultant would have full access to the chart. It didn’t occur to them that the consultant might not want to (or have the time to) wade through the dozens of encounters that were present trying to figure out what was going on, especially if those encounters contained a lot of confusing cut-and-paste documentation. Since the EHR’s referral module was largely about handling insurance referrals and ensuring payment for the consultant versus conveying useful clinical information, there wasn’t clear communication about the nature of the consultation request. Several more senior physicians chimed in with stories of “back in my day” before we could easily share records, where we’d draft a one-page letter to the consultant, summarizing what had already been done, our thoughts, and what questions we had for them. It sounds like the primary care physician didn’t do anything like this, and ultimately the patient’s time was wasted (not only at the appointment but the multi-month wait leading up to it) as well as the consultant’s time.

Unfortunately, this is all too often the kind of care we see now that everyone is operating under great pressure – whether it’s time pressures created by administrative teams, or whether it’s due to the scarcity of certain kinds of consultants, or whether it’s due to physician burnout, patient care ultimately suffers. Information-blocking rules aren’t going to fix that. The current information-blocking rules also aren’t going to fix the problem of health systems dragging their feet releasing records or images to competing health systems, although many of us are hopeful that a proposed rule for provider penalties will help with that particular problem. As a patient who watched organizations argue with each other about some pathology slides a couple of years ago, I’m supportive of most anything that will make things easier for the patients.

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Over the weekend, we slipped from June into July. For many of us who are physicians, July 1 has a special place in our memories because it’s traditionally the date that newly minted physicians become interns at training hospitals. For other residents, it’s the day you move up in the hierarchy, becoming a supervisor of the brand-new interns who just started. For those just using their medical degrees for the first time, it can be terrifying, especially when you’re called in the middle of the night to look at a STAT x-ray or to give orders in response to lab results for patients you’ve never met. I was fortunate to be part of an amazing intern class that you could always count on to have your back. Even decades later, we know we can call each other for things big or small. Honestly, I would hop on a plane with a moment’s notice if one of them needed me, because those are the kinds of relationships that are forged when you go through those kinds of circumstances with a team like that. A toast to my class, and a salute to all the new interns who are on Day 3 of the rest of their lives.

If you’re a physician, what’s your best or worse memory of internship? Leave a comment or email me.

Email Dr. Jayne.

Morning Headlines 7/3/23

July 2, 2023 Headlines No Comments

Santa Monica-based Headspace meditation app maker lays off 15% of employees

Mental health and meditation app Headspace Health lays off 181 employees, its second round of job cuts since December.

LIJ Forest Hills Hospital to implement telehealth pilot program for burn patients

Northwell Health’s Forest Hills Long Island Jewish Hospital launches a tele-burn virtual consult service, giving on-site providers the ability to virtually consult with specialists at Staten Island University Hospital’s Regional Burn Center.

Mountain View Hospital restores clinical functions; culprit behind cyberattack still unknown

Mountain View Hospital and Idaho Falls Community Hospital and its partner clinics restore their clinical systems after a cyberattack forced them offline over a month ago.

Monday Morning Update 7/3/23

July 2, 2023 News 2 Comments

Top News

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Staffing and consulting services company Optimum Healthcare IT acquires ECloud Managed Solutions, a cloud adoption and digital transformation firm based in Georgia. ECloud Managing Partner Eric Sanders will transition to Optimum as head of business development.


HIStalk Announcements and Requests

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A majority of patients have been receptive to their physician’s decision to not prescribe a desired drug or treatment.

New poll to your right or here: How will health IT business conditions change in the next 12 months?


Webinars

July 12 (Wednesday) 2 ET. “101: National Network Data Exchanges.” Sponsor: Particle Health. Presenter: Troy Bannister, founder and CEO, Particle Health. It’s highly likely that your most recent medical records were indexed by a national Health Information Network (HIN). Network participants can submit basic demographic information into an API and receive full, longitudinal medical records sourced from HINs. Records come in a parsed, standardized format, on demand, with a success rate above 90%. There’s so much more to learn and discover, which is why Troy Bannister is going to provide a 101 on all things HIN. You will learn what HINs are, see how the major HINS compare, and learn how networks will evolve due to TEFCA.

July 27 (Thursday) noon ET. “Why You Shouldn’t Wait to Use Generative AI.” Sponsor: Orbita. Presenter: Bill Rogers, co-founder, president, and chairman, Orbita. The advent of generative AI tools truly represents a paradigm shift. And while some healthcare leaders embrace the transformation, others are hesitant. Invest 20 minutes to learn why you shouldn’t wait. When combined with natural language processing, workflow automation and conversational dialogs, generative AI can help leaders address a raft of challenges: from over-extended staff, to the rising demand for self-service tools, to delivering secure information to key stakeholders. You will learn where AI delivers the greatest value for providers and life sciences, how it can solve critical challenges faced by healthcare leaders, and how Orbita has integrated generative AI into its conversational platform so healthcare leaders can leverage its full capabilities safely and securely.

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


Acquisitions, Funding, Business, and Stock

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Specialty medication enrollment software startup RxLightning opens an office – its first – in Indiana after having been a remote-only company since its launch in 2020.

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Bright Health exits the insurance business with the sale of its California Medicare Advantage business to Molina Healthcare for $600 million. The company, which now solely operates 70 clinics in California, Florida, and Texas, announced in March that it had overdrawn its credit and was unsure about its ability to remain in business. Its valuation at the time was down 97% since its IPO height of $11 billion two years ago.

Mental health and meditation app Headspace Health lays off 181 employees, its second round of job cuts since December.


People

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Vyne Medical names Caleb Manscill (DentalRay) president.

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Kathleen Bresette (DrFirst) joins RxLightning as chief revenue officer.


Announcements and Implementations

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In New York, Northwell Health’s Forest Hills Long Island Jewish Hospital launches a tele-burn virtual consult service, giving on-site providers the ability to virtually consult with specialists at Staten Island University Hospital’s Regional Burn Center.


Government and Politics

Amazon Pharmacy’s PillPack will pay $300,000 to settle allegations that it failed to keep accurate records of controlled substances. Amazon acquired PillPack in 2018 for $753 million.


Privacy and Security

In Idaho, Mountain View Hospital and Idaho Falls Community Hospital and its partner clinics restore their clinical systems after a cyberattack forced them offline over a month ago. Administrative functions, including billing, have yet to be fully restored.


Sponsor Updates

  • Black Book releases its analysis of top customer-rated vendors serving the payer industry. Recognized HIStalk Sponsors include NTT Data (infrastructure and core IT modernization services), Wolters Kluwer (member and consumer education solutions), and Optum (payer analytics outsourcing/end-to-end RCM outsourcing).
  • AdvancedMD releases over 25 product enhancements to drive greater productivity for private practices.
  • Memorial Health System evolves its patient engagement app using Meditech’s Greenfield Workspace.
  • Nordic releases a new Designing for Health Podcast featuring Memorial Hermann Health System VP of Consumerism Dense Worrell.
  • OptimizeRx wins a Digital Health Merit Award for its connected digital health point-of-care programs.
  • Waystar publishes a report with HFMA featuring research and insights on denials in healthcare.

Blog Posts


Contacts

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

Morning Headlines 6/30/23

June 29, 2023 Headlines No Comments

Optimum Healthcare IT Acquires eCloud Managed Solutions

Staffing and consulting services company Optimum Healthcare IT acquires ECloud Managed Solutions, a cloud adoption and digital transformation firm based in Milton, GA.

RxLightning opens 8,000-square-foot New Albany headquarters

Specialty medication enrollment software startup RxLightning opens an office – its first – in Indiana after having been a remote-only company since its launch in 2020.

HHS Office for Civil Rights Settles HIPAA Investigation with iHealth Solutions Regarding Disclosure of Protected Health Information on an Unsecured Server for $75,000

IHealth Solutions will pay $75,000 to settle potential HIPAA violations related to the 2017 unauthorized transfer of PHI from an unprotected server.

News 6/30/23

June 29, 2023 News No Comments

Top News

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Just in time for the long holiday weekend, HHS publishes a 130-page final rule outlining the civil money penalties health IT developers will incur for information-blocking. HHS may publish a proposed rule for provider penalties in September.


Webinars

July 12 (Wednesday) 2 ET. “101: National Network Data Exchanges.” Sponsor: Particle Health. Presenter: Troy Bannister, founder and CEO, Particle Health. It’s highly likely that your most recent medical records were indexed by a national Health Information Network (HIN). Network participants can submit basic demographic information into an API and receive full, longitudinal medical records sourced from HINs. Records come in a parsed, standardized format, on demand, with a success rate above 90%. There’s so much more to learn and discover, which is why Troy Bannister is going to provide a 101 on all things HIN. You will learn what HINs are, see how the major HINS compare, and learn how networks will evolve due to TEFCA.

July 27 (Thursday) noon ET. “Why You Shouldn’t Wait to Use Generative AI.” Sponsor: Orbita. Presenter: Bill Rogers, co-founder, president, and chairman, Orbita. The advent of generative AI tools truly represents a paradigm shift. And while some healthcare leaders embrace the transformation, others are hesitant. Invest 20 minutes to learn why you shouldn’t wait. When combined with natural language processing, workflow automation and conversational dialogs, generative AI can help leaders address a raft of challenges: from over-extended staff, to the rising demand for self-service tools, to delivering secure information to key stakeholders. You will learn where AI delivers the greatest value for providers and life sciences, how it can solve critical challenges faced by healthcare leaders, and how Orbita has integrated generative AI into its conversational platform so healthcare leaders can leverage its full capabilities safely and securely.

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


Acquisitions, Funding, Business, and Stock

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The Idaho Health Data Exchange prepares to exit bankruptcy after filing for Chapter 11 last August. The nonprofit found itself facing insolvency after government funding dried up and business deals fell through, leaving it $4 million in debt and facing lawsuits from creditors. The exchange, which replaced its executive director several weeks ago, plans to achieve funding through user fees, which may be a challenge given that only 46 healthcare organizations are currently signed up for IHDE’s top tier of service.


Sales

  • Ochsner Health (LA) selects Aidoc’s enterprise AI implementation and integration platform and imaging AI algorithms.

People

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Cordea Consulting names Mike Blundell (Sharp HealthCare) VP of consulting and delivery.

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Evelyn Daniels (2Morrow) joins Laguna Health as VP of business development.


Announcements and Implementations

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Sarah Bush Lincoln Health Center (IL) integrates Sonifi Health’s patient engagement and educational content with its interactive bedside television system.

Community Health Northwest Florida rolls out EClinicalWorks across its 19 locations.

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Cleveland Clinic prepares to open a new hospital in Ohio that will offer patients in each of its 57 rooms the ability to access telehealth services from off-site specialists.

EMPI vendor 4medica announces GA of its new EZReg patient registration software.

AtlantiCare leverages Unite New Jersey, the care coordination and social services referral network developed by Unite Us.


Government and Politics

IHealth Solutions, doing business as medical coding, billing, and health IT services vendor Advantum Health, will pay $75,000 to settle potential HIPAA violations related to the 2017 unauthorized transfer of PHI from an unprotected server.


Sponsor Updates

  • EClinicalWorks releases a new podcast, “Redesigned Dashboard: Transforming Safety & Compliance.”
  • VisiQuate announces its selection as the number-one solution for hospital and health system financial IT revenue analytics by Black Book Research.
  • Carson Medical Group (NV) successfully transitions to the EClinicalWorks Cloud EHR.
  • Everest Group names AGS Health a leader in RCM operations for the third consecutive year.
  • Pivot Point Consulting partners with HIMSS as part of the HIMSS Digital Health Technology Partnership Program.
  • First Databank names Eddye Hernandez advanced software engineer, Paul Kuzma software test engineer, and C. Brett Smith business development representative.
  • The Health Information Resource Center honors Healthwise with six digital health awards for its medical illustrations and health education videos.
  • Cordea Consulting names Bill Smith (Affirm) director, Epic practice; Aubrey Sherffius (Cerner) senior revenue cycle consultant; Henry Jemiola (Meditech) HIS consultant; and Kendra Krauss (Krames) strategic account director.
  • Interbit Data partners with Florie, bringing its connected communications application to Interbit’s Beacon Active downtime solution.

Blog Posts


Contacts

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

EPtalk by Dr. Jayne 6/29/23

June 29, 2023 Dr. Jayne No Comments

Telehealth is here to stay, and the Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act has been reintroduced in the US Senate, this time by a bipartisan group of 60 Senators. A companion bill was also introduced in the US House of Representatives. The bill was first introduced in 2016 and aims to expand coverage of telehealth services through the Medicare program. It would amend the Social Security Act and includes provisions to: expand the range of health professionals who can deliver telehealth services; remove requirements for in-person visits in tele-mental health programs; expand telehealth in rural health clinics and health centers; remove geographic restrictions on telehealth services; and require research on the impact of telehealth on quality of care.

Broadening the reach of telehealth is part of the overall solution package needed to deal with the physician shortage, disparate distribution of physicians between urban and rural areas, and lack of access for many in the US. It’s naturally complimentary to other strategies such as team-based care, nontraditional appointment times, and the ability for patients to be seen at a location that is convenient to them. In speaking with members of my community, a large number of people aren’t aware of the care options available to them, including after-hours clinics and telehealth. In addition to legislation, health systems and care delivery organizations need to do a better job informing patients of their options for care beyond the traditional doctor’s office. It seems like payers and employers are doing a better job pushing telehealth (most likely because they see it as a lower-cost alternative to in-person visits), but depending on where they’re steering patients, it might be contributing to fragmented care. We’ll have to see how this bill makes it way through Congress or if it will just sit there on Capitol Hill like so many other bills.

I’ve been following some public health informatics issues, and was surprised to see a recent write up describing the transmission of malaria in the US. A handful of cases have been detected in Florida and Texas, after being eliminated from the US in 1951. (An eight-person cluster of cases was identified in Florida in 2003 without further spread.) Although the risk of being infected with the disease is low in the US, there are plenty of other reasons to either use insect repellent or wear long pants and long sleeves during outdoor activities. Malaria is a serious medical condition and most physicians in the US don’t think about it when they’re seeing patients who haven’t traveled to areas in the world where transmission is more common. I’ve seen a couple of professional organizations issue bulletins to their members, so hopefully this will help get the word out as well. Maybe some of us in the CMIO trenches can consider clinical decision support interventions to help our clinicians think of diseases that might not yet be on their radar. Symptoms include fever, chills, headache, and fatigue. Although patients typically get sick within a few weeks, there can be a lag of up to a year after the initial infection, which adds to the difficulty in diagnosis.

In other public health news, healthcare expenditures due to pickleball are on the rise. UnitedHealth Group has detected an increase in healthcare utilization due to pickleball-related injuries. The game is increasingly popular among the senior set and may be contributing in the neighborhood of $377 million to healthcare costs for procedures such as emergency department visits, outpatient visits, knee surgeries, and hip replacements. It would be interesting to see if the increase in costs is similarly associated with paddle tennis, which is a similar concept but “not remotely the same” according to my racquet-wielding friends who can cite the differences like they’re defending a dissertation. Pickleball growth continues with estimates that the number of players will reach 22.3 million this year, with seniors accounting for nearly a third of the pickleball regulars.

Complaining about the EHR is a common activity for many physicians, especially those whose organizations haven’t taken steps to tame the inbox or provide adequate support staff to manage the rising numbers of patient-generated messages and requests. A recent study in JAMA Network Open notes that part-time primary care physicians spend more time using the EHR per hour of clinic than their full-time colleagues, and also spend more time outside scheduled appointments. Data from the University of Wisconsin-Madison looked at 11 months between May 2021 and March 2022. EHR measures were normalized per week and per eight hours of scheduled patient time. The authors found that panel size, visit volume, or message volumes didn’t explain the additional time spent by part-time physicians.

They did find that the part-timers spent more time in their inboxes but were unable to fully draw conclusions from that finding, hypothesizing that “more EHR work outside scheduled hours … may allow them to feel caught up or allocate more time for panel management work ….” The study is limited by the fact that it was done at only one center and had a relatively small number of participants. It also included non-patient-care EHR administrative work that part-timers (such as your friendly neighborhood CMIO, super user, or practice champion) might do. Understanding exactly what is going on in the EHR with various providers is the key to improving their efficiency. I continue to see physicians who refuse to take advantage of EHR features that are designed to make their lives easier, and who would rather type the same phrase 20 times each day than spend the seconds it takes to create it as a favorite for future use. It’s baffling, and I struggle to get into the user psychology that supports it, but I’ll continue to advocate to get physicians on the happy path.

On a recent trip, my inbound aircraft was carrying the remains of a fallen soldier. I was impressed by the level of respect shown by those waiting at the gate as well as the airport staff. Resources from the airport fire department and security offices were lined up on the tarmac in tribute alongside what appeared to be family members. The flight crew held all passengers on the plane while an honor guard transferred the flag-draped coffin from the aircraft to a waiting hearse. For that moment in time everything stopped – a fitting tribute to someone willing to give his or her life in service of our country. Well done, MKE, well done.

For those of you preparing for the Independence Day holiday and the potential family gatherings this weekend – be safe, enjoy the time with family, celebrate our nation’s birth, and don’t forget the insect repellent.

Email Dr. Jayne.

Morning Headlines 6/29/23

June 28, 2023 Headlines No Comments

Regulations to govern use of AI in health records could come later this year

ONC hopes to finalize a rule later this year that will require EHRs that use predictive solutions like AI and algorithms to provide end users with an explanation of how that technology works, as well as a description of the data used.

Blueprint Raises $9 Million Series A to Help Therapists Deliver Higher Quality Care in Less Time

Blueprint, which offers mental health providers patient tracking and outcomes assessment technologies, raises $9 million in a Series A funding round.

Cleveland Clinic to open first telehealth hub at new Mentor Hospital

Cleveland Clinic prepares to open a new hospital in Ohio that will offer patients in each of its 57 rooms the ability to access telehealth services from off-site specialists.

Healthcare AI News 6/28/23

June 28, 2023 News No Comments

News

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Navina develops a generative AI assistant to help improve the workflows of primary care physicians.

Ballad Health will use MedAware’s AI-powered medication safety monitoring platform to identify and prevent medication-related safety errors.

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Former Optum Health Chief AI Officer Dennis Chornenky joins UC Davis Health as its first chief AI advisor, tasked with establishing an AI strategy for the health system.

Nuance will make its Dragon Ambient EXperience Express solution available to select Epic users this summer. The AI-powered tool can automatically generate draft clinical notes after a patient visit, as well as quickly generate notes from real-time recordings of physician/patient interactions.


Business

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Medical imaging data and AI company Flywheel raises $54 million in a Series D investment round.

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BeeKeeperAI, a San Francisco-based AI development and deployment support startup, announces $12 million in funding.


Research

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In an effort to even out workloads for cancer patient navigators, researchers at OSF Healthcare develop a smart algorithm that predicts upcoming navigator workloads and then distributes new patients to navigators accordingly. The health system plans to incorporate the algorithm within its OSF Community Connect automated workflow platform and pilot it when its new OSF Cancer Institute opens next year.

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A new report from the World Economic Forum highlights the challenges and promises of using AI in healthcare, noting that provider shortages, an exponential growth in health data, and increasingly swift advances in AI technology make its adoption and utilization an almost foregone conclusion in the areas of diagnosis and risk stratification, outbreak prediction, and clinical trial optimization.

Researchers determine that large language models like ChatGPT may potentially assist primary care providers in making clinical decisions, evaluating patients, and ordering appropriate imaging tests for breast cancer screenings and breast pain.


Other

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FedScoop reviews an ONC proposed rule, released in April, that would require EHRs that use predictive solutions like AI and algorithms to provide end users with an explanation of how that technology works, as well as a description of the data it uses. ONC is reviewing comments now and hopes to have a final rule published later this year.

Senate Majority Leader Chuck Schumer (D-NY) pushes forward with potential legislation regulating AI, highlighting national security, misinformation and bias, and transparency from AI developers.


Contacts

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

Morning Headlines 6/28/23

June 27, 2023 Headlines No Comments

Revolutionizing Medical AI Development: Flywheel Announces $54 Million in Series D Funding led by Novalis LifeSciences and NVentures

Medical imaging and AI company Flywheel raises $54 million in a Series D investment round.

Riverside Partners’ Portfolio Company UnisLink Acquires HST

RCM and population health management company UnisLink acquires RCM vendor Healthcare Support Technologies.

BeeKeeperAI Raises $12.1 Million Series A to Accelerate AI Development on Privacy Protected Healthcare Data

BeeKeeperAI, a San Francisco-based AI development and deployment support startup, announces $12 million in new funding.

THL explores sale of healthcare IT firm Nextech

THL Partners considers selling specialty practice-focused health IT vendor Nextech in a deal that could be worth $1.5 billion.

News 6/28/23

June 27, 2023 News No Comments

Top News

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Amazon postpones the launch of its Amazon Clinic expansion by three weeks after lawmakers raise concerns about the company’s privacy practices, specifically its method of collecting and sharing customer health data.

Launched last November, Amazon Clinic offers a form-initiated, message-based telemedicine service in 33 states. Amazon had planned to expand it this week to all 50 states with the additional offering of video-based consults. 


Reader Comments

From NighttimeSleepAid: “Re: First-ever Meditech layoffs.” An internal email shared by NSA indicates the company has decided to “downsize the company by less than 2% of our staff” as it seeks ways to adjust expenses and compensate for overstaffing. Impacted roles will mainly include newer staff hired within the last year and niche roles that are no longer needed.


Webinars

July 12 (Wednesday) 2 ET. “101: National Network Data Exchanges.” Sponsor: Particle Health. Presenter: Troy Bannister, founder and CEO, Particle Health. It’s highly likely that your most recent medical records were indexed by a national Health Information Network (HIN). Network participants can submit basic demographic information into an API and receive full, longitudinal medical records sourced from HINs. Records come in a parsed, standardized format, on demand, with a success rate above 90%. There’s so much more to learn and discover, which is why Troy Bannister is going to provide a 101 on all things HIN. You will learn what HINs are, see how the major HINS compare, and learn how networks will evolve due to TEFCA.

July 27 (Thursday) noon ET. “Why You Shouldn’t Wait to Use Generative AI.” Sponsor: Orbita. Presenter: Bill Rogers, co-founder, president, and chairman, Orbita. The advent of generative AI tools truly represents a paradigm shift. And while some healthcare leaders embrace the transformation, others are hesitant. Invest 20 minutes to learn why you shouldn’t wait. When combined with natural language processing, workflow automation and conversational dialogs, generative AI can help leaders address a raft of challenges: from over-extended staff, to the rising demand for self-service tools, to delivering secure information to key stakeholders. You will learn where AI delivers the greatest value for providers and life sciences, how it can solve critical challenges faced by healthcare leaders, and how Orbita has integrated generative AI into its conversational platform so healthcare leaders can leverage its full capabilities safely and securely.

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


Acquisitions, Funding, Business, and Stock

UnitedHealth Group-owned Optum beats out Option Care Health in its bid to acquire home healthcare provider Amedisys in a deal valued at $3.3 billion. Amedisys will join home health and hospice provider LHC Group – acquired by UnitedHealth in February for $5.4 billion – under the Optum umbrella.

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Home healthcare provider Signify Health, acquired by CVS Health earlier this year for $8 billion, opens a technology center in Galway, Ireland. It is the Dallas-based company’s first facility outside of the US.


Sales

  • Temple University Health System (PA) selects DrFirst’s AI-powered medication history and real-time prescription benefit check solutions.
  • The American Lung Association will leverage Azara Healthcare’s data reporting and analytics as a part of its Project Breathe NY asthma control program.
  • Amstelland Hospital in the Netherlands will implement Sectra’s enterprise imaging subscription service.

People

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Evangelical Community Hospital (PA) promotes Elizabeth Price to VP of information systems and CIO.

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Erica Franko (AGS Health) joins Ventra Health as chief transformation officer.

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Loyal names Austin Pauls (Stord) as its first CFO.

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NHS England promotes John Quinn to CIO.

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Vanderbilt University Medical Center (TN) names Vanderbilt professor Paul Harris VP for research informatics.


Announcements and Implementations

The US Virgin Islands Office of Health Information Technology will work with CRISP Shared Services to launch a pilot interoperability program that will serve as the initial infrastructure for its first HIE CRISP supports HIEs in six states and Washington, DC.

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Mass General Brigham’s Newton-Wellesley Hospital implements Smart Placement transitions-of-care decision support software from Radial Analytics.


Government and Politics

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VA Assistant Secretary for Congressional and Legislative Affairs Patricia Ross assures Cathy McMorris Rodgers (R-WA) that the VA “will spare no expense” to maintain services and staff at its hospitals in Spokane and Walla Walla, where budget constraints caused by the troubled Oracle Cerner roll out have led to talk of layoffs.

In England, the NHS mandates that 90% of its nearly 225 trusts should have EHRs by December of this year, while 95% should have them by March 2025; and that 75% of adults should be registered on the NHS app by March 2024.


Other

El Camino Health (CA) launches a healthcare technology innovation fund, initially focusing on investing in projects related to remote patient monitoring, contactless patient check-in, and AI-powered diagnostic imaging, among several others.


Sponsor Updates

  • FQHC Mountain Park Health Center increases its number of available appointments using health IT solutions from EClinicalWorks.
  • Fakeeh Care Group integrates Wolters Kluwer Health’s UpToDate clinical decision support solution with its YASASII EHR.
  • Black Book survey-takers give AQuity top customer satisfaction marks for outsourced medical coding solutions.
  • CHIME issues a statement of support for the CONNECT for Health Act.
  • Arrive Health publishes a new whitepaper, “Technology’s Increasing Role in Unlocking Pharmacy Value.”
  • The Tech Trek Podcast features Artera CTO Ashu Agte, “Inheriting an organization and its transformation.”
  • Ernst & Young names Availity CEO Russ Thomas 2023 Florida Entrepreneur of the Year.
  • Baker Tilly co-authors a clinical study in the Journal of Comparative Effectiveness Research demonstrating the value of risk assessment tools in managing women at risk for ovarian cancer.
  • Bamboo Health names Jonathan Koenig (Numerated) implementation specialist and Sheila Sullivan (Humana) executive director.
  • Biofourmis becomes a new Switchboard Health network partner.
  • Nuance makes its Dragon Ambient EXperience Express solution available to Epic users.
  • Hebrew SeniorLife in Boston implements Meditech Expanse.

Blog Posts


Contacts

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

Morning Headlines 6/27/23

June 26, 2023 Headlines 1 Comment

Amazon delays virtual care service’s unveiling after senators raised privacy concerns

Amazon postpones the launch of its Amazon Clinic expansion by three weeks after lawmakers raised concerns about the company’s privacy practices.

Clarivate snaps up former Cerner employees, plans move into OP office

Clarivate, a global data, insights, analytics, and workflow solutions company, hires 40 former Cerner employees as it prepares to move into a new office in Overland Park, KS.

US Virgin Islands to test data interoperability program ahead of new health information exchange

The US Virgin Islands Office of Health Information Technology will work with CRISP Shared Services to launch a pilot interoperability program as it prepares to build out infrastructure for its first HIE

Curbside Consult with Dr. Jayne 6/26/23

June 26, 2023 Dr. Jayne 2 Comments

The clinical informatics community is buzzing with the news that ChatGPT was used to “pass” a simulated clinical informatics board exam. A recent article in the Journal of the American Medical Informatics Association describes the process used to evaluate the tool and goes further to question whether or not the general availability of AI tools is signaling the end of the “open book” maintenance of certification programs that many board certified physicians, including clinical informaticists, have come to enjoy.

Many of the medical specialty boards have moved to the ongoing maintenance of certification process, shifting away from the high-stakes exams that they used to require diplomates to take every seven to 10 years. My primary specialty board, the American Board of Family Medicine, began to pilot the maintenance of certification process in 2019. Since it had been a while since I practiced full-scope family medicine (which includes obstetrics), I was eager to try the new format, which delivered questions every quarter that could be answered using available resources such as textbooks, journal articles, or online references. This approach is a lot closer to how we actually practice medicine – which involves being able to investigate to find answers when we’re not able to pull the information from memory. High-stakes exams such as the ones we used to have aren’t reflective of our ability to deliver good care and such exams have been shown to negatively impact a variety of demographic groups.

The authors of the article tested ChatGPT 3.5 with more than 250 multiple choice questions drawn from a well-known clinical informatics board review book. ChatGPT correctly answered 74% of the questions, which leads to questions about whether or not it might be misused in the certification process. It was noted that ChatGPT performed differently across various areas within the clinical informatics curriculum, doing the best on fundamental knowledge, leadership and professionalism, and data governance. It did the worst on improving care delivery and outcomes, although statistical analysis didn’t find the differences across the categories to be statistically significant. The authors hypothesize that ChatGPT does better in areas where the questions are recall-based as opposed to those that emphasize application and reasoning.

They go on to propose that “since ChatGPT is able to answer multiple-choice questions accurately, permitting candidates to use artificial intelligence (AI) systems for exams will compromise the credibility and validity of at-home assessments and undermine public trust.” Based on some of the conversations I’ve had with patients over the last three years, I’m not sure patients are too impressed with the idea of board certification in the first place. It feels like some patients put more trust in what they see on TikTok and from various health influencers than in what I’ve learned over the last 25 years in family medicine. The phenomenon has definitely gotten worse since the COVID-19 pandemic turned healthcare delivery systems upside down.

The initial certification exams for specialties are still of the high-stakes format, and some specialties also require an oral examination. Those exams are proctored in order to ensure the integrity of the testing process. When I sat for the initial certification exam in Clinical Informatics nearly a decade ago, it was administered at a corporate testing center, and I took it alongside people taking the real estate licensing exam and other standardized tests. At least at the facility where I took it, I found the process to be nerve-wracking since there was a lot of waiting around and dealing with proctors who were trying to apply different standards to the different types of test takers. For example, my particular exam protocol required me to turn out my pockets and prove that there was nothing in them, but others didn’t have to go through the same steps. It created a feeling of overall uncertainty and was even worse when I needed a tissue due to a runny nose during the exam, when I was treated like I was trying to cheat somehow. Needless to say, I was happy when the maintenance of certification approach was brought to both of my specialty certifications.

One of my colleagues had asked why the use of ChatGPT was a problem since the process already allowed the use of external resources to answer the questions. (Examinees are prohibited from speaking with other people, however.) The authors addressed this in the article, noting that the current process requires examinees “to process and assimilate the information found online to determine the correct answer to the exam questions” where “when using LLMs like ChatGPT, exam takers can simply manually enter or automatically scrape the question into the freely available web interface and be given an instantaneous result. This transaction requires no prior knowledge of theory or application and eliminates the need for reflection, reasoning, and understanding but can still result in a passing score.”

The authors do note some limitations of their study, including the fact that they drew all the questions used from a single board review book. That approach may not be representative of the full range of questions used or content delivered on the actual board certification exam. Additionally, ChatGPT couldn’t be used to address questions that contained images. They go on to say that given the situation, certification bodies need “to explore new approaches to evaluating and measuring mastery.” They suggest that testing may need to include more complicated or novel question types, or may need to include images or graphics that can’t be easily interpreted by current AI technologies. They do suggest that “in some situations, there may be a need to consider reverting to proctored, in-person exams,” although I think there would be a general revolt of diplomates if the board actually considered this approach.

It should be noted that the maintenance of certification process currently includes an honor code attestation, where diplomates certify that they’re following the rules on the use of reference materials and that they aren’t consulting other people for help with the questions. It would be easy enough to broaden that statement and ask diplomates to agree to avoid using AI assistants or other similar technologies when completing their maintenance of certification processes. Personally, I’m glad to be at a point in my career where I might only have to recertify each of my specialty boards one more time. I don’t envy those in earlier phases of their careers who will have to tiptoe through the veritable minefields that new technologies are creating.

What do you think about ongoing proficiency exams, whether for physicians or other industry professionals? Are they useful for demonstrating competency and ability or just a way for certification bodies to generate cash? Leave a comment or email me.

Email Dr. Jayne.

HIStalk Interviews Bart Howe, CEO, HealthMark Group

June 26, 2023 Interviews No Comments

Bart Howe, MBA is CEO of HealthMark Group of Dallas, TX. He is also president of the Association of Health Information Outsourcing Services (AHIOS).

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Tell me about yourself and the company.

I’m a problem solver. I like to work on big projects. I started in finance and quickly determined that my entrepreneurial bug was a little too strong to stay put there, so I started a solar energy technology company and worked in molecular diagnostics before getting into my career in health information management.

I’m the CEO of HealthMark Group, which is a digital health information management solution provider that is most known for our work in the secure and digital exchange of medical records. Oftentimes that’s referred to as release-of-information. That function is perceived at times by the rest of the healthcare industry as a bit archaic, but it can, and has, benefited greatly from the evolution of technology and the way that we maintain records and transmit records. HealthMark is committed to changing that dynamic by providing technology that drives digital self-service and immediate access to patient health information.

I’m an unapologetic patient advocate, so I’m always trying to think from the patient’s perspective. I am a consumer of healthcare, as are all of the end users of the clients that we serve. I always try to have my patient perspective hat on when we’re looking at how we can do things different and better at HealthMark.

I am also, as of a few months ago, president of the national industry association that represents release-of-information vendors. It’s called AHIOS, the Association of Health Information Outsourcing Services. In that, I take a pretty active role in speaking with regulators and legislators around the evolution of the health information management industry from a regulatory perspective. There are tons of opportunities to work with ONC, OCR, and even FTC as we see them starting to regulate more in this space, to make sure that we are creating the right pathways and incentives for organizations, providers, and digital health app developers to engage more in the interoperability solutions of the future. I’m a believer, and I think that opportunities are on the horizon that people don’t even realize exist yet in terms of what can happen when information flows more freely.

How has technology changed the release-of-information process over the past five years?

It continues to change regularly, so it has changed quite a bit in the past five years. I’m sure the next five will as well. What drove me to the space was the rapid change in the way that health information is managed and being transmitted.

I had a personal challenge in one of my prior roles. I was at a molecular diagnostics company, and we were pushing the bounds of scientific discovery in some of the tools that we were using to do oncology diagnostics and provide therapeutic guidance. One of the challenges was getting access to the longitudinal patient information to demonstrate that our diagnostic tool was actually generating better outcomes for patients, and therefore should justify better reimbursement. I saw a need for a better solution for accessing and transmitting health records. When I came across HealthMark, it struck a nerve as an opportunity to jump into an industry that is changing quite a bit and that has a lot of opportunities for improvement.

But to answer your question more acutely, the way that it has changed over the past five years is that everything is going faster. Medical records requests take all sorts of shapes and sizes and they come from all sorts of different parties, such as patients, other physician practices, attorneys, and insurance companies. But expectations for turnaround time for delivery of those records have increased dramatically. They will continue to increase until we can truly hit that target that I’m shooting for with our organization, which is immediate. We want to be able to provide immediate access to that medical information for a variety of different purposes while maintaining the security and privacy of that information.

As EMRs have proliferated throughout the healthcare ecosystem, a lot of that information is now stored digitally instead of on paper, where it was copied or scanned and delivered via snail mail. Today, we try to digitize as much of that delivery as possible. You would be surprised how much of that information is still being requested via a snail mail pathway, but in every chance that we get, we’re pushing requesters towards receiving and ingesting that information in a digital form.

The molecular diagnostics example is a near real-time, business-to-business transaction. How you see the line drawn between release-of-information versus interoperability?

That line is blurring entirely, and that is a good thing. From my perspective, the release of information function, again, has historically been perceived as relatively archaic and lagging behind much of the rest of the industry in terms of moving towards interoperability. I would challenge you to look at HealthMark a little bit differently. We are definitely embracing interoperability as a tool to be able to help deliver digital self-service and immediate access to those records.

To your point, we deliver records for both B2B purposes as well as B2C purposes or B-2-patient purposes. It covers all aspects of what we do. I’m incredibly excited about the trajectory of the industry from an interoperability perspective, and I really want HealthMark to be a leader on the forefront of that push.

On the patient side, how has the Cures Act change how patients request and receive access to their medical records?

I don’t think we’ve seen yet the inflection point of adoption that I hope that we will see at some point, in terms of the adoption of FHIR endpoints and the delivery of information through API methods that will enable a digital healthcare app ecosystem that doesn’t yet exist. We certainly have elements of it and we’re starting to see more of it, but we haven’t hit the inflection point yet.

Do hospitals see release-of-information as a necessarily evil or as an opportunity and a touch point for patient engagement?

If they are not looking at it as an opportunity or as a necessary touch point for patient engagement, then they are looking at it the wrong way. It is absolutely one of the areas that can cause the most abrasion between patient and provider if they aren’t given timely access to their information. They certainly need to think about that as a core competency of either their organization or of a partner that they’re working with to help facilitate that information flow as easily and seamlessly as possible. Maybe it used to be viewed as a necessary evil, but certainly it is an opportunity today.

Much of the information requests that the release-of-information association or partners fulfill are still continuity-of-care requests, so a lot of that information used to treat patients is still flowing through those means. It is critical to the patient as well that they get access to that information for those purposes.

You offer services related to the Family and Medical Leave Act. What kind of information requests are involved?

It’s not just FMLA. There are disability requests and requests for other information that require the physician or physician practice to complete information related to that patient’s care or related to that patient’s treatment regimen. It’s not something that you can pull directly out of a discrete data field. It often takes physician know-how of the situation, or specifically what the request is about, to complete that information. We work on behalf of our healthcare provider partners to alleviate some of that administrative burden.

Ultimately, HealthMark is trying to alleviate, across the ecosystem of our clients, the administrative burdens that we see in our US healthcare ecosystem, which is two to three times the administrative burden that we see in other developed nations. We think there are opportunities to streamline a lot of that information flow, and FMLA paperwork is one of them.

There are requests for that paperwork on a regular basis, ranging from simple requests related to a pregnancy or a surgery all the way up to things that are much more complex. Provider practices are required to fulfill that information request on behalf of their patients because it’s necessary, often for the patient to get a paycheck, so it’s critical to that patient experience.

Everything that we work on ultimately drives back to that patient experience. We are completing that paperwork on in conjunction with the provider partners that we work with to make sure that information doesn’t get stuck with the front desk staff or stuck with an MA and ultimately fall to the bottom of the priority list because it doesn’t involve treating a patient right there in front of you. These things are still critically important to the patient. We are helping make sure that we can streamline the flow of that information.

It’s vexing as a patient to go to your regular medical practice that uses an EHR and having a clipboard full of empty forms immediately shoved at you every time, especially when you know that everything you are being asked to write is already on the computer screen five feet from the clipboard. Why does that happen?

Honestly, I ask myself why that is still so often the case. Filling out paper on a clipboard should be a thing of the past. There is virtually no other situation where we complete information on a clipboard. We provide a digital patient intake solution to help streamline the flow of that information. In this case, not out of the EMR or the practice management system, but into it. We are providing a digital experience for patients to be able to bring healthcare into the modern world, into the 21st century of technology adoption.

I understand why there is a laggard nature to the healthcare industry in terms of a adopting technology. It’s a heavily regulated environment where it is difficult to make changes overnight. That has created a situation where healthcare providers are slower to adopt technology than in other industries, but I think we see that changing as well. Certainly with the pandemic, we saw a rapid overnight need to adopt technology for solutions for things that didn’t exist previously. Telemedicine skyrocketed during that period, as did things like digital patient intake, pre-registration forms, and remote check-in opportunities. We are coming along and we are making progress, but it still baffles me when I walk into a healthcare facility and I’m handed the clipboard and a pen.

Where do you see the company in three or four years?

We are going to continue to lean into the interoperability landscape. I know that is a buzzword that has been around for decades, but I hope that we are reaching the inflection point for both technical and regulatory pathways to make true interoperability a reality. There is a ton of potential in things like the Cures Act and TEFCA. As we lean into that, it will open up downstream use cases for organizations like us, where we are a trusted partner of the healthcare providers that we work with and a steward of that most precious protected healthcare information that they hold on behalf of their patients.

As we sit in that position and start to facilitate better, cheaper, faster information flow, that opens up a ton of opportunities downstream for things like analytics and focusing on the potential for using things like AI to provide relevant insights from that data back to the provider and back to driving better treatment outcomes for the patient.

This is stuff that I care deeply about, and as I mentioned at the beginning, I am an unapologetic patient advocate who tries to think about things from the patient perspective and how to make their experience better. A better experience for them is a better outcome for our clients.

Morning Headlines 6/26/23

June 25, 2023 Headlines No Comments

Babylon Announces Update on Take Private Proposal

UK-based digital health company Babylon will merge with brain technology vendor MindMaze in a take-private transaction.

AvoMD Raises $5M to Combat Clinician Burnout With No-Code Clinical App Building Platform

AvoMD, developer of a no-code platform that allows clinicians and hospitals to turn existing and new clinical evidence into their own point-of-care clinical pathway apps, closes $5 million in seed funding.

UNC Health Piloting Secure Internal Generative AI Tool for Teammates with Microsoft Azure OpenAI Service

UNC Health will launch an internal chatbot next month, powered by Microsoft Azure OpenAI Service, that allows employees to access reference materials, documents, and training libraries by asking questions.

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